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Okamoto H, Sakuramachi M, Yatsuoka W, Ueno T, Katsura K, Murakami N, Nakamura S, Iijima K, Chiba T, Nakayama H, Shuto Y, Takano Y, Kobayashi Y, Kishida H, Urago Y, Nishitani M, Nishina S, Arai K, Igaki H. A novel method for determining dose distribution on panoramic reconstruction computed tomography images from radiotherapy computed tomography. Imaging Sci Dent 2024; 54:129-137. [PMID: 38948189 PMCID: PMC11211031 DOI: 10.5624/isd.20230230] [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: 10/21/2023] [Revised: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 07/02/2024] Open
Abstract
Purpose Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images. Materials and Methods Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney U test and Student t-test were employed. Results A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (P>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy). Conclusion The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.
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Affiliation(s)
- Hiroyuki Okamoto
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Madoka Sakuramachi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Wakako Yatsuoka
- Dental Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takao Ueno
- Dental Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kouji Katsura
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Naoya Murakami
- Department of Radiology, Juntendo University, Tokyo, Japan
| | - Satoshi Nakamura
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kotaro Iijima
- Department of Radiology, Juntendo University, Tokyo, Japan
| | - Takahito Chiba
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Nakayama
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yasunori Shuto
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
- Department of Radiological Technology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Takano
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yuta Kobayashi
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hironori Kishida
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yuka Urago
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Masato Nishitani
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Shuka Nishina
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Koushin Arai
- Department of Radiological Technology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
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Mokhtari A, Razi S, Rahimipour K, Razi T. Effect of using different strips on reducing the most common error in panoramic imaging: A randomised controlled trial on palatoglossal air space shadow. J Med Radiat Sci 2024; 71:194-202. [PMID: 38323866 PMCID: PMC11177041 DOI: 10.1002/jmrs.753] [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: 05/30/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Panoramic radiography quality can be impaired by some errors such as positioning errors. Palatoglossal air space shadow error is one of the most common positioning errors and it is due to the tongue not sticking to the roof of the palate. Techniques used to deal with this error might help prevent unnecessary radiation to patients and save them time and money. The study aimed to investigate the effects of using celluloid matrix and edible tapes (fruit leather and chewing gum) on reducing the palatoglossal air space shadow error in panoramic imaging. METHODS In our study, 270 patients referred to the Department of Radiology were randomised into three groups: a control group, a celluloid matrix group and an edible tapes group. Before panoramic imaging, all patients were instructed to adhere their tongues to the roof of their mouths, with the distinction that for the celluloid matrix and edible tapes groups, patients were asked to place celluloid tapes, fruit leathers, or chewing gums on their tongues before doing so. The routine imaging process was then performed, and the results were compared across groups to evaluate the incidence of palatoglossal air space shadow error. RESULTS The number of error-free images in each fruit leather, chewing gum and celluloid tape group were significantly higher than the control group (all cases P < 0.05). The chances of error-free images in the fruit leather groups were the highest (9.57 times). The age (P = 0.136) and gender (P = 0.272) of patients had no significant effect on the results of interventions. CONCLUSION The application of fruit leathers, chewing gums and celluloid tapes reduced the palatoglossal air space shadow error of panoramic imaging.
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Affiliation(s)
| | - Sedigheh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Kasra Rahimipour
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Tahmineh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
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Timme M, Viktorov J, Steffens L, Streeter A, Karch A, Schmeling A. Dental age assessment in the living: a comparison of two common stage classifications for assessing radiographic visibility of the root canals in mandibular third molars. Int J Legal Med 2024; 138:499-507. [PMID: 37952073 PMCID: PMC10861756 DOI: 10.1007/s00414-023-03121-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: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
After dentition is complete, degenerative tooth characteristics can be used for dental age assessment. Radiological assessment of the visibility of the root canals of the mandibular third molars in dental panoramic radiographs (DPRs) is known to be one such suitable feature. Essentially, two different stage classifications are available for evaluating the visibility of the root canals of mandibular third molars in the DPR. The aim of this study was to determine if one method outperforms the other. Therefore, the 2010 method of Olze et al. was directly compared to the 2017 method of Lucas et al. in the 2020 modification of Al Qattan et al. To this end, 233 DPRs from 116 females and 117 males aged 20.0 to 40.9 years were evaluated by three independent experienced examiners. In addition, one examiner ran two independent evaluations. Correlation between age and stage was investigated, and the inter- and intra-rater reliability was estimated for both methods. Correlation between age and stage was higher with the Olze method (Spearman rho 0.388 [95% CI 0.309, 0.462], males and 0.283 [95% CI 0.216, 0.357], females) than the Lucas method (0.212 [95% CI 0.141, 0.284], males and 0.265 [95% CI 0.193, 0.340], females). The intra-rater repeatability of the Olze method (Krippendorff's α = 0.576 [95% CI 0.508, 0.644], males and α = 0.592 [95% CI 0.523, 0.661], females) was greater than that for the Lucas method (intra-rater α = 0.422 [95% CI 0.382, 0.502], males and α = 0.516 [95% CI 0.523, 0.661], females). Inter-rater reproducibility was also greater for the Olze method (α = 0.542 [95% CI 0.463, 0.620], males and α = 0.533 [95% CI 0.451, 0.615], females) compared to the Lucas method (α = 0.374 [95% CI 0.304, 0.443], males and α = 0.432 [95% CI 0.359, 0.505], females). The method of Olze et al. was found to present marginal advantages to the Lucas et al. method across all examinations and may be a more appropriate method for application in future studies.
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Affiliation(s)
- Maximilian Timme
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany.
| | - Jan Viktorov
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Laurin Steffens
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
| | - Adam Streeter
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Domagkstraße 3, 48149, Münster, Germany
| | - Andreas Schmeling
- Institute of Legal Medicine, University Hospital Münster, Röntgenstraße 23, 48149, Münster, Germany
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Kurt-Bayrakdar S, Bayrakdar İŞ, Yavuz MB, Sali N, Çelik Ö, Köse O, Uzun Saylan BC, Kuleli B, Jagtap R, Orhan K. Detection of periodontal bone loss patterns and furcation defects from panoramic radiographs using deep learning algorithm: a retrospective study. BMC Oral Health 2024; 24:155. [PMID: 38297288 PMCID: PMC10832206 DOI: 10.1186/s12903-024-03896-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND This retrospective study aimed to develop a deep learning algorithm for the interpretation of panoramic radiographs and to examine the performance of this algorithm in the detection of periodontal bone losses and bone loss patterns. METHODS A total of 1121 panoramic radiographs were used in this study. Bone losses in the maxilla and mandibula (total alveolar bone loss) (n = 2251), interdental bone losses (n = 25303), and furcation defects (n = 2815) were labeled using the segmentation method. In addition, interdental bone losses were divided into horizontal (n = 21839) and vertical (n = 3464) bone losses according to the defect patterns. A Convolutional Neural Network (CNN)-based artificial intelligence (AI) system was developed using U-Net architecture. The performance of the deep learning algorithm was statistically evaluated by the confusion matrix and ROC curve analysis. RESULTS The system showed the highest diagnostic performance in the detection of total alveolar bone losses (AUC = 0.951) and the lowest in the detection of vertical bone losses (AUC = 0.733). The sensitivity, precision, F1 score, accuracy, and AUC values were found as 1, 0.995, 0.997, 0.994, 0.951 for total alveolar bone loss; found as 0.947, 0.939, 0.943, 0.892, 0.910 for horizontal bone losses; found as 0.558, 0.846, 0.673, 0.506, 0.733 for vertical bone losses and found as 0.892, 0.933, 0.912, 0.837, 0.868 for furcation defects (respectively). CONCLUSIONS AI systems offer promising results in determining periodontal bone loss patterns and furcation defects from dental radiographs. This suggests that CNN algorithms can also be used to provide more detailed information such as automatic determination of periodontal disease severity and treatment planning in various dental radiographs.
