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Alves LVGL, Pires CRF, Sousa-Neto MD, Prado HS, Mazzi-Chaves JF, Candemil AP. Metal artifact reduction tool and mA levels impact on the diagnosis of fracture extension in endodontically treated teeth using cone-beam CT. Clin Oral Investig 2024; 28:531. [PMID: 39298025 DOI: 10.1007/s00784-024-05945-3] [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: 04/15/2024] [Accepted: 09/14/2024] [Indexed: 09/21/2024]
Abstract
AIM To evaluate the influence of different levels of metal artifact reduction (MAR) tool and milliamperage (mA) on the diagnosis of fracture extension in endodontically treated teeth using cone beam CT (CBCT). MATERIALS AND METHODS Ten maxillary premolars were endodontically treated and positioned in the empty sockets of a human maxilla covered with wax. CBCT acquisitions were performed using the Eagle Edge device (Dabi Atlante, Brazil) adjusted to 120 kVp, FOV of 4 × 6 cm, exposure time of 24 s and voxel size of 0.2 mm in 8 different conditions with different MAR (1, 2 and 3) and mA (3.2 and 6.3) levels. Crown-root fractures were simulated in the universal testing machine, and CBCT images were acquired again. Five radiologists evaluated the presence and extension of fractures with a 5-point scale. Statistical analysis was performed by analysis of variance, Tukey and Kappa test (α = 0.05). RESULTS Although different mA levels did not significantly (p > 0.05) affect the diagnosis values for fracture presence and extension, when evaluated the different levels of MAR, AUC and sensitivity showed significantly higher values (p < 0.05) for MAR 0 using 6.3 mA and kappa agreement showed significantly higher values (p < 0.05) for MAR 0 and 2 using 6.3 mA. CONCLUSIONS Although mA levels do not have a diagnostic effect when isolating the MAR level; in 6.3 mA, MAR 0 and 2 can positively influence the diagnosis of fracture extension in endodontically treated teeth using CBCT. CLINICAL RELEVANCE The isolate evaluation of dental fracture presence can overlook diagnostics error of its extension.
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Affiliation(s)
- Luísa Valente Gotardo Lara Alves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Cassiano Ricardo Ferreira Pires
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Heitor Silva Prado
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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Nahir CB, Çitir M, Çolak S, Keldal G. Assessment of cone beam computed tomography use in pediatric and adolescent patients: a cross-sectional study. BMC Oral Health 2024; 24:1068. [PMID: 39261834 PMCID: PMC11391848 DOI: 10.1186/s12903-024-04813-6] [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: 01/22/2024] [Accepted: 08/26/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND The use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA's recommendations. METHODS For each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading "other". RESULTS The most common indication was the "other" category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was "orofacial cleft" (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed. CONCLUSIONS Although the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed.
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Affiliation(s)
- Canan Bayraktar Nahir
- Department of Pediatric Dentistry, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey
| | - Mesude Çitir
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tokat Gaziosmanpaşa University. Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi, Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey
| | - Sefa Çolak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpaşa University. Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi, Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey.
| | - Göksal Keldal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpaşa University. Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi, Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey
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Kaaber L, Matzen LH, Schropp L, Spin-Neto R. Low-dose CBCT protocols in implant dentistry: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:427-439. [PMID: 38679501 DOI: 10.1016/j.oooo.2024.03.013] [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: 02/09/2024] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To evaluate the state-of-the-art evidence for applying low-dose CBCT protocols in 3 stages of implant therapy (planning, insertion, and follow-up examination of peri-implantitis) and assess the overall body of evidence presented in the literature. STUDY DESIGN The search was conducted in the MEDLINE/Pubmed and Scopus databases. Studies comparing low-dose CBCT protocols to a relevant reference standard in relation to any stage of implant therapy were included. Data extraction and quality assessment were performed for all included studies. RESULTS Sixteen studies were included. Low-dose protocols were reported to result from reduction of the exposure parameters of kV, mA, resolution (through increased voxel size), exposure time, and scanning trajectory. The current literature suggests that low-dose CBCT protocols perform similarly in the 3 stages of implant therapy compared to higher resolution protocols regarding objective measurements, with adverse impacts mostly on subjective assessment of image quality. The results also suggest that CBCT-based bone measurements are similar to direct measurements, independent of the imaging protocol. Reduction in all parameters except kV seems feasible as the basis of low-dose CBCT protocols for implant therapy. CONCLUSIONS The use of low-dose CBCT protocols does not impact objective image quality assessment in any stage of implant therapy. Clinical studies are needed to indicate if the reported results can be extrapolated to improve patient care in relation to the responsible use of ionizing radiation.
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Affiliation(s)
- Laurits Kaaber
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark.
| | - Louise Hauge Matzen
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
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Rodriguez Betancourt A, Kripfgans OD, Meneghetti PC, Mendonça G, Pereira R, Teixeira W, Zambrana N, Samal A, Chan HL. Intraoral ultrasonography image registration for evaluation of partial edentulous ridge: A methodology and validation study. J Dent 2024; 148:105136. [PMID: 38885734 DOI: 10.1016/j.jdent.2024.105136] [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: 11/23/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Ultrasound (US) reveals details for diagnosing soft- and hard-tissue dimensions around teeth, implants, and the edentulous ridge, not seen in 2D radiographs. Co-registering free-hand US scans with other 3D modalities presents reliability challenges. This study first aims to develop and validate a registration method to longitudinally reproduce US images of the jawbone on a simulator. In addition, it also evaluates the degree of the anatomical match in humans between US images acquired by the proposed registration method and the commonly used freehand acquisitions in comparison to cone beam computed tomography (CBCT) and intra-oral optical scan (IOS), used as references. METHODS A previously introduced ultrasound phantom was employed as a CBCT-US hybrid, suitable for training and technique development of US guides in edentulous ridges. After establishing feasibility in the phantom, the methodology was validated in a cohort of 24 human subjects (26 cases). Soft tissues were delineated on US and IOS, and hard tissues on US and CBCT. US accuracy and repeatability from both guided and freehand scans (non-guided) was assessed as the average distance between US and the references. RESULTS Guided US images resembled the references more closely than freehand (non-guided) scans. Notably, delineation of soft and hard tissues was significantly more accurate when employing guides. In the phantom, guided scans exhibited an absolute mean deviation of 81.8 µm for gingiva and 90.4 µm for bone, whereas non-guided scans showed deviations of 150.4 µm and 177.2 µm, respectively. Similarly, in vivo, guided US outperformed non-guided US, with gingiva deviations of 125 µm and 196 µm, and bone deviations of 354 µm and 554 µm, respectively. CONCLUSIONS By using a registration method, guided US scans improved repeatability and accuracy of mapping hard and soft tissue of the edentulous ridge when compared to non-guided scans. CLINICAL RELEVANCE This guided US imaging method could lay the foundation for longitudinal evaluation of tissue behavior and dimensional changes with improved accuracy.
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Affiliation(s)
- Amanda Rodriguez Betancourt
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, University of Illinois Chicago, College of Dentistry, Chicago, IL, USA
| | - Oliver D Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Priscila Ceolin Meneghetti
- Department of Restorative Sciences, University of Alabama School of Dentistry, Birmingham, AL, USA; Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Gustavo Mendonça
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Rafael Pereira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Wendel Teixeira
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nataly Zambrana
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Ankita Samal
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Division of Periodontology, the Ohio State University, College of Dentistry, Columbus, OH, USA.
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Tuntiwong K, Tungjitkusolmun S, Phasukkit P. Automated Crack Detection in Monolithic Zirconia Crowns Using Acoustic Emission and Deep Learning Techniques. SENSORS (BASEL, SWITZERLAND) 2024; 24:5682. [PMID: 39275594 PMCID: PMC11397990 DOI: 10.3390/s24175682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/16/2024]
Abstract
Monolithic zirconia (MZ) crowns are widely utilized in dental restorations, particularly for substantial tooth structure loss. Inspection, tactile, and radiographic examinations can be time-consuming and error-prone, which may delay diagnosis. Consequently, an objective, automatic, and reliable process is required for identifying dental crown defects. This study aimed to explore the potential of transforming acoustic emission (AE) signals to continuous wavelet transform (CWT), combined with Conventional Neural Network (CNN) to assist in crack detection. A new CNN image segmentation model, based on multi-class semantic segmentation using Inception-ResNet-v2, was developed. Real-time detection of AE signals under loads, which induce cracking, provided significant insights into crack formation in MZ crowns. Pencil lead breaking (PLB) was used to simulate crack propagation. The CWT and CNN models were used to automate the crack classification process. The Inception-ResNet-v2 architecture with transfer learning categorized the cracks in MZ crowns into five groups: labial, palatal, incisal, left, and right. After 2000 epochs, with a learning rate of 0.0001, the model achieved an accuracy of 99.4667%, demonstrating that deep learning significantly improved the localization of cracks in MZ crowns. This development can potentially aid dentists in clinical decision-making by facilitating the early detection and prevention of crack failures.
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Affiliation(s)
- Kuson Tuntiwong
- Department of Biomedical Engineering, School of Engineering, King Mongkut's Institute of Technology Ladkrabang, Bangkok 10520, Thailand
| | - Supan Tungjitkusolmun
- Department of Biomedical Engineering, School of Engineering, King Mongkut's Institute of Technology Ladkrabang, Bangkok 10520, Thailand
| | - Pattarapong Phasukkit
- Department of Biomedical Engineering, School of Engineering, King Mongkut's Institute of Technology Ladkrabang, Bangkok 10520, Thailand
- King Mongkut Chaokhun Thahan Hospital, King Mongkut's Institute of Technology Ladkrabang, Bangkok 10520, Thailand
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Andraws Yalda F, Chawshli OF, Al-Talabani SZ, Ali SH, Shihab OI. Evaluation of Palatal Thickness for the Placement of MARPE Device among a Cohort of Iraqi-Kurdish Population: A Retrospective CBCT Study. Int J Dent 2024; 2024:6741187. [PMID: 39234263 PMCID: PMC11374425 DOI: 10.1155/2024/6741187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 06/17/2024] [Accepted: 08/03/2024] [Indexed: 09/06/2024] Open
Abstract
Objectives This study aimed to evaluate and compare palatal thickness in adults for the placement of mini-implants for miniscrew-assisted rapid palatal expansion (MARPE) appliances using cone-beam computed tomography (CBCT) in a sample of Iraqi-Kurdish people. Materials and Methods CBCT scans from 68 Kurdish patients, aged between 18 and 30 years, were assessed retrospectively. Of these, 37 were males and 31 were females. The measurements were performed at 3 mm from the mid-palatal suture. T-zone was selected for the anterior points, at the level of the palatal cusps of 2nd premolars, and the posterior point at the level of mesio-palatal cusps of 1st molars bilaterally. Palatal thickness of males and females bilaterally, as well as anterior and posterior areas, were measured and compared. An independent t-test was applied for comparison for normally distributed data, and the Mann-Whitney test was utilized for nonnormally distributed data. Additionally, Bonferroni correction was implemented for p-value adjustment. Results The mean palatal thickness at the anterior area was 6.06 mm for males, 6.17 mm for females on the right side, 5.94 mm for males, and 5.99 mm for females on the left side. The mean palatal thickness at the posterior area was almost the same for both genders (4.40 mm for males and 4.44 mm for females) on the right side, 4.35 mm for males, and 4.54 mm for females on the left side. Statistically, no significant difference was recorded between males and females, as well as right and left sides in both anterior and posterior regions; however, a very highly statistically significant difference (p < 0.001) was recorded when comparing total thickness, including both hard and soft tissue, between anterior and posterior regions. Conclusions CBCT proves a highly effective modality in assessing palatal thickness and suggesting ideal locations for orthodontic mini-screw placement. Our examination of palatal thickness in a sample of Iraqi-Kurdish individuals revealed no statistical difference between genders or sides, but significant variations were noted between anterior and posterior thicknesses. Comprehensive clinical and pre-expansion CBCT evaluations are crucial for precisely determining the optimal placement of MARPE devices in each patient, ensuring successful outcomes.
