UNIVERSITY SCIENCES MAlAYSIA

HUSHAM AHMED MOHAMMED

ESTIMATION OF ABSORBED DOSE AND IMAGE QUALITY ON SELECTED DENTAL

FILLINGS

 
 Supervisor: Dr. Yasmin Binti Md Radzi

Co-supervisor: Dr. Naser Mahmoud Ahmed 

 
 
 
 
 
 
 
 
 
 Introduction
 An x-ray dental radiograph is a non-invasive medical test that helps physicians to diagnose

and treat dental oral conditions.

 Dental imaging involves exposing the inside of the oral cavity using a small dose of ionizing

radiation to produce images. Dental x-ray tools and techniques are designed to limit the

body's exposure to radiation and every precaution is taken to ensure that radiation exposure

is As Low as Reasonably Achievable (ALARA principle).

 Dental fillings are used to repair cracked or broken teeth and teeth that have been worn

down.
 Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam
(which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-coloured, plastic, and
materials called composite resin fillings.
 There is also a material that contains glass particles and is known as glass ionomer. This material is used in
ways similar to the use of composite resin fillings. And this study will focus on dental fillings composite
and amalgam
Objectives of the study:
1- To estimate the absorbed dose on selected dental fillings under the diagnostic range of x-ray.

2- To study image quality of film under diagnostic x-ray range in terms of Optical Density (OD)

and Signal-to-Noise Ratio (SNR)

3- To find the relationship and to state the optimum kVp for the selected dental fillings that

produced the good image quality and minimal dose range .

 Motivation and Problem statement

The developed equipment and materials are useding in as dental fillings and use of x-ray

photoradiography for pre-and-post fillings made thinking that to what extend that the x-ray in different kVp

with a various dental fillings, had interacted and gave some amount of absorbed dose to the side effect in

normal soft tissue that in the surrounded teeth. Furthermore, the location of the oral cavity is near to many

Organ-at-Risks (OAR) such as head-and-neck central nervous system, eyes, thyroid glands and etc. Hence,

validating the dose absorbed by the dental filling could be the benchmark of targeting and estimating the

tolerance range of an optimal relationship between dose and image quality using diagnostic x-ray.

verifying dose from detector x-ray with dose from optical density. estimate the absorbed dose on dental

fillings, within the range of diagnostic x-ray and investigate the optimal relationship between dose and

image quality.
 
METHODOLOGY AND RESULTS

1. Methodology
2-Results

The reason that composite and amalgam samples were being selected in the study is that these dental
fillings are readily available and are widely used in dentistry. A linear relation was found between the
measured absorbed dose and the kVp with 1sec exposure time at a constant SSD of 40 cm. The different
values were found in absorbed dose with respect to kVp, where the kVp varies from 40 to 70 kVp
Table 4.1 shows absorbed dose and optical density at x-ray range according to various kVp for composite.
Table 4.2 shows absorbed dose and optical density at x-ray range according to various kVp for amalgam.
Analysis of the results is drawn from data obtained for the absorbed dose of dental fillings in order to
investigate the optimum relationship between dose and image quality.
For irradiated composite, the highest absorption is 1.38 mGy and optical density is o.33 at 70kVp ,and the
lowest absorption is 0.45 and optical density is 0.13 at 40 kVp for composite. For irradiated amalgam, the
highest absorption is 1.38 mGy at 70 kVp and the lowest absorption is at 40 kVp.
Table 4.1: shows absorbed dose and optical density at x-ray range according to various kVp for
composite
Kilovoltage Optical Signal-to- Absorbed Extrapolated Dose
peak (kVp) Density Noise Ratio Dose, D Absorbed Dose difference
(pixel/cm^2) (SNR) value (mGy) (mGy) (%)

40 0.33 1129 0.45 0.45 2.20

50 0.19 869 0.76 0.77 0.70

60 0.16 844 1.05 1.04 1.00
70 0.13 728 1.38 1.38 0.30

Table 4.2 : shows absorbed dose and optical density at x-ray range according to various
kVp for amalgam
Kilovoltage Optical Density Signal-to- Absorbed Extrapolated Dose difference
peak (kVp) (pixel/cm^2) Noise Dose, D Absorbed (%)
Ratio (mGy) Dose (mGy)
(SNR)
value

40 0.395 1367 0.21 2.30

0.205
50 0.345 1326 0.59 0.577 2.10

60 0.32 1324 0.85 2.10

0.832  
70 0.278 1278 1.38 1.20
1.362
a) Composite

Figure 4.1 shows relation between absorbed dose and kVp, and through results obtained , it

has clearly understood that increase kVp will also increase the absorbed dose to the dental

fillings.