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Affiliation(s)
- Sevda Kurt-Bayrakdar
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey.
- Division of Oral and Maxillofacial Radiology, Department of Care Planning and Restorative Sciences, University of Mississippi Medical Center School of Dentistry, Jackson, MS, USA.
| | - İbrahim Şevki Bayrakdar
- Division of Oral and Maxillofacial Radiology, Department of Care Planning and Restorative Sciences, University of Mississippi Medical Center School of Dentistry, Jackson, MS, USA
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Muhammet Burak Yavuz
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
| | - Nichal Sali
- Faculty of Dentistry, Department of Periodontology, Eskisehir Osmangazi University, Eskisehir, 26240, Turkey
| | - Özer Çelik
- Faculty of Science, Department of Mathematics and Computer Science, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Oğuz Köse
- Faculty of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | | | - Batuhan Kuleli
- Faculty of Dentistry, Department of Orthodontics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Rohan Jagtap
- Division of Oral and Maxillofacial Radiology, Department of Care Planning and Restorative Sciences, University of Mississippi Medical Center School of Dentistry, Jackson, MS, USA
| | - Kaan Orhan
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ankara University, Ankara, Turkey
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Al-Haj Husain A, Stadlinger B, Winklhofer S, Bosshard FA, Schmidt V, Valdec S. Imaging in Third Molar Surgery: A Clinical Update. J Clin Med 2023; 12:7688. [PMID: 38137758 PMCID: PMC10744030 DOI: 10.3390/jcm12247688] [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: 11/27/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Third molar surgery is one of the most common surgical procedures performed in oral and maxillofacial surgery. Considering the patient's young age and the often-elective nature of the procedure, a comprehensive preoperative evaluation of the surgical site, relying heavily on preoperative imaging, is key to providing accurate diagnostic work-up, evidence-based clinical decision making, and, when appropriate, indication-specific surgical planning. Given the rapid developments of dental imaging in the field, the aim of this article is to provide a comprehensive, up-to-date clinical overview of various imaging techniques related to perioperative imaging in third molar surgery, ranging from panoramic radiography to emerging technologies, such as photon-counting computed tomography and magnetic resonance imaging. Each modality's advantages, limitations, and recent improvements are evaluated, highlighting their role in treatment planning, complication prevention, and postoperative follow-ups. The integration of recent technological advances, including artificial intelligence and machine learning in biomedical imaging, coupled with a thorough preoperative clinical evaluation, marks another step towards personalized dentistry in high-risk third molar surgery. This approach enables minimally invasive surgical approaches while reducing inefficiencies and risks by incorporating additional imaging modality- and patient-specific parameters, potentially facilitating and improving patient management.
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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.); (B.S.); (F.A.B.); (V.S.)
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.); (F.A.B.); (V.S.)
| | | | - Fabienne A. Bosshard
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.); (F.A.B.); (V.S.)
| | - Valérie Schmidt
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.); (F.A.B.); (V.S.)
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.); (F.A.B.); (V.S.)
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Karagöz A, Beler M, Altun BD, Ünal İ, Cansız D, Gündüz H, Alturfan AA, Emekli-Alturfan E, Erçalık Yalçınkaya Ş. Panoramic dental X-ray exposure leads to oxidative stress, inflammation and apoptosis-mediated developmental defects in zebrafish embryos. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101661. [PMID: 37866507 DOI: 10.1016/j.jormas.2023.101661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
Panoramic x-ray units are widely used in dental radiodiagnostics. Patients are exposed to relatively low radiation doses with panoramic imaging, but considering lifetime frequency of exposure, even a small risk can have serious health consequences. Our aim was to assess the effects of panoramic x-rays at two different exposure times on developing zebrafish embryos, focusing on oxidative stress, inflammation, apoptotic pathways, and development. Zebrafish embryos were divided into three groups: control, standard panoramic (SPE, 5.5 s exposure time) and pedodontic panoramic x-ray group (PPE, 4.8 s exposure time). Optically stimulated luminescence dosimeters were used to measure absorbed doses. Mean radiation doses for SPE and PPE were 7.83 mSv and 5.83 mSv respectively. At the end of 96 h post-fertilization, lipid peroxidation (LPO), nitric oxide (NO), reduced glutathione (GSH), glutathione S-transferase and superoxide dismutase were measured in the embryos. Expressions of genes related with inflammation (tnfα, il6, ill15, il21), immunoregulation (ifng) and apoptosis (p53, bax, casp2, casp3, casp8) were determined by RT-PCR. Even at reduced doses at high-speed mode, developmental toxicity was observed in both groups as evidenced by decreased pigmentation, yolk sac oedema, and spinal curvature. While deterioration of oxidant-antioxidant balance, suppression of immune response, induction of inflammation and apoptosis were observed through increased LPO, NO, decreased GSH, ifng, and increased expressions of genes related with inflammation and apoptosis, these effects were more pronounced in the SPE group. These results demonstrate the influence of exposure time and indicate the need for further consideration of optimal panoramic modes from a radiation-induced damage perspective.
