Thai tsunami victim identification overview to date.
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The boxing day tsunami of 26 December 2004 caused devastation and loss of life around the Indian ocean. International disaster victim identification efforts were centred in Thailand, with many odontologists from over 20 countries contributing to the examination of deceased, collection of antemortem information, comparison and reconciliation of data. The contribution of forensic odontology to the identification process conducted in Thailand in response to the tsunami devastation is presented in a composite of short reports focused on the five phases associated with disaster victim identification. To date 1,474 deceased have been identified. Dental comparison has been the primary identifier in 79% of cases and a contributor in another 8%, a total of 87%. (+info)
Accuracy and consistency of radiographic interpretation among clinical instructors using two viewing systems.
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Accurate and consistent radiographic interpretation among clinical instructors is needed for assessment of teaching, student performance, and patient care. The purpose of this investigation was to determine if the method of radiographic viewing affects accuracy and consistency of instructors' determinations of bone loss. Forty-one clinicians who provide instruction in a dental school clinical teaching program (including periodontists, general dentists, periodontal graduate students, and dental hygienists) quantified bone loss for up to twenty-five teeth into four descriptive categories using a view box for plain film viewing or a projection system for digitized image viewing. Ratings were compared to the correct category as determined by direct measurement using the Schei ruler. Agreement with the correct choice for the view box and projection system was 70.2 percent and 64.5 percent, respectively. The mean difference was better for a projection system due to small rater error by graduate students. Projection system ratings were slightly less consistent than view box ratings. Dental hygiene faculty ratings were the most consistent but least accurate. Although the projection system resulted in slightly reduced accuracy and consistency among instructors, training sessions utilizing a single method for projecting digitized radiographic images have their advantages and may positively influence dental education and patient care by enhancing accuracy and consistency of radiographic interpretation among instructors. (+info)
Longitudinal trends in the use of individualized radiographic examinations at dental schools in the United States and Canada.
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In the spring of 2002, a mail survey was conducted to determine the use of individualized radiographic examinations (selective radiography) for comprehensive care patients at all sixty-four U.S. and Canadian dental schools. Results from previous surveys were used to evaluate the long-term longitudinal trends. Among sixty-two schools (97 percent response rate), selective radiography was used by 34 percent of schools for dentulous adult patients, by 100 percent for edentulous adults, and by 28 percent for children. Having a credentialed chief of service increased the likelihood that selective radiography would be used for dentulous adults (odd ratio[OR]=2.36) and for children (OR=2.33). Selective radiography for dentulous adults increased from 2 percent of schools in 1977 to 36 percent in 1997 and leveled off thereafter. Between 1987 and 2002, selective radiography for edentulous adults was used at nearly all schools (96-100 percent) and for children at about a quarter of dental schools (22-28 percent). Among the sixty-one schools for which there are complete data since 1987, the continuous use of routine radiography was most common (39 percent of schools) for dentulous adult patients, whereas the continuous use of selective radiography was uncommon (7 percent). (+info)
Clinical applications of cone-beam computed tomography in dental practice.
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Cone-beam computed tomography (CBCT) systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimetre resolution in images of high diagnostic quality, with short scanning times (10-70 seconds) and radiation dosages reportedly up to 15 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a 3-dimensional representation of the maxillofacial skeleton with minimal distortion. This article provides an overview of currently available maxillofacial CBCT systems and reviews the specific application of various CBCT display modes to clinical dental practice. (+info)
Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT.
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The authors evaluated the imaging performance of cone-beam computed tomography (CBCT) for dental use using 3DX multi-image micro-CT (Morita Co., Kyoto, Japan) and four-row multi-detector helical computed tomography (MDCT) using an Asteion (Toshiba, Tokyo, Japan). A dried right maxillary bone was cut into eight slices 2 mm thick toward the zygomatico-palate and used as a phantom. Images of the phantom were then taken using 3DX and MDCT. The images of two bone slices were evaluated by five dentists for image quality and reproducibility of cancellous bone, as well as enamel, dentin, pulp cavity, periodontal ligament space, lamina dura and the overall image. Using the MDCT images as the standard, the 3DX images were evaluated with a subjective 5-level scale: 3 for an image equal to the MDCT image, 4 or greater for better, and 2 or lower for worse. The scores for all parameters exceeded 4 points. Maximum mean score was 4.8 for the lamina dura. Statistically significant differences were found for all items (P < 0.01). Our subjective evaluation of imaging performance clarified that 3DX was superior to MDCT. The results of this study suggest that 3DX is useful for imaging in the dental field. (+info)
Accuracy and consistency of radiographic interpretation among clinical instructors in conjunction with a training program.
