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Parize H, Sadilina S, Caldas RA, Cordeiro JVC, Kleinheinz J, Laganá DC, Sesma N, Bohner L. Magnetic resonance imaging for jawbone assessment: a systematic review. Head Face Med 2024; 20:25. [PMID: 38641613 PMCID: PMC11027384 DOI: 10.1186/s13005-024-00424-2] [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: 02/14/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024] Open
Abstract
PURPOSE To evaluate the accuracy of magnetic resonance imaging (MRI) for jawbone assessment compared to reference-standard measurements in the literature. MATERIALS AND METHODS An electronic database search was conducted in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library in June 2022, and updated in August 2023. Studies evaluating the accuracy of MRI for jawbone assessment compared with reference-standard measurements (histology, physical measurements, or computed tomography) were included. The outcome measures included bone histomorphometry and linear measurements. The risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The review was registered in the PROSPERO database (CRD42022342697). RESULTS From 63 studies selected for full-text analysis, nine manuscripts were considered eligible for this review. The studies included assessments of 54 participants, 35 cadavers, and one phantom. A linear measurement error ranging from 0.03 to 3.11 mm was shown. The accuracy of bone histomorphometry varies among studies. Limitations of the evidence included heterogeneity of MRI protocols and the methodology of the included studies. CONCLUSION Few studies have suggested the feasibility of MRI for jawbone assessment, as MRI provides comparable results to those of standard reference tests. However, further advancements and optimizations are needed to increase the applicability, validate the efficacy, and establish clinical utility of these methods.
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Affiliation(s)
- Hian Parize
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Sofya Sadilina
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ricardo Armini Caldas
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil.
| | - João Victor Cunha Cordeiro
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
| | - Dalva Cruz Laganá
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Newton Sesma
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
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Schwarz L, Unger E, Gahleitner A, Rausch-Fan X, Jonke E. A novel approach for gingiva thickness measurements around lower anterior teeth by means of dental magnetic resonance imaging. Clin Oral Investig 2023; 28:18. [PMID: 38135801 PMCID: PMC10746778 DOI: 10.1007/s00784-023-05459-4] [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: 08/24/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This diagnostic accuracy study aims to present the first measurements of gingiva thickness around lower anterior teeth using dental magnetic resonance imaging (MRI) and to compare these measurements with two established methods: (1) gingival phenotype assessment via periodontal probing, and (2) the superimposition of cone-beam computed tomography (CBCT) scans with intraoral scans of teeth and gums. MATERIALS AND METHODS Ten patients with substantial orthodontic treatment need and anterior mandibular crowding were consecutively included in this clinical case series. After periodontal probing, each patient underwent a CBCT scan, an intraoral scan of the mandible, and an MRI investigation using a novel mandibula 15-channel dental coil. RESULTS The mean gingiva thickness was 0.72 mm measured on MRI and 0.97 mm measured on CBCT, with a mean difference between the measurement methods of 0.17 ± 0.27 mm (p < 0.001). Measurement agreement between the index tests (MRI and CBCT) and the clinical reference standard (probing) yielded an overall percent agreement of 64.94% and 47.02% for MRI and CBCT, respectively. Teeth with thin phenotypes were associated with lower soft tissue dimensions in both free (MRI: 0.56 mm vs. CBCT: 0.79 mm) and supracrestal gingiva (MRI: 0.75 mm vs. CBCT: 1.03 mm) when compared to those with thick phenotypes. However, only the measurements obtained from MRI scans showed statistically significant differences between the two phenotypes. CONCLUSION Dental MRI successfully visualizes delicate structures like the gingiva in the anterior mandible and achieves a high correlation with superimposed CBCT scans, with clinically acceptable deviations. CLINICAL RELEVANCE The present study helps to establish dental MRI as a radiation-free alternative to conventional radiographic methods.
