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Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ. Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ. Braz Dent J 2018; 28:511-516. [PMID: 29160405 DOI: 10.1590/0103-6440201701525] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.
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Affiliation(s)
- Helena Aguiar Ribeiro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | | | | | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | - Flavia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
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202
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Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. Am J Orthod Dentofacial Orthop 2018; 154:15-25. [DOI: 10.1016/j.ajodo.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 10/28/2022]
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203
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Peacock ZS, Krishnan DG. Advances in Imaging Over 100 Years: The Impact on Oral and Maxillofacial Surgery. J Oral Maxillofac Surg 2018; 76:1387-1399. [DOI: 10.1016/j.joms.2018.02.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 02/28/2018] [Accepted: 02/28/2018] [Indexed: 01/08/2023]
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204
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Freitas DQ, Fontenele RC, Nascimento EHL, Vasconcelos TV, Noujeim M. Influence of acquisition parameters on the magnitude of cone beam computed tomography artifacts. Dentomaxillofac Radiol 2018; 47:20180151. [PMID: 29916722 DOI: 10.1259/dmfr.20180151] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AIM To evaluate the influence of kilovoltage (kVp) and metal artifact reduction tool (MAR) on the magnitude of cone beam CT (CBCT) artifacts. METHODS A titanium and zirconia implants were inserted alternately in a posterior region of a mandible. CBCT exams were acquired with ProMax 3D (Planmeca Oy, Helsinki, Finland) and Picasso Trio machines (Vatech, Hwaseong, South Korea) using 70 kVp, 80 kVp and 90 kVp with and without MAR activation. The other exposure factors remained fixed at 5mA, field of view 80 × 50 mm and voxel 0.20 mm. The scans were performed before and after the insertion of the implants. Regions of interest were determined in different distances from the artifact production area (15, 25 and 35 mm) in an axial image, in which standard deviation (SD) of grayscale values was measured and contrast-to-noise ratio (CNR) was calculated. Analysis of variance was used to compare the data. RESULTS Overall, in cases where the artifact was pronounced, MAR was efficient in reducing SD values. MAR also improved the CNR of ProMax images, but did not affect the Picasso images. Additionally, the higher was the kVp, the lower was the SD value and the higher was the CNR in both machines. CONCLUSION In both machines, increasing kVp and MAR are effective in decreasing the CBCT artifacts in all their magnitude when they are pronounced. Therefore, the professionals should choose one of those options or even both considering the purpose of the CBCT imaging and radiation dose for the patient.
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Affiliation(s)
- Deborah Queiroz Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Limeira , Brazil
| | - Rocharles Cavalcante Fontenele
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Limeira , Brazil
| | | | | | - Marcel Noujeim
- 3 Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio , San Antonio, TX , United States
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Ozemre MO, Gulsahi A. Comparison of the accuracy of full head cone beam CT images obtained using a large field of view and stitched images. Dentomaxillofac Radiol 2018; 47:20170454. [PMID: 29851353 DOI: 10.1259/dmfr.20170454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE: The aim of this study was to investigate the accuracy of the new stitching feature of the Morita 3D Accuitomo device by comparing it with the I-CAT device and real measurements. METHODS: Eight dry skulls were used in this study. The full scan mode of an I-CAT device and the new stitching feature of the Morita 3D Accuitomo device were used to obtain full head cone beam CT (CBCT) images, and the linear distances between the selected anatomical sites were measured by two observers. The real distances were measured directly on the skulls using digital calipers. Statistical analyses were performed using the intraclass correlation coefficient and Bland-Altman Limits of Agreement. RESULTS: High or perfect agreement was detected between the CBCT images and real measurements. The Bland-Altman Limits of Agreement analysis revealed that the stitched coronal and sagittal images of the Morita might differ by >1.54-1.67 or <0.01 mm from the real measurements. CONCLUSIONS: The stitched images of the Morita CBCT device showed perfect agreement with both real measurements and the images of an I-CAT full head scan. After the evaluation of the radiation doses received from stitching sectional images, this device may be used to obtain full head images.
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Affiliation(s)
- Mehmet Ozgur Ozemre
- 1 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University , Ankara , Turkey
| | - Ayse Gulsahi
- 1 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University , Ankara , Turkey
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206
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Al-Ekrish AA, Alfadda SA, Ameen W, Hörmann R, Puelacher W, Widmann G. Accuracy of computer-aided design models of the jaws produced using ultra-low MDCT doses and ASIR and MBIR. Int J Comput Assist Radiol Surg 2018; 13:1853-1860. [PMID: 29909528 DOI: 10.1007/s11548-018-1809-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/06/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare the surface of computer-aided design (CAD) models of the maxilla produced using ultra-low MDCT doses combined with filtered backprojection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) reconstruction techniques with that produced from a standard dose/FBP protocol. METHODS A cadaveric completely edentulous maxilla was imaged using a standard dose protocol (CTDIvol: 29.4 mGy) and FBP, in addition to 5 low dose test protocols (LD1-5) (CTDIvol: 4.19, 2.64, 0.99, 0.53, and 0.29 mGy) reconstructed with FBP, ASIR 50, ASIR 100, and MBIR. A CAD model from each test protocol was superimposed onto the reference model using the 'Best Fit Alignment' function. Differences between the test and reference models were analyzed as maximum and mean deviations, and root-mean-square of the deviations, and color-coded models were obtained which demonstrated the location, magnitude and direction of the deviations. RESULTS Based upon the magnitude, size, and distribution of areas of deviations, CAD models from the following protocols were comparable to the reference model: FBP/LD1; ASIR 50/LD1 and LD2; ASIR 100/LD1, LD2, and LD3; MBIR/LD1. The following protocols demonstrated deviations mostly between 1-2 mm or under 1 mm but over large areas, and so their effect on surgical guide accuracy is questionable: FBP/LD2; MBIR/LD2, LD3, LD4, and LD5. The following protocols demonstrated large deviations over large areas and therefore were not comparable to the reference model: FBP/LD3, LD4, and LD5; ASIR 50/LD3, LD4, and LD5; ASIR 100/LD4, and LD5. CONCLUSIONS When MDCT is used for CAD models of the jaws, dose reductions of 86% may be possible with FBP, 91% with ASIR 50, and 97% with ASIR 100. Analysis of the stability and accuracy of CAD/CAM surgical guides as directly related to the jaws is needed to confirm the results.
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Affiliation(s)
- Asma'a A Al-Ekrish
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, 60169, Riyadh, 11545, Saudi Arabia.
| | - Sara A Alfadda
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, 60169, Riyadh, 11545, Saudi Arabia
| | - Wadea Ameen
- Department of Industrial Engineering, Advanced Manufacturing Institute, College of Engineering, King Saud University, 800, Riyadh, 11421, Saudi Arabia
| | - Romed Hörmann
- Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstrasse 59, 6020, Innsbruck, Austria
| | - Wolfgang Puelacher
- Department of CMF Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
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207
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Irradiation provided by dental radiological procedures in a pediatric population. Eur J Radiol 2018; 103:112-117. [DOI: 10.1016/j.ejrad.2018.04.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/06/2018] [Accepted: 04/21/2018] [Indexed: 11/20/2022]
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208
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Rozema R, Doff MH, van Ooijen PM, Postmus D, Westerlaan HE, Boomsma MF, van Minnen B. Diagnostic reliability of low dose multidetector CT and cone beam CT in maxillofacial trauma-an experimental blinded and randomized study. Dentomaxillofac Radiol 2018; 47:20170423. [PMID: 29745761 DOI: 10.1259/dmfr.20170423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To assess the diagnostic reliability of low dose multidetector CT (MDCT) and cone beam CT (CBCT) for zygomaticomaxillary fracture diagnosis. METHODS Unilateral zygomaticomaxillary fractures were inflicted on four out of six fresh frozen human cadaver head specimens. All specimens were scanned using four MDCT and two CBCT imaging protocols of which the radiation exposure was systematically reduced. A blinded diagnostic routine was simulated at which 16 radiologists and 8 oral and maxillofacial (OMF) surgeons performed randomized image assessments. We considered the findings during an open operative approach of the zygomatic region as the gold standard. RESULTS Zygomaticomaxillary fractures were correctly diagnosed in 90.3% (n = 130) of the image assessments. The zygomatic arch was most often correctly diagnosed (91.0%). The zygomatic alveolar crest showed the lowest degree of correct diagnosis (65.3%). Dose reduction did not significantly affect the objective visualization of fractures of the zygomaticomaxillary complex. The sensitivity and specificity also remained consistent among the low dose scan protocols. Dose reduction did not decrease the ability to assess dislocation, comminution, orbital volume, volume rendering and soft tissues. OMF surgeons considered the low dose protocols sufficient for treatment planning. CONCLUSIONS Dose reduction did not decrease the diagnostic reliability of MDCT and CBCT for the diagnosis of zygomaticomaxillary fractures.
