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Kazimierczak W, Kazimierczak N, Kędziora K, Szcześniak M, Serafin Z. Reliability of the AI-Assisted Assessment of the Proximity of the Root Apices to Mandibular Canal. J Clin Med 2024; 13:3605. [PMID: 38930132 PMCID: PMC11204399 DOI: 10.3390/jcm13123605] [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: 06/06/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Background: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular teeth using computed tomography (CT). Methods: This study involved 57 patients aged 18-30 whose CT scans were analyzed by both AI and human experts. The primary aim was to measure the closest distance between the MC and RAs and to assess the AI tool's diagnostic performance. The results indicated significant variability in RA-MC distances, with third molars showing the smallest mean distances and first molars the greatest. Diagnostic accuracy metrics for the AI tool were assessed at three thresholds (0 mm, 0.5 mm, and 1 mm). Results: The AI demonstrated high specificity but generally low diagnostic accuracy, with the highest metrics at the 0.5 mm threshold with 40.91% sensitivity and 97.06% specificity. Conclusions: This study underscores the limited potential of tested AI programs in reducing iatrogenic damage to the inferior alveolar nerve (IAN) during dental procedures. Significant differences in RA-MC distances between evaluated teeth were found.
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Affiliation(s)
- Wojciech Kazimierczak
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland; (K.K.); (Z.S.)
| | - Natalia Kazimierczak
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Kamila Kędziora
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland; (K.K.); (Z.S.)
| | - Marta Szcześniak
- Chair of Practical Clinical Dentistry, Department of Diagnostics, Poznań University of Medical Sciences, Fredry 10, 61-701 Poznań, Poland;
| | - Zbigniew Serafin
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland; (K.K.); (Z.S.)
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Shen TC, Tu MG, Huang HL, Peng SL, Hsu JT. Analysis of mandibular molar anatomy in Taiwanese individuals using cone beam computed tomography. J Dent Sci 2024; 19:419-427. [PMID: 38303847 PMCID: PMC10829672 DOI: 10.1016/j.jds.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Before periapical surgery in the mandibular posterior teeth is performed, the thicknesses of the buccal alveolar bone wall and buccolingual root might be a critical issue. This study aimed to assess the anatomical structure of the posterior region of the mandible in Taiwanese individuals using cone-beam computed tomography (CBCT). Materials and methods The CBCT images of 96 Taiwanese individuals (51 male and 45 female), which included 192 mandibular first molars and 192 mandibular second molars, were imported into medical imaging software to measure the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex. Statistical analysis was conducted to examine the impact of tooth position, gender, and age on the anatomical position of mandibular molars. Results The buccal alveolar bone thickness at 3 mm above the root apex of the mandibular second molar demonstrates a significantly higher value when compared to that of the first molar. Nonetheless, concerning the buccolingual root thickness, no significant differences were observed between these two teeth. In addition, the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex may not be influenced by gender and age. Conclusion The anatomical structures of the posterior region of the mandible in Taiwanese individuals exhibited variations between the mandibular first and second molars. However, these differences were not influenced by gender or age.
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Affiliation(s)
- Ting-Chun Shen
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Ming-Gene Tu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University. Taichung, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
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Khazaal Al-Jaboori AS, Hassan NA. Cone Beam CT Assessment of Bone Width of Upper and Lower Jaws for Dental Implant Placement: An Iraqi Study. SCIENTIFICA 2023; 2023:4472154. [PMID: 37091876 PMCID: PMC10118883 DOI: 10.1155/2023/4472154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/04/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Background Implantology focuses on the measurement of bone thickness in both the lower and upper jaws. This study aimed to measure and compare alveolar bone thickness of the upper and lower jaws at single edentate sites and cortical bone thickness of their mesial and distal dentate sites. Methods Thickness of alveolar bone thickness was measured in 80 upper and 80 lower implant edentate sites and that of buccal and lingual cortical plates of their mesial and distal dentate sites using Cone beam CT. The bone thickness of the edentulous sites was recorded at 3 points (crestal bone, five mm from the crest, and ten mm from the crest), while the bone thickness of the dentate sites was determined at four points (crestal bone, midroot bone, mid of the alveolar bone housing, and apical portion). Results An increased amount of bone was measured from the crest to the apical portion of the dentate sites on the buccal and lingual sides of both jaws with a highly significant difference detected among all the tested points (P < 0.0001). No statistical difference was detected between the means of buccal bone width at the first 3 points, except at point 4 (the apical portion), where the mean of the lower jaw (3.35 ± 0.54) was significantly larger than that of the upper jaw (3.17 ± 0.55) (P = 0.04). Bone width measured in the edentulous sites showed a gradual increase from the crest to the apical portions in both jaws. Conclusion Bone thickness at the coronal levels is low and susceptible to resorption compared to the apical portions regardless of the dentate state.
