Academic literature on the topic 'Radiographic prescription'

Objective This study aimed to assess the familiarity of general dental practitioners (GDPs) in the South West of England with the guidelines in the first edition of the then Faculty of General Dental Practitioners (UK) ‘good practice guidelines’ publication Selection Criteria for Dental Radiography (henceforth referred to as ‘the guidelines’) by studying the prescription of radiographs for children in two case scenarios. Method A single mailshot of questionnaires containing questions relating to the guidelines and the two case scenarios was sent to 136 GDPs in the South West of England. Their recommendations for the prescription of radiographs for the children in the two scenarios were then compared with the guidelines. Results There was a 60% response rate. Of the respondents, 48% reported that they had access to the guidelines. Of those who responded to the question, 66% said that they found the guidelines easy to use. Seventy per cent of respondents reported that they preferred the concept of guidelines to that of protocols. The results from the case scenarios revealed an under-prescription of radiographs for patients presenting with developmental problems or trauma when compared to the recommendations in the guidelines. There was good correlation for the prescription of radiographs for caries but little consensus on radiographic review times. Conclusions The study highlighted (a) areas within the guidelines that require further clarification and research and (b) that in the group studied half did not have access to the guidelines.

Aims The primary aims of the study were to investigate the use of digital radiography within primary dental care practices in the West Kent Primary Care Trust (PCT) area and general dental practitioners’ (GDPs) self-reported change in radiographic prescribing patterns following the introduction of the nGDS contract in 2006. Methods Data were gathered via a piloted, self-completed questionnaire, and circulated to all GDPs listed on the National Health Service (NHS) Choices website as practising in the West Kent PCT area. There were three mailings and follow-up telephone calls. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test and Pearson correlation coefficient. Results Of 223 GDPs, 168 (75%) responded. There were 163 usable questionnaires. The respondents represented 85% of the general dental practices in West Kent. Eighty (49%) respondents were using digital intra-oral radiography. Of those who used digital radiography, 44 (55%) reported that they used phosphor plate systems and 36 (45%) that they used direct digital sensors. Eighty-three (51%) had a panoramic machine in their practice, 46 of whom (55%) were using digital systems; of these, 32 (67%) were using a direct digital system. Seventy-one GDPs reported that they worked exclusively or mainly in private practice. Forty (56%) of these ‘mainly private’ GDPs reported that they used digital radiographic systems, whereas only 40 (44%) of the 89 ‘mainly NHS’ GDPs reported using digital radiographic systems. On average, mainly private GDPs made the transition to a digital radiographic system six months before mainly NHS GDPs. Of those who provided NHS dentistry before and after April 2006, only 18 (14%) reported taking fewer radiographs and seven (6%) taking more. Conclusions In February 2010, of the West Kent GDPs who responded to the questionnaire, just under 50% used digital radiography. Mainly private GDPs were more likely to use digital radiography than their mainly NHS counterparts. A link between digital radiography and increased prescription of radiographs was not specifically apparent from this study. There was no evidence that West Kent GDPs were taking fewer radiographs than they did prior to the introduction of the new GDS contract in April 2006. Research is needed to investigate whether the uptake of digital radiography by GDPs in the rest of the country is similar to that in West Kent.

