Purpose: This study was conducted to compare the objective image quality of radiographs acquired with a handheld X-ray device to those obtained with a wall-mounted X-ray device. Materials and Methods: Brightness, noise, uniformity, and contrast were evaluated. To assess the first 3 parameters,radiographs of an acrylic block were acquired with an unused photostimulable phosphor (PSP) plate from the VistaScan system (Mini Easy, Dürr Dental, Bietigheim-Bissingen, Germany). Initially, 6 radiographs were taken with a Focus X-ray wall-mounted device (Instrumentarium, Tuusula, Finland) operating at 60 kVp, 7 mA, and 0.125 s.Another 6 radiographs were captured using an Eagle handheld X-ray device (Alliage, São Paulo, Brazil) at 60 kVp, 2.5 mA, and 0.35 s. The means and standard deviations of the gray values for all radiographs were calculated using ImageJ (National Institutes of Health, Bethesda, MD, USA). For contrast assessment, radiographs of an aluminum step wedge were obtained using the same PSP plate, X-ray devices, and acquisition parameters. The percentage of contrast variation was determined. The impacts of the devices on image quality were compared using the Student t-test, with a significance level of 5% (P<0.05). Results: Compared with the wall-mounted device, the handheld device produced radiographs with higher brightness and noise, as indicated by mean values of 6.57 (0.49) and 3.49 (0.02), respectively. Furthermore, it demonstrated lower uniformity and contrast, with respective means of 3.75 (0.02) and 35.48 (0.09) (P<0.05). Conclusion Radiographs obtained using a handheld X-ray device exhibit lower theoretical image quality than those acquired with a wall-mounted device.

Purpose: This study was conducted to compare the objective image quality of radiographs acquired with a handheld X-ray device to those obtained with a wall-mounted X-ray device. Materials and Methods: Brightness, noise, uniformity, and contrast were evaluated. To assess the first 3 parameters,radiographs of an acrylic block were acquired with an unused photostimulable phosphor (PSP) plate from the VistaScan system (Mini Easy, Dürr Dental, Bietigheim-Bissingen, Germany). Initially, 6 radiographs were taken with a Focus X-ray wall-mounted device (Instrumentarium, Tuusula, Finland) operating at 60 kVp, 7 mA, and 0.125 s.Another 6 radiographs were captured using an Eagle handheld X-ray device (Alliage, São Paulo, Brazil) at 60 kVp, 2.5 mA, and 0.35 s. The means and standard deviations of the gray values for all radiographs were calculated using ImageJ (National Institutes of Health, Bethesda, MD, USA). For contrast assessment, radiographs of an aluminum step wedge were obtained using the same PSP plate, X-ray devices, and acquisition parameters. The percentage of contrast variation was determined. The impacts of the devices on image quality were compared using the Student t-test, with a significance level of 5% (P<0.05). Results: Compared with the wall-mounted device, the handheld device produced radiographs with higher brightness and noise, as indicated by mean values of 6.57 (0.49) and 3.49 (0.02), respectively. Furthermore, it demonstrated lower uniformity and contrast, with respective means of 3.75 (0.02) and 35.48 (0.09) (P<0.05). Conclusion Radiographs obtained using a handheld X-ray device exhibit lower theoretical image quality than those acquired with a wall-mounted device.

Purpose: This study was conducted to compare the objective image quality of radiographs acquired with a handheld X-ray device to those obtained with a wall-mounted X-ray device. Materials and Methods: Brightness, noise, uniformity, and contrast were evaluated. To assess the first 3 parameters,radiographs of an acrylic block were acquired with an unused photostimulable phosphor (PSP) plate from the VistaScan system (Mini Easy, Dürr Dental, Bietigheim-Bissingen, Germany). Initially, 6 radiographs were taken with a Focus X-ray wall-mounted device (Instrumentarium, Tuusula, Finland) operating at 60 kVp, 7 mA, and 0.125 s.Another 6 radiographs were captured using an Eagle handheld X-ray device (Alliage, São Paulo, Brazil) at 60 kVp, 2.5 mA, and 0.35 s. The means and standard deviations of the gray values for all radiographs were calculated using ImageJ (National Institutes of Health, Bethesda, MD, USA). For contrast assessment, radiographs of an aluminum step wedge were obtained using the same PSP plate, X-ray devices, and acquisition parameters. The percentage of contrast variation was determined. The impacts of the devices on image quality were compared using the Student t-test, with a significance level of 5% (P<0.05). Results: Compared with the wall-mounted device, the handheld device produced radiographs with higher brightness and noise, as indicated by mean values of 6.57 (0.49) and 3.49 (0.02), respectively. Furthermore, it demonstrated lower uniformity and contrast, with respective means of 3.75 (0.02) and 35.48 (0.09) (P<0.05). Conclusion Radiographs obtained using a handheld X-ray device exhibit lower theoretical image quality than those acquired with a wall-mounted device.