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Affiliation(s)
- Fedil Andraws Yalda
- The Department of Oral Diagnosis College of Dentistry Hawler Medical University, Erbil, Iraq
| | - Omar Fawzi Chawshli
- The Department of Pedodontics Orthodontics and Preventive Dentistry College of Dentistry Hawler Medical University, Erbil, Iraq
| | - Shaho Ziyad Al-Talabani
- The Department of Pedodontics Orthodontics and Preventive Dentistry College of Dentistry Hawler Medical University, Erbil, Iraq
| | - Sarkawt Hamad Ali
- The Department of Oral Diagnosis College of Dentistry Hawler Medical University, Erbil, Iraq
| | - Omed Ikram Shihab
- The Department of Oral and Maxillofacial Surgery College of Dentistry Hawler Medical University, Erbil, Iraq
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Johansson K, Paulsson L, Christell H. Reliability and agreement of root length measurements during orthodontic treatment in images from different CBCT machines using multiplanar reconstruction. Biomater Investig Dent 2024; 11:41161. [PMID: 39228399 PMCID: PMC11371306 DOI: 10.2340/biid.v11.41161] [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: 05/15/2024] [Accepted: 07/08/2024] [Indexed: 09/05/2024] Open
Abstract
Objectives To assess inter- and intrarater reliability and agreement for measurements of root lengths using multiplanar reconstruction (MPR) in cone beam computed tomography (CBCT) examinations.Furthermore, to determine whether using MPR from different CBCT machines was a reliable and reproducible method for assessment of root length during orthodontic treatment of adolescents. Materials and methods A total of 40 CBCT examinations obtained before, during and after orthodontic treatment of 14 adolescents, with fixed appliances from a multicentre randomised controlled trial, were used. All roots from the incisors to the first molars were measured by two independent raters and in accordance with a protocol preceded by a multi-step calibration. Reliability was assessed by intra class correlation (ICC). Agreement was assessed by measurement error according to the Dahlberg formula and Bland-Altman plot. Results The number of repeated measurements varied from 436 to 474 for the different timepoints. Good to excellent inter- and intrarater reliability for different tooth groups and timepoints were shown. Measurement error for inter- and intrarater agreement varied between 0.41 mm and 0.77 mm. The Bland-Altman plot with 95% limits of agreement varied between +1.43 mm and -2.01 mm for different tooth groups and timepoints. Conclusions The results of this study indicate that CBCT using MPR from different machines is a reproducible method for measuring root length during different phases of orthodontic treatment. When interpreting root shortening measurements in CBCT using MPR for clinical or research purposes, values below 2 mm should be approached with caution, as they may contain measurement errors.
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Affiliation(s)
- Kristina Johansson
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Orthodontics, Östersund Hospital, Östersund, Sweden
| | | | - Helena Christell
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Diagnostics, Helsingborg Hospital, Helsingborg, Sweden
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Khubrani YH, Geha H, Katkar RA, Maghsoodi-Zahedi T, Moore W, Abdelkarim AZ. Efficacy of the CALM ® Algorithm in Reducing Motion-Induced Artifacts in CBCT Imaging: A Fractal Dimension Analysis of Trabecular Bone. Dent J (Basel) 2024; 12:262. [PMID: 39195106 DOI: 10.3390/dj12080262] [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: 07/07/2024] [Revised: 07/31/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE The primary goal of this investigation was to ascertain the efficacy of the CALM® motion artifact reduction algorithm in diminishing motion-induced blurriness in Cone Beam Computed Tomography [CBCT] images. The assessment was conducted through Fractal Dimension [FD] analysis of the trabecular bone. METHODS AND MATERIALS A desiccated human mandible was subjected to Planmeca ProMax 3D® scanning under eight distinct protocols, marked by variations in motion presence [at 5, 10, and 15 degrees] and the deployment of CALM®. In every scan, five distinct regions of interest [ROIs] were designated for FD analysis, meticulously avoiding tooth roots or cortical bone. The FD was computed employing the box-counting method with Image-J 1.53 software. RESULTS Our findings reveal that a 5-degree motion does not significantly disrupt FD analysis, while a 10-degree motion and beyond exhibit statistical differences and volatility among the sites and groups. A decreased FD value, signifying a less intricate or "rough" bone structure, correlated with amplified motion blurriness. The utilization of CALM® software seemed to counteract this effect in some instances, reconciling FD values to those akin to the control groups. Nonetheless, CALM®'s efficacy differed across sites and motion degrees. Interestingly, at one site, CALM® application in the absence of motion resulted in FD values considerably higher than all other groups. CONCLUSION The study indicates that motion, particularly at 10 degrees or more, can considerably impact the FD analysis of trabecular bone in CBCT images. In some situations, the CALM® motion artifact reduction algorithm can alleviate this impact, though its effectiveness fluctuates depending on the site and degree of motion. This underscores the necessity of factoring in motion and the employment of artifact reduction algorithms during the interpretation of FD analysis outcomes in CBCT imaging. More research is necessary to refine the application of such algorithms and to comprehend their influence on different sites under varying motion degrees.
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Affiliation(s)
- Yahia H Khubrani
- Department of Oral and Maxillofacial Radiology, Jazan University College of Dentistry, Jazan 82621, Saudi Arabia
| | - Hassem Geha
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Rujuta A Katkar
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Taraneh Maghsoodi-Zahedi
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - William Moore
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Ahmed Z Abdelkarim
- Division of Oral and Maxillofacial Radiology, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
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Koç S, Harorlı H, Kuştarcı A. Comparative evaluation of the accuracy of electronic apex locators and cone-beam computed tomography in detection of root canal perforation and working length during endodontic retreatment. BMC Oral Health 2024; 24:953. [PMID: 39152371 PMCID: PMC11328487 DOI: 10.1186/s12903-024-04713-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND To evaluate the accuracy of the electronic apex locators (EALs), and Cone-Beam Computed Tomography (CBCT) scanning, both in working length (WL) determination and in the detection of root canal perforations in retreatment cases. METHODS Sixty human mandibular premolars were selected. After crown removal partially and canal access, root canals were instrumented and irrigated. The obturation process utilized gutta-percha and sealer with warm vertical compaction. Two groups were distinguished: one without perforation (Group 1) and the other with an apical third perforation (Group 2). Retreatment included filling removal, apical preparation, and irrigation. Actual working lengths (AWL) were determined using a stereomicroscope. CBCT images were used to measure CBCT working length (CWL), with adjustments for optimal views. Propex II and Dentaport ZX were used to measure electronic working length (EWL). Differences between EWL and AWL, as well as CWL, were analyzed to gauge accuracy. Data underwent Two-way ANOVA analysis. Measurements within ± 0.5 and ± 1 mm tolerance ranges were deemed successful for each device, followed by applying the Pearson Chi-square test. RESULTS The study reveals no significant inter-group variations in device performance (p > .05). Dentaport ZX missed detecting perforation in two Group 2 (apical perforation) cases. For ± 1 mm tolerance, Propex II displayed the highest success in Group 2 (apical perforation). CONCLUSION This study demonstrates the comparable performance of Propex II, Dentaport ZX, and CBCT in endodontic retreatment, providing insights into diagnostic reliability.
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Affiliation(s)
- Simay Koç
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey, 07070
- Health Sciences Institute, Department of Medical Biotechnology, Akdeniz University, Antalya, Turkey, 07070
| | - Hatice Harorlı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey, 07070.
| | - Alper Kuştarcı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey, 07070
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Chen RQ, Lee Y, Yan H, Mupparapu M, Lure F, Li J, Setzer FC. Leveraging Pretrained Transformers for Efficient Segmentation and Lesion Detection in Cone-Beam Computed Tomography Scans. J Endod 2024:S0099-2399(24)00408-4. [PMID: 39097163 DOI: 10.1016/j.joen.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) is widely used to detect jaw lesions, although CBCT interpretation is time-consuming and challenging. Artificial intelligence for CBCT segmentation may improve lesion detection accuracy. However, consistent automated lesion detection remains difficult, especially with limited training data. This study aimed to assess the applicability of pretrained transformer-based architectures for semantic segmentation of CBCT volumes when applied to periapical lesion detection. METHODS CBCT volumes (n = 138) were collected and annotated by expert clinicians using 5 labels - "lesion," "restorative material," "bone," "tooth structure," and "background." U-Net (convolutional neural network-based) and Swin-UNETR (transformer-based) models, pretrained (Swin-UNETR-PRETRAIN), and from scratch (Swin-UNETR-SCRATCH), were trained with subsets of the annotated CBCTs. These models were then evaluated for semantic segmentation performance using the Sørensen-Dice coefficient (DICE), lesion detection performance using sensitivity and specificity, and training sample size requirements by comparing models trained with 20, 40, 60, or 103 samples. RESULTS Trained with 103 samples, Swin-UNETR-PRETRAIN achieved a DICE of 0.8512 for "lesion," 0.8282 for "restorative materials," 0.9178 for "bone," 0.9029 for "tooth structure," and 0.9901 for "background." "Lesion" DICE was statistically similar between Swin-UNETR-PRETRAIN trained with 103 and 60 images (P > .05), with the latter achieving 1.00 sensitivity and 0.94 specificity in lesion detection. With small training sets, Swin-UNETR-PRETRAIN outperformed Swin-UNETR-SCRATCH in DICE over all labels (P < .001 [n = 20], P < .001 [n = 40]), and U-Net in lesion detection specificity (P = .006 [n = 20], P = .031 [n = 40]). CONCLUSIONS Transformer-based Swin-UNETR architectures allowed for excellent semantic segmentation and periapical lesion detection. Pretrained, it may provide an alternative with smaller training datasets compared to classic U-Net architectures.
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Affiliation(s)
- Rui Qi Chen
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Yeonju Lee
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Hao Yan
- School of Computing and Augmented Intelligence Arizona State University, Tempe, Arizona
| | - Muralidhar Mupparapu
- Department of Oral Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Fleming Lure
- MS Technologies Corporation, Rockville, Maryland
| | - Jing Li
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Frank C Setzer
- Department of Endodontics, University of Pennsylvania, Philadelphia, Pennsylvania.
