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Mosca Balma A, Cavagnetto D, Pavone L, Mussano F. Assessing the Volume of the Head of the Mandibular Condyle Using 3T-MRI-A Preliminary Trial. Dent J (Basel) 2024; 12:220. [PMID: 39057007 PMCID: PMC11276145 DOI: 10.3390/dj12070220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Due to potentially harmful exposure to X-rays, condylar growth in response to orthodontic treatment is poorly studied. To overcome this limitation, here, the authors have proposed high-resolution MRI as a viable alternative to CBCT for clinical 3D assessment of TMJ. A male subject underwent both MRI and CBCT scans. The obtained three-dimensional reconstructions of the TMJ were segmented and superimposed by a semiautomatic algorithm developed in MATLAB R2022a. The condylar geometries were reconstructed using dedicated software for image segmentation. Two geometrical parameters, i.e., the total volume and surface of the single condyle model, were selected to quantify the intraclass and interclass variability from the mean of each DICOM series (CBCT and MRI). The final comparison between the reference standard model of CBCT and 3T MRI showed that the former was more robust in terms of reproducibility, while the latter reached a higher standard deviation compared to CBCT, but these values were similar between the operators and clinically not significant. Within the inherent limitation of image reconstruction on MRI scans due to the current lower resolution of this technique, the method proposed here could be considered as a nucleus for developing future completely automatic AI algorithms, owing to its great potential and satisfactory consistency among different times and operators.
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Affiliation(s)
- Alessandro Mosca Balma
- Bone and Dental Bioengineering Laboratory, CIR Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126 Turin, Italy; (A.M.B.); (L.P.); (F.M.)
| | - Davide Cavagnetto
- Bone and Dental Bioengineering Laboratory, CIR Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126 Turin, Italy; (A.M.B.); (L.P.); (F.M.)
- Department of Mechanical and Aerospace Engineering, Polytechnic of Turin, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Lorenzo Pavone
- Bone and Dental Bioengineering Laboratory, CIR Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126 Turin, Italy; (A.M.B.); (L.P.); (F.M.)
| | - Federico Mussano
- Bone and Dental Bioengineering Laboratory, CIR Dental School, Department of Surgical Sciences, University of Turin, Via Nizza 230, 10126 Turin, Italy; (A.M.B.); (L.P.); (F.M.)
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Martinho FC, Bisi BG, Gavini G, Griffin IL, Tordik PA. Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-post Removal: Small versus Large Field-of-view Registration Workflows. J Endod 2024:S0099-2399(24)00363-7. [PMID: 38945199 DOI: 10.1016/j.joen.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION This study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw). METHODS Fifty-six extracted human maxillary molars were divided into DNS-SFOVw (n = 28) and DNS-LFOVw (n = 28). The palatal canal was restored with an intraradicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam computed tomography (CBCT) scan was taken with a 40 × 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional deviations, angular deflection, number of mishaps, registration, and total operation time were calculated. RESULTS The DNS-SFOVw was as accurate as DNS-LFOVw (P > .05). The DNS-LFOVw registration time was less than DNS-SFOVw (P < .05). There was no difference in the number of mishaps (P > .05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (P < .05). CONCLUSION Within the limitations of this in-vitro study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiberpost removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland.
| | - Bruno G Bisi
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil; Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
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Shujaat S, Vasconcelos KDF, Kesztyüs A, Fontenele RC, Oliveira-Santos N, Nagy K, Shaheen E, Jacobs R. Optimization of orofacial cleft imaging protocols using device-specific low-dose cone-beam computed tomography. J Oral Rehabil 2024. [PMID: 38873694 DOI: 10.1111/joor.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE The aim of this study was to present optimized device-specific low-dose cone-beam computed tomography (CBCT) protocols with sufficient image quality for pre-surgical diagnostics and three-dimensional (3D) modelling of cleft defects. METHODS Six paediatric skulls were acquired, and an artificial bony cleft was created. A high-resolution CBCT scan acted as a reference standard (Accuitomo 170, Morita, Kyoto, Japan) for comparing eight low-dose protocols of Newtom VGi-evo (QR Verona, Cefla, Verona, Italy), which included Eco and Regular protocols with different field of views (FOVs). Delineation of lamina dura, cementoenamel junction (CEJ), trabecular bone and bony bridge were assessed. A 3D model of the defect was also evaluated. RESULT The dose area product of low-dose protocols ranged from 31 to 254 mGy*cm2. Despite the dose difference of up to eight times between applied protocols, trabecular bone and CEJ exhibited appropriate image quality in all scans. However, Regular small FOV protocols (5 × 5 and 8 × 5 cm2), for both lamina dura and bony bridge, demonstrated a significant improvement in image quality compared to Eco FOV counterparts. Based on 3D defect analysis, no significant difference existed between low-dose protocols and the reference standard. CONCLUSION The findings highlight the possibility of achieving a considerable reduction (up to eight times) in the radiation dose using low-dose CBCT protocols while maintaining sufficient image quality for assessing anatomical structures and 3D modelling in cleft cases.
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Affiliation(s)
- Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Artúr Kesztyüs
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Nicolly Oliveira-Santos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Krisztian Nagy
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
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Ruiz DC, Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ. Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters. Imaging Sci Dent 2024; 54:139-145. [PMID: 38948185 PMCID: PMC11211027 DOI: 10.5624/isd.20230233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Results Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). Conclusion MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | | | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Elsonbaty S, Elgarba BM, Fontenele RC, Swaity A, Jacobs R. Novel AI-based tool for primary tooth segmentation on CBCT using convolutional neural networks: A validation study. Int J Paediatr Dent 2024. [PMID: 38769619 DOI: 10.1111/ipd.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Primary teeth segmentation on cone beam computed tomography (CBCT) scans is essential for paediatric treatment planning. Conventional methods, however, are time-consuming and necessitate advanced expertise. AIM The aim of this study was to validate an artificial intelligence (AI) cloud-based platform for automated segmentation (AS) of primary teeth on CBCT. Its accuracy, time efficiency, and consistency were compared with manual segmentation (MS). DESIGN A dataset comprising 402 primary teeth (37 CBCT scans) was retrospectively retrieved from two CBCT devices. Primary teeth were manually segmented using a cloud-based platform representing the ground truth, whereas AS was performed on the same platform. To assess the AI tool's performance, voxel- and surface-based metrics were employed to compare MS and AS methods. Additionally, segmentation time was recorded for each method, and intra-class correlation coefficient (ICC) assessed consistency between them. RESULTS AS revealed high performance in segmenting primary teeth with high accuracy (98 ± 1%) and dice similarity coefficient (DSC; 95 ± 2%). Moreover, it was 35 times faster than the manual approach with an average time of 24 s. Both MS and AS demonstrated excellent consistency (ICC = 0.99 and 1, respectively). CONCLUSION The platform demonstrated expert-level accuracy, and time-efficient and consistent segmentation of primary teeth on CBCT scans, serving treatment planning in children.
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Affiliation(s)
- Sara Elsonbaty
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Egyptian Ministry of Health and Population, Cairo, Egypt
| | - Bahaaeldeen M Elgarba
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Prosthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Rocharles Cavalcante Fontenele
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Abdullah Swaity
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Willershausen I, Kopp M, Scholz M, Ströbel A, Seidel CL, Paulsen F, Uder M, Gölz L, May MS. Feasibility of 3 Tesla MRI for the assessment of mid-palatal suture maturation: a retrospective pilot study. Odontology 2024:10.1007/s10266-024-00950-0. [PMID: 38758257 DOI: 10.1007/s10266-024-00950-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/04/2024] [Indexed: 05/18/2024]
Abstract
The maxilla occupies a key position in dentofacial orthopaedics, since its transversal development can be directly influenced by orthodontic therapy. The maturation stages of the mid-palatal suture, which are obtained from cone-beam computed tomography images (CBCT), present an addition to clinical decision-making in transversal discrepancies of the upper jaw. In an endeavour to reduce ionizing radiation in adolescents and young adults, who are particularly susceptible to long term stochastic irradiation effects, we investigated the feasibility of 3 Tesla (3T) MRI in detecting the maturation stages of the mid-palatal suture. A collective of 30 patients aged 24-93 years with routine neck MRI at 3T, underwent an additional three-dimensional isotropic T1 weighted study sequence of the midface. Image evaluation was performed on axial, multi-planar formatted reconstructions of the dataset aligned to the midline axis of the palate, and curved reconstructions aligned to the concavity of the palate. Inverted images helped to achieve an image impression similar to the well-known CBCT appearance. All datasets were reviewed by three readers and mid-palatal maturation was scored twice according to Angelieri et al. Intra- and inter-rater agreement were evaluated to measure the robustness of the images for clinical evaluation. 3T MRI deemed reliable for the assessment of mid-palatal suture maturation and hence for the appraisal of the hard palate and its adjacent sutures. The data of this pilot study display the feasibility of non-ionizing cross-sectional MRI for the determination of sutural maturation stages. These findings underline the potential of MRI for orthodontic treatment planning, further contributing to the avoidance of unnecessary radiation doses.
