|
1
|
Deniz Y, Çetin Genç Ç, Orhan K. Cone beam computed tomography vs. microcomputed tomography for trabecular bone healing assessment : An ex vivo study in rabbit mandibles. J Orofac Orthop 2025:10.1007/s00056-025-00589-8. [PMID: 40392312 DOI: 10.1007/s00056-025-00589-8] [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: 05/01/2024] [Accepted: 02/10/2025] [Indexed: 05/22/2025]
Abstract
PURPOSE This study aimed to compare cone beam computed tomography (CBCT) and microcomputed tomography (μCT) data to evaluate the micromorphological structure of healing bone in defects created on rabbit mandibles at different stages. METHODS Residual rabbit mandibular alveolar bone tissues from another animal study involving 18 rabbits were utilized. In the prior study, 10 × 4 mm bone cavities were created, left to heal naturally, and the animals were sacrificed after 21, 45, and 90 days. In this study, CBCT and μCT imaging were performed on the excised defect regions. The micromorphometry parameters including bone-volume fraction (BV/TV), bone-surface density (BS/TV), fractal dimension, connectivity density (Conn. Dn.), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were examined by ImageJ (US National Institutes of Health, Bethesda, MD, USA). Paired two-sample t‑tests, Wilcoxon test, and Bland-Altman plots were performed. RESULT Differences in the parameters Conn. Dn., fractal dimension, Tb.Th, and Tb.Sp were observed between CBCT and μCT on day 21. By day 45, no significant differences were noted in BV/TV, BS/TS, Tb.Th, and Tb.Sp. On day 90, all measured parameters showed no statistically significant differences between CBCT and μCT. Bland-Altman analysis showed an agreement for most parameters (BV/TV, BS/TV, fractal dimension, Tb.Th, and Tb.Sp) after 21, 45, and 90 days, with minimal biases emerging over time, while a more notable divergence in Conn. Dn. was observed. CONCLUSION CBCT can be used for micromorphological analyses on days 45 and 90 of bone healing as there were no differences between CBCT and μCT during these periods.
Collapse
Affiliation(s)
- Yeşim Deniz
- Department of Dental and Maxillofacial Radiology, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 2-1 Yamadaoka, 565-0871, Suita, Osaka, Japan.
| | - Çiğdem Çetin Genç
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Kaan Orhan
- Department of Dental and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1088, Budapest, Hungary
| |
Collapse
|
|
2
|
Kim IH, Jeong J, Kim JS, Lim J, Cho JH, Hong M, Kang KH, Kim M, Kim SJ, Kim YJ, Sung SJ, Kim YH, Lim SH, Baek SH, Park JW, Kim N. Predicting orthognathic surgery results as postoperative lateral cephalograms using graph neural networks and diffusion models. Nat Commun 2025; 16:2586. [PMID: 40091067 PMCID: PMC11911408 DOI: 10.1038/s41467-025-57669-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: 06/24/2024] [Accepted: 02/27/2025] [Indexed: 03/19/2025] Open
Abstract
Orthognathic surgery, or corrective jaw surgery, is performed to correct severe dentofacial deformities and is increasingly sought for cosmetic purposes. Accurate prediction of surgical outcomes is essential for selecting the optimal treatment plan and ensuring patient satisfaction. Here, we present GPOSC-Net, a generative prediction model for orthognathic surgery that synthesizes post-operative lateral cephalograms from pre-operative data. GPOSC-Net consists of two key components: a landmark prediction model that estimates post-surgical cephalometric changes and a latent diffusion model that generates realistic synthesizes post-operative lateral cephalograms images based on predicted landmarks and segmented profile lines. We validated our model using diverse patient datasets, a visual Turing test, and a simulation study. Our results demonstrate that GPOSC-Net can accurately predict cephalometric landmark positions and generate high-fidelity synthesized post-operative lateral cephalogram images, providing a valuable tool for surgical planning. By enhancing predictive accuracy and visualization, our model has the potential to improve clinical decision-making and patient communication.
Collapse
Affiliation(s)
- In-Hwan Kim
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiheon Jeong
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- SK Telecom Incorporation, Seoul, Republic of Korea
| | - Jun-Sik Kim
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jisup Lim
- Department of Convergence Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jin-Hyoung Cho
- Department of Orthodontics, Chonnam National University School of Dentistry, Gwangju, Republic of Korea
| | - Mihee Hong
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Kyung-Hwa Kang
- Department of Orthodontics, School of Dentistry, Wonkwang University, Iksan-si, Republic of Korea
| | - Minji Kim
- Department of Orthodontics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Republic of Korea
| | - Yoon-Ji Kim
- Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Jin Sung
- Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Ho Kim
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Sung-Hoon Lim
- Department of Orthodontics, College of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jae-Woo Park
- Department of Convergence Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - Namkug Kim
- Department of Convergence Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| |
Collapse
|
|
3
|
Estrela LRDA, Bueno MR, Azevedo BC, de Sousa VC, Guedes OA, Estrela C. A novel methodology for detecting separated endodontic instruments using a combination of algorithms in post-processing CBCT software. Sci Rep 2025; 15:6088. [PMID: 39972195 PMCID: PMC11840140 DOI: 10.1038/s41598-025-90652-6] [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: 11/30/2024] [Accepted: 02/14/2025] [Indexed: 02/21/2025] Open
Abstract
Separated endodontics instruments and high-density obturating materials produce metal artifacts on cone-beam computed tomography (CBCT) scans. This study evaluated a novel methodology to detect separated instruments using artifact suppression and color map algorithms with CBCT post-processing software and compared with periapical radiographs (PRs). Endodontic instruments were incorporated into 168 root canals filled with four sealers. Additionally, 40 root canals were only filled, serving as control. CBCT scans were acquired in PreXion-3D-Elite, and digital PRs were taken in distoradial, mesioradial, orthoradial, and proximal directions. The treated teeth were analyzed using an artifact suppression algorithm combined with a color map algorithm. The separated instruments appear in the color map with larger expansion in red to allow identification. This map provides valuable information by showing dynamic visualization toward the point of expansion of the high-density object, hence suggesting a separated instrument. The chi-square test was used to compare the separated instruments among the imaging methods. Bonferroni correction was used for multiple comparisons. Statistical significance was considered P < 0.05. Overall, CBCT performed significantly better than PRs (P < 0.001) in detecting separated instruments. PR was influenced by all the variables studied (P < 0.05). The artifact suppression and color map algorithms, combined with dynamic navigation, effectively identified separated instrument fragments in all the root canal fillings, regardless of filling material, image view, or root canal. Only 32.3% of the root canal fillings viewed by PR detected separated instrument fragments. This method seems to be useful in the resolution of the problem of viewing separated instruments with CBCT post-processing software.
Collapse
Affiliation(s)
| | | | - Bruno Correa Azevedo
- IB Bender Postdoctoral Endodontic Program, Albert Einstein Medical Center, Philadelphia, PA, USA
| | | | | | - Carlos Estrela
- Department of Stomatology Sciences, Federal University of Goiás, Goiânia, Brazil.
| |
Collapse
|
|
4
|
Estrela C, Endo MM, Bueno MR, Azevedo BC, Decurcio DA, Estrela LRA. Application of artifact suppression algorithm of post-processing CBCT software in root canal filling materials. Braz Oral Res 2025; 39:e011. [PMID: 39907325 PMCID: PMC11790072 DOI: 10.1590/1807-3107bor-2025.vol39.011] [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: 08/14/2024] [Revised: 10/30/2024] [Accepted: 09/18/2024] [Indexed: 02/06/2025] Open
Abstract
OBJECTIVES Cone beam computed tomography (CBCT) is an imaging exam used increasingly in various fields of dentistry, and a greater number of endodontists are progressively gaining access to this technology. This study focused on applying an artifact suppression algorithm featured in CBCT software, and designed specifically to address artifacts related to root canal filling materials. METHOD The sample consisted of eighty-four mandibular molars, with mesial root canals endodontically treated by using the lateral condensation technique. Four root canal sealers were applied: G1 - Sealapex®, G2 - AH Plus®, G3 - Endofill®, and G4 - Bio-C Sealer. CBCT scans were taken using PreXion 3D Elite®. Initially, the diameter of the root canal filling (in the mesiodistal and buccolingual directions) was measured using a digital micrometer (control). Next, these diameters were reevaluated in the CBCT images using the blooming artifact reduction (BAR) tool of the e-Vol DX software. The Van der Waerden nonparametric analysis of variance was performed, followed by applying the Tukey test to the normalized data. The significance level was set at α = 5%. RESULTS There were no statistically significant differences (p>0.05) in the measurement of original root canal filling materials obtained by the micrometer versus the e-Vol DX software in the mesiodistal and buccolingual directions. CONCLUSIONS The tested software algorithm effectively suppressed artifacts resulting from obturation materials.
Collapse
Affiliation(s)
- Carlos Estrela
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | - Mônica Misaé Endo
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | | | | | - Daniel Almeida Decurcio
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | | |
Collapse
|
|
5
|
Schulze R, Klingler S, Biel P, Spin-Neto R, Berkhout E, Drage N, Jäghagen EL, Semper-Hogg W, Różyło-Kalinowska I, Hol C, Arvidsson L. Cone beam computed tomography - Frequency and exposure settings at University (Dental) hospitals in Central and Northern Europe. Eur J Radiol 2025; 183:111886. [PMID: 39700879 DOI: 10.1016/j.ejrad.2024.111886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 11/13/2024] [Accepted: 12/09/2024] [Indexed: 12/21/2024]
Abstract
PURPOSE To investigate the frequency of CBCT scans, the exposure settings, volume sizes and the patient demographics (age and sex) of patients undergoing CBCT scans in university-based dental hospitals in different European countries over a one-year period. METHOD Eight University Dental Hospitals from eight countries in central and northern Europe agreed to collect data from their CBCT-databases. Exposure data including field of view (FOV), dose area product (DAP) and optimization settings plus (anonymous) age and sex of the patients were collected for the entire year 2023. In addition, centre- and healthcare-system- related characteristics were assembled. Data were statistically evaluated using R Statistical Software. RESULTS A total of 7320 CBCT-scans from eight centres and eight different CBCT-machines were evaluated. DAPs ranged between 34 and 4390mGycm2 (mean: 700.8mGycm2), kV between 60 kV and 120 kV. Patient age (range 4yrs to 97yrs) differed significantly between the centres, yet with a cumulative peak between 10 and 20yrs. Optimization protocols were observed for all centres, depending on their centre- and also healthcare-characteristics. 21 % of the scans applied some sort of special dose reduction means. CONCLUSIONS The overall age-peak between 10 and 20yrs highlights the need to optimized maxillofacial CBCT-protocols. The differences between the centres seem to be mainly related to healthcare-system and centre-related characteristics, which differ largely between the eight centres.
