The value of a quality improvement programme for panoramic radiography: a cluster randomised controlled trial.

Objectives: To assess the value of a quality improvement programme for panoramic radiography.

Methods: A prospective, cluster randomised controlled trial was conducted in 40 dental practices in England. Practices were randomly assigned into two groups, an 'active' practice receiving regular feedback on film quality and a 'control' practice receiving no feedback until the completion of the study.

The use of radiography and the apex locator in endodontic treatment within the UK: a comparison between endodontic specialists and general dental practitioners.

Aim: To investigate the attitudes of general dental practitioners (GDPs) and specialist endodontists working in the UK in the use of radiography and apex locators during root canal treatment and to see if use was related to respondent's age and the year of graduation.

Methodology: A postal questionnaire was sent to 857 randomly selected GDPs and all endodontic specialists working in the UK (170). Non-responders were sent a further two mailings.

A study to determine the added value of 740 screening panoramic radiographs compared to intraoral radiography in the management of adult (>18 years) dentate patients in a primary care setting.

Objectives: To measure the added value of panoramic radiography in new dentate patients attending for routine treatment.

Methods: Thirty-seven general dental practitioners using panoramic radiographs routinely were recruited. Twenty dentate patients were identified prospectively by each participating dentist if they were new to the practice, attending for an examination and requesting any treatment deemed necessary.

A questionnaire study to derive information on the working environment, clinical training, use of ancillary staff and optimization of patient radiation dose within UK dental practice.

Aim: To evaluate the working environment of GDPs and Endodontists and the methods used to optimize patient radiation dose.

Methodology: A total of 857 GDPs and 170 specialist Endodontists were contacted. The responders, 603 of the former and 132 of the latter, completed a questionnaire covering practitioner demographics, pattern of practice, the use of radiographic techniques and the optimization of dose.

The impact of different viewing conditions on radiological file and working length measurement.

Aim: To determine the effect of different viewing conditions and observer experience upon the accuracy of file and working length measurements using analogue intra-oral radiographs.

Methodology: Twenty-five observers from a range of clinical backgrounds examined working length analogue periapical radiographs of 30 extracted teeth. Each participant measured both file (FL) and working length (WL) on each of the radiographs using three different viewing conditions consisting of a viewing box, a viewing box with film masking and a viewing box with film masking and x2 magnification.

The influence of coronal tooth tissue in the diagnosis of apical pathosis.

Aim: To assess the influence of the status of the crown of the tooth on the observers' periapical radiological assessment.

Methodology: Seven clinical tutors, eight postgraduate students and seven undergraduate students were recruited. Each evaluated 24 periapical radiographs comprising 12 radiographs with teeth restored with small to medium coronal restorations and 12 radiographs displaying teeth which were either heavily restored or exhibited gross caries.

Academic dentistry.

Since 1988, thirteen dental schools have provided dental undergraduate programmes within the United Kingdom (UK). In 2006, two new dental schools were created supporting dental education in the community. A further new dental school in Scotland will be accepting students in autumn 2008.

Glandular function in Sjögren syndrome: assessment with dynamic contrast-enhanced MR imaging and tracer kinetic modeling--initial experience.

Purpose: To prospectively use dynamic contrast material-enhanced magnetic resonance (MR) imaging and a tracer kinetic model to compare parotid gland microvascular characteristics in patients who have Sjögren syndrome (SS) with those in healthy volunteers.

Materials And Methods: The local research ethics committee approved the study, and written informed consent was obtained from all participants. Twenty-one patients (19 women, two men; age range, 31-73 years) with a diagnosis of SS and 11 healthy volunteers (10 women, one man; age range, 41-68 years) underwent three-dimensional T1-weighted dynamic contrast-enhanced MR imaging of the parotid gland at 1.

Clinical justification of dental radiology in adult patients: a review of the literature.

Although the radiological doses used by dentists are low individually, patients are often exposed to many repeat dental radiographic examinations. The "routine" use of dental radiography, such as screening of all patients using dental panoramic radiography (DPRs) or a random decision to take a dental radiograph, will inevitable lead to unnecessary patient exposure. The use of Radiographic Referral Criteria has now become a legal requirement for all practitioners following the adoption of European Legislation.

A comparative study of three periapical radiographic techniques for endodontic working length estimation.

Aim: To compare the diagnostic quality of endodontic working length estimation films produced using film holders with those taken using the bisecting angle technique and to assess the level of acceptance of film holders by operator and patient.

Methodology: Five post-graduate and 20 final year undergraduate students attending a UK Dental School produced working length radiographs using either the paralleling or the bisecting angle technique. The paralleling group used one of two film holders, the Endoray II or the XCP Endodontic Instrument, on alternate patients.

Salivary otorrhoea: a case report and a review of the literature.

This report presents an unusual case of spontaneous salivary otorrhoea in which advanced imaging was used to identify a developmental defect in the anterior wall of the bony external auditory meatus. This defect, the so-called foramen of Huschke, was subsequently found to be the source of the fistula. A review of the literature highlights the diagnostic dilemmas that such cases pose for the clinician.

The effectiveness of undergraduate teaching of the identification of radiographic film faults.

Objectives: To see if there were any differences in the ability of final year dental students at two UK dental schools, who were within 4 months of graduation, to identify radiographic film faults.

