[Oradlist] Artifact on intraoral radiographs

alexandre khairallah alexandrekhairallah at hotmail.com
Wed Apr 21 10:05:41 PDT 2010


Hello Erika

 

It is indeed a bending of the film especially that we can see a large distortion in the images. I'm posting two radiographs; the first one is a film bending (looks like a Ray ban sun glasses)  that we did deliberately to show our students this kind of error, the second one is due to an accidental bending of the inner lead covering of the positioning cone that came in the axis of the X rays.
 
> From: axel-ruprecht at uiowa.edu
> To: oradlist at lists.ucla.edu
> Date: Wed, 21 Apr 2010 09:22:59 -0500
> Subject: Re: [Oradlist] Artifact on intraoral radiographs
> 
> Hello Erika
> 
> It is indeed from bending. I have seen that thing that looks like a satellite or ring in the past, usually toward the corner of a film. It is not sharp bending but curling over of the edge of the film.
> 
> Rgds
> 
> Axel Ruprecht D.D.S., M.Sc.D., F.R.C.D.(C)
> Diplomate of the American Board of Oral and Maxillofacial Radiology
> Gilbert E. Lilly Professor of Diagnostic Sciences
> Professor and Director of Oral and Maxillofacial Radiology
> Director of Advanced Education in Oral and Maxillofacial Radiology
> Professor of Radiology
> Professor of Anatomy and Cell Biology
> The University of Iowa
> http://ruprecht.radiology.uiowa.edu
> 319-335-7341
> 
> 
> 
> 
> -----Original Message-----
> From: oradlist-bounces at lists.ucla.edu [mailto:oradlist-bounces at lists.ucla.edu] On Behalf Of Benavides, Erika
> Sent: Wednesday, April 21, 2010 6:17 AM
> To: oradlist at lists.ucla.edu
> Subject: [Oradlist] Artifact on intraoral radiographs
> 
> Dear All,
> For the past few weeks, we have been getting a completely radiopaque rather large artifact on some of the intraoral radiographs taken at our Radiology Clinic. We use F-speed film and have seen this artifact on films from different boxes, both on patient and DXTTR films, processed in either of two automatic processors, and has happened often enough to get us frustrated. It kind of looks like fixer spots but we have ruled out possible contamination prior to processing. The only thing these films appear to have in common is bending but the artifact does not happen every time a film gets bent. I am hoping that one of you has seen this before and could help us solve this mystery. I am attaching a few examples of films with this kind of artifact.
> Thank you very much for your time and help!
> Best regards,
> Erika
> 
> Erika Benavides, DDS, PhD
> Diplomate, American Board of Oral and Maxillofacial Radiology Clinical Assistant Professor, Department of Periodontics and Oral Medicine The University of Michigan School of Dentistry Office 2029A
> 1011 N University Ave.
> Ann Arbor, MI 48109-1078
> Phone: 734-936-0051 or 734-358-5104
> Fax: 734-764-2469
> UM Hospital Paging: 734-936-6266 ID#4062
> Pager:734-651-5946
> E-mail: benavid at umich.edu
> ________________________________________
> From: oradlist-bounces at lists.ucla.edu [oradlist-bounces at lists.ucla.edu] On Behalf Of oradlist-request at lists.ucla.edu [oradlist-request at lists.ucla.edu]
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> To: oradlist at lists.ucla.edu
> Subject: Oradlist Digest, Vol 78, Issue 29
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> Today's Topics:
> 
> 1. Re: "scarce trabeculae" of the jaw in panoramic (Allan Abuabara)
> 2. Re: Use of Panoramic X-Ray to Determine Position of Impacted
> Maxillary Canines. (Mike Spoon)
> 3. Re: Use of Panoramic X-Ray to Determine Position ofImpacted
> Maxillary Canines. (Ann Wenzel)
> 
> 
> ----------------------------------------------------------------------
> 
> Message: 1
> Date: Tue, 20 Apr 2010 19:32:41 -0300
> From: Allan Abuabara <allan.abuabara at gmail.com>
> To: Oral Radiology Discussion Group <oradlist at lists.ucla.edu>
> Subject: Re: [Oradlist] "scarce trabeculae" of the jaw in panoramic
> Message-ID:
> <q2rb3ad3f2c1004201532n17e26b64saed770854657d358 at mail.gmail.com>
> Content-Type: text/plain; charset="iso-8859-1"
> 
> Thank you Dr. Arnaout.
> 
> I'm very curious about the final diagnosis of the patient. I hope to get it.
> I also believe that something wrong (you listed) is going on.
> 
> Allan Abuabara.
