6-12 yaş çocuklardan alınan anterior periapikal filmlerin radyografik ve diyagnostik açıdan retrospektif olarak değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Doğru ve güvenilir bir teşhisle dental radyografilerin kalitesi birbiriyle yakın ilişkilidir. Bu çalışmanın amacı 6-12 yaş arası hastaların daimî anterior dişlerinden alınan periapikal radyografilerin radyolojik kalitelerinin değerlendirilmesi, tespit edilen diyagnostik bulguların raporlanması ve pandemi sürecinin bunlara etkisinin incelenmesidir. Bu çalışmada 597 çocuk hastaya ait 1069 anterior dijital periapikal radyografi etik kurul onayı alındıktan sonra retrospektif olarak değerlendirildi. Araştırmacı iç güvenirliğinin belirlenmesi için ilk periapikal filmden başlayarak her on filmin ilkini işaretleyerek seçilmiş (yaklaşık %10) 107 radyografi ilk değerlendirmeden 2 hafta sonra tekrar değerlendirildi ve yapılan kappa analizinde diyagnostik açıdan kabul edilebilirlik bakımından iki değerlendirme arasında neredeyse mükemmel derecede uyum tespit edildi (kappa=0,966). İncelenen 1069 filmin 945'inin (%88,4) pandemi haricinde, 124'ünün (% 11,6) pandemi sırasında alındığı saptandı. Pandemi sürecindeki hastaların yaş ortalamasının (9,62±1,69) ile pandemi haricindekilere (10±1,73) göre istatistiksel olarak anlamlı düzeyde daha düşük olduğu saptandı. Pandemi haricinde 10 yaş ve üzeri hastalardan, pandemi sürecindeyse 10 yaş altı hastalardan anlamlı düzeyde daha fazla film alındığı görüldü (p=0,008). İncelenen filmlerin %26,9'unda hata varlığı saptanırken filmlerin tekrarlanma oranı %10,3 olarak bulundu. Pandeminin filmlerdeki hata varlığına ve tekrar oranlarına istatistiksel olarak anlamlı etkisi saptanmadı. İncelenen filmlerde en çok sırasıyla fosfor plakta hasar varlığı (%55,2) saptanırken bunu pozisyonlandırma hatalarına bağlı dişin tamamının filmde görülmemesi (%18,5), filmin uygun dikey açılamayla çekilmemesi (%10,6) ve ışınlama parametrelerine bağlı hatalardan dolayı kontrastın uygun olmaması (%10,5) takip etti. Tekrarlanan filmlerde fosfor plakta hasar varlığından (%67,3) sonra en çok apeks eksikliği (%39,1) daha sonra kesici kenar eksikliği (%31,8) tespit edildi. Diyagnostik açıdan kabul edilemez filmlerde hasarlı fosfor plakların oranı pandemi haricinde (%64,7) pandemi sürecindeki filmlere göre (%37,5) anlamlı düzeyde daha fazla olduğu görüldü. Görüntüde kesici kenar eksikliği pandemi haricinde (%53,2) pandemi dönemine (%18,8) göre anlamlı düzeyde fazla görüldü. Öte yandan apeks eksikliği oranı pandemi döneminde (%81,3) pandemi haricine (%40,4) göre anlamlı düzeyde yüksek bulundu. Üst çeneden 1016 film alınırken alt çeneden yalnızca 53 film alındığı tespit edildi. Santral dişlerde en fazla görülen bulgunun değişen oranlarla dental travma olduğu görüldü. Üst lateral dişlerde ise en fazla çürük bulgusu saptandı. Alt lateral dişler ve kaninlerle ilgili yeterli veriye ulaşılamadı. Pandemi hariciyle pandemi süreci arasında dental bulguların filmlerde görülme oranları bakımından çoğunlukla anlamlı farklılık görülmedi. Hastaların %8,2'sinde meziodens varlığı tespit edildi. Hastalar 10 yaş altı ve üzeri olarak gruplandığında hastaların yaşının periapikal filmlerin diyagnostik kalitesine ve radyografi hatalarına etkisi istatistiksel olarak anlamlı bulunmadı. 11,12,21,22 ve 41 nolu dişlerde 10 yaş üzerinde 10 yaş altına göre çürük bulgusu anlamlı düzeyde daha fazla görüldü (p<0,05). Sonuç olarak incelenen tüm filmlerin %83,9'u diyagnostik olarak kabul edilebilir bulunurken bu oran pandemi haricinde %83,49 ve pandemi döneminde %87 olarak saptandı. Buna göre diyagnostik kabul oranı pandemi döneminde istatistiksel olarak anlamlı olmamakla birlikte bir miktar yüksek bulunsa da bu oranlar literatürde önerilen başarı hedefinden düşüktür. Fosfor plakların hasar açısından belli aralıklarla kontrol edilmesi ve dayanıklığını artırıcı önlemler uygulanarak kullanılması, paralel teknik ve film tutucuların yaygınlaştırılması, röntgen teknisyenlerinin çocuk hastalarla çalışma konusunda eğitilmesi ve hastalara daha fazla zaman ayrılabilmesiyle radyografilerin diyagnostik kaliteleri arttırılabilir. Gelecekte yürütülecek radyografik kalite denetim çalışmalarıyla karşılaştırılabilmesi açısından çalışmamızın bulguları bir referans değeri taşımaktadır.
