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Kazzaz SH, Faris TM, Abdulrahman MS, Baban MTA, Talabani RM, Abdalrahman KO. Age estimation from morphometric features of maxillary central incisors using CBCT images. BMC Oral Health 2025; 25:821. [PMID: 40437491 PMCID: PMC12117955 DOI: 10.1186/s12903-025-06193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2025] [Accepted: 05/19/2025] [Indexed: 06/01/2025] Open
Abstract
BACKGROUND Forensic dentistry is crucial in human identification, with dental age estimation being a key component of this process. The deposition of secondary dentin over an individual's lifetime, along with the resulting changes in tooth anatomy, serves as an important factor in age estimation. The objective of this study was to develop regression equations for estimating age in adults based on linear measurements and ratios obtained from axial, sagittal, and coronal planes of the maxillary central incisors in the Iraqi subpopulation using cone beam computed tomography (CBCT). METHODS In this retrospective cross-sectional study, Multiplanar measurements of 400 maxillary central incisors from subjects ranging in age from 18 to 84 years were taken for a sample of 200 CBCTs. The data were analyzed using independent Student's t-test, Mann-Whitney test, and Spearman's and Pearson's correlation coefficients to determine the strength of correlations. Multiple regression analysis was performed to predict age, and a p-value of ≤ 0.05 was considered statistically significant. RESULTS The age range of the participants was 18-84 years. The results revealed a statistically significant difference in age between male and female samples (p = 0.018). Consequently, separate age estimation equations were developed for each sex. In males, the equation derived from multiplanar linear measurements demonstrated a standard error of estimate (SEE) of ± 10.84 years, with a coefficient of determination (R²) of 0.49. In contrast, the equation for females, based on multiplanar measurements, yielded a SEE of ± 11.11 years and an R² value of 0.393. CONCLUSIONS Based on the findings of this study, dental morphometric measurement of maxillary central incisors using CBCT was found to be an acceptable method for age estimation especially for identification of unknow human remains. Horizontal measurements improve the accuracy of age estimate equations.
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Affiliation(s)
- Sara Hilmi Kazzaz
- Conservative Department, College of Dentistry, University of Sulaimani, Sulimaniyah, Kurdistan Region, Iraq
| | - Tavga Mustafa Faris
- Conservative Department, College of Dentistry, University of Sulaimani, Sulimaniyah, Kurdistan Region, Iraq
| | | | - Mohammed Taha Ahmed Baban
- Department of Dental Nursing, Sulaimani Technical Institute, Sulaimani Polytechnic University, Sulimaniyah, Kurdistan Region, Iraq.
| | - Ranjdar Mahmood Talabani
- Conservative Department, College of Dentistry, University of Sulaimani, Sulimaniyah, Kurdistan Region, Iraq
| | - Kazhan Omer Abdalrahman
- Conservative Department, College of Dentistry, University of Sulaimani, Sulimaniyah, Kurdistan Region, Iraq
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Fuessinger MA, Russe MF, Brandenburg LS, Metzger MC, Schulze J, Schlager S, Semper-Hogg W. Optimization of the size and location of the FOVs for CBCT capture of the TMJ. BMC Oral Health 2025; 25:709. [PMID: 40349044 PMCID: PMC12066044 DOI: 10.1186/s12903-025-06081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/29/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Osseous pathologies of the temporomandibular joint (TMJ) such as degenerative joint disease, trauma, and deformity contribute to orofacial morbidity and are considered a major factor in temporomandibular dysfunction. Cone beam computed tomography (CBCT) is a recommended diagnostic tool in imaging of osseous tissue pathologies. However, CBCT contributes to patient radiation exposure, and limiting the CBCT field of view (FOV) may reduce it. This study aims to investigate the possibility and clinical applicability of optimizing the size and location of the FOVs for CBCT capture of the TMJ. METHODS Three-dimensional CBCT data sets in which the bilateral positions and dimensions of the TMJs were analyzed. A total of 201 data sets with 402 condyles were mapped in relation to the CBCT device. By transformation into a common coordinate space using the device's chin rest as a joint denominator, we were able to determine the optimal size and location for uni- and bilateral capture of the TMJ for both best-case and worst-case scenarios with regard to patient positioning. RESULTS The minimal FOVs for unilateral capture were H 28.2 mm × R 22.9 mm in the best-case scenario assuming optimal patient positioning and H 47.0 mm × R 28.3 mm in the worst-case scenario with rotational deviation along the transversal axis. For bilateral capture, we determined the best-case FOV as H 24.9 mm × R 66.5 mm and the worst-case FOV as H 42.8 mm × R 66.7 mm. DISCUSSION This research yields indication-specific FOVs for both uni- and bilateral imaging of the TMJ. Considering the best clinical practices for CBCT imaging, clinically feasible FOV dimensions in consideration of the technical specifications of common CBCT devices can be suggested. The clinical application of the results may help reducing radiation exposure of patients receiving CBCT imaging of the TMJ. The transferability of the present results to other CBCT devices requires further research. TRIAL REGISTRATION The study is registered in the German Trial Register with the number DRKS00026149, 2024/02/21.
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Affiliation(s)
- Marc Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Maximilian Frederik Russe
- Department of Radiology, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Johannes Schulze
- Department of Oral and Maxillofacial Surgery, Albert-Einstein University Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Stefan Schlager
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Wiebke Semper-Hogg
- Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
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Romeo DJ, Sussman JH, Massenburg BB, Halverson M, Ng JJ, Wu M, Liu GT, Bartlett SP, Taylor JA, Swanson JW. Optic Nerve Sheath Diameter on Computed Tomography Scans Reflects Elevated Intracranial Pressure in Patients with Craniosynostosis. Plast Reconstr Surg 2025; 155:837-847. [PMID: 39212982 DOI: 10.1097/prs.0000000000011698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Assessment for elevated intracranial pressure (ICP) helps guide interventional decision-making to treat craniosynostosis. However, noninvasive techniques for measuring ICP are limited. This study assessed whether optic nerve sheath diameter (ONSD) on low-dose computed tomographic (CT) scans is associated with ICP in patients with craniosynostosis. METHODS Pediatric patients treated between 2014 and 2023 with craniosynostosis, intraoperative ICP measurements by direct subdural catheterization, and spectral domain-optical coherent tomographic (SD-OCT) data were included. ONSD was retrospectively assessed on preoperative CT scans by a masked neuroradiologist and compared with measures and proxies of ICP. RESULTS Among the 132 patients included (median age, 6.9 years; interquartile range, 4.7 to 9.5 years), 41 (31.1%) had a syndromic diagnosis. Maximal ONSD was increased in patients with an ICP of 15 mmHg or greater (6.1 mm versus 5.5 mm; P < 0.01) and 20 mmHg or greater (6.3 mm versus 5.6 mm; P < 0.01). Maximal ( r = 0.32; P < 0.001), minimum ( r = 0.26; P = 0.003), and average ( r = 0.29; P < 0.001) ONSD correlated with direct ICP measurements. ONSD and SD-OCT measurements were also correlated (maximum retinal nerve fiber layer, r = 0 .21, P = 0.04; maximum retinal thickness, r = 0.24, P = 0.02). An ONSD max threshold of 5.75 mm demonstrated 65% sensitivity and 64% specificity for detecting ICP of 15 mmHg or greater on optimized receiver operating characteristic curve analysis. Multivariable logistic regression generated an algorithm incorporating ONSD max and age to detect an ICP of 20 mmHg or greater with 64% sensitivity and 80% specificity. CONCLUSIONS ONSD measured on low-dose CT scans detected elevated ICP with moderate accuracy. Precision increased when patient age was taken into consideration. Given the ease of accessing CT scan data, this may be a helpful ICP proxy for clinical decision-making. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, II.
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Affiliation(s)
- Dominic J Romeo
- From the Divisions of Plastic, Reconstructive, and Oral Surgery
| | | | | | | | - Jinggang J Ng
- From the Divisions of Plastic, Reconstructive, and Oral Surgery
| | - Meagan Wu
- From the Divisions of Plastic, Reconstructive, and Oral Surgery
| | - Grant T Liu
- Ophthalmology, Children's Hospital of Philadelphia
- Division of Neurology, Perelman School of Medicine, University of Pennsylvania
| | | | - Jesse A Taylor
- From the Divisions of Plastic, Reconstructive, and Oral Surgery
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Ünal SY, Namdar Pekiner F. Evaluation of the mandibular canal and the third mandibular molar relationship by CBCT with a deep learning approach. Oral Radiol 2025; 41:222-230. [PMID: 39658743 DOI: 10.1007/s11282-024-00793-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 11/27/2024] [Indexed: 12/12/2024]
Abstract
OBJECTIVE The mandibular canal (MC) houses the inferior alveolar nerve. Extraction of the mandibular third molar (MM3) is a common dental surgery, often complicated by nerve damage. CBCT is the most effective imaging method to assess the relationship between MM3 and MC. With advancements in artificial intelligence, deep learning has shown promising results in dentistry. The aim of this study is to evaluate the MC-MM3 relationship using CBCT and a deep learning technique, as well as to automatically segment the mandibular impacted third molar, mandibular canal, mental and mandibular foramen. METHODS This retrospective study analyzed CBCT data from 300 patients. Segmentation was used for labeling, dividing the data into training (n = 270) and test (n = 30) sets. The nnU-NetV2 architecture was employed to develop an optimal deep learning model. The model's success was validated using the test set, with metrics including accuracy, sensitivity, precision, Dice score, Jaccard index, and AUC. RESULTS For the MM3 annotated on CBCT, the accuracy was 0.99, sensitivity 0.90, precision 0.85, Dice score 0.85, Jaccard index 0.78, AUC value 0.95. In MC evaluation, accuracy was 0.99, sensitivity 0.75, precision 0.78, Dice score 0.76, Jaccard index 0.62, AUC value 0.88. For the evaluation of mental foramen; accuracy 0.99, sensitivity 0.64, precision 0.66, Dice score 0.64, Jaccard index 0.57, AUC value 0.82. In the evaluation of mandibular foramen, accuracy was found to be 0.99, sensitivity 0.79, precision 0.68, Dice score 0.71, and AUC value 0.90. Evaluating the MM3-MC relationship, the model showed an 80% correlation with observer assessments. CONCLUSION The nnU-NetV2 deep learning architecture reliably identifies the MC-MM3 relationship in CBCT images, aiding in diagnosis, surgical planning, and complication prediction.
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Affiliation(s)
- Suay Yağmur Ünal
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Başıbüyük, Başıbüyük Başıbüyük Yolu Marmara Üniversitesi, Sağlık Yerleşkesi 9/3, 34854, Maltepe, Istanbul, Turkey.
| | - Filiz Namdar Pekiner
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Başıbüyük, Başıbüyük Başıbüyük Yolu Marmara Üniversitesi, Sağlık Yerleşkesi 9/3, 34854, Maltepe, Istanbul, Turkey
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Aryanezhad SS, Jafari-Pozve N, Abrishami M, Arianezhad SM. Investigating the Anatomy and Location of the Infraorbital Canal in Relation to the Adjacent Structures in Cone Beam Computed Tomography (CBCT) Images. J Maxillofac Oral Surg 2025; 24:542-556. [PMID: 40182441 PMCID: PMC11961809 DOI: 10.1007/s12663-024-02191-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/23/2024] [Indexed: 04/05/2025] Open
Abstract
Background Although the canal protects the infraorbital nerve and artery, they can be easily injured during manipulation in this area. This study aimed to examine the structure and position of the infraorbital canal (IOC) and nearby features using cone beam computed tomography (CBCT) images. Methods This study was conducted on 94 CBCT images (47 men and 47 women of 20-55 years). The infraorbital groove (IOG), infraorbital foramen (IOF) and infraorbital canal (IOC) points, and other related parameters are investigated bilaterally using OnDemand3D software. Data were studied by paired t, independent t, and Kruskal-Wallis statistical tests (α = 0.05). Results The average angle between IOC, sagittal, axial planes, and IOG 29.08° (SD = 7.33), 56.01° (SD = 10.39), and 121.44° (SD = 43.44). The average IOC and IOG lengths were 10.83 (SD = 3.87) and 19.01 (SD = 5.81) mm. The average IOF vertical diameter was 5.5 (SD = 1.80) mm. The mean skin thickness over IOF was 10.38 (SD = 2.42) mm. The average length between the IOF and the infraorbital rim, the lateral nasal wall, the midsagittal plane, the line perpendicular to the axis of the canine apex, the occlusal plane of the premolar, the vertical axis of the lateral rim of the frontozygomatic suture 9.7 (SD = 2.52), 11.76 (SD = 2.92), 16.4 (SD = 6.42), and 91.11 (SD = 4.15), 42 (SD = 7.61) and 22.55 (SD = 3.25) mm. Images showed the presence of accessory IOF in 13.45% of cases, and the presence of Haller cells in 17.75% of cases, and sex did not affect the studied variables. Conclusion CBCT is an accurate 3-dimensional imaging modality for assessment of the anatomy of the IOC, IOG, and IOF. Knowledge of the IOC/G anatomy for preoperative treatment planning utilizing CBCT can assist surgeons in avoiding potential surgical complications and improving treatment efficacy.