Methods: The two groups of undergraduates were shown 11 dental radiographs using a slide format. The 11 radiographs included 8 films with film faults, 2 films without technical or processing errors and a film with minimal faults.

A laboratory comparison of three imaging systems for image quality and radiation exposure characteristics.

Aim: To measure and compare the relationships between image quality and X-ray exposure for three types of intraoral imaging system (conventional film, phosphor plate system and CCD-based system).

Methodology: Kodak 'Insight' F-speed film, Digora FMX (phosphor plate system) and Visualix USB (CCD system) were used to produce series of radiographic images of two tooth-bearing jaw specimens (maxillary molar and mandibular molar regions) at a range of X-ray exposures from 10 ms to 2000 ms (all at 6 mA and 60 kV). Digital images were viewed from a computer monitor and films viewed on a conventional light box.

Does the procedure of arthrography affect the range of movement in patients with locking of the temporomandibular joint?

The aim of this study was to investigate whether arthrography itself altered the range of mandibular movements, in a group of patients with locking of the temporomandibular joint (TMJ). The clinical records of a series of 161 patients who were diagnosed with locking of the TMJ were retrospectively analysed. Mouth opening had improved in 57 out of 161 patients (35%).

Routine panoramic radiography of new adult patients in general dental practice: relevance of diagnostic yield to treatment and identification of radiographic selection criteria.

Objectives: We sought to measure the diagnostic yield of relevance to treatment on routine panoramic radiographs taken of new adult (ie, 18 years and over) patients in general dental practice.

Study Design: Routine panoramic radiographs (n = 1817) obtained from general dental practice were assessed and radiologic yield recorded using consensus viewing by 2 dental radiologists. A modified diagnostic yield of relevance to treatment for each radiograph was calculated by omission of findings that would have been identified on bilateral posterior bitewing radiographs and of radiologic findings of no relevance to treatment.

Screening panoramic radiography of new adult patients: diagnostic yield when combined with bitewing radiography and identification of selection criteria.

Objectives: To measure the radiological diagnostic yield on screening panoramic radiographs taken of new adult patients and to identify selection criteria for panoramic radiography of new adult patients.

Design: Survey of 1,817 consecutive panoramic radiographs taken as 'routine' on new patients with statistical analysis of clinical and radiological findings.

Setting: All radiographs were obtained from 41 general dental practitioners (GDPs).

Screening panoramic radiology of adults in general dental practice: radiological findings.

Aim: To identify the radiological findings from routine screening panoramic radiographs taken of adult (> or = 18 years) patients in general dental practice.

Method: Forty-one general dental practitioners (GDPs) who routinely took panoramic radiographs of all new adult patients were recruited. In total, they submitted 1,818 panoramic radiographs of consecutive patients along with basic patient information, radiological reports and treatment plans.

The influence of viewing conditions on radiological diagnosis of periapical inflammation.

Objectives: To determine the effect of viewing conditions upon diagnosis of early periapical inflammatory pathosis on intra-oral radiographs, and to examine the effect of observer experience upon diagnostic performance in this task.

Methods: 50 observers examined 18 periapical radiographs using three different viewing conditions (room lighting; viewing box; viewing box with x2 magnification and masking). Their diagnoses were compared with an 'expert' diagnosis provided by repeated viewings of the films by two dental radiologists.

Factors influencing the selection of panoramic radiography in general dental practice.

Objectives: To identify factors influencing dentists' decisions to take panoramic radiographs and to determine dentists' perceptions of the value of panoramic radiographs in the diagnosis of common dental pathologies.

Methods: Questionnaire of dentists with access to panoramic radiography equipment in 22 randomly selected Family Health Service Authorities in England and Wales. Dentists were asked to score 17 factors for their influence upon panoramic use, compare the relative diagnostic value of panoramic and intraoral radiographs for diagnosis of common dental pathologies and state their principal reasons for taking panoramic radiographs.

The quality of panoramic radiographs in a sample of general dental practices.

Objective: To assess the quality of panoramic radiographs in a sample of general dental practices, to determine the relative frequency of errors and to identify those errors directly responsible for diagnostically inadequate images.

Materials And Methods: Examination of 1,813 panoramic radiographs obtained from 41 general dental practitioners and recording of faults. The study was carried out in 1998.

Canalis sinuosus mimicking a periapical inflammatory lesion.

A case is presented in which an anatomical feature, canalis sinuosus, manifested as a periapical radiolucency on an upper canine. This may have been interpreted as an inflammatory lesion and led to the patient receiving inappropriate treatment had a further radiograph not been taken. The incisive foramen and mental foramen are well known anatomical features which may mimic periapical inflammatory lesions but it is less common for a neurovascular canal to manifest as a periapical radiolucency on an upper canine.

Aspects of panoramic radiography in general dental practice.

Objectives: To gather information on the types of panoramic x-ray equipment used in NHS dental practice and whether dentists satisfy the legal requirements for safety, to determine which practice personnel take panoramic radiographs and to assess the prevalence of the practice of 'routine' panoramic radiography among NHS dentists.

Design: Postal questionnaire survey of general dental practitioners carried out during 1997 in selected FHSAs in England and Wales.

Results: 542 dentists returned the questionnaire, a 73.