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Affiliation(s)
- Ines Willershausen
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
| | - Markus Kopp
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Scholz
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Armin Ströbel
- Center for Clinical Studies (CCS), Medical Faculty, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias Stefan May
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Ugolini A, Abate A, Donelli M, Gaffuri F, Bruni A, Maspero C, Lanteri V. Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:501. [PMID: 38671718 PMCID: PMC11049362 DOI: 10.3390/children11040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. METHODS The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. RESULTS A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. CONCLUSIONS SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
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Affiliation(s)
- Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Margherita Donelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Valentina Lanteri
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
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Vicente A, Wiedel AP, Becker M, Brogårdh-Roth S, Shi XQ, Hellén-Halme K. Quantitative assessment of cleft volume and evaluation of cleft's impact on adjacent anatomical structures using CBCT imaging. Oral Radiol 2024; 40:295-303. [PMID: 38302684 DOI: 10.1007/s11282-023-00736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/18/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To determine pre-operative cleft volume and evaluate cleft´s impact on surrounding anatomical structures in children and adolescents with orofacial clefts using cone bean computed tomography (CBCT) imaging. METHODS The present retrospective study retrieved CBCT examinations of 68 patients from a previous study. The examinations had been exposed either before (n = 53) or after (n = 15) alveolar bone grafting. Pre-operative volume of cleft was determined, and type and location were evaluated. Morphological changes on the adjacent anatomical structures, including the incisive foramen, the nasal septum and floor, and the inferior turbinate, were assessed. RESULTS Mean bilateral cleft volume was 0.76 cm3, while mean unilateral cleft volume was 1.08 cm3; the difference was significant (p < 0.001). Variation in cleft volume, however, was large. The incisive foramen was not visible in the majority of cases with bilateral clefts (71%); the difference was significant (p = 0.001). In cases with unilateral clefts, the nasal septum in 87% was curved towards the cleft or graft side. Also, the mean size of the widest part of the inferior turbinate was 8.8 mm on the cleft or graft side and 10.4 mm on the non-cleft side. The difference was significant (p < 0.001). CONCLUSIONS When required, CBCT is a feasible method for quantitatively illustrating alveolar clefts and their impact on the morphological development of surrounding structures. Variation in cleft volume was large.
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Affiliation(s)
- António Vicente
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21, Malmö, Sweden.
| | - Anna-Paulina Wiedel
- Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Magnus Becker
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden
| | - Susanne Brogårdh-Roth
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21, Malmö, Sweden
- Section of Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Carl Gustafs Väg 34, 214 21, Malmö, Sweden
- Section of Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Candemil AP, Alves Dos Santos GN, Oliveira ML, Gatti F, Silva-Sousa YTC, Silva-Sousa AC, Mazzi-Chaves JF, Sousa-Neto MD. Accuracy of Magnetic Resonance Imaging in Clinical Endodontic Applications: A Systematic Review. J Endod 2024; 50:434-449. [PMID: 38290691 DOI: 10.1016/j.joen.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The development of dedicated coils and new magnetic resonance imaging (MRI) sequences has led to an increase in image resolution and a reduction in artifacts. Consequently, numerous studies have demonstrated the utility of MRI as a nonionizing alternative to cone-beam computed tomographic imaging. The aim of this systematic review was to evaluate the accuracy of MRI in clinical applications in endodontics. METHODS A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. The inclusion criteria encompassed studies evaluating MRI applications in endodontics, covering tooth and root canal anatomy, root canal working length, pulp vitality and regeneration, the effect of caries on dental pulp, guided endodontics, periapical lesions, and root cracks/fractures. The selected studies examined both ex vivo and in vivo human teeth using clinical MRI units. Two researchers independently screened the studies, applied the eligibility criteria, and assessed the potential risk of bias using the revised QUADAS-2 tool (Bristol Medical School, University of Bristol, UK). RESULTS A total of 18 studies were included in this systematic review, demonstrating that the use of MRI has a high diagnostic value in endodontics. In the evaluation of tooth and root canal anatomy, pulp vitality and regeneration, the effect of caries on dental pulp, periapical lesions, and root cracks/fractures, MRI's accuracy is comparable to or even higher than reference standards such as cone-beam computed tomographic imaging, micro-computed tomographic imaging, and histology. CONCLUSIONS MRI has high potential accuracy for diagnosing various clinical endodontic tasks, except for root canal length, size of caries, and periapical lesion dimensions, which are overestimated in MRI.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil; CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France.
| | | | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Filippo Gatti
- CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France
| | | | - Alice C Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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10
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Benavides E, Krecioch JR, Connolly RT, Allareddy T, Buchanan A, Spelic D, O'Brien KK, Keels MA, Mascarenhas AK, Duong ML, Aerne-Bowe MJ, Ziegler KM, Lipman RD. Optimizing radiation safety in dentistry: Clinical recommendations and regulatory considerations. J Am Dent Assoc 2024; 155:280-293.e4. [PMID: 38300176 DOI: 10.1016/j.adaj.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/20/2023] [Accepted: 12/12/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND The value of dental radiographs to oral health care decision making must be balanced with radiation safety to minimize patient exposure and occupational risk of oral health care providers. This review summarizes recommendations and regulatory guidance regarding dental radiography and cone-beam computed tomography. An expert panel presents recommendations on radiation safety, appropriate imaging practices, and reducing radiation exposure. TYPES OF STUDIES REVIEWED A systematic search run in Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews identified relevant topical systematic reviews, organizational guidelines, and regulatory reviews published in the peer-reviewed literature since 2010. A supplemental search of the gray literature (eg, technical reports, standards, and regulations) identified topical nonindexed publications. Inclusion criteria required relevance to primary oral health care (ie, general or pediatric dentistry). RESULTS A total of 95 articles, guidance documents, and regulations met the inclusion criteria. Resources were characterized as applicable to all modalities, operator and occupational protection, dose reduction and optimization, and quality assurance and control. PRACTICAL IMPLICATIONS Understanding factors affecting imaging safety and applying fundamental principles of radiation protection consistent with federal, state, and local requirements are essential for limiting patient ionizing radiation exposure, in conjunction with implementing optimal imaging procedures to support prudent use of dental radiographs and cone-beam computed tomographic imaging. The regulatory guidance and best practice recommendations summarized in this article should be followed by dentists and other oral health care providers.
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11
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Gurgel M, Alvarez MA, Aristizabal JF, Baquero B, Gillot M, Al Turkestani N, Miranda F, Castillo AAD, Bianchi J, de Oliveira Ruellas AC, Ioshida M, Yatabe M, Rey D, Prieto J, Cevidanes L. Automated artificial intelligence-based three-dimensional comparison of orthodontic treatment outcomes with and without piezocision surgery. Orthod Craniofac Res 2024; 27:321-331. [PMID: 38009409 PMCID: PMC10949222 DOI: 10.1111/ocr.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/26/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE(S) This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)-automated tools. MATERIALS AND METHODS Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI-automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial-distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared. RESULTS The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth. CONCLUSION The open source-automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.
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Affiliation(s)
- Marcela Gurgel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Baptiste Baquero
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Maxime Gillot
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Najla Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Felicia Miranda
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Aron Aliaga-Del Castillo
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonas Bianchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Marcos Ioshida
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Diego Rey
- Department of Orthodontics, CES University, Medellin, Colombia
| | - Juan Prieto
- Department of Computer Sciences, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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12
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Savoldi F, Dagassan-Berndt D, Patcas R, Mak WS, Kanavakis G, Verna C, Gu M, Bornstein MM. The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing. Dentomaxillofac Radiol 2024; 53:178-188. [PMID: 38265247 PMCID: PMC11003665 DOI: 10.1093/dmfr/twae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/14/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.
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Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032, Switzerland
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
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13
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de Oliveira Reis L, Santos-Corvini JPA, Gaêta-Araujo H, Sampaio-Oliveira M, Oliveira ML, Freitas DQ. Do voxel size and filter application on CBCT images improve the diagnosis of condylar morphological alterations? An ex vivo study. J Oral Rehabil 2024; 51:517-525. [PMID: 37941125 DOI: 10.1111/joor.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/11/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There is no established protocol for the low doses of cone-beam computed tomography (CBCT) acquisition and filter application on the diagnosis of condylar morphological alterations. OBJECTIVES The objective of the study was to evaluate the influence of voxel size and filter application on the diagnosis of condylar morphological alterations in CBCT using an ex vivo model. METHODS CBCT scans of 36 temporomandibular joints were acquired using OP300 Maxio with voxel sizes of 0.085, 0.125 and 0.280 mm. Three radiologists evaluated the condyles in the CBCT volumes under three filter modes: no filter, '1x' sharpen filter and '2x' sharpen filter. The area under the ROC curve, sensitivity and specificity were calculated by comparing the evaluators' responses with the reference standard and compared among experimental groups using analysis of variance (ANOVA) (α = 5%). RESULTS The area under the ROC curve, sensitivity and specificity were not affected by voxel size and filter application (p > .05). For osteophyte and flattening, there were more true-positive responses in smaller voxel size. For erosion, the increase of true- and false-positive responses occurred with a larger voxel size. Overall, there was a tendency to decrease true positives for osteophyte and erosion and increase false positives for flattening with the '2x' sharpen filter. CONCLUSIONS The diagnosis of condylar morphological alterations assessed in this ex vivo analysis is not influenced by the voxel size and the application of the filters. However, attention is needed with the occurrence of false-positive diagnosis with a larger voxel size for erosion and '2x' sharpen filter for flattening.
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Affiliation(s)
- Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares (UFJF-GV), Governador Valadares, Minas Gerais, Brazil
| | | | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Matheus Sampaio-Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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14
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Grün P, Pfaffeneder-Mantai F, Bandura P, Schneider B, Bandura AS, Turhani D. A Cone Bean Computer Tomography Investigation of the Newly Formed Mandibular Anterior Ridge following the Treatment of an Extended Comminuted Fracture: A 12-Year Follow-Up. Case Rep Dent 2024; 2024:1824016. [PMID: 38419613 PMCID: PMC10901576 DOI: 10.1155/2024/1824016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 01/27/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Extensive comminuted fractures are associated with tooth loss that ultimately leads to dimensional changes in the hard and soft tissues of the alveolar ridge. Reconstruction of the lost mandibular anterior ridge is very complex due to the natural curvature of the region. Case Presentation. In this case report, the combination of the modified shell technique with autologous bone plates and the guided bone regeneration (GBR) technique was performed on an 18-year-old patient after a comminuted fracture, to ensure new bone formation in the anterior ridge with a natural curvature. After the treatment progressed without complications, three dental implants were placed. Annual cone beam computed tomography (CBCT) images were obtained and evaluated using the GNU Image Manipulation Program (GIMP© 2.10). This allowed measurements of the buccal and lingual bone around the implants, showing the annual bone loss in a twelve-year observation period. Discussion. The treatment of the comminuted fracture and the combination of the modified shell technique with autologous bone plates, the GBR technique, and implant placement can be considered successful. The three dental implants were osseointegrated in 2010, with the buccal bone level averaging 1.31 mm below the implant shoulder and the lingual bone level 1.57 mm above the implant shoulder. In 2021, the measurements showed a bone loss of 0.99 mm at the buccal implant shoulder and 0.69 mm at the lingual implant shoulder. Conclusion The combination of the modified shell technique with autologous bone plates and the GBR technique is a reliable method to ensure new bone formation in the anterior ridge. The use of CBCT is an excellent method to evaluate bone resorption around dental implants, but due to minimal bone resorption in the observation period, an annual CBCT examination is exaggerated.