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Affiliation(s)
- Romke Rozema
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | | | - Peter Ma van Ooijen
- 2 Center for Medical Imaging - North East Netherlands (CMI-NEN2), University Medical Center Groningen, University of Groningen, Groningen , Groningen , The Netherlands.,3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Douwe Postmus
- 4 Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Henriëtte E Westerlaan
- 3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Martijn F Boomsma
- 5 Department of Radiology, Isala Hospital , Zwolle , The Netherlands
| | - Baucke van Minnen
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
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209
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Shah H, Hernandez P, Budin F, Chittajallu D, Vimort JB, Walters R, Mol A, Khan A, Paniagua B. Automatic quantification framework to detect cracks in teeth. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10578. [PMID: 29769755 DOI: 10.1117/12.2293603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Studies show that cracked teeth are the third most common cause for tooth loss in industrialized countries. If detected early and accurately, patients can retain their teeth for a longer time. Most cracks are not detected early because of the discontinuous symptoms and lack of good diagnostic tools. Currently used imaging modalities like Cone Beam Computed Tomography (CBCT) and intraoral radiography often have low sensitivity and do not show cracks clearly. This paper introduces a novel method that can detect, quantify, and localize cracks automatically in high resolution CBCT (hr-CBCT) scans of teeth using steerable wavelets and learning methods. These initial results were created using hr-CBCT scans of a set of healthy teeth and of teeth with simulated longitudinal cracks. The cracks were simulated using multiple orientations. The crack detection was trained on the most significant wavelet coefficients at each scale using a bagged classifier of Support Vector Machines. Our results show high discriminative specificity and sensitivity of this method. The framework aims to be automatic, reproducible, and open-source. Future work will focus on the clinical validation of the proposed techniques on different types of cracks ex-vivo. We believe that this work will ultimately lead to improved tracking and detection of cracks allowing for longer lasting healthy teeth.
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Affiliation(s)
- Hina Shah
- Kitware, Inc. 101 East Weaver Street, Carrboro, NC, USA 25710
| | - Pablo Hernandez
- Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
| | - Francois Budin
- Kitware, Inc. 101 East Weaver Street, Carrboro, NC, USA 25710
| | | | | | - Rick Walters
- School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC, USA 27599
| | - André Mol
- School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC, USA 27599
| | - Asma Khan
- School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC, USA 27599
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210
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Marcu M, Hedesiu M, Salmon B, Pauwels R, Stratis A, Oenning ACC, Cohen ME, Jacobs R, Baciut M, Roman R, Dinu C, Rotaru H, Barbur I. Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D. Int J Paediatr Dent 2018; 28:300-309. [PMID: 29356184 DOI: 10.1111/ipd.12355] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND An increasing number of CBCT units and a wide variability of radiation doses have been reported in dentistry lately. AIM To estimate the effective, cumulative, and organ absorbed doses in children exposed to CBCT over 2 years. DESIGN A prospective study was conducted in children who underwent CBCT diagnostic imaging with the ProMax3D machine. Organ and effective doses were calculated by Monte Carlo simulation using 5- and 8-year-old pediatric voxel phantoms. Extrapolation procedures were applied to estimate doses for other ages and CBCT protocols used in clinical conditions. RESULTS The median effective dose was 137.9 μSv, and the median cumulative dose was 231.4 μSv. Statistically significant differences in the effective doses and cumulative doses were found for various indications of CBCT in children (P < 0.001). The median absorbed organ dose for brain and thyroid was significantly higher for the clinical condition that required large FOVs (2.5 mGy and 1.05 mGy, respectively) compared to medium (0.19 and 0.51 mGy) and small FOVs (0.07 and 0.24 mGy; P < 0.05). The radiation dose of salivary glands did not vary significantly with FOV. CONCLUSION The results revealed the variation of CBCT doses and the influence of FOV size in pediatric exposure.
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Affiliation(s)
- Maria Marcu
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Benjamin Salmon
- EA 2496-Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité, Paris, France
| | - Ruben Pauwels
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Andreas Stratis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anne Caroline Costa Oenning
- EA 2496-Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité, Paris, France.,Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba, Sao Paulo, Brazil
| | - Mike E Cohen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mihaela Baciut
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Roman
- Department of Oral Radiology, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotaru
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Maxillofacial Surgery, Faculty of Dentistry, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
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211
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Jadu FM, Alzahrani AA, Almutairi MA, Al-Amoudi SO, Jan AM, Khafaji MA. The effect of varying cone beam computed tomography image resolution and field-of-view centralization on effective radiation dose. Saudi Med J 2018; 39:470-475. [PMID: 29738006 PMCID: PMC6118184 DOI: 10.15537/smj.2018.5.21658] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/28/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate changes in the effective radiation dose (E) in relation to variations in voxel (VOX) size settings and the field-of-view (FOV) centralization. Methods: This cross-sectional dosimetry study used nanoDot OSLD dosimeters placed at 25 pre-determined sites in the head and neck slices of a RANDO male phantom to measure the absorbed radiation. The imaging scans took place at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia between September 2016 and May 2017 using the i-CAT classic cone beam computed tomography (CBCT) unit. Three VOX size setting were examined: 0.2 mm, 0.3 mm and 0.4 mm. The FOV was alternatively eccentrically centered on the maxillary and mandibular arches while holding all other factors constant. Effective radiation doses were calculated for each VOX size and FOV centralization setting. Results: An inverse and indirect relation was found between E and the VOX size setting with smaller VOX yielding higher E. CBCT scans centered on the mandible resulted in higher E than scans centered on the maxilla. Conclusion: Effective radiation doses are significantly affected by changes in VOX size settings and FOV centralization options. This reflects on the potential radiation risk to patients and highlights the importance of choosing exposure parameters carefully.
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Affiliation(s)
- Fatima M Jadu
- Division of Oral and Maxillofacial Radiology, Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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3D Comparison of Mandibular Response to Functional Appliances: Balters Bionator versus Sander Bite Jumping. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2568235. [PMID: 29854734 PMCID: PMC5941721 DOI: 10.1155/2018/2568235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/18/2018] [Indexed: 11/24/2022]
Abstract
Aim To assess the three-dimensional (3D) maxillomandibular and dental response to Balters Bionator (BB) and the Sander Bite Jumping Appliance (SBJA) in growing patients. Materials and Methods Twenty-seven Class II division 1 patients (13 males, 14 females), consecutively treated with either the BB (9 females, 7 males; 10.1 ± 1.6 years) or SBJA (5 females, 6 males; 11 ± 1.9 years), were collected from a single orthodontic practice. All patients presented overjet ≥5 mm, full Class II or end-to-end molar relationship, mandibular retrusion. CBCT scans were available at T1 and after removal of the functional appliances (T2) with a mean interval of 18 months. The 3D location and direction of skeletal and dental changes with growth and treatment were quantitatively assessed. Statistical analysis was performed by means of Mann–Whitney U test (p < 0.05). Results Patients treated with the SBJA and BB orthopedic appliances presented, respectively, 4.7 mm and 4.5 mm of 3D displacement of the chin, with marked ramus growth of, respectively, 3.7 mm and 2.3 mm. While the mandible and maxilla grew downward and forward, no opening of the mandible plane was observed. Both appliances adequately controlled labial inclination of lower incisors (1.3° and 0.3°, for the SBJA and BB groups, resp.). No significant between-group differences were found for the T2−T1 changes for any of the variables, with the exception of molar displacements (significantly greater in the SBJA group than in the BB group, 1.2 mm and 0.9 mm, resp.). Conclusions The maxillomandibular and dental growth responses to BB and SBJA therapies are characterized by vertical ramus growth and elongation of mandible that improve the maxillomandibular relationship with adequate control of lower incisor position.
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213
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Lim LZ, Padilla RJ, Reside GJ, Tyndall DA. Comparing panoramic radiographs and cone beam computed tomography: Impact on radiographic features and differential diagnoses. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:S2212-4403(18)30888-5. [PMID: 29748039 DOI: 10.1016/j.oooo.2018.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 03/13/2018] [Accepted: 03/26/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aims of this study were to determine whether lesion features appear differently on panoramic radiography (PAN) and cone beam computed tomography (CBCT), and whether the use of CBCT affects diagnostic accuracy and observers' confidence in comparison with PAN. STUDY DESIGN Three oral and maxillofacial radiologists reviewed 33 sets of PAN images and CBCT volumes of biopsy-proven lesions. They described 12 different lesion features and provided up to 3 ranked differential diagnoses, as well as their confidence with respect to those diagnoses. Their confidence was weighted by the rank at which the correct diagnosis was provided. RESULTS Odds ratios (ORs) were statistically significant for border definition (OR = 5.45; P = .004), continuity of border cortication (OR = 0.34; P = .035), effect on neurovascular canals (OR = 6.38; P = .043), expansion (OR = 18.56; P < .001), cortical thinning (OR = 30.22; P < .001), and cortical destruction (OR = 9.80; P < .001). There was no association between the 2 modalities and the rank at which the correct differential diagnoses were made or the observers' weighted confidence. CONCLUSIONS Before acquiring a CBCT scan to aid in the diagnosis of an intraosseous lesion, clinicians should consider the diagnostic information that is expected to be gained. In this study, although there were differences between PAN and CBCT with respect to some lesion features, CBCT did not help improve diagnostic accuracy.