While Figure 4.2 demonstrated that there was an inverse relationship between kVp and OD

which increase kVp would decrease OD gradually. In Figure 4.3 the graph, the relation between

the (absorbed dose, kVp )and another side( OD, kVp) at composite . From two paragraphs in the

same kVp gradual are using that connected in one point. This point gave more description, the

better optical density with lower kVp follow lower dose and kVp, the best result at the dose

0.76 mGy, and OD 0.19 pixel/cm^2 at 50 kVp .

 In Figure 4.4 for linear graph, and according to the equation found it in the drawing,

verification procedure between dose detector and dose OD, the results of dose OD were

approach to results dose detector, where the difference percentage at kVp 50, absorbed dose

0.76 mGy, dose (OD) 0.766 mGy and OD 0.19 pixel/cm^2 is 0.7%. The difference

percentage ranged from the lowest percentage 0.3% at 70 kVp to the highest percentage 2.2

% at 40 kVp.

In Figure 4.5 shows a linear relation between kVp and SNR, there is an inverse

relationship between kVp and SNR, whenever increase kVp decrease SNR and invariable

mAs and SSD, so the image will be a good resolution because the Noise is less. So,

wherever an increase kVp, the image of composite and profile (x ,y) are shown in Figure 4.6

to Figure 4.10.

 
Absorbed Dose(mGy

O p tica l D e n sity ( p ix e l/ c
1.6
Composite 0.2 g, mAs = 1sec, S.I.D = 40 cm, thickness = 0.2 cm
1.38
1.4
f(x) = 0 x² + 0.28 x + 0.17 Composite 0.2 g, mAs = 1sec, S.I.D = 40 cm, thickness = 0.2 cm
1.2 R² = 1
1.05
0.33
0.35

1 0.3 f(x) = 0.03 x² − 0.2 x + 0.5

R² = 0.99
0.76 0.25
0.8
0.19
d 0.2
0.6
os
0.16 OD
0.45
e 0.15
0.13
Polynomial (OD)
0.4
0.1
0.2
0.05
0
40 50 60 70 0
40 50 60 70

Kilovoltage peak (kVp) Kilovoltage peak (kVp)

Figure 4.1 The line graph of Absorbed dose (mGy) of dental Figure 4.2 The graph of Optical Density (OD) of dental
fillings(composite) against kVp. fillings(composite) against kVp
 
Absorbed dose (mGy)

1.6
  0.35
0.33
1.4 1.38
0.3 d
o
1.2 s
0.25 e
1.05
1
0.19 0.2

OD
0.8 0.76
0.16 0.15
0.6 0.14
0.45 0.1
0.4

0.2 0.05

0 0
40 50 60 70

Kilovoltage peak (kVp)

Figure 4.3 Relationship between Absorbed dose and Optical Density for
composite fillings against kVp.
 Absorbed dose (mGy
1.6
1.38
1.4
f(x) = 40.19 x² − 23.16 x + 3.72
1.2 R² = 1
1.05
1
0.76 Do
0.8 se

0.6
0.45
0.4

0.2

0
0.1 0.15 0.2 0.25 0.3 0.35

Optical diensity (pixle/cm^2)

Figure 4.4: Absorbed Dose against Optical Density

sign a l N oise to Ra tio ( S N R)

1129
1200

1000
869 844
800 728

600
SRN
Polynomial (SRN)
400

200

0
40 50 60 70
Kilovoltage Peak(kVp)

Figure 4.5: The line graph SNR against kVp

Figure 4.6:The Image of Composite
Figure 4.7:Example of X and Y profiles for composite filling Figure 4.8:Example of X and Y profiles for composite filling at
at 40kVp 50kVp
Figure 4.9:Example of X and Y profiles for composite filling Figure 4.10: Example of X and Y profiles for composite
at 60kVp filling at 70kVp
b) Amalgam

The different values were found in absorbed dose concerning amalgam and

kVp. The estimated absorbed dose from the extrapolated value ranged from the

lowest value of 0.21 mGy to the highest value 1.38 mGy, and the Optical Density

varies from the lowest value 0.278 pixel/cm ^2 to the highest value 0.395 pixel/cm ^2.

Also through results amalgam , it has clearly understood that increase kVp will

also increase the absorbed dose to the dental fillings. While Figure 4.12

demonstrated that there was an inverse relationship between kVp and OD which

increase kVp would decrease OD gradually.

 In Figure 4.4 for linear graph, and according to the equation found it in the

drawing, verification procedure between dose detector and dose OD, the

results of dose OD were approach to results dose detector, where the

difference percentage at kVp 60, absorbed dose 0.85 mGy, dose (OD) 0.83

mGy and OD 0.32 pixel/cm^2is 2.10%. The difference percentage ranged

from the lowest percentage 1.20% at 70 kVp to the highest percentage 2.30

% at 40 kVp.

