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Bastos MF, Visconti MA, Pinto RR, Junqueira RB, Verner FS. Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study. J Endod 2024; 50:835-843. [PMID: 38395388 DOI: 10.1016/j.joen.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Considering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. METHODS This ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. RESULTS In the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). CONCLUSIONS The MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.
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Affiliation(s)
- Mayara Fidelis Bastos
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rocha Pinto
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora/GV Campus, Governador Valadares, Brazil
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Soltani P, Devlin H, Aydin U, Tafti KT, Baghaei K. Soft tissue simulant materials in X-ray-based imaging in dentomaxillofacial radiology: a scoping review. Oral Radiol 2024; 40:109-123. [PMID: 38129699 DOI: 10.1007/s11282-023-00721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION In in-vitro dental radiographic research, simulation of soft tissue is required to replicate the clinical condition as close as possible. This study aimed to find out which soft tissue simulation material have been studied to use in dentomaxillofacial radiology and showed similarity in radiodensity to the soft tissues of the maxillofacial region. METHODS In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool). RESULTS Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant. CONCLUSION Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.
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Affiliation(s)
- Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Hugh Devlin
- Division of Dentistry, The University of Manchester, Manchester, UK
- Department of Restorative Dentistry, School of Dentistry, Jordan University, Amman, Jordan
| | - Ulkem Aydin
- Department of Dentomaxillofacial Radiology, School of Dental Sciences, Cyprus Health and Social Sciences University, Morphou, North Cyprus
| | - Kioumars Tavakoli Tafti
- Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimia Baghaei
- Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
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Munhoz EA, Xavier CRG, Salles RP, Capelozza ALA, Bodanezi AV. Convenient model of hard tissue simulation for dental radiographic research and instruction. World J Methodol 2024; 14:88850. [PMID: 38577207 PMCID: PMC10989409 DOI: 10.5662/wjm.v14.i1.88850] [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: 10/13/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The authors describe a technique for building an alternative jawbone phantom using dental gypsum and rice for research and dental radiology instruction. AIM To investigate the potential of an alternative phantom to simulate the trabecular bone aspect of the human maxilla in periapical radiographs. METHODS Half-maxillary phantoms built from gypsum-ground rice were exposed to X-rays, and the resulting images (experimental group) were compared to standardized radiographic images produced from dry human maxillary bone (control group) (n = 7). The images were blindly assessed according to strict criteria by three examiners for the usual trabecular aspects of the surrounding bone, and significant differences between groups and in assessment reliability were compared using Fisher's exact and kappa tests (α = 0.05). RESULTS The differences in the trabecular aspects between groups were not statistically significant. In addition, interobserver agreement among observers was 0.43 and 0.51 for the control and experimental groups, respectively, whereas intraobserver agreement was 0.71 and 0.73, respectively. CONCLUSION The tested phantom seemed to demonstrate potential for trabecular bone image simulation on maxillary periapical radiographs.
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Affiliation(s)
- Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Claudio Roberto Gaiao Xavier
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Roberto Ponce Salles
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Ana Lúcia Alvares Capelozza
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Augusto Vanni Bodanezi
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
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Ghamri M, Dritsas K, Probst J, Jäggi M, Psomiadis S, Schulze R, Verna C, Katsaros C, Halazonetis D, Gkantidis N. Accuracy of facial skeletal surfaces segmented from CT and CBCT radiographs. Sci Rep 2023; 13:21002. [PMID: 38017262 PMCID: PMC10684569 DOI: 10.1038/s41598-023-48320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
The accuracy of three-dimensional (3D) facial skeletal surface models derived from radiographic volumes has not been extensively investigated yet. For this, ten human dry skulls were scanned with two Cone Beam Computed Tomography (CBCT) units, a CT unit, and a highly accurate optical surface scanner that provided the true reference models. Water-filled head shells were used for soft tissue simulation during radiographic imaging. The 3D surface models that were repeatedly segmented from the radiographic volumes through a single-threshold approach were used for reproducibility testing. Additionally, they were compared to the true reference model for trueness measurement. Comparisons were performed through 3D surface approximation techniques, using an iterative closest point algorithm. Differences between surface models were assessed through the calculation of mean absolute distances (MAD) between corresponding surfaces and through visual inspection of facial surface colour-coded distance maps. There was very high reproducibility (approximately 0.07 mm) and trueness (0.12 mm on average, with deviations extending locally to 0.5 mm), and no difference between radiographic scanners or settings. The present findings establish the validity of lower radiation CBCT imaging protocols at a similar level to the conventional CT images, when 3D surface models are required for the assessment of facial morphology.
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Affiliation(s)
- Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Jeddah Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Jannis Probst
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Maurus Jäggi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Symeon Psomiadis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Ralf Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058, Basel, Switzerland
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland.