ABSTRACT Aim To assess the level of knowledge of appropriate prescription of dental radiographs amongst Interns of two dental institutes of Belagavi city. Materials and methods A cross-sectional study was conducted on 120 interns of 2 dental institutes of Belagavi city. The knowledge of appropriate prescription of dental radiographs was assessed using a structured, close ended and self-designed questionnaire. Results Knowledge of appropriate prescription of dental radiographs was significantly lower in Institute 1 than Institute 2 (p=0.001*).Only a small % of 33.76 and 38.66 of interns of institutes 1,2 respectively had an above average knowledge. Thus, it is inferred that the awareness level of interns of correct prescription of radiographs is lower than expected. Conclusion The lack of awareness could be due to various factors such as a lack of previous knowledge, inadequate quality and quantity of educational courses and so on. Thus, students should receive the necessary education on correct prescription of radiographs to ensure their correct prescription, circumventing unnecessary exposure and their consequent detrimental effects. Clinical significance Radiographic examination is an important diagnostic tool used by dentists leading to an increased exposure to radiation. However, unessential exposure may lead to detrimental effects such as mutations, genetic changes and so on. One efficient way of decreasing exposure is to avoid their application when not indicated. Thus, it is the professional duty of a dentist to have adequate and accurate knowledge of prescription of radiographs. The present study shows the necessity to optimize educational tools to increase the theoretical knowledge of students and consequently improve clinical application of the knowledge gained. How to cite this article Tyagi P, Naik Z, De Piedade Sequeira MAKE. Knowledge of Appropriate Prescription of Dental Radiographs among Interns of Two Dental Institutes of Belagavi City: A Questionnaire Study. Int J Res Foundation Hosp Healthc Adm 2016;4(2):61-65.

Aims The primary aims of the study were to investigate the use of bitewing radiography within primary dental care and adherence to guidelines on bitewing radiography by general dental practitioners (GDPs) in the West Kent Primary Care Trust (PCT) area. Within the overall aims, the study had objectives to investigate the use of radiographic guidelines, audit and caries risk assessment, the influence of private and National Health Service (NHS) practice, and the influence of the demographic profile of the GDPs on these variables. Methods Data were gathered via a piloted self-completion questionnaire, circulated to all GDPs listed on the NHS Choices website as practising in the West Kent PCT area. Three mailings and follow-up telephone calls were used. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test. Results Of 223 GDPs, 167 responded (75%). GDPs with a high NHS commitment were significantly less likely to follow Faculty of General Dental Practice (UK) guidance on prescribing bitewing radiographs for adults ( P<0.01) and children ( P<0.05) than were mainly private GDPs. Mainly NHS GDPs were more likely ‘always/mostly’ to follow National Institute for Health and Clinical Excellence guidance (83 compared to 59) ( P<0.05) and also to risk-assess patients (83 compared to 62). Only 115 (71%) had carried out a radio graphic audit or peer review in the preceding three years. Those with postgraduate qualifications were more likely ( P<0.05) to carry out radiographic audit. Conclusions The study confirmed previous research reporting the under-use of radiography for caries detection and also the failure of some GDPs to comply with ionising radiation regulations. West Kent GDPs with a high NHS commitment were less likely to follow radiographic guidance than their private counterparts. This suggests that further efforts to disseminate information on radiographic guidelines and to educate GDPs are necessary to improve adherence with all aspects of radiography within general dental practice. Research into factors that influence GDPs’ decision-making with regards to radiographic prescription may further inform the profession as to the best methods to lead to behavioural change. The dental profession and its regulators need to make a concerted effort to educate and inform GDPs so that this behaviour is modified.

This prospective cohort study investigated the distribution pattern of carious lesions diagnosed by visual tactile and radiographic examinations, assessed the radiographic yield for clinical caries diagnosis, and estimated how accurately commonly used indicators for caries identified young adults who would benefit from radiographs at different thresholds. Overall, 576 patients aged 16–32 years seeking a first consultation were included. Patients were examined for caries and answered a validated questionnaire on sociodemographics and oral health behavior. Almost 10% of clinically sound approximal surfaces presented radiolucency in enamel/dentine. Of the clinically diagnosed noncavitated approximal and occlusal lesions, 22.5 and 17.7%, respectively, presented radiolucency reaching dentine at the radiographic examination. Noncavitated/enamel lesions detected radiographically were mainly at approximal surfaces (73.2%), while at occlusal surfaces these were negligible (0.7%). More than half of approximal dentine lesions were only detected radiographically (61.3%), while more than half of occlusal dentine lesions were only clinically diagnosed (57.1%). The hierarchical logistic regression analysis showed that patient’s caries activity, D1MFS scores ≥17, and frequent consumption of soft drinks were significantly associated with detection of approximal enamel/dentine lesions. Also, patient’s caries activity and frequent consumption of soft drinks were significantly associated with occlusal dentine caries (p ≤ 0.05). The indicator power of grouping these indicators as a predictor for the presence of radiographically detected lesions showed high sensitivity (0.84–0.91) and moderate specificity (0.64–0.73) for all surfaces and thresholds tested. In conclusion, radiographs increased significantly the number of approximal enamel/dentine and occlusal dentine lesions diagnosed. The ability to identify young adults with approximal lesions from the predictor was satisfactory. Bearing in mind that an essential contribution of bitewing radiographs to clinical examination is the detection of approximal noncavitated/enamel lesions that can be inactivated by nonoperative interventions, our results support the prescription of radiographs in young adults seeking a first consultation. Updating of current guidelines’ recommendation of radiographs is warranted.

