Overcoming barriers to image quality
Featured Products Promotional FeaturesPosted by: Dental Design 16th October 2021
Regardless of the complexity of the treatment that a patient requires, good quality diagnostic images are essential.
However, image acquisition isn’t always straightforward. There are a number of variables that can directly impact the quality of diagnostic images, so professionals need to be aware of these and know how to overcome them in order to avoid the need for retakes as often as possible.
The problem with retakes
In a study that examined frequency of retakes during the CBCT image acquisition process, results found that the retake rate was 4.6%.[i] While this may not sound like a huge ratio, retakes are inevitably still better avoided for a number of reasons.
Arguably the most frustrating part of needing to retake a diagnostic image is that it wastes time for patients and professionals alike. Though image acquisition is swift, needing to retake images does extend appointment times, leaving you less time to interact with the patient and discuss other aspects of treatment. Beyond this, patients may also start to lose confidence in your skills as a professional if too many retakes are needed.
We also need to consider the radiation exposure that comes into play when there are too many retakes. While dosage is minimal in most modern machines, radiation is cumulative, meaning the fewer attempts at image acquisition the better.
But what are some of the main problems that can impact image quality?
Incorrect file-of-view (FOV)
Interestingly, one of the more recurrent problems during image acquisition is incomplete FOV coverage. Data suggests that the majority of retakes are necessary because of this problem (57.5%)[ii] meaning that it is a core concern that clinicians need to focus on when taking diagnostic images.
This usually occurs when clinicians select the incorrect FOV for the area they want to diagnose, resulting in images that only capture partial information. An easy way to bypass this problem is to invest in a system that has multiple FOVs available, so that you can assess which dimensions suit your needs best and select this for the initial scan.
Patient positioning
Perhaps one of the most common problems that leads to retakes is issues with patient positioning and movement. In fact, in the aforementioned study looking at CBCT retakes in dentistry, it was found that 27.5% of retakes were necessary due to motion artifacts.[iii]
These image defects tend to occur due to a patient making a sudden movement or not being properly positioned to begin with. They may also occur if a patient is nervous and cannot stop moving out of fear.
The best way to combat these types of defects is to take the time to position patients carefully and explain to them why absolute stillness is necessary. Some modern systems have inbuilt software that aids patient positioning, and this can significantly improve the quality of outcomes.
For nervous patients, it’s a smart idea to have a talk with them first and try to allay their fears as much as possible so that they know what the process involves and can take the time they need to calm themselves down before image acquisition. You may also consider investing in a system that has face-to-face position or that can be adjusted to accommodate seated patients to help people feel less enclosed, more comfortable and at ease.
Metal artifacts
According to recent statistics, 84% of dentate adults in the UK have at least one filling.[iv] Unfortunately there are no set statistics on how many of these are amalgam, precious metals, composite and other filling materials, but it can safely be assumed that a large percentage of the population have metal fillings and crowns in their mouths. This is especially true when you consider that they remain the most accessible option for many.
As such, it’s easy to see why metal artifacts on images is such a common problem. Metal restorations reflect and distort the beams used during CBCT scanning, and this often shows up on final images as bright patches of light or heavily blurred areas that make the images unusable.
One smart way to bypass this problem is to look at systems that have metal artifact reducing software built in, such as the CS 8200 3D CBCT unit from Carestream Dental. A cutting-edge CBCT system that offers low dose imaging, multiple selectable FOVs, laser-free patient positioning and more, the unit also includes Carestream Dental’s unique CS Mar software. This drastically reduces metal artifacts, reducing the risk of misinterpretation and the need for retakes.
Invest in imaging systems that support you
As diagnostic images are such a crucial part of treatment, it pays to invest in systems that help you to navigate and avoid the common pitfalls that impact image quality. By doing so, you not only ensure you have the technology you need to capture incredibly accurate and artifact-free images, but can also treat patients to streamlined, comfortable treatment with a significantly reduced risk of needing image retakes.
Nimisha Nariapara
Bio
Nimisha is the Trade Marketing Manager at Carestream Dental covering the UK, Middle East, Nordics, South Africa, Russia and CIS regions. She has worked at Carestream Dental for the past 7 years, where she has developed her marketing skills and industry knowledge to bring the core values and philosophy of the company to the market. 
For more information, contact Carestream Dental on 0800 169 9692 or
visit www.carestreamdental.co.uk
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[i] Hung,K. et al. Image Retake Rates On Cone Beam Computed Tomography In A Dental Institution. Clinical Oral Investigations volume 24, pages4501–4510 (2020).
[ii] Hung,K. et al. Image Retake Rates On Cone Beam Computed Tomography In A Dental Institution. Clinical Oral Investigations volume 24, pages4501–4510 (2020).
[iii] Hung,K. et al. Image Retake Rates On Cone Beam Computed Tomography In A Dental Institution. Clinical Oral Investigations volume 24, pages4501–4510 (2020).
[iv] Dantaly.org. Interesting Facts About Teeth and UK Dental Statistics. Link: https://www.dentaly.org/en/dental-facts-statistics/ [Last accessed July 21]