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Yadegari A, Safi Y, Shahbazi S, Yaghoutiazar S, Ghazizadeh Ahsaie M. Assessment of CBCT gray value in different regions-of-interest and fields-of-view compared to Hounsfield unit. Dentomaxillofac Radiol 2023; 52:20230187. [PMID: 37874074 PMCID: PMC10968765 DOI: 10.1259/dmfr.20230187] [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: 04/28/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVES Different factors can affect the discrepancy between the gray value (GV) measurements obtained from CBCT and the Hounsfield unit (HU) derived from multidetector CT (MDCT), which is considered the gold-standard density scale. This study aimed to explore the impact of region of interest (ROI) location and field of view (FOV) size on the difference between these two scales as a potential source of error. METHODS Three phantoms, each consisting of a water-filled plastic bin containing a dry dentate human skull, were prepared. CBCT scans were conducted using the NewTom VGi evo system, while MDCT scans were performed using Philips system. Three different FOV sizes (8 × 8 cm, 8 × 12 cm, and 12 × 15 cm) were used, and the GVs obtained from eight distinct ROIs were compared with the HUs from the MDCT scans. The ROIs included dental and bony regions within the anterior and posterior areas of both jaws. Statistical analyses were performed using SPSS v. 26. RESULTS The GVs derived from CBCT images were significantly influenced by both ROI location and FOV size (p < 0.05 for both factors). Following the comparison between GVs and HUs, the anterior mandibular bone ROI represented the minimum error, while the posterior mandibular teeth exhibited the maximum error. Moreover, the 8 × 8 cm and 12 × 15 cm FOVs resulted in the lowest and highest degrees of GV error, respectively. CONCLUSIONS The ROI location and the FOV size can significantly affect the GVs obtained from CBCT images. It is not recommended to use the GV scale within the posterior mandibular teeth region due to the potential for error. Additionally, selecting smaller FOV sizes, such as 8 × 8 cm, can provide GVs closer to the gold-standard numbers.
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Affiliation(s)
- Atiye Yadegari
- Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Shahbazi
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Yaghoutiazar
- Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Effect of hydration on the anatomical form of human dry skulls. Sci Rep 2022; 12:22549. [PMID: 36581665 PMCID: PMC9800411 DOI: 10.1038/s41598-022-27042-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
In radiology research soft tissues are often simulated on bone specimens using liquid materials such as water, or gel-like materials, such as ballistic gel. This study aimed to test the effect of hydration on the anatomical form of dry craniofacial bone specimens. Sixteen human dry skulls and 16 mandibles were scanned with an industrial scanner in dry conditions and after water embedding. Ten skulls were also embedded for different time periods (5 or 15 min). The subsequent 3D surface models were best-fit superimposed and compared by calculating mean absolute distances between them at various measurement areas. There was a significant, primarily enlargement effect of hydration on the anatomical form of dry skeletal specimens as detected after water embedding for a short time period. The effect was smaller in dry skulls (median 0.20 mm, IQR 0.17 mm) and larger in mandibles (median 0.56 mm, IQR 0.57 mm). The effect of different water embedding times was negligible. Based on the present findings, we suggest to shortly hydrate the skeletal specimens prior to reference model acquisition so that they are comparable to hydrated specimens when liquid materials are used as soft-tissue simulants for various radiologic research purposes.
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Liu H, Miyamoto N, Nguyen MT, Shirato H, Yonezawa T. Injectable Fiducial Marker for Image-Guided Radiation Therapy Based on Gold Nanoparticles and a Body Temperature-Activated Gel-Forming System. ACS APPLIED BIO MATERIALS 2022; 5:4838-4848. [PMID: 36074396 DOI: 10.1021/acsabm.2c00566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Injectable fiducial markers are crucial in image-guided radiation therapy (IGRT) due to their minimally invasive operations and improved patient compliance. This study presents the development of a ready-to-use injectable fiducial marker utilizing alginate stabilized-gold nanoparticles (alg-Au NPs) and a body temperature-activated in situ gel-forming system. Gram-scale alg-Au NPs were prepared in an hour by a green microwave-induced plasma-in-liquid process (MWPLP). Sodium alginate was introduced in this process to avoid aggregation between Au NPs, which ensured their stability and injectability. The gelation behavior of alginate with divalent cations and a temperature-dependent release of calcium source (glucono-delta-lactone (GDL) and CaCO3) served as the foundation of the body temperature-activated in situ gel-forming system. The injectable fiducial marker GDL/CaCO3/alg-Au NPs could maintain a liquid state at a low temperature for a higher injectability. After injection, on the other hand, Ca2+ would be released due to the body temperature-activated hydrolysis of GDL and the subsequent reaction with CaCO3, which would initiate the gelation of alginate. The injectable fiducial marker can be therefore delivered via injection and form gel at target site to avoid marker movement or Au NPs leakage after injection. Rheological measurements demonstrate the stability and gelation behavior of GDL/CaCO3/alg-Au NPs at different temperatures. Furthermore, the injectability and imaging ability of GDL/CaCO3/alg-Au NPs were also examined. In summary, ready-to-use injectable fiducial marker GDL/CaCO3/alg-Au NPs were developed via a green and facile method for IGRT.
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Affiliation(s)
- Haoran Liu
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Naoki Miyamoto
- Division of Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
- Department of Medical Physics, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Mai Thanh Nguyen
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Hiroki Shirato
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Tetsu Yonezawa
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
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Ikeda K, Liu H, Miyamoto N, Nguyen MT, Shirato H, Yonezawa T. Preparation of Biopex-Supported Gold Nanoparticles as Potential Fiducial Markers for Image-Guided Radiation Therapy. ACS APPLIED BIO MATERIALS 2022; 5:1259-1266. [PMID: 35175735 DOI: 10.1021/acsabm.1c01271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Image-guided radiation therapy (IGRT) has emerged as a promising technique for cancer treatment to improve radiation precision and accuracy, thereby reducing the treatment toxicity and optimizing therapeutic efficacy. In IGRT, fiducial markers are required to be inserted near the tumor to get the spatial information of the tumor. Currently used metal fiducial markers with large sizes would be highly invasive; therefore, it is critical to develop minimally invasive alternatives to these markers. In this work, an injectable marker based on Biopex-supported Au NPs with adequate radio-opacity for X-ray visualization was developed. Biopex can function as a substrate for the growth of Au NPs and avoid excessive reaction-induced aggregation and precipitation. The self-curing property of Biopex prevents the leakage and elimination of isolated Au NPs, enabling long-term X-ray observation and radiotherapy. The effect of Biopex amount, gold precursor concentration, and reaction time were evaluated. The visibility of samples prepared by the optimized formula was also examined. The developed Biopex-Au NPs could be injected through a 21 G needle and exhibit great visibility in the X-ray visualization test, showing great potential as a fiducial marker for image-guided radiation therapy.
