BACKGROUND: Diagnosis in dentistry begins with the correct reading and interpreting of the dental radiograph.
OBJECTIVE: The aim of the present study was to examine the effects of the imaging technique used, the dentistry specialty and the years of experience on the gray-level perception among dentists.
METHODS: A custom web application was developed. Dentomaxillofacial radiologists (DentRads), endodontists (Ends) and general dental practitioners (GDPs) were invited via e-mail to participate in the study. A total of 46 participants met the requirements of the test. The test comprised 2 webpages. On the 1st page, the participants were asked for information such as gender, specialty, the years of experience, and the imaging techniques they used. Then, on the 2nd page, they were welcomed with instructions and directions, and asked to rearrange 85 gray color tones represented by square bars of equal dimensions. These mixed gray bars were placed in 4 rows according to the principles of the FarnsworthMunsell 100-hue test (FM). Each clinician\'s test results were recorded in a database. The individual\'s level of recognition of gray tones was evaluated through the total error score (TES), which was calculated using a web-based independent scoring software program. Lower TES values were a desirable result, indicating fewer misplacement, while higher scores indicated more misplacements of gray tones. The testing time (TT) was recorded automatically.
RESULTS: The years of the participants\' experience as dentists or specialists did not affect TES or TT. The dentists who used the charge-coupled device-complementary metal oxide semiconductor (CCD-CMOS) had lower TES values than those who used analog radiographs (p < 0.05).
CONCLUSIONS: While the specialty and the years of experience did not affect the clinicians\' ability to recognize gray tones, the digital imaging techniques (photostimulable phosphor (PSP) and CCD/CMOS) could improve the clinicians\' gray-level perception.

BACKGROUND: Acquiring adequate theoretical knowledge in the field of dental radiography (DR) is essential for establishing a good foundation at the prepractical stage. Currently, nonface-to-face DR education predominantly relies on two-dimensional (2D) videos, highlighting the need for developing educational resources that address the inherent limitations of this method. We developed a virtual reality (VR) learning medium using 360° video with a prefabricated head-mounted display (pHMD) for nonface-to-face DR learning and compared it with a 2D video medium.
METHODS: Forty-four participants were randomly assigned to a control group (n = 23; 2D video) and an experimental group (n = 21; 360° VR). DR was re-enacted by the operator and recorded using 360° video. A survey was performed to assess learning satisfaction and self-efficacy. The nonparametric statistical tests comparing the groups were conducted using SPSS statistical analysis software.
RESULTS: Learners in the experimental group could experience VR for DR by attaching their smartphones to the pHMD. The 360° VR video with pHMD provided a step-by-step guide for DR learning from the point of view of an operator as VR. Learning satisfaction and self-efficacy were statistically significantly higher in the experimental group than the control group (p < 0.001).
CONCLUSIONS: The 360° VR videos were associated with greater learning satisfaction and self-efficacy than conventional 2D videos. However, these findings do not necessarily substantiate the educational effects of this medium, but instead suggest that it may be considered a suitable alternative for DR education in a nonface-to-face environment. However, further examination of the extent of DR knowledge gained in a nonface-to-face setting is warranted. Future research should aim to develop simulation tools based on 3D objects and also explore additional uses of 360° VR videos as prepractical learning mediums.

OBJECTIVE: To utilize standardized clinical veterinary methods to analyze dental health in a series of Roman dog maxillae and mandibles and to compare results to modern clinical data.
METHODS: 28 skulls of juvenile and adult dogs from three archaeological sites in Switzerland and Germany dating to the Roman period.
METHODS: Standardized examination was carried out, which included metric radiographic assessment to diagnose oral pathology and estimate age at death. In one case, CT analysis was undertaken.
RESULTS: The estimated average age at death was between three and four years old. Tooth fracture, periodontal disease, the presence of non-vital teeth, and brachycephalic skull form were found in the sample. Tooth resorption was unexpectedly noted.
CONCLUSIONS: The study provides valuable insights into the dental health of dogs in the Roman era. Compared to modern dogs, Roman dogs examined in this study appear to have a shorter lifespan but display a high rate of pathological dental disease, while disease patterns were very similar to those of modern dogs. Dogs with pronounced brachycephalic features were found.
CONCLUSIONS: This pilot study is the first to use standardized clinical examination and recording techniques to assess dental health in dogs from archaeological contexts. It provides insight into the dental health of Roman era dogs and offers data upon which cross-populational studies can be initiated.
CONCLUSIONS: The sample size and geographic location of the archaeological sites were limited.
UNASSIGNED: Subsequent standardized studies, preferably in as many different Roman Empire regions as possible, are recommended.