Collapse
Affiliation(s)
- Ralf Schulze
- Universität Bern, Division of Oral Diagnostic Sciences, School of Dental Medicine, Freiburgstr. 7, 3010 Bern, Switzerland.
| | | | - Philippe Biel
- Universität Bern, Department of Oral Surgery and Stomotology, Switzerland
| | - Rubens Spin-Neto
- Aarhus University, Department of Dentistry and Oral Health - Section for Oral Radiology and Endodontics, Denmark
| | - Erwin Berkhout
- University of Amsterdam, Academic Centre for Dentistry Amsterdam, Oral Radiology, the Netherlands
| | - Nicolas Drage
- University Dental Hospital, Department of Dental and Maxillofacial Radiology, Cardiff, UK
| | - Eva Levring Jäghagen
- Umeå University, Department of Odontology Section: School of Dentistry, Oral and Maxillofacial Radiology, Sweden
| | - Wiebke Semper-Hogg
- University of Freiburg, Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Germany
| | | | - Caroline Hol
- University of Oslo, Department of Maxillofacial Radiology, Norway
| | - Linda Arvidsson
- University of Oslo, Department of Maxillofacial Radiology, Norway
| |
Collapse
|
|
6
|
Kamburoğlu K. Trends in dentomaxillofacial radiology. World J Radiol 2025; 17:97255. [PMID: 39876885 PMCID: PMC11755909 DOI: 10.4329/wjr.v17.i1.97255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 10/19/2024] [Accepted: 12/12/2024] [Indexed: 01/21/2025] Open
Abstract
Oral and maxillofacial diagnostic imaging is of paramount importance in dental clinical diagnosis, treatment planning, and follow-up procedures. Periapical radiographic examination and numerous panoramic systems are used in routine clinical dental practice. Cone beam CT is widely used and currently the method of choice in oral and maxillofacial implantology, endodontics, maxillofacial surgery, periodontics, degenerative temporomandibular joint disease, orthodontics, airway studies, sleep disorders, and forensic dentistry. Another innovative laboratory research tool that offers three-dimensional (3D) detailed high-resolution images of in vitro teeth and neighboring structures with submicrometric accuracy is microcomputed tomography. Ultra-high radiation doses, long scanning times, and high costs preclude its routine clinical use. In response to the high demand for a technique that could provide real-time images using a cost-effective, rapid, user-friendly, and portable technique without ionizing radiation, some authors proposed ultrasound imaging methods as an alternative to X-ray imaging techniques. Ultrasonography can be used in the dentomaxillofacial region for various diagnostic purposes such as salivary gland and superficial tissue examination. Recently, dedicated dental magnetic resonance imaging with appropriate software, hardware, sequences, and field of view tailored to fit dentomaxillofacial anatomy was introduced. Lately, 3D printing technologies and their application in dentistry has attracted attention. During 3D printing a given material is added in successive layers to create a 3D object. The application of this technology has the potential to decrease operation time and minimize operator bias and the possibility of procedural errors. Another hot topic regarding dentomaxillofacial radiology is artificial intelligence, which is a field related to computer science dedicated to developing systems or machines that can perform tasks traditionally associated with human intelligence. It is obvious that further investigation and research in the field of dentomaxillofacial radiology will make great contributions to diagnostic imaging for various dental specialties.
Collapse
Affiliation(s)
- Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara 06500, Türkiye
- Department of Surgery and Pediatric Dentistry, Faculty of Stomatology, Akhmet Yassewi International Kazakh Turkish University, Turkestan 161200, Kazakhstan
| |
Collapse
|
|
7
|
Zhou J, Mao Z, Chen K, Xu S, Cui Y. CBCT-Based Analysis of Factors Influencing the Quality of New Bone Formation Following Mandibular Distraction Osteogenesis in Children With Pierre Robin Sequence. J Craniofac Surg 2025:00001665-990000000-02338. [PMID: 39774676 DOI: 10.1097/scs.0000000000011054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Accepted: 12/13/2024] [Indexed: 01/11/2025] Open
Abstract
The aim of this study was to explore the factors influencing the quality of new bone formation after distraction osteogenesis in children with Pierre Robin sequence (PRS). Using cone-beam computed tomography (CBCT), bone density relative grayscale values of the region of new bone formation before and 3 to 4 months after mandibular distraction osteogenesis (MDO) were measured in 80 children with PRS, and correlation analysis was conducted with the potential clinical influencing factors of the children. CBCT reconstruction of the panoramic film showed that the new bone formation was good at 3 to 4 months after MDO. There was a statistically significant difference in the gray value of cancellous bone before and after the operation (P<0.01). The gray values of bilateral mandibular new bone after MDO were related to cleft palate, preoperative weight, preoperative body mass index (BMI), and distraction length. Finally, the variables included in the multiple linear regression model were cleft palate and preoperative BMI. At 3 to 4 months after MDO, the mineralization degree of cancellous bone in the central region of the bilateral mandibular new bone formation area was lower. The presence of cleft palate and preoperative BMI were identified as the main factors influencing the new bone formation in bilateral mandibles after MDO. This may be attributed to the catch-up nutritional acquisition and growth promotion in children, which facilitates new bone formation, along with greater chewing muscle strength to prevent mineral loss from bones.
Collapse
Affiliation(s)
- Jiawei Zhou
- Department of Oral and Maxillofacial Surgery, Guangzhou Medical University Affiliated Women and Children's Medical Center, Guangzhou, China
| | | | | | | | | |
Collapse
|
|
8
|
Solomonov M, Shapinko Y, Lalum E, Ben Itzhak J, Argaman S, Schottig M, Halpern A, Yavnai N, Stiklaru I. Can Viewing Modality Affect Frontal Mandibular Bone Height Measurement? A Comparison Between 3D Digital Imaging and Communications in Medicine Viewer and Printed Portable Document Format Cone Beam Computer Tomography Reports. Dent J (Basel) 2025; 13:22. [PMID: 39851598 PMCID: PMC11763400 DOI: 10.3390/dj13010022] [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: 10/31/2024] [Revised: 12/04/2024] [Accepted: 12/31/2024] [Indexed: 01/26/2025] Open
Abstract
Objectives: Buccal cortical bone dimensions are crucial in dental radiology, as they impact orthodontic treatment outcomes. Changes in alveolar bone dimensions can result in malocclusion and require interdisciplinary approaches for correction. The accurate quantification of buccal bone dimensions is crucial for appropriate treatment planning and avoiding medico-legal issues. This study aimed to compare buccal bone height measurements between three-dimensional (3D) digital imaging and communications in medicine (DICOM) data and portable document format (PDF) cone beam computer topography reports for mandibular frontal teeth, testing the hypothesis of no difference in values between the two modalities. Methods: Each of the five observers performed a total of 720 height measurements (360 by DICOM and 360 by PDF), yielding a total of 3600 measurements overall. Results: Compared with the DICOM format, using PDF files was associated with a significantly greater rate of inability to carry out the measurements (8.8% vs. 3%, respectively, p < 0.001, chi-square). The average buccal bone height measured in the DICOM was 11.51 mm, which was significantly greater than the 10.35 mm measured in the PDF (p < 0.001). The mean height measured by the DICOM was consistently greater than that measured by the PDF, with highly significant differences in the findings of four of the examiners (p < 0.001). Conclusions: Viewing modality significantly affected the height of the buccal bone in the frontal mandibular area. Compared with the generated PDF reports, the 3D DICOM viewer performed better than the printed PDF and enabled more measurements in the target area.
Collapse
Affiliation(s)
- Michael Solomonov
- Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel
| | - Yoav Shapinko
- Departments of Orthodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
| | - Ella Lalum
- Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel
| | - Joe Ben Itzhak
- Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel
| | - Sapir Argaman
- Medical Corps, Israel Defense Forces (IDF), Ramat Gan 52625, Israel
| | - Matan Schottig
- Departments of Orthodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
| | - Amit Halpern
- Medical Corps, Israel Defense Forces (IDF), Ramat Gan 52625, Israel
| | - Nirit Yavnai
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem Campus, Jerusalem 91120, Israel
| | - Idan Stiklaru
- Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel
| |
Collapse
|
|
9
|
Nguyen TP, Ahn JH, Lim HK, Kim A, Yoon J. Automated Measurements of Tooth Size and Arch Widths on Cone-Beam Computerized Tomography and Scan Images of Plaster Dental Models. Bioengineering (Basel) 2024; 12:22. [PMID: 39851296 PMCID: PMC11762162 DOI: 10.3390/bioengineering12010022] [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: 11/17/2024] [Revised: 12/14/2024] [Accepted: 12/26/2024] [Indexed: 01/26/2025] Open
Abstract
Measurements of tooth size for estimating inter-arch tooth size discrepancies and inter-tooth distances, essential for orthodontic diagnosis and treatment, are primarily done using traditional methods involving plaster models and calipers. These methods are time-consuming and labor-intensive, requiring multiple steps. With advances in cone-beam computerized tomography (CBCT) and intraoral scanning technology, these processes can now be automated through computer analyses. This study proposes a multi-step computational method for measuring mesiodistal tooth widths and inter-tooth distances, applicable to both CBCT and scan images of plaster models. The first step involves 3D segmentation of the upper and lower teeth using CBCT, combining results from sagittal and panoramic views. For intraoral scans, teeth are segmented from the gums. The second step identifies the teeth based on an adaptively estimated jaw midline using maximum intensity projection. The third step uses a decentralized convolutional neural network to calculate key points representing the parameters. The proposed method was validated against manual measurements by orthodontists using plaster models, achieving an intraclass correlation coefficient of 0.967 and a mean absolute error of less than 1 mm for all tooth types. An analysis of variance test confirmed the statistical consistency between the method's measurements and those of human experts.
Collapse
Affiliation(s)
- Thong Phi Nguyen
- Department of Mechanical Design Engineering, Hanyang University, 222, Wangsimni-ro, Seongdongsu, Seoul 04763, Republic of Korea; (T.P.N.)
- BK21 FOUR ERICA-ACE Center, Hanyang University, Ansan 15588, Gyeonggi-do, Republic of Korea
| | - Jang-Hoon Ahn
- Department of Orthodontics, Gwangmyeong Hospital, Chungang University, 110, Deokan-ro, Gwangmyeong 07440, Gyeonggi-do, Republic of Korea;
| | - Hyun-Kyo Lim
- Department of Mechanical Design Engineering, Hanyang University, 222, Wangsimni-ro, Seongdongsu, Seoul 04763, Republic of Korea; (T.P.N.)
- Department of Mechanical Engineering, Hanyang University, 55, Hanyangdaehak-ro, Sangnok-gu, Ansan 15588, Gyeonggi-do, Republic of Korea
| | - Ami Kim
- Seoul Ami Orthodontic Private Practice, 22, Harmony-ro, 178 Beon-gil, Yeonsu-gu, Incheon 22011, Republic of Korea
| | - Jonghun Yoon
- BK21 FOUR ERICA-ACE Center, Hanyang University, Ansan 15588, Gyeonggi-do, Republic of Korea
- Department of Mechanical Engineering, Hanyang University, 55, Hanyangdaehak-ro, Sangnok-gu, Ansan 15588, Gyeonggi-do, Republic of Korea
| |
Collapse
|
|
10
|
Islam SMRS, Biguri A, Landi C, Di Domenico G, Schneider B, Grün P, Sarti C, Woitek R, Delmiglio A, Schönlieb CB, Turhani D, Kronreif G, Birkfellner W, Hatamikia S. Source-detector trajectory optimization for FOV extension in dental CBCT imaging. Comput Struct Biotechnol J 2024; 24:679-689. [PMID: 39610702 PMCID: PMC11602572 DOI: 10.1016/j.csbj.2024.11.010] [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: 08/19/2024] [Revised: 11/04/2024] [Accepted: 11/04/2024] [Indexed: 11/30/2024] Open
Abstract
In dental imaging, Cone Beam Computed Tomography (CBCT) is a widely used imaging modality for diagnosis and treatment planning. Small dental scanning units are the most popular due to their cost-effectiveness. However, these small systems have the limitation of a small field of view (FOV) as the source and detector move at a limited angle in a circular path. This often limits the FOV size. In this study, we addressed this issue by modifying the source-detector trajectory of the small dental device. The main goal of this study was to extend the FOV algorithmically by acquiring projection data with optimal projection angulation and isocenter location rather than upgrading any physical parts of the device. A novel algorithm to implement a Volume of Interest (VOI) guided trajectory is developed in this study based on the small dental imaging device's geometry. In addition, this algorithm is fused with a previously developed off-axis scanning method which uses an elliptical trajectory, to compensate for the existing constraints and to further extend the FOV. A comparison with standard circular trajectory is performed. The FOV of such a standard trajectory is a circle of 11 cm diameter in the axial plane. The proposed novel trajectory extends the FOV significantly and a maximum FOV of 19.5 cm is achieved with the Structural Similarity Index Measure (SSIM) score ranging between (≈98-99%) in different VOIs. The study results indicate that the proposed source-detector trajectory can extend dental imaging FOV and increase imaging performance, which ultimately results in more precise diagnosis and enhanced patient outcomes.