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Affiliation(s)
- Seyed Sasan Aryanezhad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran
| | - Nasim Jafari-Pozve
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran
| | - Mehdi Abrishami
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran
| | - S. Marjan Arianezhad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cao J, Zhang Z, Liu L, Xia Y, Zhuang J, Lin J, Su X, Guo F, Hu J. Differences in the Size and Morphology of Masseter Muscle and Mandible Assessed Using Three-Dimensional Computed Tomography. Aesthetic Plast Surg 2025:10.1007/s00266-025-04734-x. [PMID: 40014119 DOI: 10.1007/s00266-025-04734-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Accepted: 02/07/2025] [Indexed: 02/28/2025]
Abstract
BACKGROUND Mandibular angular hypertrophy and hemifacial microsomia involve deformities in the mandibular region, resulting in facial asymmetry that severely affects patients' appearance. This study evaluated the masseter muscle-mandibular correlation in patients with hemifacial microsomia and those with mandibular angular hypertrophy using three-dimensional CT and compared them with normal individuals. METHODS This study included 310 participants. Craniofacial scans were performed using three-dimensional CT in all participants to obtain masseter muscle and mandibular size and morphology data. RESULTS In the normal population, there are sex differences in the shape and size of the masseter muscle and mandible, and the size of masseter muscle correlates with the mandible. In all three groups, there were differences in morphology and size of masseter muscle and mandible between the right and left sides (healthy and affected sides). Compared with the normal population, patients with hemifacial microsomia have a smaller masseter muscle and mandible on the affected side, while the healthy side is similar to the normal population. The measurement results significantly differed among patients with different severities of hemifacial microsomia and tended to worsen with increasing severity. In addition, the masseter muscle and mandibles on the left and right sides of patients with mandibular hypertrophy were larger than those of the normal population. CONCLUSIONS Three-dimensional CT proved reliable and accurate for measuring the masseter muscle and mandible size and morphology. We report masseter muscle and mandible characteristics in different populations. These findings can guide medical personnel in determining the diagnosis, treatment, and prognosis of these diseases. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jie Cao
- Radiology Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Ziming Zhang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Li Liu
- Radiology Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Yuxi Xia
- School of Basic Medicine, Xinxiang Medical University, Xinxiang, 453003, Henan, China
| | - Jun Zhuang
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Jinhao Lin
- School of Basic Medicine, Xinjiang Second Medical College, Kelamayi, 834000, Xinjiang, China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China
| | - Fengfeng Guo
- Department of Cosmetic Injection Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, Shijingshan District, China.
| | - Jintian Hu
- Department of Cosmetic Injection Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Beijing, 100144, Shijingshan District, China.
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Jiang D, Hong J, Yan Y, Huang H, You P, Huang W, Zhao X, She D, Cao D. Preoperative evaluation of lingual cortical plate thickness and the anatomical relationship of the lingual nerve to the lingual cortical plate via 3T MRI nerve-bone fusion. Dentomaxillofac Radiol 2025; 54:163-172. [PMID: 39589903 DOI: 10.1093/dmfr/twae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 09/04/2024] [Accepted: 10/31/2024] [Indexed: 11/28/2024] Open
Abstract
OBJECTIVES To evaluate the reliability of 3T MRI nerve-bone fusion in assessing the lingual nerve (LN) and its anatomical relationship to the lingual cortical plate prior to the impacted mandibular third molar (IMTM) extraction. METHODS The MRI nerve and bone sequences used in this study were 3D T2-weighted fast field echo (3D-T2-FFE) and fast field echo resembling a CT using restricted echo-spacing (FRACTURE), respectively. Both sequences were performed in 25 subjects, and the resulting 3D-T2-FFE/FRACTURE fusion images were assessed by 2 independent observers. Semi-quantitative analyses included assessments of overall image quality, image artefacts, nerve continuity, and the detectability of 5 intermediate points (IPs). Quantitative analyses included measurements of the lingual cortical plate thickness (LCPT), vertical distance (V1* and V2*), and the closest horizontal distance (CHD) between the LN and the lingual cortical plate. Reliability was evaluated using weighted Cohen's kappa coefficient (κ), intraclass correlation coefficient (ICC), and Bland-Altman plots. Differences in LCPT between 3D-T2-FFE/FRACTURE fusion images and cone-beam computed tomography (CBCT) were compared using independent samples t-tests or Mann-Whitney U tests. RESULTS The fusion images demonstrated that the LN continuity score was 3.00 (1.00) (good), with 88% (44/50) of LNs displayed continuously at the IMTM level. Intra-reader agreement for nerve continuity was moderate (κ = 0.527), as was inter-reader agreement (κ = 0.428). The intra-reader and inter-reader agreement for LCPT measurements at the neck, mid-root, and apex of the IMTM were all moderate (ICC > 0.60). Intra-reader agreements for V1*, V2*, and CHD were moderate to excellent (ICC = 0.904, 0.967, and 0.723, respectively), and inter-reader agreements for V1*, V2*, and CHD were also moderate to excellent (ICC = 0.948, 0.941 and 0.623, respectively). The reliability of LCPT measurements between 3D-T2-FFE/FRACTURE fusion and CBCT was moderate (ICC = 0.609-0.796). CONCLUSIONS The 3D-T2-FFE/FRACTURE fusion technique demonstrated potential feasibility for the identification of the LN and its relationship to the lingual cortical plate, as well as for the measurement of LCPT. This study has generated a dataset that is capable of simultaneously defining the LN and LCPT.
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Affiliation(s)
- Dongmei Jiang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Junhuan Hong
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Yalan Yan
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Hao Huang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Peiying You
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Weilin Huang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
| | - Xiance Zhao
- Philips Healthcare, Shanghai 200000, P.R. China
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, P.R. China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, P.R. China
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, P.R. China
- Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, P.R. China
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Rau S, Pichotka MP, Rau A, Reisert M, Altenburger MJ, Schmelzeisen R, Cieplik F, Bamberg F, Russe MF, Semper-Hogg W. Photon-counting-detector CT outperforms state-of-the-art cone-beam and energy-integrated-detector CT in delineation of dental root canals. Sci Rep 2025; 15:2978. [PMID: 39849001 PMCID: PMC11758001 DOI: 10.1038/s41598-025-87081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 01/15/2025] [Indexed: 01/25/2025] Open
Abstract
This experimental phantom study investigates current standard of care protocols in cone beam computed tomography (CBCT), energy-integrating-detector (EID) CT, and photon-counting-detector (PCD) CT regarding their potential in delineation of dental root canals. Artificial accessory canals (diameters: 1000, 600, 400, 300 and 200 μm) were drilled into three bovine teeth mounted on a bovine rib as a jaw substitute. The phantom was scanned in two dental CBCTs, two EID-CTs and a PCD-CT using standard clinical protocols. Scans from a micro-CT served as reference standard. Spatial resolution was evaluated via line profiles through the canals, whereby visibility compared to surrounding noise and compared to the ground truth were assessed. PCD-CT was able to delineate all artificial canals down to 200 μm diameter. In CBCT and EID-CT canals could only be reliably detected down to 300 μm. Also, PCD-CT showed a considerably smaller width-divergence from the ground trough with 4.4% at 1000 μm and 35.1% at 300 μm compared to CBCT (13.5 and 72.9%) and EID-CT (10.1 and 115.7%). PCD-CT provided superior resolution, accurate size measurement, and enhanced detection of small dental root canals, thereby offering improvements in diagnostic capabilities compared to CBCT and EID-CT systems.
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Affiliation(s)
- Stephan Rau
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Martin Peter Pichotka
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Alexander Rau
- Department of Neuroradiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Markus Jörg Altenburger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
- Department of Orthodontics, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, 79106, Freiburg, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Fabian Cieplik
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Wiebke Semper-Hogg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
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Ahmed AS, Ali BJ, Hassan BK, Sabah Mohammad A. The Estimation of Cementoenamel Junction Crestal Bone Distance in Mandibular Anterior Teeth. Clin Cosmet Investig Dent 2025; 17:13-20. [PMID: 39807250 PMCID: PMC11726059 DOI: 10.2147/ccide.s492129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 12/06/2024] [Indexed: 01/16/2025] Open
Abstract
Purpose The study aimed to measure the distance from the cementoenamel junction (CEJ) to the alveolar bone crest on both the buccal and lingual sides of the anterior mandibular teeth utilizing cone beam computed tomography (CBCT). Materials and Methods Cone-beam computed tomography (CBCT) was utilized to measure the distance between CEJ and the alveolar bone crest on both the buccal and lingual sides of the mandible's anterior teeth. Results The mean of the distance on buccal side for the central, lateral, and canine teeth were (1.6 mm), (1.6 mm), and (1.5 mm) respectively. On the lingual side, the mean for all teeth (central, lateral, and canine) was 1.7 mm. The study demonstrated a significant difference in distance across age groups (<30 and ≥30 years) for all teeth on both the buccal and lingual sides, except for the canine on the buccal side. Conclusion The distance from the CEJ to the bone crest on both the buccal and lingual sides varies significantly by age group. This data is essential for developing orthodontic, implant, and periodontal therapies.
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Affiliation(s)
- Ammar Sh Ahmed
- Department of Pedodontics, Orthodontic and Preventive Dentistry, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - Banaz Jabbar Ali
- Department of Periodontics, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - Ban Karem Hassan
- Department of Periodontics, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
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Pietzka S, Grieser A, Winter K, Schramm A, Metzger M, Semper-Hogg W, Grunert M, Ebeling M, Sakkas A, Wilde F. Comparison of the Effective Radiation Dose in the Region of the Facial Skull Between Multidetector CT, Dental Conebeam CT and Intraoperative 3D C-Arms. Craniomaxillofac Trauma Reconstr 2024; 17:270-278. [PMID: 39634571 PMCID: PMC11613283 DOI: 10.1177/19433875231213906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2024] Open
Abstract
Study Design Experimental single-centre study of X-ray absorption using a phantom skull. Objective This experimental study aimed to compare the radiation doses of different 3D imaging devices used in maxillofacial surgery, including one Multidetector CT (MDCT), two Conebeam CT (CBCT) and four intraoperative 3D C-arms. Methods Thermoluminescent dosimeters (TLD) were used to determine the absorbed radiation in an Alderson-Rando phantom skull. The phantom skull was positioned in the before mentioned seven devices and a defined 3D facial skull image was acquired. Subsequently, the TLD'S were read out and the effective doses (ED) and the organ doses (OD) were calculated and compared. Results OD varied significantly between tissues as well as between the 3D X-ray devices. The OD of the 3D C-arms were significantly lower than those of all other devices. The OD of the CT, especially in the standard setting, was the highest. Only by special adjustments of the scan protocol regarding CMF requirements for traumatology, the MDCT could achieve almost equivalent doses as the two tested CBCT-scanners. The calculated effective doses were also lowest for the 3D C-arm devices (11.2 to 129.9 μSv). The ED of the MDCT were significant higher (284.52-844.97 μSv) than in all other devices. The ED of the CBCTs (173.7-184.9) were lower than for MDCT but still higher than those of the 3D C-arms. Conclusions Intraoperative imaging using 3D C-arm devices is an effective method to verify reduction results in maxillofacial surgery intraoperatively with significantly lower ED than postoperatively CBCT and MDCT imaging.