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Affiliation(s)
- Atakan Karagöz
- Department Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Merih Beler
- Department Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Büşra Dilara Altun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - İsmail Ünal
- Department Biochemistry, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Derya Cansız
- Department of Biochemistry, Faculty of Medicine, Istanbul Medipol University, Kavacık, Istanbul, Turkey
| | - Hüseyin Gündüz
- Epsilon Landauer Dosimeter Technologies, Istanbul, Turkey
| | - Ahmet Ata Alturfan
- Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, Istanbul, Turkey
| | - Ebru Emekli-Alturfan
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - Şebnem Erçalık Yalçınkaya
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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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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Kim HS, Ha EG, Lee A, Choi YJ, Jeon KJ, Han SS, Lee C. Refinement of image quality in panoramic radiography using a generative adversarial network. Dentomaxillofac Radiol 2023; 52:20230007. [PMID: 37129509 PMCID: PMC10304845 DOI: 10.1259/dmfr.20230007] [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: 12/28/2022] [Revised: 03/07/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE We aimed to develop and assess the clinical usefulness of a generative adversarial network (GAN) model for improving image quality in panoramic radiography. METHODS Panoramic radiographs obtained at Yonsei University Dental Hospital were randomly selected for study inclusion (n = 100). Datasets with degraded image quality (n = 400) were prepared using four different processing methods: blur, noise, blur with noise, and blur in the anterior teeth region. The images were distributed to the training and test datasets in a ratio of 9:1 for each group. The Pix2Pix GAN model was trained using pairs of the original and degraded image datasets for 100 epochs. The peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) were obtained for the test dataset, and two oral and maxillofacial radiologists rated the quality of clinical images. RESULTS Among the degraded images, the GAN model enabled the greatest improvement in those with blur in the region of the anterior teeth but was least effective in improving images exhibiting blur with noise (PSNR, 36.27 > 32.74; SSIM, 0.90 > 0.82). While the mean clinical image quality score of the original radiographs was 44.6 out of 46.0, the highest and lowest predicted scores were observed in the blur (45.2) and noise (36.0) groups. CONCLUSION The GAN model developed in this study has the potential to improve panoramic radiographs with degraded image quality, both quantitatively and qualitatively. As the model performs better in refining blurred images, further research is required to identify the most effective methods for handling noisy images.
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Affiliation(s)
- Hak-Sun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Eun-Gyu Ha
- Department of Electrical and Electronic Engineering, Yonsei University College of Engineering, Seoul, South Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
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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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10
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Edvardsen IP, Teterina A, Johansen T, Myhre JN, Godtliebsen F, Bolstad NL. Automatic detection of the mental foramen for estimating mandibular cortical width in dental panoramic radiographs: the seventh survey of the Tromsø Study (Tromsø7) in 2015–2016. J Int Med Res 2022; 50:3000605221135147. [DOI: 10.1177/03000605221135147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To apply deep learning to a data set of dental panoramic radiographs to detect the mental foramen for automatic assessment of the mandibular cortical width. Methods Data from the seventh survey of the Tromsø Study (Tromsø7) were used. The data set contained 5197 randomly chosen dental panoramic radiographs. Four pretrained object detectors were tested. We randomly chose 80% of the data for training and 20% for testing. Models were trained using GeForce RTX 2080 Ti with 11 GB GPU memory (NVIDIA Corporation, Santa Clara, CA, USA). Python programming language version 3.7 was used for analysis. Results The EfficientDet-D0 model showed the highest average precision of 0.30. When the threshold to regard a prediction as correct (intersection over union) was set to 0.5, the average precision was 0.79. The RetinaNet model achieved the lowest average precision of 0.23, and the precision was 0.64 when the intersection over union was set to 0.5. The procedure to estimate mandibular cortical width showed acceptable results. Of 100 random images, the algorithm produced an output 93 times, 20 of which were not visually satisfactory. Conclusions EfficientDet-D0 effectively detected the mental foramen. Methods for estimating bone quality are important in radiology and require further development.
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Affiliation(s)
- Isak Paasche Edvardsen
- Department of Physics and Technology, Faculty of Science and Technology, UiT The Arctic University of Norway, PO Box 6050, Langnes, N-9037 Tromsø, Norway
| | - Anna Teterina
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, PO Box 6050, Langnes, N-9037 Tromsø, Norway
| | - Thomas Johansen
- Department of Energy and Technology, NORCE Norwegian Research Center, Sykehusveien 23, 9294 Tromsø, Norway
| | - Jonas Nordhaug Myhre
- Department of Energy and Technology, NORCE Norwegian Research Center, Sykehusveien 23, 9294 Tromsø, Norway
| | - Fred Godtliebsen
- Department of Mathematics and Statistics, Faculty of Science and Technology, UiT The Arctic University of Norway, PO Box 6050, Langnes, N-9037 Tromsø, Norway
| | - Napat Limchaichana Bolstad
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, PO Box 6050, Langnes, N-9037 Tromsø, Norway
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Choi H, Jeon KJ, Kim YH, Ha EG, Lee C, Han SS. Deep learning-based fully automatic segmentation of the maxillary sinus on cone-beam computed tomographic images. Sci Rep 2022; 12:14009. [PMID: 35978086 PMCID: PMC9385721 DOI: 10.1038/s41598-022-18436-w] [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: 01/14/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
The detection of maxillary sinus wall is important in dental fields such as implant surgery, tooth extraction, and odontogenic disease diagnosis. The accurate segmentation of the maxillary sinus is required as a cornerstone for diagnosis and treatment planning. This study proposes a deep learning-based method for fully automatic segmentation of the maxillary sinus, including clear or hazy states, on cone-beam computed tomographic (CBCT) images. A model for segmentation of the maxillary sinuses was developed using U-Net, a convolutional neural network, and a total of 19,350 CBCT images were used from 90 maxillary sinuses (34 clear sinuses, 56 hazy sinuses). Post-processing to eliminate prediction errors of the U-Net segmentation results increased the accuracy. The average prediction results of U-Net were a dice similarity coefficient (DSC) of 0.9090 ± 0.1921 and a Hausdorff distance (HD) of 2.7013 ± 4.6154. After post-processing, the average results improved to a DSC of 0.9099 ± 0.1914 and an HD of 2.1470 ± 2.2790. The proposed deep learning model with post-processing showed good performance for clear and hazy maxillary sinus segmentation. This model has the potential to help dental clinicians with maxillary sinus segmentation, yielding equivalent accuracy in a variety of cases.
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Affiliation(s)
- Hanseung Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Eun-Gyu Ha
- 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
| | - 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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12
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Ha EG, Jeon KJ, Kim YH, Kim JY, Han SS. Automatic detection of mesiodens on panoramic radiographs using artificial intelligence. Sci Rep 2021; 11:23061. [PMID: 34845320 PMCID: PMC8629996 DOI: 10.1038/s41598-021-02571-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/16/2021] [Indexed: 11/15/2022] Open
Abstract
This study aimed to develop an artificial intelligence model that can detect mesiodens on panoramic radiographs of various dentition groups. Panoramic radiographs of 612 patients were used for training. A convolutional neural network (CNN) model based on YOLOv3 for detecting mesiodens was developed. The model performance according to three dentition groups (primary, mixed, and permanent dentition) was evaluated, both internally (130 images) and externally (118 images), using a multi-center dataset. To investigate the effect of image preprocessing, contrast-limited histogram equalization (CLAHE) was applied to the original images. The accuracy of the internal test dataset was 96.2% and that of the external test dataset was 89.8% in the original images. For the primary, mixed, and permanent dentition, the accuracy of the internal test dataset was 96.7%, 97.5%, and 93.3%, respectively, and the accuracy of the external test dataset was 86.7%, 95.3%, and 86.7%, respectively. The CLAHE images yielded less accurate results than the original images in both test datasets. The proposed model showed good performance in the internal and external test datasets and had the potential for clinical use to detect mesiodens on panoramic radiographs of all dentition types. The CLAHE preprocessing had a negligible effect on model performance.