> 
> On Tue, Apr 20, 2010 at 7:05 PM, <arnou001 at umn.edu> wrote:
> 
> > Dear Dr, Abuabara I agree with Dr, Malcolm. The Panoramic radiograph
> > showed the following:
> > 1. Generalized decrease in bone density compared with bright teeth
> > contrast( appear as scarce bone trabeculae) 2. Generalized loss of
> > lamina dura of maxillary and mandibular teeth 3. Bilateral loss of
> > cortical boundaries of inferior alveolar canal 4. Bilateral thinning
> > of cortical bone of external oblique ridge and inferior cortices of
> > mandible 5. Bilateral thinning of cortical boundaries of maxillary
> > sinuses 6. Thinning of cortical boundaries of nasal cavity 7. Thinning
> > of cortical boundaries of inferior cortical boundaries of orbital
> > cavity.
> >
> > Suggesting:
> > Rickets/Osteomalacia
> > Renal osteodestrophy
> > Hypophosphatemia
> > Hypophosphatasia( younger age group)
> > Cushings syndrome (older age group)
> > Hyperparathyroidism ( older age group)
> >
> > Regards
> > Eman Arnaout
> > Assistant lecturer, Ain-Shams university Egypt PhD research
> > student,University of Minnesota
> >
> >
> >
> >
> >
> >
> > On Apr 18 2010, Allan Abuabara wrote:
> >
> > Hello All,
> >>
> >> The panoramic radiography attached is an asymptomatic 17y-o girl.
> >> We can see a "scarce trabeculae" of the jaw. It would just be a
> >> normal variation or may suggest a hormonal and/or calcium/phosphate imbalance.
> >>
> >> Thanks in advanced.
> >>
> >>
> > _______________________________________________
> > Oradlist mailing list
> > Oradlist at lists.ucla.edu
> > http://lists.ucla.edu/cgi-bin/mailman/listinfo/oradlist
> >
> 
> 
> 
> --
> Allan
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> ------------------------------
> 
> Message: 2
> Date: Tue, 20 Apr 2010 18:52:28 -0400
> From: Mike Spoon <mspoon at rochester.rr.com>
> To: Oral Radiology Discussion Group <oradlist at lists.ucla.edu>
> Subject: Re: [Oradlist] Use of Panoramic X-Ray to Determine Position
> of Impacted Maxillary Canines.
> Message-ID: <A7171EF4-32A8-4CD8-8354-226808D9E199 at rochester.rr.com>
> Content-Type: text/plain; charset="iso-8859-1"
> 
> 3D information is absolutely essential from an orthodontic standpoint. In the past we have taken multiple views, oftentimes resulting in the same ionizing dosage as a CBCT, and still we had to use a Gestalt methodology to arrive at a best estimate. CBCT eliminates the quesswork.
> 
> 3D information is important for assessing root recession on the lingual of the incisors or bicuspids that may display as a perfectly normal profile on a panoramic radiograph. 3D information, including the ability to measure root length accurately, is also necessary for calculating vectors and planning the mechanics of tooth movement. As you are pulling the crown down, the root is (generally speaking) rotating in the opposite direction. Also, it is helpful to know if there is a canine rotation you're going to have to deal with once the tooth emerges. Have you created enough clearance to be able to upright and move the tooth into position? Do the maxillary sinuses intrudes in the area where you need to move the root? I've seen canines lingual to the adjacent lateral and buccal to the central roots. How do you sort that out with 20th century imaging techniques? I could probably come up with the few more reasons if you like.
> 
> Michael E. Spoon, DDS
> Orthodontist
> 
> 
> On Apr 20, 2010, at 6:15 PM, Asma Al-Ekrish wrote:
> 
> > The question arises: How much detailed info do orthodontists need regarding the relationship of an impacted canine to the adjacent teeth. Is it sufficient for them to know whether the tooth is buccal or lingual to the adjacent teeth, along with the vertical angle of impaction? Or does additional information obtained by 3-D imaging (such as the distance between the impacted tooth and adjacent teeth and the horizontal angle of impaction) improve the diagnostic and therapeutic outcome for orthodontic patients? We will need the input of orthodontists in this matter.
> >
> >
> >
> > On Wed, Apr 21, 2010 at 12:02 AM, Allan Abuabara <allan.abuabara at gmail.com> wrote:
> > Hello All,
> >
> > I read this recent and interesting manuscript and I want to share with you.
> > Best regards.
> >
> > Allan Abuabara.
> > J Oral Maxillofac Surg. 2010 Feb 4. [Epub ahead of print]
> >
> > Use of Panoramic X-Ray to Determine Position of Impacted Maxillary Canines.
> >
> > Katsnelson A, Flick WG, Susarla S, Tartakovsky JV, Miloro M.
