Clinical application of a modified image receptor-holding device to reduce proximal surfaces overlapping in bitewing radiography.

Objectives: To clinically validate the use of a modified image receptor-holding device (IRHD) for the bitewing technique.

Methods: Premolars and molars' bitewing radiographs of 101 patients were acquired using two IRHD (traditional and modified). The modified IRHD was computer-aided designed and 3D printed. Images were acquired by a single operator using a digital radiographic system with phosphor storage plates. A questionnaire regarding the perception of the use of the two IRHD was applied to patients and the operator. Image evaluation (paired and individual) was performed by two oral and maxillofacial radiologists. Repetition, overlap rate and operator/patient perception were expressed as absolute and relative frequencies, and compared between the devices using the chi-square test with a 5% significance level.

Results: The paired evaluation showed no difference in the rate of proximal surface overlap between the IRHDs (p ≥ 0.05). Individual evaluation showed a lower rate of proximal surface overlap with the modified IRHD, with emphasis on the distal surface in the premolar region (p < 0.05). The modified IRHD presented greater ease of positioning (52.3%), greater stability (64.9%), preference of use by the operator (54.5%) and greater comfort was reported by the patients (54.5%).

Conclusions: The modified IRHD may be more comfortable and has the potential to reduce the proximal surface overlap than the traditional IRHD, especially when there is an indication for a single radiograph in the premolar region.

Advances in knowledge: We clinically validated a modified IRHD that has potential to decrease proximal surfaces overlap with greater comfort for the patients.