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Affiliation(s)
- Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Anne Grieser
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Karsten Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Marc Metzger
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Freiburg, Freiburg, Germany
| | - Wiebke Semper-Hogg
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Freiburg, Freiburg, Germany
| | - Michael Grunert
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
| | - Marcel Ebeling
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
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11
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Neralla A, Mishra S, Nc S, Srinivasan B, Bajoria AA, Singh D. Assessing the Accuracy of Linear Alveolar Bone Measurements for Implant Planning Using Cone-Beam Computed Tomography by Comparing Three Competent Three-Dimensional Imaging Software: An In Vitro Study. Cureus 2024; 16:e73172. [PMID: 39650903 PMCID: PMC11624290 DOI: 10.7759/cureus.73172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 11/06/2024] [Indexed: 12/11/2024] Open
Abstract
OBJECTIVE This study aims to assess the accuracy of linear alveolar bone measurements for implant planning using cone-beam computed tomography (CBCT) by comparing three 3D imaging software: CareStream (Carestream Health, Rochester, New York, United States), RadiAnt (Medixant, Poznan, Poland), and iRYS (Cefla s.c., Imola, Italy). METHODS Twenty-seven dry goat mandibles were used for this in-vitro study. Gutta-percha markers were placed on the mandibles, which were then scanned using a CBCT machine. Linear measurements of the alveolar bone were taken at the implant sites using CareStream, RadiAnt, and iRYS software, and compared to gold-standard measurements obtained using digital Vernier calipers. Measurements included bone height and width, and the absolute measurement errors were calculated to assess accuracy. RESULTS iRYS consistently provided the most accurate measurements compared to the control, especially at lower error thresholds. RadiAnt tended to overestimate, while CareStream yielded intermediate values. Across all thresholds, iRYS showed the least deviation, followed by CareStream and RadiAnt. Statistical analysis showed no significant differences between the three software programs at higher error thresholds, confirming the reliability of each for implant planning. CONCLUSION All three software programs (iRYS, CareStream, and RadiAnt) offered reliable and accurate measurements for implant planning using CBCT, with iRYS being the most accurate. Clinicians can confidently use any of the three, although iRYS may be preferred for cases requiring higher precision.
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Affiliation(s)
- Ananya Neralla
- Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Bhubaneswar, IND
| | - Silpiranjan Mishra
- Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Bhubaneswar, IND
| | - Sangamesh Nc
- Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Bhubaneswar, IND
| | | | - Atul Anand Bajoria
- Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Bhubaneswar, IND
| | - Dhirendra Singh
- Periodontology, Kalinga Institute of Dental Sciences, Bhubaneswar, IND
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Mancini AXM, Carmozini GA, Inácio TM, Réa MT, Viccari C, Brasil DM, Oliveira-Santos C. Variations in head tilt during the acquisition of cone beam computed tomography scans and their effects on effective radiation dose. Dentomaxillofac Radiol 2024; 53:566-572. [PMID: 39133160 DOI: 10.1093/dmfr/twae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/17/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVES This study evaluated the impact of variations in anteroposterior and lateral tilts of patients head on radiation-weighted doses to organs/tissues and effective doses using 3 different cone beam computed tomography (CBCT) machines. METHODS An anthropomorphic phantom was used to estimate radiation doses in 3 CBCT machines (OP300, Eagle X 3D, and Eagle Edge). Thermoluminescent dosimeters were placed in regions corresponding to pre-stablished organ/tissues. CBCT examinations from the posterior mandible and anterior maxilla regions were acquired, with 3 different anteroposterior angulations (0°, 30°, and 45°), and from the posterior mandible in 3 different lateral angulations (0°, 20° to the left, and 20° to the right side). Radiation-weighted doses for each organ/tissue and effective doses were calculated for each machine and angulation. RESULTS For the posterior mandible acquisitions, anteroposterior angulations of the head at 30° and 45° yielded a reduction in effective doses in all 3 devices. A 20° tilt to the right side resulted in lower doses than to the left [same side as the field of view (FOV)]. For the anterior maxilla, increased anteroposterior angulation was associated with reduction in effective dose in 2 devices. CONCLUSIONS Effective doses are lower when small FOV CBCT exams of the posterior mandible and anterior maxilla are acquired with increased anteroposterior head angulation at 30° and 45°. For FOV in the posterior mandible, a 20° lateral tilt towards the side opposite to the FOV also yields lower effective doses. The main contribution to these dose reductions is the decrease in dose to salivary glands.
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Affiliation(s)
- Arthur X M Mancini
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Gabriela A Carmozini
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Thiago M Inácio
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Marcela T Réa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, 13414-903, Brazil
| | - Cassiana Viccari
- Center for Instrumentation, Dosimetry and Radioprotection (CIDRA), University of Sao Paulo, Ribeirao Preto, Sao Paulo, 14040-904, Brazil
| | - Danieli M Brasil
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, Kentucky, 40208 , United States of America
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, Kentucky, 40208 , United States of America
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Barros-Costa M, Britten J, Jones C, Ramage A, Cascante-Sequeira D, Blackburn M, Swanson C, Santaella GM, Scarfe W, Oliveira-Santos C. Effective doses of scout projections in maxillofacial cone beam computed tomography. Clin Oral Investig 2024; 28:572. [PMID: 39367969 DOI: 10.1007/s00784-024-05971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 09/26/2024] [Indexed: 10/07/2024]
Abstract
OBJECTIVES To assess the effective and organ/tissue equivalent radiation doses of different scout projection protocols in four CBCT units. METHODS Optically stimulated luminescence dosimeters (OSLD) were placed in reference anatomical locations in the head and neck segments of an anthropomorphic phantom representing an average adult male. Ten repeated exposures were obtained from each of the twelve scout projections studied, acquired from four maxillofacial cone beam computed tomography (CBCT) units (Midmark EIOS, 3D Accuitomo F170, Veraviewepocs 3D R100, and Veraview X800). The effective and organ/tissue equivalent doses were calculated for each protocol. RESULTS Effective doses ranged from 0.7 µSv (Accuitomo F170 60 × 60 mm-anterior maxilla) to 6.9 µSv (Midmark 50 × 50 mm-anterior maxilla). The highest organ/tissue equivalent doses were recorded for the oral mucosa and salivary glands; however, the thyroid was the highest contributor to the effective dose, followed by the salivary glands. CONCLUSIONS Despite some variability among CBCT machines and protocols, the acquisition of scout projections is a low-dose procedure. The use of scout projections to ensure an adequate position of the region of interest within the field of view is highly desirable as they contribute minimally to overall CBCT patient dose.
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Affiliation(s)
- Matheus Barros-Costa
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Jack Britten
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA
| | - Colin Jones
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA
| | - Amanda Ramage
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA
| | - Deivi Cascante-Sequeira
- Department of Diagnostic Sciences, University of Costa Rica School of Dentistry, San Jose, Costa Rica
| | - Megan Blackburn
- Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Christine Swanson
- Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Gustavo Machado Santaella
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA
| | - William Scarfe
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA.
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Bernasconi A, Dechir Y, Izzo A, D’Agostino M, Magliulo P, Smeraglia F, de Cesar Netto C, International Weightbearing CT Society, Lintz F. Trends in the Use of Weightbearing Computed Tomography. J Clin Med 2024; 13:5519. [PMID: 39337007 PMCID: PMC11432607 DOI: 10.3390/jcm13185519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
Background: This review aimed to critically appraise the most recent orthopedic literature around cone beam weightbearing computed tomography (WBCT), summarizing what evidence has been provided so far and identifying the main research trends in the area. Methods: This scoping review was performed on studies published between January 2013 and December 2023 on the Pubmed database. All studies (both clinical and nonclinical) in which WBCT had been used were critically analyzed to extract the aim (or aims) of the study, and the main findings related to the role of this imaging modality in the diagnostic pathway. Results: Out of 1759 studies, 129 were selected. One hundred five manuscripts (81%) dealt with elective orthopedic conditions. The majority of the analyses (88 studies; 84%) were performed on foot and ankle conditions, while 13 (12%) studies looked at knee pathologies. There was a progressive increase in the number of studies published over the years. Progressive Collapsing Foot Deformity (22 studies; 25%) and Hallux Valgus (19 studies; 21%) were frequent subjects. Twenty-four (19%) manuscripts dealt with traumatic conditions. A particular interest in syndesmotic injuries was documented (12 studies; 60%). Conclusions: In this review, we documented an increasing interest in clinical applications of weightbearing CT in the orthopedic field between 2013 and 2023. The majority of the analyses focused on conditions related to the foot and the ankle; however, we found several works investigating the value of WBCT on other joints (in particular, the knee).
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Affiliation(s)
- Alessio Bernasconi
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (A.I.); (M.D.); (P.M.); (F.S.)
| | - Yanis Dechir
- Department of Orthopaedic and Trauma Surgery, Centre Hospitalier Universitaire (CHU) de Toulouse, 31300 Toulouse, France;
| | - Antonio Izzo
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (A.I.); (M.D.); (P.M.); (F.S.)
| | - Martina D’Agostino
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (A.I.); (M.D.); (P.M.); (F.S.)
| | - Paolo Magliulo
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (A.I.); (M.D.); (P.M.); (F.S.)
| | - Francesco Smeraglia
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy; (A.I.); (M.D.); (P.M.); (F.S.)
| | | | | | - François Lintz
- Department of Foot and Ankle Surgery, Ramsay Healthcare, Clinique de l’Union, 31240 Saint Jean, France;
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15
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Dai J, Guo X, Zhang H, Xie H, Huang J, Huang Q, Huang B. Cone-beam CT landmark detection for measuring basal bone width: a retrospective validation study. BMC Oral Health 2024; 24:1091. [PMID: 39277722 PMCID: PMC11402203 DOI: 10.1186/s12903-024-04798-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 08/23/2024] [Indexed: 09/17/2024] Open
Abstract
BACKGROUND Accurate assessment of basal bone width is essential for distinguishing individuals with normal occlusion from patients with maxillary transverse deficiency who may require maxillary expansion. Herein, we evaluated the effectiveness of a deep learning (DL) model in measuring landmarks of basal bone width and assessed the consistency of automated measurements compared to manual measurements. METHODS Based on the U-Net algorithm, a coarse-to-fine DL model was developed and trained using 80 cone-beam computed tomography (CBCT) images. The model's prediction capabilities were validated on 10 CBCT scans and tested on an additional 34. To evaluate the performance of the DL model, its measurements were compared with those taken manually by one junior orthodontist using the concordance correlation coefficient (CCC). RESULTS It took approximately 1.5 s for the DL model to perform the measurement task in only CBCT images. This framework showed a mean radial error of 1.22 ± 1.93 mm and achieved successful detection rates of 71.34%, 81.37%, 86.77%, and 91.18% in the 2.0-, 2.5-, 3.0-, and 4.0-mm ranges, respectively. The CCCs (95% confidence interval) of the maxillary basal bone width and mandibular basal bone width distance between the DL model and manual measurement for the 34 cases were 0.96 (0.94-0.97) and 0.98 (0.97-0.99), respectively. CONCLUSION The novel DL framework developed in this study improved the diagnostic accuracy of the individual assessment of maxillary width. These results emphasize the potential applicability of this framework as a computer-aided diagnostic tool in orthodontic practice.
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Affiliation(s)
- Juan Dai
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518055, China
| | - Xinge Guo
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
| | - Hongyuan Zhang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
| | - Haoyu Xie
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
| | - Jiahui Huang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
| | - Qiangtai Huang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China.
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, China.