> >
> > Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
> >
> > Abstract
> >
> > PURPOSE: To evaluate the position of impacted maxillary canines in the alveolus using panoramic radiographs. MATERIALS AND METHODS: The present study was a retrospective chart review of 102 patients with 130 impacted maxillary canines from the University of Illinois at Chicago College of Dentistry and private practice. Of the 130 impacted maxillary canines, 59 were impacted buccally and 71 were impacted palatally. The inclination of the impacted maxillary canines to a horizontal line from the mesiobuccal cusps of the maxillary molars was measured. We used these measurements to predict the position of the tooth and correlate this prediction with the actual approach used during surgery. RESULTS: The mean angulation of the buccally impacted maxillary canines was 75.1 degrees +/- 18.2 degrees (range, 8 degrees to 111 degrees ). The mean angulation of the palatally impacted maxillary canines was 51.3 degrees +/- 15.3 degrees (range, 12 degrees to 91 degrees ). The mean differen!
> ce between the angulation of the impacted maxillary canines as measured on the panoramic radiographs was statistically significant (P < .001). >From a receiver-operator characteristic curve and using a logistic regression model, impactions greater than 65 degrees were 26.6 times more likely to be buccally impacted maxillary canines (P < .001). CONCLUSIONS: Panoramic radiographs are useful for predicting the location of impacted maxillary canines and the subsequent surgical approach required for exposure and orthodontic appliance attachment when computed tomography is unavailable or unnecessary otherwise. The use of panoramic radiographs for determing impacted maxillary canine position has a high sensitivity and specificity, with angulations greater than 65 degrees associated with buccal impactions. Copyright ? 2010 American Association of Oral and Maxillofacial Surgeons. All rights reserved.
> >
> >
> > --
> > Allan
> >
> > _______________________________________________
> > Oradlist mailing list
> > Oradlist at lists.ucla.edu
> > http://lists.ucla.edu/cgi-bin/mailman/listinfo/oradlist
> >
> >
> >
> >
> > --
> > Asma'a Al-Ekrish, MDS
> > Lecturer, OMFR
> > King Saud University
> > Riyadh, Saudi Arabia
> > _______________________________________________
> > Oradlist mailing list
> > Oradlist at lists.ucla.edu
> > http://lists.ucla.edu/cgi-bin/mailman/listinfo/oradlist
> 
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> ------------------------------
> 
> Message: 3
> Date: Wed, 21 Apr 2010 11:10:32 +0200
> From: "Ann Wenzel" <awenzel at odont.au.dk>
> To: "Oral Radiology Discussion Group" <oradlist at lists.ucla.edu>
> Subject: Re: [Oradlist] Use of Panoramic X-Ray to Determine Position
> ofImpacted Maxillary Canines.
> Message-ID: <5F72216C9CC246BFB45FD376A9507289 at DENTAL.Local>
> Content-Type: text/plain; charset="iso-8859-1"
> 
> hi all.
> 
> see also this paper:
> 
> Swed Dent J. 2008;32(4):179-85.
> Ectopic maxillary canines and root resorption of adjacent incisors. Does computed tomography (CT) influence decision-making by orthodontists?
> Bjerklin K, Bondemark L.
> 
> Department of Orthodontics, Institute for Postgraduate Dental Education, J?nk?ping, Sweden. krister.bjerklin at lj.se
> 
> Abstract
> The purpose of this investigation was to evaluate whether access to computed tomography (CT) influences orthodontists' decision-making about management of incisor root resorption due to ectopic maxillary canines. The study base comprised orthodontic specialists and active members of the Swedish Orthodontic Society: 182 orthodontists under 65 years of age, who had been registered specialists for at least one year and were providing specialist treatment for regular orthodontic patients. A questionnaire was sent out, comprising 8 questions about management and decision-making in cases of ectopic maxillary canines with root resorption of adjacent incisors and 7 questions about practice profile. The orthodontists were asked whether they altered their treatment decisions when CT was available as a diagnostic tool. The response rate was high, 86%. Sixty of the orthodontists had access to CT. Sixty-one percent of the 97 orthodontists without access to CT stated that, in cases with s!
> pace deficiency, they seldom or never considered extraction of a lateral incisor with suspected root resorption if the resorption was not discernible on intra-oral or panoramic radiographs. It was evident that even in cases of root resorption of lateral incisors due to ectopic canines,the orthodontists' management decisions were not particularly influenced by availability of CT diagnostic data. In the extraction cases 55% of the orthodontists considered extraction of the affected incisor first when root resorption was severe, i.e. involving the pulp and 37% when the resorption reached half way to the pulp. In cases without space deficiency 82% preferred to extract these resorbed lateral incisors not until the resorption reached the pulp.
> 
> 
> 
> best regards
> 
> Ann Wenzel
> 
> ----- Original Message -----
> From: Mike Spoon
> To: Oral Radiology Discussion Group
> Sent: Wednesday, April 21, 2010 12:52 AM
> Subject: Re: [Oradlist] Use of Panoramic X-Ray to Determine Position ofImpacted Maxillary Canines.
