Method: 32 images on 16 neurodevelopmentally disordered subjects were made using the DenOptix® storage-phosphor system (Kavo/Gendex, Des Plaines, Il) using a single panoramic size plates for each bi-lateral image pair. Half of the storage-phosphor plate was used to image each side while the other half was lead shield masked. The masked side was reversed while obtaining the contralateral image. Each patient sat in an upright position facing forward while the assistant held the storage phosphor plate against the side of the patient's face, with the lower border of the cassette parallel to the mandibular arch. The central beam was directed anteriorly, from the opposite side, posterior and inferior to the angle of the mandible. The X-ray generator was a Kodak Irix® (Paris, France) operating at 7 mA and 70 kVp and utilizing an exposure time of 0.12 s. Images were processed in the DenOptix® laser scanner to a resolution of 150 dpi using VinWix2000® (Kavo/Gendex) as the acquisition and display software.
Results: Images provided a good view of the mandibular posterior teeth and alveolar bone. Anatomic clutter proved to be a substantial problem that reduced the diagnostic quality for the maxillary teeth. Images were inconsistent in quality due to difficulty in assessing the optimal beam angulation with respect to a relatively non-compliant patient.
Conclusion: Although the working time is improved, success of this technique relies on better stabilizing the patient. While intraoral radiography takes a considerable amount of time and effort, the previously described six image intraoral x-ray mini-panel is preferable to the bi-lateral imaging approach for this population.