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Affiliation(s)
- Eun-Gyu Ha
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
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Friedlander-Barenboim S, Hamed W, Zini A, Yarom N, Abramovitz I, Chweidan H, Finkelstein T, Almoznino G. Patterns of Cone-Beam Computed Tomography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center. Healthcare (Basel) 2021; 9:healthcare9081042. [PMID: 34442182 PMCID: PMC8392371 DOI: 10.3390/healthcare9081042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 01/30/2023] Open
Abstract
The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9-86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.
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Affiliation(s)
| | - Wafi Hamed
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Avraham Zini
- Hadassah Medical Center, Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Noam Yarom
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
| | - Itzhak Abramovitz
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Harry Chweidan
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Tamar Finkelstein
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel
| | - Galit Almoznino
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
- Hadassah Medical Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Hadassah Medical Center, Big Biomedical Data Research Laboratory, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +972-2-677-6194
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14
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Abstract
The scope of oral and maxillofacial surgery treatment and care is very broad, from dentoalveolar surgery, to pathology and reconstruction, to treatment of craniofacial deformities. The effective surgical treatment of patients requires appropriate and accurate diagnostic imaging. The various imaging modalities used in oral and maxillofacial surgery are typically for diagnostic and treatment planning purposes. With the improvements of three-dimensional imaging and software programs, surgical treatment and care have been enhanced with patient-specific guides, hardware, and implants. This article discusses the various imaging modalities used for a variety of typical oral and maxillofacial surgery procedures.
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Affiliation(s)
- Steven Wang
- Department of Oral and Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, 1st Floor Schattner Building, Philadelphia, PA 19104, USA.
| | - Brian Ford
- Department of Oral and Maxillofacial Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, 1st Floor Schattner Building, Philadelphia, PA 19104, USA
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15
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Cederhag J, Lundegren N, Alstergren P, Shi XQ, Hellén-Halme K. Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population. Eur J Dent 2020; 15:266-272. [PMID: 33368065 PMCID: PMC8184276 DOI: 10.1055/s-0040-1721294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. MATERIALS AND METHODS From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars' characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. STATISTICAL ANALYSIS Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients' age or gender had an impact or not was also analyzed. RESULTS The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. CONCLUSIONS Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.
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Affiliation(s)
- Josefine Cederhag
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nina Lundegren
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Specialized Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, 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, Malmö, Sweden
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16
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Elevated Coronary Artery Calcium scores are associated with tooth loss. PLoS One 2020; 15:e0243232. [PMID: 33326424 PMCID: PMC7743922 DOI: 10.1371/journal.pone.0243232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/17/2020] [Indexed: 12/17/2022] Open
Abstract
Aim This study explores the association between Coronary Artery Calcium (CAC) scores and dental pathology such as missing teeth, the (peri-apical) health status and restoration grade of the teeth, and the grade of alveolar bone loss seen on a dental panoramic radiograph (Orthopantomograph–OPG). Materials and methods In this retrospective cross-sectional study, data was collected from three hospitals spread in the Netherlands. Patients were included when a CAC score and an OPG were available, both recorded within a maximum period of 365 days from 2009–2017. The CAC score was measured on a CT scan, using the Agatston method. To assess dental pathology, the number of missing teeth, the number of dental implants, alveolar bone loss, caries, endodontic treatments, peri-apical radiolucencies, bone loss at implants, impacted teeth and dental cysts, were determined on the OPG. All observers were calibrated. The electronic health records provided information about: gender, age, smoking, Diabetes Mellitus, hypercholesterolemia, hypertension and Body Mass Index (BMI). Results 212 patients were included. We found a statistically significant association between the number of missing teeth and the CAC score. When modeling age, sex, and other well-known risk factors for cardiovascular disease, the significant correlation was no longer present after multivariate correction. Furthermore, the results showed a trend for more teeth with peri-apical lesions and a higher percentage of mean alveolar bone loss in the group with the highest CAC scores. Conclusion This study showed that being edentulous or missing teeth is correlated to higher CAC scores however failed to be an independent predictor of atherosclerotic cardiovascular diseases. The number of (missing) teeth is an easily accessible marker and could be used as a marker for atherosclerotic cardiovascular disease (ACVD) risk by almost any healthcare worker. The current study needs to be considered as an explorative pilot study and could contribute to the design of further (prospective) studies on the relationship between dental pathology and coronary artery calcification by adding clinical information and extra cardiovascular biomarkers.
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17
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Al Faleh W, Bin Mubayrik A, Al Dosary S, Almthen H, Almatrafi R. Public Perception and Viewpoints of Dental Radiograph Prescriptions and Dentists' Safety Protection Practice. Clin Cosmet Investig Dent 2020; 12:533-539. [PMID: 33235512 PMCID: PMC7680142 DOI: 10.2147/ccide.s281851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/10/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The exposure of patients to ionizing radiation used in dentistry comes with a subtle risk of a stochastic effect, but there is tremendous benefit obtained from radiographic investigation for diagnosis, management, and monitoring of the treatment offered. Aim The aim of this study was to assess the viewpoint of the population concerning the prescriptions and practices in dentistry associated with dental radiographs and the safe use of ionizing radiation in dental clinics. Patients and Methods Validated and pretested structured self-administered questionnaires with 11 items were used. An electronic version of the questionnaire was created using Google Forms and distributed online through social media outlets. A total of 437 patients completed the questionnaire which contains questions about their demographic data and their perception of the practice of dentistry regarding hazard from dental radiographs. The collected data were analyzed statistically. Results Up to 88.6% of the study participants underwent dental radiography for various dental treatments. A majority of them relied on the dentist for the type of requested radiograph, 40% of them reported that dentist never explained the hazards associated with radiography. More than half of the participants (55%) never or hardly ever asked about safety measures before undergoing radiography. Most of the participants approved of radiography and never refrained. Conclusion There is a spectrum of perceptions by the population. Continuous patient education is recommended to enhance awareness regarding this matter. Community perception assists in correcting wrong beliefs and ensuring improvement.