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Affiliation(s)
- Kai Ikeda
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Haoran Liu
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Naoki Miyamoto
- Division of Applied Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan.,Department of Medical Physics, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-ku, Sapporo, Hokkaido 060-8648, Japan
| | - Mai Thanh Nguyen
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
| | - Hiroki Shirato
- Global Station of Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Tetsu Yonezawa
- Division of Materials Science and Engineering, Faculty of Engineering, Hokkaido University, Kita 13 Nishi 8, Kita-ku, Sapporo, Hokkaido 060-8628, Japan
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Zhao Z, Xie L, Cao D, Izadikhah I, Gao P, Zhao Y, Yan B. Accuracy of three-dimensional photogrammetry and cone beam computed tomography based on linear measurements in patients with facial deformities. Dentomaxillofac Radiol 2021; 50:20200001. [PMID: 32791014 DOI: 10.1259/dmfr.20200001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study was aimed to investigate the accuracy of soft-tissue measurements obtained by two imaging modalities, three-dimensional (3D) photogrammetry and cone beam CT (CBCT) when confounded by influence factors (facial deformities and partitions). METHODS 60 wax facial models from facially deformed patients were captured by 3D photogrammetry and CBCT. 19 linear distances on each image were measured and juxtaposed to reference values attained via a coordinate-measuring machine (CMM) as the gold-standard. Paired t-tests were used to compare linear accuracy of the test and reference systems. The influence of deformities and partitions (created by dividing the face with three vertical and five horizontal lines) on the measurement errors were analyzed by independent sample t-test and one-way ANOVA. RESULTS Statistically significant differences were found between linear accuracy of the test and reference systems. The test values obtained by 3D photogrammetry were closer to the reference values than CBCT's. 3D photogrammetry's measurement errors were significantly higher in deformed areas, unlike CBCT's. Both systems reported significantly lower errors within partitions 8 and 13 compared to other partitions; for CBCT, aside from partitions 8 and 13, the differences in the errors for partitions 6 and 10 were significant compared to partitions 8, 12, 13, 14. CONCLUSION 3D photogrammetry showed a higher linear accuracy than CBCT in patients with facial deformities due to protuberances. Facial reconstruction by both test modalities was significantly influenced in different facial partitions, but facial deformities extensively affected the results from 3D photogrammetry.
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Affiliation(s)
- Zhenqi Zhao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Stomatology, The First People's Hospital of Nantong, Nantong, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Lizhe Xie
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Engineering center for digital medical technology of stomatology, Nanjing Medical University, Nanjing, China
| | - Dan Cao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Iman Izadikhah
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Pengcheng Gao
- Department of Orthodontics, Zhongda hospital, Southeast university, Nanjing, China
| | - Yang Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bin Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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Rocha BDC, Rosa BSPA, Cerqueira TS, de-Azevedo-Vaz SL, Barbosa GLDR, Ferreira LM, Verner FS, Visconti MA. Evaluation of different teaching methods in the radiographic diagnosis of proximal carious lesions. Dentomaxillofac Radiol 2020; 50:20200295. [PMID: 33141626 DOI: 10.1259/dmfr.20200295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate four different teaching methodologies in the radiographic diagnosis of proximal carious lesions and in the students' perception of these methodologies. METHODS 71 undergraduate dental students were subdivided into 4 groups according to the teaching methodologies used (traditional, hybrid, e-learning and problem-based learning). All methods were applied by two properly trained researchers. Initially, students completed a pre-methodology test (index test). After applying the teaching methodologies, the students were submitted to a post-methodology test containing periapical radiographs for evaluation of proximal carious lesions. Then, the students answered a questionnaire to verify their perception of the different teaching methodologies. Statistical analysis was done. RESULTS There were no relationship between the results of pre- and post-methodologies tests, irrespective of the teaching methodology employed (p > 0.05). No differences between the teaching methodologies studied (p > 0.05) were found regarding the amount of correct answers. However, the students who participated in the active (e-learning and problem-based learning) and hybrid teaching methodology reported a positive impact in relation to their diagnostic skills at the questionnaire. CONCLUSIONS All the tested methodologies had a similar performance; however, the traditional methodology showed less acceptance by the students when analyzed subjectively and comparatively. The results of the present study increase comprehension about teaching methodologies for radiographic diagnosis of proximal carious lesions, and there is a potential to build on the knowledge base and provide practical support for students and educators.