Collapse
Affiliation(s)
- S M Ragib Shahriar Islam
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
- Research Center for Clinical AI-Research in Omics and Medical Data Science (CAROM), Department of Medicine, Danube Private University (DPU), Krems, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
| | - Ander Biguri
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, United Kingdom
| | - Claudio Landi
- SeeThrough SrL, Via Bolgara 2, Brusaporto (BG), Italy
| | | | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Krems, Austria
| | - Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Krems, Austria
| | | | - Ramona Woitek
- Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Department of Medicine, Danube Private University (DPU), Krems, Austria
| | | | - Carola-Bibiane Schönlieb
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge, United Kingdom
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University (DPU), Krems, Austria
| | - Gernot Kronreif
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
| | - Wolfgang Birkfellner
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
| | - Sepideh Hatamikia
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
- Research Center for Clinical AI-Research in Omics and Medical Data Science (CAROM), Department of Medicine, Danube Private University (DPU), Krems, Austria
| |
Collapse
|
|
11
|
Chawshli OF, Hasan HS, Yalda FA, Al-Talabani SZ. The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail. Orthod Craniofac Res 2024; 27:118-125. [PMID: 37496467 DOI: 10.1111/ocr.12700] [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: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND OBJECTIVES The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. MATERIALS AND METHODS Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. RESULTS The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. CONCLUSION This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.
Collapse
Affiliation(s)
- Omar Fawzi Chawshli
- The Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Hasan Sabah Hasan
- Orthodontic Department, Azadi Dental Center, General Directorate of Hawler, Ministry of Health, Erbil, Iraq
- Orthodontic Department, Privet Specialized Dental Clinic, Erbil, Iraq
| | - Fedil Andraws Yalda
- The Department of Oral Diagnosis, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Shaho Z Al-Talabani
- P.O.P Department, College of Dentistry, Hawler Medical University, Erbil, Iraq
| |
Collapse
|
|
12
|
Muttanahally KS, Sheppard S, Yadav S, Tadinada A. The Utility of Cone Beam Computed Tomography Scans in Diagnosing and Treating Anterior Lesions of the Maxilla and Mandible. Cureus 2024; 16:e52804. [PMID: 38389599 PMCID: PMC10883409 DOI: 10.7759/cureus.52804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The standard screening protocol for radiographic examination in dentistry as per the American Dental Association recommendations is a panoramic radiograph (PAN) and four horizontal bitewings. PAN inherently suffers from several shortcomings like the superimposition of anatomic structures, especially of the cervical spine that obscures a significant portion of the anterior maxilla and mandible. This region has a significant amount of pathology that is not adequately imaged. Three-dimensional (3D) imaging provides circumferential information on the area of interest and adds value to the diagnosis and treatment planning of pathology, especially in the anterior maxilla and mandible. However, there is not an adequate number of well-designed studies that articulate the true value addition of 3D imaging for the evaluation of this region. OBJECTIVES The objective of this study is to evaluate the value addition of 3D imaging in diagnosing pathologies in the anterior maxilla and mandible when compared to two-dimensional PAN. MATERIALS AND METHODS A total of 25 cases that had a diagnosis of anterior pathology and had both a PAN and a cone beam computed tomography (CBCT) scan were collected for this study. An institutional review board approval to retrospectively evaluate these data was obtained. The PAN and CBCT scans were randomly evaluated by a second-year dental student, an oral and maxillofacial radiology resident in training, and a board-certified oral radiologist. The scans were evaluated using a three-point modified Likert scale, where 1 represents "not visible or clear," 2 represents "visible but not clear," and 3 represents "visible and clear." The lesions were evaluated for characteristics like lesion location, size & shape, internal contents, borders of the lesion, cortical integrity, locularity, and effect on adjacent structures like root resorption. After the evaluation was completed, a comparison of the lesion diagnosis was done with histopathology to confirm the diagnosis. The evaluators were also asked to comment on the specific feature that 3D imaging provided that added value to the case. Kappa analysis was done to evaluate inter-operator reliability. RESULTS PAN demonstrated significantly lower efficacy in identifying and diagnosing lesions. Only 56% of cases were analyzed using PAN, with 44% deemed undetectable or poorly visualized. These challenging cases necessitated CBCT scans for accurate diagnosis, which successfully diagnosed all 25 cases. The p-value of 0.0002 for PAN implies a highly significant difference from histopathology, suggesting the distinctions are not due to chance. Conversely, the p-value of 0.3273 for CBCT implies that observed differences may be random, lacking sufficient evidence to reject the null hypothesis. CBCT scans consistently outperformed PAN in visualizing various lesion characteristics, underscoring their superior diagnostic capabilities. CONCLUSIONS In this study, with a small sample size, 3D imaging provided a significant value addition to the diagnosis and treatment planning by providing additional information regarding the location, extent, internal content, and effect on adjacent structures. The practical implications for clinical settings, along with comparisons to current literature, underscore the study's distinctiveness.
Collapse
Affiliation(s)
- Kavya Shankar Muttanahally
- Oral and Maxillofacial Radiology, Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Samantha Sheppard
- Department of General Dentistry, University of Connecticut, Farmington, USA
| | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
| |
Collapse
|
|
13
|
Klingler S, Biel P, Tschanz M, Schulze R. CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria. Clin Oral Investig 2023; 27:5627-5636. [PMID: 37522991 PMCID: PMC10492752 DOI: 10.1007/s00784-023-05184-y] [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: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice.
Collapse
Affiliation(s)
- Samuel Klingler
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Philippe Biel
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Moses Tschanz
- Information Technology (IT) Group, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Ralf Schulze
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| |
Collapse
|
|
14
|
Giorgi H, Tomi F, Glard Y, Afonso D, Montanari L, Faure A. Change of vertebral orientation, between the supine position and the prone position. Spine Deform 2023; 11:1079-1092. [PMID: 37221317 DOI: 10.1007/s43390-023-00704-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/06/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE Our aim was to assess the change of vertebral orientation, expressed in the sagittal plane, in the transversal plane and in the frontal plane, at each level from T1 to S1 between the supine position (like in in a CT scan) and the prone position lying on bolsters like in an OR. METHODS Thirty-six patients were selected and included for a total number of one hundred and forty-eight vertebral levels. There were 30 females and 6 males. The mean age was 15 years and 9 months. A semi-automatic image processing technique and software (3D slicer), with a custom-made python script add-on, was used for each patient: paired preoperative CT scan and intraoperative cone beam computed tomography (CBCT) scan were processed to acquire complete spinal reconstructions in a consistent 3D coordinate system. The aim was to automatically compute a set of sagittal, transversal, and frontal rotations of each vertebral level of the same patient describing the 3D vertebral rotation between the supine position and the prone position lying on bolsters. RESULTS For sagittal analysis, the results showed a behavior in the evolution of rotation depending on the level. Between T01 and T10, the rotation was between - 14° and - 8°. Between T10 and L05, the sagittal rotation increased from - 10° up to + 10°. For frontal and transversal analysis, the rotations were under 6.5°. CONCLUSION These results could be valuable to perform a safe virtual templating: the information given by the virtual templating seems to be more accurate in the transversal plane than in the sagittal plane.
Collapse
Affiliation(s)
- Hadrien Giorgi
- Institut Méditerranéen du Dos, 232 Av. du Prado, 13008, Marseille, France
| | - Florent Tomi
- Laboratoire de Biomécanique Appliquée, Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, 13016, Marseille, France
| | - Yann Glard
- Hôpital Saint Joseph, Service de Chirurgie Pédiatrique, 13008, Marseille, France.
| | - David Afonso
- Hôpital Saint Joseph, Service de Chirurgie Pédiatrique, 13008, Marseille, France
| | - Lucrezia Montanari
- Hôpital Saint Joseph, Service de Chirurgie Pédiatrique, 13008, Marseille, France
| | - Aymeric Faure
- Institut Méditerranéen du Dos, 232 Av. du Prado, 13008, Marseille, France
| |
Collapse
|
|
15
|
Nomura Y, Watanabe H, Tomisato H, Kawashima S, Miura M. Gumbel distribution-based technique enables quantitative comparison between streak metal artifacts of multidetector row CT and cone-beam CT: a phantom study. Phys Eng Sci Med 2023; 46:801-812. [PMID: 37052806 DOI: 10.1007/s13246-023-01252-5] [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: 12/02/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Abstract
Cone-beam computed tomography (CBCT), derived from multidetector row CT (MDCT), has a high spatial resolution and has recently been applied to various organs. One of the severe limitations common to CBCT and MDCT is metal artifacts. In particular, streak metal artifacts (SMAs) between multiple metal materials often hinder diagnosis. However, no studies have quantitatively compared the strength of SMAs in MDCT and CBCT. Nomura et al. reported an evaluation method specialized in SMAs of CBCT using the Gumbel distribution (GD), which can also be applied to SMAs of MDCT (Oral Surg Oral Med Oral Pathol Oral Radiol 131: 494-502, 2021, https://doi.org/10.1016/J.OOOO.2020.08.031 ). This study aimed to quantitatively compare SMAs occurring between titanium materials on MDCT and CBCT images using the GD-based method. The SMAs were investigated as follows: A hydroxyapatite block was sandwiched between two titanium rods to generate an SMA. They were placed in an acrylic phantom, simulating a human head, and scanned using an MDCT scanner and two CBCT scanners. The obtained images were analyzed using Gumbel plots and location parameters, and the SMA strength was calculated. The results showed that the SMAs on the MDCT images were significantly weaker than those on the CBCT images. In the CBCT scans, a smaller volume CT dose index value caused stronger SMAs. These results indicate that MDCT is more advantageous than CBCT in terms of SMA reduction when bone morphology between titanium materials must be evaluated. The characteristic should be considered in clinical cases.
Collapse
Affiliation(s)
- Yoshikazu Nomura
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Hiroshi Watanabe
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroshi Tomisato
- Radiology Center, Division of Integrated Facilities, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Sakurako Kawashima
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Masahiko Miura
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| |
Collapse
|
|
16
|
Ketabi AR, Piwowarczyk A, Schulz MC, Lauer HC, Hassfeld S. Evaluation of the contour of edentulous jaw sections in the transversal plane and the buccolingual vertical-level disparity in CBCT and panoramic radiography images: a retrospective comparative study. Int J Implant Dent 2023; 9:1. [PMID: 36595148 PMCID: PMC9810779 DOI: 10.1186/s40729-022-00466-8] [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: 05/06/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE This study investigates whether edentulous jaw sections in the planned implant position exhibit jaw contours funnel-shaped or exhibit pronounced retraction of the jaw (unusual jaw contours) in the transversal plane of the three-dimensional (3D) images, not visible in two-dimensional (2D) images. METHODS A total of 335 patients with an edentulous section of the jaw that required dental implants were selected. Anonymised radiologic patients' data were collected, comprising cone-beam computed tomography (CBCT) images of the edentulous jaw sections. In the first stage, unusual jaw contours were examined, including funnel-shaped or pronounced retraction of the jaw and hypodense regions with an undercut and/or bone deficit. In the second stage, the variation in the height of the alveolar ridge between the lingual and buccal contour in the edentulous jaw sections was assessed. RESULTS The CBCT images of an unusual jaw contour were observed in 8 cases (2.4%) in the maxilla on the left and 10 cases (3%) in the maxilla on the right. In the mandible, a jaw contour deviates in 39 cases (12.1%) on the left side and 39 cases (12.1%) on the right side. A height difference was detected in the upper jaw in 307 cases and the lower jaw in 265 cases. The discrepancy was 2.09 mm (± 2.25 mm) in the maxilla and 3.97 mm (± 3.45 mm) in the mandible. CONCLUSIONS The CBCT scan provides useful information to avoid complications in the preoperative planning phase and surgical planning in implant dentistry.
