Precision of aiming with a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography

Abstract

Background: Hand-held (HH) X-ray devices are currently introduced for routine dentistry in some global areas. Safety issues are resolved but imaging quality aspects remain to be explored. Aim: To compare the aiming accuracy of two intraoral radiography devices: the portable Nomad Pro2 and the wall-mounted (WM) Planmeca Intra. Setting and design: In vitro experimentation involving radiologic mannequins and unbiased student operators. Methods and materials: 20 operators obtained intraoral radiographs of four regions (bitewing, upper molar, lower molar and upper anterior) in five mannequins, using HH and WM devices. Beam-aiming devices were fitted with metal cross-wires to project on image sensors. Deviation from ideal perpendicular incidence of beam was calculated, based on positions of cross-wires relative to gold-standard positions (i.e. average of 10-fold precise aiming by authors via WM system). Analytic models relied on Wilcoxon signed-rank test and mixed model analyses. Results: Mean deviations from perfect aim were 2.88˚ (± 1.80˚) for WM and 3.06˚ (± 1.90˚) for HH methods. The difference among all operators (HH vs WM) was 0.17˚ (± 2.48˚), which was not significant. Seven operators showed better aim by HH device (13 by WM system); and in one instance, this difference was significant. Conclusions: Aiming precision proved similar for HH and WM methods of intraoral radiography, although individual operators may perform better using one of these modalities. Aim is not an expected limiting factor for image quality in HH (vs WM) diagnostics.

Image quality of a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography

“…On the whole, our results in this respect are similar to those of a recent study by Hoogeveen et al, who do not see any difference in target precision between HH and WM devices. In contrast to our study, however, they only used dental students as operators [ 5 ]. Collectively, additional studies with more personnel in different stages of training need to be conducted to test for operator-dependent differences in dental X-ray image quality.…”

“…This often leads to the problem of insufficient diagnostic statements and might lead to incorrect therapeutic decisions. Recently, handheld (HH) dental X-ray devices, such as the Nomad Pro 2 (Kavo Kerr, Biberach, Germany), were introduced as an alternative to the conventional WM units [ 5 ]. These devices claim to offer a convenient and portable size and are supposed to be easily operated even under difficult conditions, such as bedside dental X-ray imaging in hospitals and nursing homes, while offering equivalent operator doses to standard WM units [ 6 ].…”

A Comparison of Contemporary Portable X-Ray Systems

“…Intraoral radiographs of four regions (bitewing, upper molar, lower molar and upper anterior) in five mannequins were obtained using the NOMAD TM Pro2 handheld device and a wall-mounted unit. Their study design found aiming precision proved similar for both systems although individuals may perform better using one or the other modality 30 . They also mentioned that aiming precision is not a limiting factor for image quality.…”

“…A previous study by Hoogeveen et. al showed that individual operators may perform better using either a handheld device or the conventional wall-mounted unit, however aiming precision appeared similar for both modalities 30 . In the present study one operator made all exposures.…”

Update on Hand-Held X-Ray Devices in Dentistry: a Literature Review

“…Si bien diversas investigaciones han encontrado una calidad de imagen aceptable al usar EP, similar a la obtenida con los equipos fijos (13,19,20), el inconveniente se presenta con el uso diario del equipo, que provoca una disminución en la carga de la batería. Por lo tanto, para evitar disminución en la calidad de imagen por un menor kV, se recomienda mantener siempre la batería con carga (21), una recarga regular y el uso de baterías más eficientes (22).…”