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Affiliation(s)
| | - Nuhad A. Hassan
- Department of Oral Medicine, College of Dentistry, AL-Mustansiriyah University, Baghdad, Iraq
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Three-dimensional Analysis of Alveolar Bone With and Without Periodontitis. Int Dent J 2022; 72:634-640. [PMID: 35760735 PMCID: PMC9485513 DOI: 10.1016/j.identj.2022.03.003] [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: 10/22/2021] [Revised: 02/04/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the alveolar bone density and thickness in Chinese participants with and without periodontitis. METHODOLOGY This study was retrospective and cross-sectional in nature and used cone-beam computed tomography (CBCT) to evaluate alveolar bone loss, bone density, and bone thickness around 668 mandibular molars (344 periodontally healthy teeth and 324 teeth with periodontitis). Comparative statistical tests were done related to the age, sex, tooth type, tooth side, and degree of bone loss. The significance level was set to be P < .05. RESULTS The alveolar bone density significantly differed between the healthy and periodontitis groups (mean difference = 24.4 Hounsfield units; P = .007). Similarly, the alveolar bone thickness of the healthy group was significantly higher than that of the periodontitis group (4.6 ± 1.8 mm compared to 4.2 ± 1.1 mm). Teeth in females demonstrated a significantly (P ˂ .001) higher bone density compared with males in both healthy and compromised groups. However, males showed a significantly (P ˂ .05) thicker bone of the teeth than females in relation to the healthy group. The alveolar bone density and thickness in both healthy and periodontitis groups significantly differed between the first and the second molars (P < .001). The alveolar bone thickness had a highly significant difference (P < .001) between the different degrees of bone loss. CONCLUSIONS Alveolar bone thickness and density were reduced at periodontally diseased teeth.
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Alqhtani N, Alqahtani F, Almalki A, Alanazi A, Alkhuriaf H, Alkhtani F, AlEnazi A. Relationship between buccal alveolar bone thickness and crown-to-root dimensions around mandibular first and second molars: A cone-beam-computed tomography-based study. Technol Health Care 2020; 29:725-733. [PMID: 33185619 DOI: 10.3233/thc-202587] [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: 11/15/2022]
Abstract
BACKGROUND Assessment of buccal alveolar bone thickness (ABT) and crown-to-root dimensions are essential in implant density; therefore, three-dimensional evaluation of these parameters provides a superior visualization than conventional radiographs. OBJECTIVE The present cross-sectional cohort study aims to investigate the relationship between buccal ABT and crown-to-root dimensions around the mandibular first and second molars using cone-beam-computed tomography (CBCT). METHODS Initially, CBCT-based scans from 271 individuals were assessed. Based on the inclusion and exclusion criteria, 171 CBCT-based scans were excluded. In total, 100 CBCT-scans were included in the present investigation and processed for data extraction. On the mandibular first and second molars, the mesial and distal root lengths and mesiodistal diameter of the crowns were measured. The pulpal floor served as a reference point for assessment of root length. The buccal ABT was measured at the coronal, middle and apical one-third of the root. Statistical analysis was performed and the level of significance was set at P< 0.01. One-hundred CBCT-scans from 294 mandibular teeth (137 first molars and 157 second molars) were included. One hundred and eighty-nine and 105 teeth were from males and females, respectively. RESULTS The normality plot showed a normal data distribution. The mesiodistal crown width showed a weak yet significant correlation with mesial root length (r= 0.137), bone thickness at mesial apical third (r= 0.180), distal apical (r= 0.157) and distal coronal third (r= 0.161). Bone thickness at mesial, middle and apical third correlated significantly with one other (r= 0.786). CONCLUSION There is a direct correlation between the buccal ABT and tooth dimensions around the mandibular first and second molars.