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There are inaccuracies and inconsistencies of radiographic interpretation among clinical instructors. The purpose of this investigation was to determine if a training program could improve the accuracy and consistency of instructors' ratings of bone loss. A total of thirty-five clinical instructors consisting of periodontal faculty (periodontists and general dentists), dental hygiene faculty, and periodontal graduate students viewed projected digitized radiographic images and quantified bone loss for twenty-five teeth into four descriptive categories. Ratings of bone loss were made immediately before (pretest) and after (post-test 1) initiation of the training program and then again three months later (post-test 2). Ratings were compared to the correct choice categories as determined by direct measurement using the Schei ruler. Overall agreement with the correct choice improved over time (from 64.5 percent to 85.2 percent) with the greatest change from pretest (64.5 percent) to post-test 1 (76.5 percent). Mean and absolute differences improved in three of the four categories, but worsened in one from pretest to post-test 1. This category returned to its original high value at post-test 2. The greatest improvement in consistency among instructors' ratings was seen in one of the four categories, which was "none" (no bone loss). Extension of the training program may further enhance the accuracy and consistency of instructors' radiographic interpretation. (+info)
Identification of unknown body using DNA analysis and dental characteristics in chest X-ray photograph.
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An unknown skeletonized body was identified by DNA analysis and dental information. The body had already been cremated when a candidate for the unknown body was proposed. Therefore, for DNA analysis we used teeth that had been kept for a long time after use for serological examination. We also used a chest X-ray photograph of the candidate and photographs of dentition, as well as dental X-ray photographs taken when the unknown body was found. Because DNA obtained from teeth was highly degraded, we amplified three PCR fragments to determine the 766 bp mitochondrial DNA (mtDNA) sequence including HV1 and HV2. Polymorphism of the ABO locus was also analyzed using small PCR fragments. Although the isolated DNA was contaminated, probably with DNA from a different individual, DNA polymorphisms of mtDNA and the ABO locus could be analyzed. We discuss the reliability of our conclusions from the point of view of the necessity of constructing an accurate mtDNA database. Although a dentist who had treated the teeth of the unknown body could not be found, a chest X-ray photograph for medical diagnosis was very useful in comparing dental characteristics, as it included an image of the frontal part of the lower jaw and upper teeth. (+info)
Practice characteristics associated with patient-specific receipt of dental diagnostic radiographs.
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OBJECTIVE: To quantify the role of practice characteristics in patient-specific receipt of dental diagnostic radiographic services. DATA SOURCE/STUDY SETTING: Florida Dental Care Study (FDCS). Study Design. The FDCS was a 48-month prospective observational cohort study of community-dwelling adults. Participants' dentists were asked to complete a questionnaire about their practice characteristics. DATA COLLECTION/EXTRACTION METHODS: In-person interviews and clinical examinations were conducted at baseline, 24, and 48 months, with 6-monthly telephone interviews in between. A single multivariate (four radiographic service outcomes) multivariable (multiple explanatory covariates) logistic regression was used to model service receipts. PRINCIPAL FINDINGS: These practice characteristics were significantly associated with patient-specific receipt of radiographic services: number of different practices attended during follow-up; dentist's rating of how busy the practice was; typical waiting time for a new patient examination; practice size; percentage of patients that the dentist reported as interested in details about the condition of their mouths; percentage of African American patients in the practice; percentage of patients in the practice who do not have dental insurance; and dentist's agreement with a statement regarding whether patients should be dismissed from the practice. Effects had differential magnitudes and directions of effect, depending upon radiograph type. CONCLUSIONS: Practice characteristics were significantly associated with patient-specific receipt of services. These effects were independent of patient-specific disease level and patient-specific sociodemographic characteristics, suggesting that practitioners do influence receipt of these diagnostic services. These findings are consistent with the conclusion that practitioners act in response to a mix of patients' interests, economic self-interests, and their own treatment preferences. (+info)