Accurate and reliable diagnosis and the quality of dental radiographs are closely related. This study aims to evaluate the radiological quality of the periapical radiographs taken from the permanent anterior teeth of patients aged 6-12 years, to report the detected diagnostic findings, and to examine the effect of the pandemic period on them. In this study, 1069 anterior digital periapical radiographs of 597 pediatric patients were evaluated retrospectively after ethics committee approval. In order to determine investigator internal reliability, 107 radiographs (approximately 10%) selected by marking the first of every ten films, starting from the first periapical film, were re-evaluated 2 weeks after the first evaluation, and the kappa analysis showed an almost perfect agreement between the two evaluations in terms of diagnostic acceptability (kappa= 0.966). It was seen that 124 (11.6%) of the 1069 films examined were taken during the pandemic, while 945 (88.4%) of them were out of the pandemic. It was found that the mean age of the patients during the pandemic (9,62±1,69) was statistically significantly lower than those from the non-pandemic period (10±1,73). It was observed that significantly more films were taken from patients aged 10 years and older out of the pandemic, and from patients younger than 10 years of age during the pandemic (p=0.008). Defects were detected in 26.9% of the films examined, while the repetition rate of the films was found to be 10.3%. There was no statistically significant effect of the pandemic on the presence of errors and repetition rates in the films. In the films examined, the presence of damage in the phosphor plate was determined the most (55.2%), and respectively it was followed by the absence of the entire tooth in the film due to positioning errors (18.5%). Then incorrect vertical angulation (10.6%) and unsuitable contrast (10.5%) followed. The presence of damage to the phosphor plate (67.3%), then the apex deficiency (39.1%) followed by the lack of incisal edge (31.8%) were the most common errors in repeated films. The rate of damaged phosphor plates in diagnostically unacceptable films were significantly higher during the non-pandemic period (64.7%) on the contrary lower during the pandemic (37.5%). The lack of incisal edge in the image was significantly higher in the non-pandemic period (53.2 %) than during the pandemic (18.8%). On the other hand, the apex deficiency rate was significantly higher during the pandemic period (81.3%) compared to the non-pandemic (40.4%). It was determined that while 1016 films were taken from the upper jaw, only 53 films were taken from the lower jaw. It was observed that the most common finding in central teeth was dental trauma with varying rates. On the upper lateral teeth, the most common finding was caries presence. Sufficient data could not be obtained about the lower lateral teeth and canines. There was mostly no significant difference between the non-pandemic and the pandemic period in terms of the incidence of dental findings in the films. The presence of mesiodens was detected in 8.2% of the patients. When the patients were grouped as under 10 years of age and above, the effect of the age of the patients on the diagnostic quality of the periapical films and the radiography errors was not found statistically significant. In teeth 11,12,21,22 and 41, caries findings were significantly more common over the age of 10 than under the age of 10 (p<0.05). As a result, 83.9% of all radiographs examined were found diagnostically acceptable, while this rate was 83.49% except for the pandemic and 87% during the pandemic. Accordingly, although the diagnostic acceptance rate is not statistically significant during the pandemic, it is found to be somewhat higher, but these rates are lower than the success rate suggested in the literature. The diagnostic quality of radiographs can be increased by periodically checking phosphor plates for damage and using measures to increase their durability, expanding the use of parallel techniques and film holders, training X-ray technicians on working with pediatric patients, and spending more time with patients. The findings of our study have a reference value in order to be compared with the radiographic quality control studies to be carried out in the future.