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Affiliation(s)
- Linda Schwarz
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - André Gahleitner
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Erwin Jonke
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
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Al-Haj Husain A, Schmidt V, Valdec S, Stadlinger B, Winklhofer S, Schönegg D, Sommer S, Özcan M, Al-Haj Husain N, Piccirelli M. MR-orthopantomography in operative dentistry and oral and maxillofacial surgery: a proof of concept study. Sci Rep 2023; 13:6228. [PMID: 37069287 PMCID: PMC10110573 DOI: 10.1038/s41598-023-33483-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/13/2023] [Indexed: 04/19/2023] Open
Abstract
This prospective study aimed to present, compare, and evaluate the suitability of five different magnetic resonance imaging (MRI) protocols (3D double-echo steady-state (DESS), 3D fast spin echo short-tau inversion recovery (SPACE-STIR), 3D fast spin echo spectral attenuated inversion recovery (SPACE-SPAIR), volumetric interpolated breath-hold examination (T1-VIBE-Dixon), and ultrashort echo time (UTE)) and for orthopantomogram (OPG)-like MRI reconstructions using a novel mandibular coil. Three readers assessed MR-OPGs of 21 volunteers regarding technical image quality (4, excellent; 0, severely reduced), susceptibility to artifacts (3, absence; 0, massive), and visualization of anatomical structures in the oral cavity and surrounding skeletal structures (4, fine details visible; 0, no structures visible). Average image quality was good (3.29 ± 0.83) for all MRI protocols, with UTE providing the best image quality (3.52 ± 0.62) and no to minor artifacts (2.56 ± 0.6). Full diagnostic interpretability of the osseous structures is best in VIBE-Dixon and UTE MR-OPGs. DESS provided excellent visualization of the finest details of the nervous tissue (3.95 ± 0.22). Intra-reader and inter-reader agreement between the readers was good to excellent for all protocols (ICCs 0.812-0.957). MR-OPGs provide indication-specific accurate imaging of the oral cavity and could contribute to the early detection of pathologies, staging, and radiological follow-up of oral and maxillofacial diseases.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland.
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Valérie Schmidt
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daphne Schönegg
- Departement of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Stefan Sommer
- Siemens Healthineers International AG, Zurich, Switzerland
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Departement of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Sukegawa S, Tanaka F, Hara T, Yoshii K, Yamashita K, Nakano K, Takabatake K, Kawai H, Nagatsuka H, Furuki Y. Deep learning model for analyzing the relationship between mandibular third molar and inferior alveolar nerve in panoramic radiography. Sci Rep 2022; 12:16925. [PMID: 36209283 PMCID: PMC9547920 DOI: 10.1038/s41598-022-21408-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/27/2022] [Indexed: 12/29/2022] Open
Abstract
In this study, the accuracy of the positional relationship of the contact between the inferior alveolar canal and mandibular third molar was evaluated using deep learning. In contact analysis, we investigated the diagnostic performance of the presence or absence of contact between the mandibular third molar and inferior alveolar canal. We also evaluated the diagnostic performance of bone continuity diagnosed based on computed tomography as a continuity analysis. A dataset of 1279 images of mandibular third molars from digital radiographs taken at the Department of Oral and Maxillofacial Surgery at a general hospital (2014-2021) was used for the validation. The deep learning models were ResNet50 and ResNet50v2, with stochastic gradient descent and sharpness-aware minimization (SAM) as optimizers. The performance metrics were accuracy, precision, recall, specificity, F1 score, and area under the receiver operating characteristic curve (AUC). The results indicated that ResNet50v2 using SAM performed excellently in the contact and continuity analyses. The accuracy and AUC were 0.860 and 0.890 for the contact analyses and 0.766 and 0.843 for the continuity analyses. In the contact analysis, SAM and the deep learning model performed effectively. However, in the continuity analysis, none of the deep learning models demonstrated significant classification performance.