Collapse
Affiliation(s)
- Ali Reza Ketabi
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany. .,Private Dental Office, Epplestraße 29 a, 70597, Stuttgart, Germany.
| | - Andree Piwowarczyk
- grid.412581.b0000 0000 9024 6397Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455 Witten, Germany
| | - Matthias Christian Schulz
- grid.10392.390000 0001 2190 1447Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
| | - Hans-Christoph Lauer
- grid.7839.50000 0004 1936 9721Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
| | - Stefan Hassfeld
- grid.412581.b0000 0000 9024 6397Department of Oral and Maxillofacial Surgery, Dortmund Hospital GmbH and Faculty of Health, Witten/Herdecke University, Muensterstr. 240, 44145 Dortmund, Germany
| |
Collapse
|
|
17
|
Detectability of simulated apical lesions on mandibular premolars and molars between radiographic intraoral and cone-beam computed tomography images: an ex vivo study. Sci Rep 2022; 12:14032. [PMID: 35982122 PMCID: PMC9388656 DOI: 10.1038/s41598-022-18289-3] [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: 01/15/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Adequate endodontic diagnostic is essential when making a therapy decision. Radiographic imagining acquisition methods (IAMs) are fundamental apical lesions of endodontic (ALE) origin diagnose tool. Thus, the aim of this research was to compare the simulated apical lesions (SALs) diagnose potential of digital intraoral radiography (DIR) and cone-beam computed tomography (CBCT), if there is a relationship between the IAMs, SALs-depth and their correct diagnose likelihood in human mandibular specimens’ datasets. 1024 SALs were prepared in cancellous and cortical bone with different penetration depths. The SALs-stages were radiographed with CBCT and DIR. The IAMs were randomly evaluated by 16 observers in two trials. Possible SAL findings were analyzed according to a five-point scale. The null hypothesis established that SALs detection accuracy does not differ between CBCT and DIR. Significantly differences (first 0.935 and second trial 0.960) were found for the CBCT area under the curve when compared with the DIR (first 0.859 and second trial 0.862) findings. SALs of smaller size were earlier detected by CBCT. In SALs without cortical involvement the probability of detection increased from 90 to 100%. The SALs-depth had the highest detectability influence on cancellous bone lesions and CBCT SALs detectability was 84.9% higher than with DIR images. The CBCT diagnose reproducibility was higher than the one of DIR (Kappa CBCT 75.7–81.4%; DIR 53.4–57.1%). Our results showed that CBCT has a higher SALs IAM diagnosing accuracy and that SALs detection accuracy incremented as the SALs-size increased.
Collapse
|
|
18
|
Canal-Net for automatic and robust 3D segmentation of mandibular canals in CBCT images using a continuity-aware contextual network. Sci Rep 2022; 12:13460. [PMID: 35931733 PMCID: PMC9356068 DOI: 10.1038/s41598-022-17341-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to propose a continuity-aware contextual network (Canal-Net) for the automatic and robust 3D segmentation of the mandibular canal (MC) with high consistent accuracy throughout the entire MC volume in cone-beam CT (CBCT) images. The Canal-Net was designed based on a 3D U-Net with bidirectional convolutional long short-term memory (ConvLSTM) under a multi-task learning framework. Specifically, the Canal-Net learned the 3D anatomical context information of the MC by incorporating spatio-temporal features from ConvLSTM, and also the structural continuity of the overall MC volume under a multi-task learning framework using multi-planar projection losses complementally. The Canal-Net showed higher segmentation accuracies in 2D and 3D performance metrics (p < 0.05), and especially, a significant improvement in Dice similarity coefficient scores and mean curve distance (p < 0.05) throughout the entire MC volume compared to other popular deep learning networks. As a result, the Canal-Net achieved high consistent accuracy in 3D segmentations of the entire MC in spite of the areas of low visibility by the unclear and ambiguous cortical bone layer. Therefore, the Canal-Net demonstrated the automatic and robust 3D segmentation of the entire MC volume by improving structural continuity and boundary details of the MC in CBCT images.
Collapse
|
|
19
|
Lee JS, Kim SR, Hwang HS, Lee KC. Accuracy of virtual 3-dimensional cephalometric images constructed with 2-dimensional cephalograms using the biplanar radiography principle. Imaging Sci Dent 2022; 51:407-412. [PMID: 34988001 PMCID: PMC8695469 DOI: 10.5624/isd.20210091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the accuracy of virtual 3-dimensional (3D) cephalograms constructed using the principle of biplanar radiography by comparing them with cone-beam computed tomography(CBCT) images. Materials and Methods Thirty orthodontic patients were enrolled in this study. Frontal and lateral cephalograms were obtained with the use of a head posture aligner and reconstructed into 3D cephalograms using biplanar radiography software. Thirty-four measurements representing the height, width, depth, and oblique distance were computed in 3 dimensions, and compared with the measurements from the 3D images obtained by CBCT, using the paired t-test and Bland-Altman analysis. Results Comparison of height, width, depth, and oblique measurements showed no statistically significant differences between the measurements obtained from 3D cephalograms and those from CBCT images (P>0.05). Bland-Altman plots also showed high agreement between the 3D cephalograms and CBCT images. Conclusion Accurate 3D cephalograms can be constructed using the principle of biplanar radiography if frontal and lateral cephalograms can be obtained with a head posture aligner. Three-dimensional cephalograms generated using biplanar radiography can replace CBCT images taken for diagnostic purposes.
Collapse
Affiliation(s)
- Jae-Seo Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Sang-Rok Kim
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Hyeon-Shik Hwang
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Kyungmin Clara Lee
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| |
Collapse
|
|
20
|
Arai Y. Local cone beam CT: how did it all start? Dentomaxillofac Radiol 2021; 50:20210276. [PMID: 34739304 PMCID: PMC8611279 DOI: 10.1259/dmfr.20210276] [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: 06/07/2021] [Revised: 08/10/2021] [Accepted: 09/23/2021] [Indexed: 11/05/2022] Open
Abstract
The mathematical theory of CT was proposed by J. Radon in 1917. It was declared that the projection of whole data sets was needed to reconstruct CT images. Therefore, according to J. Radon's original theory, local cone beam CT (local CBCT) was impossible to achieve.In this paper, I discuss how local CBCT was discovered and developed. Its development required many technical elements, such as a turntable and X-ray television system, for basic experiments such as those on which narrow collimation theory and multifunctional panoramic tomography were based. These experiments endured many failures during development.Now, local CBCT is extremely popular in dental practice because local CBCT has a low radiation dose and high resolution. This paper introduces the technical elements and outlines the important stages during the development of local CBCT in the 1990s.
Collapse
Affiliation(s)
- Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, Japan
| |
Collapse
|
|
21
|
Fahrig R, Jaffray DA, Sechopoulos I, Webster Stayman J. Flat-panel conebeam CT in the clinic: history and current state. J Med Imaging (Bellingham) 2021; 8:052115. [PMID: 34722795 DOI: 10.1117/1.jmi.8.5.052115] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/27/2021] [Indexed: 11/14/2022] Open
Abstract
Research into conebeam CT concepts began as soon as the first clinical single-slice CT scanner was conceived. Early implementations of conebeam CT in the 1980s focused on high-contrast applications where concurrent high resolution ( < 200 μ m ), for visualization of small contrast-filled vessels, bones, or teeth, was an imaging requirement that could not be met by the contemporaneous CT scanners. However, the use of nonlinear imagers, e.g., x-ray image intensifiers, limited the clinical utility of the earliest diagnostic conebeam CT systems. The development of consumer-electronics large-area displays provided a technical foundation that was leveraged in the 1990s to first produce large-area digital x-ray detectors for use in radiography and then compact flat panels suitable for high-resolution and high-frame-rate conebeam CT. In this review, we show the concurrent evolution of digital flat panel (DFP) technology and clinical conebeam CT. We give a brief summary of conebeam CT reconstruction, followed by a brief review of the correction approaches for DFP-specific artifacts. The historical development and current status of flat-panel conebeam CT in four clinical areas-breast, fixed C-arm, image-guided radiation therapy, and extremity/head-is presented. Advances in DFP technology over the past two decades have led to improved visualization of high-contrast, high-resolution clinical tasks, and image quality now approaches the soft-tissue contrast resolution that is the standard in clinical CT. Future technical developments in DFPs will enable an even broader range of clinical applications; research in the arena of flat-panel CT shows no signs of slowing down.
Collapse
Affiliation(s)
- Rebecca Fahrig
- Innovation, Advanced Therapies, Siemens Healthcare GmbH, Forchheim, Germany.,Friedrich-Alexander Universitat, Department of Computer Science 5, Erlangen, Germany
| | - David A Jaffray
- MD Anderson Cancer Center, Departments of Radiation Physics and Imaging Physics, Houston, Texas, United States
| | - Ioannis Sechopoulos
- Radboud University Medical Center, Department of Medical Imaging, Nijmegen, The Netherlands.,Dutch Expert Center for Screening (LRCB), Nijmegen, The Netherlands.,University of Twente, Technical Medical Center, Enschede, The Netherlands
| | - J Webster Stayman
- Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
| |
Collapse
|
|
22
|
Kong ZL, Wang GG, Liu XY, Ye ZY, Xu DQ, Ding X. Influence of bone anatomical morphology of mandibular molars on dental implant based on CBCT. BMC Oral Health 2021; 21:528. [PMID: 34654414 PMCID: PMC8518329 DOI: 10.1186/s12903-021-01888-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background To apply CBCT to investigate the anatomical relationship between the mandibular molar and alveolar bone, aimed to provide clinical guidelines for the design of implant restoration. Methods 201 CBCT data were reevaluated to measure height of the alveolar process (EF), width of the alveolar process (GH), width of the basal bone (IJ), the angle between the long axis of the first molar and the alveolar bone (∠a) and the angle between the long axis of the alveolar bone and basal bone (∠b). The angle and width were measured to determine the implant-prosthodontic classification of the morphology in the left lower first molar (36) and right lower first molar (46). All measurements were performed on the improved cross-sectional images. Results EF, GH and IJ were measured as (10.83 ± 1.31) mm, (13.93 ± 2.00) mm and (12.68 ± 1.96) mm for 36, respectively; and (10.87 ± 1.24) mm, (13.86 ± 1.93) mm and (12.60 ± 1.90) mm for 46, respectively. No statistical significance was observed in EF, GH, IJ, ∠a and ∠b between 36 and 46 (all P > 0.05). The morphology was divided into three categories including the straight (68.7–69.2%), oblique (19.9–20.4%) and concave types (11%). Each type was consisted of two subcategories. Conclusions The proposed classification could provide evidence for appropriate selection and direction design of the mandibular molar implant in clinical. The concave type was the most difficult to implant with the highest risk of lingual perforation. The implant length, width, direction required more attention.
Collapse
Affiliation(s)
- Zhuo-Lin Kong
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Ge-Ge Wang
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Xue-Ying Liu
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zhang-Yan Ye
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Dong-Qian Xu
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Xi Ding
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China.
| |
Collapse
|
|
23
|
Fischer J, Augdal TA, Angenete O, Gil EG, Skeie MS, Åstrøm AN, Tylleskär K, Rosendahl K, Shi XQ, Rosén A. In children and adolescents with temporomandibular disorder assembled with juvenile idiopathic arthritis - no association were found between pain and TMJ deformities using CBCT. BMC Oral Health 2021; 21:518. [PMID: 34641860 PMCID: PMC8513178 DOI: 10.1186/s12903-021-01870-z] [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: 07/26/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from temporomandibular disorder (TMD). Due to this, imaging diagnosis is crucial in JIA with non-symptomatic TM joint (TMJ) involvement. The aim of the study was to examine the association between clinical TMD signs/symptoms and cone-beam computed tomography (CBCT) findings of TMJ structural deformities in children and adolescents with JIA. Methods This cross-sectional study is part of a longitudinal prospective multi-centre study performed from 2015–2020, including 228 children and adolescents aged 4–16 years diagnosed with JIA, according to the International League of Associations for Rheumatology (ILAR). For this sub-study, we included the Bergen cohort of 72 patients (32 female, median age 13.1 years, median duration of JIA 4.5 years). Clinical TMD signs/symptoms were registered as pain on palpation, pain on jaw movement, and combined pain of those two. The severity of TMJ deformity was classified as sound (no deformity), mild, or moderate/severe according to the radiographic findings of CBCT. Results Of 72 patients, 21 (29.2%) had pain on palpation at and around the lateral pole, while 41 (56.9%) had TMJ pain upon jaw movement and 26 (36.1%) had pain from both. Of 141 TMJs, 18.4% had mild and 14.2% had moderate/severe structural deformities visible on CBCT. CBCT findings were not significantly associated with either the pain on palpation or the pain on jaw movement. A significant difference was found between structural deformities in CBCT and the combined pain outcome (pain at both palpation and movement) for both TMJs for the persistent oligoarticular subtype (p = 0.031). Conclusions There was no association between painful TMD and CBCT imaging features of the TMJ in patients with JIA, but the oligoarticular subtype of JIA, there was a significant difference associated with TMJ pain and structural CBCT deformities. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01870-z.