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Kim HS, Choi YJ, Jeon KJ, Han SS, Lee C. Image quality-based dose optimization in pediatric cone-beam computed tomography: A pilot methodological study. Imaging Sci Dent 2024; 54:264-270. [PMID: 39371303 PMCID: PMC11450406 DOI: 10.5624/isd.20240030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/16/2024] [Accepted: 04/26/2024] [Indexed: 10/08/2024] Open
Abstract
Purpose This study aimed to propose a methodological approach for reducing the radiation dose in pediatric conebeam computed tomography (CBCT), focusing exclusively on balancing image quality with dose optimization. Materials and Methods The dose-area product (DAP) for exposure was reduced using copper-plate attenuation of an X-ray source. The thickness of copper (Cu) was increased from 0 to 2.2 mm, and 10 different DAP levels were used. The QUART DVT_AP phantom and pediatric radiologic dentiform were scanned under the respective DAP levels. The contrast-to-noise ratio (CNR), image homogeneity, and modulation transfer function (MTF) were analyzed using the QUART DVT_AP phantom. An expert evaluation (overall image grade, appropriateness of field of view, artifacts, noise, and resolution) was conducted using pediatric dentiform images. The critical DAP level was determined based on phantom and dentiform analysis results. Results CNR and image homogeneity decreased as the DAP was reduced; however, there was an inflection point of image homogeneity at Cu 1.6 mm (DAP=138.00 mGy·cm2), where the value started increasing. The MTF showed constant values as the DAP decreased. The expert evaluation of overall image grades showed "no diagnostic value" for dentiform images with Cu 1.9-2.2 mm (DAP=78.00-103.33 mGy·cm2). The images with Cu 0-1.6 mm (DAP=138.00-1697.67 mGy·cm2) had a "good," "moderate," or "poor but interpretable" grade. Conclusion Reducing DAP beyond a 1.6-mm Cu thickness degraded CBCT image quality. Image homogeneity and clinical image grades indicated crucial decision points for DAP reduction in pediatric CBCT scans.
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Affiliation(s)
- Hak-Sun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
- Department of Oral and Maxillofacial Radiology, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
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Özköylü G, Saraç D, Sasany R, Umurca DG. Comparison of monoblock and twinblock mandibular advancement devices in patiens with obstructive sleep apnea and temporomandibular disorder: effects on airway volume, polysomnography parameters, and sleepiness scale scores. BMC Oral Health 2024; 24:1026. [PMID: 39215302 PMCID: PMC11365127 DOI: 10.1186/s12903-024-04653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE This study aimed to compare the effects of two different mandibular advancement devices on the upper airway volume, polysomnographic parameters, and sleepiness scale scores in patients with obstructive sleep apnea and Temporomandibular disorders (TMD). MATERIALS AND METHODS Monoblock and twinblock mandibular advancement devices were applied to patients with obstructive sleep apnea syndrome for 3 months separated by a wash-out period of 2 weeks. Research Diagnostic Criteria for TMD (RDC/TMD), Polysomnographic parameters and cone-beam computed tomography findings were recorded before and after the use of the mandibular advancement devices. A three-dimensional analysis of the airway was then performed. RESULTS The use of the monoblock device significantly increased the upper airway volume compared with the use of the twinblock device (p = 0.032). The polysomnographic parameters similarly improved with the use of the twin-block and monoblock devices. The significant reduction in TMD symptoms was observed. CONCLUSION The use of the monoblock device increased the retropalatal airway volume. This volume increase may be attributed to the fact that the design of the monoblock device allows less mandibular movement than does that of the twinblock device. Indicates the potential benefits of MADS treatment in alleviating TMD-related issues. CLINICAL SIGNIFICANCE Monoblock MADs have improved effects on respiratory parameters and upper airway dimensions in patients with OSA and mild to moderate TMD.
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Affiliation(s)
| | - Duygu Saraç
- Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Rafat Sasany
- Department of Prosthodontics, Faculty of Dentistry, İstanbul Biruni University, İstanbul, Turkey.
| | - Dilara Gülhan Umurca
- Department of Othodontics, Faculty of Dentistry, İstanbul Biruni University, İstanbul, Turkey
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18
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Kumar N, Malik B, Dubey A, Kaur H, Mujoo S, Jugade SC, Gulia SK. Long-Term Trends in the Utilization of Cone Beam Computed Tomography in Oral and Maxillofacial Radiology. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2585-S2587. [PMID: 39346142 PMCID: PMC11426885 DOI: 10.4103/jpbs.jpbs_295_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 10/01/2024] Open
Abstract
Background Cone beam computed tomography (CBCT) has become a cornerstone in oral and maxillofacial radiology due to its high-resolution, three-dimensional imaging capabilities and lower radiation exposure compared to traditional computed tomography (CT). The purpose of this retrospective study is to examine long-term patterns in the use of CBCT in a tertiary care context, with an emphasis on patient characteristics, CBCT indications, and variations in use patterns over time. Methods During the course of 5 years, a tertiary care facility performed 500 CBCT scans, all of which were included in the study. Information on the age, sex, and source of referral for each patient was gathered from their electronic medical records. Radiology data were used to categorize CBCT indications, which included implant planning, impacted tooth assessment, and pathology evaluation. Regression analysis and descriptive statistics were used to examine utilization trends. Results Throughout the study period, there was a consistent rise in the use of CBCT, with implant planning being the most often cited indication. Impacted tooth assessment and pathology evaluation were next in line. Considerable differences were noted in the use of CBCT for various age groups and indications. The results demonstrate how CBCT is improving oral and maxillofacial radiology's diagnostic precision and treatment planning. In summary, this study offers a significant understanding of the long-term patterns in CBCT use in a tertiary care context. With ramifications for resource allocation, patient care, and future research objectives, the observed trends highlight the increasing acceptability and incorporation of CBCT into standard clinical practice.
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Affiliation(s)
- Nithin Kumar
- School of Dentistry, Central Asian University, Tashkent, Uzbekistan
| | - Bhavna Malik
- Department of Dentistry, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Alok Dubey
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Harveen Kaur
- Department of Oral Medicine and Radiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Sheetal Mujoo
- Division of Oral Medicine and Radiology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shraddha C. Jugade
- Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Sunil K. Gulia
- Oral and Maxillofacial Surgery, SGT University, Jhajjar, Haryana, India
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Becker K, Ehrlich H, Hüfner M, Rauch N, Busch C, Schwarz-Herzke B, Drescher D, Becker J. Eligibility of a novel BW + technology and comparison of sensitivity and specificity of different imaging methods for radiological caries detection. Oral Radiol 2024; 40:424-435. [PMID: 38683260 PMCID: PMC11180636 DOI: 10.1007/s11282-024-00748-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Bitewing radiography is considered to be of high diagnostic value in caries detection, but owing to projections, lesions may remain undetected. The novel bitewing plus (BW +) technology enables scrolling through radiographs in different directions and angles. The present study aimed at comparing BW + with other 2D and 3D imaging methods in terms of sensitivity, specificity, and user reliability. MATERIALS AND METHODS Five human cadavers were used in this study. In three cadavers, natural teeth were transplanted post-mortem. BW + , two-dimensional (digital sensors, imaging plates, 2D and 3D bitewing radiographs) and 3D methods (high and low dose CBCT) were taken. Carious lesions were evaluated on 96 teeth at three positions (mesial, distal, and occlusal) and scored according to their level of demineralization by ten observers, resulting in 35,799 possible lesions across all observers and settings. For reference, µCT scans of all teeth were performed. RESULTS Overall, radiographic evaluations showed a high rate of false-negative diagnoses, with around 70% of lesions remaining undetected, especially enamel lesions. BW + showed the highest sensitivity for dentinal caries and had comparatively high specificity overall. CONCLUSIONS Within the limits of the study, BW + showed great potential for added diagnostic value, especially for dentinal caries. However, the tradeoff of diagnostic benefit and radiation exposure must be considered according to each patient's age and risk.
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Affiliation(s)
- Kathrin Becker
- Department of Orthodontics and Dentofacial Orthopaedics, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Henrike Ehrlich
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Mira Hüfner
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Caroline Busch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Dieter Drescher
- Department of Orthodontics and Dentofacial Orthopaedics, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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20
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Kulkarni V, Kumar CS, Mishra M, Shetty L, Verma P, Ghosh S, Koul R. Volumetric Analysis and Healing Ratio: Refining Prognostic Assessment in Maxillofacial Cysts Using Cone-Beam Computed Tomography. J Maxillofac Oral Surg 2024; 23:676-687. [PMID: 38911431 PMCID: PMC11190105 DOI: 10.1007/s12663-024-02168-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/16/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Volumetric analysis with imaging techniques provides clinicians with the capability to visualize the spatial extent of the lesions. CBCT offers images with minimal radiation, facilitating a detailed assessment of cystic dimension's relationships. This crucial information helps in formulating appropriate strategies, including excision, enucleation, or nonsurgical approaches. The "Healing ratio" emerges as a valuable technique for prognostic evaluation. Materials and Methods This retrospective study focused on outpatient cases with, clinic-radiologically diagnosed cases of odontogenic keratocyst or radicular cysts. Preoperative CBCT was utilized for volumetric analysis through MIMIC Software. Subsequent analyses were performed at 24 and 48 weeks postoperatively. The healing ratio was calculated for further correlation. Results A total of 21 cases were included in the study, with a mean age of 36.67 years with predominance of males (72.6%, n = 16). Healing ratio estimation revealed minimal or no association with age, gender, and location on point-biserial analysis. Noteworthy implications were observed concerning total cyst volume and the specific diagnosis of the cyst. Results suggested more favorable healing outcomes in smaller cysts and those diagnosed as radicular cysts. Discussion Proficiency in deciphering three-dimensional CBCT images accurately demands specialized training. The crux of our study lies in the application of volumetric analysis, particularly the "Healing Ratio," as a robust means of evaluating prognoses in management. The Healing Ratio, derived from three-dimensional imaging techniques, offers a comprehensive insight into the spatial dynamics of cystic lesions. Our findings underscore its significance as the optimal technique for prognostic assessment in the context of cyst management. Supplementary Information The online version contains supplementary material available at 10.1007/s12663-024-02168-7.
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Affiliation(s)
- Vishal Kulkarni
- Department of Oral & Maxillofacial Surgery, Command Military Dental Centre, Lucknow, India
| | - C. Senthil Kumar
- Department of Oral & Maxillofacial Surgery, Command Military Dental Centre, Lucknow, India
| | - Madan Mishra
- Department of OMFS, Sardar Patel PG Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh India
| | - Lakshmi Shetty
- Department of OMFS, Dr. DY Patil Dental College and Hospital, Dr. DY Patil Vidyapeeth, Pimpri, Pune, India
| | - Pradhuman Verma
- Chairman Department of Oral Medicine and Radiology, Dr Ziauddin Ahmad Dental College and Hospital, Aligarh Muslim University Campus, Aligarh, Uttar Pradesh India
| | - Sirsendu Ghosh
- Department of Biostatistics, Command Military Dental Centre, Lucknow, India
| | - Rahul Koul
- Department of Pedodontics, Army Dental Centre (Research & Referral), Delhi Cantt, New Delhi, India
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Santos AA, de Freitas Silva BS, Correia FFN, Mezaiko E, de Souza Roriz CF, Silva MAG, Freitas DQ, Yamamoto-Silva FP. Optimizing cone-beam computed tomography exposure for an effective radiation dose and image quality balance. Imaging Sci Dent 2024; 54:159-169. [PMID: 38948188 PMCID: PMC11211023 DOI: 10.5624/isd.20230251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose while maintaining image quality. Materials and Methods The effective dose emitted by a CBCT device was calculated using thermoluminescent dosimeters placed in a Rando Alderson phantom. Image quality was assessed by 3 experienced evaluators. The relationship between image quality and confidence was evaluated using the Fisher exact test, and the agreement among raters was assessed using the kappa test. Multiple linear regression analysis was performed to investigate whether the technical parameters could predict the effective dose. P-values<0.05 were considered to indicate statistical significance. Results The optimized protocol (3 mA, 99 kVp, and 450 projection images) demonstrated good image quality and a lower effective dose for radiation-sensitive organs. Image quality and confidence had consistent values for all structures (P<0.05). Multiple linear regression analysis resulted in a statistically significant model. The milliamperage (b=0.504; t=3.406; P=0.027), kilovoltage peak (b=0.589; t=3.979; P=0.016) and number of projection images (b=0.557; t=3.762; P=0.020) were predictors of the effective dose. Conclusion Optimized CBCT acquisition protocols can significantly reduce the effective radiation dose while maintaining acceptable image quality by adjusting the milliamperage and projection images.