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Affiliation(s)
- Shintaro Sukegawa
- grid.414811.90000 0004 1763 8123Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa 760-8557 Japan ,grid.258331.e0000 0000 8662 309XDepartment of Oral and Maxillofacial Surgery, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793 Japan ,grid.261356.50000 0001 1302 4472Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558 Japan
| | - Futa Tanaka
- grid.256342.40000 0004 0370 4927Department of Electrical, Electronic and Computer Engineering, Faculty of Engineering, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1193 Japan
| | - Takeshi Hara
- grid.256342.40000 0004 0370 4927Department of Electrical, Electronic and Computer Engineering, Faculty of Engineering, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1193 Japan ,Center for Healthcare Information Technology (C-HiT), Tokai National Higher Education and Research System, 1-1 Yanagido, Gifu, Gifu 501-1193 Japan
| | - Kazumasa Yoshii
- grid.256342.40000 0004 0370 4927Department of Electrical, Electronic and Computer Engineering, Faculty of Engineering, Gifu University, 1-1 Yanagido, Gifu, Gifu 501-1193 Japan
| | - Katsusuke Yamashita
- Polytechnic Center Kagawa, 2-4-3, Hananomiya-cho, Takamatsu, Kagawa 761-8063 Japan
| | - Keisuke Nakano
- grid.261356.50000 0001 1302 4472Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558 Japan
| | - Kiyofumi Takabatake
- grid.261356.50000 0001 1302 4472Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558 Japan
| | - Hotaka Kawai
- grid.261356.50000 0001 1302 4472Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558 Japan
| | - Hitoshi Nagatsuka
- grid.261356.50000 0001 1302 4472Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558 Japan
| | - Yoshihiko Furuki
- grid.414811.90000 0004 1763 8123Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa 760-8557 Japan
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Al-Haj Husain A, Sekerci E, Schönegg D, Bosshard FA, Stadlinger B, Winklhofer S, Piccirelli M, Valdec S. Dental MRI of Oral Soft-Tissue Tumors—Optimized Use of Black Bone MRI Sequences and a 15-Channel Mandibular Coil. J Imaging 2022; 8:jimaging8050146. [PMID: 35621910 PMCID: PMC9146760 DOI: 10.3390/jimaging8050146] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Soft-tissue lesions in the oral cavity, one of the most common sites for tumors and tumor-like lesions, can be challenging to diagnose and treat due to the wide spectrum from benign indolent to invasive malignant lesions. We report an abnormally large, rapidly growing hyperplastic lesion originating from the buccal mucosa in a 28-year-old male patient. Clinical examination revealed a well-circumscribed, smooth-surfaced, pinkish nodular lesion measuring 2.3 × 2 cm, which suggested the differential diagnosis of irritation fibroma, pyogenic granuloma, oral lipoma, and other benign or malignant neoplasms such as hemangioma, non-Hodgkin’s lymphoma, or metastases to the oral cavity. Dental MRI using a 15-channel mandibular coil was performed to improve perioperative radiological and surgical management, avoiding adverse intraoperative events and misdiagnosis of vascular malformations, especially hemangiomas. Black bone MRI protocols such as STIR (short-tau inversion recovery) and DESS (double-echo steady-state) were used for high-resolution radiation-free imaging. Radiologic findings supported the suspected diagnosis of an irritation fibroma and ruled out any further head and neck lesions, therefore complete surgical resection was performed. Histology confirmed the tentative diagnosis. This article evaluates the use of this novel technique for MR diagnosis in the perioperative management of soft-tissue tumors in oral and maxillofacial surgery.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (E.S.); (F.A.B.); (B.S.)
| | - Esra Sekerci
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (E.S.); (F.A.B.); (B.S.)
| | - Daphne Schönegg
- Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Fabienne A. Bosshard
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (E.S.); (F.A.B.); (B.S.)
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (E.S.); (F.A.B.); (B.S.)
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (E.S.); (F.A.B.); (B.S.)
- Correspondence: ; Tel.: +41-44-643-32-90
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