Collapse
Affiliation(s)
- J Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.
| | - T A Augdal
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - O Angenete
- Department of Radiology and Nuclear Medicine, St. Olav Hospital HF, Trondheim, Norway.,Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - E G Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - M S Skeie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - A N Åstrøm
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Public Dental Service Competence Centre of Western-Norway (TkVest), Bergen, Norway
| | - K Tylleskär
- Paediatric Clinic at Haukeland University Hospital, Bergen, Norway
| | - K Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway.,UiT Arctic University of North Norway, Tromsø, Norway
| | - X-Q Shi
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - A Rosén
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | | |
Collapse
|
|
24
|
Belmans N, Oenning AC, Salmon B, Baselet B, Tabury K, Lucas S, Lambrichts I, Moreels M, Jacobs R, Baatout S. Radiobiological risks following dentomaxillofacial imaging: should we be concerned? Dentomaxillofac Radiol 2021; 50:20210153. [PMID: 33989056 PMCID: PMC8404518 DOI: 10.1259/dmfr.20210153] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR). METHODS Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields. RESULTS There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children. CONCLUSIONS In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.
Collapse
Affiliation(s)
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São, Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | | | - Bjorn Baselet
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
| | | | - Stéphane Lucas
- Laboratory of Analysis by Nuclear Reaction (LARN/PMR), Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Ivo Lambrichts
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
| | - Marjan Moreels
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
| | | | | |
Collapse
|
|
25
|
Friedlander-Barenboim S, Hamed W, Zini A, Yarom N, Abramovitz I, Chweidan H, Finkelstein T, Almoznino G. Patterns of Cone-Beam Computed Tomography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center. Healthcare (Basel) 2021; 9:1042. [PMID: 34442182 PMCID: PMC8392371 DOI: 10.3390/healthcare9081042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 01/30/2023] Open
Abstract
The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9-86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.
Collapse
Affiliation(s)
| | - Wafi Hamed
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Avraham Zini
- Hadassah Medical Center, Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Noam Yarom
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
| | - Itzhak Abramovitz
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Harry Chweidan
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Tamar Finkelstein
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel
| | - Galit Almoznino
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
- Hadassah Medical Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Hadassah Medical Center, Big Biomedical Data Research Laboratory, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| |
Collapse
|
|
26
|
Yeung AWK, Wong NSM. Reject Rates of Radiographic Images in Dentomaxillofacial Radiology: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158076. [PMID: 34360368 PMCID: PMC8345626 DOI: 10.3390/ijerph18158076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023]
Abstract
This report surveyed the image reject rates of intra-oral, extra-oral, and cone-beam computed tomography (CBCT) imaging in the academic literature. PubMed, Web of Science, and Scopus databases were queried in mid-April 2021. Manual screening of the reference lists of the identified publications was performed to identify papers missed from the database search. All publications returned by the searches were initially included. Exclusion criteria included irrelevance, no reporting of reject rate, no access to the article, and not original article. The total number of images and the number of rejects were recorded for each type of radiographic images. Factors and commonest errors associated with the rejects were recorded. Twenty-six original articles were identified and reviewed. The average reject rate was 11.25% for bitewings, 16.38% for periapicals, 4.10% for panoramics, 6.08% for lateral cephalography, and 2.77% for CBCT. Positioning error and patient movement were two common reasons for the rejects. The average reject rates computed from data pooled across studies should form the reference values for quality assurance programs to follow. Future reject analysis studies should report more radiographic parameters such as type of collimation for intra-oral radiography and patient posture for CBCT.
Collapse
Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Correspondence:
| | - Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
| |
Collapse
|
|
27
|
Al-Okshi A, Horner K, Rohlin M. A meta-review of effective doses in dental and maxillofacial cone beam CT using the ROBIS tool. Br J Radiol 2021; 94:20210042. [PMID: 33989050 PMCID: PMC8248222 DOI: 10.1259/bjr.20210042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To apply the ROBIS tool for assessment of risk of bias (RoB) in systematic reviews (SRs) in a meta-review on effective doses (EDs) in dental and maxillofacial cone beam CT. METHODS Three electronic databases and reference lists of included SRs were searched. Eligible SRs were classified as having low, high or unclear RoB. Findings of SRs were synthesised and data from primary studies combined to relate ED to field of view (FOV) and operating potential (kV). RESULTS Seven SRs were included: three displayed low RoB, three high and one had unclear RoB. Only one SR related ED to image quality. Deficiencies in reporting of eligibility criteria, study selection and synthesis of results in SRs were identified. FOV height had a significant relationship with ED, explaining 27.2% of its variability. Median ED for three FOV categories differed significantly. Operating potential had a weak relationship with ED, with no significant difference in median ED between three operating potential groups. CONCLUSION The ROBIS tool should have a role for meta-reviews of different aspects of radiology. The disappointing results for RoB might be remedied by developing standards to improve the quality of reporting of primary dosimetry studies and of SRs. Future dosimetry studies should always relate ED to image quality or diagnostic accuracy. ADVANCES IN KNOWLEDGE This meta-review is the first to implement ROBIS for SRs of ED and identified that trustworthiness of some SRs is questionable. The percentage change in average ED per cm increase in FOV height could be calculated, emphasizing the importance of FOV as a determinant of ED in CBCT.
Collapse
Affiliation(s)
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | |
Collapse
|
|
28
|
Wenzel A. Radiographic modalities for diagnosis of caries in a historical perspective: from film to machine-intelligence supported systems. Dentomaxillofac Radiol 2021; 50:20210010. [PMID: 33661697 PMCID: PMC8231685 DOI: 10.1259/dmfr.20210010] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 01/17/2023] Open
Abstract
Radiographic imaging for the diagnosis of caries lesions has been a supplement to clinical examination for approximately a century. Various methods, and particularly X-ray receptors, have been developed over the years, and computer systems have focused on aiding the dentist in the detection of lesions and in estimating lesion depth. The present historical review has sampled accuracy ex vivo studies and clinical studies on radiographic caries diagnosis that have compared two or more receptors for capturing the image. The epochs of film radiography, xeroradiography, digital intraoral radiography, panoramic radiography and other extraoral methods, TACT analysis, cone-beam CT and artificial intelligence systems aiding in decision-making are reviewed. The author of this review (43 years in academia) has been involved in caries research and contributed to the literature in all the mentioned epochs.
Collapse
Affiliation(s)
- Ann Wenzel
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
|
29
|
Mahmoud O, Awad Abdelmagied MH, Dandashi AH, Jasim BN, Tawfik Kayali HA, Al Shehadat S. Comparative Evaluation of Accuracy of Different Apex Locators: Propex IQ, Raypex 6, Root ZX, and Apex ID with CBCT and Periapical Radiograph-In Vitro Study. Int J Dent 2021; 2021:5563426. [PMID: 34054960 PMCID: PMC8112958 DOI: 10.1155/2021/5563426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 04/25/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed to validate the accuracy of working length (WL) measurements obtained with the newly introduced Propex IQ apex locator and to compare it with the latest generations of other electronic apex locators, CBCT, and conventional periapical radiographs by using the actual WL measurements obtained by using an endodontics microscope as a reference. MATERIALS AND METHODS Thirty-five extracted single-rooted human mandibular first premolars with curvatures from 10° to 20° were selected according to the inclusion and exclusion criteria and cut at the cementoenamel junction to achieve a standard reference point for WL determination. The actual WL was obtained by inserting a size-15 k-file in the root canal until the tip of the file was visible under an endodontic microscope. The definitive WL was measured using Propex IQ (Dentsply Sirona), Raypex 6 (VDW Dental), Root ZX (Morita), and Apex ID (Kerr Dental). In addition, radiographic WL was obtained using periapical radiographs and CBCT. One-way ANOVA was used for comparisons of the WL values, with a p value < 0.05. The percentage of success of each method for determination of the definitive WL was assessed using cross-tabulation and chi-square tests. RESULTS CBCT radiographs and Propex IQ apex locator yielded the most accurate WL measurements in comparison with the actual WL measurements (p < 0.05). Raypex 6, Root ZX, and Apex ID yielded more accurate WL measurements than conventional periapical radiographs (p < 0.05). Periapical radiographs yielded the least accurate WL measurements in comparison with the actual WL values (p < 0.05). CONCLUSIONS Within the limitations of this study, the Propex IQ apex locator showed higher accuracy than Raypex 6, Root ZX, and Apex ID for WL determination in the root canal. Nevertheless, CBCT radiographs yielded the maximum accuracy for WL measurements.
Collapse
Affiliation(s)
- Okba Mahmoud
- Clinical Sciences Department, Faculty of Dentistry, Ajman University, Ajman, UAE
| | | | | | - Bakr Nssaief Jasim
- Clinical Sciences Department, Faculty of Dentistry, Ajman University, Ajman, UAE
| | | | - Saaid Al Shehadat
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| |
Collapse
|
|
30
|
A Conservative Approach to Surgical Management of Root Canal Perforation. Case Rep Dent 2021; 2021:6633617. [PMID: 33542842 PMCID: PMC7843180 DOI: 10.1155/2021/6633617] [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: 10/08/2020] [Accepted: 01/12/2021] [Indexed: 11/17/2022] Open
Abstract
This study describes a conservative approach to surgical management of root canal perforation in maxillary lateral incisors. A patient was referred for retreatment of a maxillary lateral incisor. Her chief complaint was discomfort in the buccal mucosa. Periapical radiography showed radiopaque material consistent with sealing material inside the root canal. A CBCT scan was acquired and revealed a gutta-percha cone outside the root canal, from the middle third to beyond the root apex. The imaging examination showed that the pulp cavity had not been affected. Thus, we took the clinical alternative of surgically managing the perforation by sealing with MTA, thereby avoiding endodontic treatment, and followed up with only clinical and radiographic control. At the two-year follow-up, after the surgical procedure to remove the extruded filling material, we observed bone tissue formation and positive response to pulp tests, without any clinical signs or symptoms. Root perforation is considered an unpleasant error in an operative procedure. Once a perforation is properly diagnosed, located, and sealed with biomaterial, a favorable prognosis is often achieved. MTA offered good sealing of the perforation, with promising results. Decision-making using the CBCT scan enabled us to adopt a conservative approach and favored more reliable treatment predictability.