Artificial intelligence (AI) has taken hold in public health because more and more people are looking to make a diagnosis using technology that allows them to work faster and more accurately, reducing costs and the number of medical errors.
In the present study, 120 panoramic X-rays (OPGs) were randomly selected from the Department of Oral and Maxillofacial Sciences of Sapienza University of Rome, Italy. The OPGs were acquired and analyzed using Apox, which takes a panoramic X-rayand automatically returns the dental formula, the presence of dental implants, prosthetic crowns, fillings and root remnants. A descriptive analysis was performed presenting the categorical variables as absolute and relative frequencies.
In total, the number of true positive (TP) values was 2.195 (19.06%); true negative (TN), 8.908 (77.34%); false positive (FP), 132 (1.15%); and false negative (FN), 283 (2.46%). The overall sensitivity was 0.89, while the overall specificity was 0.98.
The present study shows the latest achievements in dentistry, analyzing the application and credibility of a new diagnostic method to improve the work of dentists and the patients\' care.

BACKGROUND: In dentistry, the reporting of panoramic radiographs is particularly challenging, as many structures are depicted in one image and pathologies need to be identified completely. To enhance the learning process for these interpretations, the advantages of the increasingly popular education method of mobile learning could be used. Therefore, this study aimed to determine the effectiveness of learning to report panoramic radiographs using an application (app) on a mobile device.
METHODS: The existing e-learning programme \'PantoDict\' was further developed into a mobile app with a new training section. Participants of a dental radiology course were divided into two groups, one of which additionally had the chance to practise reporting panoramic radiographs using the app. A test to assess the knowledge gained was conducted at the end of the semester; the course and the app were also evaluated.
RESULTS: The group that used the app showed significantly better results in the test than the control group (p < 0.05). Although the app group approved a high satisfaction using the app as an additional supplement to the course, this did not result in a higher overall satisfaction with the course. Further, these students observed that the traditional face-to-face seminar could not be replaced by the app.
CONCLUSIONS: By using the PantoDict app, students were offered better training options for writing reports on panoramic radiographs, which resulted in significantly better test results than the results of the control group. Therefore, the mobile app is a useful supplement to classical education formats within the context of a blended learning approach.

Purpose: Dental hygienists have the potential for filling critical roles in multidisciplinary victim identification teams. The purpose of this pilot study was to evaluate the accuracy of dental hygiene students utilizing dental charting, bitewings, and skull dentitions for the purpose of making identification matches.Methods: Thirty senior dental hygiene students (n=30) independently viewed an asynchronous online multimedia-based presentation on the procedures used for collecting and recording forensic dental evidence. Following the presentation participants attempted to chart and match three bitewing radiograph sets to three human skull dentitions by correlating matches/exclusions. Immediately following the activity, each student completed a questionnaire rating the difficulty of the exercise, as well as their confidence, and willingness to volunteer as a forensics team member. Descriptive statistics were used to analyze the data.Results: Of the total sample 36.7% (n=11) reported having prior experiences with dental radiography; while the majority (63.33%, n=19) reported no prior experience. Participants\' accuracy scores for dental charting ranged from 91.23% (SD=9.42) to 99.06% (SD=3.60), with no statistically significant difference based on prior experience (p>0.05). The average interrater reliability was 86% (p<0.0001), indicating a high level of agreement with charting skulls and radiographs. No statistically significant differences were found for charting time, perceived difficulty, or level of confidence when comparing experience among the participants (p>0.05).Conclusions: Regardless of previous experience, dental hygiene students were able to match postmortem dentitions and radiographs with good interrater reliability and did not differ statistically for charting time, perceived difficulty, or confidence. Results suggest dental hygienists can work as effective victim identification team members when educational programs are implemented.

