Digital dental x-ray with periapical film

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    Digital Film X-ray
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Discussion Overview

The discussion centers on the differences between digital dental x-rays and traditional periapical film x-rays, particularly regarding radiation exposure, image clarity, and the sensitivity of sensors used in digital imaging. Participants explore the implications of using traditional film in a digital x-ray system and the complexities involved in digital imaging technology.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • Some participants propose that digital dental x-rays result in less radiation exposure due to the faster acting sensors compared to traditional film.
  • One participant expects that CCD or CMOS sensors used in digital cameras are significantly more sensitive than traditional optical film, suggesting a similar sensitivity in the x-ray range.
  • Concerns are raised about the clarity of digital x-rays of periapical teeth compared to traditional x-rays, with a request for explanations on this issue.
  • A participant challenges the initial question, emphasizing that the x-ray tube is not digital, but rather the image receptor is, and discusses the complexities of patient dose and image quality in digital versus film systems.
  • The discussion includes considerations about how digital images can be post-processed to adjust brightness and contrast, potentially masking issues of under-exposure or over-exposure that would be more apparent in traditional film.
  • Standards and protocols for digital imaging are highlighted as critical factors affecting the quality and safety of x-ray imaging.

Areas of Agreement / Disagreement

Participants express differing views on the effectiveness and clarity of digital x-rays compared to traditional methods, indicating that multiple competing perspectives remain unresolved.

Contextual Notes

The discussion touches on the complexities of digital imaging technology, including issues related to exposure levels, image processing, and the importance of equipment standards, which are not fully resolved.

rodsika
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It is said that digital dental x-ray has less radiation. Is it because the sensor used that acts faster in capturing the image. What if you use a traditional film on a digital dental x-ray. Would the radiation be the same?
 
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I would expect that the sensor is much more sensitive than traditional film. A CCD or CMOS sensor in standard digital cameras is between 5-10 times as sensitive as traditional optical film is, so I would think it would be similar in the x-ray range.
 
But digital xrays of perapical tooth is not as clear as traditional x-ray.. if anyone knows.. pls. tell why
 
rodsika said:
It is said that digital dental x-ray has less radiation. Is it because the sensor used that acts faster in capturing the image. What if you use a traditional film on a digital dental x-ray. Would the radiation be the same?

The question makes no sense to me. The x-ray tube isn't what is digital. The image receptor is digital.

Here are a couple of links that discuss digital imaging and digital vs. film/screen

http://www.aapm.org/meetings/05AM/pdf/18-2623-22086-53.pdf

http://www.aapm.org/pubs/reports/RPT_116Execsummary.pdf

This is a complex topic, so I’ll be rather general. As for patient dose in general, digital has some potential issues. In film and film/screen systems, the x-ray exposure level determines the image brightness and whether you can see what needs to be seen and the tissue contrast is controlled by the kVp of the x-ray. In the digital world, the x-ray exposure level tends to effect quantum mottle (noise). The brightness and contrast of digital images can be post-processed by adjusting a window level and width. In other words, an under-exposed or over-exposed film or film/screen image is of limited clinical use and obvious when it needs to be repeated. A digital image that is under-exposed or over-exposed can simply be windowed and leveled to make it "look" good. The underlying technique used to create the digital image may result in too much exposure, etc. There are a host of issues that are too much to get into. The first paper discusses how things work. The second paper discusses the need for standards and why. Bottom line, IMO, the equipment standards, protocols, acceptance, commissioning, testing, training, etc. are very important. Film, CR, and DR all have issues, mostly with the user.
 

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