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Affiliation(s)
- Pascal Grün
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Patrick Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Anna Sophia Bandura
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria
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15
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Ruiz DC, Reis LDO, Fontenele RC, Miranda-Viana M, Farias-Gomes A, Freitas DQ. Influence of an adjacent zirconium implant, tube current, and metal artifact reduction algorithm on horizontal root fracture diagnosis in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:190-198. [PMID: 37940483 DOI: 10.1016/j.oooo.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE We evaluated the influence of an adjacent zirconium implant, tube current (mA), and a metal artifact reduction algorithm (MARA) on horizontal root fracture (HRF) diagnosis in cone beam computed tomography (CBCT). STUDY DESIGN Nineteen teeth (9 with HRF, 10 without) were individually placed in a human maxilla. Scan volumes were acquired without and with a zirconium implant adjacent to the tooth at settings of 4, 8, and 10 mA, with MARA disabled and enabled, using a 5×5 cm field of view, 0.085-mm voxel size, and 90 kV. Four maxillofacial radiologists individually assessed the scans. Diagnostic metrics were compared by multiway analysis of variance (α=5%). Inter- and intraexaminer agreements for HRF diagnosis were evaluated with the weighted kappa test. RESULTS Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were significantly lower in the presence of the implant (P≤.005). AUC values were higher in scans obtained with 8 and 10 mA compared with 4 mA (P=0.010), but 10 mA without MARA was better with the implant present. MARA did not significantly influence outcomes (P≥0.240). Inter- and intraexaminer agreements ranged from moderate to almost perfect. CONCLUSIONS The presence of the zirconium implant impairs HRF detection. Settings of 8 or 10 mA improve HRF detection regardless MARA condition without the implant. With an adjacent implant, 10 mA without MARA is recommended to improve diagnostic performance.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Murilo Miranda-Viana
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias-Gomes
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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16
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Swaity A, Elgarba BM, Morgan N, Ali S, Shujaat S, Borsci E, Chilvarquer I, Jacobs R. Deep learning driven segmentation of maxillary impacted canine on cone beam computed tomography images. Sci Rep 2024; 14:369. [PMID: 38172136 PMCID: PMC10764895 DOI: 10.1038/s41598-023-49613-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
The process of creating virtual models of dentomaxillofacial structures through three-dimensional segmentation is a crucial component of most digital dental workflows. This process is typically performed using manual or semi-automated approaches, which can be time-consuming and subject to observer bias. The aim of this study was to train and assess the performance of a convolutional neural network (CNN)-based online cloud platform for automated segmentation of maxillary impacted canine on CBCT image. A total of 100 CBCT images with maxillary canine impactions were randomly allocated into two groups: a training set (n = 50) and a testing set (n = 50). The training set was used to train the CNN model and the testing set was employed to evaluate the model performance. Both tasks were performed on an online cloud-based platform, 'Virtual patient creator' (Relu, Leuven, Belgium). The performance was assessed using voxel- and surface-based comparison between automated and semi-automated ground truth segmentations. In addition, the time required for segmentation was also calculated. The automated tool showed high performance for segmenting impacted canines with a dice similarity coefficient of 0.99 ± 0.02. Moreover, it was 24 times faster than semi-automated approach. The proposed CNN model achieved fast, consistent, and precise segmentation of maxillary impacted canines.
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Affiliation(s)
- Abdullah Swaity
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Prosthodontic Department, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Bahaaeldeen M Elgarba
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Prosthodontics, Tanta University, Tanta, Egypt
| | - Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Saleem Ali
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Restorative Dentistry Department, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Elena Borsci
- Oral Diagnostic Clinic, Karolinska Institute, Stockholm, Sweden
| | - Israel Chilvarquer
- Department of Oral Radiology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
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17
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Ismayılov R, Özgür B. Indications and use of cone beam computed tomography in children and young individuals in a university-based dental hospital. BMC Oral Health 2023; 23:1033. [PMID: 38129827 PMCID: PMC10740269 DOI: 10.1186/s12903-023-03784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the indications of cone beam computed tomography (CBCT) in children and young individuals in a university-based dental hospital and their association with age, gender and field of view. METHODS 7131 CBCT scans, taken during 3-year period, were reviewed and a total of 649 pediatric patients (0-18 years) with complete request forms were included. Data related to gender, age, referring department, CBCT indications, field of view (FOV), region of interest (ROI), need for re-exposure and patients received more than one CBCT examination were recorded. RESULTS The mean age was 13.57 ± 3.52 years and "malocclusion and dentofacial anomaly" (28.7%) was the most common clinical indication. Facial trauma, dental trauma and supernumerary tooth in males; "malocclusion and dentofacial anomaly" and implant planning in females were recorded more frequently compared to other gender. Maxilla was the most frequently monitored ROI (35.1%) for patients. Small (≤ 10 cm) FOV was preferred in 58.1% of all patients. Large FOV was selected in the majority of patients who underwent CBCT scan for "malocclusion and dentofacial anomaly" (89.6%). The repeated scans constituted 2.3% of patients and 105 patients (16.2%) underwent multiple CBCT scans on different dates for mainly orthodontic follow-up. CONCLUSIONS The justification of CBCT scans was not fully compatible with current guidelines and mainly larger FOV was preferred. The number of CBCT examination in children and young individuals tends to increase. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Rovshan Ismayılov
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, Altındağ, Ankara, 06100, Turkey
| | - Beste Özgür
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, Altındağ, Ankara, 06100, Turkey.
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18
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Almeida-Marques M, Ingold MMS, da Silva-Junior AF, Franco A, Junqueira JLC, Oenning AC. Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1975. [PMID: 38004024 PMCID: PMC10672905 DOI: 10.3390/medicina59111975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (κ = 0.42) and fair agreement (κ = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.
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Affiliation(s)
- Marcia Almeida-Marques
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Mara Magnoler Sampaio Ingold
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Alberto Ferreira da Silva-Junior
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Ademir Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
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19
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Candemil AP, Mazzi-Chaves JF, Oliveira ML, Ambrosano GB, Vasconcelos KF, Pauwels R, Jacobs R, Sousa-Neto MD. Assessment of the root filling volume in C-shaped root canal on cone-beam CT and micro-CT in relation to nano-CT. Clin Oral Investig 2023; 27:6413-6420. [PMID: 37704914 DOI: 10.1007/s00784-023-05244-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
AIM To assess the observed volume of filled C-shaped root canals from different CBCT and micro-CT having nano-CT as a reference. MATERIALS AND METHODS Twelve extracted mandibular molars with C-shaped root canals were endodontically treated using Reciproc Blue R25 (VDW GMBH, Munich, Germany) in a reciprocating system and filled with gutta-percha (Dentsply Maillefer) and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). CBCT scans were performed using 3 units-3D Accuitomo 170 (J. Morita, Kyoto, Japan), ProMax 3D Max (Planmeca, Helsinki, Finland), and NewTom VGi EVO (Cefla QR, Verona, Italy)-at two resolution modes: standard and high. Micro-CT and nano-CT scans were also obtained. The volume of all filled C-shaped root canals was obtained using CTAn software (Bruker, Kontich, Belgium), and the blooming artifact, in relation to nano-CT volume, was calculated. The data were evaluated by the Bland-Altman plots and ANOVA two-way for repeated measures (α = 0.05). RESULTS All CBCT units and micro-CT showed significantly larger observed volume of root canal filling when compared to nano-CT. The blooming artifact of root canal filling in standard resolution was significantly larger than that in high resolution (p < 0.05) in all CBCT units. CONCLUSIONS Endodontic filling material with AH Plus sealer causes blooming artifacts in CBCT units and micro-CT. CLINICAL RELEVANCE Considering the anatomical complexity of C-shaped root canals and the challenges associated with endodontic treatment, CBCT is frequently recommended for follow-up evaluations. However, the presence of endodontic filling material can result in blooming artifacts that may potentially impact the accurate diagnosis of endodontic complications.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Guilherme Bovi Ambrosano
- Department of Statistical Genetics, Luiz de Queiroz College of Agriculture, University of São Paulo, São Paulo, Brazil
| | | | - Ruben Pauwels
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café-Subsetor Oeste-11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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Teixeira R, Massaro C, Garib D. Vertical and sagittal changes produced by an expander with differential opening and fan-type expander: A post-hoc analysis of a randomised controlled trial. J Orthod 2023:14653125231208465. [PMID: 37905906 DOI: 10.1177/14653125231208465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE). DESIGN Two-arm parallel randomised clinical trial (RCT). METHODS This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the t-test and Mann-Whitney U test (P < 0.05). RESULTS The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 men, 14 women; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). A greater palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort. CONCLUSION Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors compared to the EDOs. However, the amount of sagittal difference was not clinically relevant. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.