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Affiliation(s)
- Ananda Amaral Santos
- Department of Oral Radiology, University of Anápolis, Anápolis, GO, Brazil
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
- Science Program in Dentistry, University of Anápolis, Anápolis, GO, Brazil
| | | | - Eleazar Mezaiko
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Oral Radiology, University of Anápolis, Anápolis, GO, Brazil
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
- Science Program in Dentistry, University of Anápolis, Anápolis, GO, Brazil
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Mihailidis DN, Stratis A, Gingold E, Carlson R, DeForest W, Gray J, Lally MT, Pizzutiello R, Rong J, Spelic D, Hilohi MC, Massoth R. AAPM Task Group Report 261: Comprehensive quality control methodology and management of dental and maxillofacial cone beam computed tomography (CBCT) systems. Med Phys 2024; 51:3134-3164. [PMID: 38285566 DOI: 10.1002/mp.16911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/31/2024] Open
Abstract
Cone-beam computed tomography (CBCT) systems specifically designed and manufactured for dental, maxillofacial imaging (MFI) and otolaryngology (OLR) applications have been commercially available in the United States since 2001 and have been in widespread clinical use since. Until recently, there has been a lack of professional guidance available for medical physicists about how to assess and evaluate the performance of these systems and about the establishment and management of quality control (QC) programs. The owners and users of dental CBCT systems may have only a rudimentary understanding of this technology, including how it differs from conventional multidetector CT (MDCT) in terms of acceptable radiation safety practices. Dental CBCT systems differ from MDCT in several ways and these differences are described. This report provides guidance to medical physicists and serves as a basis for stakeholders to make informed decisions regarding how to manage and develop a QC program for dental CBCT systems. It is important that a medical physicist with experience in dental CBCT serves as a resource on this technology and the associated radiation protection best practices. The medical physicist should be involved at the pre-installation stage to ensure that a CBCT room configuration allows for a safe and efficient workflow and that structural shielding, if needed, is designed into the architectural plans. Acceptance testing of new installations should include assessment of mechanical alignment of patient positioning lasers and x-ray beam collimation and benchmarking of essential image quality performance parameters such as image uniformity, noise, contrast-to-noise ratio (CNR), spatial resolution, and artifacts. Several approaches for quantifying radiation output from these systems are described, including simply measuring the incident air-kerma (Kair) at the entrance surface of the image receptor. These measurements are to be repeated at least annually as part of routine QC by the medical physicist. QC programs for dental CBCT, at least in the United States, are often driven by state regulations, accreditation program requirements, or manufacturer recommendations.
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Affiliation(s)
- Dimitris N Mihailidis
- University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Eric Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ray Carlson
- Radiological Physics Services, Inc, Plymouth, Michigan, USA
| | | | | | - Mary T Lally
- Intersocietal Accreditation Commission, Ellicott City, Maryland, USA
| | | | - John Rong
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - David Spelic
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Mike C Hilohi
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Richard Massoth
- Sunflower Medical Physics, LLC, Sioux Falls, South Dakota, USA
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23
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Tabellion M, Schneider JLFG, Linsenmann CC, Lisson JA. Comparison of PAS and adenoids in patients with and without maxillary micrognathia before orthodontic treatment. Clin Oral Investig 2024; 28:252. [PMID: 38627272 PMCID: PMC11021280 DOI: 10.1007/s00784-024-05657-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Craniofacial anomalies are widely discussed as predisposing factors of breathing disorders. Since many more cofactors exist, this study investigated the association between maxillary micrognathia and morphological changes of posterior airway space and adenoids in these patients. MATERIAL AND METHODS Cephalometric radiographs of n = 73 patients were used for data acquisition. The patients were divided into two groups according to certain skeletal characteristics: maxillary micrognathia (n = 34, 16 female, 18 male; mean age 10.55 ± 3.03 years; defined by a SNA angle < 79°) and maxillary eugnathia (n = 39, 19 female, 20 male; mean age 10.93 ± 3.26 years; defined by a SNA angle > 79°). The evaluation included established procedures for measurements of the maxilla, posterior airway space and adenoids. Statistics included Kolmogorov-Smirnov-, T- and Mann-Whitney-U-Tests for the radiographs. The level of significance was set at p < 0.05. RESULTS The cephalometric analysis showed differences in the superior posterior face height and the depth of the posterior airway space at palatal level among the two groups. The depth of the posterior airway space at mandibular level was the same for both groups, just as the size of the area taken by adenoids in the nasopharynx. CONCLUSIONS Skeletal anomalies affect the dimension of the posterior airway space. There were differences among the subjects with maxillary micrognathia and these with a normal maxilla. However, the maxilla was only assessed in the sagittal direction, not in the transverse. This study showed that the morphology of the maxilla relates to the posterior airway space whereas the adenoids seem not to be affected. CLINICAL RELEVANCE Maxillary micrognathia is significantly associated with a smaller depth of the posterior airway space at the palatal level compared to patients with maxillary eugnathia.
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Affiliation(s)
- Maike Tabellion
- Department of Orthodontics, Saarland University, Homburg, Saar, Germany.
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24
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Berends B, Bielevelt F, Schreurs R, Vinayahalingam S, Maal T, de Jong G. Fully automated landmarking and facial segmentation on 3D photographs. Sci Rep 2024; 14:6463. [PMID: 38499700 PMCID: PMC10948387 DOI: 10.1038/s41598-024-56956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/13/2024] [Indexed: 03/20/2024] Open
Abstract
Three-dimensional facial stereophotogrammetry provides a detailed representation of craniofacial soft tissue without the use of ionizing radiation. While manual annotation of landmarks serves as the current gold standard for cephalometric analysis, it is a time-consuming process and is prone to human error. The aim in this study was to develop and evaluate an automated cephalometric annotation method using a deep learning-based approach. Ten landmarks were manually annotated on 2897 3D facial photographs. The automated landmarking workflow involved two successive DiffusionNet models. The dataset was randomly divided into a training and test dataset. The precision of the workflow was evaluated by calculating the Euclidean distances between the automated and manual landmarks and compared to the intra-observer and inter-observer variability of manual annotation and a semi-automated landmarking method. The workflow was successful in 98.6% of all test cases. The deep learning-based landmarking method achieved precise and consistent landmark annotation. The mean precision of 1.69 ± 1.15 mm was comparable to the inter-observer variability (1.31 ± 0.91 mm) of manual annotation. Automated landmark annotation on 3D photographs was achieved with the DiffusionNet-based approach. The proposed method allows quantitative analysis of large datasets and may be used in diagnosis, follow-up, and virtual surgical planning.
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Affiliation(s)
- Bo Berends
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Freek Bielevelt
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Ruud Schreurs
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (UMC), AMC, Academic Center for Dentistry Amsterdam (ACTA), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center Nijmegen, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Thomas Maal
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Guido de Jong
- 3D Lab Radboudumc, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Rashid A, Feinberg L, Fan K. The Application of Cone Beam Computed Tomography (CBCT) on the Diagnosis and Management of Maxillofacial Trauma. Diagnostics (Basel) 2024; 14:373. [PMID: 38396412 PMCID: PMC10888223 DOI: 10.3390/diagnostics14040373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
The assessment and management of facial trauma in an acute setting is one of the core services provided by oral and maxillofacial units in the United Kingdom. Imaging is a pre-requisite for appropriate diagnosis and treatment planning, with a combination of plain radiographs and medical-grade CT being the mainstay. However, the emergence of cone beam CT in recent years has led to its wider applications, including facial trauma assessment. It can offer multi-planar reformats and three-dimensional reconstruction at a much lower radiation dose and financial cost than conventional CT. The purpose of this review is to appraise its potential indications in all anatomical areas of maxillofacial trauma and provide our experience at a level 1 trauma centre.
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Affiliation(s)
- Arif Rashid
- St George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK;
| | - Lee Feinberg
- King’s College Hospital NHS Foundation Trust, King’s College London, London SE5 9RS, UK;
| | - Kathleen Fan
- King’s College Hospital NHS Foundation Trust, King’s College London, London SE5 9RS, UK;
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Aboelmaaty W, Alfadley A, Awawdeh M, Sapri AS, Awawdeh L, Mira ES. Utilizing a Novel AI Tool to Detect the Posterior Superior Alveolar Artery's Location's Impact on Maxillary Sinus Mucosal Thickening in the Presence of Periapical Lesions. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:140. [PMID: 38256400 PMCID: PMC10820000 DOI: 10.3390/medicina60010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Periapical lesions have been implicated in sinus-related complications, but the precise influence of anatomical variations in the posterior superior alveolar artery (PSAA) on mucosal thickening remains an uncharted aspect. The new AI tool employed in this research utilizes advanced image processing algorithms to enhance image visualization. Background and Objectives: This study examines the accuracy of a new cone beam computed tomography (CBCT) software (eVol DXS, version 1.0.1.0) employing AI to detect the PSAA's location and the effect of that on maxillary sinus thickening in the presence of periapical lesions. Materials and Methods: This retrospective study included 120 CBCT cases with posterior maxillary periapical lesions and 120 without odontogenic infections. Teeth with proximity (<2 mm) to the sinus were excluded in both groups to eliminate the sinus floor's perforation effect. Both the PSAA locations and maxillary sinus thickening were classified and compared. Results: The mucosal thickening differs significantly (p < 0.001) between the study group and the control group. The study showed that an increased sinus thickness occurred when the PSAA was beneath the sinus membrane in the study group (62.5% compared to 8.6%; p < 0.001 *). The AI tool helped to achieve a 100% identification rate in determining the PSAA locations. Conclusions: AI algorithms for PSAA localization, which affects mucosal thickness in response to periapical lesions, yield excellent results.
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Affiliation(s)
- Wael Aboelmaaty
- Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia
- Oral Radiology and Diagnostic Sciences Department, Faculty of Dentistry, Mansoura University, Mansoura City 35516, Egypt;
- Dental Services, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia; (A.A.); (M.A.)
- King Abdullah International Medical Research Center, Ministry of National Guard—Health Affairs, Riyadh 11481, Saudi Arabia
| | - Abdulmohsen Alfadley
- Dental Services, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia; (A.A.); (M.A.)
- King Abdullah International Medical Research Center, Ministry of National Guard—Health Affairs, Riyadh 11481, Saudi Arabia
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Mohammed Awawdeh
- Dental Services, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia; (A.A.); (M.A.)
- King Abdullah International Medical Research Center, Ministry of National Guard—Health Affairs, Riyadh 11481, Saudi Arabia
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia
- College of Medicine & Dentistry, Ulster University, Birmingham B4 6BN, UK
| | - Ahmed Saaduddin Sapri
- Division of Oral and Maxillofacial Surgery, Batterjee Medical College, Jeddah 21442, Saudi Arabia;
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura City 35516, Egypt
| | - Lama Awawdeh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Eman Shawky Mira
- Oral Radiology and Diagnostic Sciences Department, Faculty of Dentistry, Mansoura University, Mansoura City 35516, Egypt;
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Takusagawa M, Nishii Y, Nojima K, Abe S, Takaki T, Sueishi K. Three-dimensional Maxillofacial Morphology Measurements in Japanese Adults with Normal Occlusion. THE BULLETIN OF TOKYO DENTAL COLLEGE 2023; 64:115-124. [PMID: 37967938 DOI: 10.2209/tdcpublication.2023-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Accurate orthodontic analysis and diagnosis based on anatomical landmarks is essential to the success of orthodontic treatment. Helical computed tomography (CT) has evolved markedly, and dentists can now quickly obtain 3-dimensional (3D) reconstruction data using this imaging modality. The planning of orthodontic treatment had traditionally been based on cephalometric analysis using 2D landmarks. This study aimed to collect 3D morphological data using CT images to establish new landmarks for analysis and diagnosis in orthodontic treatment. Twenty male and 20 female adult Japanese dry skulls with of normal occlusion were selected. The skulls were scanned using a multidetector helical CT system (SIEMENS, Volume Zoom Plus 4, Germany). Models were reconstructed using 3D measurement software (Simplant, Dentsply Sirona, Tokyo, Japan) and 45 landmarks determined. Three-dimensional measurement for a total of 30 items representing these landmarks was then performed. The results provided 3D standard values for maxillofacial morphology in adult Japanese individuals with normal occlusion. These measurement items should allow the disadvantages of 2D cephalometric analysis to be overcome.
