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Accurate radiographs with intravenous sedation or general anesthesia
Accurate radiographs with intravenous sedation or general anesthesia James A. Wallace, D.D.S., M.D.&‘.,* CASE WESTERN
RESERVE
UNIVERSlTY
and Bernard D. Cohen, D.D.S.,**
SCHOOL
Cleveland, Ohio
OF DENTISTRY
A
modification of the precision x-ray holders has been produced to enable the endodontist to obtain clinically functional radiographs of the compromised patient who is under intravenous sedation or general anesthesia. This makes adequate endodontic therapy possible for these patients without requiring their cooperation or someone else to hold the film in place. Over the years, many film holders have been devised along with cylindrical beam collimators to reproduce a series of accurate films for diagnostic purposes as well as to reduce the amount of radiation exposure to the patient. The x-ray beam has been collimated to the approximate shape and size of the film being exposed. The decrease in scattered radiation-induced fog obtained by this further collimation results in superior contrast and, therefore, a better image.’ Scatter is further reduced via metal balking plates. In situations in which accuracy and reproducibility are critical (e.g., endodontics,) these devices take on increased importance. One of the problems in the use of these products, however, is the cooperation of the patient. This is not ordinarily a problem during routine procedures, but it is a distinct difficulty when the patient is under heavy sedation. The device shown in Fig. 1 is proposed as a solution to this problem. By fixing the paralleling part of the film holder to the x-ray tube by way of a custom ring (Fig. 2), we can effectively place the film in its desired position without the patient’s participation (Fig. 3). Thus, the management of very apprehensive *Assistant **Assistant Continuing
240
Professor and Acting Chairman of Endodontics. Professor of Restorative Dentistry and Director Dental Education.
of
Fig.
1.
patients, medically compromised patients, physically and mentally handicapped patients, and patients having a problem with anesthesia can be successfully carried out with reduced stress to patient, dental auxillary personnel, and dentist. For further information on the manufacture of these devices, please write to either of the authors.
Volume 65 Number 2
Accurate radiographs with IV sedation or general anesthesia
Fig.
2.
Fig.
3
REFERENCES 1. Pitts NB. Film-holding, beam-aiming and collimating devices as an aid to standardization in intraoral radiography: a review. J Dent 1984;12:36-46. 2. Nery EB, Olson JW, Henkin JM, Kalbfleisch JH. Filmholder device for radiographic assessment of periodontal tissues. J Periodont Res 1985;20:97-105.
Reprint
requests
to:
Dr. James A. Wallace Department of Endodontia Case Western Reserve University School of Dentistry 2123 Abington Rd. Cleveland, Ohio 44 106
241
RESERVE
UNIVERSlTY
and Bernard D. Cohen, D.D.S.,**
SCHOOL
Cleveland, Ohio
OF DENTISTRY
A
modification of the precision x-ray holders has been produced to enable the endodontist to obtain clinically functional radiographs of the compromised patient who is under intravenous sedation or general anesthesia. This makes adequate endodontic therapy possible for these patients without requiring their cooperation or someone else to hold the film in place. Over the years, many film holders have been devised along with cylindrical beam collimators to reproduce a series of accurate films for diagnostic purposes as well as to reduce the amount of radiation exposure to the patient. The x-ray beam has been collimated to the approximate shape and size of the film being exposed. The decrease in scattered radiation-induced fog obtained by this further collimation results in superior contrast and, therefore, a better image.’ Scatter is further reduced via metal balking plates. In situations in which accuracy and reproducibility are critical (e.g., endodontics,) these devices take on increased importance. One of the problems in the use of these products, however, is the cooperation of the patient. This is not ordinarily a problem during routine procedures, but it is a distinct difficulty when the patient is under heavy sedation. The device shown in Fig. 1 is proposed as a solution to this problem. By fixing the paralleling part of the film holder to the x-ray tube by way of a custom ring (Fig. 2), we can effectively place the film in its desired position without the patient’s participation (Fig. 3). Thus, the management of very apprehensive *Assistant **Assistant Continuing
240
Professor and Acting Chairman of Endodontics. Professor of Restorative Dentistry and Director Dental Education.
of
Fig.
1.
patients, medically compromised patients, physically and mentally handicapped patients, and patients having a problem with anesthesia can be successfully carried out with reduced stress to patient, dental auxillary personnel, and dentist. For further information on the manufacture of these devices, please write to either of the authors.
Volume 65 Number 2
Accurate radiographs with IV sedation or general anesthesia
Fig.
2.
Fig.
3
REFERENCES 1. Pitts NB. Film-holding, beam-aiming and collimating devices as an aid to standardization in intraoral radiography: a review. J Dent 1984;12:36-46. 2. Nery EB, Olson JW, Henkin JM, Kalbfleisch JH. Filmholder device for radiographic assessment of periodontal tissues. J Periodont Res 1985;20:97-105.
Reprint
requests
to:
Dr. James A. Wallace Department of Endodontia Case Western Reserve University School of Dentistry 2123 Abington Rd. Cleveland, Ohio 44 106
241