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Affiliation(s)
- Rodrigo Teixeira
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Pálvölgyi L, Kesztyűs A, Shujaat S, Jacobs R, Nagy K. Creation of Dimicleft radiological cleft phantom skulls using reversed virtual planning technique. Dentomaxillofac Radiol 2023; 52:20230121. [PMID: 37395648 PMCID: PMC10552124 DOI: 10.1259/dmfr.20230121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVES The aim of this technical report was to develop customized pediatric phantoms for cone-beam computed tomography (CBCT)-related research in cleft patients. METHODS Six human pediatric skulls (age: 5-10 years) were recruited. A cone-beam computed tomography (CBCT) scan was taken for each skull, followed by virtual modeling through the process of segmentation. An artificial cleft was designed and printed to be applied onto the skull for the creation of an artificial cleft. The skulls were covered with non-radiopaque tape and immersed in melted Mix-D soft tissue equivalent material. The resulting phantoms covered with Mix-D were assessed radiologically by two expert radiologists. These phantoms were referred to as Dimicleft pediatric skull phantoms. RESULTS Dimicleft phantoms were able to appropriately mimic in vivo circumstances. No gaps existed between Mix-D and bony tissue. Virtual planning allowed the optimal designing of an artificial cleft onto the phantom. The artificially created cleft was suitable to determine the size, location, and extent of the cleft. CONCLUSIONS Dimicleft phantoms could act as a viable alternative to other commercially available options for assessing image quality and optimizing CBCT protocols in cleft patients for diagnostics and three-dimensional treatment planning.
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Affiliation(s)
- Laura Pálvölgyi
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Artúr Kesztyűs
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | | | | | - Krisztián Nagy
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
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22
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Teixeira R, Massaro C, Garib D. Comparison of nasal cavity changes between the expander with differential opening and the fan-type expander: a secondary data analysis from an RCT. Clin Oral Investig 2023; 27:5999-6006. [PMID: 37620440 DOI: 10.1007/s00784-023-05213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The aim of this study was to compare the nasal cavity skeletal changes between the expander with differential opening (EDO) and the fan-type expander (FE). METHODS This study was a secondary analysis of a previous randomized clinical trial. Forty-eight patients with posterior crossbite were randomly allocated into two study groups. Twenty-four patients (11 male, 13 female) with a mean initial age of 7.6 ± 0.9 years were treated with rapid maxillary expansion (RME) using the EDO. Twenty-four patients (10 male, 14 female) with a mean initial age of 7.8 ± 0.9 years were treated with the FE. Cone-beam computed tomography (CBCT) was performed before treatment and 1 to 6 months after the active phase of RME. Using frontal CBCT slices passing at the level of maxillary permanent first molars and maxillary deciduous canines, the width of the nasal cavity was measured in the lower, middle and upper thirds. Nasal cavity height was also evaluated in both slices. Intergroup comparisons of interphase changes were performed using t or Mann-Whitney tests (P < 0.05). RESULTS The two groups were similar regarding baseline data. EDO showed a greater transverse increase in the lower third of the nasal cavity in both canine (P = 0.007) and molar regions (P < 0.001). No intergroup difference was observed for changes in middle and upper widths and height of the nasal cavity. CONCLUSIONS Both expanders are effective in promoting an increase of the nasal cavity skeletal dimensions. The expander with differential opening produced a greater transverse increase in the lower third of the nasal cavity compared to the fan-type expander, both at the anterior and posterior regions of the maxilla. CLINICAL RELEVANCE EDO might be more beneficial to pediatric patients with oral breathing and obstructive sleep apnea compared to FE.
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Affiliation(s)
- Rodrigo Teixeira
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil.
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-901, Brazil
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Ver Berne J, Politis C, Shaheen E, Jacobs R. Cumulative exposure and lifetime cancer risk from diagnostic radiation in patients undergoing orthognathic surgery: a cross-sectional analysis. Int J Oral Maxillofac Surg 2023; 52:1064-1070. [PMID: 36804279 DOI: 10.1016/j.ijom.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/15/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Radiation doses in dentomaxillofacial imaging are typically very low. However, diagnostic and follow-up protocols in orthognathic surgery result in a patient-specific risk in effective dose. Estimating the cancer risks from these exposures remains abstract for many maxillofacial surgeons. In this study, 40 orthognathic patients were randomly sampled and their cumulative effective dose (ED) calculated. The lifetime attributable risk of cancer (LAR) was calculated based on the standard radiological protocol for orthognathic surgery follow-up using methods described in the BEIR VII report and RadRAT. The mean cumulative ED of the 40 sampled patients at the end of their 2-year follow-up period was 1.91 ± 0.58 mSv. The LAR at the end of follow-up was 17.65 (90% confidence interval 6.46-32.90) per 100,000 person-years for male orthognathic patients and 13.93 (90% confidence interval 6.27-25.24) per 100,000 person-years for female orthognathic patients. This represents 0.70% and 0.68%, respectively, of the baseline cancer risk for oral, thyroid, and brain cancer combined. Although theoretical, these results provide a framework for interpreting radiation doses and cancer risks in patients undergoing orthognathic surgery. Considering the increased radiation sensitivity in children and adolescents, indication-oriented and patient-specific imaging protocols should be advised.
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Affiliation(s)
- J Ver Berne
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium.
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - E Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - R Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium; Department of Dentistry, Karolinska Institutet, Stockholm, Sweden
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Shujaat S, Kesztyüs A, Song D, Regnstrand T, Benchimol D, Nagy K, Jacobs R. Moving toward patient specificity for devising cone-beam computed tomography field-of-views: A normative maxillary skeletal dimensional analysis. Int J Paediatr Dent 2023; 33:477-486. [PMID: 37203232 DOI: 10.1111/ipd.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND A lack of evidence exists comprehensively assessing skeletal dimensions in a Caucasian population group at different ages. AIM To provide age- and gender-specific normative skeletal dimensional measurements of the maxillary region using cone-beam computed tomography (CBCT) imaging. DESIGN Cone-beam computed tomography images of Caucasian patients were acquired and divided into different age groups ranging from 8 to 20 years. Linear measurements were taken to evaluate seven distance-based variables, which included anterior nasal spine-posterior nasal spine (ANS-PNS) distance, bilateral maxillary first molar's central fossae (CF) distance, palatal vault depth (PVD), bilateral palatal cementoenamel junction (PCEJ) distance, bilateral vestibular CEJ (VCEJ) distance, bilateral jugulare distance (Jug) and arch length (AL). RESULTS A total of 529 patients (243 male, 286 female) were selected. ANS-PNS and PVD showed the highest change in dimensions from 8 to 20 years of age. On the contrary, AL had the least variability in all age groups. Male patients had larger dimensions and showed a significant change in all dimensional measurements (p < .001) than female patients. CONCLUSION The maxillary linear dimensions varied across different age groups. The presented maxillary normative data could serve as a reference guide for devising patient-specific CBCT field of views.
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Affiliation(s)
- Sohaib Shujaat
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Artúr Kesztyüs
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Dandan Song
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Tobias Regnstrand
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Daniel Benchimol
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Krisztian Nagy
- Center for Facial Reconstruction, 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
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Klingler S, Biel P, Tschanz M, Schulze R. CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria. Clin Oral Investig 2023; 27:5627-5636. [PMID: 37522991 PMCID: PMC10492752 DOI: 10.1007/s00784-023-05184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice.
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Affiliation(s)
- Samuel Klingler
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Philippe Biel
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Moses Tschanz
- Information Technology (IT) Group, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Ralf Schulze
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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McLaughlin V, Liu J, Kalim S, Nguyen K, Kim DG, Sun Z. Application of metal artifact reduction algorithm for CBCT diagnosis of temporary anchorage device-tooth root contact: inadequate to reduce false-positive rate. Dentomaxillofac Radiol 2023; 52:20220396. [PMID: 37427694 PMCID: PMC10461258 DOI: 10.1259/dmfr.20220396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES It was recently found that when cone beam computed tomography (CBCT) was used to examine temporary anchorage device (TAD)-tooth root contact, it tends to yield high false-positive (FP) diagnoses. This study investigated whether application of a metal artifact reduction (MAR) algorithm or reducing CBCT scan voxel-size can remediate this problem. METHODS 18 fresh pig cadaver mandibles underwent TAD placement bilaterally at first molar lingual furcation regions. CBCT scans were taken under varied MAR (absence, presence) and voxel-size (400 µm, 200 µm) settings. Then, TADs were removed and a micro-CT scan (27 µm voxel-size) of the TAD placement site was performed. Three raters, blinded of CBCT scan setting, independently diagnosed whether TADs were in contact with roots. The reliability and accuracy of CBCT diagnoses using micro-CT as the gold-standard were statistically examined. RESULTS Generally, CBCT diagnoses had intrarater (Cohen's κ: 0.54-1) and interrater (Fleiss' κ: 0.73-0.81) reliability, within the moderate to excellent range, which did not vary with MAR setting or scan voxel-size. For diagnostic accuracy, FP rate among all raters was mostly in the 15-25% range and did not change with MAR or scan voxel-size settings (McNemar tests, p > 0.05) while false-negative rate was relatively minimal and only occurred to one rater (9%). CONCLUSIONS When using CBCT to diagnose possible TAD-root contact, applying a currently available Planmeca MAR algorithm or reducing CBCT scan voxel-size from 400 µm to 200 µm may not decrease FP rate. Further optimization of the MAR algorithm for this purpose may be needed.
