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      Brazilian young dental practitioners' use and acceptance of digital radiographic examinations

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          Abstract

          Purpose

          The aim of this study was to investigate the use and acceptance of digital radiographic examinations by Brazilian dental practitioners in daily practice and to evaluate the advances that have occurred over the past 5 years.

          Materials and Methods

          Dental practitioners enrolled in extension courses at the Piracicaba Dental School, University of Campinas, Brazil, responded to a self-administered questionnaire in the years 2011 and 2015. They were asked about sociodemographic factors and their knowledge and use of digital radiographic examinations. Descriptive analysis was performed, as well as the chi-square and Fisher exact tests, with a significance level of 5% (α=0.05).

          Results

          A total of 181 participants responded to the questionnaire in the years 2011 and 2015. Most of the respondents worked in private practice, had graduated within the last 5 years, and were between 20 and 30 years old. In 2011, 55.6% of respondents reported having ever used digital radiographic examinations, while in 2015 this number increased significantly to 85.4% (p<.0001), out of which 71.4% preferred it to conventional images. Moreover, 21.4% of respondents reported having used digital radiographic examinations for more than 3 years. A significant increase in use of intraoral digital radiography (p=0.0316) was observed in 2015. In both years, image quality and high cost were indicated, respectively, as the main advantage and disadvantage of digital radiographic examinations.

          Conclusion

          This study showed that digital radiology has become more common in Brazil over the past 5 years. Most of the Brazilian dental practitioners evaluated in 2015 used digital radiographic examinations.

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          Most cited references15

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          Digital radiography and caries diagnosis.

          A Wenzel (1998)
          Direct digital acquisition of intra-oral radiographs has been possible only in the last decade. Several studies have shown that, theoretically, there are a number of advantages of direct digital radiography compared with conventional film. Laboratory as well as controlled clinical studies are needed to determine whether new digital imaging systems alter diagnosis, treatment and prognosis compared with conventional methods. Most studies so far have evaluated their diagnostic performance only in laboratory settings. This review concentrates on what evidence we have for the diagnostic efficacy of digital systems for caries detection. Digital systems are compared with film and those studies which have evaluated the effects on diagnostic accuracy of contrast and edge enhancement, image size, variations in radiation dose and image compression are reviewed together with the use of automated image analysis for caries diagnosis. Digital intra-oral radiographic systems seem to be as accurate as the currently available dental films for the detection of caries. Sensitivities are relatively high (0.6-0.8) for detection of occlusal lesions into dentine with false positive fractions of 5-10%. A radiolucency in dentine is recognised as a good predictor for demineralisation. Radiography is of no value for the detection of initial (enamel) occlusal lesions. For detection of approximal dentinal lesions, sensitivities, specificities as well as the predictive values are fair, but are very poor for lesions known to be confined to enamel. Very little documented information exists, however, on the utilization of digital systems in the clinic. It is not known whether dose is actually reduced with the storage phosphor system, or whether collimator size is adjusted to fit sensor size in the CCD-based systems. There is no evidence that the number of retakes have been reduced. It is not known how many images are needed with the various CCD systems when compared with a conventional bitewing, nor how stable these systems are in the daily clinical use or whether proper cross-infection control can be maintained in relation to scanning the storage phosphor plates and the sensors and the cable. There is only sparse evidence that the enhancement facilities are used when interpreting images, and none that this has changed working practices or treatment decisions. The economic consequences for the patient, dentist and society require examination.
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            Direct digital radiography in the dental office.

            With rapidly developing technology, conventional dental radiography is being overtaken by a revolution in digital radiography. In recent years the emphasis has been on indirect digital radiography involving the conversion of conventional film radiographs into digital images. This stage has been useful in helping the research and development of direct digital radiography which is now coming to the fore. Using this technique, direct images are acquired in the dental practice. These images can be manipulated, enhanced, stored and exchanged for referral and other purposes, making them of great potential use. In addition to the direct clinical and diagnostic benefits, the techniques also have distinct environmental advantages including less use of resources and reduced radiation dosages.
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              Work flow with digital intraoral radiography: a systematic review.

              This systematic review evaluates the six most frequently emphasized advantages of working with digital radiography: less working time, lower radiation dose to the patient, fewer retakes and errors, wider dynamic range, easier access to patient information and easier image storage and communication. Moreover, some clinical aspects and possible disadvantages of digital imaging that were not foreseen at the beginning of the digital era, such as patient discomfort, damage to the receptor, degradation of the image, cross-contamination and viewing conditions, were assessed. The literature search used the PubMed database with no limits and was performed during June to August 2009. Search strategies are described in the text for each of the mentioned tasks. A hand search of task-specific journals supplemented the search strategies. Time seems to be saved when switching from film to digital imaging in dental practice, a dose reduction may not be obtained, retakes and errors may be increased, the dynamic range may be wider with photostimulable storage phosphor (PSP) plates but not with sensors, the effect on patient information has not been well studied and storage and communication create new challenges with regard to handling large files and image compression. In addition, patient discomfort seems to be pronounced with sensors compared with PSP plates and film, the PSP plate may be scratched in clinical use and a two-layer barrier seems to be needed to prevent contamination of the receptor. The type of monitor may not be of major concern if the image is viewed in a room with subdued light. Not all of the predicted advantages with digital compared to film-based radiography hold true in daily clinical work. Of particular interest is the relationship between number of images, retakes and the dose given to the patient.
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                Author and article information

                Journal
                Imaging Sci Dent
                Imaging Sci Dent
                ISD
                Imaging Science in Dentistry
                Korean Academy of Oral and Maxillofacial Radiology
                2233-7822
                2233-7830
                December 2016
                20 December 2016
                : 46
                : 4
                : 239-244
                Affiliations
                [1 ]Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil.
                Author notes
                Correspondence to: Dr. Karla Rovaris. Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, 13414-903, Piracicaba, Sao Paulo, Brazil. Tel) 55-19-2106-5327, Fax) 55-19-3421-0144, karlarovaris@ 123456gmail.com
                Article
                10.5624/isd.2016.46.4.239
                5192021
                5e1ce0dd-f520-4561-8700-ed07e98a1de3
                Copyright © 2016 by Korean Academy of Oral and Maxillofacial Radiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 March 2016
                : 12 June 2016
                : 29 June 2016
                Categories
                Original Article

                Dentistry
                radiography, digital, dental,knowledge,dentists,general practice, dental
                Dentistry
                radiography, digital, dental, knowledge, dentists, general practice, dental

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