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11
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La Rosa GRM, Peditto M, Venticinque A, Marcianò A, Bianchi A, Pedullà E. Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications. AUST ENDOD J 2024; 50:397-408. [PMID: 38887152 DOI: 10.1111/aej.12865] [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: 02/09/2024] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Peditto
- Postgraduate School of Oral Surgery, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Venticinque
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonia Marcianò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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12
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Fuglsig JMDCES, Reis INRD, Yeung AWK, Bornstein MM, Spin-Neto R. The current role and future potential of digital diagnostic imaging in implant dentistry: A scoping review. Clin Oral Implants Res 2024; 35:793-809. [PMID: 37990981 DOI: 10.1111/clr.14212] [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: 08/11/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Diagnostic imaging is crucial for implant dentistry. This review provides an up-to-date perspective on the application of digital diagnostic imaging in implant dentistry. METHODS Electronic searches were conducted in PubMed focusing on the question 'when (and why) do we need diagnostic imaging in implant dentistry?' The search results were summarised to identify different applications of digital diagnostic imaging in implant dentistry. RESULTS The most used imaging modalities in implant dentistry include intraoral periapical radiographs, panoramic views and cone beam computed tomography (CBCT). These are dependent on acquisition standardisation to optimise image quality. Particularly for CBCT, other technical parameters (i.e., tube current, tube voltage, field-of-view, voxel size) are relevant minimising the occurrence of artefacts. There is a growing interest in digital workflows, integrating diagnostic imaging and automation. Artificial intelligence (AI) has been incorporated into these workflows and is expected to play a significant role in the future of implant dentistry. Preliminary evidence supports the use of ionising-radiation-free imaging modalities (e.g., MRI and ultrasound) that can add value in terms of soft tissue visualisation. CONCLUSIONS Digital diagnostic imaging is the sine qua non in implant dentistry. Image acquisition protocols must be tailored to the patient's needs and clinical indication, considering the trade-off between radiation exposure and needed information. growing evidence supporting the benefits of digital workflows, from planning to execution, and the future of implant dentistry will likely involve a synergy between human expertise and AI-driven intelligence. Transiting into ionising-radiation-free imaging modalities is feasible, but these must be further developed before clinical implementation.
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Affiliation(s)
| | | | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Rubens Spin-Neto
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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da Fonte JBM, Fontenele RC, Farias-Gomes A, Ruiz DC, Andrade-Bortoletto MFS, Sousa Melo SL, Freitas DQ. Do the number of zirconia implants and the thickness of CBCT image reconstruction affect the detection of peri-implant bone defect? A diagnostic accuracy ex vivo study. Clin Oral Implants Res 2024. [PMID: 39072795 DOI: 10.1111/clr.14336] [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: 04/01/2024] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES To evaluate the influence of multiplanar reconstruction thickness on the detection of peri-implant bone defects with a standalone zirconia implant and compare it to when another implant is in the vicinity using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Five dry human mandibles were used to create twenty implant sites in the second premolar and first molar regions. The OP300 Maxio was used to acquire CBCT images (90 kVp, 6.3 mA, 5 × 5 cm FOV, and 0.125 mm3 voxel size) before and after creating 3 mm peri-implant bone defects in the buccal aspect of the premolar region. Half of the scans featured a single zirconia implant in the premolar region, while the others had two implants in the premolar and molar regions. Three reconstruction thicknesses (0.125 mm, 1 mm, and 2 mm) were considered for the multiplanar reconstruction analyses. Five oral and maxillofacial radiologists assessed the detection of peri-implant bone defects using a 5-point scale. Diagnostic parameters were calculated and compared using Two-way ANOVA (α = .05). RESULTS The studied factors showed no significant influence on the diagnosis of peri-implant bone defects (p > .05). Diagnostic performance was notably higher with a single implant, especially with a 2-mm reconstruction thickness (AUC = 0.88, sensitivity = 0.68, specificity = 0.94). Although the differences were not statistically significant, the results were more modest when two implants were present (AUC = 0.80, sensitivity = 0.58, specificity = 0.82). CONCLUSIONS The presence of an adjacent zirconia implant and variations in reconstruction thickness did not influence the detection of 3 mm buccal peri-implant bone defects on CBCT images.
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Affiliation(s)
- Juliana Batista Melo da Fonte
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Oral and Maxillofacial Diagnostic Sciences, School of Dental Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Débora Costa Ruiz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Saulo L Sousa Melo
- Department of Oral and Craniofacial Sciences, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Alrashed S, Dutra V, Chu TMG, Yang CC, Lin WS. Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial-intelligence-based system. J Prosthodont 2024; 33:574-583. [PMID: 38305665 DOI: 10.1111/jopr.13827] [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: 06/28/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
PURPOSE To evaluate the effects of exposure protocol, voxel sizes, and artifact removal algorithms on the trueness of segmentation in various mandible regions using an artificial intelligence (AI)-based system. MATERIALS AND METHODS Eleven dry human mandibles were scanned using a cone beam computed tomography (CBCT) scanner under differing exposure protocols (standard and ultra-low), voxel sizes (0.15 mm, 0.3 mm, and 0.45 mm), and with or without artifact removal algorithm. The resulting datasets were segmented using an AI-based system, exported as 3D models, and compared to reference files derived from a white-light laboratory scanner. Deviation measurement was performed using a computer-aided design (CAD) program and recorded as root mean square (RMS). The RMS values were used as a representation of the trueness of the AI-segmented 3D models. A 4-way ANOVA was used to assess the impact of voxel size, exposure protocol, artifact removal algorithm, and location on RMS values (α = 0.05). RESULTS Significant effects were found with voxel size (p < 0.001) and location (p < 0.001), but not with exposure protocol (p = 0.259) or artifact removal algorithm (p = 0.752). Standard exposure groups had significantly lower RMS values than the ultra-low exposure groups in the mandible body with 0.3 mm (p = 0.014) or 0.45 mm (p < 0.001) voxel sizes, the symphysis with a 0.45 mm voxel size (p = 0.011), and the whole mandible with a 0.45 mm voxel size (p = 0.001). Exposure protocol did not affect RMS values at teeth and alveolar bone (p = 0.544), mandible angles (p = 0.380), condyles (p = 0.114), and coronoids (p = 0.806) locations. CONCLUSION This study informs optimal exposure protocol and voxel size choices in CBCT imaging for true AI-based automatic segmentation with minimal radiation. The artifact removal algorithm did not influence the trueness of AI segmentation. When using an ultra-low exposure protocol to minimize patient radiation exposure in AI segmentations, a voxel size of 0.15 mm is recommended, while a voxel size of 0.45 mm should be avoided.
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Affiliation(s)
- Safa Alrashed
- Oral Biology PhD program in the College of Dentistry, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vinicius Dutra
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Chao-Chieh Yang
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Mladenovic M, Freezer S, Dreyer C, Meade MJ. The orthodontic extraction of second premolars: The influence on airway volume. Am J Orthod Dentofacial Orthop 2024; 166:61-68. [PMID: 38678455 DOI: 10.1016/j.ajodo.2024.02.013] [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: 10/01/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION The extraction of second premolars and associated changes in the volume of the airway have not been previously explored. This retrospective study aimed to compare the volumetric changes of the airway preorthodontic and postorthodontic treatment in relevant extraction and control samples and to identify variables that may influence the outcome. METHODS Cone-beam computed radiography scans of 54 patients with second premolar extraction and 59 nonextraction patients treated in a private orthodontic practice were matched for crowding. The average age for both samples was 15 years. The images were individually landmarked and measured by applying volumetric, linear, and angular parameters. The results were analyzed using repeated measures, such as variance analysis, correlation testing, and regression statistical analyses. RESULTS There was a statistically significant increase in the airway volume for both groups (P <0.05). The difference in increase between the groups was not statistically significant. Seven variables demonstrated a collectively significant effect on changes to airway volume (F[7,112] = 38.48; P <0.001; r2 = 0.701), with 70% of the variation predicted by the variables. Multiple regression analyses indicated that changes to the area of minimum constriction (B = 32.45; t = 11.95; P <0.001) and changes to airway length (B = 94.75; t = 7.79; P <0.001) had a statistically significant effect on airway volume. CONCLUSIONS The volume of the airway increased in both the extraction and nonextraction samples. The biggest contributors to the increase were an increase in airway length and an increase in the area of minimum constriction, which likely occurred as a result of natural growth.
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Affiliation(s)
- Miodrag Mladenovic
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Simon Freezer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Craig Dreyer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
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Popkowski A, Rhodes SC, Hatton JF. Proposed Diagnostic Reference Levels in the Missouri/Southern Illinois Region Associated with Cone-beam Computed Tomography Use in Endodontics. J Endod 2024; 50:966-975. [PMID: 38382736 DOI: 10.1016/j.joen.2024.02.006] [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: 07/28/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Diagnostic reference levels (DRLs) are intended to improve patient safety and ensure that patient ionizing radiation doses are as low as reasonably achievable. The purpose of this dosimetry study was to establish regional DRL levels for cone-beam computed tomography (CBCT) imaging for specialty endodontics. Another aim was to compare phantom-measured ionizing radiation dose index 1 (DI1) index doses to the manufacturer-provided dose area product (DAP) radiation output values for each of the CBCT machines studied, to ascertain their degree of correlation. DAP refers to the dose area product, a measure of radiation dose monitoring which represents the dose within the beam times the area within the beam at that position. METHODS A thimble ionization chamber and polymethyl methacrylate phantom were used to obtain DI1 values using the SEDENTEXTCT method from 21 different CBCT units. DRLs were calculated based on the 75th percentile (third quartile) of the median output values. RESULTS The proposed DRL from the CBCT units surveyed has a DAP value of 838 mGy cm2 and a DI1 value of 3.924 mGy. DAP versus DI1 values of 500.6 mGy cm2 versus 2.006 mGy, and 838 mGy cm2 versus 3.906 mGy represented the third quartile of the median values for the 4-cm × 4-cm and 5-cm × 5-cm field of views (FOVs), respectively. CONCLUSIONS The DI1 and DAP values strongly correlated when 3 outlier CBCT machines (J Morita Veraview X800) using a novel 360° (full rotation) acquisition mode were excluded. The importance of selectable exposure parameters as directly related to ionizing radiation output is illustrated among the CBCT units surveyed. Although the actual FOV that is selected is ultimately dictated by the specific clinical requirements, a 4-cm × 4-cm FOV is recommended for specialist endodontics practice, whenever clinically practical, based on the decreased ionizing radiation output, as compared to that from a 5-cm × 5-cm FOV.
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Affiliation(s)
- Arthur Popkowski
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
| | - S Craig Rhodes
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri.
| | - John F Hatton
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
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Yavuz E, Yardimci S. Comparison of periapical radiography, panoramic radiography, and CBCT in the evaluation of trabecular bone structure using fractal analysis. Oral Radiol 2024; 40:394-400. [PMID: 38407759 DOI: 10.1007/s11282-024-00743-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim of this study is to compare imaging techniques to evaluate trabecular bone structure using Fractal Analysis (FA). METHODS Fifteen sheep hemimandibles were used for this study. Digital images were obtained using periapical radiography, panoramic radiography, and cone-beam computed tomography (CBCT). CBCT imaging was performed in standard (STD) and high-resolution (HR) modes. FA was conducted using ImageJ 1.3 software with the box-counting method on the images. The fractal dimension (FD) values were analyzed by the statistical software Jamovi 1.6.23. Statistical significance was accepted as p < 0.05. RESULTS The highest mean FD value was the FD on digital periapical radiographs (PaFD) (1.28 ± 0.04), and the lowest mean FD value was the FD on standard resolution cone-beam computed tomography images (STD-CBCTFD) (1.12 ± 0.10). Although there was no statistically significant difference between the PaFD and the FD on digital panoramic radiographs (PanFD) (p = 0.485), the PaFD was found to be significantly higher than STD-CBCTFD (p < 0.001), and the FD on high-resolution cone-beam computed tomography images (HR-CBCTFD) (p = 0.007). The PanFD was found to be significantly higher than the STD-CBCTFD (p = 0.004). CONCLUSION According to our results, in the evaluation of trabecular bone structure using FA, periapical radiographs and panoramic radiographs have similar image quality for assessment of the FD. On the other hand, CBCT results did not correlate with results from any of the other techniques in this study.