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Affiliation(s)
- Wafa Al Faleh
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
| | - Azizah Bin Mubayrik
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Al Dosary
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
| | - Haifa Almthen
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Razan Almatrafi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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KURT S, ÇELİK Ö, BAYRAKDAR İŞ, ORHAN K, BİLGİR E, ODABAS A, ASLAN AF. Determination Alveolar Bone Loss Using Artificial Intelligence System on Dental Panoramic Radiography. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.777057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Amorim PHJ, Moraes TF, Silva JVL, Pedrini H, Ruben RB. Reconstruction of Panoramic Dental Images Through Bézier Function Optimization. Front Bioeng Biotechnol 2020; 8:794. [PMID: 32903678 PMCID: PMC7438751 DOI: 10.3389/fbioe.2020.00794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
Computed tomography (CT) and X-ray images have been extensively used as a valuable diagnostic tool in dentistry for surgical planning and treatment. Nowadays, dental cone beam CT has been extensively used in dental clinics. Therefore, it is possible to employ three-dimensional (3D) data from the CT to reconstruct a two-dimensional (2D) panoramic dental image that provides a longitudinal view of the mandibular region of the patient, avoiding an additional exposure to X-ray. In this work, we developed a new automatic method for reconstructing 2D panoramic images of the dental arch based on 3D CT images, using Bézier curves and optimization techniques. The proposed method was applied to five patients, some of them with missing teeth, and smooth panoramic images with good contrast were obtained.
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Affiliation(s)
- Paulo H J Amorim
- Tridimensional Technology Division, Center for Information Technology Renato Archer, Campinas, Brazil
| | - Thiago F Moraes
- Tridimensional Technology Division, Center for Information Technology Renato Archer, Campinas, Brazil
| | - Jorge V L Silva
- Tridimensional Technology Division, Center for Information Technology Renato Archer, Campinas, Brazil
| | - Helio Pedrini
- Institute of Computing, University of Campinas, Campinas, Brazil
| | - Rui B Ruben
- CDRsp-ESTG, Polytechnic Institute of Leiria, Leiria, Portugal
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Beshtawi K, Qirresh E, Parker M, Shaik S. Custom Focal Trough in Cone-Beam Computed Tomography Reformatted Panoramic Versus Digital Panoramic for Mental Foramen Position to Aid Implant Planning. J Clin Imaging Sci 2020; 10:34. [PMID: 32547837 PMCID: PMC7294321 DOI: 10.25259/jcis_150_2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 05/17/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives: To compare the linear measurements from digital panoramic (DP) radiographs and cone-beam computed tomography (CBCT) volumes for the localization of the mental foramen (MF). Material and Methods: Thirty-one patients with panoramic and CBCT radiographs depicted on the same machine were analyzed. The vertical and horizontal positions of the MF were compared by the differences in distances measured from reference points to the boundaries (tangents) of the MF in digital panoramic (DP) and CBCT reformatted panoramic (CRP) views. The vertical position of MF was also analyzed on CBCT oblique coronal views (CORO) and compared with its corresponding distances on DP and CRP views. Results: Statistically significant differences (P < 0.05) were found in all compared measurements between CRP and DP views. In addition, the vertical distance (Y1) compared between DP, CRP, and CORO views also showed a statistically significant measurement discrepancy in the mean distance (P < 0.000) with the highest mean difference of 1.59 mm (P < 0.05) was attained from Y1 (DP-CORO). Inter- and intra-examiner analysis indicated a high level of agreement for all measurements. Conclusion: The mean values of discrepancies in measurements between DP and CRP views for horizontal and vertical linear measurements were clinically tolerable. Nevertheless, significant differences in the vertical MF position were detected between the panoramic views (DP, CRP) and the coronal views (CORO). This implies that the use of coronal view measurements during implant planning might reduce the risk of neurovascular injuries.
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Affiliation(s)
- Khaled Beshtawi
- Department of Diagnostics and Radiology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Emad Qirresh
- Department of Oral Radiology and Diagnosis, Al Quds University, Abu-Dis, Jerusalem
| | - Mohamed Parker
- Department of Diagnostics and Radiology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Shoayeb Shaik
- Department of Diagnostics and Radiology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
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Jeon KJ, Han SS, Lee C, Choi YJ, Jung HI, Kim YH. Application of panoramic radiography with a multilayer imaging program for detecting proximal caries: a preliminary clinical study. Dentomaxillofac Radiol 2020; 49:20190467. [PMID: 32348170 DOI: 10.1259/dmfr.20190467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The aim of this study is to introduce a novel program of panoramic radiography that shows 41 multilayer images from the buccal to lingual aspects in a region of interest, and to evaluate the effectiveness of this program for detecting proximal caries. METHODS In total, 480 premolars and molars on 30 panoramic radiographs taken with the multilayer imaging program were included in this study. The presence or absence of caries in 960 proximal surfaces was assessed by three experienced oral and maxillofacial radiologists as a consensus-based gold-standard. Two general dentists evaluated and scored proximal caries on 980 surfaces on panoramic radiographs with and without the multilayer imaging program. The two general dentists' scores were compared with the gold-standard, and were analyzed for sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic (ROC) curve with and without using the program. The area under the ROC curve was analyzed using STATA/SE 13.1. RESULTS When the multilayer imaging program was used for panoramic radiography, the inter- and intraobserver agreement of the two general dentists improved. All values, including the area under the ROC curve, were higher when the multilayer imaging program was used than when it was not used. The area under the ROC curve showed a statistically significant improvement only in Observer 1, whose diagnostic ability was poorer than that of Observer 2. CONCLUSIONS:O This multilayer imaging program might help the inexperienced dentist to improve the diagnostic accuracy of proximal caries. If further studies would be performed in various clinical application, it could be useful when intraoral radiography taking is difficult for reasons such as mouth-opening limitations and the gag reflex of the patients.
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Affiliation(s)
- Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Hoi In Jung
- Department of Preventive Dentistry & Public Oral Health, Yonsei University College of Dentistry, Seoul, Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
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Teh LA, Abdullah D, Liew AKC, Soo E. Evaluation of Pulpal Involvement, Ulceration, Fistula, and Abscess Index and Periapical Index in Screening for Endodontic Disease: Reliability and Accuracy. J Endod 2020; 46:748-755. [PMID: 32279884 DOI: 10.1016/j.joen.2020.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The pulpal involvement, ulceration, fistula, and abscess (PUFA) index was developed to screen for the clinical consequences of untreated dental caries. The aim of this study was to compare the diagnostic accuracy of the PUFA index and the periapical index (PAI) in identifying pulpal and periapical diseases. METHODS A cross-sectional study was conducted using consecutive sampling. Each participant went through screening using the PUFA index, orthopantomography assessment using PAI, and comprehensive clinical examination to derive pulpal and apical diagnoses. The outcomes were dichotomized. Reliability was estimated using the Cohen kappa coefficient. Sensitivity, specificity, and predictive values were calculated. The area under the receiver operating characteristic curve was compared using the chi-square test. RESULTS A total of 165 participants were examined, 98.2% of whom had a decayed, missing, or filled tooth index >0. Of 4115 teeth assessed, 16.2% (n = 666) were diagnosed with pulpal disease and 7.9% (n = 325) with periapical disease. Interexaminer reliability for the PUFA index and PAI was 0.87 and 0.80, respectively. Intraexaminer reliability was 0.83 and 0.76 for the PUFA index and 0.75 and 0.72 for PAI. For pulpal diagnosis, the sensitivity of the PUFA index and PAI was 67.6% and 41.7%, respectively; the specificity of the PUFA index and PAI was 99.8% and 99.2%, respectively. For apical diagnosis, the sensitivity of the PUFA index and PAI was 87.7% and 75.4%, respectively; the specificity of the PUFA index and PAI was 95.4% and 98.4%, respectively. The PUFA index is statistically more accurate than PAI for pulpal diagnosis and apical diagnosis (P < .05). CONCLUSIONS The PUFA index can be used in screening for pulpal and periapical diseases with some limitations.