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Affiliation(s)
- Li Zhen Lim
- Department of Diagnostic Sciences, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA.
| | - Ricardo J Padilla
- Department of Diagnostic Sciences, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - Glenn J Reside
- Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - Donald A Tyndall
- Department of Diagnostic Sciences, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
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Bornstein MM, Horner K, Jacobs R. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 2018; 73:51-72. [PMID: 28000270 DOI: 10.1111/prd.12161] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest.
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Amintavakoli N, Spivakovsky S. Cone-beam computed tomography or conventional radiography for localising of maxillary impacted canines? Evid Based Dent 2018; 19:22-23. [PMID: 29568018 DOI: 10.1038/sj.ebd.6401291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Data sourcesPubMed, Web of Science, CINHAL and the Cochrane Library were searched until May 2016. Unpublished data were searched in Pro-Quest Dissertation, Abstracts and Thesis and Google Scholar, supplemented with manual search of the included studies references. No language restriction was used.Study selectionAll types of study designs were included, except case reports, comparing CBCT data with conventional radiographs. The primary outcome was: diagnostic accuracy between modalities, agreement in position, treatment planning and outcome efficacy. The secondary outcome was intermodality agreement in lateral root resorption detection and intra and inter-observer agreement values.Data extraction and synthesisTwo reviewers independently selected the studies for inclusion, performed data extraction and evaluated risk of bias. Discrepancies were resolved by discussions and reaching consensus. The Newcastle-Ottawa Scale was used to assess the risk of bias for case-controlled and cohort studies and a modified version for cross-sectional studies. The Quality Assessment of Diagnostic Accuracy (QUADAS-2) tool was used to rate diagnostic accuracy studies.ResultsEight studies met the inclusion criteria, two on diagnostic accuracy. The remaining six included 292 impacted canines in 224 patients. Outcomes were presented as calculated level of agreement and statistical significance for each primary outcome reported. Based on the diagnostic accuracy of two in vitro studies, the CBCT accuracy ranged from 50% to 95% while for conventional radiographs it ranged from 39% to 85%.The other six studies reported inter-modalities agreement in localisation (six studies) and treatment planning agreement (three studies). The inter-modalities agreement varied from 0.20 to 0.82, with observed agreement of 64% to 84% in localisation of canine. The treatment planning agreement varied from 0.36 to 0.72.ConclusionsThe authors concluded that CBCT is more accurate than conventional radiographs in localising maxillary impacted canines and there is a broad range of inter-observer and modalities agreement for location and treatment planning. There is no robust evidence to support using CBCT as first line imaging method.
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Kim EK, Han WJ, Choi JW, Battulga B. Estimation of the effective dose of dental cone-beam computed tomography using personal computer-based Monte Carlo software. Imaging Sci Dent 2018; 48:21-30. [PMID: 29581946 PMCID: PMC5863016 DOI: 10.5624/isd.2018.48.1.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/22/2017] [Accepted: 12/28/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To calculate the effective doses of cone-beam computed tomography (CBCT) using personal computer-based Monte Carlo (PCXMC) software (Radiation and Nuclear Safety Authority, Helsinki, Finland) and to compare the calculated effective doses with those measured using thermoluminescent dosimeters (TLDs) and an anthropomorphic phantom. Materials and Methods An Alphard VEGA CBCT scanner (Asahi Roentgen Ind. Co., Kyoto, Japan) with multiple fields of view (FOVs) was used for this study. The effective doses of the scout and main projections of CBCT using 1 large and 2 medium FOVs with a height >10 cm were calculated using PCXMC and PCXMCRotation software and then were compared with the doses obtained using TLD-100 LiF and an anthropomorphic adult human male phantom. Furthermore, it was described how to determine the reference points on the Y- and Z-axes in PCXMC, the important dose-determining factors in this software. Results The effective doses at CBCT for 1 large (20.0 cm×17.9 cm) and 2 medium FOVs (15.4 cm×15.4 cm and 10.2 cm×10.2 cm) calculated by the PCXMC software were 181, 300, and 158 µSv, respectively. These values were comparable (16%–18% smaller) to those obtained through TLD measurements in each mode. Conclusion The use of PCXMC software could be an alternative to the TLD measurement method for effective dose estimation in CBCT with large and medium FOVs.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Won-Jeong Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Jin-Woo Choi
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Bulgan Battulga
- Dental Hospital, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Cone-beam CT in paediatric dentistry: DIMITRA project position statement. Pediatr Radiol 2018; 48:308-316. [PMID: 29143199 DOI: 10.1007/s00247-017-4012-9] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/11/2017] [Accepted: 10/11/2017] [Indexed: 01/05/2023]
Abstract
DIMITRA (dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks) is a European multicenter and multidisciplinary project focused on optimizing cone-beam CT exposures for children and adolescents. With increasing use of cone-beam CT for dentomaxillofacial diagnostics, concern arises regarding radiation risks associated with this imaging modality, especially for children. Research evidence concerning cone-beam CT indications in children remains limited, while reports mention inconsistent recommendations for dose reduction. Furthermore, there is no paper using the combined and integrated information on the required indication-oriented image quality and the related patient dose levels. In this paper, therefore, the authors initiate an integrated approach based on current evidence regarding image quality and dose, together with the expertise of DIMITRA's members searching for a state of the art. The aim of this DIMITRA position statement is to provide indication-oriented and patient-specific recommendations regarding the main cone-beam CT applications in the pediatric field. The authors will review this position statement document when results regarding multidisciplinary approaches evolve, in a period of 5 years or earlier.
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Kirnbauer B, Jakse N, Rugani P, Schwaiger M, Magyar M. Assessment of impacted and partially impacted lower third molars with panoramic radiography compared to MRI-a proof of principle study. Dentomaxillofac Radiol 2018; 47:20170371. [PMID: 29388826 DOI: 10.1259/dmfr.20170371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Third molars often require surgical removal. Since three-dimensional radiological assessment is often indicated in difficult cases to avoid surgical complications, the radiation burden has to be considered. Here, MRI may offer a dose-free alternative to conventional X-ray techniques. The aim of this retrospective analysis was to evaluate the assessment quality of MRI compared to panoramic radiography in impacted and partially impacted lower third molars. METHODS Panoramic radiographs and MRI scans of 28 Caucasian patients were assessed twice by four investigators. Wisdom teeth were classified according to Juodzbalys and Daugela 2013. RESULTS When radiological lower third molar assessments with panoramic radiography and MRI were compared, staging concurred in 73% in the first round of assessments and 77% in the second. CONCLUSIONS The presented study demonstrates that MRI not only provides much the same information that panoramic radiography usually does, but also has the advantages of a dose-free three-dimensional view. This may facilitate and shorten third molar surgery. Image interpretation, however, can differ depending on training and experience.
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Affiliation(s)
- Barbara Kirnbauer
- 1 Department of Oral surgery and Orthodontics, Medical University of Graz , Graz , Austria
| | - Norbert Jakse
- 1 Department of Oral surgery and Orthodontics, Medical University of Graz , Graz , Austria
| | - Petra Rugani
- 1 Department of Oral surgery and Orthodontics, Medical University of Graz , Graz , Austria
| | - Michael Schwaiger
- 2 Department of Maxillofacial surgery, Medical University of Graz , Graz , Austria
| | - Marton Magyar
- 3 Department of Radiology, Medical University of Graz , Graz , Austria
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Widmann G, Al-Ekrish AA. Ultralow Dose MSCT Imaging in Dental Implantology. Open Dent J 2018; 12:87-93. [PMID: 29492174 PMCID: PMC5814940 DOI: 10.2174/1874210601812010087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/20/2017] [Accepted: 01/05/2018] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION The Council Directive 2013/59 Euratom has a clear commitment for keeping medical radiation exposure as low as reasonably achievable and demands a regular review and use of diagnostic reference levels. METHODS In dental implantology, the range of effective doses for cone beam computed tomography (CBCT) shows a broad overlap with multislice computed tomography (MSCT). More recently, ultralow dose imaging with new generations of MSCT scanners may impart radiation doses equal to or lower than CBCT. Dose reductions in MSCT have been further facilitated by the introduction of iterative image reconstruction technology (IRT), which provides substantial noise reduction over the current standard of filtered backward projection (FBP). AIM The aim of this article is to review the available literature on ultralow dose CT imaging and IRTs in dental implantology imaging and to summarize their influence on spatial and contrast resolution, image noise, tissue density measurements, and validity of linear measurements of the jaws. CONCLUSION Application of ultralow dose MSCT with IRT technology in dental implantology offers the potential for very large dose reductions compared with standard dose imaging. Yet, evaluation of various diagnostic tasks related to dental implantology is still needed to confirm the results obtained with various IRTs and ultra-low doses so far.