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Affiliation(s)
- Esra Yavuz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Selmi Yardimci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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彭 声, 王 永, 边 兆, 马 建, 黄 静. [A dual-domain cone beam computed tomography reconstruction framework with improved differentiable domain transform for cone-angle artifact correction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2024; 44:1188-1197. [PMID: 38977350 PMCID: PMC11237300 DOI: 10.12122/j.issn.1673-4254.2024.06.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE We propose a dual-domain cone beam computed tomography (CBCT) reconstruction framework DualCBR-Net based on improved differentiable domain transform for cone-angle artifact correction. METHODS The proposed CBCT dual-domain reconstruction framework DualCBR-Net consists of 3 individual modules: projection preprocessing, differentiable domain transform, and image post-processing. The projection preprocessing module first extends the original projection data in the row direction to ensure full coverage of the scanned object by X-ray. The differentiable domain transform introduces the FDK reconstruction and forward projection operators to complete the forward and gradient backpropagation processes, where the geometric parameters correspond to the extended data dimension to provide crucial prior information in the forward pass of the network and ensure the accuracy in the gradient backpropagation, thus enabling precise learning of cone-beam region data. The image post-processing module further fine-tunes the domain-transformed image to remove residual artifacts and noises. RESULTS The results of validation experiments conducted on Mayo's public chest dataset showed that the proposed DualCBR-Net framework was superior to other comparison methods in terms of artifact removal and structural detail preservation. Compared with the latest methods, the DualCBR-Net framework improved the PSNR and SSIM by 0.6479 and 0.0074, respectively. CONCLUSION The proposed DualCBR-Net framework for cone-angle artifact correction allows effective joint training of the CBCT dual-domain network and is especially effective for large cone-angle region.
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Burck I, Yel I, Martin S, Albrecht MH, Koch V, Booz C, Pinto Dos Santos D, Kaltenbach B, Ackermann H, Koivisto J, Helbig S, Stöver T, Vogl TJ, Scholtz JE. Comparison of 96-kV and 120-kV cone-beam CT for the assessment of cochlear implants. BMC Med Imaging 2024; 24:145. [PMID: 38872126 DOI: 10.1186/s12880-024-01322-4] [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: 05/04/2023] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND To compare the diagnostic value of 120-kV with conventional 96-kV Cone-Beam CT (CBCT) of the temporal bone after cochlear implant (CI) surgery. METHODS This retrospective study included CBCT scans after CI surgery between 06/17 and 01/18. CBCT allowed examinations with 96-kV or 120-kV; other parameters were the same. Two radiologists independently evaluated following criteria on 5-point Likert scales: osseous spiral lamina, inner and outer cochlear wall, semi-circular canals, mastoid trabecular structure, overall image quality, metal and motion artefacts, depiction of intracochlear electrode position and visualisation of single electrode contacts. Effective radiation dose was assessed. RESULTS Seventy-five patients (females, n = 39 [52.0%], mean age, 55.8 ± 16.5 years) were scanned with 96-kV (n = 32, 42.7%) and 120-kV (n = 43, 57.3%) protocols including CI models from three vendors (vendor A n = 7; vendor B n = 43; vendor C n = 25). Overall image quality, depiction of anatomical structures, and electrode position were rated significantly better in 120-kV images compared to 96-kV (all p < = 0.018). Anatomical structures and electrode position were rated significantly better in 120-kV CBCT for CI models from vendor A and C, while 120-kV did not provide improved image quality in CI models from vendor B. Radiation doses were significantly higher for 120-kV scans compared to 96-kV (0.15 vs. 0.08 mSv, p < 0.001). CONCLUSIONS 120-kV and 96-kV CBCT provide good diagnostic images for the postoperative CI evaluation. While 120-kV showed improved depiction of temporal bone and CI electrode position compared to 96-kV in most CI models, the 120-kV protocol should be chosen wisely due to a substantially higher radiation exposure.
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Affiliation(s)
- Iris Burck
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Simon Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Daniel Pinto Dos Santos
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Benjamin Kaltenbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, University Hospital Frankfurt, Frankfurt, Germany
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Silke Helbig
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | - Timo Stöver
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Jan-Erik Scholtz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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Yeung AWK, AlHadidi A, Vyas R, Bornstein MM, Watanabe H, Tanaka R. Nonionizing diagnostic imaging modalities for visualizing health and pathology of periodontal and peri-implant tissues. Periodontol 2000 2024; 95:87-101. [PMID: 38951932 DOI: 10.1111/prd.12591] [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: 02/07/2024] [Revised: 05/20/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024]
Abstract
Radiographic examination has been an essential part of the diagnostic workflow in periodontology and implant dentistry. However, radiographic examination unavoidably involves ionizing radiation and its associated risks. Clinicians and researchers have invested considerable efforts in assessing the feasibility and capability of utilizing nonionizing imaging modalities to replace traditional radiographic imaging. Two such modalities have been extensively evaluated in clinical settings, namely, ultrasonography (USG) and magnetic resonance imaging (MRI). Another modality, optical coherence tomography (OCT), has been under investigation more recently. This review aims to provide an overview of the literature and summarize the usage of USG, MRI, and OCT in evaluating health and pathology of periodontal and peri-implant tissues. Clinical studies have shown that USG could accurately measure gingival height and crestal bone level, and classify furcation involvement. Due to physical constraints, USG may be more applicable to the buccal surfaces of the dentition even with an intra-oral probe. Clinical studies have also shown that MRI could visualize the degree of soft-tissue inflammation and osseous edema, the extent of bone loss at furcation involvement sites, and periodontal bone level. However, there was a lack of clinical studies on the evaluation of peri-implant tissues by MRI. Moreover, an MRI machine is very expensive, occupies much space, and requires more time than cone-beam computed tomography (CBCT) or intraoral radiographs to complete a scan. The feasibility of OCT to evaluate periodontal and peri-implant tissues remains to be elucidated, as there are only preclinical studies at the moment. A major shortcoming of OCT is that it may not reach the bottom of the periodontal pocket, particularly for inflammatory conditions, due to the absorption of near-infrared light by hemoglobin. Until future technological breakthroughs finally overcome the limitations of USG, MRI and OCT, the practical imaging modalities for routine diagnostics of periodontal and peri-implant tissues remain to be plain radiographs and CBCTs.
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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
| | - Abeer AlHadidi
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University, New York, New York, USA
| | - Rutvi Vyas
- University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Hiroshi Watanabe
- Dental Radiology and Radiation Oncology, Department of Oral Restitution, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Barros-Costa M, Barros-Candido JR, Sampaio-Oliveira M, Freitas DQ, Sverzut AT, Oliveira ML. Impact of the spatial orientation of the patient's head, metal artifact reduction, and tube current on cone-beam computed tomography artifact expression adjacent to a dental implant: A laboratory study using a simulated surgical guide. Imaging Sci Dent 2024; 54:191-199. [PMID: 38948193 PMCID: PMC11211021 DOI: 10.5624/isd.20240016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose The aim of this study was to evaluate image artifacts in the vicinity of dental implants in cone-beam computed tomography (CBCT) scans obtained with different spatial orientations, tube current levels, and metal artifact reduction algorithm (MAR) conditions. Materials and Methods One dental implant and 2 tubes filled with a radiopaque solution were placed in the posterior region of a mandible using a surgical guide to ensure parallel alignment. CBCT scans were acquired with the mandible in 2 spatial orientations in relation to the X-ray projection plane (standard and modified) at 3 tube current levels: 5, 8, and 11 mA. CBCT scans were repeated without the implant and were reconstructed with and without MAR. The mean voxel and noise values of each tube were obtained and compared using multi-way analysis of variance and the Tukey test (α=0.05). Results Mean voxel values were significantly higher and noise values were significantly lower in the modified orientation than in the standard orientation (P<0.05). MAR activation and tube current levels did not show significant differences in most cases of the modified spatial orientation and in the absence of the dental implant (P>0.05). Conclusion Modifying the spatial orientation of the head increased brightness and reduced spatial orientation noise in adjacent regions of a dental implant, with no influence from the tube current level and MAR.
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Affiliation(s)
- Matheus Barros-Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Julia Ramos Barros-Candido
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus Sampaio-Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alexander Tadeu Sverzut
- Division of Oral and Maxillofacial Surgery, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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22
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Ruiz DC, Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ. Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters. Imaging Sci Dent 2024; 54:139-145. [PMID: 38948185 PMCID: PMC11211027 DOI: 10.5624/isd.20230233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Results Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). Conclusion MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | | | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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23
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Dogan OB, Boyacioglu H. Medial sigmoid depression prevalence and association with a sigmoid notch: cone beam computed tomography and panoramic image study. Sci Rep 2024; 14:11554. [PMID: 38773238 PMCID: PMC11109133 DOI: 10.1038/s41598-024-62490-5] [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: 03/04/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024] Open
Abstract
This study aims to determine whether and how the data of the medial sigmoid depression (MSD) area via cone beam computed tomography (CBCT) differs from panoramic radiography. This study also aims to evaluate various sigmoid notch types and assess the relationship between sigmoid depression and notch morphology. A total of 129 individuals consisting of 258 sides were evaluated. Chi-Square/Fisher Exact tests were used to assess parameters on a categorical scale between two or more groups. McNemar's test compared the findings detected on panoramic and CBCT images. MSD was more prevalent in females than males in both techniques, but this difference was not statistically significant. There was no association between the prevalence of MSD and the morphology of the sigmoid notch. The incidence of MSD shape was not significantly different between both imaging modalities. In both panoramic and CBCT, we found a high and similar prevalence of MSD. While the MSD prevalence was 66.7% for CBCT, it was 58.1% for panoramic. The shape or prevalence of MSDs in either approach did not correlate with sigmoid notch morphology. The two approaches' identical prevalence indicates that the panoramic image has adequately defines MSD. The high prevalence of MSD demonstrated how important it is for clinicians to characterize this anatomical variation accurately for the surgical treatment.