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Affiliation(s)
- Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Fawaz Alqahtani
- Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Abdulrahman Almalki
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Ahmed Alanazi
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Hamad Alkhuriaf
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Fahad Alkhtani
- Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Adel AlEnazi
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
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Jeon KJ, Lee C, Choi YJ, Han SS. Anatomical analysis of mandibular posterior teeth for endodontic microsurgery: a cone-beam computed tomographic evaluation. Clin Oral Investig 2020; 25:2391-2397. [PMID: 32901333 DOI: 10.1007/s00784-020-03562-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the anatomical structures relevant for endodontic microsurgery in the mandibular posterior teeth using a cone-beam computed tomography (CBCT). MATERIAL AND METHODS A total of 963 mandibular posterior teeth were analyzed in CBCT scans from 133 patients. The buccolingual and mesiodistal dimensions of the root and the buccal bone thickness overlying the root were measured at the site of root resection (apical 3 mm). At this location, the relationship between the buccal cortical bone and root was classified into three types (separated, contact, and exposed), and the distance from the root apex to the mandibular canal was measured. RESULTS The thickest buccolingual dimension of the roots was found in the mesial roots of first molars, at 5.59 ± 0.97 mm. The buccal bone thickness overlying the root became thicker in posterior tooth locations. In the first premolar and first molar mesial root, contact was the most common type of relationship between the buccal cortical bone and root. As the position of the teeth became more posterior, the distance from the apex to the mandibular canal became shorter. CONCLUSIONS As the position of the teeth became more posterior, the buccal bone thickness increased and the distance to the mandibular canal became closer; therefore, particular attention is required for posterior teeth. The first premolar and the first molar mesial root are often in contact with the buccal cortical bone, which may allow infections to spread to the buccal structure more easily and negatively affect for post-surgical healing. CLINICAL RELEVANCE When planning and performing endodontic microsurgery, understanding the anatomical structure of the surgical site will help minimize tissue damage and reduce complications.
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Affiliation(s)
- Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.
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Iwanaga J, Matsushita Y, Decater T, Ibaragi S, Tubbs RS. Mandibular canal vs. inferior alveolar canal: Evidence‐based terminology analysis. Clin Anat 2020; 34:209-217. [DOI: 10.1002/ca.23648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Dental and Oral Medical Center Kurume University School of Medicine Kurume Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy Kurume University School of Medicine Kurume Japan
| | - Yuki Matsushita
- School of Dentistry University of Michigan Ann Arbor Michigan USA
- Department of Clinical Oral Oncology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Tess Decater
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Department of Anatomical Sciences St. George's University St. George's Grenada
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - R. Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Department of Anatomical Sciences St. George's University St. George's Grenada
- Department of Structural and Cellular Biology Tulane University School of Medicine New Orleans Louisiana USA
- Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System New Orleans Louisiana USA
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Porto OCL, Silva BSDF, Silva JA, Estrela CRDA, Alencar AHGD, Bueno MDR, Estrela C. CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study. J Appl Oral Sci 2020; 28:e20190148. [PMID: 32049133 PMCID: PMC6999116 DOI: 10.1590/1678-7757-2019-0148] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 09/24/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. METHODOLOGY In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). RESULTS The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). CONCLUSIONS The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.
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Affiliation(s)
- Olavo César Lyra Porto
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brasil
| | | | - Julio Almeida Silva
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brasil
| | | | | | - Mike Dos Reis Bueno
- Faculdade São Leopoldo Mandic, Faculdade de Odontologia, Departamento de Radiologia, Campinas, São Paulo, Brasil
| | - Carlos Estrela
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Ciências Estomatológicas, Goiânia, Goiás, Brasil
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Wang X, Zhang Y, Li X, Huang Z, Cui M, Huang Z, Zhang X, Hu X. Biometric analysis of apical surgery-related anatomy of mandibular first molars: a cone-beam computed tomography study in a Mongoloid population. J Int Med Res 2019; 48:300060519892396. [PMID: 31856630 PMCID: PMC7783284 DOI: 10.1177/0300060519892396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the apical surgery-related anatomy of two-rooted and three-rooted mandibular first molars (MFMs) in a Mongoloid population. Methods A total of 502 cone-beam computed tomographic images were used to evaluate the root configuration, the distance from the buccal bone to each root, root dimensions, and the complete root resection distance at the resection level for roots of MFMs. Results The prevalence of two-rooted and three-rooted MFMs was 85.1% and 14.9%, respectively. At the resection level, the distance from the buccal bone to the mesial and distal roots of two-rooted MFMs was 2.24 and 3.15 mm, respectively, while the distance was 2.44, 2.01, and 8.55 mm for the mesial, distobuccal, and distolingual roots of three-rooted MFMs, respectively. The distance from the buccal bone to each root was longer in men than in women. The largest distance for complete root resection was detected for the distal root in two-rooted MFMs and for the distolingual root in three-rooted MFMs. Conclusions The prevalence of three-rooted MFMs is common in the Mongoloid population. The distance from the buccal bone to root apex differs according to root configurations and sex. Surgical access to the distolingual root is difficult because of the long access distance.
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Affiliation(s)
- Xue Wang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuejiao Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolan Li
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zijing Huang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Minyi Cui
- Department of Radiology, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhuwei Huang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolei Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoli Hu
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Xiaoli Hu, Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou, Guangdong, 510055, China.
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