International Journal of Applied Dental Sciences 2019; 5(2): 271-276 ISSN Print: 2394-7489 ISSN Online: 2394-7497 IJADS 2019; 5(2): 271-276 Radiographic diagnostic Aids: A review © 2019 IJADS www.oraljournal.com Received: 01-02-2019 Dr. Panna Mangat, Dr. Anil K Tomer, Dr. Afnan Ajaz Raina, Dr. Faizan Accepted: 03-03-2019 Bin Ayub, Dr. Akankshita Behera, Dr. Nitish Mittal, Dr. Megna Bhatt Dr. Panna Mangat Professor, Department of Conservative and Dr. Ayush Tyagi Dentistry & Endodontics D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, Abstract India Presently diagnosis has shown a major growth in the field of Endodontics. Newer technologies have evolved in a way that human elements are being enriched in a much better way to ensure proper and Dr. Anil K Tomer Professor and Head, Department of correct diagnosis. Therefore, for a successful diagnostician, a necessity arises to keep abreast of all the Conservative Dentistry & Endodontics new methods for correct diagnosis and treatment. The aim of this review therefore is to assess the D.J. College of Dental Sciences and usefulness of some radiographic diagnostic aids and techniques used in endodontic therapy to make the Research, Modinagar, Ghaziabad, Uttar correct pulpal diagnosis. Pradesh, India Dr. Afnan Ajaz Raina Keywords: Radiographic diagnostic, aids, endodontics Post Graduate Student, Department of Conservative Dentistry & Endodontics D.J. College of Dental Sciences and Introduction Research, Modinagar, Ghaziabad, Uttar Pradesh, India Diagnosis is arguably the most critical component of all dental treatment, and Endodontics is no exception. Stedman’s Medical Dictionary describes clinical diagnosis as ‘‘the Dr. Faizan Bin Ayub determination of the nature of a disease made from a study of the signs and symptoms of a Post Graduate Student, Department of Orthodontics & Dentofacial disease.’’ The diagnostic process therefore is an essential part of treatment as well as treatment Orhtopedics, D.J. College of Dental planning. Collection of information, history, signs and symptoms, a thorough clinical Sciences and Research, Modinagar, examination, and objective testing are mandatory prior to recommending and initiating Ghaziabad, Uttar Pradesh, India treatment. Only after collecting this information can one come up with a diagnosis that Dr. Akankshita Behera benefits the patient. ‘‘Providing the wrong treatment for a patient could not only intensify a Post Graduate Student, Department of Conservative Dentistry & Endodontics patient’s symptom but make it even more difficult to arrive at the correct diagnosis. D.J. College of Dental Sciences and Knowledge of endodontic disease, radiographic interpretation, and clinical manifestations is an Research, Modinagar, Ghaziabad, Uttar [1] Pradesh, India integral and important part to achieving the correct diagnosis . The oldest diagnostic tests were the simple percussion and palpation. In the early 1900s, the Dr. Nitish Mittal Post Graduate Student, Department of following tests were considered essential‑ roentgenograms (in particular, bitewings for Conservative Dentistry & Endodontics children and adolescents), Transillumination (noting the color changes between a tooth with a D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar vital and nonvital pulp), percussion and palpation, thermal vitality tests (use of ice or hot Pradesh, India water), electric pulp tester, mobility tests, test cavity and the anesthetic test. Although these Dr. Megna Bhatt have served the dental clinician well over the many decades, these come with their share of Post Graduate Student, Department of limitations-putting the patient through any more pain than already is in or invading the Orthodontics & Dentofacial Orhtopedics, D.J. College of Dental Sciences and irreplaceable tissues, being not free from doctor and patient bias, along with the lack of Research, Modinagar, Ghaziabad, Uttar correlation with the histological status of the pulp and dubious accuracy and therefore the need Pradesh, India [2] arose for newer methods to detect pulp vitality . Dr. Ayush Tyagi Recently, various diagnostic aids for assessing the dental pulp vitality have been reported. Post Graduate Student, Department of Conservative Dentistry & Endodontics These include Caries Diagnostic Advances, Radiographic methods like Xeroradiography, D.J. College of Dental Sciences and Radiovisiography, Digital Subtraction Radiography, Micro CT, Magnetic Resonance Imaging, Research, Modinagar, Ghaziabad, Uttar Pradesh, India Ultrasound, etc. Various diagnostic aids Radiographic methods Correspondence Dr. Afnan Ajaz Raina Xeroradiography Post Graduate Student, Department of Radiovisiography Conservative Dentistry & Endodontics D.J. College of