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Affiliation(s)
- Ozlem Busra Dogan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye, Ankara, Turkey.
| | - Hatice Boyacioglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye, Ankara, Turkey
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24
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Mihailidis DN, Stratis A, Gingold E, Carlson R, DeForest W, Gray J, Lally MT, Pizzutiello R, Rong J, Spelic D, Hilohi MC, Massoth R. AAPM Task Group Report 261: Comprehensive quality control methodology and management of dental and maxillofacial cone beam computed tomography (CBCT) systems. Med Phys 2024; 51:3134-3164. [PMID: 38285566 DOI: 10.1002/mp.16911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/31/2024] Open
Abstract
Cone-beam computed tomography (CBCT) systems specifically designed and manufactured for dental, maxillofacial imaging (MFI) and otolaryngology (OLR) applications have been commercially available in the United States since 2001 and have been in widespread clinical use since. Until recently, there has been a lack of professional guidance available for medical physicists about how to assess and evaluate the performance of these systems and about the establishment and management of quality control (QC) programs. The owners and users of dental CBCT systems may have only a rudimentary understanding of this technology, including how it differs from conventional multidetector CT (MDCT) in terms of acceptable radiation safety practices. Dental CBCT systems differ from MDCT in several ways and these differences are described. This report provides guidance to medical physicists and serves as a basis for stakeholders to make informed decisions regarding how to manage and develop a QC program for dental CBCT systems. It is important that a medical physicist with experience in dental CBCT serves as a resource on this technology and the associated radiation protection best practices. The medical physicist should be involved at the pre-installation stage to ensure that a CBCT room configuration allows for a safe and efficient workflow and that structural shielding, if needed, is designed into the architectural plans. Acceptance testing of new installations should include assessment of mechanical alignment of patient positioning lasers and x-ray beam collimation and benchmarking of essential image quality performance parameters such as image uniformity, noise, contrast-to-noise ratio (CNR), spatial resolution, and artifacts. Several approaches for quantifying radiation output from these systems are described, including simply measuring the incident air-kerma (Kair) at the entrance surface of the image receptor. These measurements are to be repeated at least annually as part of routine QC by the medical physicist. QC programs for dental CBCT, at least in the United States, are often driven by state regulations, accreditation program requirements, or manufacturer recommendations.
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Affiliation(s)
- Dimitris N Mihailidis
- University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Eric Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ray Carlson
- Radiological Physics Services, Inc, Plymouth, Michigan, USA
| | | | | | - Mary T Lally
- Intersocietal Accreditation Commission, Ellicott City, Maryland, USA
| | | | - John Rong
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - David Spelic
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Mike C Hilohi
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Richard Massoth
- Sunflower Medical Physics, LLC, Sioux Falls, South Dakota, USA
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25
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Carneiro ALE, Reis INR, Bitencourt FV, Salgado DMRA, Costa C, Spin-Neto R. Accuracy of linear measurements for implant planning based on low-dose cone beam CT protocols: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:207-221. [PMID: 38429951 PMCID: PMC11056743 DOI: 10.1093/dmfr/twae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES The aim of this systematic review was to verify the accuracy of linear measurements performed on low-dose CBCT protocols for implant planning, in comparison with those performed on standard and high-resolution CBCT protocols. METHODS The literature search included four databases (Pubmed, Web of Science, Embase, and Scopus). Two reviewers independently screened titles/abstracts and full texts according to eligibility criteria, extracted the data, and examined the methodological quality. Risk of bias assessment was performed using the Quality Assessment Tool For In Vitro Studies. Random-effects meta-analysis was used for pooling measurement error data. RESULTS The initial search yielded 4684 titles. In total, 13 studies were included in the systematic review, representing a total of 81 samples, while 9 studies were included in the meta-analysis. The risk of bias ranged from medium to low. The main results across the studies indicate a strong consistency in linear measurements performed on low-dose images in relation to the reference methods. The overall pooled planning measurement error from low-dose CBCT protocols was -0.24 mm (95% CI, -0.52 to 0.04) with a high level of heterogeneity, showing a tendency for underestimation of real values. Various studies found no significant differences in measurements across different protocols (eg, voxel sizes, mA settings, or dose levels), regions (incisor, premolar, molar) and types (height vs. width). Some studies, however, noted exceptions in measurements performed on the posterior mandible. CONCLUSION Low-dose CBCT protocols offer adequate precision and accuracy of linear measurements for implant planning. Nevertheless, diagnostic image quality needs must be taken into consideration when choosing a low-dose CBCT protocol.
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Affiliation(s)
- Ana Luiza E Carneiro
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Isabella N R Reis
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Fernando Valentim Bitencourt
- Section for Oral Ecology and Inflammation, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
- Steno Diabetes Center Aarhus, Aarhus, 8200, Denmark
| | - Daniela M R A Salgado
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health—Section for Oral Radiology and Endodontics, Aarhus University, Aarhus, 8000, Denmark
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26
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Zheng Q, Gao Y, Zhou M, Li H, Lin J, Zhang W, Chen X. Semi or fully automatic tooth segmentation in CBCT images: a review. PeerJ Comput Sci 2024; 10:e1994. [PMID: 38660190 PMCID: PMC11041986 DOI: 10.7717/peerj-cs.1994] [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: 09/18/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Cone beam computed tomography (CBCT) is widely employed in modern dentistry, and tooth segmentation constitutes an integral part of the digital workflow based on these imaging data. Previous methodologies rely heavily on manual segmentation and are time-consuming and labor-intensive in clinical practice. Recently, with advancements in computer vision technology, scholars have conducted in-depth research, proposing various fast and accurate tooth segmentation methods. In this review, we review 55 articles in this field and discuss the effectiveness, advantages, and disadvantages of each approach. In addition to simple classification and discussion, this review aims to reveal how tooth segmentation methods can be improved by the application and refinement of existing image segmentation algorithms to solve problems such as irregular morphology and fuzzy boundaries of teeth. It is assumed that with the optimization of these methods, manual operation will be reduced, and greater accuracy and robustness in tooth segmentation will be achieved. Finally, we highlight the challenges that still exist in this field and provide prospects for future directions.
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Affiliation(s)
- Qianhan Zheng
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Gao
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengqi Zhou
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huimin Li
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Lin
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weifang Zhang
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Social Medicine & Health Affairs Administration, Zhejiang University, Hangzhou, China
| | - Xuepeng Chen
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Clinical Research Center for Oral Diseases of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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27
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Johnston A, Mahesh M, Uneri A, Rypinski TA, Boone JM, Siewerdsen JH. Objective image quality assurance in cone-beam CT: Test methods, analysis, and workflow in longitudinal studies. Med Phys 2024; 51:2424-2443. [PMID: 38354310 DOI: 10.1002/mp.16983] [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: 09/22/2023] [Revised: 12/20/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Standards for image quality evaluation in multi-detector CT (MDCT) and cone-beam CT (CBCT) are evolving to keep pace with technological advances. A clear need is emerging for methods that facilitate rigorous quality assurance (QA) with up-to-date metrology and streamlined workflow suitable to a range of MDCT and CBCT systems. PURPOSE To evaluate the feasibility and workflow associated with image quality (IQ) assessment in longitudinal studies for MDCT and CBCT with a single test phantom and semiautomated analysis of objective, quantitative IQ metrology. METHODS A test phantom (CorgiTM Phantom, The Phantom Lab, Greenwich, New York, USA) was used in monthly IQ testing over the course of 1 year for three MDCT scanners (one of which presented helical and volumetric scan modes) and four CBCT scanners. Semiautomated software analyzed image uniformity, linearity, contrast, noise, contrast-to-noise ratio (CNR), 3D noise-power spectrum (NPS), modulation transfer function (MTF) in axial and oblique directions, and cone-beam artifact magnitude. The workflow was evaluated using methods adapted from systems/industrial engineering, including value stream process modeling (VSPM), standard work layout (SWL), and standard work control charts (SWCT) to quantify and optimize test methodology in routine practice. The completeness and consistency of DICOM data from each system was also evaluated. RESULTS Quantitative IQ metrology provided valuable insight in longitudinal quality assurance (QA), with metrics such as NPS and MTF providing insight on root cause for various forms of system failure-for example, detector calibration and geometric calibration. Monthly constancy testing showed variations in IQ test metrics owing to system performance as well as phantom setup and provided initial estimates of upper and lower control limits appropriate to QA action levels. Rigorous evaluation of QA workflow identified methods to reduce total cycle time to ∼10 min for each system-viz., use of a single phantom configuration appropriate to all scanners and Head or Body scan protocols. Numerous gaps in the completeness and consistency of DICOM data were observed for CBCT systems. CONCLUSION An IQ phantom and test methodology was found to be suitable to QA of MDCT and CBCT systems with streamlined workflow appropriate to busy clinical settings.
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Affiliation(s)
- Ashley Johnston
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mahadevappa Mahesh
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ali Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tatiana A Rypinski
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - John M Boone
- Department of Radiology, University of California - Davis, Davis, California, USA
| | - Jeffrey H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Sawall S, Maier J, Sen S, Gehrig H, Kim TS, Schlemmer HP, Schönberg SO, Kachelrieß M, Rütters M. Dental imaging in clinical photon-counting CT at a quarter of DVT dose. J Dent 2024; 142:104859. [PMID: 38272436 DOI: 10.1016/j.jdent.2024.104859] [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: 10/31/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To investigate the image quality of a low-dose dental imaging protocol in the first clinical photon-counting computed tomography (PCCT) system in comparison to a normal-dose acquisition in a digital volume tomography (DVT) system. MATERIALS AND METHODS Clinical PCCT systems offer an increased spatial resolution compared to previous generations of clinical systems. Their spatial resolution is in the order of dental DVT systems. Resolution-matched acquisitions of ten porcine jaws were performed in a PCCT (Naeotom Alpha, Siemens Healthineers) and in a DVT (Orthophos XL, Dentsply Sirona). PCCT images were acquired with 90 kV at a dose of 1 mGy CTDI16 cm. DVT used 85 kV at 4 mGy. Image reconstruction was performed using the standard algorithms of each system to a voxel size of 160 × 160 × 200 µm. The dose-normalized contrast-to-noise ratio (CNRD) was measured between dentine and enamel and dentine and bone. Two readers evaluated overall diagnostic quality of images and quality of relevant structures such as root channels and dentine. RESULTS CNRD is higher in all PCCT acquisitions. CNRD is 37 % higher for the contrast dentine-enamel and 31 % higher for the dentine-bone contrast (p < 0.05). Overall diagnostic image quality was higher for PCCT over DVT (p < 0.02 and p < 0.04 for readers 1 and 2). Quality scores for anatomical structures were higher in PCCT compared to DVT (all p < 0.05). Inter- and intrareader reproducibility were acceptable (all ICC>0.64). CONCLUSIONS PCCT provides an increased image quality over DVT even at a lower dose level and might enable complex dental imaging protocols in the future. CLINICAL SIGNIFICANCE The evolution of photon-counting technology and it's optimization will increasingly move dental imaging towards standardized 3D visualizations providing both minimal radiation exposure and high diagnostic accuracy.