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Affiliation(s)
- Lay Ann Teh
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dalia Abdullah
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Amy Kia Cheen Liew
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Eason Soo
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Svenson B, Båth M, Karlsson R. Can adaptive post-processing of storage phosphor plate panoramic radiographs provide better image quality? A comparison of anatomical image quality of panoramic radiographs before and after adaptive processing. Acta Odontol Scand 2019; 77:328-333. [PMID: 30623704 DOI: 10.1080/00016357.2018.1556801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of the present study was to study the effect of adaptive image processing on the visibility of anatomical structures in storage phosphor plate (SPP) panoramic images. MATERIALS AND METHODS Three hundred SPP panoramic X-ray radiographs of children and adolescents were used. The radiographs were post-processed using general operator processor (GOP) technology, resulting in both a standard-processed and a GOP-processed radiograph. Four specialists in dental radiology compared the structural image quality of all standard-processed and GOP-processed panorama images for six anatomical structures, using a six-point scale for visual grading characteristics (VGC) analysis. RESULTS For three of the anatomic structures - the root canal space of the mandibular left first premolar, mandibular canal left side and periodontal ligament space of the mandibular right first molar - there was a statistically significant difference to the GOP's advantage. For the three remaining structures - dentino-enamel junction of the maxillary right first molar, crista alveolaris of the mandibular left molar area and floor of maxillary sinus right side - no significant difference between standard processing and GOP processing was obtained. CONCLUSIONS The study demonstrates that it is possible to improve the quality of SPP radiographs and the visibility of anatomical structures by using the GOP technique. Manufacturers' image-processing programs can be further developed, as there is a possibility of improving the diagnostic content of an image with external processing.
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Affiliation(s)
- Björn Svenson
- Dental Research Department, Postgraduate Dental Education Center, Örebro, Sweden
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Magnus Båth
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Radiation Physics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Reet Karlsson
- Department of Radiology, Skaraborg Hospital, Skövde, Sweden
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L K SK, Zachariah GP, Chandran S. Ultrasonography: A step forward in temporomandibular joint imaging. A preliminary descriptive study. Clin Pract 2019; 9:1134. [PMID: 31341577 PMCID: PMC6610715 DOI: 10.4081/cp.2019.1134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/21/2019] [Indexed: 11/23/2022] Open
Abstract
Ultrasonography (USG) is a cost-effective and noninvasive imaging modality commonly employed for imaging the abdominal region and extremities. Currently, with the availability of higher frequency probes and higher resolution devices, USG imaging of the temporomandibular joint (TMJ) looks promising. The aim is to evaluate and demonstrate the role of USG as an imaging modality of TMJ by visualizing the static and dynamic relationship of the joint, assessment of joint space and eliciting reproducibility at both open and closed mouth positions. 30 volunteers were selected based on the inclusion criteria in line with the research diagnostic criteria/temporomandibular disorders guidelines. High-resolution USG (≥12 MHz) of the right TMJ (chosen for uniformity) was done in the left decubitus position on (n=30) volunteers. The joint disc movement was directly visualized during opening and closing motions. The vertical joint space was assessed using the firmware and accurate reproducibility was checked. At the closed mouth position, the measured values ranged from 0.2 mm to 0.7 mm with a median of 0.05 cm and a mean of 0.4±0.15 mm. At the position of maximal mouth opening, the measured values ranged from 0.9 mm to 1.5 mm with a median of 1.1 mm and a mean of 1.1±0.17 mm. USG enables visualization of the dynamic relationship between joint structures, with particular importance to the condyle and disc position. The articular disc appears on the USG as a thin layer of hyperechogenicity surrounded by a hypoechoic halo, located between 2 hyperechoic lines viz, the condyle and the articular eminence We recommend ultrasonographic imaging as a noninvasive diagnostic technique with relatively high specificity for patients with temporomandibular disorders.
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Affiliation(s)
- Surej Kumar L K
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Thiruvananthapuram, India
| | - Georgie P Zachariah
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Thiruvananthapuram, India
| | - Sumesh Chandran
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Thiruvananthapuram, India
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Freire JL, França SR, Teixeira FW, Fonteles FA, Chaves FN, Sampieri MB. Prevalence of calcification of the head and neck soft tissue diagnosed with digital panoramic radiography in Northeast Brazilian population. ACTA ACUST UNITED AC 2019; 68:17-24. [DOI: 10.23736/s0026-4970.18.04187-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hwang SY, Choi ES, Kim YS, Gim BE, Ha M, Kim HY. Health effects from exposure to dental diagnostic X-ray. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2018; 33:e2018017. [PMID: 30661338 PMCID: PMC6341170 DOI: 10.5620/eht.e2018017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/04/2018] [Indexed: 05/05/2023]
Abstract
The purpose of this review is to summarize the results of studies on of the association between exposure to dental X-rays and health risk. To perform the systematic review, We searched the PUBMED, EMBASE, and MEDLINE databases for papers published before December 15, 2016. A total of 2 158 studies, excluding duplicate studies, were found. Two reviewers independently evaluated the eligibility of each study. The final 21 studies were selected after application of exclusion criteria. In terms of health outcomes, there were 10 studies about brain tumors, 5 about thyroid cancer, 3 about tumors of head and neck areas, and 3 related to systemic health. In brain tumor studies, the association between dental X-ray exposure and meningioma was statistically significant in 5 of the 7 studies. In 4 of the 5 thyroid-related studies, there was a significant correlation with dental diagnostic X-rays. In studies on head and neck areas, tumors included laryngeal, parotid gland, and salivary gland cancers. There was also a statistically significant correlation between full-mouth X-rays and salivary gland cancer, but not parotid gland cancer. Health outcomes such as leukemia, low birth weight, cataracts, and thumb carcinomas were also reported. In a few studies examining health effects related to dental X-ray exposure, possibly increased risks of meningioma and thyroid cancer were suggested. More studies with a large population and prospective design are needed to elaborate these associations further.