Dental Sciences and Digital subtraction radiography Research, Modinagar, Ghaziabad, Uttar Pradesh, India Micro computed tomography ~ 271 ~ International Journal of Applied Dental Sciences Cone beam computed tomography 40μ with the latest versions in the 20μ range. The rows of Optical coherence tomography (OCT) pixels are arranged in a matrix of 512 x 512 pixels. Tuned aperture computed tomography (TACT) There are two types of digital sensor array designs: area and Spiral computed tomography linear. Area arrays are used for intraoral radiography, while [5] Magnetic resonance imaging linear arrays are used in extra oral imaging . Ultrasound imaging in Endodontics Orascope Applications a. Dental Caries Detection Endoscope b. Intrabony defects Computerized expert system c. Periapical pathologies detection d. Detection of root fractures Xeroradiography e. Detection of root canal lengths Xeroradiography is an electrostatic process which uses an f. Application in mentally retarded/developmentally amorphous selenium photoconductor material, vacuum disabled individuals deposited on an aluminium substrate to form a plate. the plate g. Telemedicine [11] enclosed in tight cassette, may be linked to films used in halide based intraoral technique. The key functional steps in Disadvantages the process involve the sensitization of the photoconductor a. Previous disadvantages of the system included limitations plate in the charging station by depositing a uniform positive caused by the relatively small sensor size and its greater charge on its surface with a corona emitting device called thickness than conventional film. scorotron. That is the uniform electrostatic charge placed on a b. To date, only limited clinical studies have been reported layer of selenium is in electrical contact with a grounded regarding the RVG technique. The possibilities of the conductive backing. In the absence of electromagnetic technique’s unique ability of image ‘enhancement’ have radiation, the photoconductor remains non-conductive still to be explored to the full. uniform electrostatic charge when radiation is passed through c. As the technique is so different from the conventional, it an object which will vary the intensity of radiation, observed is important for the observer to view the image produced by Rawls and Owen. The photoconductor will then conduct without the constraints imposed by conventional its electrostatic charge into its grounded base in proportion to radiography. the intensity of the exposure. After charging the cassette is d. The technique is simple to use, but assessment of images inserted into a thin polyethylene bag to protect the cassette may require a certain degree of familiarization as the and plate from saliva [3]. image is different from a conventional radiograph [6]. Advantages Digital Subtraction Radiography Elimination of accidental film exposure, Digital subtraction of images: has been applied to dental High resolution, radiography for more than 20 years. Film subtraction was the Simultaneous evaluation of multiple tissues, established standard method for cerebral angiography and was Ease of reviewing, widely used until digital subtraction fluoroscopy became Economic benefit, available in the late 1970s. Nowadays, filmless' Reduced exposure to radiation hazards, photoelectronic imaging systems, specially video fluoroscopy, Cephalometrics analysis. are used to subtract diagnostic images [12]. It improves the detection of density changes in bony Disadvantages structures, and significantly, the sensitivity and accuracy of Technical difficulties, the evaluations. Fragile selenium coat, Transient image retention, a. With conventional radiography, a change in Slower speed, mineralization of 30-60% is necessary to be detected by Technical limitations [4] an experimented radiologist, also the lesions restricted to cancellous bone could not be detected because of it's less Radiovisiography mineral contents than the cortical bone, but with DSR the The RVG system is capable of rapidly displaying a digital alveolar bone changes of 1-5% per unit volume and radiographic image on a monitor which results in a lower significant differences in crestal bone height of 0.78 mm patient radiation. The "Radio" component is the conventional can be detected x-ray generator with a timer, capable of very short exposure b. This technique is used in periodontal diagnosis because time, along with image receptor. The "Visio" portion converts of its potentially high sensitivity to detect of bone the output signal from a CCD to a digital format and displays changes as little as 1% and changes in the third it on a monitor. The "Graphy" component consists of data dimension (bone density, bone thickness). storage unit