Collapse
|
|
31
|
Evaluation of Mental Foramen with Cone Beam Computed Tomography: A Systematic Review of Literature. Radiol Res Pract 2021; 2021:8897275. [PMID: 33505723 PMCID: PMC7806401 DOI: 10.1155/2021/8897275] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/19/2020] [Accepted: 11/23/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this systematic review is to assess whether the anatomy of mental foramen is precisely evaluable with cone beam computed tomography (CBCT) before implantation in humans. Methods A systematic review was carried out to evaluate the anatomy of mental foramen (size, position, symmetry, anterior loop, and accessory mental foramen or multiple mental foramina). According to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, an electronic search of three databases (Medline, Web of Science, and Cochrane Library) was undertaken until June 2020 and was supplemented by manual searching. Two reviewers will independently perform the processes of study inclusion, data extraction, and quality assessment. Systematic reviews, studies about children, and case reports were excluded. Only studies using CBCT to do preoperative evaluation were selected. Results From 728 potentially eligible articles, 72 were included in the qualitative analysis and quantitative synthesis. This systematic review provided an assessment of the anatomy of the mental foramen. The mental foramen was located mostly between the two premolars (between 50.4% and 61.95%) or apically to the second premolar (from 50.3% to 57.9%). The mean diameter of the mental foramen was bigger in males than in females; the difference between them could reach 0.62 mm. The anterior loop seemed to be longer in males (between 0.87 ± 1.81 and 7.25 ± 2.02 mm) than in females (between 0.81 ± 1.18 and 6.52 ± 1.63 mm) and with the presence of teeth (from 0.91 ± 1.18 to 2.55 ± 1.28 for dentate people and from 0.25 ± 0.61 to 2.40 ± 0.88 mm for edentate population). The anterior loop and the accessory mental foramina were detected more frequently with CBCT than panoramic X-ray: only between 0.0 and 48.6% AMFs detected with CBCT were also seen with panoramic images. Clinical Significance. The mental foramen (MF) is an important landmark for local anesthesia and surgical and implantology procedures. Its location, morphology, and anatomical variations need to be considered to avoid mental nerve injury. The aim of this review is to evaluate the mental foramen using CBCT through a systematic literature review to improve knowledge of this complex area for the clinician.
Collapse
|
|
32
|
Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring. J Digit Imaging 2020; 34:96-104. [PMID: 33269449 DOI: 10.1007/s10278-020-00406-1] [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: 05/25/2020] [Revised: 11/04/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022] Open
Abstract
Several visual scoring methods are currently used to assess progression of rheumatoid arthritis (RA) on radiography. However, they are limited by its subjectivity and insufficient sensitivity. We have developed an original measurement system which uses a technique called phase-only correlation (POC). The purpose of this study is to validate the system by using a phantom simulating the joint of RA patients.A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. The phantom was scanned with radiography, 320 multi detector CT (MDCT), high-resolution peripheral quantitative CT (HR-pQCT), cone beam CT (CBCT), and tomosynthesis. The width was adjusted to the average size of a women's metacarpophalangeal joint, from 1.2 to 2.2 mm with increments of 0.1 mm and 0.01 mm. Radiographical images were analyzed by the POC-based system and manual method, and images from various tomographical modalities were measured via the automatic margin detection method. Correlation coefficients between true JSW difference and measured JSW difference were all strong at 0.1 mm intervals with radiography (POC-based system and manual method), CBCT, 320MDCT, HR-pQCT, and tomosynthesis. At 0.01 mm intervals, radiography (POC-based system), 320MDCT, and HR-pQCT had strong correlations, while radiography (manual method) and CBCT had low correlations, and tomosynthesis had no statistically significant correlation. The smallest detectable changes for radiography (POC-based system), radiography (manual method), 320MDCT, HR-pQCT, CBCT, and tomosynthesis were 0.020 mm, 0.041 mm, 0.076 mm, 0.077 mm, 0.057 mm, and 0.087 mm, respectively. We conclude that radiography analyzed with the POC-based system might sensitively detect minute joint space changes of the finger joint.
Collapse
|
|
33
|
Mao WY, Lei J, Lim LZ, Gao Y, Tyndall DA, Fu K. Comparison of radiographical characteristics and diagnostic accuracy of intraosseous jaw lesions on panoramic radiographs and CBCT. Dentomaxillofac Radiol 2020; 50:20200165. [PMID: 32941743 DOI: 10.1259/dmfr.20200165] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the differences in imaging characteristics and the diagnostic accuracy of 225 intraosseous jaw lesions on panoramic radiographs (PAN) versus cone beam computed tomography (CBCT). METHODS 225 sets of PAN and CBCT images with biopsy-proven histopathological diagnoses were retrospectively compared in terms of radiographic features and diagnostic accuracy. The imaging characteristics of PAN and CBCT were independently evaluated by two oral and maxillofacial radiologists who were required to answer 12 questions and provided up to three differential diagnoses with their confidence scores. RESULTS Odds ratios (ORs) were statistically significant for border cortication (OR = 1.521; p = .003) and border continuity (OR = 0.421; p = .001), involvement on neurovascular canals (OR = 2.424; p < .001), expansion (OR = 7.948; p < .001), cortical thinning (OR = 20.480; p < .001) as well as its destruction (OR = 25.022; p < .001) and root resorption (OR = 2.477; p < .001). Furthermore, imaging features in the posterior and mandibular regions showed better agreement than those in the anterior and maxillary regions, respectively. The diagnostic accuracy of the first differential diagnosis was higher on CBCT than on PAN (Observer 1:78.7 vs 64.4%; Observer 2: 78.7 vs 70.2% (p < .001)). The observers' confidence scores were also higher at CBCT interpretation compared with PAN. CONCLUSIONS CBCT demonstrated a greater number of imaging characteristics of intraosseous jaw lesions compared with PAN, especially in the anterior regions of both jaws and in the maxilla. Diagnostic accuracy is improved with CBCT compared to PAN, especially for lesions in the maxilla. Radiologists have greater confidence when using CBCT.
Collapse
Affiliation(s)
- Wei-Yu Mao
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jie Lei
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Li Zhen Lim
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, Singapore, Singapore.,Department of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, USA
| | - Yan Gao
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China.,Department of Oral Pathology, Peking University School & Hospital of Stomatology, Beijing, China
| | - Donald A Tyndall
- Department of Diagnostic Sciences, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC, USA
| | - Kaiyuan Fu
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China.,Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
|
34
|
Van Acker JWG, Pauwels NS, Cauwels RGEC, Rajasekharan S. Outcomes of different radioprotective precautions in children undergoing dental radiography: a systematic review. Eur Arch Paediatr Dent 2020; 21:463-508. [PMID: 32557182 DOI: 10.1007/s40368-020-00544-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the effectiveness of all radioprotective measures in underage patients who undergo a dental radiodiagnostic examination. METHODS A systematic review was performed including randomised controlled trials (RCTs), or cluster trials, cohort studies, cross-sectional studies, case-control studies and comparative in vitro research. These studies examined the healthy underage human population (below 18 years) undergoing a dental radiodiagnostic examination. All radioprotective measures were included except for justification as an intervention. The primary outcomes were in vivo mortality and morbidity. Some surrogate or indirect outcomes such as in vitro effective dose and organ absorbed doses were also accepted. Secondary outcomes with regards to image quality and therapeutic value were also analysed. RESULTS Eighteen papers were eligible for implementation. Fifteen studies underwent narrative synthesis. Regression analysis was performed on three studies. CONCLUSION The following radioprotective measures can reduce the exposure dose. For lateral cephalometry: collimation, filtration, the fastest receptor type and circumstantial thyroid shielding. For oblique lateral radiographs: the shortest exposure time, a smaller horizontal angulation, a longer focus to skin distance. For intraoral radiography: rectangular collimation, the fastest image receptor speed and thyroid shielding when the thyroid gland is in line of or very close to the primary beam. For panoramic radiographs: collimation, the fastest receptor type and the use of automatic exposure control (AEC) or manual adjustment of intensity. For cone-beam computed tomography: collimation, the largest voxels size in relation to the treatment need, change in image settings such as ultra-low dose settings, shorter exposure time, a lower amount of projections, lower beam intensity, reduction of the potential, use of a thyroid shield except in two situations and the use of AEC. All of the changes in exposure parameters should be performed while maintaining a sufficient therapeutic value on an individual and indication-based level.
Collapse
Affiliation(s)
- J W G Van Acker
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium.
| | - N S Pauwels
- Knowledge Center Ghent, Ghent University Hospital, C. Heymanslaan 10 (K3), 9000, Ghent, Belgium
| | - R G E C Cauwels
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium
| | - S Rajasekharan
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium
| |
Collapse
|
|
35
|
Gaêta-Araujo H, Alzoubi T, Vasconcelos KDF, Orhan K, Pauwels R, Casselman JW, Jacobs R. Cone beam computed tomography in dentomaxillofacial radiology: a two-decade overview. Dentomaxillofac Radiol 2020; 49:20200145. [PMID: 32501720 DOI: 10.1259/dmfr.20200145] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate and summarise features of currently and formerly available cone beam CT (CBCT) devices from 1996 to 2019. Additionally, a recommendation for standardised reporting of CBCT characteristics was provided. METHODS AND MATERIALS Information about the features of all available CBCT devices was obtained from the manufacturers' available data. Moreover, site visits to newly developed CBCT machines' manufacturers were performed in order to obtain relevant information. RESULTS A total of 279 CBCT models from 47 manufacturers located in 12 countries (Brazil, China, Denmark, Finland, France, Germany, Italy, Japan, Republic of Korea, Slovakia, Thailand, and USA) could be listed. Overall, wide variations in CBCT features and technical specifications were identified. CONCLUSIONS CBCT in dentomaxillofacial radiology is a generic term applicable to a broad range of CBCT machines and features. Experimental outcomes and literature statements regarding radiation doses, imaging performance and diagnostic applicability of dental CBCT cannot be simply transferred from one CBCT model to another considering a wide variation in technical characteristics and clinical diagnostic performance. The information tabulated in the present study will be later provided on the International Association of DentoMaxilloFacial Radiology website (www.iadmfr.one).
Collapse
Affiliation(s)
- Hugo Gaêta-Araujo
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Tamara Alzoubi
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Kaan Orhan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of DentoMaxillofacial Radiology, Ankara University, Faculty of Dentistry, Ankara, Turkey
| | - Ruben Pauwels
- Medical Physics & Quality Assessment Department of Imaging & Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.,Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | | | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
|
36
|
Molteni R. The way we were (and how we got here): fifty years of technology changes in dental and maxillofacial radiology. Dentomaxillofac Radiol 2020; 50:20200133. [PMID: 32525697 DOI: 10.1259/dmfr.20200133] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The history of the last 50 years (1970-2020) of technological changes and progresses for equipment and procedures in dental and maxillofacial radiology is related from the insider perspective of an industrial physicist and technologist who has been instrumental at innovating and developing medical equipment in different parts of the world. The onset and improvement of all major categories of dental and maxillofacial radiographic equipment is presented, from the standpoint of their practical acceptance and impact among common dentists and maxillofacial radiologists: X-ray sources and detectors for intraoral radiography, and panoramic systems, both film-based and digital (including photo-stimulated phosphor plates); and cone beam CT.
Collapse
|
|
37
|
Ghoncheh Z, Panjnoush M, Kaviani H, Kharazifard MJ, Zahirnia F. Knowledge and Attitude of Iranian Dentists towards Cone-Beam Computed Tomography. Front Dent 2020; 16:379-385. [PMID: 32123878 PMCID: PMC7040564 DOI: 10.18502/fid.v16i5.2292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 08/18/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives We aimed to evaluate the knowledge and attitude of Iranian dentists towards cone-beam computed tomography (CBCT). Materials and Methods A 20-item questionnaire was distributed among 410 Iranian dentistry graduates attending the 56th Congress of Iranian Dental Association held in Tehran, Iran. The questionnaire included items on demographic characteristics, namely full name, age, gender, work experience, type of current activity (individual or group), and the highest educational level. In addition, the questionnaire contained items on the knowledge and attitude of dentists. The obtained data were analyzed using statistical tests. Results In this study, 49.3% and 22.4% of the subjects were male and female, respectively, 47.1% of whom used CBCT, while 49.8% did not. In detail, 72.2% of the dentists used the technique to evaluate the location of implants, whereas 19.7%, 3.2%, and 2.7% of the subjects applied it to localize the inferior alveolar nerve (IAN), evaluate the location of implants and localize the IAN, and perform cephalometric analysis, respectively. The main causes of lack of prescription of CBCT entailed high cost (80%), high rate of patient absorbed dose (27.6%), insufficient number of CBCT centers (46.3%), and the long duration of the process (15.6%). Conclusion CBCT is an advantageous imaging technique in dentistry. Considering the increased application of CBCT in dentistry, attending workshops could help train dentists to use the technique.
