Digital intraoral radiographic exposures are optimized largely on the basis of subjective
assessment of diagnostic image quality. This study presents an objective approach
to optimize radiographic exposure settings for digital intraoral radiographic systems.
Seven size 2 digital intraoral systems were assessed for image quality and determination
of optimal exposure following the protocol specified in American National Standard Institute/American Dental Association Standard No. 1094:
Quality Assurance for Digital Intra-Oral Radiographic Systems. A ProX radiograph unit (Planmeca) at 63 kVp and 6 mA was used to obtain radiographs
of the Dental Digital Quality Assurance phantom. ImageJ software (National Institutes
of Health) was used to quantify dynamic range and spatial resolution, and contrast
perceptibility was evaluated visually. Optimal exposure is the setting with the maximal
contrast perceptibility and spatial resolution while displaying the full dynamic range.
After image optimization, a custom phantom consisting of an endodontically prepared
tooth was imaged to evaluate the file position relative to the apex for each system.
Differences in distances between file position relative to the root apex at the optimal
exposure as well as 1 increment above and below were measured.
Radiographic images obtained at the optimal exposure yielded better visualization
and more accurate measurements of the file tip relative to the apex.
Optimizing radiographic exposures improves image quality and accuracy in clinical
Improvement in image quality and better accuracy in actual distance of the endodontic
file to the radiographic apex coupled with complete cleaning, shaping, and obturation
of the canal should lead to better endodontic treatment outcomes.
Published online: November 16, 2022
In Press Corrected Proof
Disclosures. Dr. Mah is the president of Dental Imaging Consultants, which holds a patent for the Digital Dental Quality Assurance phantom and is an authorized distributor for Raysafe Unfors products. Drs. Barrineau and Mallya did not report any disclosures.
This study was conducted at the University of California at Los Angeles, Los Angeles, CA.
The data in this article were presented, in part, as a poster for a Table Clinic at the American Association of Endodontics Annual Session 2019; April 10-13, 2019; Montreal, Quebec, Canada; and an oral presentation by A.B.B. as the winner of the 2019 Robert H. Ahlstrom New Investigator Award for Dental Informatics Research at the American Dental Association Standards Council for Dental Informatics plenary session; September 4, 2019; San Francisco, CA.
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