> 
> 
> 3D information is absolutely essential from an orthodontic standpoint. In the past we have taken multiple views, oftentimes resulting in the same ionizing dosage as a CBCT, and still we had to use a Gestalt methodology to arrive at a best estimate. CBCT eliminates the quesswork.
> 
> 
> 3D information is important for assessing root recession on the lingual of the incisors or bicuspids that may display as a perfectly normal profile on a panoramic radiograph. 3D information, including the ability to measure root length accurately, is also necessary for calculating vectors and planning the mechanics of tooth movement. As you are pulling the crown down, the root is (generally speaking) rotating in the opposite direction. Also, it is helpful to know if there is a canine rotation you're going to have to deal with once the tooth emerges. Have you created enough clearance to be able to upright and move the tooth into position? Do the maxillary sinuses intrudes in the area where you need to move the root? I've seen canines lingual to the adjacent lateral and buccal to the central roots. How do you sort that out with 20th century imaging techniques? I could probably come up with the few more reasons if you like.
> 
> 
> Michael E. Spoon, DDS
> Orthodontist
> 
> 
> 
> 
> On Apr 20, 2010, at 6:15 PM, Asma Al-Ekrish wrote:
> 
> 
> The question arises: How much detailed info do orthodontists need regarding the relationship of an impacted canine to the adjacent teeth. Is it sufficient for them to know whether the tooth is buccal or lingual to the adjacent teeth, along with the vertical angle of impaction? Or does additional information obtained by 3-D imaging (such as the distance between the impacted tooth and adjacent teeth and the horizontal angle of impaction) improve the diagnostic and therapeutic outcome for orthodontic patients? We will need the input of orthodontists in this matter.
> 
> 
> 
> 
> On Wed, Apr 21, 2010 at 12:02 AM, Allan Abuabara <allan.abuabara at gmail.com> wrote:
> 
> Hello All,
> 
> I read this recent and interesting manuscript and I want to share with you.
> Best regards.
> 
> Allan Abuabara.
> 
> J Oral Maxillofac Surg. 2010 Feb 4. [Epub ahead of print]
> 
> Use of Panoramic X-Ray to Determine Position of Impacted Maxillary Canines.
> Katsnelson A, Flick WG, Susarla S, Tartakovsky JV, Miloro M.
> 
> Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
> 
> Abstract
> PURPOSE: To evaluate the position of impacted maxillary canines in the alveolus using panoramic radiographs. MATERIALS AND METHODS: The present study was a retrospective chart review of 102 patients with 130 impacted maxillary canines from the University of Illinois at Chicago College of Dentistry and private practice. Of the 130 impacted maxillary canines, 59 were impacted buccally and 71 were impacted palatally. The inclination of the impacted maxillary canines to a horizontal line from the mesiobuccal cusps of the maxillary molars was measured. We used these measurements to predict the position of the tooth and correlate this prediction with the actual approach used during surgery. RESULTS: The mean angulation of the buccally impacted maxillary canines was 75.1 degrees +/- 18.2 degrees (range, 8 degrees to 111 degrees ). The mean angulation of the palatally impacted maxillary canines was 51.3 degrees +/- 15.3 degrees (range, 12 degrees to 91 degrees ). The mean diff!
> erence between the angulation of the impacted maxillary canines as measured on the panoramic radiographs was statistically significant (P < .001). >>From a receiver-operator characteristic curve and using a logistic regression model, impactions greater than 65 degrees were 26.6 times more likely to be buccally impacted maxillary canines (P < .001). CONCLUSIONS: Panoramic radiographs are useful for predicting the location of impacted maxillary canines and the subsequent surgical approach required for exposure and orthodontic appliance attachment when computed tomography is unavailable or unnecessary otherwise. The use of panoramic radiographs for determing impacted maxillary canine position has a high sensitivity and specificity, with angulations greater than 65 degrees associated with buccal impactions. Copyright ? 2010 American Association of Oral and Maxillofacial Surgeons. All rights reserved.
> 
> 
> --
> Allan
> 
> _______________________________________________
> Oradlist mailing list
> Oradlist at lists.ucla.edu
> http://lists.ucla.edu/cgi-bin/mailman/listinfo/oradlist
> 
> 
> 
> 
> 
> --
> Asma'a Al-Ekrish, MDS
> Lecturer, OMFR
> King Saud University
> Riyadh, Saudi Arabia
> 
> _______________________________________________
> Oradlist mailing list
> Oradlist at lists.ucla.edu
> http://lists.ucla.edu/cgi-bin/mailman/listinfo/oradlist
> 
> 
> 
> 
> 
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