Collapse
Affiliation(s)
- Zahra Ghoncheh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Panjnoush
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Kaviani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamad Javad Kharazifard
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Zahirnia
- Department of Oral and Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
38
|
Belmans N, Gilles L, Vermeesen R, Virag P, Hedesiu M, Salmon B, Baatout S, Lucas S, Lambrichts I, Jacobs R, Moreels M. Quantification of DNA Double Strand Breaks and Oxidation Response in Children and Adults Undergoing Dental CBCT Scan. Sci Rep 2020; 10:2113. [PMID: 32034200 PMCID: PMC7005754 DOI: 10.1038/s41598-020-58746-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 01/03/2020] [Indexed: 01/22/2023] Open
Abstract
Assessing the possible biological effects of exposure to low doses of ionizing radiation (IR) is one of the prime challenges in radiation protection, especially in medical imaging. Today, radiobiological data on cone beam CT (CBCT) related biological effects are scarce. In children and adults, the induction of DNA double strand breaks (DSBs) in buccal mucosa cells and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-dG) and antioxidant capacity in saliva samples after CBCT examination were examined. No DNA DSBs induction was observed in children nor adults. In children only, an increase in 8-oxo-dG levels was observed 30 minutes after CBCT. At the same time an increase in antioxidant capacity was observed in children, whereas a decrease was observed in adults. Our data indicate that children and adults react differently to IR doses associated with CBCT. Fully understanding these differences could lead to an optimal use of CBCT in different age categories as well as improved radiation protection guidelines.
Collapse
Affiliation(s)
- Niels Belmans
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium
| | - Liese Gilles
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
| | - Randy Vermeesen
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium
| | - Piroska Virag
- Institute of Oncology "Prof. dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- 'Iuliu Hatieganu' University of Medicine and Pharmacy, Department of Oral and Maxillofacial Radiology, Cluj-Napoca, Romania
| | - Benjamin Salmon
- Paris Descartes University - Sorbonne Paris Cité, EA 2496 - Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris, France
| | - Sarah Baatout
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium
| | - Stéphane Lucas
- Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Ivo Lambrichts
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
| | - Reinhilde Jacobs
- Katholieke Universiteit Leuven, Department of Imaging and Pathology, OMFS-IMPATH Research group, and University Hospitals, Oral and Maxillofacial Surgery, Dentomaxillofacial Imaging Center, Kapucijnenvoer 7, Leuven, Belgium
- Karolinska Institutet, Department Dental Medicine, Huddinge, Sweden
| | - Marjan Moreels
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium.
| |
Collapse
|
|
39
|
Liberton DK, Verma P, Contratto A, Lee JS. Development and Validation of Novel Three-Dimensional Craniofacial Landmarks on Cone-Beam Computed Tomography Scans. J Craniofac Surg 2019; 30:e611-e615. [PMID: 31478954 PMCID: PMC7500863 DOI: 10.1097/scs.0000000000005627] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
As cone-beam computed tomography (CBCT) scans become increasingly common, it is vital to have reliable 3-dimensional (3D) landmarks for quantitative analysis of craniofacial skeletal morphology. While some studies have developed and used 3D landmarks, these landmark sets are generally small and derived primarily from previous 2-dimensional (2D) cephalometric landmarks. These derived landmarks lack information in parts of the skull such as the cranial base, which is an important feature for cranial growth and development. The authors see a real need for development and validation of 3D landmarks, particularly bilateral landmarks, across the skull for improved cephalometric analysis. The primary objective of this study is to develop and validate a set of 61 3D anatomical landmarks on the face, cranial base, mandible, and teeth for use in clinical and research studies involving CBCT imaging. Each landmark was placed 3 times by 3 separate trained observers on a set of 10 anonymized CBCT patient scans. Intra-rater and inter-rater estimates of consistency and agreement were calculated using the intraclass correlation coefficient. Measurement error was calculated per landmark and per X, Y, and Z landmark coordinate. The authors had high ICC estimates within rates, indicating high consistency, and high ICC estimates among raters, indicate good agreement across raters. Overall measurement error for each landmark and each X, Y, and Z coordinate was low. Our results confirm the accuracy of novel 3D landmarks including several on the cranial base that will serve researchers and clinicians for use in future studies involving 3D CBCT imaging and craniofacial development.
Collapse
Affiliation(s)
- Denise K. Liberton
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Payal Verma
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
- University of Cincinnati College of Medicine, Division of Oral & Maxillofacial Surgery, Cincinnati, Ohio, United States of America
| | - Anthony Contratto
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
- University of Missouri - Kansas City School of Dentistry, Kansas City, Missouri, United States of America
| | - Janice S. Lee
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
|
40
|
Corbella S, Baruffaldi M, Perondi I, Taschieri S. Surgically-oriented anatomical study of mandibular premolars: A CBCT study. J Clin Exp Dent 2019; 11:e877-e882. [PMID: 31636856 PMCID: PMC6797462 DOI: 10.4317/jced.55848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
Background The knowledge of root canal anatomy and of the anatomical relationship should be considered mandatory when planning surgical endodontics. The aim of the study was to investigate the anatomical features of mandibular premolars, evaluating their relationship with mental nerve. Material and Methods CBCT scans were evaluated recording the number of roots, root canal configuration and the relationship with mental nerve of 100 mandibular premolars. After simulating a resection of 3 mm of the root, the shape and the number of canals, and the distance to the buccal and lingual bone plate and to the mental foramen was evaluated. Results The one root - one canal configuration was the most common configuration. The mental foramen was located at the level of MSPs in 40% cases, and it was between MSP and MFP in 46% of cases. The distance between the apex and the vestibular plate was lower than the distance to the lingual one. Conclusions We found a significant heterogeneity in the anatomy of mandibular premolars. CBCT could be considered important when planning surgical endodontics in this region. Key words:Cone-Beam Computed Tomography, bicuspid, root canal, root canal therapy, apicoectomy, mandibular nerve.
Collapse
Affiliation(s)
- Stefano Corbella
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
| | - Martino Baruffaldi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Isabella Perondi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy
| | - Silvio Taschieri
- Visiting Professor, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, Dental Clinic, Milan, Italy. Professor, Institute of Dentistry, Dept. of Oral Surgery, I. M. Sechenov First Moscow state medical University, Moscow, Russia
| |
Collapse
|
|
41
|
Beganović A, Ciraj-Bjelac O, Dyakov I, Gershan V, Kralik I, Milatović A, Šalát D, Stepanyan K, Vladimirov A, Vassileva J. IAEA survey of dental cone beam computed tomography practice and related patient exposure in nine Central and Eastern European countries. Dentomaxillofac Radiol 2019; 48:20190157. [PMID: 31530009 DOI: 10.1259/dmfr.20190157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Cone beam CT (CBCT) in dentistry and maxillofacial surgery is a widely used imaging method for the assessment of various maxillofacial and dental pathological conditions. The objective of this study was to summarize the results of a multinational retrospective-prospective study that focused on patient exposure in this modality. METHODS The study included 27 CBCT units and 325 adult and paediatric patients, in total. Data on patients, clinical indications, technical parameters of exposure, patient dose indicator, or, alternatively, dose to phantom were collected. The dose indicator used was air kerma-area product, PKA. RESULTS In most scanners operators are offered with a variety of options regarding technical parameters, especially the field of view size. The median and the third quartile value of PKA for adult patients in 14 different facilities were 820 mGy cm² and 1000 mGy cm² (interquartile range = 1058 mGy cm²), and 653 mGy cm² and 740 mGy cm² (interquartile range = 1179 mGy cm²) for children, as reported by four different institutions. Phantom dose data were reported from 15 institutions, and median PKA ranged from 125 mGy cm² to 1951 mGy cm². Median PKA values varied by more than a 10-fold between institutions, mainly due to differences in imaging protocol used, in particular field of view and tube current-exposure time product. CONCLUSIONS The results emphasize the need for a cautious approach to using dental CBCT. Imaging only when the clinical indications are clear, accompanied with the appropriate radiographic techniques and the optimum imaging protocol, will help reduce radiation dose to patients.
Collapse
Affiliation(s)
- Adnan Beganović
- Clinical Centre of Sarajevo University, Sarajevo, Bosnia and Herzegovina
| | | | | | - Vesna Gershan
- Ss. Cyril and Methodius University, Skopje, North Macedonia
| | | | | | - Dušan Šalát
- University of St. Cyril and Methodius, Trnava, Slovakia
| | - Karapet Stepanyan
- Department of Radiation Safety, Ministry of Health, Yerevan, Armenia
| | | | | |
Collapse
|
|
42
|
Belmans N, Gilles L, Virag P, Hedesiu M, Salmon B, Baatout S, Lucas S, Jacobs R, Lambrichts I, Moreels M. Method validation to assess in vivo cellular and subcellular changes in buccal mucosa cells and saliva following CBCT examinations. Dentomaxillofac Radiol 2019; 48:20180428. [PMID: 30912976 PMCID: PMC6747439 DOI: 10.1259/dmfr.20180428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/08/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Cone-beam CT (CBCT) is a medical imaging technique used in dental medicine. However, there are no conclusive data available indicating that exposure to X-ray doses used by CBCT are harmless. We aim, for the first time, to characterize the potential age-dependent cellular and subcellular effects related to exposure to CBCT imaging. Current objective is to describe and validate the protocol for characterization of cellular and subcellular changes after diagnostic CBCT. METHODS Development and validation of a dedicated two-part protocol: 1) assessing DNA double strand breaks (DSBs) in buccal mucosal (BM) cells and 2) oxidative stress measurements in saliva samples. BM cells and saliva samples are collected prior to and 0.5 h after CBCT examination. BM cells are also collected 24 h after CBCT examination. DNA DSBs are monitored in BM cells via immunocytochemical staining for γH2AX and 53BP1. 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-dG) and total antioxidant capacity are measured in saliva to assess oxidative damage. RESULTS Validation experiments show that sufficient BM cells are collected (97.1 ± 1.4 %) and that γH2AX/53BP1 foci can be detected before and after CBCT examination. Collection and analysis of saliva samples, either sham exposed or exposed to IR, show that changes in 8-oxo-dG and total antioxidant capacity can be detected in saliva samples after CBCT examination. CONCLUSION The DIMITRA Research Group presents a two-part protocol to analyze potential age-related biological differences following CBCT examinations. This protocol was validated for collecting BM cells and saliva and for analyzing these samples for DNA DSBs and oxidative stress markers, respectively.
Collapse
Affiliation(s)
| | - Liese Gilles
- Morphology Group, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Piroska Virag
- ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, Department of Oral and Maxillofacial Radiology, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, Department of Oral and Maxillofacial Radiology, Cluj-Napoca, Romania
| | - Benjamin Salmon
- Department of Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine, Paris Descartes University - Sorbonne Paris Cité, Bretonneau Hospital, HUPNVS, AP-HP, Paris, France
| | - Sarah Baatout
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium
| | - Stéphane Lucas
- University of Namur, Research Institute for Life Sciences, Namur, Belgium
| | | | - Ivo Lambrichts
- Morphology Group, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Marjan Moreels
- Belgian Nuclear Research Centre, Radiobiology Unit, SCK•CEN, Mol, Belgium
| |
Collapse
|
|
43
|
De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. Eur J Orthod 2019; 41:381-389. [PMID: 30351398 PMCID: PMC6686083 DOI: 10.1093/ejo/cjy066] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. OBJECTIVE The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. SEARCH METHODS MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. SELECTION CRITERIA The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. CONCLUSIONS CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. REGISTRATION None. CONFLICT OF INTEREST None to declare.