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Affiliation(s)
| | | | - Kunihiko Nojima
- Department of Orthodontics, Tokyo Dental College Chiba Dental Center
| | | | - Takashi Takaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College Chiba Dental Center
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Cascante-Sequeira D, Oliveira-Santos C, Brasil DM, Santaella GM, Swanson C, Blackburn M, Scarfe WC, Haiter-Neto F. Convex triangular vs. cylindrical field of view: how does the shape of the FOV affect radiation dose? Clin Oral Investig 2023; 27:7881-7888. [PMID: 37993703 DOI: 10.1007/s00784-023-05380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To compare the dosimetry between convex triangular fields of view (FOV) and similar dimension cylindrical FOVs of two cone-beam computed tomography (CBCT) models. METHODS Optically stimulated luminescence dosimeters (OSLDs) were placed in fiducial anatomical locations in an anthropomorphic phantom representing an adult head male for dosimetry scans. Convex triangular FOVs (100 × 80 mm/maxilla-mandible; 100 × 50 mm mandible; 100 × 50 mm/maxilla) from Veraviewepocs 3D R100 (J. Morita, Kyoto, Japan) (R100) and Veraview® X800 (J. Morita, Kyoto, Japan) (X800) and cylindrical FOVs from R100 and X800 (80 × 80 mm/maxilla-mandible; 80 × 50 mm/mandible; 80 × 50 mm/maxilla) were obtained, resulting in 12 different scan protocols. Equivalent doses for each relevant organ/tissue and the effective dose for each protocol were calculated. Mean effective doses were compared by the two-way analysis of variance (ANOVA) with Tukey's post hoc test to evaluate the effect of the FOV and device (α = 0.05). RESULTS The effective doses ranged between 69 and 324 μSv for the convex triangular FOVs and 76 and 332 μSv for the cylindrical FOVs. Convex triangular FOVs from the R100 device had effective doses 2.3 to 15.3% lower than their corresponding cylindrical FOVs with similar height (p < 0.05), and that difference ranged between 8.8 and 11.8% for the X800 device (p < 0.05). CONCLUSION Convex triangular fields of view delivered slightly lower effective doses than the cylindrical fields of view of similar dimensions in the R100 and X800 CBCT devices. CLINICAL RELEVANCE Understanding the influence of the image geometry formation in effective dose allows optimization to reduce patient dose.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Danieli Moura Brasil
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Gustavo M Santaella
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Christine Swanson
- Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Megan Blackburn
- Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA
| | - William C Scarfe
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, KY, USA
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Jadhav A, Desai NG, Tadinada A. Accuracy of Anatomical Depictions in Cone Beam Computed Tomography (CBCT)-Reconstructed Panoramic Projections Compared to Conventional Panoramic Radiographs: A Clinical Risk-Benefit Analysis. Cureus 2023; 15:e44723. [PMID: 37809250 PMCID: PMC10552931 DOI: 10.7759/cureus.44723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Two-dimensional (2D) radiographs are the standard of care for diagnosis and treatment planning in the day-to-day practice of dentistry. With the growing popularity of cone beam computed tomography (CBCT), it is now becoming the standard of care in many areas of general dentistry due to its ability to create non-linear projections from volumetric data. The CBCT-generated non-orthogonal radiographs can serve as easy-to-use 2D and three-dimensional (3D) diagnostic tools and offer a similar experience for diagnosis as conventional 2D images. The aim of this study is to compare the accuracy of conventional radiographs and CBCT-generated projections to identify relevant anatomic landmarks and their associated variants. METHODS Thirty-two patients referred to the University of Connecticut School of Dental Medicine's Advanced Imaging Center were selected for this retrospective analysis. Nineteen anatomical landmarks were retrospectively assessed on conventional panoramic and CBCT scans generated panoramic radiographs using two different digital imaging and communications in medicine viewers. A total of 1,216 anatomical landmarks were evaluated by two oral and maxillofacial radiologists to assess the accuracy and consistency of the depiction of radiographic anatomy. RESULTS There was a very good agreement between the two evaluators with a Cohen's kappa value of 0.934. McNemar change test concluded that the anatomical assessment values compared between conventional panoramic and CBCT-generated panoramic radiographs are similar. CONCLUSION This study showed that CBCT-generated panoramic images are comparable to conventional panoramic radiographs in identifying anatomical landmarks typically evaluated using a conventional panoramic projection. In addition, they have the added advantage of having 3D information in the acquired volume to better evaluate the area of interest. In clinical situations where a mid- to large-volume CBCT scan is available, a simulated panoramic image can be generated using the CBCT volume, leaving exposure of the patient to the additional radiation of a panoramic image unnecessary.
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Affiliation(s)
- Aniket Jadhav
- Oral and Maxillofacial Radiology, Virginia Commonwealth University School of Dentistry, Richmond, USA
| | - Neha G Desai
- Dentistry and Public Health, Jefferson Dental Care (JDC) Healthcare, Houston, USA
| | - Aditya Tadinada
- Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
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Benavides E, Bhula A, Gohel A, Lurie AG, Mallya SM, Ramesh A, Tyndall DA. Patient shielding during dentomaxillofacial radiography: Recommendations from the American Academy of Oral and Maxillofacial Radiology. J Am Dent Assoc 2023; 154:826-835.e2. [PMID: 37530694 DOI: 10.1016/j.adaj.2023.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The American Academy of Oral and Maxillofacial Radiology established an ad hoc committee to draft evidence-based recommendations and clinical guidance for the application of patient contact shielding during dentomaxillofacial imaging. TYPES OF STUDIES REVIEWED The committee reviewed monographs and reports from radiation protection organizations and studies that reported radiation dose to gonads, breasts, and thyroid gland from dentomaxillofacial imaging. RESULTS Considering the absence of radiation-induced heritable effects in humans and the negligible dose to the gonads and fetus from dentomaxillofacial imaging, the committee recommends discontinuing shielding of the gonads, pelvic structures, and fetuses during all dentomaxillofacial radiographic imaging procedures. On the basis of radiation doses from contemporaneous maxillofacial imaging, the committee considered that the risks from thyroid cancer are negligible and recommends that thyroid shielding not be used during intraoral, panoramic, cephalometric, and cone-beam computed tomographic imaging. PRACTICAL IMPLICATIONS This position statement informs and educates the reader on evolving radiation protection practices and provides simple, unequivocal guidance to dental personnel to implement these guidelines. State and local authorities should be contacted to update regulations to reflect these recommendations.
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Zhang L, Zhang Y, Xu Q, Shu J, Xu B, Liu L, Chen H, Hu Y, Li Y, Song L. Increased risks of maxillary sinus mucosal thickening in Chinese patients with periapical lesions. Heliyon 2023; 9:e18050. [PMID: 37519707 PMCID: PMC10372233 DOI: 10.1016/j.heliyon.2023.e18050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives This study aimed to evaluate the effects of factors related to periapical lesions (PALs) on sinus membrane thickening (SMT) in the Chinese population using cone-beam computed tomography (CBCT). Methods In this retrospective study, CBCT images (n = 512) of maxillary sinuses of 446 patients were evaluated by two examiners for SMT and PALs, PAL size, and the distance between the maxillary sinus floor (MSF), and the PAL's edge/root apex. The data were analyzed using analysis of variance, the Kruskal-Wallis test, χ2-test, and logistic regression. Results A binary logistic regression model showed that the prevalence and severity of SMT > 2 mm were significantly associated with older age (>60 years) (odds ratio [OR]: 4.03, 95% confidence interval [CI]): 2.24-7.72, P < 0.001], male sex (OR: 2.08, 95% CI: 1.21-3.56, P < 0.006), and PALs (OR: 6.89, 95% CI: 3.93-12.08, P < 0.001). The type of contact and penetration between the MSF and PALs or root apex showed a more significant relation with SMT > 2 mm than did distance after adjusting for confounding factors, including age and sex (PALs: OR = 10.17 and 14.57, P < 0.001; root apex: OR = 3.49 and 5.86, P < 0.001). Conclusions The prevalence and severity of SMT were significantly associated with older age, male sex, PALs, PAL size, and the distance between the MSF and PALs/root apex. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of SMT of dental origin.
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Affiliation(s)
- Limin Zhang
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yanan Zhang
- Department of Stomatology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, China
| | - Qimei Xu
- School of Stomatology, Bengbu Medical College, Bengbu, Anhui 233000, China
| | - Jingjing Shu
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bin Xu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liuhui Liu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Huijuan Chen
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yue Hu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yinghua Li
- Clinical Laboratory, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liang Song
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
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Kang SR, Shin W, Yang S, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ. Structure-preserving quality improvement of cone beam CT images using contrastive learning. Comput Biol Med 2023; 158:106803. [PMID: 36989743 DOI: 10.1016/j.compbiomed.2023.106803] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/13/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Cone-beam CT (CBCT) is widely used in dental clinics but exhibits limitations in assessing soft tissue pathology because of its lack of contrast resolution and low Hounsfield Units (HU) quantification accuracy. We aimed to increase the image quality and HU accuracy of CBCTs while preserving anatomical structures. We generated CT-like images from CBCT images using a patchwise contrastive learning-based GAN model. Our model was trained on unpaired CT and CBCT datasets with the novel combination of losses and the feature extractor pretrained on our training dataset. We evaluated the quality of the images generated by our model in terms of Fréchet inception distance (FID), peak signal-to-noise ratio (PSNR), mean absolute error (MAE), and root mean square error (RMSE). Additionally, the structure preservation performance was assessed by the structure score. As a result, the generated CT-like images by our model were significantly superior to those generated by various baseline models in terms of FID, PSNR, MAE, RMSE, and structure score. Therefore, we demonstrated that our model provided the complementary benefits of preserving the anatomical structures of the input CBCT images and improving the image quality to be similar to those of CT images.
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Jouhar R, Alkhames HM, Ahmed MA, Almadeh NM, Faheemuddin M, Umer MF. CBCT Evaluation of Periapical Pathologies in Maxillary Posterior Teeth and Their Relationship with Maxillary Sinus Mucosal Thickening. Healthcare (Basel) 2023; 11:787. [PMID: 36981444 PMCID: PMC10048390 DOI: 10.3390/healthcare11060787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.
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Affiliation(s)
- Rizwan Jouhar
- Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia; (H.M.A.); (M.A.A.); (N.M.A.)
- Department of Operative Dentistry and Endodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
| | - Hussain Mohammed Alkhames
- Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia; (H.M.A.); (M.A.A.); (N.M.A.)
| | - Muhammad Adeel Ahmed
- Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia; (H.M.A.); (M.A.A.); (N.M.A.)
| | - Naji Mohammad Almadeh
- Department of Restorative Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia; (H.M.A.); (M.A.A.); (N.M.A.)
| | - Muhammad Faheemuddin
- Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Muhammad Farooq Umer
- Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Vinayahalingam S, Berends B, Baan F, Moin DA, van Luijn R, Bergé S, Xi T. Deep learning for automated segmentation of the temporomandibular joint. J Dent 2023; 132:104475. [PMID: 36870441 DOI: 10.1016/j.jdent.2023.104475] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVE Quantitative analysis of the volume and shape of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) requires accurate segmentation of the mandibular condyles and the glenoid fossae. This study aimed to develop and validate an automated segmentation tool based on a deep learning algorithm for accurate 3D reconstruction of the TMJ. MATERIALS AND METHODS A three-step deep-learning approach based on a 3D U-net was developed to segment the condyles and glenoid fossae on CBCT datasets. Three 3D U-Nets were utilized for region of interest (ROI) determination, bone segmentation, and TMJ classification. The AI-based algorithm was trained and validated on 154 manually segmented CBCT images. Two independent observers and the AI algorithm segmented the TMJs of a test set of 8 CBCTs. The time required for the segmentation and accuracy metrics (intersection of union, DICE, etc.) was calculated to quantify the degree of similarity between the manual segmentations (ground truth) and the performances of the AI models. RESULTS The AI segmentation achieved an intersection over union (IoU) of 0.955 and 0.935 for the condyles and glenoid fossa, respectively. The IoU of the two independent observers for manual condyle segmentation were 0.895 and 0.928, respectively (p<0.05). The mean time required for the AI segmentation was 3.6 s (SD 0.9), whereas the two observers needed 378.9 s (SD 204.9) and 571.6 s (SD 257.4), respectively (p<0.001). CONCLUSION The AI-based automated segmentation tool segmented the mandibular condyles and glenoid fossae with high accuracy, speed, and consistency. Potential limited robustness and generalizability are risks that cannot be ruled out, as the algorithms were trained on scans from orthognathic surgery patients derived from just one type of CBCT scanner. CLINICAL SIGNIFICANCE The incorporation of the AI-based segmentation tool into diagnostic software could facilitate 3D qualitative and quantitative analysis of TMJs in a clinical setting, particularly for the diagnosis of TMJ disorders and longitudinal follow-up.