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Affiliation(s)
- Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Asma'a A. Al-Ekrish
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Hayashi T, Arai Y, Chikui T, Hayashi-Sakai S, Honda K, Indo H, Kawai T, Kobayashi K, Murakami S, Nagasawa M, Naitoh M, Nakayama E, Nikkuni Y, Nishiyama H, Shoji N, Suenaga S, Tanaka R. Clinical guidelines for dental cone-beam computed tomography. Oral Radiol 2018; 34:89-104. [PMID: 30484133 DOI: 10.1007/s11282-018-0314-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/28/2022]
Abstract
Dental cone-beam computed tomography (CBCT) received regulatory approval in Japan in 2000 and has been widely used since being approved for coverage by the National Health Insurance system in 2012. This imaging technique allows dental practitioners to observe and diagnose lesions in the dental hard tissue in three dimensions (3D). When performing routine radiography, the examination must be justified, and optimal protection should be provided according to the ALARA (as low as reasonably achievable) principles laid down by the International Commission on Radiological Protection. Dental CBCT should be performed in such a way that the radiation exposure is minimized and the benefits to the patient are maximized. There is a growing demand for widespread access to cutting-edge health care through Japan's universal health insurance system. However, at the same time, people want our limited human, material, and financial resources to be used efficiently while providing safe health care at the least possible cost to society. Japan's aging population is expected to reach a peak in 2025, when most of the baby boomer generation will be aged 75 years or older. Comprehensive health care networks are needed to overcome these challenges. Against this background, we hope that this text will contribute to the nation's oral health by encouraging efficient use of dental CBCT.
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Affiliation(s)
- Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Toru Chikui
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Sachiko Hayashi-Sakai
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Hiroko Indo
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Kaoru Kobayashi
- Department of Oral and Maxillofacial Radiology and Diagnosis, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masako Nagasawa
- Division of Bio-Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Munetaka Naitoh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Eiji Nakayama
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Yutaka Nikkuni
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Noriaki Shoji
- Division of Oral Diagnosis, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Shigeaki Suenaga
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China
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Sato K. [9. Diagnostic Reference Levels for Dental Radiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:398-403. [PMID: 29681608 DOI: 10.6009/jjrt.2018_jsrt_74.4.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Kenji Sato
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University
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Abstract
Data sourcesMedline, Embase, relevant dental journals, reference lists of included studies and the World Health Organisation International Clinical Trials Registry.Study selectionStudies evaluating the predictive accuracy of panoramic radiography for postoperative inferior alveolar nerve (IAN) injury reporting on at least one of the seven signs of IAN injury and providing data to calculate false-positive (FP), true-positive (TP), false-negative (FN) and true-negative (TN) proportions were included.Data extraction and synthesisData were abstracted independently by two reviewers. Positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity were extracted or calculated. Overall pooled estimates of sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR) (LR-) and diagnostic odds ratio (DOR), with 95% confidence intervals (CIs) were calculated using a random effects model. Summary receiver operating characteristic (SROC) curves were also generated. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool (http://www.bristol.ac.uk/social-community-medicine/projects/quadas/quadas-2/).ResultsEight studies were included. Only one study was considered to be at low risk of bias, one at low risk and the remainder at unclear risk. A summary of the pooled sensitivity, specificity and diagnostic odds ratios are shown in the table.ConclusionsFor all seven signs, the added value of panoramic radiography is too low to consider it appropriate for ruling out postoperative IAN in the decision-making before MM3 surgery. The added value of panoramic radiography for determining the presence of diversion of the canal, interruption of the white line of the canal and darkening of the root can be considered sufficient for ruling in the risk of postoperative IAN injury in the decision-making before MM3 surgery.
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Tsapaki V. Radiation protection in dental radiology – Recent advances and future directions. Phys Med 2017; 44:222-226. [DOI: 10.1016/j.ejmp.2017.07.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/21/2017] [Accepted: 07/22/2017] [Indexed: 10/19/2022] Open
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da Fonte JB, Andrade TMD, Albuquerque RL, de Melo MDFB, Takeshita WM. Evidence of genotoxicity and cytotoxicity of X-rays in the oral mucosa epithelium of adults subjected to cone beam CT. Dentomaxillofac Radiol 2017; 47:20170160. [PMID: 29091472 DOI: 10.1259/dmfr.20170160] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess cytological evidence of genotoxicity and cytotoxicity of X-rays in oral exfoliated cells of adults subjected to partial and total cone beam CT (CBCT) (stitching module) by means of micronuclei frequency, associated with counting of degenerative nuclear alterations (pyknosis, karyolysis, karyorrhexis, buds and broken eggs), besides comparing the partial and total CBCT (stitching module) in search of possible differences in the nature and/or intensity of the effects. METHODS 29 adults who were referred to total or partial CBCT were selected. All CBCT were performed with a Carestream CS 9000 3D scanner (Carestream Health Inc., Rochester, NY). Material collection was done immediately before CBCT and 10 days later, by scraping the left and right cheek mucosa with a plastic spatula. Statistical analysis was performed using the Wilcoxon test (paired data), at a significance level of 5%. RESULTS The statistically significant difference was noted in the frequency of micronucleated cells for both partial and total acquisition (p = 0.008 and p < 0.001, respectively). Regarding to cytotoxicity, there was a statistically significant difference for both partial and total acquisition (p < 0.001 and p < 0.001, respectively). CONCLUSIONS The partial and total CBCT seems to offer risks of inducing genetic damage. In addition both forms of CBCT acquisition have promoted the induction of cytotoxic nuclear alterations.
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Affiliation(s)
- Juliana Bm da Fonte
- 1 Department of Dentistry, Master's Degree Program in Dentistry, Federal University of Sergipe, UFS, Aracaju, Brazil.,2 Department of Dentistry, Discipline of Radiology and Dental Imaging, Federal University of Sergipe, UFS Aracaju, Brazil
| | - Taís M de Andrade
- 3 Department of Dentistry, Federal University of Sergipe, UFS, Aracaju, Brazil
| | - Ricardo Lc Albuquerque
- 4 Department of Dentistry, Discipline of Oral and Maxillofacial Pathology, Tiradentes University, UNIT, Aracaju, Brazil
| | - Maria de Fátima B de Melo
- 2 Department of Dentistry, Discipline of Radiology and Dental Imaging, Federal University of Sergipe, UFS Aracaju, Brazil.,5 Departament of Oral Pathology, Radiology & Medicine, University of Iowa, Iowa, IA, USA
| | - Wilton M Takeshita
- 2 Department of Dentistry, Discipline of Radiology and Dental Imaging, Federal University of Sergipe, UFS Aracaju, Brazil
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Salineiro FCS, Kobayashi-Velasco S, Braga MM, Cavalcanti MGP. Radiographic diagnosis of root fractures: a systematic review, meta-analyses and sources of heterogeneity. Dentomaxillofac Radiol 2017; 46:20170400. [PMID: 28749700 DOI: 10.1259/dmfr.20170400] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Many studies to evaluate the accuracy of root fracture diagnosis have been conducted. However, there is a scarcity of studies to assess the quality and the sources of heterogeneity in the literature. For this reason, the aim of this study was to conduct systematic reviews and meta-analyses to summarize the available evidence on detection of root fractures by cone beam CT (CBCT) and periapical radiograph (PR) images and the interference of artefact by investigating possible sources of heterogeneity. METHODS Studies reporting root fracture detection, from January 2010 to February 2016, were selected. All selected studies were subjected to selection criteria and then, comparative and qualitative analyses by using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool were performed. Pooled sensitivity, specificity and diagnostic odds ratios were calculated. Also, receiver operator characteristics (ROC) curves were built to summarize the results. SROC curve analyses were performed to investigate the heterogeneity among studies. RESULTS Initially, 799 articles were selected. After screening titles and abstracts, 743 articles were excluded. After reading the remaining 56 full-texts, 47 relevant articles were included in this study. Diagnostic odds ratio values revealed a wide range of results across the studies and determined a higher heterogeneity for PR compared with CBCT. The analyses of the SROC curves compared CBCT imaging versus PR in the diagnosis of root fracture, favouring CBCT modality. CONCLUSIONS CBCT was the imaging exam that rendered a higher diagnostic accuracy for root fractures.