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Affiliation(s)
- Stefan Sawall
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany; Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg 69120, Germany.
| | - Joscha Maier
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Holger Gehrig
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
| | - Ti-Sun Kim
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
| | - Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Stefan O Schönberg
- Department of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Theodor-Kurz-Ufer 1-3, Mannheim 68167, Germany
| | - Marc Kachelrieß
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany; Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg 69120, Germany
| | - Maurice Rütters
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
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Lucca LV, Cascante-Sequeira D, Coelho-Silva F, Ruiz-Imbert AC, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. The effect of voxel and field of view size on the volumetric alteration artifact of high-density materials with 2 cone beam computed tomography devices. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:290-300. [PMID: 37980244 DOI: 10.1016/j.oooo.2023.10.004] [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: 05/25/2023] [Revised: 09/28/2023] [Accepted: 10/07/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE We investigated the influence of voxel and field of view (FOV) sizes on expression of the volumetric alteration artifact (VAA) of 5 high-density materials in 2 cone beam computed tomography (CBCT) devices. STUDY DESIGN Cylinders of amalgam, cobalt-chromium, gutta-percha, titanium, and zirconium were individually positioned in a polymethyl methacrylate phantom. OP300 Maxio and ProMax 3D Classic CBCT devices were used to acquire images with varying voxel and FOV sizes, totaling 585 scans. Two evaluators segmented the high-density cylinder images to obtain the tomographic volumes. The difference between the tomographic and physical volume of each cylinder (i.e., volumetric alteration) was calculated. Statistical analysis was conducted with multiway ANOVA and the Tukey post hoc test (α = 5%). Evaluator reliability was measured with the intraclass correlation coefficient (ICC). RESULTS All studied parameters and nearly all interactions influenced the VAA (P < .05). The post hoc test demonstrated less volumetric alteration for the smallest voxel sizes, 61 × 78 mm FOV, and gutta-percha for OP300, and for the smallest voxel sizes, 80 × 80 mm FOV, and gutta-percha and titanium for ProMax 3D (P < .05). The ICC demonstrated perfect reliability (1.00). CONCLUSIONS Voxel and FOV sizes influenced VAA expression. Using smaller voxel sizes, the 61 × 78 mm FOV for OP300 and the 80 × 80 mm FOV for ProMax 3D, and materials with lower density and lower atomic number reduced VAA expression.
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Affiliation(s)
- Luiza Valdemarca Lucca
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
| | - Deivi Cascante-Sequeira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Coelho-Silva
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ana Cecilia Ruiz-Imbert
- Department of Diagnostic Sciences, Oral Radiology Section, Dentistry Faculty, Universidad de Costa Rica, San José, Costa Rica
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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Abramson Z, Oh C, Wells M, Choudhri AF, Whitehead MT. CT and MR Appearance of Teeth: Analysis of Anatomy and Embryology and Implications for Disease. J Clin Med 2024; 13:1187. [PMID: 38592028 PMCID: PMC10932355 DOI: 10.3390/jcm13051187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various stages of maturation are required for the appreciation of abnormal dental development. While many tooth abnormalities are well-depicted on dedicated dental radiographs, the first encounter with a dental anomaly may be by a radiologist on a computed tomographic (CT) or magnetic resonance (MR) exam performed for other reasons. This article depicts normal dental anatomy and development, describing the appearance of the neonatal dentition on CT and MRI, the modalities most often encountered by clinical radiologists. The radiology and dental literature are reviewed, and key concepts are illustrated with supplemental cases from our institution. The value of knowledge of dental development is investigated using the analysis of consecutive MR brain examinations. Finally, the anatomical principles are applied to the diagnosis of odontogenic infection on CT. Through analysis of the literature and case data, the contrast of dental pathology with normal anatomy and development facilitates the detection and characterization of both congenital and acquired dental disease.
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Affiliation(s)
- Zachary Abramson
- Clinical Radiology, Radiologist, Body Imaging, Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Chris Oh
- Quantum Radiology, 790 Church St., Suite 400, Marietta, GA 30060, USA;
| | - Martha Wells
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Asim F. Choudhri
- Department of Radiology, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, 50 N. Dunlap St., Memphis, TN 38103, USA;
| | - Matthew T. Whitehead
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Division of Neuroradiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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Russe MF, Rau A, Ermer MA, Rothweiler R, Wenger S, Klöble K, Schulze RKW, Bamberg F, Schmelzeisen R, Reisert M, Semper-Hogg W. A content-aware chatbot based on GPT 4 provides trustworthy recommendations for Cone-Beam CT guidelines in dental imaging. Dentomaxillofac Radiol 2024; 53:109-114. [PMID: 38180877 PMCID: PMC11003655 DOI: 10.1093/dmfr/twad015] [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: 10/30/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVES To develop a content-aware chatbot based on GPT-3.5-Turbo and GPT-4 with specialized knowledge on the German S2 Cone-Beam CT (CBCT) dental imaging guideline and to compare the performance against humans. METHODS The LlamaIndex software library was used to integrate the guideline context into the chatbots. Based on the CBCT S2 guideline, 40 questions were posed to content-aware chatbots and early career and senior practitioners with different levels of experience served as reference. The chatbots' performance was compared in terms of recommendation accuracy and explanation quality. Chi-square test and one-tailed Wilcoxon signed rank test evaluated accuracy and explanation quality, respectively. RESULTS The GPT-4 based chatbot provided 100% correct recommendations and superior explanation quality compared to the one based on GPT3.5-Turbo (87.5% vs. 57.5% for GPT-3.5-Turbo; P = .003). Moreover, it outperformed early career practitioners in correct answers (P = .002 and P = .032) and earned higher trust than the chatbot using GPT-3.5-Turbo (P = 0.006). CONCLUSIONS A content-aware chatbot using GPT-4 reliably provided recommendations according to current consensus guidelines. The responses were deemed trustworthy and transparent, and therefore facilitate the integration of artificial intelligence into clinical decision-making.
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Affiliation(s)
- Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Alexander Rau
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
- Department of Neuroradiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Michael Andreas Ermer
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - René Rothweiler
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Sina Wenger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Klara Klöble
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Ralf K W Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Bern 3010, Switzerland
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Marco Reisert
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
- Department of Stereotactic and Functional Neurosurgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Wiebke Semper-Hogg
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
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Ruiz DC, Reis LDO, Fontenele RC, Miranda-Viana M, Farias-Gomes A, Freitas DQ. Influence of an adjacent zirconium implant, tube current, and metal artifact reduction algorithm on horizontal root fracture diagnosis in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:190-198. [PMID: 37940483 DOI: 10.1016/j.oooo.2023.10.001] [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: 06/15/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE We evaluated the influence of an adjacent zirconium implant, tube current (mA), and a metal artifact reduction algorithm (MARA) on horizontal root fracture (HRF) diagnosis in cone beam computed tomography (CBCT). STUDY DESIGN Nineteen teeth (9 with HRF, 10 without) were individually placed in a human maxilla. Scan volumes were acquired without and with a zirconium implant adjacent to the tooth at settings of 4, 8, and 10 mA, with MARA disabled and enabled, using a 5×5 cm field of view, 0.085-mm voxel size, and 90 kV. Four maxillofacial radiologists individually assessed the scans. Diagnostic metrics were compared by multiway analysis of variance (α=5%). Inter- and intraexaminer agreements for HRF diagnosis were evaluated with the weighted kappa test. RESULTS Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were significantly lower in the presence of the implant (P≤.005). AUC values were higher in scans obtained with 8 and 10 mA compared with 4 mA (P=0.010), but 10 mA without MARA was better with the implant present. MARA did not significantly influence outcomes (P≥0.240). Inter- and intraexaminer agreements ranged from moderate to almost perfect. CONCLUSIONS The presence of the zirconium implant impairs HRF detection. Settings of 8 or 10 mA improve HRF detection regardless MARA condition without the implant. With an adjacent implant, 10 mA without MARA is recommended to improve diagnostic performance.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Murilo Miranda-Viana
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias-Gomes
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Ríos-Osorio N, Quijano-Guauque S, Briñez-Rodríguez S, Velasco-Flechas G, Muñoz-Solís A, Chávez C, Fernandez-Grisales R. Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications. Restor Dent Endod 2024; 49:e1. [PMID: 38449497 PMCID: PMC10912545 DOI: 10.5395/rde.2024.49.e1] [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: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024] Open
Abstract
The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.
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Affiliation(s)
- Néstor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sara Quijano-Guauque
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sandra Briñez-Rodríguez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Gustavo Velasco-Flechas
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | | | - Carlos Chávez
- Postgraduate Endodontics Department, IMED, Guadalajara, México
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Zaman MU. Comparing Radiation Doses in CBCT and Medical CT Imaging for Dental Applications. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S883-S885. [PMID: 38595575 PMCID: PMC11001137 DOI: 10.4103/jpbs.jpbs_1077_23] [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: 10/18/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background We are always concerned about radiation exposure during dental imaging procedures. We explore the crucial differences in radiation doses between Cone Beam Computed Tomography (CBCT) and Medical computed tomography (CT) imaging, aiming to shed light on the safety and efficiency of these techniques. Materials and Methods In this study, we conducted a comprehensive analysis using state-of-the-art dental imaging equipment. We employed phantoms that simulated real dental scenarios, ensuring accuracy in our measurements. The radiation doses were measured with precision dosimeters, and various exposure settings were tested to obtain a comprehensive dataset. Results Our findings reveal substantial differences in radiation doses between CBCT and Medical CT for dental applications. In the case of CBCT, the average effective dose was found to be approximately 100 microsieverts (μSv), making it a preferable choice for routine dental imaging. Medical CT, on the other hand, yielded significantly higher radiation exposure, with an average effective dose exceeding 500 μSv, emphasizing its need for specific clinical scenarios. Conclusion In conclusion, the choice between CBCT and Medical CT for dental applications should be made with careful consideration of radiation dose implications. CBCT emerges as the safer and more efficient option for routine dental imaging, offering a lower radiation burden to patients while still delivering high-quality diagnostic images. However, Medical CT may be necessary for specialized cases where the additional radiation risk is justified by diagnostic requirements.
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Affiliation(s)
- Mahmud U. Zaman
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Al-Kharj, Saudi Arabia
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Heller ZA, Hogge M, Ragan MR, Portnof JE. Applications of Cone Beam Computed Tomography Scans in Dental Medicine and Potential Medicolegal Issues. Dent Clin North Am 2024; 68:55-65. [PMID: 37951637 DOI: 10.1016/j.cden.2023.07.009] [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] [Indexed: 11/14/2023]
Abstract
A cone beam central tomography (CBCT) scan produces images in orthogonal and non-orthogonal with great spatial resolution. When a dental health care practitioner (DHP) orders a CBCT scan, they should consider if it is truly indicated, as CBCT scans carry up to four times the dosage of radiation compared to panoramic radiographs. Any diagnostic imaging obtained of a patient should include a formal interpretive report commenting on the findings within the imaging. Ordering of limited field of view (FOV) CBCT scans and failing to report on abnormal findings present outside of the region of interest (ROI) is a potential medicolegal issue.