Respiratory syncytial virus (RSV) represents the main cause of acute respiratory tract infections in children worldwide and is the leading cause of hospitalization in infants. RSV infection is a self-limiting condition and does not require antibiotics. However hospitalized infants with clinical bronchiolitis often receive antibiotics for fear of bacteria coinfection, especially when chest radiography is performed due to similar radiographic appearance of infiltrate and atelectasis. This may lead to unnecessary antibiotic prescription, additional cost, and increased risk of development of resistance. Despite the considerable burden of RSV bronchiolitis, to date, only symptomatic treatment is available, and there are no commercially available vaccines. The only licensed passive immunoprophylaxis is palivizumab. The high cost of this monoclonal antibody (mAb) has led to limiting its prescription only for high-risk children: infants with chronic lung disease, congenital heart disease, neuromuscular disorders, immunodeficiencies, and extreme preterm birth. Nevertheless, it has been shown that the majority of hospitalized RSV-infected children do not fully meet the criteria for immune prophylaxis. While waiting for an effective vaccine, passive immune prophylaxis in children is mandatory. There are a growing number of RSV passive immunization candidates under development intended for RSV prevention in all infants. In this review, we describe the state-of-the-art of palivizumab’s usage and summarize the clinical and preclinical trials regarding the development of mAbs with a better cost-effectiveness ratio.

Resumo: A redução da dose de radiação ao paciente é aceita em Radiologia Odontológica, com a finalidade de diminuir os riscos associados ao exame radiográfico. Para atingir este objetivo, além do avanço tecnológico ocorrido nas últimas décadas, devemos considerar a importância do Critério de Seleção para o paciente e da prescrição radiográfica na indicação correta do tipo de radiografia necessária para cada um deles. O objetivo deste trabalho foi avaliar a prescrição radiográfica de pacientes atendidos pelo Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP durante o período de 1989 a 1993. Selecionamos 396 prontuários que constituiu a totalidade dos que continham exames radiográficos. Para a análise da prescrição radiográfica, consideramos as informações obtidas da ficha clínica e da interpretação das radiografias, utilizando os Critérios de Seleção e a análise de decisão clínica. Os resultados demonstraram um alto índice de pacientes com prescrição incorreta (44,0%); tendo em 24,7% dos pacientes ocorrido mais de uma radiografia prescrita incorretamente. Com relação ao tipo de técnica com prescrição incorreta, em 31,6% dos pacientes foi realizada a radiografia panorâmica, vindo a seguir a oclusal (28,7%), outro (17,2%) e a associação da panorâmica e oclusal (12,6%). Pacientes portadores de doenças e alterações de tecido mole tiveram a mais alta freqüência de prescrições incorretas, seguidos pelos portadores de doenças das glândulas salivares (13,5%) (incluindo os tumores); outros (10,1%); distúrbios da A.T.M. (9,0%); inflamação e infecção dos maxilares (6,8%); tumores benignos (5,6%) e tumores malignos (5,6%). Em 62,9% dos pacientes, o exame radiográfico contribuiu para o diagnóstico e tratamento. A alta porcentagem de prescrição incorreta encontrada evidencia a necessidade de... (Resumo completo, clicar acesso eletrônico abaixo).<br>Abstract: The reduction in the exposure rate to the patient is very known in Oral Radiology for reducing the patient risk from radiographic examination.Besides the thecnological advances in last decades, development of Selection Criteria for radiographic examination has also been instrumental in patient dose's reduction. A correct radiographic prescription means the correct radiographic view for each individual patient is used. The purpose of this study was to analyse the radiographic prescription of patients in the Oral Medicine Clinic, at Araraquara Dental School - UNESP, during the period between 1989 and 1993. The sample of this study was all of the files that had any type of radiographic examination (396). For the radiographic prescription we have considered the informations from the files and the radiographic interpretation based on Selection Criteria and clinical decision analysis methods.The results showed a high percentage of patients with incorrect prescription ( 44.0%); 24.7% had at least more than one incorrect prescription.From the radiographic views, the panoramic radiographic was prescribed incorrectly in 31.6% of the patients, following by an occlusal view (28.7%) , others (17.2%) and the association of panoramic and occlusal views (12.6%). The patients with soft tissues diseases have had the highest percentage of incorrect prescription (35.0%), following by salivary gland diseases, including the tumors (13.5%); others (10.1%); TMJ disorders (9.0%); jaw's inflamation and infections (6.8%); benign tumors (5.6%) and malignant tumors (5.6%). The radiographic examination contributed for diagnosis and treatment in 62.9% of the patients.The high percentage of incorrect radiographic prescription shows the importance to develop the guidelines in Oral Medicine.