Purpose: This study aimed to compare the diagnostic performance of cone-beam computed tomography (CBCT) and digital periapical radiography in detecting separated endodontic instruments (SI) according to their type and length infilled root canals of mandibular molars. Materials and Methods: Forty-two extracted mandibular molars were divided into 2 groups: control (without SI) and experimental (with SI). In the experimental group, SI fragments (2 or 3 mm) from 3 endodontic instruments (WaveOne Gold, Reciproc Blue, and ProTaper Next) were inserted into the mesiobuccal canals of 30 teeth. CBCT scans were obtained using the KAVO OP 3D PRO device, and digital periapical radiographs (orthoradial, distal, and mesial) were acquired using the Focus X-ray unit with the RVG 5200 solid sensor. Three experts independently evaluated all images for SI detection using a 5-point scale. Diagnostic performance metrics were calculated for each imaging method, andcomparisons were performed using 1-way analysis of variance with Tukey post-hoc tests. The significance level wasset at 5% (P = 0.05). Results: Digital periapical radiography demonstrated higher area under the receiver operating characteristic curve (Az), sensitivity, and specificity values than CBCT. ProTaper Next SI on CBCT scans showed the lowest Az values (0.58and 0.56 for 2- and 3-mm fragments, respectively). These values were significantly different from those of the other SIconditions (both CBCT and digital periapical radiography) (P<0.05). Conclusion Digital periapical radiography outperformed CBCT in detecting SI in filled root canals of mandibularmolars and should be the preferred modality. Furthermore, SI detectability varies with imaging modality, depending on instrument type and fragment length.

Purpose: This study was performed to evaluate the expression of beam hardening artifacts generated by high atomic number materials in stitched cone-beam computed tomography (CBCT) images, compared to the traditional acquisition mode. Materials and Methods: CBCT volumes were acquired using an acrylic resin phantom embedded with pairs of cylinders made from amalgam dental alloy, cobalt-chromium alloy, gutta-percha, titanium, and zirconium.These cylinders were placed within the overlapping zones of the stitching reconstruction area. For each material, 3 acquisitions were conducted: 1 utilizing the automatic stitching process with a FOV of 80 × 37 mm, and 2 with smaller FOVs of 50 × 37 mm. For the smaller FOVs, 1 scan targeted the anterior region, while the other focused on the left posterior region. Thus, 3 groups were formed: stitched FOV, anterior FOV, and posterior FOV. Artifact expression was assessed by calculating the means and standard deviations (SDs) of the gray values in 4 regions of interest located anteriorly, posteriorly, medially, and laterally to the cylinders. Analysis of variance was used to compare the data, with an alpha level of 5%. Results: The stitched FOV exhibited lower SD values than the posterior and anterior FOVs (P<0.05). Regarding the materials evaluated, amalgam, cobalt-chromium, and zirconium generally demonstrated higher SDs of the gray values than gutta-percha and titanium (P<0.05). Conclusion Horizontally stitched CBCT images demonstrated lower artifact expression compared to the traditional mode of acquisition.

Purpose: This study was performed to evaluate the expression of beam hardening artifacts generated by high atomic number materials in stitched cone-beam computed tomography (CBCT) images, compared to the traditional acquisition mode. Materials and Methods: CBCT volumes were acquired using an acrylic resin phantom embedded with pairs of cylinders made from amalgam dental alloy, cobalt-chromium alloy, gutta-percha, titanium, and zirconium.These cylinders were placed within the overlapping zones of the stitching reconstruction area. For each material, 3 acquisitions were conducted: 1 utilizing the automatic stitching process with a FOV of 80 × 37 mm, and 2 with smaller FOVs of 50 × 37 mm. For the smaller FOVs, 1 scan targeted the anterior region, while the other focused on the left posterior region. Thus, 3 groups were formed: stitched FOV, anterior FOV, and posterior FOV. Artifact expression was assessed by calculating the means and standard deviations (SDs) of the gray values in 4 regions of interest located anteriorly, posteriorly, medially, and laterally to the cylinders. Analysis of variance was used to compare the data, with an alpha level of 5%. Results: The stitched FOV exhibited lower SD values than the posterior and anterior FOVs (P<0.05). Regarding the materials evaluated, amalgam, cobalt-chromium, and zirconium generally demonstrated higher SDs of the gray values than gutta-percha and titanium (P<0.05). Conclusion Horizontally stitched CBCT images demonstrated lower artifact expression compared to the traditional mode of acquisition.

Purpose: This study was performed to evaluate the expression of beam hardening artifacts generated by high atomic number materials in stitched cone-beam computed tomography (CBCT) images, compared to the traditional acquisition mode. Materials and Methods: CBCT volumes were acquired using an acrylic resin phantom embedded with pairs of cylinders made from amalgam dental alloy, cobalt-chromium alloy, gutta-percha, titanium, and zirconium.These cylinders were placed within the overlapping zones of the stitching reconstruction area. For each material, 3 acquisitions were conducted: 1 utilizing the automatic stitching process with a FOV of 80 × 37 mm, and 2 with smaller FOVs of 50 × 37 mm. For the smaller FOVs, 1 scan targeted the anterior region, while the other focused on the left posterior region. Thus, 3 groups were formed: stitched FOV, anterior FOV, and posterior FOV. Artifact expression was assessed by calculating the means and standard deviations (SDs) of the gray values in 4 regions of interest located anteriorly, posteriorly, medially, and laterally to the cylinders. Analysis of variance was used to compare the data, with an alpha level of 5%. Results: The stitched FOV exhibited lower SD values than the posterior and anterior FOVs (P<0.05). Regarding the materials evaluated, amalgam, cobalt-chromium, and zirconium generally demonstrated higher SDs of the gray values than gutta-percha and titanium (P<0.05). Conclusion Horizontally stitched CBCT images demonstrated lower artifact expression compared to the traditional mode of acquisition.