Reject Analysis of Intra-Oral Periapical (IOPA) Radiographs of Department of Radiology, Dental Teaching Hospital, Peradeniya, Sri Lanka

Abstract

Intra-oral Periapical (IOPA) X-rays are the most common dental radiographs taken at the Department of Dental Radiology and which require considerable intervention of radiographer compared with the other modes of radiation diagnosis. It is shown that there are frequent repetitions of X-ray films that are reported in IOPA imaging due to the unacceptable image quality thereby subjecting the patients to excess radiation exposure and extra cost. This creates a situation which necessitates the need to explore causes of rejection and repetition of dental x-ray investigations. The objectives of this study were to identify the most susceptible region that is likely to be repeated in IOPA imaging and to find out the most common error associated on image repetition. Two hundred and fifty eight (258) rejected IOPA films taken by the radiographers, student radiographers and dental students during the period of February to December, 2014 were collected and analysed by a dental surgeon and three (03) qualified radiographers with a help of an illuminator which can provide standard viewing conditions. The observations on associated errors and the rejected region were recorded in a spreadsheet. The data was analysed by SPSS 17 software. The Results identified that the highest percentage of rejected region was molar (48%), followed by premolar (27.9%) and anterior teeth (24.1%). According to the study, film and/or radiation beam positioning was the major error highlighted and it was associated with the molar region in IOPA radiography. These results imply that the half of the rejected images of molar region is mainly due to the difficulties in positioning of radiographs in that particular region of oral cavity. It is also noted that the elongation was the mostly affected error to reject anterior teeth and there was a significant association between the elongation and anterior teeth region. Based on this study, it is strongly suggested to modify and improve the imaging techniques involved in IOPA molar imaging. Further, it is also essential to remedy the error of elongation by applying correct positioning of film and the tube at the region of anterior teeth. These suggestions would contribute to minimize the frequent repetitions of IOPA Radiographs.