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Affiliation(s)
- Beatriz de Carvalho Rocha
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Thaís Santos Cerqueira
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Colloc T, Brown T, Keys W. Role of the consultant in restorative dentistry in managing head and neck cancer patients undergoing radiotherapy: a novel intraoral shield appliance design. Br Dent J 2020; 229:655-660. [DOI: 10.1038/s41415-020-2349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/18/2020] [Indexed: 11/09/2022]
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Nascimento EHL, Fontenele RC, Lopes PDA, Santaella GM, Vasconcelos KF, de Freitas DQ, Oenning AC, Groppo FC. Development of a model of soft tissue simulation using ballistic gelatin for CBCT acquisitions related to dentomaxillofacial radiology research. Dentomaxillofac Radiol 2020; 50:20200191. [PMID: 32941781 DOI: 10.1259/dmfr.20200191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To present the ballistic gelatin as a new material capable of simulating the soft tissues in cone-beam CT (CBCT) images. METHODS CBCT images of three piglet heads were acquired with their soft tissues intact (standard group). Subsequently, the piglet heads were fixed in a container using metallic pins and moulded with acrylic resin; the soft tissues were then removed and replaced by ballistic gelatin, with the same thickness of the original soft tissues. The images were evaluated by two oral radiologists, to check the adaptation on bone surfaces, thickness and density, penetration into large bone cavities and cancellous bone, and the presence of air bubbles using a 5-score scale. Additionally, an objective analysis was carried out by one oral radiologist. For each CBCT scan, three axial reconstructions were selected to represent the mandibular, occlusal, and maxillary levels. The mean and standard deviation (SD) of the grey values were calculated in four regions of interest determined on soft tissue areas and compared by two-way ANOVA. RESULTS The ballistic gelatin showed subjective scores ranging from good to excellent for all parameters evaluated. There was no significant difference in the mean and SD values of the grey values between ballistic gelatin and the gold standard groups for all levels (p > 0.05). Higher SD values were observed in the occlusal level for both groups (p < 0.05). CONCLUSIONS Ballistic gelatin has visual and objective similarity with the gold standard. Thus, the ballistic gelatin is a promising material capable of simulating soft tissues in CBCT images.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.,Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Priscila de Azeredo Lopes
- Odontoclínica Central da Marinha, Serviço de radiologia e Imaginologia Odontológica, Brazilian Navy, Rio de Janeiro, RJ, Brazil
| | - Gustavo Machado Santaella
- Radiology and Imaging Sciences, Department of Diagnosis and Oral Health, University of Louisville, Lousville, KY, USA
| | - Karla Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Deborah Queiroz de Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Detection of alveolar bone defects with three different voxel sizes of cone-beam computed tomography: an in vitro study. Sci Rep 2019; 9:8146. [PMID: 31148581 PMCID: PMC6544761 DOI: 10.1038/s41598-019-44675-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/20/2019] [Indexed: 11/16/2022] Open
Abstract
This study was conducted to assess the accuracy of cone-beam computed tomography (CBCT) of different voxel sizes in the detection of alveolar bone defects, and to select the optimal voxel size for clinical use. 46 in-vitro teeth were placed in bovine ribs in which alveolar bone defects were randomly simulated. In total, 32 alveolar bone defects and 14 teeth without periodontal defects were used. CBCT images were acquired with the use of three different voxel sizes: 0.125-mm, 0.2-mm and 0.4-mm. The scan data were 3D-reconstructed in Mimics software and evaluated by two observers with more than 5 years of experience in CBCT. Receiver operating characteristic (ROC) curves and diagnostic values were obtained. Pairwise comparison of ROC curves was made for evaluation of the diagnostic values of different voxel sizes. Kappa statistics assessed the observer reliability. Results were considered significant at P < 0.05. It showed no statistically significant difference between 0.125-mm group and 0.2-mm group, but 0.4-mm group had lower Az values that differed significantly from 0.125-mm and 0.2-mm groups (P < 0.05). Based on diagnostic value and radiation protection, 0.2-mm voxel size may be a good choice for the detection of bone defects with CBCT.
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Santaella GM, Visconti MAPG, Devito KL, Groppo FC, Haiter-Neto F, Asprino L. Evaluation of different soft tissue-simulating materials in pixel intensity values in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:e102-e107. [PMID: 30685389 DOI: 10.1016/j.oooo.2018.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/23/2018] [Accepted: 12/19/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate different materials as soft tissue simulators and the influence of soft tissues in cone beam computed tomography. STUDY DESIGN Images of 5 piglet heads were acquired with intact soft tissues, with the tissues stripped, and with the use of different soft tissue simulators, following the same acquisition protocol. Four different materials were tested, individually or in combination: acrylic, water, utility wax, and expanded polystyrene (EPS). Pixel intensity values of 8 quadrangular regions, that is, upper and lower teeth and alveolar bone, were obtained. The mean values were used for comparison by analysis of variance (ANOVA; α = 5%). RESULTS No differences were observed for the "No Material," "EPS," "Acrylic," and "EPS and Wax" groups for the lower anterior and posterior teeth, the upper posterior tooth, and the anterior and posterior bone, and for the "No Material," "EPS," and "EPS and Wax," groups for the lower posterior bone. All groups showed statistical differences for the lower anterior bone and the upper anterior tooth. CONCLUSIONS Expanded 2-cm thick polystyrene, with or without 1-cm thick utility wax, was effective for most regions, followed by acrylic 0.5 cm. Soft tissues were not of great influence in most regions. Water was not an effective material for any of the regions.
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Affiliation(s)
- Gustavo Machado Santaella
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | | | - Karina Lopes Devito
- Departament of Dental Clinic, Division of Oral Radiology, Dental School, Juiz de Fora Federal University, Juiz de Fora, Minas Gerais, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Luciana Asprino
- Department of Oral Diagnosis, Division of Oral Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Adibi S, Amrollahi A, Dehghani Nazhvani A, Movahhedian N. Assessing the Accuracy of Caries Diagnosis in Bitewing Radiographs Using Different Reproduction Media. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2018; 19:174-180. [PMID: 30175186 PMCID: PMC6092465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STATEMENT OF THE PROBLEM After introducing digital radiography, practitioners started reading radiographs from computer monitors; however, many still prefer hard-copy radiographs. PURPOSE This study aimed to assess the possible superiority of either type of radiograph recording media (computer monitor, film, or paper) in diagnosis and perception of the depth of the cariogenic lesions. MATERIALS AND METHOD Twenty digital bitewing radiographs, obtained from 200 posterior extracted teeth, were displayed on an LG monitor and printed on paper and film using Kodak printers. Two observers independently measured lesions depth on the images. Serial sections of teeth were obtained and the sections were evaluated by a stereomicroscope to determine the actual depth of cariogenic lesions. The efficacy of the each medium was assessed by determining its specificity and sensitivity in comparison with those of histological images. Weighted kappa coefficients and the ROC analysis were used for the statistical analysis. RESULTS Strong intra- and inter-observer agreements (0.818 to 0.958, 0.77 to 0.85) were found for all detection methods. The highest Az value was obtained with the monitor-displayed images (Az: 0.879); however, differences between detection methods were not statistically significant (p> 0.05). CONCLUSION Monitor-displayed bitewing radiographs, paper, and film prints used in our study performed similarly in the detection of proximal caries.