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Affiliation(s)
- Su-Yeon Hwang
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Eun-Sil Choi
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Young-Sun Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Bo-Eun Gim
- Expert Group on Health Promotion for Seoul Metropolitan Government, Seoul, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Hae-Young Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
- Corresponding author: Hae-Young Kim Department of Health Policy and Management, College of Health Sciences, Korea University, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea E-mail:
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Do we need CBCTs for sufficient diagnostics?-dentist-related factors. Int J Implant Dent 2018; 4:37. [PMID: 30443865 PMCID: PMC6238012 DOI: 10.1186/s40729-018-0147-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/08/2018] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to assess the diagnostic accuracy of various dentoalveolar pathologies based on panoramic radiography (OPG), cone beam computed tomography (CBCT) and printed 3D models in consecutive order; and to evaluate the impact of specialisation of residents in oral surgery (OS) versus residents in orthodontics (ORTH). Methods Fourteen residents were recruited to evaluate nine selected cases with different dentoalveolar pathologies. The residents were given for each case an OPG, a CBCT and a printed 3D model. For each case and imaging modality, the residents were asked several questions relating to (i) diagnosis, and (ii) the request for consecutive imaging in order to enable treatment. Further, aspects like impact of specialisation (OS versus ORTH), gender and years of experience were analysed. Results In this study, diagnostic accuracy (i) improved for OS from OPG to CBCT (OPG 66.3%, CBCT 83.4%) and likewise for ORTH (OPG 63.7%, CBCT 78.0%). 3D models generally did not seem more useful than CBCTs. For treatment planning (ii), residents in orthodontics considered OPGs significantly more often as sufficient compared to residents in oral surgery (OR 6.3, p < 0.001). Further, the odds to request a CBCT after OPG for treatment planning is influenced by dentist-related factors: female dentists (OR 3.8) or residents with limited professional experience as dentists (OR 3.0) asked more frequently for a CBCT. Conclusions Overall diagnostic accuracy is decent with OPG and can be improved with CBCT. Specialisation seems to have a moderate impact on diagnostic accuracy, but influences whether a CBCT was requested for treatment planning. Based on these findings, future studies shall analyse the diagnostic accuracy of specific pathologies in higher number in order to substantiate the present findings with regard to specific pathologies.
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A comparison of panoramic radiography and cone beam computed tomography in the detection of osteosynthesis complications in sheep mandibular angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:167-174. [PMID: 30415905 DOI: 10.1016/j.oooo.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/26/2018] [Accepted: 10/05/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to compare the diagnostic efficacy of panoramic radiography (PANO) and cone beam computed tomography (CBCT) in detecting simulated complications of plate osteosynthesis applied to mandibular angle fractures (MAFs). STUDY DESIGN Unfavorable MAFs were created in 100 fresh sheep hemimandibles. Fractures were fixed with 4-hole titanium miniplates and screws. Bone necrosis around the screws, penetration of the screw into the inferior alveolar canal, screw loosening, and plate breakage were simulated. The diagnostic efficacy of the imaging techniques was compared by using intra- and interobserver agreement scores and area under the receiver operating characteristic curve (AUC) values. Examination time (ET), confidence scores (CS), and planar preference (PP) in CBCT evaluation were assessed. RESULTS Intra- and interobserver agreement scores varied between 0.61 and 0.91. AUCs for screw penetration into the inferior alveolar canal and screw loosening were significantly higher in CBCT than in PANO (P < .05). CBCT presented significantly higher ET and CS values compared with PANO (P < .05). PP showed significant differences among types of complications (P < .05). CONCLUSIONS PANO provided acceptable outcomes in the detection of bone necrosis and broken plates around the screw, but CBCT was more likely to enable detection of all simulated types of complications with higher confidence.
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Selim DG, Sexton C, Monsour P. Dentomaxillofacial radiology in Australia and dentist satisfaction with radiology reports. Aust Dent J 2018; 63:402-413. [PMID: 29963705 DOI: 10.1111/adj.12642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dentomaxillofacial Radiology (DMFR) is comprised of the smallest cohort of specialists in Australia. A survey was undertaken to assess awareness of DMFR, radiology reporting and referring protocols as well as dental practitioners' satisfaction with their radiology reporting arrangements. METHODS An original online survey created using Checkbox† was sent to dental practitioners. The survey was promoted on Australian-based dental Facebook forums and emailed to targeted members via Australian professional dental associations. RESULTS A total of 399 responses were received, with over 80% of respondents aware of DMFR as a specialty. Approximately 40% of practitioners were self-reporting their imaging. There was correlation between increased satisfaction with external reporting and utilization of DMFR services and decreased satisfaction with medical radiology services. More than 90% of general dentists and greater than 85% of dental specialists prefer DMFR reports to medical radiology reports. Approximately 80% of practitioners believed that their satisfaction would change positively if they had access to a DMFR report. CONCLUSION The research indicates a high degree of self-reporting or non-reporting by dental practitioners. There is low satisfaction with external reporting performed by Medical Radiologists primarily due to a lack of dental knowledge or detail and a preference for DMF Radiology reports.
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Affiliation(s)
- D G Selim
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - C Sexton
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - P Monsour
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
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Kratz RJ, Nguyen CT, Walton JN, MacDonald D. Dental Students' Interpretations of Digital Panoramic Radiographs on Completely Edentate Patients. J Dent Educ 2018; 82:313-321. [PMID: 29496811 DOI: 10.21815/jde.018.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 07/30/2017] [Indexed: 11/20/2022]
Abstract
The ability of dental students to interpret digital panoramic radiographs (PANs) of edentulous patients has not been documented. The aim of this retrospective study was to compare the ability of second-year (D2) dental students with that of third- and fourth-year (D3-D4) dental students to interpret and identify positional errors in digital PANs obtained from patients with complete edentulism. A total of 169 digital PANs from edentulous patients were assessed by D2 (n=84) and D3-D4 (n=85) dental students at one Canadian dental school. The correctness of the students' interpretations was determined by comparison to a gold standard established by assessments of the same PANs by two experts (a graduate student in prosthodontics and an oral and maxillofacial radiologist). Data collected were from September 1, 2006, when digital radiography was implemented at the university, to December 31, 2012. Nearly all (95%) of the PANs were acceptable diagnostically despite a high proportion (92%) of positional errors detected. A total of 301 positional errors were identified in the sample. The D2 students identified significantly more (p=0.002) positional errors than the D3-D4 students. There was no significant difference (p=0.059) in the distribution of radiographic interpretation errors between the two student groups when compared to the gold standard. Overall, the category of extragnathic findings had the highest number of false negatives (43) reported. In this study, dental students interpreted digital PANs of edentulous patients satisfactorily, but they were more adept at identifying radiographic findings compared to positional errors. Students should be reminded to examine the entire radiograph thoroughly to ensure extragnathic findings are not missed and to recognize and report patient positional errors.
