The main consideration taken by the dental operator before the conduction of the radiographic examinations include the age and gender (Jansson et al. 2014). Other factors taken under consideration include evaluation of the dento-alveolar trauma in case of the intra-oral radiographic examination. If the main zone of interest extends beyond the dento-alveolar complex then extra-oral imaging is recommended. In case of bone-loss due to peri-dontal disease, development of the anomalies along with occult disease is also considered. However, it is not recommended to conduct radiographic screening for the purpose of detecting the disease before conduction of the clinical examination (Jansson et al. 2014). In case of a child with transitional dentition, individualised radiographic exam is considered done in the posterior bitewings with the help of the panoramic exam and periapical images. 6-12 months of interval is taken under consideration if the proximal surfaces cannot be examined visually or by the use of the probe (Jansson et al. 2014).
Artefacts in the image of the dental X-ray can occur as a result of the improper handling of the packet of the film or improper process of the films, excessive moment of tube. Thus in order to avoid the formation of artefacts over the X-ray film, proper handling of the radiographic film and image processing technique must be undertaken like use of gloves and controlling the exposure of the film during the developing phase. Tan et al. (2013) are of the opinion that in order to control the distorted images, proper alignment of the tube is important like vertical elongation at an optimum level. In order to avoid the finger marks proper handling of hands is important like avoidance to contact of fluoride particles (grease) over the finger tips. In order to control the blurred images proper movement of hands is important during the tubing exposure. The duplicating image must be free from dirt and radiolucent spots (powder from the gloves, developer drops and spilling of developing chemicals) thus developing stage must be done under utter sincerity (Tan et al. 2013).
The bitewing film refers to little piece or tab of plastic or paper situated at the centre of the X-ray film. The tab when bitten enables the film to hover so that it can capture an even amount of the dental information. The bitewing portion of the film packet must be positioned along the long axis either horizontally or vertically (Herman and Ashkenazi 2013). According to Herman and Ashkenazi (2013), bitewing of the X-ray film is done in order to hold the teeth of the patient in place that in between the film attached and on the side of their tongue. The X-ray beam is directed outside of the cheek of the patient in order to make equitable exposure. This particular design helps to get a clearer image as the bite of the patient helps to keep the film still and free from distortion thereby making it easier in order to view the signs of the early decay of teeth.
There are three types of intra-oral X-rays
(i) Bite-wing X-rays: It helps to highlight the lower and the upper part of the teeth in one area of the mouth. After each bite-wing the teeth is exposed from its crown (the exposed surface) to the base level of the supporting bone. It used to detect the thickness of the gum disease (Ludwig et al. 2016)
(ii) Peri-apical X-rays: It is done to show whole portion of the mouth starting crown area to beyond the root where the tooth is attached within the haw. Entire portion of the teeth is exposed in exposed thus helping to detect unusual changes in the root and the surrounding bone structures. This approach is used in case of the detection of the cavity for the paediatric gum and teeth care (Ludwig et al. 2016)
(iii) Occlusal X-rays: It is used to track the development and placement of the overall arch of the teeth either in the upper or the lower jaw portion of the teeth (Ludwig et al. 2016)
Magnetic resonance is most comprehensive radiological imaging technique which helps in accurate evaluation of the joint structures of the bone and the soft tissue of the gum. This imaging technique helps in the detection of the acute and sub-acute images of the tooth decay and the problem in gum under the application of the “light bulb effect” over the fat-suppressed sequences done under long-repetition time. Magnetic resonance imaging is known for their excellent spatial resolution and is thus helpful in highlighting the complex bone structures of the bones. The magnetic resonance imaging are at times manipulated in the form of the cone beam computerised tomography in order to evaluate more intricate imaging of the teeth (Tan et al. 2013)
Apart from this, two dimensional, peri-apical and panoramic radiographs are frequently used in the dental practice. However, these two-dimensional imaging techniques are associated with sudden limitations which can be over-come under the application of the one-dimensional imaging technique (Tan et al. 2013)
- Binary image: It is the simplest form of image and can record two values like white and black under the parameter of 0 or 1. It is referred as 1-bit image as it takes only 1 binary digit in order to represent each pixel. It is frequently used to outline the basic shape of teeth (Rad, Rahim and Norouzi 2013)
- Gray-scale image: It is also known as monochrome image or one-colour image and they contain gray-level information and no specific information about the colour, the total number of bits used for each pixel determinants is regarded as the number of different gray level present within the image. Mainly it contains 8 bits/pixel data (Rad, Rahim and Norouzi 2013)
- Colour image: it is modelled as three-band monochrome image where each of the band correspond to different colours. The main information stored within the digital data is known as gray-level information. It is 24 bits/pixel image where 8-bits is considered for each for the colour bands like red, green and blue (Rad, Rahim and Norouzi 2013)
Giving informed consent means given consent to conduct a therapy plan or undertake a biochemical imaging technique under consent of the patient or his or her family members (in case of minor patient). Here the term informed signifies that patient is well-aware about the intended outcome of the technique along with the prognosis of the therapy. The informed consent is taken in pen and paper. Here the patient is asked to sign a document before the initiation of the tests or the therapy plan. If the patient is unable to understand the therapy informed consent then it is duty of the nursing professional to make the patient understand the entire therapy plan by the use of the effective communication skills. Abiding by the informed consent helps to align with the ethical principal of autonomy which states that it is the right of the patient to have comprehensive right to provide consent before the initiation of the therapy plan (Kakar et al. 2014).
References
Herman, H.D. and Ashkenazi, M., 2013. Quality of bitewing radiographs in children in relation to the type of film holder used. European Archives of Paediatric Dentistry, 14(3), pp.141-146.
Jansson, H., Wahlin, Å., Johansson, V., Åkerman, S., Lundegren, N., Isberg, P.E. and Norderyd, O., 2014. Impact of periodontal disease experience on oral health–related quality of life. Journal of periodontology, 85(3), pp.438-445.
Kakar, H., Gambhir, R.S., Singh, S., Kaur, A. and Nanda, T., 2014. Informed consent: Corner stone in ethical medical and dental practice. Journal of family medicine and primary care, 3(1), p.68.
Ludwig, U., Eisenbeiss, A.K., Scheifele, C., Nelson, K., Bock, M., Hennig, J., Von Elverfeldt, D., Herdt, O., Flügge, T. and Hövener, J.B., 2016. Dental MRI using wireless intraoral coils. Scientific reports, 6, p.23301.
Rad, A.E., Rahim, M.S.M. and Norouzi, A., 2013. Digital dental X-ray image segmentation and feature extraction. TELKOMNIKA Indonesian Journal of Electrical Engineering, 11(6), pp.3109-3114.
Tan, J.H., Chao, C., Zawaideh, M., Roberts, A.C. and Kinney, T.B., 2013. Informatics in radiology: Developing a touchless user interface for intraoperative image control during interventional radiology procedures. Radiographics, 33(2), pp.E61-E70.