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Affiliation(s)
- Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands.
| | - Bo Berends
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands; Radboudumc 3DLab, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Frank Baan
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands; Radboudumc 3DLab, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Rik van Luijn
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Postal number 590, Nijmegen, HB 6500, The Netherlands
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Yang P, Xuan B, Li G, Qi S. Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis. BMC Oral Health 2023; 23:127. [PMID: 36841769 PMCID: PMC9960480 DOI: 10.1186/s12903-023-02832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVE This systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination. METHODS We performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2-0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I2 statistics, in which I2 > 50% was considered substantial heterogeneity. RESULTS A total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = - 0.56, 95%-CI = - 0.99 ~ - 0.13, p = 0.01). Because of the high heterogeneity among the studies (I2 = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I2 = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD = - 0.35, 95%-CI = - 0.59 ~ - 0.11, p = 0.004). CONCLUSION This review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.
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Affiliation(s)
- Pan Yang
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China
| | - Bin Xuan
- Department of Stomatology, Aerospace Center Hospital, Beijing, China
| | - Gang Li
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
| | - Senrong Qi
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
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Mirdad A, Alaqeely R, Ajlan S, Aldosimani MA, Ashri N. Incidence of maxillary sinus septa in the saudi population. BMC Med Imaging 2023; 23:23. [PMID: 36739395 PMCID: PMC9898957 DOI: 10.1186/s12880-023-00980-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/30/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The variability in the maxillary sinus anatomy makes dental implant planning challenging. One of the anatomical landmarks that could affect the decision for implant placement around the maxillary sinus is the sinus septa. This study aimed to retrospectively determine the prevalence, anatomical distribution, and morphology of the maxillary sinus septa. MATERIALS AND METHODS This study included 309 CBCT images that were analyzed to determine the prevalence, height, location, and orientation of the maxillary sinus septa. Descriptive statistics, Mann‒Whitney U tests, and Kruskal‒Wallis tests were used for data analysis. RESULTS A total of 618 maxillary sinuses were analyzed. Maxillary septa were present in 30% (n = 188) of the sinuses and in approximately 45% of the analyzed images. The mean height of the septa was 5.09 mm. The presence of bilateral septa was evident in 49 subjects (35.25%). Female subjects were significantly more likely to have only one septum (n = 67, 53.6%, p < 0.05). CONCLUSION The presence of septa is very common, found in one-third to approximately half of the evaluated cases, which warrants careful examination before any surgical interventions to avoid possible complications.
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Affiliation(s)
- Amani Mirdad
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Razan Alaqeely
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sumaiah Ajlan
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mazen A. Aldosimani
- grid.56302.320000 0004 1773 5396Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nahid Ashri
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Rath DR, NC DS, Bajoria DAA, Pani SR. Cone- Beam Computed Tomography study of morphologic and morphometric characteristics of Mental Foramen in an Eastern Indian population. FORENSIC IMAGING 2023. [DOI: 10.1016/j.fri.2023.200538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Khanagar SB, Alfadley A, Alfouzan K, Awawdeh M, Alaqla A, Jamleh A. Developments and Performance of Artificial Intelligence Models Designed for Application in Endodontics: A Systematic Review. Diagnostics (Basel) 2023; 13:414. [PMID: 36766519 PMCID: PMC9913920 DOI: 10.3390/diagnostics13030414] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Technological advancements in health sciences have led to enormous developments in artificial intelligence (AI) models designed for application in health sectors. This article aimed at reporting on the application and performances of AI models that have been designed for application in endodontics. Renowned online databases, primarily PubMed, Scopus, Web of Science, Embase, and Cochrane and secondarily Google Scholar and the Saudi Digital Library, were accessed for articles relevant to the research question that were published from 1 January 2000 to 30 November 2022. In the last 5 years, there has been a significant increase in the number of articles reporting on AI models applied for endodontics. AI models have been developed for determining working length, vertical root fractures, root canal failures, root morphology, and thrust force and torque in canal preparation; detecting pulpal diseases; detecting and diagnosing periapical lesions; predicting postoperative pain, curative effect after treatment, and case difficulty; and segmenting pulp cavities. Most of the included studies (n = 21) were developed using convolutional neural networks. Among the included studies. datasets that were used were mostly cone-beam computed tomography images, followed by periapical radiographs and panoramic radiographs. Thirty-seven original research articles that fulfilled the eligibility criteria were critically assessed in accordance with QUADAS-2 guidelines, which revealed a low risk of bias in the patient selection domain in most of the studies (risk of bias: 90%; applicability: 70%). The certainty of the evidence was assessed using the GRADE approach. These models can be used as supplementary tools in clinical practice in order to expedite the clinical decision-making process and enhance the treatment modality and clinical operation.
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Affiliation(s)
- Sanjeev B. Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Abdulmohsen Alfadley
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Khalid Alfouzan
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Mohammed Awawdeh
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Ali Alaqla
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Ahmed Jamleh
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
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Soundarajan S, Kaarthikeyan G. Evaluation of alveolar antral anastomosis in south Indian population using cone beam computed tomography: a prospective study. Oral Radiol 2023; 39:101-107. [PMID: 35488959 DOI: 10.1007/s11282-022-00607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/04/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA), both of which are ultimate branches of the maxillary artery, are connected by a horizontal anastomosis. PSAA anastomoses intraosseously and extraosseously with IOA. Profuse bleeding from the lateral wall while performing the direct sinus augmentation is a significant intraoperative complication.Thus the present study focused to assess the location of an alveolar antral anastomosis (AAA) in relation to the crest of the alveolar bone using cone beam computed tomography (CBCT). METHODS A total of 200 CBCT scans of patients who were indicated for implant surgery were chosen and assessed. Group 1 includes 100 dentate patients and Group 2 includes 100 partially edentulous patients. The location of anastomosis along the lateral wall of the maxillary sinus was evaluated in association with alveolar bone height with respect to three posterior maxillary teeth: first premolar, second premolar, and first molar. RESULTS The mean distance for P1, P2, and M1 was 21.94 ± 1.02 mm, 19.41 ± 0.40 mm, and 17.36 ± 0.51 mm, respectively, in the dentate group, whereas in the edentulous group, it was 20.07 ± 0.46 mm, 18.95 ± 0.32 mm, and 16.08 ± 0.16 mm. In 80% of participants, the distance of an AAA from the alveolar crest was between 16 and 23 mm, whereas in 12% of the participants the distance of an AAA from the alveolar crest was less than 16 mm. CONCLUSION The present study concludes that the first premolar region is safe for preparing the lateral window but for the second premolar and first molar additional care should be taken prior to surgery.
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Affiliation(s)
- Subasree Soundarajan
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, 600077, Tamil Nadu, India
| | - Gurumoorthy Kaarthikeyan
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, 600077, Tamil Nadu, India.
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Pinto Nicodemo O, Fiori-Chíncaro GA, Agudelo-Botero AM, Llaguno-Rubio JM, García Díaz R. [Radiation dose permitted in dentistry patients. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e144. [PMID: 38303741 PMCID: PMC10832395 DOI: 10.21142/2523-2754-1101-2023-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/01/2023] [Indexed: 02/03/2024] Open
Abstract
In dental practice, the use of imaging has increased over the years, generating an increase in the radiation dose for the dental patient. One factor under discussion is the amount of dose used in patients, men, women and children, at different stages of their life, due to the scientific evidence of the harmful effects of ionizing radiation. This review of the literature analyzed the characteristics of radiation and its effects in relation to the doses administered, and its equivalences in dental practice in panoramic periapical radiographs and cone beam tomographies. A search of the literature was carried out in the main information sources such as Medline (via PubMed), SEVIER, SCIELO, and LILACS, using the search terms with a date limitation of the last 10 years. The selected articles had to include information regarding the keywords used, including "Dental Offices, Radiation Dose, X-Rays, Ambulatory Care."
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Affiliation(s)
- Omar Pinto Nicodemo
- Carrera de Estomatologia, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca. Sucre, Bolivia. Universidad Mayor de San Francisco Xavier Carrera de Estomatologia Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca Sucre Bolivia
| | - Gustavo Adolfo Fiori-Chíncaro
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Ana María Agudelo-Botero
- Facultad de Estomatologia, Universidad Autonoma de Manizales. Manizales, Colombia. Universidad Autonoma de Manizales Facultad de Estomatologia Universidad Autonoma de Manizales Manizales Colombia
| | - Jhoana M Llaguno-Rubio
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Rosaura García Díaz
- Facultad de Estomatologia, Universidad de Guadalajara. Guadalajara, Mexico. Universidad de Guadalajara Facultad de Estomatologia Universidad de Guadalajara Guadalajara Mexico
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Patil DJ, More CB, Venkatesh R, Shah P. Insight in to the Awareness of CBCT as an Imaging Modality in the Diagnosis and Management of ENT Disorders: A Cross Sectional Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5283-5293. [PMID: 36742614 PMCID: PMC9895214 DOI: 10.1007/s12070-020-02209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023] Open
Abstract
The advent of Cone-beam computed tomography (CBCT), has revolutionized 3D imaging in dentistry. CBCT has enormous potential to be used as an alternative imaging modality by Otolaryngologists. But their knowledge regarding CBCT is limited. The study aims to evaluate the awareness of CBCT as an imaging modality among Ear, nose and Throat (ENT) practitioners. The validated questionnaire was sent by email and the participants were asked to fill the google form through the link provided to record the responses. The participants were asked to answer 25 multiple choice questions regarding the general information and practice related to CBCT imaging. Data was evaluated according to the descriptive statistics and the Chi-square test was used to determine the test of significance. The response rate for this study was 84.4%. The mean age of the participants was 44.9 ± 11.3. 69% of the respondents were academicians,14.2% had exclusive clinical practice, and 16.8% had both clinical and academic exposure. Among the study population, 76.8% had never advised CBCT in their practice. Only 10.3% of the study participants were aware of the potential of CBCT in ENT disorders. The mean knowledge, attitude and practice scores were very low regarding the applications of CBCT. Most of the study participants advised CBCT for maxillofacial fractures (78.1%) and was statistically significant p < 0.05. The knowledge about various advantages and clinical applications of CBCT among Otolaryngologists is limited. However, continuing medical education and inclusion in the medical curriculum will increase the scope and awareness about CBCT among ENT fraternity.
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Affiliation(s)
- Deepa Jatti Patil
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Chandramani B. More
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Rashmi Venkatesh
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Palak Shah
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
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Safi Y, Behnam B, Amid R, Kadkhodazadeh M. Soft and Hard Tissue Changes Subsequent to Spontaneous Healing of the Extraction Sockets Using Cone-Beam Computed Tomography: A Cross-Sectional Study. J Maxillofac Oral Surg 2022; 21:1168-1174. [PMID: 36896068 PMCID: PMC9989054 DOI: 10.1007/s12663-021-01651-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022] Open
Abstract
Objective This study sought to compare the thickness of hard and soft tissues between edentulous and contralateral tooth sites. Materials and Methods This split-mouth study evaluated 153 partially edentulous patients. The measurements were made on cone-beam computed tomography (CBCT) scans. The soft tissue thickness was measured at the cementoenamel junctional (CEJ) level, and at 2, 4, and 6 mm apical to the CEJ in the facial and palatal aspects. The bone thickness of the opposite quadrant was also recorded at 2, 4, and 6 mm apical to the CEJ. The Mann-Whitney U test and the Spearman's rank correlation coefficient were applied for further statistical analyses. Results At the edentulous sites, significant soft tissue loss was noted at the CEJ level (p < 0.0001) and a considerable gain was noted at 2, 4, and 6 mm apical to the CEJ (p = 0.004, p < 0.0001, p ≤ 0.0001, respectively). A significant hard tissue loss was noted at 2 mm apical to the CEJ but a significant hard tissue gain was observed at the edentulous sites (p < 0.0001). The soft tissue gain at 6 mm apical to the CEJ was significantly associated with an increase in buccolingual diameter (p = 0.004) while the hard tissue loss at 2 mm apical to the CEJ was significantly correlated with a reduction in buccolingual diameter (p = 0.020). Conclusion Different amounts of tissue thickness alterations occurred in different levels of socket.