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Affiliation(s)
| | | | - Mariana Minatel Braga
- 2 Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Nascimento EHL, Oenning ACC, Freire BB, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ. Comparison of panoramic radiography and cone beam CT in the assessment of juxta-apical radiolucency. Dentomaxillofac Radiol 2017; 47:20170198. [PMID: 28871830 DOI: 10.1259/dmfr.20170198] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the performance of panoramic radiography (PAN) and cone beam CT (CBCT) in the detection of juxta-apical radiolucency (JAR), as well as to investigate, in CBCT images, if there are factors associated with the detection of JAR on PAN. METHODS Two oral radiologists assessed the presence of JAR in PAN and CBCT images of 175 individuals (308 mandibular third molars). The cortical plates involvement and the JAR size and location were assessed on CBCT to evaluate if these factors were related to JAR detection on PAN. McNemar's test and multiple logistic regression were performed. RESULTS PAN and CBCT differed significantly in the detection of JAR (p = 0.001). On PAN, JAR was identified on 24% of the patients while on CBCT its detection increased to 32.6%. JAR was detected only on CBCT and only on PAN in 26 and 7 cases, respectively. Distal/mesial surfaces of dental roots were where JAR was mostly located (84.5%), cortical thinning was found in 59.2% of cases and the mean (SD) of JAR size was 5.03 (±1.8) mm. However, these factors were not associated with JAR detection on PAN (p > 0.05). On the other hand, the location of the cortical involvement (if buccal or lingual) was associated with JAR detection on PAN, which was more detectable when the thinning was on buccal cortical. CONCLUSIONS Juxta-apical radiolucency is more often detected on CBCT than on PAN. JAR detection on PAN was improved when it was related to the buccal cortical plate of the mandible.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Anne Caroline Costa Oenning
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Bernardo Barbosa Freire
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Scarfe WC, Azevedo B, Toghyani S, Farman AG. Cone Beam Computed Tomographic imaging in orthodontics. Aust Dent J 2017; 62 Suppl 1:33-50. [PMID: 28297089 DOI: 10.1111/adj.12479] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process. Specific recommendations provide selection guidance based on variables such as phase of treatment, clinically-assessed treatment difficulty, the presence of dental and/or skeletal modifying conditions, and pathology. CBCT imaging in orthodontics should always be considered wisely as children have conservatively, on average, a three to five times greater radiation risk compared with adults for the same exposure. The purpose of this paper is to provide an understanding of the operation of CBCT equipment as it relates to image quality and dose, highlight the benefits of the technique in orthodontic practice, and provide guidance on appropriate clinical use with respect to radiation dose and relative risk, particularly for the paediatric patient.
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Affiliation(s)
- W C Scarfe
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - B Azevedo
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - S Toghyani
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - A G Farman
- University of Louisville School of Dentistry and Independent Consultant in Oral and Maxillofacial Radiology, Chicago, Illinois, USA
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Nardi C, Talamonti C, Pallotta S, Saletti P, Calistri L, Cordopatri C, Colagrande S. Head and neck effective dose and quantitative assessment of image quality: a study to compare cone beam CT and multislice spiral CT. Dentomaxillofac Radiol 2017; 46:20170030. [PMID: 28511564 PMCID: PMC5988185 DOI: 10.1259/dmfr.20170030] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/28/2017] [Accepted: 05/15/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To evaluate the effective dose and image quality of horizontal CBCT in comparison with multislice spiral CT (MSCT) in scans of the head, cervical spine, ear and dental arches. METHODS A head and neck Alderson-Rando® phantom (The Phantom Laboratory, Salem, NY) equipped with 74 thermoluminescence dosemeters was exposed according to 5 different scans in CBCT and 4 different scans in MSCT. Spatial and contrast resolutions, in terms of modulation transfer function and contrast-to-noise ratio (CNR), were measured to obtain a quantitative assessment of image quality. RESULTS The CBCT effective dose was 248, 249, 361, 565 and 688 µSv in the cervical spine, head, ear, dental arches with small field of view and dental arches with medium field of view, respectively. The MSCT effective dose was 3409, 1892, 660 and 812 µSv in the cervical spine, head, ear and dental arches, respectively. The modulation transfer function was 0.895 vs 0.347, 0.895 vs 0.275, 0.875 vs 0.342 and 0.961 vs 0.352 for CBCT vs MSCT in the cervical spine, head, ear and dental arches, respectively. Head and cervical spine MSCT showed greater CNR than CBCT, whereas CNR of the ear and dental arches showed comparable values. CONCLUSIONS CBCT was preferable to MSCT for the ear and dental arches volumetric imaging due to its lower radiation dose and significantly higher spatial resolution. In the case of cervical spine and head imaging, MSCT should be generally recommended if a high contrast resolution is required, despite the greater radiation exposure.
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Affiliation(s)
- Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cinzia Talamonti
- Department of Experimental and Clinical Biomedical Sciences, Medical Physics Unit, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stefania Pallotta
- Department of Experimental and Clinical Biomedical Sciences, Medical Physics Unit, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Paola Saletti
- Department of Health Directorate, UOC Health Physics Unit, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cesare Cordopatri
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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230
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Rios HF, Borgnakke WS, Benavides E. The Use of Cone-Beam Computed Tomography in Management of Patients Requiring Dental Implants: An American Academy of Periodontology Best Evidence Review. J Periodontol 2017; 88:946-959. [DOI: 10.1902/jop.2017.160548] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hector F. Rios
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Wenche S. Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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231
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Secgin CK, Kulah CK, Gulsahi A. Analysis of mandibular changes using panoramic-based indices in patients with chronic renal failure. Int J Artif Organs 2017; 41:0. [PMID: 28967087 DOI: 10.5301/ijao.5000649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Chronic renal failure (CRF) is a progressive disease affecting many systems and causing dental and periodontal problems, in particular a decrease or loss in the amount of cortical bone that is visible on radiographs. Panoramic radiography is useful for determining these changes. The aim of this study was to evaluate cortical parts of the mandible using panoramic-based indices in patients with CRF. METHODS 70 subjects with CRF were included in the study. The measurements of panoramic indices were made according to the visibility (mandibular cortical index, MCI) and thickness (mental index, MI) of the inferior cortex of the mandible. Then, these indices, obtained from 70 healthy controls of the same age and gender, were assessed and the results were compared. The effects of dental status and hemodialysis duration on MCI and MI were also investigated. RESULTS The frequency of an eroded cortex was significantly elevated in patients with CRF (p<0.05). The mean MI was lower in patients with CRF than in healthy subjects (5.53 ± 1.62 and 5.73 ± 1.31 mm, respectively), but the difference was not statistically significant (p>0.05). No correlation was found between hemodialysis duration and mandibular indices (p>0.05). Dental status was not associated with mandibular indices (p>0.05). CONCLUSIONS These results suggest that MCI might be a useful radiographic parameter for evaluating changes occurring in the cortical parts of the mandible in CRF patients. Clinicians should be aware of these changes while planning invasive dental treatments in CRF patients.
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Affiliation(s)
- Cansu K Secgin
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara - Turkey
| | - Cemal K Kulah
- Department of Dentomaxillofacial Radiology, Antalya - Turkey
| | - Ayşe Gulsahi
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara - Turkey
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232
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Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners. Phys Med 2017; 41:71-77. [DOI: 10.1016/j.ejmp.2017.03.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/24/2017] [Accepted: 03/29/2017] [Indexed: 11/22/2022] Open
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233
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Connert T, Zehnder MS, Amato M, Weiger R, Kühl S, Krastl G. Microguided Endodontics: a method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided technique. Int Endod J 2017; 51:247-255. [DOI: 10.1111/iej.12809] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 06/26/2017] [Indexed: 12/17/2022]
Affiliation(s)
- T. Connert
- Department of Periodontology, Endodontology and Cariology; University Centre for Dental Medicine; University of Basel; Basel Switzerland
| | - M. S. Zehnder
- Department of Periodontology, Endodontology and Cariology; University Centre for Dental Medicine; University of Basel; Basel Switzerland
| | - M. Amato
- Department of Periodontology, Endodontology and Cariology; University Centre for Dental Medicine; University of Basel; Basel Switzerland
| | - R. Weiger
- Department of Periodontology, Endodontology and Cariology; University Centre for Dental Medicine; University of Basel; Basel Switzerland
| | - S. Kühl
- Department of Oral Surgery; Oral Radiology and Oral Medicine; University Centre for Dental Medicine; University of Basel; Basel Switzerland
| | - G. Krastl
- Department of Operative Dentistry and Periodontology; University of Würzburg; Würzburg Germany
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234
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Vidor MM, Liedke GS, Fontana MP, da Silveira HLD, Arus NA, Lemos A, Vizzotto MB. Is cone beam computed tomography accurate for postoperative evaluation of implants? An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:500-505. [PMID: 28867464 DOI: 10.1016/j.oooo.2017.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/18/2017] [Accepted: 07/22/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT) for evaluation of the bone-implant interface in comparison with periapical radiography. STUDY DESIGN Titanium implants were inserted in 74 bovine rib blocks in intimate contact with bone walls and with a gap of 0.125 mm (simulating failure in the osseointegration process). Periapical radiographs were taken with conventional film, and CBCT scans were acquired with i-CAT (0.2 mm and 0.125 mm voxel) and Kodak (0.2 mm and 0.076 mm voxel) units. Three examiners evaluated the images using a 5-point scale. Diagnostic accuracy was analyzed through sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) with 95% confidence intervals (CIs). Intra- and interexaminer agreements were analyzed through Kendall's concordance test. RESULTS Intra- and interexaminer agreements showed satisfactory results. The greatest accuracy was observed with conventional radiography (AUC = 0.963; CI 95% = 0.891-0.993). I-CAT 0.125-mm images showed good accuracy (AUC = 0.885; CI 95% = 0.790-0.947), with no significant difference compared with conventional radiography. Kodak images had high specificity and low sensitivity, presenting more false-negative results. CONCLUSIONS Conventional radiography showed the highest accuracy for assessment of the bone-implant interface. However, CBCT (i-CAT; 0.125-mm voxel), if available or if performed for preoperative assessment of another implant site, may provide similar accuracy.
