Condition category
Oral Health
Date applied
24/04/2012
Date assigned
30/04/2012
Last edited
11/08/2016
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
Radiography is an essential part of dental practice, with few patients undergoing a course of treatment without having at least one x-ray taken. However, there is some evidence that large x-rays taken outside the mouth not only do not give much useful information to the dentist when formulating a definitive treatment plan but that they also vary greatly in quality. As exposure to x-rays carries with it an associated risk to the patient, it is essential that these x-rays be taken only when necessary and that their quality should be of the highest standard.
This study aimed to determine whether long-distance education could improve the quality of panoramic x-rays taken by general dental practitioners, not only from the technical aspect in correctly positioning the patient prior to the x-ray being taken but also in the processing of the film to provide a clinically acceptable film.

Who can participate?
The participants in this study were general dental practitioners who routinely took panoramic x-rays on all new patients attending their practice for routine treatment and these were taken only on dentate patients who were over the age of 18.

What does the study involve?
Forty general dental practitioners were randomly divided into two groups, an ‘active’ and a ‘control’ group. Each dental practitioner provided 20 panoramic radiographs for the researcher to evaluate with regard to technical and processing faults apparent on the x-rays. The ‘active’ group provided 20 x-rays for the researcher to evaluate. The first five were examined for technical and processing faults and were returned to the practitioner describing the faults and giving instructions on how to correct those faults with a request to act on the recommendations. The second five were treated in the same manner, as were the final ten x-rays. The ‘control’ group provided 20 films but only received evaluation after all 20 films had been received.
Eight weeks later a reassessment of film quality was undertaken with the practitioners providing a further ten x-rays. The researcher was then able to evaluate the effectiveness of distance education in the short term and the effect of the intervention in the medium long term.

What are the possible benefits and risks of participating?
The benefits of this study were:
1. Educating the dental practitioner to take an acceptable x-ray in the first instance, which eliminated the possible necessity for a retake. This has both a financial and a time-saving benefit to practitioner and patient alike.
2. Provided an appreciation of the deleterious effect of ‘spent’ processing chemicals, which can lead to a poor image that would not be of any diagnostic benefit in treatment planning.
3. X-rays that are acceptable from a technical and processing view will avoid the need for retakes, thereby reducing patient radiation exposure.
There are no risks attached in the participation of this study.

Where is the study run from?
This study has been run from the Dental School, Manchester University.

When is the study starting and how long is it expected to run for?
The study ran from January 2004 to January 2008.

Who is funding the study?
AXA PPP Healthcare.

Who is the main contact?
Dr Michael Rushton.

Trial website

Contact information

Type

Scientific

Primary contact

Dr Michael Rushton

ORCID ID

Contact details

Well Farm House
Well Lane
Little Budworth
Tarporley
CW6 9DA
United Kingdom

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

5439/1612

Study information

Scientific title

A quality improvement programme for panoramic radiography: a cluster randomised controlled trial

Acronym

Study hypothesis

Null hypothesis: There would be no improvement in the technical and/or processing quality of dental panoramic radiographs of the practices as a result of feedback information by the researchers in the immediate short and moderate long term. This was tested against the alternative hypothesis:

Hı: There would be an improvement in the technical and/or processing quality of dental panoramic radiographs of the practices as a result of feedback information by the researchers in the immediate short and moderate long term.

Ethics approval

Ethical approval was applied for this study from the Manchester Local Research Ethics Committee who advised that as the data was anonymised and unlinked, there were no apparent ethical issues identified. Hence no approval was required.

Study design

Cluster randomised controlled trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Other

Trial type

Diagnostic

Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet

Condition

Primary dental healthcare

Intervention

Forty general dental practitioners were divided into two groups of twenty, an active and a control group. Each dental practitioner provided twenty panoramic radiographs for the researcher to evaluate with regard to technical and processing faults apparent on the x-rays.

The active group provided 20 x-rays in tranches of 5, 5 and 10 for the researcher to evaluate. The first five were examined for technical and processing faults and were returned to the practitioner describing the faults and giving instructions on how to correct those faults with a request to act on the recommendations. The second tranche of five were treated in the same manner as was the final 10 x-rays.

The control group provided 20 films but only received evaluation after all twenty films had been received.

Intervention type

Other

Phase

Not Applicable

Drug names

Primary outcome measures

Improvements were found in both short term and medium long term in participants that received feedback on how to correct the faults found on the radiographs

Secondary outcome measures

The control group showed no improvement in improving technical faults but did in improving processing faults

Overall trial start date

01/01/2004

Overall trial end date

01/01/2008

Reason abandoned

Eligibility

Participant inclusion criteria

Dental practices that took panoramic radiographs on all new patients over the age of 18 attending for the first time

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

40

Participant exclusion criteria

Specialist dental practices involved in orthodontics

Recruitment start date

01/01/2004

Recruitment end date

01/01/2008

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Well Farm House
Tarporley
CW6 9DA
United Kingdom

Sponsor information

Organisation

AXA PPP Healthcare (UK)

Sponsor details

Phillips House
The Crescent
Kent
Tunbridge Wells
TN1 2PL
United Kingdom

Sponsor type

Industry

Website

http://www.axappphealthcare.co.uk/

Funders

Funder type

Industry

Funder name

AXA PPP Healthcare (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

2013 results: http://www.ncbi.nlm.nih.gov/pubmed/23337088

Publication citations

Additional files

Editorial Notes

11/08/2016: Publication reference added