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Affiliation(s)
- Zachary A Heller
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA.
| | - Maritzabel Hogge
- Department of Maxillofacial Medicine, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Michael R Ragan
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Jason E Portnof
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA; Private Practice, 9980 North Central Park Boulevard, Suite 113, Boca Raton, FL 33428, USA
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Li J, Joda T, Revilla-León M, Saleh MHA, Chen Z, Wang HL. Recommendations for successful virtual patient-assisted esthetic implant rehabilitation: A guide for optimal function and clinical efficiency. J ESTHET RESTOR DENT 2024; 36:186-196. [PMID: 37792734 DOI: 10.1111/jerd.13142] [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: 07/15/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Complete arch implant rehabilitation necessitates meticulous treatment planning and high-level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient-assisted esthetic implant rehabilitation workflow. OVERVIEW This article summarizes recommendations for virtual patient-assisted esthetic implant rehabilitation in the following five aspects: three-dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face- and prosthetic-driven surgical planning, reuse of presurgical data ("Copy & Paste"), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete-mouth implant rehabilitation completed within six visits using this virtual patient workflow is presented. CONCLUSION The virtual patient workflow serves as an invaluable tool to perform treatment planning, enhance efficiency, and ensure predictable outcomes in esthetic complete arch implant rehabilitation. CLINICAL SIGNIFICANCE Virtual workflows are increasingly prevalent in esthetic implant rehabilitation. Nevertheless, these workflows necessitate a distinct set of knowledge and tools divergent from conventional dentistry practices. This article offers guidelines and recommendations for dental clinicians who are new to this field.
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Affiliation(s)
- Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Graduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Adames C, Gaêta-Araujo H, Franco A, Soares MQS, Junqueira JLC, Oenning AC. Influence of CBCT-derived panoramic curve variability in the measurements for dental implant planning. Oral Radiol 2024; 40:30-36. [PMID: 37540349 DOI: 10.1007/s11282-023-00703-9] [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: 04/14/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. METHODS Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. RESULTS The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68-100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). CONCLUSION Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning.
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Affiliation(s)
- Cyntia Adames
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Hugo Gaêta-Araujo
- Division of Oral Radiology, School of Dentistry, University of São Paulo (FORP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Ademir Franco
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil.
| | - Mariana Quirino Silveira Soares
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
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Xavier PNI, Vizzotto MB, Arús NA, Tiecher PFDS, Gamba TDO, Fontana MP, Beltrão RG, da Silveira HLD. Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study. Clin Oral Implants Res 2023; 34:1385-1394. [PMID: 37752682 DOI: 10.1111/clr.14182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/23/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. METHODS Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. RESULTS There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). CONCLUSION The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.
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Affiliation(s)
- Paula N I Xavier
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana B Vizzotto
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Nádia Assein Arús
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Priscila F da S Tiecher
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Thiago de Oliveira Gamba
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Pante Fontana
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Heraldo L D da Silveira
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, 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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Jahanshahiafshar Z, Ghorbani H, Seyedmajidi M, Nabahati M, Ebrahimnejad Gorji K, Seyedmajidi S, Moudi E. Genotoxic and Cytotoxic Effects of Cone Beam Computed Tomography and Multidetector Computed Tomography on Exfoliated Buccal Epithelial Cells. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:572-581. [PMID: 38094288 PMCID: PMC10715117 DOI: 10.30476/ijms.2023.96522.2807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/22/2022] [Accepted: 12/25/2022] [Indexed: 12/18/2023]
Abstract
Background Cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) are frequently used in dental and maxillofacial problems. This study aimed to assess the genotoxicity and cytotoxicity effects of CBCT and MDCT radiographies on exfoliated buccal epithelial cells during dental examinations. Methods This prospective experimental study was conducted at Babol University of Medical Sciences (Babol, Iran) from March 2021 to April 2021. Buccal mucosa smears were collected bilaterally pre-exposure and 12 days after CBCT or MDCT examinations. To compare the frequency of micronuclei and other cytotoxic cellular changes such as pyknosis, karyolysis, and karyorrhexis, the paired sample t test and Wilcoxon test were used. In addition, independent sample t test, Mann-Whitney, and Chi square tests were used to investigate the differences between the imaging methods and between men and women. All statistical analyses were performed using the SPSS software, and P≤0.05 was considered statistically significant. Results The current study included 60 adult patients (30 patients in each group), ranging in age from 21 to 50 years. The micronuclei and the other cytotoxic cellular changes increased significantly after CBCT and MDCT radiographic examinations on the 12th day compared to the pre-exposure results (P<0.001). MDCT had statistically higher cytotoxic and genotoxic effects than CBCT (9.4%, 23.1%, and 40% higher values in micronucleus frequency, the mean frequency of micronuclei, and other cytotoxic changes, respectively). There were no significant differences between men and women in the two examination methods (P=0.46 and P=0.49, respectively). Conclusion Dental examinations with CBCT and MDCT can increase cytotoxicity and chromosomal damage in both men and women. Due to its lower radiation toxicities, CBCT can be recommended as an alternative to MDCT for dental examinations.
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Affiliation(s)
| | - Hakimeh Ghorbani
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Seyedmajidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Nabahati
- Department of Radiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Kourosh Ebrahimnejad Gorji
- Department of Medical Physics, Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Seyedali Seyedmajidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Moudi
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Yeshua T, Ladyzhensky S, Abu-Nasser A, Abdalla-Aslan R, Boharon T, Itzhak-Pur A, Alexander A, Chaurasia A, Cohen A, Sosna J, Leichter I, Nadler C. Deep learning for detection and 3D segmentation of maxillofacial bone lesions in cone beam CT. Eur Radiol 2023; 33:7507-7518. [PMID: 37191921 DOI: 10.1007/s00330-023-09726-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To develop an automated deep-learning algorithm for detection and 3D segmentation of incidental bone lesions in maxillofacial CBCT scans. METHODS The dataset included 82 cone beam CT (CBCT) scans, 41 with histologically confirmed benign bone lesions (BL) and 41 control scans (without lesions), obtained using three CBCT devices with diverse imaging protocols. Lesions were marked in all axial slices by experienced maxillofacial radiologists. All cases were divided into sub-datasets: training (20,214 axial images), validation (4530 axial images), and testing (6795 axial images). A Mask-RCNN algorithm segmented the bone lesions in each axial slice. Analysis of sequential slices was used for improving the Mask-RCNN performance and classifying each CBCT scan as containing bone lesions or not. Finally, the algorithm generated 3D segmentations of the lesions and calculated their volumes. RESULTS The algorithm correctly classified all CBCT cases as containing bone lesions or not, with an accuracy of 100%. The algorithm detected the bone lesion in axial images with high sensitivity (95.9%) and high precision (98.9%) with an average dice coefficient of 83.5%. CONCLUSIONS The developed algorithm detected and segmented bone lesions in CBCT scans with high accuracy and may serve as a computerized tool for detecting incidental bone lesions in CBCT imaging. CLINICAL RELEVANCE Our novel deep-learning algorithm detects incidental hypodense bone lesions in cone beam CT scans, using various imaging devices and protocols. This algorithm may reduce patients' morbidity and mortality, particularly since currently, cone beam CT interpretation is not always preformed. KEY POINTS • A deep learning algorithm was developed for automatic detection and 3D segmentation of various maxillofacial bone lesions in CBCT scans, irrespective of the CBCT device or the scanning protocol. • The developed algorithm can detect incidental jaw lesions with high accuracy, generates a 3D segmentation of the lesion, and calculates the lesion volume.
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Affiliation(s)
- Talia Yeshua
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
| | - Shmuel Ladyzhensky
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
| | - Amal Abu-Nasser
- Oral Maxillofacial Imaging, Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ragda Abdalla-Aslan
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Tami Boharon
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Avital Itzhak-Pur
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Asher Alexander
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Adir Cohen
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Sosna
- Department of Radiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Isaac Leichter
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
- Department of Radiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chen Nadler
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
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Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. Saudi Dent J 2023; 35:780-784. [PMID: 38025595 PMCID: PMC10658366 DOI: 10.1016/j.sdentj.2023.07.005] [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: 04/09/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. AIM To understand the importance of root morphology in endodontic treatment. METHODOLOGY A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. RESULTS CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. CONCLUSION The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.
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Affiliation(s)
- Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudia Arabia
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Biun J, Dudhia R, Arora H. The in-vitro accuracy of fiducial marker-based versus markerless registration of an intraoral scan with a cone-beam computed tomography scan in the presence of restoration artifact. Clin Oral Implants Res 2023; 34:1257-1266. [PMID: 37602506 DOI: 10.1111/clr.14166] [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: 05/24/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To determine the effect of restoration artifact ('metal artifact') on registration accuracy of an intraoral scan and cone-beam computed tomography (CBCT) scan, comparing fiducial marker-based registration with markerless registration. MATERIALS AND METHODS A maxillary model was fitted with multiple configurations of zirconia crowns to simulate various states of oral rehabilitation. Intraoral scans and CBCT scans (half and full rotation) were acquired. Registration was performed using markerless (point-based registration with surface-based refinement) and fiducial marker-based registration. Each experimental condition was repeated 10 times (n = 320). The absolute deviation was measured at the canines and first molars, and the average and maximum values were analysed using multiple linear regression. RESULTS R2 was 0.874 for average error and 0.858 for maximum error. For markerless registration, there were 0.041 mm (p < .001) and 0.045 mm (p < .001) increases in average and maximum error per crown, respectively. For fiducial marker-based registration, the effect of additional crowns was not statistically significant for average (p = .067) or maximum (p = .438) error. For a full arch of crowns, the regression model predicted average and maximum errors of 0.581 and 0.697 mm for the markerless technique, and 0.185 and 0.210 mm for the fiducial marker-based technique. Overall, the fiducial marker-based technique was more accurate for four or more crowns. The half rotation scan increased average error by 0.021 mm (p = .001) and maximum error by 0.029 mm (p < .001). CONCLUSIONS Under the present study's experimental conditions, the fiducial marker-based technique should be considered if four or more full-coverage highly radiopaque restorations are present.