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Affiliation(s)
- Sadaf Adibi
- Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anita Amrollahi
- Undergraduate Student, School of Dentistry, International branch, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Dehghani Nazhvani
- Dept. of Oral and Maxillofacial Pathology, Biomaterial Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Najmeh Movahhedian
- Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Lopes PA, Santaella GM, Lima CAS, Vasconcelos KDF, Groppo FC. Evaluation of soft tissues simulant materials in cone beam computed tomography. Dentomaxillofac Radiol 2018; 48:20180072. [PMID: 30004256 DOI: 10.1259/dmfr.20180072] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate different materials in simulating soft tissues and to analyze the influence of these materials on the mean (MPIV) and standard deviation of pixel intensity values comparing them to a gold-standard in CBCT images. METHODS Images of three piglet heads with their soft tissues intact (gold-standard) and different simulant materials were acquired: ice, modelling wax, and ballistic gelatin, with the same thickness of the original soft tissues. The pixel intensities were measured in dental, bone and soft tissues regions, in the mandible and maxilla, for all the groups. Analysis of variance, Dunnet's, Pearson's and linear regression tests were performed. RESULTS The simulators did not significantly change the MPIV of teeth in comparison with the gold-standard (p = 0.1017). Only ice (p = 0.0156) affected the MPIV of bone. Wax (p = 0.001) and ice (p = 0.0076), but not ballistic gelatin (p = 0.5814), altered the MPIV of soft tissue regions. When assessing the influence of the location (mandible or maxilla) among the simulants, the differences were significant only for the soft tissue regions. Standard deviation was not influenced by simulants (p > 0.05), but ballistic gelatin presented the lower variability. CONCLUSIONS The ballistic gelatin was the best soft tissue simulant since it had the lowest influence on the pixel intensity values for all regions.
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Affiliation(s)
- Priscila A Lopes
- Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Gustavo M Santaella
- Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Carlos Augusto S Lima
- Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Karla de Faria Vasconcelos
- Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Francisco C Groppo
- Department of Physiological Sciences, University of Campinas, Piracicaba, São Paulo, Brazil
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Francio LA, Silva FE, Valerio CS, Cardoso CAEA, Jansen WC, Manzi FR. Accuracy of various imaging methods for detecting misfit at the tooth-restoration interface in posterior teeth. Imaging Sci Dent 2018; 48:87-96. [PMID: 29963479 PMCID: PMC6015931 DOI: 10.5624/isd.2018.48.2.87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/26/2018] [Accepted: 03/14/2018] [Indexed: 12/31/2022] Open
Abstract
Purpose The present study aimed to evaluate which of the following imaging methods best assessed misfit at the tooth-restoration interface: (1) bitewing radiographs, both conventional and digital, performed using a photostimulable phosphor plate (PSP) and a charge-coupled device (CCD) system; (2) panoramic radiographs, both conventional and digital; and (3) cone-beam computed tomography (CBCT). Materials and Methods Forty healthy human molars with class I cavities were selected and divided into 4 groups according to the restoration that was applied: composite resin, composite resin with liner material to simulate misfit, dental amalgam, and dental amalgam with liner material to simulate misfit. Radiography and tomography were performed using the various imaging methods, and the resulting images were analyzed by 2 calibrated radiologists. The true presence or absence of misfit corresponding to an area of radiolucency in regions subjacent to the esthetic and metal restorations was validated with microscopy. The data were analyzed using a receiver operating characteristic (ROC) curve, and the scores were compared using the Cohen kappa coefficient. Results For bitewing images, the digital systems (CCD and PSP) showed a higher area under the ROC curve (AUROC) for the evaluation of resin restorations, while the conventional images exhibited a larger AUROC for the evaluation of amalgam restorations. Conventional and digital panoramic radiographs did not yield good results for the evaluation of resin and amalgam restorations (P<.05). CBCT images exhibited good results for resin restorations (P>.05), but showed no discriminatory ability for amalgam restorations (P<.05). Conclusion Bitewing radiographs (conventional or digital) should be the method of choice when assessing dental restoration misfit.
