A comparative study of radiographic quality with five periapical techniques in general dental practice

The use of film holders for intraoral radiography is advocated in current guidelines to British dentists. No assessment of the use of film holders has been carried out in a general dental practice environment. The aim of this study was to compare the performance of a range of film holders for periapical radiography in general dental practices in terms of the diagnostic quality of the radiographs. Twelve general dental practitioners (GDPs) were recruited to participate in the study. Each GDP was asked to perform 50 periapical radiographs using their conventional (bisecting angle) technique (BAT) followed by 50 using, in turn, four film holders: the Stabe (S), the Eggen (E), the Rinn (R) and the 'Superbite' devices (SB). Each radiograph was examined simultaneously by two assessors, scored for film faults and diagnostic acceptability. With BAT, 44.5% of radiographs were diagnostically unacceptable, while using film holders 32.8% (S), 33.7% (E), 38.2% (R) and 35.8% (SB) were unacceptable. These reductions in unacceptable films were highly significant (P < 0.01) for S and E techniques, significant (P < 0.05) for SB, while with R the reduction was not statistically significant. These results give support for the use of film holders for periapical radiography. However, their effectiveness may be improved by better manufacturers' instructions and practical training of GDPs.