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Affiliation(s)
- Victoria McLaughlin
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Jie Liu
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Sonya Kalim
- Division of Oral and Maxillofacial Radiology, College of Dentistry, Ohio State University, Columbus, Ohio, United States
| | - Kristin Nguyen
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Zongyang Sun
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
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Zhang Y, Zheng X, Zhang Q, He Z, Huang W, Yan X, Lv T, Yuan X. Clinical finite element analysis of mandibular displacement model treated with Twin-block appliance. Am J Orthod Dentofacial Orthop 2023; 164:395-405. [PMID: 37029052 DOI: 10.1016/j.ajodo.2023.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION The mechanical distribution of the mandible is an important factor that affects functional orthosis during Twin-block (TB) appliance correction. Changes in the mandible before and after TB appliance correction are also key factors in maintaining the therapeutic effect. Finite element analysis, a powerful numerical, analytical tool, is widely used to predict the stress and strain distribution of the craniofacial bone that orthodontics generates. METHODS The sample was a 14-year-old male patient with Class II malocclusion during growth. A cone-beam computed tomography scan was undertaken at pretreatment and posttreatment. In the Finite element analysis of the pretreatment model, the remote displacement model of the mandible was established with the sella point as the center. A mandibular model under TB appliance loading was established. Its mandibular displacement and von Mises stress were compared before and after loading. Three-dimensional registration was conducted on the pretreatment and posttreatment models to measure the sagittal displacement of the centrosome. RESULTS The force on the mandible occurred mainly in the condyle neck and medial mandible after the TB appliance moved the mandible. After displacement, the posterior upper margin of the condyle was farther away from the articular fossa. Three-dimensional registration results showed that new bone had formed behind and above the condyle after TB appliance treatment. CONCLUSION The TB appliance provides additional advantages in treating skeletal Class II malocclusions by helping to reduce the burden on the temporomandibular joint and promoting the adaptive reconstruction of the mandible.
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Affiliation(s)
- Yingyue Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Xinyu Zheng
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Qiang Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Zijing He
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Wenli Huang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Xiao Yan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China
| | - Tao Lv
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Qingdao, China.
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, China.
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Abate A, Ugolini A, Maspero C, Silvestrini-Biavati F, Caprioglio A, Lanteri V. Comparison of the skeletal, dentoalveolar, and periodontal changes after Ni-Ti leaf spring expander and rapid maxillary expansion: a three-dimensional CBCT based evaluation. Clin Oral Investig 2023; 27:5249-5262. [PMID: 37466717 PMCID: PMC10492880 DOI: 10.1007/s00784-023-05144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The aim of the present study was twofold:(1) three-dimensionally evaluate the quantitative skeletal and dentoalveolar changes after Ni-Ti leaf spring expander (leaf expander) and rapid maxillary expansion (RME) in mixed dentition patients;(2) analyze the modifications of the buccal alveolar bone plate of the maxillary first permanent molars. METHODS Patients who underwent CBCT scans before and after maxillary expansion were randomly selected from the records archived at the Department of Biomedical Surgical and Dental Sciences, University of Milan, Italy. Inclusion criteria were the following: no systemic disease or syndromes; maxillary transverse deficiencies (difference between the upper intermolar width and the lower intermolar width of at least 3 mm and/or clinical need based on radiographic evaluation), early mixed dentition with ages between 7 to 10 years old; cervical vertebra maturation stage (CVMS) 1 or 2; no pathologic periodontal status; skeletal class I or II; maxillary expander cemented on the upper second deciduous molars. Exclusion criteria were the following: patients with pubertal or post-pubertal stage of development (CVMS 3-6); late deciduous or late mixed dentition, impossibility to use the second primary molar as anchorage; skeletal class III malocclusion; craniofacial syndromes; patients unable to be followed during the treatment period. Twenty-three patients treated with Leaf Expander, 11 males (mean age 7.8 ± 0.6 years) and 12 females (mean age 8.1 ± 0.8 years), met the inclusion criteria and constituted the case group. Twenty-four (control group) treated with conventional RME, 12 males (mean age 8.4 ± 0.9 years) and 12 females (mean age 8.1 ± 0.7 years). The paired-sample T test was used for intra-group comparison to evaluate the difference between before (T1) and after (T2) maxillary expansion. Independent sample t-test was computed to perform between groups comparison of the skeletal, dentoalveolar, and periodontal changes. RESULTS The Leaf Expander and RME group showed a significant increase between T1 and T2 for most of the skeletal and dentoalveolar variables. Concerning the skeletal variables only the RME demonstrated a significant increase at the level of the posterior nasal (PNW) and apical base width (PABW) and maxillary mid-alveolar width (MMW). Despite this, when compare with the Leaf Expander, the RME group exhibited a statistically larger width increase for only two skeletal parameters: PNW (p = 0.03) and MMW (p = 0.02). No significant changes at the periodontal level were found in either group. CONCLUSIONS According to the current research, the authors confirm the effectiveness of the Leaf Expander and RME to produce similar skeletal and dentoalveolar effects in mixed dentition subjects. Moreover, the devices anchored to deciduous teeth did not reduce the thickness and height of the buccal bone at the level of the maxillary permanent first molars in either of the two groups.
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Affiliation(s)
- Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, Genoa, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy.
| | | | - Alberto Caprioglio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
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de Lima JP, Mazzi-Chaves JF, de Sousa-Neto MD, Candemil AP. Could Low-dose Cone-beam CT be Used for Endodontic Intraoperative Diagnosis? J Endod 2023; 49:1161-1168. [PMID: 37451335 DOI: 10.1016/j.joen.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) allows three-dimensional evaluation and has high diagnostic accuracy of endodontic conditions. Considering that the most indicated protocol for endodontics should have smaller field-of-view and higher spatial resolution, a higher radiation dose may be associated. Thus, this study evaluated the accuracy of an optimized CBCT protocol for the detection of intraoperative endodontic complications. METHODS An image phantom was custom-made with a human mandible covered with Mix-D and forty mandibular first molars. The teeth were subdivided into 4 groups of endodontic complications which were simulated. All teeth were individually inserted into the left second molar socket of the phantom and CBCT images were acquired with OP 300 unit adjusted to a field-of-view of 6 × 4 cm, 90kVp, and 2 dose protocols: low and high. Furthermore, a titanium implant, a tooth with endodontic treatment, and a cobalt-chromium post were inserted into the empty sockets adjacent to the teeth of interest and additional images were acquired. Four endodontists evaluated the images and indicated the presence of endodontic complications on a 5-point scale. Sensitivity, specificity, and area under the receiver operating characteristic curve were obtained. The different groups were compared by ANOVA and Tukey tests (α = 0.05). RESULTS In most conditions, irrespective of the presence of metallic materials, the values of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve did not differ significantly (P > .05) between the dose protocols. CONCLUSIONS Optimized CBCT protocols should be considered for the detection of intraoperative endodontic Diagnostic complications.
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Affiliation(s)
- João Pedro de Lima
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião de Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Christiaens V, Pauwels R, Mowafey B, Jacobs R. Accuracy of Intra-Oral Radiography and Cone Beam Computed Tomography in the Diagnosis of Buccal Bone Loss. J Imaging 2023; 9:164. [PMID: 37623696 PMCID: PMC10455186 DOI: 10.3390/jimaging9080164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The use of cone beam computed tomography (CBCT) in dentistry started in the maxillofacial field, where it was used for complex and comprehensive treatment planning. Due to the use of reduced radiation dose compared to a computed tomography (CT) scan, CBCT has become a frequently used diagnostic tool in dental practice. However, published data on the accuracy of CBCT in the diagnosis of buccal bone level is lacking. The aim of this study was to compare the accuracy of intra-oral radiography (IOR) and CBCT in the diagnosis of the extent of buccal bone loss. METHODS A dry skull was used to create a buccal bone defect at the most coronal level of a first premolar; the defect was enlarged apically in steps of 1 mm. After each step, IOR and CBCT were taken. Based on the CBCT data, two observers jointly selected three axial slices at different levels of the buccal bone, as well as one transverse slice. Six dentists participated in the radiographic observations. First, all observers received the 10 intra-oral radiographs, and each observer was asked to rank the intra-oral radiographs on the extent of the buccal bone defect. Afterwards, the procedure was repeated with the CBCT scans based on a combination of axial and transverse information. For the second part of the study, each observer was asked to evaluate the axial and transverse CBCT slices on the presence or absence of a buccal bone defect. RESULTS The percentage of buccal bone defect progression rankings that were within 1 of the true rank was 32% for IOR and 42% for CBCT. On average, kappa values increased by 0.384 for CBCT compared to intra-oral radiography. The overall sensitivity and specificity of CBCT in the diagnosis of the presence or absence of a buccal bone defect was 0.89 and 0.85, respectively. The average area under the curve (AUC) of the receiver operating curve (ROC) was 0.892 for all observers. CONCLUSION When CBCT images are available for justified indications, other than bone level assessment, such 3D images are more accurate and thus preferred to 2D images to assess periodontal buccal bone. For other clinical applications, intra-oral radiography remains the standard method for radiographic evaluation.
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Affiliation(s)
- Véronique Christiaens
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark;
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Radiology, Chulalongkorn University, 10330 Bangkok, Thailand
| | - Bassant Mowafey
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Oral medicine, Periodontology, Diagnosis and Oral radiology, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Dental Medicine, Karolinska Institutet, 14152 Huddinge, Sweden
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Pauwels R. A new formula for converting dose-area product to effective dose in dental cone-beam computed tomography. Phys Med 2023; 112:102639. [PMID: 37441822 DOI: 10.1016/j.ejmp.2023.102639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/09/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE The purpose of this study was to determine a dedicated conversion formula between dose-area product (DAP) and effective dose (E) for dental CBCT, which incorporates X-ray beam energy as well as geometric factors. METHODS CBCT exposures of an adult phantom were simulated using PCXMC 2.0 (STUK, Finland). Fifty-seven fields of view (FOV) were included, ranging from Ø4x4cm to Ø21x19cm. Six tube voltages (70 kV to 120 kV), eight combinations of Al (2.5 to 10 mm) and Cu (0 to 0.5 mm) filtration, and four source-isocentre distances (35 to 65 cm) were used, resulting in 10 896 simulated scan protocols. In addition, 10 944 random combinations of scan parameters within the aforementioned ranges were simulated, resulting in 21 840 scan protocols that were used for fitting a formula using multiple linear regression with 8 independent variables. Finally, 2304 random scan protocols were simulated as validation data to evaluate the formula's generalizability. RESULTS E/DAP ranged between 0.031 µSv/mGy.cm2 and 0.294 µSv/mGy.cm2, with a mean of 0.150 µSv/mGy.cm2. Due to extensive clustering of the E/DAP, three formulas were determined according to FOV categories (Small: <100 cm2, Medium: 100-400 cm2, Large: >400 cm2). The resulting formulas showed mean absolute errors of 7.9%, 4.0% and 3.6%, respectively, for the validation data. CONCLUSION The new formulas allow for a straightforward, yet accurate, estimation of the effective dose for dental CBCT based on DAP. Further fine-tuning of the model could be achieved by incorporating, for example, bowtie filtration and off-axis beam geometries.