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Affiliation(s)
| | | | - Claudia Scigliano Valerio
- Department of Oral Radiology, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Flávio Ricardo Manzi
- Department of Oral Radiology, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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Wanderley VA, Freitas DQ, Haiter-Neto F, Oliveira ML. Influence of Tooth Orientation on the Detection of Vertical Root Fracture in Cone-beam Computed Tomography. J Endod 2018; 44:1168-1172. [DOI: 10.1016/j.joen.2018.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/18/2018] [Accepted: 04/02/2018] [Indexed: 10/14/2022]
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Vasconcelos KDF, Rovaris K, Nascimento EHL, Oliveira ML, Távora DDM, Bóscolo FN. Diagnostic accuracy of phosphor plate systems and conventional radiography in the detection of simulated internal root resorption. Acta Odontol Scand 2017; 75:573-576. [PMID: 28754080 DOI: 10.1080/00016357.2017.1359331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the performance of conventional radiography and photostimulable phosphor (PSP) plate in the detection of simulated internal root resorption (IRR) lesions in early stages. MATERIALS AND METHODS Twenty single-rooted teeth were X-rayed before and after having a simulated IRR early lesion. Three imaging systems were used: Kodak InSight dental film and two PSPs digital systems, Digora Optime and VistaScan. The digital images were displayed on a 20.1″ LCD monitor using the native software of each system, and the conventional radiographs were evaluated on a masked light box. Two radiologists were asked to indicate the presence or absence of IRR and, after two weeks, all images were re-evaluated. Cohen's kappa coefficient was calculated to assess intra- and interobserver agreement. The three imaging systems were compared using the Kruskal-Wallis test. RESULTS For interexaminer agreement, overall kappa values were 0.70, 0.65 and 0.70 for conventional film, Digora Optima and VistaScan, respectively. Both the conventional and digital radiography presented low sensitivity, specificity, accuracy, positive and negative predictive values with no significant difference between imaging systems (p = .0725). CONCLUSIONS The performance of conventional and PSP was similar in the detection of simulated IRR lesions in early stages with low accuracy.
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Affiliation(s)
- Karla de Faria Vasconcelos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Karla Rovaris
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Débora de Melo Távora
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Frab Norberto Bóscolo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Ghoncheh Z, Zonouzy Z, Kiomarsi N, Kharazifar MJ, Chiniforush N. In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations. J Lasers Med Sci 2017; 8:172-176. [PMID: 29071022 DOI: 10.15171/jlms.2017.31] [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] [Indexed: 11/09/2022]
Abstract
Introduction: Early detection of secondary proximal caries is critical for the preservation of tooth vitality. This study sought to assess and compare the diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Methods: Sixty extracted molars including 30 teeth with carious lesions and 30 sound teeth were randomly selected. Class II cavities were prepared in all teeth and carious dentin was intentionally left in the gingival floor of cavities in 30 carious teeth. All cavities were restored with composite resin. The teeth were mounted in wax blocks (three teeth per block) and examined for caries using (DIAGNOdent kaVo Dental, Biberach, Germany). Digital radiographs using DIGORA photostimulable phosphor (PSP) plates (Soredex Corporation, Helsinki, Finland) were obtained from all teeth using the parallel technique and were evaluated by 4 observers. Repeated measure analysis of variance (ANOVA) was applied to calculate sensitivity and specificity values of the two diagnostic techniques. Receiver operating characteristic (ROC) curve was plotted for DIAGNOdent results and based on that, the cutoff points were determined. Results: The sensitivity and specificity values at the cut-off point of 10.5 were 0.622±0.038 and 0.822±0.077 for DIAGNOdent and 0.591±0.093 and 0.891±0.083 for digital radiography, respectively. The area under the ROC curve was 0.7 for DIAGNOdent. Weighted kappa revealed moderate to almost perfect intra-observer agreement (0.46-0.99). Intraclass correlation coefficient (ICC) for DIAGNOdent was calculated to be 0.88. Conclusion: No statistically significant difference was noted in diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Thus, DIAGNOdent may be used as an adjunct diagnostic tool for detection of secondary proximal caries beneath composite restorations.
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Affiliation(s)
- Zahra Ghoncheh
- Department of Oral and Maxillofacial Radiology, Dental faculty, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Zahra Zonouzy
- Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | - Nazanin Kiomarsi
- Department of Operative Dentistry, Dental Faculty, Tehran University of Medical Sciences, International Campus, Tehran, Iran
| | | | - Nasim Chiniforush
- Laser Research Center of Dentistry (LRCD), Dental Research Institute, Tehran University of Medical Sciences, International Campus, Tehran, Iran
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Ghoncheh Z, Kheirandish Y, Kaviani H, Kharazi Fard MJ, Sadeghi K. Diagnosis of Approximal Caries after Delayed Scanning of Photostimulable Phosphor Plates. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2017; 18:201-206. [PMID: 29034275 PMCID: PMC5634360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
STATEMENT OF THE PROBLEM Considering the high diagnostic accuracy and wide dynamic range of photostimulable phosphor plates (PSPs), they can be a good alternative for radiographic films. PURPOSE This study was aimed to assess the effects of delay in scanning PSPs on the diagnostic accuracy of detection of approximal caries. MATERIALS AND METHOD Radiographs from fifty-two extracted molar and premolar teeth were radiographed using DIGORA PSP (Soredex Corporation, Helsinki, Finland). The teeth were either intact or with non-cavitated approximal caries. The plates were scanned immediately (time zero) and at 10 min, 30 min, 60 min and 120 min after exposure. Sixty-five images were obtained and evaluated for presence or absence of approximal caries by two oral and maxillofacial radiologists and 2 restorative specialists. The diagnostic accuracy of approximal caries detection was measured using a 5-point rating scale. Definite presence of caries was confirmed using a stereomicroscope. Analysis of caries detection data was performed by calculating sensitivity and specificity using repeated measures with ANOVA. RESULTS Significant differences were found in complete negative predictive value, absolute negative predictive value and complete dentine sensitivity value between different scan times (p< 0.05). These values were significantly different at 10 min, 60 min and 120 min (p< 0.05). However, immediate scan and 30 min delay were not significantly different (p> 0.05). The accuracy of approximal caries detection at 120 min was less than at 60 min and at 60 min was less than at 30 min. CONCLUSION In order to detect approximal caries more accurately, DIGORA PSPs should be scanned within 30 min after exposure.