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Affiliation(s)
- Michele Machado Vidor
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gabriela Salatino Liedke
- Oral Radiology, Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Mathias Pante Fontana
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Heraldo Luis Dias da Silveira
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Nadia Assein Arus
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Mariana Boessio Vizzotto
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Schulze RKW, Sazgar M, Karle H, de Las Heras Gala H. Influence of a Commercial Lead Apron on Patient Skin Dose Delivered During Oral and Maxillofacial Examinations under Cone Beam Computed Tomography (CBCT). HEALTH PHYSICS 2017; 113:129-134. [PMID: 28658058 DOI: 10.1097/hp.0000000000000676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this paper is to investigate the impact of a commercial lead apron on patient skin dose delivered during maxillofacial CBCT in five critical regions by means of solid-state-dosimetry. Five anatomical regions (thyroid gland, left and right breast, gonads, back of the phantom torso) in an adult female anthropomorphic phantom were selected for dose measurement by means of the highly sensitive solid-state dosimeter QUART didoSVM. Ten repeated single exposures were assessed for each patient body region for a total of five commercial CBCT devices with and without a lead apron present. Shielded and non-shielded exposures were compared under the paired Wilcoxon test, with absolute and relative differences computed. Reproducibility was expressed as the coefficient of variation (CV) between the 10 repeated assessments. The highest doses observed at skin level were found at the thyroid (mean shielded ± SD: 450.5 ± 346.7 μGy; non-shielded: 339.2 ± 348.8 μGy, p = 0.4922). Shielding resulted in a highly significant (p < 0.001) 93% dose reduction in skin dose in the female breast region with a mean non-shielded dose of approximately 35 μGy. Dose reduction was also significantly lower for the back-region (mean: -65%, p < 0.0001) as well as for the gonad-region (mean: -98%, p < 0.0001) in the shielded situation. Reproducibility was inversely correlated to skin dose (Rspearman = -0.748, p < 0.0001) with a mean CV of 10.45% (SD: 24.53 %). Skin dose in the thyroid region of the simulated patient was relatively high and not influenced by the lead apron, which did not shield this region. Dose reduction by means of a commercial lead apron was significant in all other regions, particularly in the region of the female breast.
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Ernst M, Manser P, Dula K, Volken W, Stampanoni MF, Fix MK. TLD measurements and Monte Carlo calculations of head and neck organ and effective doses for cone beam computed tomography using 3D Accuitomo 170. Dentomaxillofac Radiol 2017; 46:20170047. [PMID: 28749697 DOI: 10.1259/dmfr.20170047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES In dentistry, the use of cone beam CT has steadily increased over the last few years. The aim of this study was to measure organ doses and to perform dose calculations based on Monte Carlo (MC) simulations to work out a basis for full three-dimensional (3D) dose calculations for any patient examination performed with the machine used in this study. METHODS TLD-100 LiF detectors were placed at 71 measurement positions on the surface and within a RT-Humanoid phantom to cover all relevant radiosensitive organs and tissues. Three examinations with different protocols were performed with the 3D Accuitomo® and dose calculations with MC simulations were carried out for the same three protocols using the EGSnrc MC transport code system. RESULTS Field of views of 140 × 100, 80 × 50 and 40 × 40 mm2 were selected, the mean organ doses were measured as 5.2, 2.75 and 1.5 mGy and the effective doses were determined as 250, 97 and 48 µSv. For the MC simulation of organ doses and the thermoluminescent dosemeter measurements, an overall agreement within ±10.1% (two standard deviations) was achieved. The measured dose values for 3D Accuitomo® were about a factor 2 lower when compared with conventional CT examinations. CONCLUSIONS Reliable results for the organ doses as well as effective dose values were achieved with thermoluminescent dosemeter measurements in the RT-Humanoid phantom. This study provides the basis for the application of MC simulations for further dose determinations of cone beam CT machines. The MC calculation may therefore be a valuable tool to support the dentists in the evaluation of the trade-off between additional information that may be relevant to the choice of therapy and the additional dose given to the patient.
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Affiliation(s)
- Marina Ernst
- 1 Department of Physics, ETH Zurich, Zurich, Switzerland.,2 Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,3 Radiotherapy Hirslanden, Hirslanden Medical Center, Aarau, Switzerland
| | - Peter Manser
- 2 Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Karl Dula
- 4 Section of Dental Radiology, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Werner Volken
- 2 Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Michael K Fix
- 2 Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Li CL, Thakur Y, Ford NL. Comparison of the CTDI and AAPM report No. 111 methodology in adult, adolescent, and child head phantoms for MSCT and dental CBCT scanners. J Med Imaging (Bellingham) 2017; 4:031212. [PMID: 28983492 PMCID: PMC5621782 DOI: 10.1117/1.jmi.4.3.031212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/18/2017] [Indexed: 11/30/2022] Open
Abstract
This study investigates the dosimetry methodology proposed by the American Association of Physicists in Medicine (AAPM) task group 111 and compares with the computed tomography dose index (CTDI) method and the SEDENTEXCT DI method on one clinical multislice CT and two dental cone beam CT (CBCT) scanners using adult, adolescent, and child head phantoms. Following the AAPM method, the normalized (100 mAs) equilibrium doses ([Formula: see text]) for Toshiba Aquilion One MSCT computed using dose measurements from the central hole of the phantom ([Formula: see text]), the peripheral hole of the phantom, ([Formula: see text]), and by the [Formula: see text] equation ([Formula: see text]) are in the range from 20 to 25 mGy. For i-CAT Next Generation dental CBCT, the normalized [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] by the two SEDENTEXCT DI methods are in the range from 12 to 15 mGy. Fitting the AAPM equation is not possible for the limited scan lengths available on the CS 9300 dental CBCT. This study offers a simple CTDI-like measurement that can approximate the AAPM [Formula: see text] in clinical CBCT scanners capable of providing four or more scan lengths.
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Affiliation(s)
- Celina L. Li
- University of British Columbia, Faculty of Science, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
| | - Yogesh Thakur
- University of British Columbia, Faculty of Science, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- Lower Mainland Medical Imaging Services, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
- University of British Columbia, Faculty of Medicine, Department of Radiology, Vancouver, British Columbia, Canada
| | - Nancy L. Ford
- University of British Columbia, Faculty of Science, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- University of British Columbia, Faculty of Dentistry, Department of Oral Biological and Medical Sciences, Vancouver, British Columbia, Canada
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238
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Ghetti C, Ortenzia O, Palleri F, Sireus M. Definition of Local Diagnostic Reference Levels in a Radiology Department Using a Dose Tracking Software. RADIATION PROTECTION DOSIMETRY 2017; 175:38-45. [PMID: 27614299 DOI: 10.1093/rpd/ncw264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
Dose optimization in radiological examinations is a mandatory issue: in this study local Diagnostic Reference Levels (lDRLs) for Clinical Mammography (MG), Computed Tomography (CT) and Interventional Cardiac Procedures (ICP) performed in our Radiology Department were established. Using a dose tracking software, we have collected Average Glandular Dose (AGD) for two clinical mammographic units; CTDIvol, Size-Specific Dose Estimate (SSDE), Dose Length Product (DLP) and total DLP (DLPtot) for five CT scanners; Fluoro Time, Fluoro Dose Area Product (DAP) and total DAP (DAPtot) for two angiographic systems. Data have been compared with Italian Regulation and with the recent literature. The 75th percentiles of the different dosimetric indices have been calculated. Automated methods of radiation dose data collection allow a fast and detailed analysis of a great amount of data and an easy determination of lDRLs for different radiological procedures.
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Affiliation(s)
- C Ghetti
- Department of Medical Physics, University Hospital of Parma, Italy
| | - O Ortenzia
- Department of Medical Physics, University Hospital of Parma, Italy
| | - F Palleri
- Department of Medical Physics, University Hospital of Parma, Italy
| | - M Sireus
- Department of Physics, University of Cagliari, Italy
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239
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Spin-Neto R, Matzen LH, Schropp L, Sørensen TS, Gotfredsen E, Wenzel A. Accuracy of video observation and a three-dimensional head tracking system for detecting and quantifying robot-simulated head movements in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:721-728. [DOI: 10.1016/j.oooo.2017.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 10/20/2022]
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240
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Buchanan A, Thachil K, Haggard C, Kalathingal S. Predoctoral and Postdoctoral Education on Cone-Beam Computed Tomography. J Evid Based Dent Pract 2017; 17:310-316. [PMID: 29197432 DOI: 10.1016/j.jebdp.2017.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVES As the use of cone beam computed tomography (CBCT) in dentistry continues to grow, questions related to appropriate radiation safety, training, and interpretation arise. Recognizing this need, the American Dental Association published an advisory statement for the safe use of CBCT in dentistry and recommended that guidelines for appropriate training be established. The purpose of this study was to assess radiation safety concerns related to CBCT and identify voids in current education on CBCT for the predoctoral dental curriculum and continuing dental education. METHODS A survey was mailed to general practitioners, oral surgeons, and periodontists in the Georgia Dental Association (n = 415). RESULTS One hundred twenty-one surveys were received for a response rate of 29%. Sixty-eight percent of practitioners reported using CBCT, with 89% having used it for over 2 years. Few (12.4%) had experience with CBCT in dental school. Interest in continuing dental education on CBCT was reported at 59.8% and 43.6% for current users and nonusers of CBCT, respectively. Approximately 50% reported using precautionary radiation safety measures, and the methods used were varied. CONCLUSIONS Although a higher survey return rate would allow for stronger evidence, this project identified some areas of education voids including radiation safety and the factors that contribute to patient dose; CBCT basics including instruction on the limitations of CBCT; CBCT anatomy and pathology with additional time dedicated to the paranasal sinuses; and interpretation.