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Affiliation(s)
- John Biun
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Raahib Dudhia
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Himanshu Arora
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Cascante-Sequeira D, Coelho-Silva F, Lopes Rosado LP, Lucca LV, Queiroz Freitas D, Lins de-Azevedo-Vaz S, Haiter-Neto F. Does cone-beam CT convex triangular field of view influence the image shape distortion of high-density materials? Dentomaxillofac Radiol 2023; 52:20230029. [PMID: 37427699 DOI: 10.1259/dmfr.20230029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES To assess the distortion of high-density materials using two CBCT devices presenting convex triangular and cylindrical fields of view (FOVs). METHODS AND MATERIALS Four high-density cylinders were individually placed in a polymethylmethacrylate phantom. 192 CBCT scans were acquired using the convex triangular and cylindrical FOVs of Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Using HorosTM's software, two oral radiologists determined the cylinders' horizontal and vertical dimensional alterations. Nine oral radiologists subjectively identified each cylinder's axial shape distortion. Statistical analysis comprised Multiway ANOVA (α = 5%), and the Kruskal-Wallis test. RESULTS The distortion in the axial plane was greater in the convex triangular FOVs for both devices in almost all the materials (p < 0.05). The evaluators subjectively identified a shape distortion in both FOVs for R100 device (p < 0.001), while no distortion was identified for X800 device (p = 0.620). A vertical magnification of all materials was observed in both FOVs for both devices (p < 0.05). No differences among vertical regions (p = 0.988) nor FOVs (p = 0.544) were found for the R100 device, while all materials showed higher magnification in all regions in the cylindrical FOV (p < 0.001) of the X800 device. CONCLUSIONS The convex triangular FOV influenced the axial distortion of the high-density materials in both devices. A vertical magnification was observed in both FOVs of both devices, but it was greater in the cylindrical FOV of the X800 device.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Surgery, Division of Oral Radiology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, Espírito Santo, Brazil
| | - Luiza Valdemarca Lucca
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Ramage A, Lopez Gutierrez B, Fischer K, Sekula M, Santaella GM, Scarfe W, Brasil DM, de Oliveira-Santos C. Filtered back projection vs. iterative reconstruction for CBCT: effects on image noise and processing time. Dentomaxillofac Radiol 2023; 52:20230109. [PMID: 37665027 DOI: 10.1259/dmfr.20230109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES To assess the effect of standard filtered back projection (FBP) and iterative reconstruction (IR) methods on CBCT image noise and processing time (PT), acquired with various acquisition parameters with and without metal artefact reduction (MAR). METHODS CBCT scans using the Midmark EIOS unit of a human mandible embedded in soft tissue equivalent material with and without the presence of an implant at mandibular first molar region were acquired at various acquisition settings (milliamperages [4mA-14mA], FOV [5 × 5, 6 × 8, 9 × 10 cm], and resolutions [low, standard, high] and reconstructed using standard FBP and IR, and with and without MAR. The processing time was recorded for each reconstruction. ImageJ was used to analyze specific axial images. Radial transaxial fiducial lines were created relative to the implant site. Standard deviations of the gray density values (image noise) were calculated at fixed distances on the fiducial lines on the buccal and lingual aspects at specific axial levels, and mean values for FBP and IR were compared using paired t-tests. Significance was defined as p < 0.05. RESULTS The overall mean for image noise (± SD) for FBP was 198.65 ± 55.58 and 99.84 ± 16.28 for IR. IR significantly decreased image noise compared to FBP at all acquisition parameters (p < 0.05). Noise reduction among different scanning protocols ranged between 29.7% (5 × 5 cm FOV) and 58.1% (5mA). IR increased processing time by an average of 35.1 s. CONCLUSIONS IR significantly reduces CBCT image noise compared to standard FBP without substantially increasing processing time.
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Affiliation(s)
- Amanda Ramage
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - Kathleen Fischer
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - William Scarfe
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Kuusisto N, Abushahba F, Syrjänen S, Huumonen S, Vallittu P, Närhi T. Zirconia implants interfere with the evaluation of peri-implant bone defects in cone beam computed tomography (CBCT) images even with artifact reduction, a pilot study. Dentomaxillofac Radiol 2023; 52:20230252. [PMID: 37641961 DOI: 10.1259/dmfr.20230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Three-dimensional cone beam computed tomography (CBCT) imaging can be considered, especially in patients with complicated peri-implantitis (PI). Artifacts induced by dense materials are the drawback of CBCT imaging and the peri-implant bone condition may not be assessed reliably because the artifacts are present in the same area. This pilot study investigates the performance of the artifact reduction algorithm (ARA) of the Planmeca Viso G7 CBCT device (Planmeca, Helsinki, Finland) with three different implant materials and imaging parameters. METHODS Three pairs of dental implants consisting of titanium, zirconia, and fiber reinforced composite (FRC) were set into a pig mandible. A vertical defect simulating peri-implantitis bone loss was made on the buccal side of one of each implant. The defect was identified and measured by two observers and compared to the actual dimensions. In addition, the bone structure and the marginal cortex visibility between the implants were estimated visually. RESULTS The bone defect and its dimensions with the zirconia implant could not be identified in any image with or without the metal artifact reduction algorithm. The bone defect of titanium and FRC implants were identified with all three imaging parameters or even without ARA. The interobserver agreement between the two observers was almost perfect for all categories analyzed. CONCLUSION Peri-implantitis defect of the zirconia implant and the peri-implant bone structure of the zirconia implants cannot be recognized reliably with any ARA levels, or any imaging parameters used with the Planmeca Viso G7. The need for ARA when imaging the peri-implant bone condition of the titanium and FRC implants may be unnecessary.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, City of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
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Halder M, Chhaparwal Y, Patil V, Smriti K, Chhaparwal S, Pentapati KC. Quantitative and Qualitative Correlation of Mandibular Lingual Bone with Risk Factors for Third Molar Using Cone Beam Computed Tomography. Clin Cosmet Investig Dent 2023; 15:267-277. [PMID: 37928771 PMCID: PMC10624182 DOI: 10.2147/ccide.s428908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/15/2023] [Indexed: 11/07/2023] Open
Abstract
Background Lingual plate thickness, density, and proximity to the tooth are linked as risk factors for various complications associated with third molar extraction. The present study aimed to assess the lingual plate thickness, and density in the mandibular third molar region using cone beam computed tomography and to estimate its correlation with type and level of impaction, number of roots, age, and gender as the risk factors. Methods This was a retrospective study on CBCT images of 648 mandibular third molars. The lingual plate thickness at three different root levels - cervical, mid-root, and apex along with the position of the tooth, number of roots, density of lingual plate, age, and gender were evaluated. The measurements were done on Invivo 5-Anatomage software. Statistical comparison of the categorical variables was done by Chi-square test, and Fisher's exact test, and univariate and multivariate analysis were done using binomial logistic regression. Results Lingual plate thickness of the third molars at the cervical, mid root, and apex were 1.28 mm, 1.42 mm and .01 mm (mean). A significantly higher proportion of subjects with thin lingual plates at mid-root (p-value=0.01) and apex (p-value=0.05) were in the 21-30 age group. Lingual bone density was significantly associated with the thickness of the lingual plate at the mid-root. A significantly higher proportion of thinner lingual plates at the mid-root level were associated with mesioangularly placed third molars (p-value=0.002). Conclusion Our study presented that lingual plate thickness has a strong association with age, angulation, and the number of roots. Knowledge about these risk factors is imperative during the management of third molar impactions.
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Affiliation(s)
- Mehuli Halder
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Yogesh Chhaparwal
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shubha Chhaparwal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kalyana C Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Miragall MF, Knoedler S, Kauke-Navarro M, Saadoun R, Grabenhorst A, Grill FD, Ritschl LM, Fichter AM, Safi AF, Knoedler L. Face the Future-Artificial Intelligence in Oral and Maxillofacial Surgery. J Clin Med 2023; 12:6843. [PMID: 37959310 PMCID: PMC10649053 DOI: 10.3390/jcm12216843] [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: 10/06/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Artificial intelligence (AI) has emerged as a versatile health-technology tool revolutionizing medical services through the implementation of predictive, preventative, individualized, and participatory approaches. AI encompasses different computational concepts such as machine learning, deep learning techniques, and neural networks. AI also presents a broad platform for improving preoperative planning, intraoperative workflow, and postoperative patient outcomes in the field of oral and maxillofacial surgery (OMFS). The purpose of this review is to present a comprehensive summary of the existing scientific knowledge. The authors thoroughly reviewed English-language PubMed/MEDLINE and Embase papers from their establishment to 1 December 2022. The search terms were (1) "OMFS" OR "oral and maxillofacial" OR "oral and maxillofacial surgery" OR "oral surgery" AND (2) "AI" OR "artificial intelligence". The search format was tailored to each database's syntax. To find pertinent material, each retrieved article and systematic review's reference list was thoroughly examined. According to the literature, AI is already being used in certain areas of OMFS, such as radiographic image quality improvement, diagnosis of cysts and tumors, and localization of cephalometric landmarks. Through additional research, it may be possible to provide practitioners in numerous disciplines with additional assistance to enhance preoperative planning, intraoperative screening, and postoperative monitoring. Overall, AI carries promising potential to advance the field of OMFS and generate novel solution possibilities for persisting clinical challenges. Herein, this review provides a comprehensive summary of AI in OMFS and sheds light on future research efforts. Further, the advanced analysis of complex medical imaging data can support surgeons in preoperative assessments, virtual surgical simulations, and individualized treatment strategies. AI also assists surgeons during intraoperative decision-making by offering immediate feedback and guidance to enhance surgical accuracy and reduce complication rates, for instance by predicting the risk of bleeding.
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Affiliation(s)
- Maximilian F. Miragall
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Rakan Saadoun
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Alex Grabenhorst
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Florian D. Grill
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Lucas M. Ritschl
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Andreas M. Fichter
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Ali-Farid Safi
- Craniologicum, Center for Cranio-Maxillo-Facial Surgery, 3011 Bern, Switzerland;
- Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Issa J, Riad A, Olszewski R, Dyszkiewicz-Konwińska M. The Influence of Slice Thickness, Sharpness, and Contrast Adjustments on Inferior Alveolar Canal Segmentation on Cone-Beam Computed Tomography Scans: A Retrospective Study. J Pers Med 2023; 13:1518. [PMID: 37888129 PMCID: PMC10608141 DOI: 10.3390/jpm13101518] [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: 09/09/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023] Open
Abstract
This retrospective study aims to investigate the impact of cone-beam computed tomography (CBCT) viewing parameters such as contrast, slice thickness, and sharpness on the identification of the inferior alveolar nerve (IAC). A total of 25 CBCT scans, resulting in 50 IACs, were assessed by two investigators using a three-score system (good, average, and poor) on cross-sectional images. Slice thicknesses of 0.25 mm, 0.5 mm, and 1 mm were tested, along with varying sharpness (0, 6, 8, and 10) and contrast (0, 400, 800, and 1200) settings. The results were statistically analyzed to determine the optimal slice thickness for improved visibility of IAC, followed by evaluating the influence of sharpness and contrast using the optimal thickness. The identified parameters were then validated by performing semi-automated segmentation of the IACs and structure overlapping to evaluate the mean distance. Inter-rater and intra-rater reliability were assessed using Kappa statistics, and inferential statistics used Pearson's Chi-square test. Inter-rater and intra-rater reliability for all parameters were significant, ranging from 69% to 83%. A slice thickness of 0.25 mm showed consistently "good" visibility (80%). Sharpness values of zero and contrast values of 1200 also demonstrated high frequencies of "good" visibility. Overlap analysis resulted in an average mean distance of 0.295 mm and a standard deviation of 0.307 mm across all patients' sides. The study revealed that a slice thickness of 0.25 mm, zero sharpness value, and higher contrast value of 1200 improved the visibility and accuracy of IAC segmentation in CBCT scans. The individual patient's characteristics, such as anatomical variations, decreased bone density, and absence of canal walls cortication, should be considered when using these parameters.
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Affiliation(s)
- Julien Issa
- Department of Diagnostics, Poznań University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
- Doctoral School, Poznań University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, 35392 Giessen, Germany
| | - Raphael Olszewski
- Department of Oral and Maxilofacial Surgery, Cliniques Universitaires Saint Luc, UCLouvain, Av. Hippocrate 10, 1200 Brussels, Belgium
- Oral and Maxillofacial Surgery Research Lab (OMFS Lab), NMSK, Institut de Recherche Experimentale et Clinique, UCLouvain, Louvain-la-Neuve, 1348 Brussels, Belgium
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Cascante-Sequeira D, Fontenele RC, Martins LAC, Brasil DM, Oliveira ML, Freitas DQ, Haiter-Neto F. Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography? Dentomaxillofac Radiol 2023; 52:20230147. [PMID: 37493606 PMCID: PMC10552126 DOI: 10.1259/dmfr.20230147] [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: 03/29/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT). METHODS AND MATERIALS Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material. RESULTS The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p < 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p < 0.0001). CONCLUSION The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, United States of America
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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