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Affiliation(s)
- Zahra Ghoncheh
- Dept. of Oral Maxillofacial Radiology, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
| | - Yasaman Kheirandish
- Dept. of Oral Maxillofacial Radiology, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hanieh Kaviani
- Dept. of Oral Maxillofacial Radiology, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
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Efficacy of Different Cone-beam Computed Tomographic Protocols in the Identification of Mesiobuccal Canals of Maxillary First Molars: A Tomographic and Ex Vivo Study. J Endod 2017; 43:810-815. [PMID: 28292600 DOI: 10.1016/j.joen.2016.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/28/2016] [Accepted: 12/10/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Complementary methods of anatomic diagnosis, including cone-beam computed tomographic (CBCT) imaging, may be useful in the diagnosis of mesiobuccal (MB) canals of maxillary molars. METHODS Thirty-five maxillary first molars were subjected to ex vivo analysis and 4 CBCT protocols: i-CAT Classic (Imaging Sciences International, Hatfield, PA) (ICC group), i-CAT Next Generation (Imaging Sciences International) (ICN group), PreXion 3D (PreXion, San Mateo, CA) (16.8-second acquisition time; PX1 group), and PreXion 3D (33.5-second acquisition time; PX2 group). The images were evaluated by 2 calibrated endodontists who kept records following protocols previously published in the literature. Micro-computed tomographic imaging was used as the control. RESULTS The correct identification of anatomic variations of MB roots was 54.3% (n = 19) in the ICC group, 65.7% (n = 23) in the ICN group, and 80.0% (n = 28) in the PX1 and PX2 groups. The probability of agreement between the ICC and the control groups was significantly different from the probability of agreement with the PX1 (P < .05) and PX2 (P < .05) groups. The other groups showed no significant differences compared with the control group. There was no difference in the probability of agreement between the tomographic protocols and the ex vivo results. CONCLUSIONS The PX1 and PX2 groups were more effective for the diagnosis of MB canals. PX1 is the most suitable because it results in a shorter radiation time and diagnostic imaging similar to PX2. The single-canal anatomy was the most prevalent in the study.
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Accuracy of digitally enhanced images compared with unprocessed digital images in the detection of external root resorption. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0258-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tahir SNA, Chettle DR. Identification of oxygen-19 duringin vivoneutron activation analysis of water phantoms. Physiol Meas 2015; 36:N127-34. [DOI: 10.1088/0967-3334/36/12/n127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Alkan BA, Aral CA, Aral K, Acer N, Şişman Y. Quantification of circumferential bone level and extraction socket dimensions using different imaging and estimation methods: a comparative study. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0225-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bagis N, Kolsuz ME, Kursun S, Orhan K. Comparison of intraoral radiography and cone-beam computed tomography for the detection of periodontal defects: an in vitro study. BMC Oral Health 2015; 15:64. [PMID: 26016804 PMCID: PMC4446848 DOI: 10.1186/s12903-015-0046-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/12/2015] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) unit with digital intraoral radiography technique for detecting periodontal defects. Methods The study material comprised 12 dry skulls with maxilla and mandible. Artificial defects (dehiscence, tunnel, and fenestration) were created on anterior, premolar and molar teeth separately using burs. In total 14 dehiscences, 13 fenestrations, eight tunnel and 16 without periodontal defect were used in the study. These were randomly created on dry skulls. Each teeth with and without defects were images at various vertical angles using each of the following modalities: a Planmeca Promax Cone Beam CT and a Digora photostimulable phosphor plates. Specificity and sensitivity for assessing periodontal defects by each radiographic technique were calculated. Chi-square statistics were used to evaluate differences between modalities. Kappa statistics assessed the agreement between observers. Results were considered significant at P < 0.05. Results The kappa values for inter-observer agreement between observers ranged between 0.78 and 0.96 for the CBCT, and 0.43 and 0.72 of intraoral images. The Kappa values for detecting defects on anterior teeth was the least, following premolar and molar teeth both CBCT and intraoral imaging. Conclusions CBCT has the highest sensitivity and diagnostic accuracy for detecting various periodontal defects among the radiographic modalities examined.
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Affiliation(s)
- Nilsun Bagis
- Faculty of Dentistry, Department of Periodontology, Ankara University, 06560, Besevler, Ankara, Turkey.
| | - Mehmet Eray Kolsuz
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, 06560, Ankara, Turkey.
| | - Sebnem Kursun
- Ministry of Health, Bolu Oral and Dental Health Centre, 14000, Bolu, Turkey.
| | - Kaan Orhan
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, 06560, Ankara, Turkey.
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Zayet MK, Helaly YR, Eiid SB. Effect of changing the kilovoltage peak on radiographic caries assessment in digital and conventional radiography. Imaging Sci Dent 2014; 44:199-205. [PMID: 25279340 PMCID: PMC4182354 DOI: 10.5624/isd.2014.44.3.199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 02/26/2014] [Accepted: 04/15/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to investigate the effect of changing the kilovoltage peak (kVp) on the radiographic assessment of dental caries. Materials and Methods Seventy-five extracted posterior teeth with proximal caries or apparently sound proximal surfaces were radiographed with conventional E-speed films and a photostimulable phosphor system using 60 kVp and 70 kVp for the caries assessment. The images were evaluated by three oral radiologists and compared with the results of the stereomicroscope analysis. Results No statistically significant difference was found between 60 kVp and 70 kVp for the caries detection, determination of caries extension into dentin, and caries severity in either the conventional or the digital images. Good to very good inter-observer and intra-observer agreements were found for both kilovoltage values on the conventional and digital images. Conclusion Changing the kilovoltage between 60 kVp and 70 kVp had no obvious effect on the detection of proximal caries or determination of its extension or severity.
