Comparative Evaluation of Extraoral and Intraoral Periapical Radiographic Technique in Children
Background: One of the most challenging tasks for the pediatric dentist is to obtain diagnostic quality radiograph on a young
child without psychological trauma. In 2003, Newman and Friedman introduced a novel technique known as extraoral periapical
(EOPA) radiography. EOPA radiography is a technique where the fi lm is placed extraorally overlying the tooth of interest, and
the X-ray beam is directed from the opposite side of the face.
Aims and Objectives: The purpose of this study was to evaluate the diagnostic value of EOPA technique in children and to
compare it with conventional intraoral periapical (IOPA) technique.
Materials and Methods: A total of 30 patients aged between 3 and 8 years were selected. Two images were obtained from each
patient, the fi rst image was taken by IOPA technique and second by EOPA technique. Radiographs obtained were compared
with each other by a pediatric dentist and an oral radiologist using questionnaire. The questionnaire consisted of parameters like
area of interest, presence of succedaneous tooth bud, visibility of periapical area, density and contrast of radiograph, distortion
of image (foreshortening/elongation) and diagnostic quality of radiograph.
Results: All the patients tolerated the extraoral radiographic procedure well, preferring it to conventional intraoral radiography.
The advantage of this technique is the increased patient compliance providing images with adequate details and diagnostic
quality. However, a slight decrease in resolution was noted.
Conclusion: EOPA radiographic technique can be used as an alternative to the conventional technique when placement of
intraoral fi lm is diffi cult which is particularly encountered in children. Although, it cannot replace IOPA radiographic technique.
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