Diagnostic Technology
Oral Radiology and Dental Imaging
Clinical data and findings are mostly composed using computer technology in oral radiology38 and with dental imaging techniques.39 Here, technology advances very quickly and new costly systems become available almost on a monthly basis. It is very difficult to distinguish differences between various intraoral digital devices. Advantages and disadvantages of intraoral periapical and bitewing films as well as panoramic and cephalometric radiography are discussed today mainly based on technical issues.40,41,42
The comparison of digital systems with conventional X-ray films in terms of resolution has found a recent break with the development of new intraoral sensors (CCD) of small pixel size43 and a spatial resolution that rivals direct-exposure intra-oral X-ray films.44
Farman and Farman recently compared extraoral and panoramic systems and demonstrated the newest technologies available in dental radiographic hardware featuring new software concepts that is useful in the diagnosis and treatment of orthodontic and maxillofacial prosthetic cases.45
From the very beginning of Computed Tomography (CT), 3D imaging was carried out in the presurgical evaluation of dental implant sites. More advanced procedures include stereolithographic methods46,47, magnetic resonance imaging (MRI)48,49, or the combination with other techniques such as videofluorography or spiral CT or the accuracy of 2D/3D CT data are currently under investigation.50,51,52
Artifacts and distortions in dental CT data were caused very often by metallic restorations. Depending on the size and location it was very difficult to use these images in 3D image reconstruction, which are needed for instance in diagnosis and treatment of dental implants, impacted teeth, or temporomandibular joints. Special algorithms to noise reduction in combination with multi directional interpolation resulted finally in clear three-dimensional images.53 The first clinical model of limited cone-beam X-ray CT for dental use named "3DX multi-image micro CT" was developed by Befu et al. and is currently available only in Japan (3DX, J. Morita MFG Co. Kyoto, Japan).
Another method to produce three-dimensional images is termed Tuned Aperture Computed Tomography (TACT)54 and has been licensed by Instrumentarium Imaging (Tuusala, Finland). The use of TACT for dental applications is work in progress for diagnostic efficacy in primary caries detection55, diagnosis of external root resorption56, the accuracy of depth discrimination57, and to assess bone defects at implant sites.58
Despite these seriously ongoing projects and modifications for digital radiographs59 potential for fraudulent use of digital radiographs have also been reported60 and give implications to develop measures both to prevent manipulation of digital radiographic images as well as to facilitate its detection.
However, digital radiographic and imaging modalities offer more advantages that may be in the patient's best interest of fast transmission to consulting dentists, insurance companies, as well as off-hours interpretation. Once all data are transformed into a digital format, they will be more frequently transmitted urging teledentistry and teleradiology to become standards.61,62
Occlusion
A new development in the diagnostic field is the virtual articulator for the analysis of dysfunctions and the dysmorphology of dental occlusion. Kordass and Gaertner use results of a 3D scan of a single tooth and combine complete denture models and their centric relation with data from a jaw movement analyzer. This enables the virtual movement and diagnosis of dynamic occlusal contacts and tooth interferences.63
 |
 |
| Page 10 of 16 | |
| Citation Number: Vol. 3, No. 1, Page 036 |
|