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Affiliation(s)
- Yaser Safi
- Oral and Maxillofacial Radiology Department, Dental School, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Behnoosh Behnam
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Velenjak St, Chamran Highway, 1983963113 Evin, Tehran, Iran
| | - Reza Amid
- Periodontics Department, Dental School, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Velenjak St, Chamran Highway, 1983963113 Evin, Tehran, Iran
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Akkurt A, Doğru M. Three dimensional evaluation of the effect of rapid maxillary expansion on maxillary sinus volume. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e930-e935. [PMID: 35840035 DOI: 10.1016/j.jormas.2022.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022]
Abstract
AIM To compare the maxillary sinus volume (MSV) of posterior cross bite (PCB) patients before and after rapid maxillary expansion (RME) by cone-beam computed tomography (CBCT). METHODS A total of 24 patients' CBCT scans that underwent RME therapy for their orthodontic treatment were used. CBCTs were obtained before (T1), immediately after (T2), and 6 months after (T3) RME. MSVs were calculated by using the 3D module of Dolphin 11.0 software. Repeated measures ANOVA (RMANOVA) was used to identify the MSV differences. RESULTS The results showed no significant differences between the right and left MSVs of the T1 group (p>.05). No significant differences were found between the right and left side MSV of the T2 group (p>.05). There were no significant differences between the right and left side MSV of the T3 group (p>.05). According to the intergroup comparisons, the RMANOVA test results revealed statistically significant right (F = 459.37, p<.001), left (F = 409.34, p<.001), and mean (F = 489.33, p<.001) MSV differences between groups. Multiple comparisons of the right, left, and mean MSV between the T1 and T2, T2 and T3, and T1 and T3 groups with Bonferroni's test revealed no significant differences between the T1 and T2 (p>.05) and T2 and T3 (p>.05) groups. However, significant differences were found in the right (p<.05), left (p<.05), and mean (p<.05) MSV between the T1 and T3 groups. The right, left, and mean MSV of the T3 group were significantly higher than those of the T1 group. CONCLUSION No significant change was detected in the MSV immediately after RME. However, MSV was significantly increased at the end of the retention period.
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Affiliation(s)
- Atılım Akkurt
- Department of Orthodontics, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey.
| | - Mehmet Doğru
- Department of Orthodontics, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
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Santos MA, Muinelo-Lorenzo J, Fernández-Alonso A, Cruz-Landeira A, Aroso C, Suárez-Cunqueiro MM. Age Estimation Using Maxillary Central Incisor Analysis on Cone Beam Computed Tomography Human Images. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13370. [PMID: 36293951 PMCID: PMC9603614 DOI: 10.3390/ijerph192013370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Forensic dentistry plays an important role in human identification, and dental age estimation is an important part of the process. Secondary dentin deposition throughout an individual's lifetime and consequent modification in teeth anatomy is an important parameter for age estimation procedures. The aim of the present study was to develop regression equations to determine age in adults by means of linear measurements and ratios on sagittal, coronal and axial slices of maxillary central incisors using cone bean computed tomography (CBCT). Multiplanar measurements of upper central incisors were taken for a sample of 373 CBCTs. Subsequently, one-way analysis of variance (ANOVA) and multivariate linear regressions were performed for age estimation. The equations obtained from axial linear measurements and ratios presented a standard error of the estimate (SEE) of ±10.9 years (R2 = 0.49), and a SEE of ±10.8 years (R2 = 0.50), respectively. The equation obtained for multiplanar linear measurements presented a SEE of ±10.9 years (R2 = 0.52), while the equation for multiplanar ratios presented a SEE of ±10.7 years (R2 = 0.51). Thus, CBCT measurements on upper central incisors were found to be an acceptable method for age estimation. Horizontal measurements, especially pulp measurements, improve the accuracy of age estimate equations.
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Affiliation(s)
- María Arminda Santos
- Department of Dental Science, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Juan Muinelo-Lorenzo
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Ana Fernández-Alonso
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Angelines Cruz-Landeira
- Department of Forensic Sciences, Pathology, Ginecology and Obstetrics, and Pediatrics, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Carlos Aroso
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politénico e Universitario (CESPU), 4585-116 Gandra, Portugal
| | - María Mercedes Suárez-Cunqueiro
- Department of Surgery and Medical-Surgical Specialties, Medicine and Dentistry School, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS), 15706 Santiago de Compostela, Spain
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Çelebi A, Gülsün B. Evaluation of accessory mental foramen and accessory infraorbital foramen with cone-beam computed tomography in Turkish population. AUST ENDOD J 2022; 49:13-19. [PMID: 36177731 DOI: 10.1111/aej.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
It was aimed to evaluate the frequency of accessory mental foramen (AMF) and accessory infraorbital foramen (AIOF) and analyse the correlation between these two foramina using cone-beam computed tomography (CBCT). The retrospective study reviewed the CBCT images of 1020 patients. The rates of AMF and AIOF were evaluated according to sex and age distributions. Correlations between the localizations of AMF and AIOF in the right and left jaws and the correlations between the occurrences of these foramina were evaluated. In the CBCT images of the 1020 patients, AMFs were detected in 48 patients, among which 14 were in the right half jaw, and 34 were in the left half jaw. AIOFs were detected in 143 patients, among which 65 were in the right half jaw, and 78 were in the left half jaw. Recognising and detecting AMF and AIOF with CBCT is important in terms of preventing complications that may occur in surgical procedures.
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Affiliation(s)
- Adalet Çelebi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Belgin Gülsün
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
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A 3-Dimensional Evaluation of Bone Density in Alveolar Cleft Grafting Methods: Bone Substitutes Versus Autologous Bone. J Craniofac Surg 2022; 33:2188-2194. [DOI: 10.1097/scs.0000000000008773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/13/2022] [Indexed: 11/27/2022] Open
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Calazans MAA, Ferreira FABS, Alcoforado MDLMG, dos Santos A, Pontual ADA, Madeiro F. Automatic Classification System for Periapical Lesions in Cone-Beam Computed Tomography. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176481. [PMID: 36080940 PMCID: PMC9459969 DOI: 10.3390/s22176481] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 05/29/2023]
Abstract
Imaging examinations are of remarkable importance for diagnostic support in Dentistry. Imaging techniques allow analysis of dental and maxillofacial tissues (e.g., bone, dentine, and enamel) that are inaccessible through clinical examination, which aids in the diagnosis of diseases as well as treatment planning. The analysis of imaging exams is not trivial; so, it is usually performed by oral and maxillofacial radiologists. The increasing demand for imaging examinations motivates the development of an automatic classification system for diagnostic support, as proposed in this paper, in which we aim to classify teeth as healthy or with endodontic lesion. The classification system was developed based on a Siamese Network combined with the use of convolutional neural networks with transfer learning for VGG-16 and DenseNet-121 networks. For this purpose, a database with 1000 sagittal and coronal sections of cone-beam CT scans was used. The results in terms of accuracy, recall, precision, specificity, and F1-score show that the proposed system has a satisfactory classification performance. The innovative automatic classification system led to an accuracy of about 70%. The work is pioneer since, to the authors knowledge, no other previous work has used a Siamese Network for the purpose of classifying teeth as healthy or with endodontic lesion, based on cone-beam computed tomography images.
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Affiliation(s)
| | - Felipe Alberto B. S. Ferreira
- Unidade Acadêmica do Cabo de Santo Agostinho, Universidade Federal Rural de Pernambuco (UFRPE), Cabo de Santo Agostinho 54518-430, Brazil
| | | | - Andrezza dos Santos
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco (UFPE), Recife 50670-420, Brazil
| | - Andréa dos Anjos Pontual
- Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco (UFPE), Recife 50670-420, Brazil
| | - Francisco Madeiro
- Escola Politécnica de Pernambuco, Universidade de Pernambuco (UPE), Recife 50720-001, Brazil
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CBCT Evaluation of Buccolingual Orientation of Inferior Alveolar Canal in Mandibular Posterior Region for Implant Planning. Int J Dent 2022; 2022:4682105. [PMID: 36065398 PMCID: PMC9440803 DOI: 10.1155/2022/4682105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Inferior alveolar nerve (IAN) can be subjected to iatrogenic injury during implant surgical procedures. The purpose of this retrospective study was to identify the buccolingual orientation of IAN in posterior mandible as adjunct information for implant planning and to estimate ethnicity-, sex-, and side-related variations in Malaysian population. Material and Methods. A total of 121 CBCT images were viewed with eXamVision software. The buccolingual position of IAN was identified in the posterior region. Buccal bone width (B), canal thickness (C), and lingual bone width (L) were measured at the horizontal canal levels. Kruskal–Wallis H test and Friedman test were used to analyze the buccolingual position. One-way ANOVA was performed to evaluate the variations in B, C, and L values. Results Overall, most of the IANs were located on the lingual sides of the second molar regions (left: 71.9%; right: 71.1%) and at the centers of the first molar regions (left: 57.9%; right: 47.10%) and exited through the mental foramen before the second premolar regions. There was statistically significant difference in the buccolingual position of the IAN between the sexes in the left second premolar regions (P = 0.03). There was variation in B between the sexes in the left first molar regions (P = 0.01). Statistically significant differences in C and L were also found between different ethnic groups (P = 0.04). Between both sides, there were variations in C in the first molar regions (P < 0.001) and the second molar regions (P = 0.03). Conclusion From the second molar to the second premolar, the buccal bone width decreased while the lingual bone width increased. There were variations between ethnicities, sexes, and sides among Malaysians.
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THE PREVALENCE AND LOCATION OF THE POSTERIOR SUPERIOR ALVEOLAR ARTERY IN THE MAXILLARY SINUS WALL: A PRELIMINARY COMPUTED-CONE BEAM STUDY. Saudi Dent J 2022; 34:629-635. [PMID: 36267528 PMCID: PMC9577964 DOI: 10.1016/j.sdentj.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/22/2022] Open
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Assessment of the Relationship between Maxillary Posterior Teeth and Maxillary Sinus Using Cone-Beam Computed Tomography. Int J Dent 2022; 2022:6254656. [PMID: 35847346 PMCID: PMC9277193 DOI: 10.1155/2022/6254656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Because of the close contact between maxillary sinus and maxillary posterior teeth, procedural errors such as perforation of the sinus may occur during surgical intervention resulting in oroantral communication, which if not corrected, would develop into a fistula. The aim of this study was to evaluate the relationship between maxillary posterior teeth and maxillary sinus floor in a population of the western area of Saudi Arabia, and if age, gender, and size may affect such distance. Materials and Methods This retrospective study evaluated 539 cone-beam computed tomography (CBCT) radiographs of patients over 20 years of age. Patients were divided into four groups according to age: group I (20–30 years), group II (31–40 years), group III (41–50 years), and group IV (more than 50 years). From coronal and sagittal images of CBCT, the vertical distance between the posterior maxillary root and the maxillary sinus was measured and classified according to its proximity to the maxillary sinus. Results Gender and size did not significantly affect the distance between maxillary posterior root and maxillary sinus. However, there was a significant increase in this distance with increased age. Mesiobuccal root of the second molar was the nearest root to the maxillary sinus (0.8 ± 1.62, p < 0.001), while the buccal root of the first premolar was the farthest root (5.39 ± 3.26, p < 0.001). Conclusion Regarding the population of this study, the buccal roots of the second molars are the closest to the sinus floor. Complications associated with maxillary molar extraction and implantation are greater at a younger age. Because the distance between posterior maxillary teeth and maxillary sinus was mostly type 1 (0–2 mm), clinicians are advised to perform CBCT to get a better understanding of the relationship between maxillary posterior roots and maxillary sinus before surgical intervention.
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