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Image Quality of Digital and Film Radiographs in Applications Sent to the Dental Insurance Office in Sweden for Treatment Approval
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0000-0001-9885-0019
Malmö högskola, Faculty of Odontology (OD).
2004 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 28, no 2, p. 77-84Article in journal (Other academic)
Abstract [en]

In July 2002, a new dental insurance program was introduced in Sweden. For all patients over 65 years, prior approval for all prosthetic work would need to be obtained from the Dental Insurance Office. From October to December 2002, 540 cases were randomly selected for evaluation from the 14,624 applications that had been sent from throughout Sweden to the Dental Insurance Office in Lund. Our aims were to appraise the quality of the radiographic examinations and to compare the quality of the digital with the film (X-ray film) radiographs. The radiographic examinations were evaluated as a whole in relation to the proposed treatment and in detail using specific criteria such as density, contrast, unsharpness, angulation, and receptor position error. The quality variables were evaluated as acceptable or unacceptable. A total of 4,687 intra-oral and 206 panoramic radiographs were evaluated. Thirteen per cent of the intra-oral radiographs and 9% of the panoramic radiographs were taken with a digital technique. Most of the digital radiographs—-70% of the intra-oral and 61% of the panoramic radiographs-—were submitted on microdisk. Twentyeight per cent of the intra-oral digital radiographs, however, were submitted on paper. The radiographic quality in 150 cases (28%) were found to be unacceptable for assessment of the proposed treatment. The most common error-—both in digital and X-ray film radiographs-—was in receptor position. Significantly more errors were found in the intra-oral digital radiographs compared to the radiographs taken with X-ray film. Most of the errors in the digital radiographs were detected in the paper copies. In conclusion, it is possible to improve the radiographic quality in applications for treatment approval, and the dentists had more difficulties with the digital technique than with X-ray film.

Place, publisher, year, edition, pages
2004. Vol. 28, no 2, p. 77-84
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-15419Local ID: 3045OAI: oai:DiVA.org:mau-15419DiVA, id: diva2:1418940
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-03-14Bibliographically approved
In thesis
1. Quality Aspects of Digital Radiography in General Dental Practice
Open this publication in new window or tab >>Quality Aspects of Digital Radiography in General Dental Practice
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

POPULÄRVETENSKAPLIG SAMMANFATTNINGDet övergripande syftet med denna avhandling var att klargöra hur digital röntgenteknik används hos allmäntandläkaren och framför allt har syftet varit att undersöka kvaliteten hos röntgenbilderna och hur den skulle kunna förbättras. I det första arbetet studerades digitala röntgenbilder som var inskickade i samband med förhandsprövningar till Försäkringskassan. Dessa var signifikant sämre när det gällde bildkvalitet än röntgenbilder tagna med film. Då riktades uppmärksamheten på vad som kunde vara problemet och en enkät skickades ut till samtliga tandläkare i Skåne som enligt ett brev hade svarat att man arbetade med digital röntgenteknik (n=139). De viktigaste fynden i enkäten var att ca 30 % av tandläkarna hade problem med den digitala detektorn och programmen. 20 % hade problem med datorerna. Enbart 40 % av tandläkarna gjorde någon form av kvalitetskontroll. Som en följd av enkätsvaren från tandläkarna besöktes 19 slumpmässigt utvalda tandläkare som arbetade med digital röntgenteknik, inom både folktandvården och privattandvården. Där fann vi att bakgrundsbelysningen hade stor betydelse för möjligheten att urskilja lågkontrastobjekt vilket är likvärdigt med kariesskador. Dessutom visade det sig att monitorn har stor betydelse för bildkvaliteten. Det finns möjlighet att ställa in monitorn med hänsyn till parametrarna kontrast och ljusstyrka. Dessa visade sig vara mycket viktiga när det gäller att optimera det digitala systemet. Dagens bildbehandlingsprogram har många möjligheter till justering av bilder. Tandläkarna ändrade, om något, ljus och kontrast. Det fanns många och stora variationer mellan de besökta klinikerna när det gällde bildkvalitet och hur man arbetade med digital röntgenteknik.I det sista arbetet undersöktes hur stor betydelse en riktigt inställd monitor och belysningen har när man diagnostiserar karies. Studien gjordes med hjälp av extraherade tänder som röntgenundersöktes och granskades av sju tandläkare. Fynden visade att bakgrundbelysningen i rummet har stor betydelse för möjligheten att diagnostisera kariesskador. Diagnostiken blev bättre när granskningen skedde i dämpad belysning och när monitorns ljusstyrka och kontrast var rätt justerad. Sammanfattningsvis så gäller det att säkerställa bildkvaliteten på digitala röntgenbilder. Det krävs en omfattande utbildning när man ska börja arbeta med en helt ny teknik. Det måste finnas utrymme för en inkörningsperiod och en vilja till att lära sig den nya tekniken. Den digitala röntgentekniken påverkas av många fler faktorer än traditionell filmteknik när gäller den slutliga röntgenbildens kvalitet.

Abstract [en]

ABSTRACTThe number of dentists who have converted from conventional film radiography to digital radiography continues to grow. A digital system has numerous advantages, but there are also many new aspects to consider. The overall aim of this thesis was to study how digital radiography was used in general dental practices. The specific aims were to study how different factors affected image quality.To determine whether there were any differences in image quality between conventional film radiographs and digital radiographs, 4863 images (540 cases) were evaluated. The cases had been sent to the Swedish Dental Insurance Office for prior treatment approval. The image quality of digital radiographs was found to be significantly lower than that of film radiographs. This result led to a questionnaire study of dentists experienced in digital radiography. In 2003, a questionnaire was sent to the 139 general practice dentists who worked with digital radiography in Skåne, Sweden; the response rate was 94%. Many general practice dentists had experienced several problems (65%), and less than half of the digital systems (40%) underwent some kind of quality control. One of the weaker links in the technical chain of digital radiography appeared to be the monitor. A field study to 19 dentists at their clinics found that the brightness and contrast settings of the monitors had to be adjusted to obtain the subjectively best image quality. The ambient light in the evaluation room was also found to affect the diagnostic outcome of low-contrast patterns in radiographs.To evaluate the effects of ambient light and technical adjustments of the monitor, a study using standardised set-ups was designed. Seven observers evaluated radiographs of 100 extracted human teeth for approximal caries under five different combinations of brightness and contrast settings on two different occasions with high and low ambient light levels in the evaluation room. The ability to diagnose carious lesions was found to be significantly better in a room with lower ambient light and on a monitor with well-adjusted brightness and contrast values than in a room with bright light and on an unadjusted monitor.In conclusion, many problems with dental digital radiography were identified. Knowledge of digital techniques and how to optimise each link in the system to maintain high radiographic quality at all times must be improved.

Place, publisher, year, edition, pages
Malmö University, 2007. p. 91
Series
Swedish Dental Journal : Supplement, ISSN 0348-6672 ; 184
Keywords
Digital radiography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:mau:diva-7748 (URN)4693 (Local ID)91-7104-291-1 (ISBN)4693 (Archive number)4693 (OAI)
Note

Paper IV in dissertation as manuscript

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-14Bibliographically approved

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Hellén-Halme, KristinaPetersson, Arne

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