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Affiliation(s)
- Allison Buchanan
- Department of Oral Health and Diagnostic Sciences, Dental College of Georgia at Augusta University.
| | | | | | - Sajitha Kalathingal
- Department of Oral Health and Diagnostic Sciences, Dental College of Georgia at Augusta University
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241
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Connert T, Zehnder MS, Weiger R, Kühl S, Krastl G. Microguided Endodontics: Accuracy of a Miniaturized Technique for Apically Extended Access Cavity Preparation in Anterior Teeth. J Endod 2017; 43:787-790. [DOI: 10.1016/j.joen.2016.12.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/21/2016] [Accepted: 12/10/2016] [Indexed: 12/18/2022]
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242
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Ferreira JB, Christovam IO, Alencar DS, da Motta AFJ, Mattos CT, Cury-Saramago A. Accuracy and reproducibility of dental measurements on tomographic digital models: a systematic review and meta-analysis. Dentomaxillofac Radiol 2017; 46:20160455. [PMID: 28362170 DOI: 10.1259/dmfr.20160455] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this systematic review with meta-analysis was to assess the accuracy and reproducibility of dental measurements obtained from digital study models generated from CBCT compared with those acquired from plaster models. METHODS The electronic databases Cochrane Library, Medline (via PubMed), Scopus, VHL, Web of Science, and System for Information on Grey Literature in Europe were screened to identify articles from 1998 until February 2016. The inclusion criteria were: prospective and retrospective clinical trials in humans; validation and/or comparison articles of dental study models obtained from CBCT and plaster models; and articles that used dental linear measurements as an assessment tool. The methodological quality of the studies was carried out by Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A meta-analysis was performed to validate all comparative measurements. RESULTS The databases search identified a total of 3160 items and 554 duplicates were excluded. After reading titles and abstracts, 12 articles were selected. Five articles were included after reading in full. The methodological quality obtained through QUADAS-2 was poor to moderate. In the meta-analysis, there were statistical differences between the mesiodistal widths of mandibular incisors, maxillary canines and premolars, and overall Bolton analysis. Therefore, the measurements considered accurate were maxillary and mandibular crowding, intermolar width and mesiodistal width of maxillary incisors, mandibular canines and premolars, in both arches for molars. CONCLUSIONS Digital models obtained from CBCT were not accurate for all measures assessed. The differences were clinically acceptable for all dental linear measurements, except for maxillary arch perimeter. Digital models are reproducible for all measurements when intraexaminer assessment is considered and need improvement in interexaminer evaluation.
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Affiliation(s)
- Jamille B Ferreira
- 1 Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ilana O Christovam
- 1 Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - David S Alencar
- 2 Department of Orthodontics, Universidade Federal Fluminense, Niterói, Brazil
| | - Andréa F J da Motta
- 2 Department of Orthodontics, Universidade Federal Fluminense, Niterói, Brazil
| | - Claudia T Mattos
- 2 Department of Orthodontics, Universidade Federal Fluminense, Niterói, Brazil
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Karnasuta P, Plianrungsi J, Denkongpon I, Horsimasathaporn N, Chayutthanabun P, Weerachartwattana J, Boonchalermchai P, Charoenwathana S, Narongrat N, Jutipimarn K, Hongsatit N, Tharanon W. Cone-beam computed tomography investigation of crucial mandibular canal variations in Thais. Oral Radiol 2017. [DOI: 10.1007/s11282-017-0270-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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244
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Connor SEJ. Contemporary imaging of auditory implants. Clin Radiol 2017; 73:19-34. [PMID: 28388970 DOI: 10.1016/j.crad.2017.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/25/2017] [Accepted: 03/02/2017] [Indexed: 12/14/2022]
Abstract
There have been significant advances in the diversity and effectiveness of hearing technologies in recent years. Implanted auditory devices may be divided into those that stimulate the cochlear hair cells (bone conduction devices and middle ear implants), and those that stimulate the neural structures (cochlear implants and central auditory implants). Contemporary preoperative and postoperative imaging may be used to help individualise implant selection, optimise surgical technique and predict auditory outcome. This review will introduce the concepts behind auditory implants, and explains how imaging is increasingly used to aid insertion and evaluation of these devices.
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Affiliation(s)
- S E J Connor
- Neuroradiology Department, King's College Hospital, London, UK; Radiology Department, Guy's and St Thomas' Hospital, London, UK.
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Oser DG, Henson BR, Shiang EY, Finkelman MD, Amato RB. Incidental Findings in Small Field of View Cone-beam Computed Tomography Scans. J Endod 2017; 43:901-904. [PMID: 28359665 DOI: 10.1016/j.joen.2017.01.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/23/2017] [Accepted: 01/29/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The use of cone-beam computed tomography (CBCT) in endodontics has increased in recent years. In clinical application of small field of view (FOV) CBCTs, these scans are not reviewed routinely by a radiologist. Studies of large FOV CBCT scans show the prevalence of incidental findings to be greater than 90%. The purpose of this study was to evaluate the prevalence of missed findings by endodontic residents as compared with a radiologist on small FOV CBCT scans. METHODS Two hundred three small FOV CBCTs obtained for endodontic purposes were analyzed by an endodontic resident and a medical radiologist. The reported findings of each practitioner were compared to evaluate for missed incidental findings by the endodontic resident. RESULTS The radiologist reported abnormalities in 176 of the 203 subjects (87%), with a total of 310 abnormalities reported. The endodontic resident reported abnormalities in 102 of the 203 subjects (50%), with a total of 126 abnormalities reported. The percentage of scans with any abnormality reported by the radiologist was significantly greater than the endodontic resident (P < .001). There was no significant difference between jaw locations in percentage of missed findings for the 3 most common types of finding-rarefying osteitis, sinusitis/mucosal lining thickening, and excess restorative material in the periapical area. Rarefying osteitis was missed significantly less than the other 2 types of findings (P < .001). CONCLUSIONS A radiologist is significantly more likely to identify incidental findings in small FOV CBCT scans than an endodontic resident. Scan location had no significant association with the rate of missed findings.
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Affiliation(s)
- David G Oser
- Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Brett R Henson
- Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Elaine Y Shiang
- Tufts University School of Dental Medicine, Boston, Massachusetts
| | | | - Robert B Amato
- Tufts University School of Dental Medicine, Boston, Massachusetts.
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246
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Bohner LOL, Tortamano P, Marotti J. Accuracy of linear measurements around dental implants by means of cone beam computed tomography with different exposure parameters. Dentomaxillofac Radiol 2017; 46:20160377. [PMID: 28267928 DOI: 10.1259/dmfr.20160377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the accuracy of linear measurements around dental implants when using CBCT unit devices presenting different exposure parameters. METHODS Dental implants (n = 18) were installed in the maxilla of human dry skulls, and images were obtained using two CBCT devices: G1-Care Stream 9300 (70 kVp, 6.3 mA, voxel size 0.18 mm, field of view 8 × 8 cm; Carestream Health, Rochester, NY) and G2-R100 Veraview® (75 kVp, 7.0 mA, voxel size 0.125 mm, field of view 8 × 8 cm; J Morita, Irvine, CA). Measurements of bone thickness were performed at three points located (A) in the most apical portion of the implant, (B) 5 mm above the apical point and (C) in the implant platform. Afterwards, values were compared with real measurements obtained by an optical microscopy [control group (CG)]. Data were statistically analyzed with the significance level of p ≤ 0.05. RESULTS There was no statistical difference for the mean values of bone thickness on Point A (CG: 4.85 ± 2.25 mm, G1: 4.19 ± 1.68 mm, G2: 4.15 ± 1.75 mm), Point B (CG: 1.50 ± 0.84 mm, G1: 1.61 ± 1.27 mm; G2: 1.68 ± 0.82 mm) and Point C (CG: 1.78 ± 1.33 mm, G1: 1.80 ± 1.09 mm; G2: 1.64 ± 1.11 mm). G1 and G2 differed in bone thickness by approximately 0.76 mm for Point A, 0.36 mm for Point B and 0.08 mm for Point C. A lower intraclass variability was identified for CG (Point A = 0.20 ± 0.25; Point B = 0.15 ± 0.20; Point C = 0.06 ± 0.05 mm) in comparison with G1 (Point A = 0.56 ± 0.52; Point B = 0.48 ± 0.50; Point C = 0.47 ± 0.56 mm) and G2 (Point A = 0.57 ± 0.51; Point B = 0.46 ± 0.46; Point C = 0.36 ± 0.31 mm). CONCLUSIONS CBCT devices showed acceptable accuracy for linear measurements around dental implants, despite the exposure parameters used.