Submitted by Cláudia Bueno (claudiamoura18@gmail.com) on 2015-11-19T19:06:36Z No. of bitstreams: 2 Dissertação - Jorge Elias Kaluf Tomeh - 2015.pdf: 12046042 bytes, checksum: 257b96a05c7c0603cf240f1054e20196 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)<br>Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-11-20T12:57:59Z (GMT) No. of bitstreams: 2 Dissertação - Jorge Elias Kaluf Tomeh - 2015.pdf: 12046042 bytes, checksum: 257b96a05c7c0603cf240f1054e20196 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)<br>Made available in DSpace on 2015-11-20T12:57:59Z (GMT). No. of bitstreams: 2 Dissertação - Jorge Elias Kaluf Tomeh - 2015.pdf: 12046042 bytes, checksum: 257b96a05c7c0603cf240f1054e20196 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2015-03-23<br>Computed tomography (CT) is a resource used in both for the diagnosis and the treatment of maxilomandibular bone lesions. The rational use of this imaging method should be guided by specific studies that reveal its real contribution and indication in the conduct of bone lesions. Objective - It is proposed to analyze the role of CT in the assessment of bone lesions in the maxillofacial region. Metodology - The sample consisted of patients with any type of bone lesion, whose diagnosis had already been made on the basis of anatomopathological findings and for whom the use of panoramic radiograph (PR) and CT was required. The examinations were performed by two radiology specialists and two maxillofacial surgeons. The criteria used were: internal arrangement, limits and changes on the surrounding anatomical structures. In addition, the examiners suggested a possible diagnosis at the end of analysis. Results - Low to moderate concordance was found. In 61,5% of cases, the possible diagnoses made after CT analysis agreed with the anatomopathological results. Conclusion - The CT has the potential to add new information to the patient's treatment plan and, when properly indicated, to contribute for the evaluation of maxillofacial bone lesions.<br>As imagens tomográficas bem indicadas de lesões ósseas da maxila e mandíbula são de grande importância para uma conduta apropriada do paciente em tratamento. Entretanto, o uso abusivo desse método de imagem tem sido descrito na literatura. Estudos são necessários para avaliar sua indicação e contribuição no diagnóstico de lesões ósseas da região bucomaxilofacial. Objetivo - Analisar o papel da tomografia computadorizada (TC) na avaliação de lesões ósseas da região bucomaxilofacial. Metodologia - A amostra foi composta de imagens radiográficas (radiografia panorâmica e TC) de pacientes de dois centros de Diagnóstico Oral que apresentavam lesão óssea na região bucomaxilofacial, cujo diagnóstico já estivesse estabelecido com base nos achados anatomopatológicos. A análise das radiografias foi realizada por quatro examinadores, sendo dois especialistas em radiologia odontológica e dois especialistas em cirurgia bucomaxilofacial. Os seguintes critérios foram utilizados para análise das lesões: padrão interno, limites, alterações sobre as estruturas anatômicas adjacentes e hipótese de diagnóstico. Resultados – Uma alta concordância entre os exames foi encontrada para “densidade radiográfica”. Todos os demais critérios apresentaram baixa concordância entre exames. Para todas as variáveis estudadas houve concordância entre os avaliadores tanto para RP quanto para TC, com exceção da análise da reação periosteal em ambos os exames e na avaliação de deslocamento e invasão de estruturas anatômicas na RP. A média entre os examinadores de concordância das hipóteses de diagnóstico originadas da TC com o exame anatomopatológico foi de 61,5%. Conclusões - O exame de TC tem o potencial de incluir novas informações ao plano de tratamento do paciente especialmente quando for necessário avaliar o padrão interno da lesão, bordas e alterações de estruturas adjacentes. As hipóteses de diagnóstico formuladas pela análise da TC têm maior concordância com o exame anatomopatológico.

