The role of stationary intraoral tomosynthesis in reducing proximal overlap in bitewing radiography

Objectives: This study examined the utility of stationary intraoral tomosynthesis (s-IOT) in opening proximal contacts in bitewing radiography. Methods: 11 DENTSPLY Rinn Dental X-ray Teaching and Training Replica mannequins (Model #546002, Elgin, Ill) were imaged with a prototype s-IOT device (Surround Medical Systems, Morrisville, NC) and standard bitewing (SBW) technique. Premolar and molar bitewings were acquired with each system. Image receptor holders were used to position receptors and aid in the alignment of the position indicating devices. An expert operator (having more than 5 years of experience in intraoral radiography) acquired the images with the s-IOT prototype and standard intraoral X-ray devices. Images were assessed to analyze percentage overlap of the proximal surfaces using the tools available in ImageJ (NIH, Bethesda Maryland). Results: 253-paired surfaces were included in the analysis. The difference in overlap was statistically significant with standard bitewing (SBW) images resulting in a median overlap of 13%, a minimum of 0%, a maximum of 100% and an interquartile range of 40%. s-IOT resulted in a median overlap of 1%, a minimum of 0%, a maximum of 37% and an interquartile range of 0%. The s-IOT prototype substantially reduced proximal surface overlap compared to conventional bitewing radiography. Conclusions: The use of s-IOT reduced proximal contact overlap compared to standard bitewing radiography for an experienced radiographer. Stationary intraoral tomosynthesis may be a potential alternative to SBW radiography, reducing the number of retakes due to closed contacts.