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Affiliation(s)
- Lauren O L Bohner
- 1 Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Department of Prosthodontics and Biomaterials, Center for Implantology, University Hospital RWTH Aachen, Aachen, Germany
| | - Pedro Tortamano
- 1 Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Juliana Marotti
- 2 Department of Prosthodontics and Biomaterials, Center for Implantology, University Hospital RWTH Aachen, Aachen, Germany
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247
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Widmann G, Bischel A, Stratis A, Bosmans H, Jacobs R, Gassner EM, Puelacher W, Pauwels R. Spatial and contrast resolution of ultralow dose dentomaxillofacial CT imaging using iterative reconstruction technology. Dentomaxillofac Radiol 2017; 46:20160452. [PMID: 28059562 DOI: 10.1259/dmfr.20160452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine how iterative reconstruction technology (IRT) influences contrast and spatial resolution in ultralow-dose dentomaxillofacial CT imaging. METHODS A polymethyl methacrylate phantom with various inserts was scanned using a reference protocol (RP) at CT dose index volume 36.56 mGy, a sinus protocol at 18.28 mGy and ultralow-dose protocols (LD) at 4.17 mGy, 2.36 mGy, 0.99 mGy and 0.53 mGy. All data sets were reconstructed using filtered back projection (FBP) and the following IRTs: adaptive statistical iterative reconstructions (ASIRs) (ASIR-50, ASIR-100) and model-based iterative reconstruction (MBIR). Inserts containing line-pair patterns and contrast detail patterns for three different materials were scored by three observers. Observer agreement was analyzed using Cohen's kappa and difference in performance between the protocols and reconstruction was analyzed with Dunn's test at α = 0.05. RESULTS Interobserver agreement was acceptable with a mean kappa value of 0.59. Compared with the RP using FBP, similar scores were achieved at 2.36 mGy using MBIR. MIBR reconstructions showed the highest noise suppression as well as good contrast even at the lowest doses. Overall, ASIR reconstructions did not outperform FBP. CONCLUSIONS LD and MBIR at a dose reduction of >90% may show no significant differences in spatial and contrast resolution compared with an RP and FBP. Ultralow-dose CT and IRT should be further explored in clinical studies.
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Affiliation(s)
- Gerlig Widmann
- 1 Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Alexander Bischel
- 2 Department of Craniomaxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Andreas Stratis
- 3 Department of Imaging and Pathology, OMFS-IMPATH Research Group, KU Leuven-Group Biomedical Sciences Oral and Maxillofacial Surgery-UZ Leuven, Leuven, Belgium
| | - Hilde Bosmans
- 3 Department of Imaging and Pathology, OMFS-IMPATH Research Group, KU Leuven-Group Biomedical Sciences Oral and Maxillofacial Surgery-UZ Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- 3 Department of Imaging and Pathology, OMFS-IMPATH Research Group, KU Leuven-Group Biomedical Sciences Oral and Maxillofacial Surgery-UZ Leuven, Leuven, Belgium
| | - Eva-Maria Gassner
- 1 Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Puelacher
- 2 Department of Craniomaxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Ruben Pauwels
- 3 Department of Imaging and Pathology, OMFS-IMPATH Research Group, KU Leuven-Group Biomedical Sciences Oral and Maxillofacial Surgery-UZ Leuven, Leuven, Belgium.,4 Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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248
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Cephalometrics of Pharyngeal Airway Space in Lebanese Adults. Int J Dent 2017; 2017:3959456. [PMID: 28133482 PMCID: PMC5241489 DOI: 10.1155/2017/3959456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 12/21/2022] Open
Abstract
Purpose. The upper airway space is significant in orthodontic diagnosis and treatment planning. The objectives of this study are to assess the dimensions of soft tissue elements of the upper pharyngeal space and evaluate potential correlations with modifying variables such as gender, skeletal class, and anthropometric parameters. Materials and Methods. Lateral cephalograms were obtained from 117 healthy young adult Lebanese subjects. Nineteen cephalometric linear/angular measurements of the nasopharynx, oropharynx, and hypopharynx were recorded. Anthropometric parameters including body mass index and neck circumference were measured. Results. Significant differences were demonstrated for 12 out of the 19 parameters considered between genders. Uvula and tongue dimensions and the distances between epiglottis-posterior pharyngeal wall and epiglottis-posterior nasal spine were significantly larger in males. The anteroposterior inclination of the uvula and the distances between the uvula and posterior pharyngeal wall were significantly greater in females. No significant differences were found between skeletal classes relative to most of the variables. Body mass index and neck circumference were positively correlated with the dimensions of tongue and uvula. Conclusions. Sexual dimorphism relative to some cephalometric variables and anthropometric parameters may account partly for larger oronasopharyngeal spaces in females. Anthropometric data need to be accounted for in population-related comparisons.
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Stratis A, Zhang G, Jacobs R, Bogaerts R, Bosmans H. Rotating and translating anthropomorphic head voxel models to establish an horizontal Frankfort plane for dental CBCT Monte Carlo simulations: a dose comparison study. Phys Med Biol 2016; 61:N681-N696. [PMID: 27893451 DOI: 10.1088/1361-6560/61/24/n681] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In order to carry out Monte Carlo (MC) dosimetry studies, voxel phantoms, modeling human anatomy, and organ-based segmentation of CT image data sets are applied to simulation frameworks. The resulting voxel phantoms preserve patient CT acquisition geometry; in the case of head voxel models built upon head CT images, the head support with which CT scanners are equipped introduces an inclination to the head, and hence to the head voxel model. In dental cone beam CT (CBCT) imaging, patients are always positioned in such a way that the Frankfort line is horizontal, implying that there is no head inclination. The orientation of the head is important, as it influences the distance of critical radiosensitive organs like the thyroid and the esophagus from the x-ray tube. This work aims to propose a procedure to adjust head voxel phantom orientation, and to investigate the impact of head inclination on organ doses in dental CBCT MC dosimetry studies. The female adult ICRP, and three in-house-built paediatric voxel phantoms were in this study. An EGSnrc MC framework was employed to simulate two commonly used protocols; a Morita Accuitomo 170 dental CBCT scanner (FOVs: 60 × 60 mm2 and 80 × 80 mm2, standard resolution), and a 3D Teeth protocol (FOV: 100 × 90 mm2) in a Planmeca Promax 3D MAX scanner. Result analysis revealed large absorbed organ dose differences in radiosensitive organs between the original and the geometrically corrected voxel models of this study, ranging from -45.6% to 39.3%. Therefore, accurate dental CBCT MC dose calculations require geometrical adjustments to be applied to head voxel models.
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Affiliation(s)
- A Stratis
- Department of Imaging and Pathology, Katholieke Universiteit Leuven, OMFS-IMPATH Research Group, Campus St. Raphael, Kapucijnenvoer 33, Leuven 3000, Belgium
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Spin-Neto R, Matzen LH, Schropp L, Gotfredsen E, Wenzel A. Detection of patient movement during CBCT examination using video observation compared with an accelerometer-gyroscope tracking system. Dentomaxillofac Radiol 2016; 46:20160289. [PMID: 27786564 DOI: 10.1259/dmfr.20160289] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To compare video observation (VO) with a novel three-dimensional registration method, based on an accelerometer-gyroscope (AG) system, to detect patient movement during CBCT examination. The movements were further analyzed according to complexity and patient age. METHODS In 181 patients (118 females/63 males; age average 30 years, range: 9-84 years), 206 CBCT examinations were performed, which were video-recorded during examination. An AG was, at the same time, attached to the patient head to track head position in three dimensions. Three observers scored patient movement (yes/no) by VO. AG provided movement data on the x-, y- and z-axes. Thresholds for AG-based registration were defined at 0.5, 1, 2, 3 and 4 mm (movement distance). Movement detected by VO was compared with that registered by AG, according to movement complexity (uniplanar vs multiplanar, as defined by AG) and patient age (≤15, 16-30 and ≥31 years). RESULTS According to AG, movement ≥0.5 mm was present in 160 (77.7%) examinations. According to VO, movement was present in 46 (22.3%) examinations. One VO-detected movement was not registered by AG. Overall, VO did not detect 71.9% of the movements registered by AG at the 0.5-mm threshold. At a movement distance ≥4 mm, 20% of the AG-registered movements were not detected by VO. Multiplanar movements such as lateral head rotation (72.1%) and nodding/swallowing (52.6%) were more often detected by VO in comparison with uniplanar movements, such as head lifting (33.6%) and anteroposterior translation (35.6%), at the 0.5-mm threshold. The prevalence of patients who move was highest in patients younger than 16 years (64.3% for VO and 92.3% for AG-based registration at the 0.5-mm threshold). CONCLUSIONS AG-based movement registration resulted in a higher prevalence of patient movement during CBCT examination than VO-based registration. Also, AG-registered multiplanar movements were more frequently detected by VO than uniplanar movements. The prevalence of patients who move was highest in patients younger than 16 years.
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Affiliation(s)
- Rubens Spin-Neto
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Louise H Matzen
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Erik Gotfredsen
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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