Pun M H Jim
Appleseed Family Dental, LLC, 1199 Delaware Ave., Suite 106, Marion, OH, 43302, USA.
Oral Radiol. 2022 Apr;38(2):297-307. doi: 10.1007/s11282-021-00559-x. Epub 2021 Aug 11.
Obtaining an intraoral periapical radiograph of the maxillary anterior teeth can be quite challenging, especially in patients where a rigid digital sensor cannot adequately fit in the palatal vault. This technical report presents a periapical radiographic technique that places the sensor in the space surrounding the hamular notch to avoid the spatial restrictions of the hard palate, opening the possibility of parallel alignment of the sensor and the long axis of the tooth, perpendicular alignment of the tube-head to both, and a minimally distorted resultant radiographic image.
Four adult patients demonstrated the quantitative and qualitative features of this hamular technique (HT). A human skull demonstrated relative magnification and image quality.
While patient and equipment-specific, comparisons of magnification, distortion, and image quality illustrate the potential capabilities and limitations of the HT. The HT radiographs appeared to be less distorted than the variable-angle technique (VAT-a clinical approximation of the bisecting angle technique) but magnified 7.9-21.6%. A radiograph of an implant showed a 2.0% distortion over true aspect ratio. The HT radiograph from a human skull showed a slightly lighter and less sharp image than the VAT radiograph.
Preliminary results showed that while the HT images were magnified, lighter, and less sharp that the VAT, they were diagnosable for caries. In all the HT images presented in this technical report, there was less distortion than comparable techniques. Notably, one HT periapical radiograph of a maxillary lateral implant showed virtually no distortion, suggesting that a nearly parallel projection was achieved using the technique. While further research is needed, this report shows that the HT has the potential to produce minimally distorted digital radiographs of anterior teeth in patients where the sensor cannot adequately fit into the palatal vault.
获取上颌前牙的口内根尖片颇具挑战性，尤其是在刚性数字传感器无法充分适配腭穹窿的患者中。本技术报告介绍了一种根尖片放射成像技术，该技术将传感器置于翼钩切迹周围的空间，以避免硬腭的空间限制，从而使传感器与牙齿长轴平行对齐、管头与两者垂直对齐成为可能，并获得失真最小的放射图像。
四名成年患者展示了这种翼钩技术（HT）的定量和定性特征。一个人类颅骨展示了相对放大率和图像质量。
虽然因患者和设备而异，但放大率、失真度和图像质量的比较说明了HT的潜在能力和局限性。HT根尖片的失真似乎比可变角度技术（VAT——平分角技术的临床近似方法）小，但放大了7.9%至21.6%。一张种植体的根尖片显示，与真实纵横比相比，失真度为2.0%。来自人类颅骨的HT根尖片显示，其图像比VAT根尖片略淡且清晰度稍低。
初步结果表明，虽然HT图像比VAT图像放大、更淡且清晰度更低，但它们可用于龋齿诊断。在本技术报告中展示的所有HT图像中，其失真度均低于可比技术。值得注意的是，一张上颌侧切牙种植体的HT根尖片几乎没有失真，这表明使用该技术实现了近乎平行的投影。虽然还需要进一步研究，但本报告表明，对于传感器无法充分适配腭穹窿的患者，HT有潜力产生失真最小的前牙数字根尖片。