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Affiliation(s)
- Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, Denmark; Aarhus Institute of Advanced Studies, Aarhus University, Denmark; Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Sennimalai K, Selvaraj M, Kharbanda OP, Kandasamy D, Mohaideen K. MRI-based cephalometrics: a scoping review of current insights and future perspectives. Dentomaxillofac Radiol 2023; 52:20230024. [PMID: 36809112 PMCID: PMC10304848 DOI: 10.1259/dmfr.20230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE This review aims to explore the current status of magnetic resonance imaging (MRI) as a cephalometric tool, summarize the equipment design and methods, and propose recommendations for future research. METHODS A systematic search was conducted in electronic databases, including PubMed, Ovid MEDLINE, Scopus, Embase, Web of Science, EBSCOhost, LILACS, and Cochrane Library, using broad search terms. The articles published in any language till June 2022 were considered. Cephalometric studies conducted using the MRI dataset on human participants, phantom or cadaver were included. Two independent reviewers assessed the final eligible articles using the quality assessment score (QAS). RESULTS Nine studies were included in the final assessment. Studies used various methods, including 1.5 T or 3 T MRI systems and 3D or 2D MRI datasets. Among the imaging sequences, T1-weighted, T2-weighted and black bone MR images were used for cephalometric analysis. In addition, the reference standards varied among studies, such as traditional 2D cephalogram, cone-beam CT and phantom measurements. The mean QAS of all the included studies was 79% (± 14.4%). The main limitation of most studies was the small sample size and the heterogeneity of the methods, statistical tools used, and metric outcomes assessed. CONCLUSIONS Despite the heterogeneity and lack of metrological evidence on the effectiveness of MRI-based cephalometric analysis, the preliminary results demonstrated by in vivo and in vitro studies are encouraging. However, future studies exploring MRI sequences specific to cephalometric diagnosis are required for wider adoption of this technique in routine orthodontic practice.
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Affiliation(s)
- Karthik Sennimalai
- Department of Orthodontics, All India Institute of Medical Sciences, Jammu, 184120, Jammu & Kashmir, India
| | - Madhanraj Selvaraj
- Division of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | | | - Devasenathipathy Kandasamy
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, Delhi, India
| | - Kaja Mohaideen
- Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, 174001, Himachal Pradesh, India
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Michielsens H, Decreus J, Begnoni G, Verdonck A, Jacobs R, Willems G, Cadenas de Llano-Pérula M. Performance of the Malmgren Index for Assessing Root Resorption on 2D vs. 3D Radiographs: A Pilot Study. Healthcare (Basel) 2023; 11:1860. [PMID: 37444694 DOI: 10.3390/healthcare11131860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/18/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES To compare the performance of the Malmgren index on 2D and 3D radiographs. METHODS Patients with a panoramic radiograph and a cone beam computed tomography (CBCT) taken at an interval of <3 months and presenting root resorption (RR) on at least one incisor and/or canine were retrospectively included. RR was scored twice by two observers using the Malmgren index in both the 2D and 3D sets, and intra-class correlation coefficient (ICC) was calculated. RESULTS 155 teeth were analyzed. The ICC was the lowest in 2D, followed by overall, transversal and sagittal 3D. Malmgren scores were systematically higher in 2D, which overestimated RR, especially in the transversal plane on all incisors and canines and in the sagittal plane on the maxillary incisors. 2D respectively leads to 28.0-34.8% of false positives and negatives when discriminating between RR or not. The early stages of RR are often misdiagnosed in 2D, while later stages are more accurate. CONCLUSIONS The original Malmgren index is not suited for 3D images, especially axial, where using dichotomized values (resorption yes/no) leads to overestimation of RR. A low-dose CBCT of the upper incisors could detect RR with high diagnostic accuracy in the early stages of orthodontic treatment, especially in patients with dental trauma or familial RR history.
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Affiliation(s)
- Hanne Michielsens
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Julie Decreus
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Giacomo Begnoni
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Anna Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium
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Wang Z, Guo X, Chen C, Qin L, Meng L. Effect of field of view and voxel size on CBCT-based accuracy of dynamic navigation in endodontic microsurgery: an in vitro study. J Endod 2023:S0099-2399(23)00290-X. [PMID: 37269977 DOI: 10.1016/j.joen.2023.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/20/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study aimed to evaluate the influence of field of view (FOV) and voxel size on the accuracy of dynamic navigation (DN)-assisted endodontic microsurgery (EMS). METHODS Nine sets of maxillary and mandibular three-dimensional-printed jaw models composed of 180 teeth were divided into nine groups with different FOVs (80 × 80 mm, 60 × 60 mm, and 40 × 40 mm) and voxel sizes (0.3, 0.16, and 0.08 mm). The endodontic DN system was used to plan and execute the EMS. The accuracy of the DN-EMS was represented by the platform deviation, end deviation, angular deviation, resection angle, and resection length deviation. Statistical analyses were performed using SPSS 24.0, and the significance level was set at p < 0.05. RESULTS The average platform, end, angular, resection angle, and resection length deviation were 0.69 ± 0.31 mm, 0.93 ± 0.44 mm, 3.47 ± 1.80°, 2.35 ± 1.76°, and 0.41 ± 0.29 mm, respectively. No statistically significant differences in accuracy were observed between the nine FOV and voxel size groups. CONCLUSION FOV and voxel size did not appear to play an important role in the accuracy of DN-EMS. Considering the image quality and radiation dose, it is reasonable to select a limited FOV (such as 40 × 40 mm and 60 × 60 mm) to cover only the registration device, involved teeth, and periapical lesion. The voxel size should be selected according to the required resolution and CBCT units.
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Affiliation(s)
- Zan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiaolong Guo
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China;.
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Guarnieri R, Grenga C, Altieri F, Rocchetti F, Barbato E, Cassetta M. Can computer-guided surgery help orthodontics in miniscrew insertion and corticotomies? A narrative review. FRONTIERS IN ORAL HEALTH 2023; 4:1196813. [PMID: 37323650 PMCID: PMC10264618 DOI: 10.3389/froh.2023.1196813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Orthodontics has considerably increased the use of technology combined with surgery as a tool to improve dental movements in terms of predictability, acceleration of movement, and fewer side effects. To achieve these goals miniscrews and corticotomy were introduced. The digital workflow permits an increase in the accuracy of surgical and orthodontic setups. The tool that transfers the information is the CAD/CAM (Computer-Aided Design/ Computer-Aided Manufacturing) template. The aim of this review is to illustrate the use of computer-guided surgery in orthodontics regarding miniscrews and piezocision. The search strategy was a combination of Medical Subject Headings (Mesh) and free text words for PubMed. A total of 27 articles were included in this review: 16 concerned miniscrews and 11 concerned corticotomy. The current need for faster treatments, the improved systems of anchorage, and the evolution of imaging technologies require operators to be knowledgeable of the digital workflow. CAD/CAM templates allow greater precision and predictability of miniscrew insertion even if in the hands of less experienced clinicians and permit a better orientation and depth of the cortical incision. In conclusion, digital planning makes surgery faster and easier and allows for the identification and correction of any potential problem before the procedure.
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:diagnostics13101684. [PMID: 37238169 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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Alves Dos Santos GN, Sousa-Neto MD, Assis HC, Lopes-Olhê FC, Faria-E-Silva AL, Oliveira ML, Mazzi-Chaves JF, Candemil AP. Prevalence and morphological analysis of dens invaginatus in anterior teeth using cone beam computed tomography: A systematic review and meta-analysis. Arch Oral Biol 2023; 151:105715. [PMID: 37146389 DOI: 10.1016/j.archoralbio.2023.105715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES To evaluate the prevalence and morphological characteristics of DI using CBCT. METHODS A literature search was performed in PubMed, Embase, Scopus, and Web of Science. Inclusion criteria were randomized clinical trials, cross-sectional studies, and prospective and retrospective cohort studies evaluating the morphological characteristics of DI in anterior teeth using CBCT. Three reviewer authors independently screened the studies, applied the eligibility criteria, assessed the risk of bias, and extracted until September (2022). The risk of bias was evaluated using the Joanna Briggs Institute criteria. Meta-analyses of proportions were used for estimate the prevalence DI according to factors at participant and tooth levels. RESULTS Six studies were included in the meta-analysis. Among 7373 individuals, a prevalence of 7.45 % of DI was observed (n = 258; τ2 = 0.0096; CI of 4.51-11.3; p < 0.05), with no significant influence of sex. Regarding laterality, unilateral DI showed higher mean prevalence (4.30 %; CI of 2.03-7.33). Among the 382 anterior teeth with DI (0.72 %), the most affected tooth was the upper lateral incisor (5.12 %; n = 329; CI of 2.35-8.86; p < 0.001), type I was the most prevalent (0.59 %; CI of 0.24-1.08) and the presence of open apex and periradicular pathology ranged from 4.3 % to 22.72 % and 3.5-77.92 %, respectively. CONCLUSIONS The prevalence of individuals with dens invaginatus was 7.45 %, the most affect tooth was the upper lateral incisor with a prevalence of 5.12 % unilaterally and type I was the most prevalent morphology.
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Affiliation(s)
- Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Helena Cristina Assis
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
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Schüler IM, Hennig CL, Buschek R, Scherbaum R, Jacobs C, Scheithauer M, Mentzel HJ. Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents. J Pers Med 2023; 13:jpm13040692. [PMID: 37109079 PMCID: PMC10141634 DOI: 10.3390/jpm13040692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm2 and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm2 and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics-reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.