Mehta casting technique applied under anesthesia is standard treatment for infantile scoliosis (IIS). However, concern has been raised about frequent anesthesia in children less than three years. The development of a customized thoracolumbar sacral orthosis (TLSO) could avoid the risks of Mehta casting. To develop a bracing technique for IIS that achieves patient compliance and scoliosis correction. Nine patients with ISS were offered a custom TLSO as an alternative to Mehta casting. One patient declined due to an insurance issue. No anesthesia was required for measurement or fitting of the TLSO. A temperature sensitive monitor recorded wear time. Brace success was determined by radiographic correction and adherence to prescription of greater than 18 hours per day. Eight patients had brace treatment with mean(range): age 19(12–44) months, curve magnitude 34° (22–44°), rib vertebral angle of greater than 20° with follow-up 17(3–28) months. In brace correction was less than 15 degrees in 6 of 8 patients. Compliance monitor recorded wear: 4 patients ≥ 18 hours, 2 patients 16–18 hours, 1 had 14 hours, and 1 monitor malfunctioned and could not be read. Brace design evolved to maximize ipsilateral abdominal relief away from the lateral apical shift of the design. Foam lining was added to prevent skin irritation through the relief opening. Average number of braces per year =2.2. A customized TLSO can achieve in brace correction comparable to Mehta casting with acceptable compliance and without the need for general anesthesia, while allowing bathing and skin care.

Root canal treatment of infected root canals represents a large percentage of business in general dental practice. It is an expensive process and often prone to failure. During root canal treatment, destructive access preparation by removing parts of tooth crown and dentin is usually needed even before a clinician’s inspection and diagnosis. This paper presents a non-destructive method for accessing the internal tooth geometry by building a 3-D tooth model from 2-D radiograph. The geometry of root canals is then formulated into a mathematical model. Based on this mathematical model, the treatment procedures utilizing the dental tools/instruments are planned by a computer aided prescription system, which yields the tool selection and tool path for the root canal preparation by an intelligent micro drilling machine with on-line monitoring. To minimize the removal of healthy tooth crown and dentin, thus protecting the strength of the patient’s infected tooth, an optimization algorithm is utilized for planning the access preparation in the root canal treatment. Although an opening of a tooth crown is still needed so that dental instruments can reach the root canal, the non-destructive 3-D modeling and the optimization of the access preparation in the new approach makes the root canal treatment minimally invasive compared to present techniques.