Collapse
Affiliation(s)
- Annelore De Grauwe
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven
- DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Irem Ayaz
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven
- DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven
- DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven
- DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
|
44
|
Pham KV, Le AHL. Evaluation of Roots and Canal Systems of Mandibular First Molars in a Vietnamese Subpopulation Using Cone-Beam Computed Tomography. J Int Soc Prev Community Dent 2019; 9:356-362. [PMID: 31516869 PMCID: PMC6714421 DOI: 10.4103/jispcd.jispcd_52_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022] Open
Abstract
Objectives: The aim of this study is to determine the prevalence of the first lower molars that have two roots or three roots and the number of the root canals of the mandibular first molars in the Vietnamese subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: The study was conducted on 166 patients who had CBCT as indicated by dentists in Nguyen Trai Dental CT Center, Ho Chi Minh City using the Picasso Trio (Ewoo Vatech, Korea). The number of root canals of the first lower molars was examined by moving cross-sectional slices from the pulpal floor to the apex. The orifices, middle thirds, and apical thirds of the canals of the first lower molar were observed, and the root canals of each root of the mandibular first molars were observed in three planes. Results: The prevalence of two, three, and four root canals of the mandibular first molars was 4.5%, 66.8%, and 28.9%, respectively. For the distal roots of these molars, a classification of Vertucci type I was the most common at a rate of 80.8%–97.6%. Whenever these teeth had three roots, a Vertucci type I was the classification of 100% of distolingual roots. Conclusion: Majority of the mandibular first molars has two roots and three canals. CBCT is appropriate equipment useful in investigating the complex root canal morphology of human teeth.
Collapse
Affiliation(s)
- Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Anh Hoang Lan Le
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| |
Collapse
|
|
45
|
Al-Falahi B, Hafez AM, Fouda M. Three-dimensional assessment of external apical root resorption after maxillary posterior teeth intrusion with miniscrews in anterior open bite patients. Dental Press J Orthod 2019; 23:56-63. [PMID: 30672986 PMCID: PMC6340203 DOI: 10.1590/2177-6709.23.6.056-063.oar] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/13/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the external apical root resorption (EARR) of the maxillary posterior teeth after intrusion with miniscrews. METHODS Fifteen patients (13 females and 2 males) with age ranging from 14.5 to 22 years (mean 18.1 ±2.03 years) were selected to participate in this study. All patients presented with anterior open bite of 3 mm or more. An intrusion force of 300 g was applied on each side to intrude the maxillary posterior teeth. Cone beam computed tomography (CBCT) scans were taken pretreatment and post-intrusion and were analyzed to evaluate the EARR. RESULTS The maxillary posterior teeth were intruded in average 2.79 ± 0.46 mm (p< 0.001) in 5.1 ± 1.3 months, and all examined roots showed statistically significant EARR (p< 0.05) with an average of 0.55 mm, except the distobuccal root of the left first permanent molars and both the palatal and buccal roots of left first premolars, which showed no statistically significant changes. CONCLUSIONS The evaluated teeth presented statistically significant EARR, but clinically, due to the small magnitude, it was not considered significant. Moreover, the CBCT provided a good visualization of all roots in all three planes, and it was effective in detecting minimal degrees of EARR.
Collapse
Affiliation(s)
- Bilal Al-Falahi
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
| | - Ahmad Mohammad Hafez
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
| | - Maher Fouda
- Mansoura University, Faculty of Dentistry, Department of Orthodontics (Mansoura, Egypt)
| |
Collapse
|
|
46
|
Cone-beam computed tomography evaluation of the pterygomaxillary fissure and pterygopalatine fossa using 3D rendering programs. Surg Radiol Anat 2019; 41:513-522. [PMID: 30725218 DOI: 10.1007/s00276-019-02201-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to investigate the detailed anatomy of the pterygomaxillary fissure (PMF) and pterygopalatine fossa (PPF) and variations therein using three-dimensional (3D) cone-beam computed tomography (CBCT) software. METHODS This study was based on a retrospective evaluation of CBCT scans. A total of 825 CBCT images of patients (448 females, 377 males) who met the inclusion criteria were analyzed. PMF shapes were classified, and morphometric measurements (PMF area and PPF volume) were performed according to age, right/left side, and gender using 3D rendering programs. Maxillary and sphenoid sinus pathologies were also classified to reveal possible correlations between morphometric measurements. Analysis of variance was used for comparisons. Multiple comparisons were assessed using the Bonferroni test. Pearson's test was used to assess correlations between parameters. A p value < 0.05 was considered to indicate statistical significance. RESULTS Six types of PMF shapes were defined. There were no significant differences in types according to gender, age or sinus pathology. Males had a significantly larger PMF area than females (p < 0.001). Left/right comparison of the PMF area revealed that the mean PMF coronal, axial, and sagittal area dimensions were significantly higher on the right side in all patients. Our results also indicated that the PMF area and PPF volume increased significantly after 40 years of age. CONCLUSION Various PMF shapes were defined and classified. PMF and PPF dimensions increased with age. Knowledge of these anatomical variations will allow surgeons to avoid damage to the neurovascular structures passing through the area.
Collapse
|
|
47
|
Schulze RKW, Doering CI. Simple computation of the approximated modulation transfer function (MTF) using spreadsheet-software: method and evaluation in five maxillofacial CBCT-devices. Dentomaxillofac Radiol 2019; 48:20180350. [PMID: 30707644 DOI: 10.1259/dmfr.20180350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To develop a simple way to compute the approximated modulation transfer function (MTF) manually using conventional spreadsheet software. METHODS Basing on an edge-image a method was developed, facilitating computation of the edge spread and line spread function in open-source spreadsheet software (Gnumeric; http://projects.gnome.org/gnumeric/downloads.shtml ). By means of the integrated fast Fourier transformation Fourier coefficients are obtained from the line spread function which can then be plotted vs spatial frequency to obtain MTF-plots. For the experimental evaluation an edge test object was exposed in five commercial CBCT devices for maxillofacial applications. RESULTS The MTF as obtained from the above-described manual method at 10% modulation ranged between 1.6 and 2.3 cycles/mm. Reproducibility as expressed as relative differences between single assessments ranging between 3% and 11%. The computed MTF-values compare well with results from the literature. CONCLUSIONS The method introduced can be used to manually and reliably estimate a CBCTs' MTF as one central parameter for the imaging systems' performance.
Collapse
Affiliation(s)
- Ralf Kurt Willy Schulze
- 1 Section of Oral Radiology, Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University , Mainz , Germany
| | | |
Collapse
|
|
48
|
Van Acker JWG, Jacquet W, Dierens M, Martens LC. A reject analysis of cone-beam CTs in under-aged patients. Dentomaxillofac Radiol 2019; 48:20180138. [PMID: 30604634 DOI: 10.1259/dmfr.20180138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: The main objective of this study was to perform a retrospective reject analysis (or audit) of 79 cone-beam CTs (CBCTs) taken in under-aged patients at the Ghent University hospital over a 2-year timespan. METHODS: Observer agreement between two oral radiologists and two senior year Master students in Paediatric Dentistry was performed for quality, diagnostic and therapeutic value. The senior year Master Students followed appropriate modules of an online course. Descriptive and comparative statistics were performed. RESULTS: For the oral radiologists, all intra rater reliabilities were moderate to good (Gwet's AC1 = 0.41-0.75). For the senior students in Paediatric dentistry, these varied highly from fair to very good (Gwet's AC1 = 0.28-0.95). There was a high level of disagreement between oral radiologists and students (Gwet's AC1 = 0.16-0.45) and in-between students concerning observed quality (Gwet's AC1 = 0.29). A total of 16 CBCTs (20%) was rejected, 24 images (30%) were acceptable and 39 images (50%) had an excellent quality. 50 CBCTs were perceived to have a diagnostic advantage. 13 of the images would have no influence on the therapy, according to the oral radiologists. A significant correlation was found between unacceptable quality, absence of perceived diagnostic advantage (p = 0.004, RR = 2.4) and influence on therapy (p < 0.0005, RR = 1.8). A small field of view (FOV) was positively correlated to an excellent quality of the image (p = 0.011, RR = 2.8). CONCLUSIONS: Image quality did not reach the proposed boundary of 10% according to the European Guidelines on Radiation Protection in Dental Radiology. This is the first published audit on an overall database of under-age children for CBCT.
Collapse
Affiliation(s)
- Jakob W G Van Acker
- 1 Department Paediatric Dentistry PaeCoMedis Research, Ghent University & University Hospital , Ghent , Belgium
| | - Wolfgang Jacquet
- 2 Department of Educational Science EDWE-LOCI, Vrije Universtiteit Brussel (VUB) , Brussels , Belgium.,3 Oral Health Research Group (ORHE), Vrije Universtiteit Brussel (VUB) , Brussels , Belgium
| | - Melissa Dierens
- 4 Department of Periodontology and Oral Implantology, Ghent University , Ghent , Belgium
| | - Luc C Martens
- 1 Department Paediatric Dentistry PaeCoMedis Research, Ghent University & University Hospital , Ghent , Belgium
| |
Collapse
|
|
49
|
Kawai T, Sato I, Asaumi R, Yosue T. Cone-beam computed tomography and anatomical observations of normal variants in the mandible: variant dentists should recognize. Oral Radiol 2018; 34:189-198. [PMID: 30484034 DOI: 10.1007/s11282-017-0307-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
Many types of cone-beam computed tomography (CBCT) have recently been developed and are being used in many dental clinics. CBCT has significantly changed imaging diagnosis in dentistry by showing detailed structures in multiple dimensions with high spatial resolution. This allows dentists to confirm what cannot be recognized with conventional two-dimensional images, such as small neurovascular canals, the buccolingual location of structures/lesions, and the three-dimensional shapes of hard tissue structures. The aim of this study was to review the normal variants of detailed anatomical structures in relation with the mandibular canal by comparing the previous reports and anatomical evaluations. These structures are likely to be observed on CBCT images by dental practitioners prior to dental procedures involving the mandibular teeth and bone. Understanding the relationship of these structures is useful for dental practitioners and oral surgeons to reduce the possibility of causing damage and patient discomfort during dental procedures.
Collapse
Affiliation(s)
- Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20, Fujimi Chiyoda-ku, Tokyo, 102-8159, Japan.
| | - Iwao Sato
- Department of Anatomy 1, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20, Fujimi Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Rieko Asaumi
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20, Fujimi Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Takashi Yosue
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20, Fujimi Chiyoda-ku, Tokyo, 102-8159, Japan
| |
Collapse
|
|
50
|
Koch GK, Hamilton A, Wang K, Herschdorfer L, Lee KH, Gallucci GO, Friedland B. Dimensional accuracy of cone beam CT with varying angulation of the jaw to the X-ray beam. Dentomaxillofac Radiol 2018; 48:20180319. [PMID: 30407848 DOI: 10.1259/dmfr.20180319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Cone beam CT (CBCT) machines do not always allow for patients to be scanned in the ideal position for image acquisition. This study aimed to investigate the influence of the position/angulation of the mandible relative to the X-ray beam of a CBCT machine. METHODS Five sequential CBCT scans were captured of a human mandible at each angulation of 10°, 20°, 30°, and 40° using a coronal and sagittal positioning. Inspection software utilized a best-fit alignment to automatically calculate the three-dimensional variation at 15 standardized points of interest. RESULTS Statistically significant differences were found between the dimensional accuracy of CBCT scans taken at 10° (26.3 µm) of coronal angulation, as well as those taken at 20° (-17.3 mm) and 30° (35.2 mm) of sagittal angulations (p < 0.001, 0.016, and <0.001, respectively). The largest deviations in accuracy included an overall maximum deviation of 490 mm. CONCLUSIONS The position of the mandible with respect to the X-ray beam has a clinically insignificant effect on dimensional accuracy, up to the maximum angle of 40° assessed.
Collapse
Affiliation(s)
- George K Koch
- 1 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine , Boston, MA , USA.,2 Boston Veteran Affairs Healthcare System , Boston, MA , USA
| | - Adam Hamilton
- 3 Department of Restorative Dentistry and Biomaterials Sciences, Division of Regenerative and Implant Sciences, Harvard School of Dental Medicine , Boston, MA , USA
| | - Kelly Wang
- 4 Harvard School of Dental Medicine , Boston, MA , USA
| | | | - Kyu Ha Lee
- 5 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine , Boston, MA , USA
| | - German O Gallucci
- 1 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine , Boston, MA , USA
| | - Bernard Friedland
- 6 Department of Oral Medicine, Infection, and Immunity, Harvard Schoolof Dental Medicine , Boston, MA , USA
| |
Collapse
|