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Affiliation(s)
- Ina Manuela Schüler
- Section Preventive Dentistry and Pediatric Dentistry, Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
| | | | - Rika Buschek
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
| | - Rebecca Scherbaum
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
| | - Marcel Scheithauer
- Radiation Protection, Centre for Health and Safety Management, Jena University Hospital, 07747 Jena, Germany
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
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Singer SR, Mupparapu M. Temporomandibular Joint Imaging. Dent Clin North Am 2023; 67:227-241. [PMID: 36965928 DOI: 10.1016/j.cden.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Prescriptions for imaging studies for temporomandibular disorders are based on the patient's complaint, history, and clinical findings. Appropriate selection criteria and justification for imaging examinations must be followed. Because the temporomandibular joint is composed of both hard and soft tissues, different studies are prescribed based on the clinically suspected condition. Current imaging modalities include panoramic radiographs, cone-beam computed tomography, and MRI. The entire examination must be interpreted, and the findings recorded in the patient record. No one imaging modalities is suitable for all patients. An oral and maxillofacial radiologist should be consulted when the interpretation of the study is beyond the scope of the practitioner.
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Affiliation(s)
- Steven R Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Room D885A, Newark, NJ 07103-2400, USA.
| | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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40
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Kadi H, Jacobs R, Shujaat S, Lemberger M, Benchimol D, Karsten A, Pegelow M. A CBCT Based Assessment of Canine Eruption and Development Following Alveolar Bone Grafting in Patients Born With Unilateral Cleft lip and/or Palate. Cleft Palate Craniofac J 2023; 60:386-394. [PMID: 34873962 DOI: 10.1177/10556656211064477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To three-dimensionally assess and visualize the eruption path and development of the maxillary canine following alveolar bone grafting in patients born with cleft lip and palate. A further objective of this analysis was to assess how the presence of the lateral incisor impacts the eruption path of the canine. Observational follow-up study. Stockholm Craniofacial Team, Karolinska University Hospital, Sweden. Thirty children born with non-syndromic unilateral cleft lip with or without palate were consecutively included. CBCT scans of the maxilla were taken six months before and six months after the alveolar bone-grafting surgery for each patient. Canine eruption (angulation and vertical movement) and canine development (length and volume). There was a significant difference pre- and post-operatively of the canine angulation between the cleft and non-cleft sides. The mean angulation on the cleft side was 14.7° (SD = 11.1°) while on the non-cleft side, it was 4.9° (SD = 9.2°). No significant differences were noted between cleft-side and non-cleft side canines in terms of amount of vertical eruption and volumetric development. Absence of the lateral incisor did not significantly contribute to either canine angulation or its vertical eruption on the cleft-side. Higher angulation of the canine on the cleft side indicates a higher risk of future canine impaction. Presence or absence of the lateral incisor did not significantly affect canine angulation or its vertical eruption. Increased age and children born with total cleft lip and palate imply a higher risk of angulated canines on the cleft side.
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Affiliation(s)
- Hasan Kadi
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Orthodontic Division, Preventative Dentistry Department, College of Dentistry, 48058Umm Al-Qura University, Makkah, Saudi Arabia
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Mathias Lemberger
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Benchimol
- Division of Oral Diagnostics and rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Karsten
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marie Pegelow
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Willershausen I, Necker F, Kloeckner R, Seidel CL, Paulsen F, Gölz L, Scholz M. Cinematic rendering to improve visualization of supplementary and ectopic teeth using CT datasets. Dentomaxillofac Radiol 2023; 52:20230058. [PMID: 37015249 PMCID: PMC10170174 DOI: 10.1259/dmfr.20230058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Ectopic, impacted, and supplementary teeth are the number one reason for cross-sectional imaging in pediatric dentistry. The accurate post-processing of acquired data sets is crucial to obtain precise, yet also intuitively understandable three-dimensional (3D) models, which facilitate clinical decision-making and improve treatment outcomes. Cinematic rendering (CR) is anovel visualization technique using physically based volume rendering to create photorealistic images from DICOM data. The aim of the present study was to tailor pre-existing CR reconstruction parameters for use in dental imaging with the example of the diagnostic 3D visualization of ectopic, impacted, and supplementary teeth. METHODS CR was employed for the volumetric image visualization of midface CT data sets. Predefined reconstruction parameters were specifically modified to visualize the presented dental pathologies, dentulous jaw, and isolated teeth. The 3D spatial relationship of the teeth, as well as their structural relationship with the antagonizing dentition, could immediately be investigated and highlighted by separate, interactive 3D visualization after segmentation through windowing. RESULTS To the best of our knowledge, CR has not been implemented for the visualization of supplementary and ectopic teeth segmented from the surrounding bone because the software has not yet provided appropriate customized reconstruction parameters for dental imaging. When employing our new, modified reconstruction parameters, its application presents a fast approach to obtain realistic visualizations of both dental and osseous structures. CONCLUSIONS CR enables dentists and oral surgeons to gain an improved 3D understanding of anatomical structures, allowing for more intuitive treatment planning and patient communication.
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Affiliation(s)
- Ines Willershausen
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | | | - Roman Kloeckner
- Institute of Interventional Radiology University Hospital of Schleswig-Holstein-Campus Lübeck, Ratzeburger Allee, Lübeck, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse, Erlangen, Germany
| | - Michael Scholz
- Institute of Functional and Clinical Anatomy Friedrich-Alexander-University Erlangen-Nürnberg, Krankenhausstrasse, Erlangen, Germany
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Marinho-Vieira LE, Martins LAC, Freitas DQ, Haiter-Neto F, Oliveira ML. Revisiting dynamic range and image enhancement ability of contemporary digital radiographic systems-part 2: a subjective assessment. Dentomaxillofac Radiol 2023; 52:20220370. [PMID: 36988093 PMCID: PMC10170171 DOI: 10.1259/dmfr.20220370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE To assess the subjective image quality of original and manually enhanced radiographs acquired at different X-ray exposure times and using different digital systems. METHODS A total of 500 radiographs obtained under 10 exposure times, 5 digital systems, and 2 enhancement conditions were assessed by 5 observers, who were asked to categorize each radiograph into acceptable or unacceptable. A radiograph was considered to be acceptable when at least four out of five observers found it acceptable. Descriptive analysis was used to summarize the outcomes and compare the subjective image quality of original and manually enhanced digital radiographs among different X-ray exposure times and digital systems. RESULTS Express had six exposure times producing acceptable original images within a range from 0.063 to 0.4 s, followed by Digora Toto, which had five within a range from 0.063 to 0.32 s, Digora Optime, which had four within a range from 0.063 to 0.2 s,and SnapShot and VistaScan, which had 2 (0.2 and 0.32 s) and 1 (0.63 s), respectively. Image enhancement turned unacceptable images into acceptable ones in four digital systems: SnapShot at three exposure times, Digora Toto at two exposure times, Express at one exposure time, and VistaScan at four exposure times. CONCLUSION Image enhancement based on brightness and/or contrast adjustments may be necessary to reveal the useful dynamic range of some digital radiographic systems and PSP-based systems may not necessarily have a wider range than sensor-based systems.
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Affiliation(s)
- Luiz Eduardo Marinho-Vieira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba-SP, Brazil
| | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba-SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba-SP, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba-SP, Brazil
| | - Matheus L. Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba-SP, Brazil
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Quaresma Rêgo IC, Oenning A, Nascimento MCC, Junqueira JLC, Oliveira LB. Cone beam computed tomography (CBCT) referrals in paediatric patients: A 24-month retrospective study in two radiological centers in Campinas, Brazil. Eur Arch Paediatr Dent 2023:10.1007/s40368-022-00775-x. [PMID: 36928835 DOI: 10.1007/s40368-022-00775-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 12/20/2022] [Indexed: 03/18/2023]
Abstract
PURPOSE To evaluate the CBCT referrals in paediatric patients over a 24-month period. METHODS A retrospective study was conducted in two radiological centers in Campinas, Brazil. Patients were divided into three age groups: G1: age under 10 years, G2: age between 10 and 12 years, and G3: age over 12 years. The following data were collected: patients' age and sex, localisation, reasons for referral and dental specialty responsible for the request of CBCT exams. RESULTS Data from 367 patients were assessed. CBCT was used more frequently in the Group 3 (58.9%). There was significant association between the region of the exam and age group (P < 0.05), with a higher percentage of exams in the maxilla for the age over 12 years (35.6%) than that of up to 10 years (50.9%) and between 10 and 12 years (51.1%). Alterations were observed in 79.3% of the exams and 47.4% showed impacted teeth with significant association with the increase in age group (P < 0.05). Of the total number of exams, (55.3%) were requested in Orthodontics followed by Oral Surgery (30.0%) and Paediatric Dentistry (9.5%). CONCLUSIONS It can be concluded that CBCT exams were indicated frequently for the age over 12 years. The presence of impacted teeth represented the main reason for referrals and Orthodontics was the dental specialty that indicated CBCT with higher frequency.
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Affiliation(s)
| | - A Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - M C C Nascimento
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - J L C Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
| | - L B Oliveira
- Division of Pediatric Dentistry, Faculdade São Leopoldo Mandic, São Leopoldo Mandic School of Dentistry, Rua José Rocha Junqueira, 13, Campinas, SP, 13045-755, Brazil.
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Yang P, Xuan B, Li G, Qi S. Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis. BMC Oral Health 2023; 23:127. [PMID: 36841769 PMCID: PMC9960480 DOI: 10.1186/s12903-023-02832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVE This systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination. METHODS We performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2-0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I2 statistics, in which I2 > 50% was considered substantial heterogeneity. RESULTS A total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = - 0.56, 95%-CI = - 0.99 ~ - 0.13, p = 0.01). Because of the high heterogeneity among the studies (I2 = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I2 = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD = - 0.35, 95%-CI = - 0.59 ~ - 0.11, p = 0.004). CONCLUSION This review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.