Accurate and reliable diagnosis and the quality of dental radiographs are closely related. This study aims to evaluate the radiological quality of the periapical radiographs taken from the permanent anterior teeth of patients aged 6-12 years, to report the detected diagnostic findings, and to examine the effect of the pandemic period on them. In this study, 1069 anterior digital periapical radiographs of 597 pediatric patients were evaluated retrospectively after ethics committee approval. In order to determine investigator internal reliability, 107 radiographs (approximately 10%) selected by marking the first of every ten films, starting from the first periapical film, were re-evaluated 2 weeks after the first evaluation, and the kappa analysis showed an almost perfect agreement between the two evaluations in terms of diagnostic acceptability (kappa= 0.966). It was seen that 124 (11.6%) of the 1069 films examined were taken during the pandemic, while 945 (88.4%) of them were out of the pandemic. It was found that the mean age of the patients during the pandemic (9,62±1,69) was statistically significantly lower than those from the non-pandemic period (10±1,73). It was observed that significantly more films were taken from patients aged 10 years and older out of the pandemic, and from patients younger than 10 years of age during the pandemic (p=0.008). Defects were detected in 26.9% of the films examined, while the repetition rate of the films was found to be 10.3%. There was no statistically significant effect of the pandemic on the presence of errors and repetition rates in the films. In the films examined, the presence of damage in the phosphor plate was determined the most (55.2%), and respectively it was followed by the absence of the entire tooth in the film due to positioning errors (18.5%). Then incorrect vertical angulation (10.6%) and unsuitable contrast (10.5%) followed. The presence of damage to the phosphor plate (67.3%), then the apex deficiency (39.1%) followed by the lack of incisal edge (31.8%) were the most common errors in repeated films. The rate of damaged phosphor plates in diagnostically unacceptable films were significantly higher during the non-pandemic period (64.7%) on the contrary lower during the pandemic (37.5%). The lack of incisal edge in the image was significantly higher in the non-pandemic period (53.2 %) than during the pandemic (18.8%). On the other hand, the apex deficiency rate was significantly higher during the pandemic period (81.3%) compared to the non-pandemic (40.4%). It was determined that while 1016 films were taken from the upper jaw, only 53 films were taken from the lower jaw. It was observed that the most common finding in central teeth was dental trauma with varying rates. On the upper lateral teeth, the most common finding was caries presence. Sufficient data could not be obtained about the lower lateral teeth and canines. There was mostly no significant difference between the non-pandemic and the pandemic period in terms of the incidence of dental findings in the films. The presence of mesiodens was detected in 8.2% of the patients. When the patients were grouped as under 10 years of age and above, the effect of the age of the patients on the diagnostic quality of the periapical films and the radiography errors was not found statistically significant. In teeth 11,12,21,22 and 41, caries findings were significantly more common over the age of 10 than under the age of 10 (p<0.05). As a result, 83.9% of all radiographs examined were found diagnostically acceptable, while this rate was 83.49% except for the pandemic and 87% during the pandemic. Accordingly, although the diagnostic acceptance rate is not statistically significant during the pandemic, it is found to be somewhat higher, but these rates are lower than the success rate suggested in the literature. The diagnostic quality of radiographs can be increased by periodically checking phosphor plates for damage and using measures to increase their durability, expanding the use of parallel techniques and film holders, training X-ray technicians on working with pediatric patients, and spending more time with patients. The findings of our study have a reference value in order to be compared with the radiographic quality control studies to be carried out in the future.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