BACKGROUND: Workplace-based assessments are methods that can be applied for assessing competence and performance. One of these methods is the mini-clinical evaluation exercise (mini-CEX). This study was conducted to determine the role of mini-CEX in students\' performance assessment on panoramic X-ray reporting at dental radiology course.
METHODS: A workshop as training for the assessors and the participants was conducted before the primary test. All participants (n = 36) were randomly allocated into six groups. Each group had three seminars in which every student reported a panoramic X-ray. Students were directly observed and rated by an assessor on a modified mini-CEX rating form. Then, a self-assessment of the students and a systematic feedback session were performed. Finally, the students and the assessors were evaluated for the acceptability and satisfaction with this tool.
RESULTS: The mean duration of the assessment and the feedback decreased significantly from the first seminar to the third seminar (P < .0001). Comparison of the results of the mini-CEX of all three assessments showed that students displayed a significantly better performance in evaluating the upper jaw and the soft tissue (P < .05). There was no significant improvement for the other aspects of the rating form. Overall, both students and assessors reported a high level of satisfaction in using the mini-CEX rating form.
CONCLUSIONS: Due to the objectivity and transparency of the assessment, the mini-CEX helped to improve the performance on reporting panoramic X-rays. Besides that, the structured feedback had major impact on the improvement. Overall, the assessors and the participants reported a high level of satisfaction using the rating form. Therefore, the mini-CEX may be an effective method for performing workplace-based assessments to evaluate students\' performance on reporting panoramic X-rays.

BACKGROUND: Radiographs form an invaluable adjunct in diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used. However, certain conditions render the placement of film difficult. In such cases, a panoramic radiograph may be taken, but it has the disadvantage of higher radiation exposure and cost. Extraoral periapical (EOPA) technique allows radiographs to be taken on an IOPA film by placing it extraorally. We aimed to evaluate its diagnostic accuracy compared to intraoral bisecting angle technique.
METHODS: Forty-five patients were randomly selected. Ninety radiographs were taken; two for each patient. First image was obtained by intraoral bisecting angle technique and second by EOPA technique. A scale was devised for the comparison of radiographs taken by the two techniques. Two experienced oral radiologists rated them based on the scale followed by statistical analysis.
RESULTS: Patients reported increased compliance with the EOPA technique. 84.40% of the EOPA radiographs (EOPARs) were diagnostically acceptable; sensitivity and specificity was 84% and 55%, respectively.
CONCLUSIONS: EOPAR is beneficial in cases where intraoral film placement is difficult, and a radiograph is necessary for patient management, even though it demonstrates comparatively lesser diagnostic accuracy.

BACKGROUND: The goal of any radiologist is to produce the highest quality diagnostic radiographs, while keeping patient exposure as low as reasonably achievable (ALARA).
OBJECTIVE: The aim of this study was to describe the reasons for radiograph rejections through a repeat film analysis in an Indian dental school.
METHODS: An observational study conducted in the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal.
METHODS: During a 6-month study period, a total of 9,495 intra-oral radiographs and 2339 extraoral radiographs taken in the Radiology Department were subjected to repeat film analysis.
METHODS: SPSS Version 16. Descriptive analysis used.
RESULTS: The results showed that the repeat rates were 7.1% and 5.86% for intraoral and extraoral radiographs, respectively. Among the causes for errors reported, positioning error (38.7%) was the most common, followed by improper angulations (26.1%), and improper film placement (11.2%) for intra-oral radiographs. The study found that the maximum frequency of repeats among extraoral radiographs was for panoramic radiographs (49%) followed by lateral cephalogram (33%), and paranasal sinus view (14%). It was also observed that repeat rate of intraoral radiographs was highest for internees (44.7%), and undergraduate students (28.2%).
CONCLUSIONS: The study pointed to a need for more targeted interventions to achieve the goal of keeping patient exposure ALARA in a dental school setting.

OBJECTIVE: (1) To evaluate the role of ultrasonography with colour Doppler in the diagnosis of fascial space infections, (2) To determine the nature, size and extent of the odontogenic infections which involve the primary and secondary fascial spaces of the maxilla and the mandible (3) To evaluate the sensitivity of ultrasonography in determining whether the inflammatory process is in a stage of cellulitis or abscess and to thus determine the appropriate time for a surgical intervention during the course of the infection and to correlate the clinical and radiographic findings with the ultrasonographic findings and (4) to determine the treatment plan.
METHODS: Thirty four patients with odontogenic infections which involved the superficial and the deep fascial spaces of the head and neck were subjected to ultrasonographic examinations over the suspected area in the transverse and axial directions to determine the stage of the infection, its anatomic location and the treatment plan.
RESULTS: Ultrasonography showed 95.7% sensitivity and 100% specificity as compared to the clinical and radiographic diagnoses and it proved to be an effective investigation modality in the diagnosis of fascial space infections.