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Affiliation(s)
- Mohamed Khalifa Zayet
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
| | - Yara Rabee Helaly
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
| | - Salma Belal Eiid
- Oral Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt
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Liang YH, Jiang L, Chen C, Gao XJ, Wesselink PR, Wu MK, Shemesh H. The Validity of Cone-beam Computed Tomography in Measuring Root Canal Length Using a Gold Standard. J Endod 2013; 39:1607-10. [DOI: 10.1016/j.joen.2013.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/31/2013] [Accepted: 08/01/2013] [Indexed: 11/24/2022]
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de Molon RS, Batitucci RG, Spin-Neto R, Paquier GM, Sakakura CE, Tosoni GM, Scaf G. Comparison of changes in dental and bone radiographic densities in the presence of different soft-tissue simulators using pixel intensity and digital subtraction analyses. Dentomaxillofac Radiol 2013; 42:20130235. [PMID: 24005061 DOI: 10.1259/dmfr.20130235] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To evaluate the influence of soft-tissue simulation materials on dental and bone tissue radiographic densities using pixel intensity (PI) and digital subtraction radiography (DSR) analyses. METHODS 15 dry human mandibles were divided into halves. Each half was radiographed using a charge-coupled device sensor without a soft-tissue simulation material (Wm) and with 5 types of materials: acrylic (Ac), wax (Wx), water (Wt), wood (Wd) and frozen bovine tissue (Bt). Three thicknesses were tested for each material: 10 mm, 15 mm and 20 mm. The material was positioned in front of the mandible and the sensor parallel to the molar region. The radiation beam was perpendicular to the sensor at 30 cm focal spot-to-object distance. The digital images of the bone and dental tissue were captured for PI analyses. The subtracted images were marked with 14 landmark magnifications, and 2 areas of analyses were defined, forming the regions of interest. Shapiro-Wilk and Kruskal-Wallis tests followed by Dunn's post-test were used (p < 0.05). RESULTS DSR showed that both the material type and the thickness tested influenced the gain of density in bone tissue (p < 0.05). PI analyses of the bone region did not show these differences, except for the lower density observed in the image without soft-tissue simulation material. In the dental region, both DSR and PI showed that soft-tissue simulators did not influence the density in these regions. CONCLUSIONS This study showed that the materials evaluated and their thicknesses significantly influenced the density-level gain in alveolar bone. In dental tissues, there was no density-level gain with any soft-tissue material tested.
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Affiliation(s)
- R S de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Univ Estadual Paulista, Araraquara, São Paulo, Brazil
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Eskandarlou A, Poorolajal J, Talaeipour AR, Talebi S, Talaeipour M. Comparison between cone beam computed tomography and multislice computed tomography in diagnostic accuracy of maxillofacial fractures in dried human skull: anin vitrostudy. Dent Traumatol 2013; 30:162-8. [DOI: 10.1111/edt.12058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Amir Eskandarlou
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Jalal Poorolajal
- Department of Epidemiology & Biostatistics; Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences; Hamadan Iran
| | - Ahmad Reza Talaeipour
- Department of Dentomaxillofacial Radiology; Dental Branch, Islamic Azad University; Tehran Iran
| | - Sahar Talebi
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Maziar Talaeipour
- Department of periodontology; Dental Branch, Islamic Azad University; Tehran Iran
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Liang YH, Jiang L, Gao XJ, Shemesh H, Wesselink PR, Wu MK. Detection and measurement of artificial periapical lesions by cone-beam computed tomography. Int Endod J 2013; 47:332-8. [DOI: 10.1111/iej.12148] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Y.-H. Liang
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - L. Jiang
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X.-J. Gao
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - H. Shemesh
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - P. R. Wesselink
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - M.-K. Wu
- Department of Endodontology; Academic Center of Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
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Schropp L, Alyass NS, Wenzel A, Stavropoulos A. Validity of wax and acrylic as soft-tissue simulation materials used in in vitro radiographic studies. Dentomaxillofac Radiol 2012; 41:686-90. [PMID: 22933536 DOI: 10.1259/dmfr/33467269] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine the thickness of wax and acrylic that provides a radiographic density similar to that of the human cheek. METHODS An intraoral film radiograph of the human cheek including a 40×30×3 mm reference aluminium block was recorded under standardized conditions in 61 subjects. Radiographic density was measured by a densitometer in ten randomly selected sites of the film to serve as the gold standard for density values of the cheek soft tissues. Thereafter, the density of series of radiographs of two tissue-simulating materials-wax and acrylic-in systematically increasing thicknesses (wax, 1.5-30 mm; acrylic, 2-40 mm) plus the reference block were measured and compared with the gold-standard values. RESULTS The radiographic density of wax with a thickness of 13-17 mm or acrylic with a thickness of 14.5 mm corresponded to the average density of the human cheek. CONCLUSION The soft tissues of the average human cheek can be simulated with 13-17 mm wax or 14.5 mm acrylic in in vitro radiographic studies.
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Affiliation(s)
- L Schropp
- Prosthetic Dentistry, Department of Dentistry, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark.
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Shemesh H, Cristescu RC, Wesselink PR, Wu MK. The Use of Cone-beam Computed Tomography and Digital Periapical Radiographs to Diagnose Root Perforations. J Endod 2011; 37:513-6. [DOI: 10.1016/j.joen.2010.12.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 12/16/2010] [Accepted: 12/20/2010] [Indexed: 11/30/2022]
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