In Figure 4.5 shows a linear relation between kVp and SNR, and this an

inverse relationship between kVp and SNR, whenever increase kVp decrease

SNR, by invariable( mAs and SSD), so the image will be a good resolution

because the Noise is less. So, wherever an increase KVP, the image of

amalgam and profile (x ,y) are shown in Figure 4.16 to Figure 4.20.
 Amalgam 1g, mAs= 1sec, S.I. D= 40 cm, thickness= 0.5 cm Amalgam 1g, mAs= 1sec, S.I. D= 40 cm, thickness= 0.5 cm

0.45
1.6
0.395
0.4
1.4
f(x) = 0 x² − 0.05 x 0.345
+ 0.44
f(x) = − 0.02 x² + 0.52 x − 0.47 0.32

Optical density (pixle/cm^2)

0.35 R² = 0.99
1.2 R² = 0.98
Absorbed dose (mGy)

0.3 0.278
1
dose 0.25 OD
0.8
Polynomial (dose) Polynomial ( OD)
0.6 0.2

0.4 0.15

0.2 0.1

0 0.05
40 50 60 70
0
40 50 60 70
Kilovoltage Peak(kVp)
Kilovoltage peak (kVp)

Figure 4.11: The line graph of Absorbed dose(mGy) of dental Figure 4.12: The line graph of Optical Density (OD) of dental
fillings(amalgam) against kVp fillings(amalgam) against kVp
Absorded dose(m Gy)

1.6 0.45

1.4 0.395 0.4

1.38
f(x) = 0 x² − 0.05 x + 0.44
1.2 R² = 0.99 0.345 0.35
dose 0.32

OD
0.3
1 Polyn 0.278
omial 0.85 0.25
0.8 (dose)
0.2
0.6 OD 0.59
0.15
0.4
0.1
0.2 0.05

0 0 0
40 50 60 70
kVp

Figure 4.13: Relationship between absorbed dose and Optical Density

for amalgam fillings against kVp
 1.6

1.38
1.4
f(x) = 36.55 x² − 34.49 x + 8.13
1.2 R² = 0.98

Absorbed dose (mGy)

1
0.85
0.8
dose
0.59 Polynomial (dose)
0.6

0.4

0.2

0
0.26 0.28 0.3 0.32 0.34 0.36 0.38 0.4 0.42 0.44 0.46
Optical denstiy (pixle/cm^2)

Figure 4.14: The absorbed dose of amalgam against Optical density

1380
1367
1360
Signal Noise to Ratio (SNR)

1340 1326 1324

1320
S
1300 N
1278 R
1280
1260
1240
1220
40 50 60 70

Kilovoltage Peak (kVp)

Figure 4.15: The line graph SNR against kVp

Figure 4.16:The Image of Amalgam
Figure 4.17:Example of X and Y profiles for amalgam Figure 4.18:Example of X and Y profiles for amalgam
filling at 40kVp filling at 50 kVp
Figure 4.19:Example of X and Y profiles for amalgam Figure 4.20:Example of X and Y profiles for amalgam
filling at 60kVp filling at 70kVp
 Conclusion

 The use of a diagnostic x-ray in this study is an easy, reliable, fast and precise way to analyse
the different dental fillings. Also, it can be comparable to other radiopacity studies using the
digital technique. The result shows that simple equipment can be used to determine
radiological quality parameters, such as; dose, kVp, and mAs. This implies that, if the
diagnostic x-ray machine is not maintaining the consistency of these parameters, it’s output
will be poor.
 Furthermore, the result of this study has shown that amalgam absorbed x-ray, which means x-
rays are unable to penetrate so they appear white on the x-ray film, and this means whenever
density increases the absorption increase. In this study, amalgam has a higher density than
composite. Conversely, for a composite filling, x-rays able to fully penetrate the material
making it appear dark on the x-ray film. This made it difficult to distinguish from decay and
leakage.
 As a conclusion, the absorption dose does not sufficiently affect the lens of the eye and facial
skin, because the unit used for absorbed radiation dose is the milli-gray (mGy). This value is
the standard international measure ICRP 103 publication (2007) for absorbed radiation for skin
(skin reddening) is 3000-6000 mGy per 1-4 weeks, (Temporary hair loss) is 4000 mGy per 2-3
weeks, and for lens of eye (detectable opacities) is 500–2000 mGy per year, and cataract
formation is 5000 mGy per year.
 In addition, calculated absorbed dose is (mGy) dental fillings were below the limit. The
composite absorbed doses for different kVp were (0.45, 0.76, 1.05, 1.38 mGy), either amalgam
absorbed doses for different kVp were (0.21, 0.59, 0.85 ,1.38 mGy). Also, it can be concluded
that the assessment of image quality is essential in the diagnostic process. There are many
factors that affect conventional processing such as human handling and skills, quality of
chemicals, film sensitivity, and repeat film rate.
Thank you for attention

‫تم بحمد هلل‬