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Affiliation(s)
- Pan Yang
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China
| | - Bin Xuan
- Department of Stomatology, Aerospace Center Hospital, Beijing, China
| | - Gang Li
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
| | - Senrong Qi
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
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Brasil DM, Merken K, Binst J, Bosmans H, Haiter-Neto F, Jacobs R. Monitoring cone-beam CT radiation dose levels in a University Hospital. Dentomaxillofac Radiol 2023; 52:20220213. [PMID: 36802857 PMCID: PMC9944015 DOI: 10.1259/dmfr.20220213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/24/2022] [Accepted: 01/10/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. METHODS An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. RESULTS A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. CONCLUSIONS Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.
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Affiliation(s)
| | - Karen Merken
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium
| | - Joke Binst
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Yeung AWK, Parvanov ED, Horbańczuk JO, Kletecka-Pulker M, Kimberger O, Willschke H, Atanasov AG. Are dental x-rays safe? Content analysis of English and Chinese YouTube videos. Digit Health 2023; 9:20552076231179053. [PMID: 37312949 PMCID: PMC10259113 DOI: 10.1177/20552076231179053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Objective This study provided a content analysis of English and Chinese YouTube videos related to dental radiation safety. Method The search string, entered in English and Chinese respectively, was: (dental x-ray safe). The searches were performed and exported with Apify YouTube scraper. By screening the resultant videos and their related videos (as recommended by YouTube), a total of 89 videos were screened. Finally, 45 videos (36 English and nine Chinese) were included and analyzed. The specific information regarding dental radiation was evaluated. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability. Results There was no significant difference between the English and Chinese videos in terms of view count, like count, comment count, and video duration. Half of the videos explicitly reassured the audience that dental x-rays are safe. Two of the English videos specifically stated that dental x-rays do not cause cancers. Numerous analogies were made in regard to radiation dose, such as equivalence to taking a flight or eating some bananas. About 41.7% of the English videos and 33.3% of the Chinese videos mentioned that patients could be further protected from scatter radiation by wearing a lead apron and thyroid collar. Videos had a good understandability score (91.3) but a poor actionability score (0). Conclusions Some of the analogies and the claimed radiation dose were questionable. One Chinese video even wrongly stated that dental x-rays are nonionizing radiation. The videos generally did not mention their information sources or the underlying radiation protection principles.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Emil D Parvanov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Jarosław Olav Horbańczuk
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Oliver Kimberger
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland
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Charuakkra A, Mahasantipiya P, Lehtinen A, Koivisto J, Järnstedt J. Comparison of subjective image analysis and effective dose between low-dose cone-beam computed tomography machines. Dentomaxillofac Radiol 2023; 52:20220176. [PMID: 36168973 PMCID: PMC9974239 DOI: 10.1259/dmfr.20220176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To compare the cone-beam computed tomography (CBCT) image quality and effective dose between low-dose scanning and standard manufacturer-recommended protocols among different CBCT units. METHODS Three human-equivalent phantoms were scanned using the ultra-low-dose (ULD), low dose (LD), and standard dose (STD) modes of ProMax 3D Mid (Planmeca Oy, Helsinki, Finland) and Orthophos SL (Sirona, Bensheim, German) for the CBCT images. The quality of the dental anatomical images was assessed by four experienced oral and maxillofacial radiologists using a 5-point Likert scale. OnDemand3D (Cybermed Co., Seoul, Korea) was used as the third-party software for viewing. The percentage of absolute agreement was calculated to determine intra- and interrater agreements among the observers. The effective doses for all CBCT scanning protocols were also calculated. RESULTS The STD protocol yielded a higher image quality than did the ULD and LD protocols in both ProMax 3D Mid and Orthophos SL. The ULD and LD protocols demonstrated an "acceptable-to-good" sense of visual perception of the CBCT images. The visibility scores significantly differed between the ULD and LD and the STD protocols in ProMax 3D Mid and Orthophos SL, except for the 120-kVp setting in ProMax 3D Mid. The average intra- and interrater agreement scores ranged from 0.63 to 0.89 and from 0.44 to 0.76, respectively. The ULD and LD protocols reduced the radiation dose sixfold compared with the STD protocol. CONCLUSIONS High-tube-voltage protocols could remarkably reduce the imaging dose without degrading the image quality. Specifically, ULD and LD CBCT protocols may be adopted as routine practice for diagnosis and treatment planning.
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Affiliation(s)
- Arnon Charuakkra
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Phattaranant Mahasantipiya
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Antti Lehtinen
- Medical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - Juha Koivisto
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Jorma Järnstedt
- Medical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, Finland
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Pinto Nicodemo O, Fiori-Chíncaro GA, Agudelo-Botero AM, Llaguno-Rubio JM, García Díaz R. [Radiation dose permitted in dentistry patients. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e144. [PMID: 38303741 PMCID: PMC10832395 DOI: 10.21142/2523-2754-1101-2023-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/01/2023] [Indexed: 02/03/2024] Open
Abstract
In dental practice, the use of imaging has increased over the years, generating an increase in the radiation dose for the dental patient. One factor under discussion is the amount of dose used in patients, men, women and children, at different stages of their life, due to the scientific evidence of the harmful effects of ionizing radiation. This review of the literature analyzed the characteristics of radiation and its effects in relation to the doses administered, and its equivalences in dental practice in panoramic periapical radiographs and cone beam tomographies. A search of the literature was carried out in the main information sources such as Medline (via PubMed), SEVIER, SCIELO, and LILACS, using the search terms with a date limitation of the last 10 years. The selected articles had to include information regarding the keywords used, including "Dental Offices, Radiation Dose, X-Rays, Ambulatory Care."
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Affiliation(s)
- Omar Pinto Nicodemo
- Carrera de Estomatologia, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca. Sucre, Bolivia. Universidad Mayor de San Francisco Xavier Carrera de Estomatologia Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca Sucre Bolivia
| | - Gustavo Adolfo Fiori-Chíncaro
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Ana María Agudelo-Botero
- Facultad de Estomatologia, Universidad Autonoma de Manizales. Manizales, Colombia. Universidad Autonoma de Manizales Facultad de Estomatologia Universidad Autonoma de Manizales Manizales Colombia
| | - Jhoana M Llaguno-Rubio
- Division de Radiologia Bucal y Maxilofacial, Instituto Latinoamericano de Altos Estudios en Estomatologia. Lima, Peru. , Division de Radiologia Bucal y Maxilofacial Instituto Latinoamericano de Altos Estudios en Estomatologia Lima Peru
| | - Rosaura García Díaz
- Facultad de Estomatologia, Universidad de Guadalajara. Guadalajara, Mexico. Universidad de Guadalajara Facultad de Estomatologia Universidad de Guadalajara Guadalajara Mexico
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Cone beam computed tomography indications for interdisciplinary therapy planning of impacted canines. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:e1-e9. [PMID: 36229372 DOI: 10.1016/j.oooo.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate how cone beam computed tomography (CBCT) affects the therapeutic planning of impacted maxillary canines. STUDY DESIGN A total of 132 impacted canines from 89 pediatric patients were collected from 3 specialist clinics in Stockholm, Sweden. An interdisciplinary therapy planning team consisting of 5 dental specialists evaluated each case and chose their preferred treatment alternative, initially without and later with CBCT images, to decide whether CBCT was justified for therapy planning. Predefined variables measurable using only 2-dimensional (2D) assessments were analyzed using stepwise logistic regression analyses. RESULTS The CBCT was considered indicated in 47% of the cases. Additional information from CBCT led to a treatment decision change in 9.8%. Significant 2D predictors for CBCT justification were horizontal canine angulation compared with vertical angulation (odds ratio [OR] = 10.9), extraction strategy involvement (OR = 6.7), and buccally positioned canines compared with palatal (OR = 5.3), central (OR = 25.0), and distal or uncertain positions (OR = 7.7). CONCLUSIONS The benefit-risk assessment of CBCT for impacted canines may be reinforced by performing and applying justification decisions for CBCT acquisition at the therapeutic thinking level. If preliminary treatment planning motivates further in-depth investigation of either root status or tooth location, a CBCT is indicated.
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Makhlynets N, Ozhogan Z, Pantus A, Pyuryk M, Fedorov S. INFLUENCE OF BAD HABITS ON THE DEVELOPMENT OF ACQUIRED DEFORMATIONS IN THE MAXILLOFACIAL AREA. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1650-1658. [PMID: 37622510 DOI: 10.36740/wlek202307120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim: Identifying the relationship between the presence of oral habit and acquired maxillomandibular anomalies, influence of oral habits on the skeleton and muscular system formation in children. PATIENTS AND METHODS Materials and methods: We conducted clinical, radiological methods of examination of 60 patients aged 9-12 with acquired maxillomandibular anomalies, 15 persons aged 9-12 years without maxillomandibular anomalies and acquired deformities (norm group) and 15 persons aged 9-12 years with hereditary syndromes, which are combined with bone deformities in the maxillofacial area (comparison group). RESULTS Results: Clinical examination showed that oral habits were manifested in 98.3% of patients. The results of clinical and radiological examination, analysis of cephalometric parameters and data on the thickness of the masticatory muscles on symmetrical areas of the face confirm the relationship between chronic oral habits and formation of acquired maxillomandibular anomalies; confirm the presence of acquired rather than congenital deformity of the facial skeleton, which is associated with changes in the thickness of the masticatory muscles on the part of the deformation та compensatory muscle hypertrophy on the opposite side. CONCLUSION Conclusions: The oral habit should be considered as one of the triggers in the development of acquired deformities of the maxillofacial area.
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Affiliation(s)
| | - Zinovii Ozhogan
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Andrii Pantus
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Markiyan Pyuryk
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Serhiy Fedorov
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
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