In vitro assessment of the accuracy of extraoral periapical radiography in root length determination

Abstract

Objective:To determine the accuracy of extra oral periapical radiography in obtaining root length by comparing it with the radiographs obtained from standard intraoral approach and extended distance intraoral approach.Materials and Methods:It was an in vitro, comparative study conducted at the dental clinics of Aga Khan University Hospital. ERC exemption was obtained for this work, ref number 3407Sur-ERC-14. We included premolars and molars of a standard phantom head mounted with metal and radiopaque teeth. Radiation was exposed using three radiographic approaches: Standard intraoral, extended length intraoral and extraoral. Since, the unit of analysis was individual root, thus, we had a total of 24 images. The images were stored in VixWin software. The length of the roots was determined using the scale function of the measuring tool inbuilt in the software. Data were analyzed using SPSS version 19.0 and GraphPad software. Pearson correlation coefficient and Bland–Altman test was applied to determine whether the tooth length readings obtained from three different approaches were correlated. P = 0.05 was taken as statistically significant.Results:The correlation between standard intraoral and extended intraoral was 0.97; the correlation between standard intraoral and extraoral method was 0.82 while the correlation between extended intraoral and extraoral was 0.76. The results of Bland–Altman test showed that the average discrepancy between these methods is not large enough to be considered as significant.Conclusions:It appears that the extraoral radiographic method can be used in root length determination in subjects where intraoral radiography is not possible.

Comparative Evaluation of Intraoral and Extraoral Periapical Radiographic Techniques in Determination of Working Length: An In Vivo Study

“…They found 75% magnification accuracy using EOPA technique, in open-mouth approach with angulations of −25 ± 5° for maxillary and −15 ± 5° for mandibular teeth. Nazeer et al 19 in an in vitro study on mannequin heads found an accuracy of 82.6% using EOPA technique, when the X-ray cone was angled −20 to −30° for maxillary posterior teeth and +20 to +30° for mandibular posterior teeth from the horizontal plane. Zafar and Javed 1 in an in vivo comparative study between IOPA and EOPA techniques with actual WL on premolars found that when the X-ray cone was angled at –35° from horizontal plane and perpendicular to the film on the opposite side of the face, a majority of extraoral radiographs (86%) determined average tooth length accurately with magnification error of less than 10%.…”

“…In the present study, the radiographic images did not show any dimensional inaccuracy using EOPAR technique as suggested by some authors. 19 In patients with exaggerated gag reflex, the extraoral technique was found to be a more comfortable imaging procedure. With regard to its diagnostic utility, EOPAR can be used in pediatric patients with noncompliance for placement of sensors, reducing errors while receptor positioning during IOPA procedure and therefore reducing multiple X-ray exposures.…”

Management of exaggerated gag reflex in dental patients using intravenous sedation with dexmedetomidine

“…An exaggerated gag reflex is a problem for effective carrying out any dental manipulations: diagnostic, hygienic, therapeutic, and surgical. [ 1 ] The overall prevalence of gagging during dental treatment is up to 8.2%. [ 2 ] Pharmacological sedation is one of the effective ways of prevention of gag reflex development during dental treatment.…”