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Affiliation(s)
- Richard J Kratz
- Dr. Kratz is a Prosthodontist in Victoria, BC, Canada; Dr. Nguyen is Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, BC Cancer Agency, Vancouver, Canada; Dr. Walton is Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry; and Dr. MacDonald is Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological, and Medical Sciences, University of British Columbia Faculty of Dentistry.
| | - Caroline T Nguyen
- Dr. Kratz is a Prosthodontist in Victoria, BC, Canada; Dr. Nguyen is Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, BC Cancer Agency, Vancouver, Canada; Dr. Walton is Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry; and Dr. MacDonald is Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological, and Medical Sciences, University of British Columbia Faculty of Dentistry
| | - Joanne N Walton
- Dr. Kratz is a Prosthodontist in Victoria, BC, Canada; Dr. Nguyen is Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, BC Cancer Agency, Vancouver, Canada; Dr. Walton is Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry; and Dr. MacDonald is Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological, and Medical Sciences, University of British Columbia Faculty of Dentistry
| | - David MacDonald
- Dr. Kratz is a Prosthodontist in Victoria, BC, Canada; Dr. Nguyen is Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, BC Cancer Agency, Vancouver, Canada; Dr. Walton is Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry; and Dr. MacDonald is Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological, and Medical Sciences, University of British Columbia Faculty of Dentistry
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Kratz RJ, Walton JN, MacEntee MI, Nguyen CT, MacDonald D. Panoramic radiographs made before complete removable dental prostheses fabrication: A retrospective study of clinical significance. J Prosthet Dent 2016; 118:26-30. [PMID: 28024823 DOI: 10.1016/j.prosdent.2016.09.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM The value of digital panoramic radiographs to screen for problems before fabricating conventional complete dentures is unclear. PURPOSE The purpose of this retrospective study was to examine the influence of pretreatment digital panoramic radiographs on the clinical management of patients receiving complete removable dental prostheses. MATERIAL AND METHODS The clinical records, including panoramic radiographs, of 169 patients seeking new complete removable dental prostheses over a 6-year period were interpreted independently by both a prosthodontist and an oral and maxillofacial radiologist to identify radiographic findings that influenced clinical patient management. A 95% confidence interval and an observed proportion of agreement were used to interpret the results. RESULTS Sixty percent of the 169 radiographs examined had 1 or more abnormal or positive radiographic findings; however, only 6 (<4%) of 165 abnormalities detected influenced patient management, and 3 of them were identified during the clinical examination. CONCLUSIONS Pretreatment digital panoramic radiographs revealed very few abnormalities that influenced the treatment of patients requiring complete removable dental prostheses. Furthermore, the digital images in this study revealed positive findings at a rate similar to those found in studies assessing analog radiographs, reinforcing current guidelines that recommend against radiographic screening of patients who seek new complete removable dental prostheses.
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Affiliation(s)
| | - Joanne N Walton
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Michael I MacEntee
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Caroline T Nguyen
- Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada; and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - David MacDonald
- Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological and Medical Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
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Kavitha MS, Park SY, Heo MS, Chien SI. Distributional Variations in the Quantitative Cortical and Trabecular Bone Radiographic Measurements of Mandible, between Male and Female Populations of Korea, and its Utilization. PLoS One 2016; 11:e0167992. [PMID: 28002443 PMCID: PMC5176279 DOI: 10.1371/journal.pone.0167992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/24/2016] [Indexed: 11/18/2022] Open
Abstract
It is important to investigate the irregularities in aging-associated changes in bone, between men and women for bone strength and osteoporosis. The purpose of this study was to characterize the changes and associations of mandibular cortical and trabecular bone measures of men and women based on age and to the evaluation of cortical shape categories, in a large Korean population. Panoramic radiographs of 1047 subjects (603 women and 444 men) aged between 15 to 90 years were used. Mandibular cortical width (MCW), mandibular cortical index (MCI), and fractal dimensions (FD) of the molar, premolar, and anterior regions of the mandibular trabecular bone were measured. Study subjects were grouped into six 10-years age groups. A local linear regression smoothing with bootstrap resampling for robust fitting of data was used to estimate the relationship between radiographic mandibular variables and age groups as well as genders. The mean age of women (49.56 ± 19.5 years) was significantly higher than that of men (45.57 ± 19.6 years). The MCW of men and women (3.17mm and 2.91mm, respectively, p < 0.0001) was strongly associated with age and MCI. Indeed, trabecular measures also correlated with age in men (r > −0.140, p = 0.003), though not as strongly as in women (r > −0.210, p < 0.0001). In men aged over 55 years, only MCW was significantly associated (r = −0.412, p < 0.0001). Furthermore, by comparison of mandibular variables from different age groups and MCI categories, the results suggest that MCW was detected to be strongly associated in both men and women for the detection of bone strength and osteoporosis. The FD measures revealed relatively higher association with age among women than men, but not as strong as MCW.
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Affiliation(s)
- Muthu Subash Kavitha
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Soon-Yong Park
- Department of Computer and Robot Vision, School of Computer Science and Engineering, Kyungpook National University, Daegu, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National niversity, Seoul, South Korea
- * E-mail: (MSH); (SIC)
| | - Sung-Il Chien
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
- * E-mail: (MSH); (SIC)
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Sex estimation based on tooth measurements using panoramic radiographs. Int J Legal Med 2016; 131:813-821. [PMID: 27534562 DOI: 10.1007/s00414-016-1434-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sex determination is an important step in establishing the biological profile of unidentified human remains. AIM The aims of the study were, firstly, to assess the degree of sexual dimorphism in permanent teeth, based on digital tooth measurements performed on panoramic radiographs. Secondly, to identify sex-related tooth position-specific measurements or combinations of such measurements, and to assess their applicability for potential sex determination. MATERIALS AND METHODS Two hundred digital panoramic radiographs (100 males, 100 females; age range 22-34 years) were retrospectively collected from the dental clinic files of the Dentomaxillofacial Radiology Center of the University Hospitals Leuven, Belgium, and imported in image enhancement software. Tooth length- and width-related variables were measured on all teeth in upper and lower left quadrant, and ratios of variables were calculated. Univariate and multivariate analyses were performed to quantify the sex discriminative value of the tooth position-specific variables and their combinations. RESULTS The mandibular and maxillary canine showed the greatest sexual dimorphism, and tooth length variables had the highest discriminative potential. Compared to single variables, combining variables or ratios of variables did not improve substantially the discrimination between males and females. DISCUSSIONS AND CONCLUSIONS Considering that the discriminative ability values (area under the curve (AUC)) were not higher than 0.80, it is not advocated to use the currently studied dental variables for accurate sex estimation in forensic practice.
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Liu YC, Chuang KS, Yu CC, Chao JH, Hsu FY. Evaluation of the medical exposure doses regarding dental examinations with different X-ray instruments. Radiat Phys Chem Oxf Engl 1993 2015. [DOI: 10.1016/j.radphyschem.2015.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jiang M, You M, Wang H, Xu L. Characteristic features of the adenomatoid odontogenic tumour on cone beam CT. Dentomaxillofac Radiol 2014; 43:20140016. [PMID: 24940808 DOI: 10.1259/dmfr.20140016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To illustrate characteristic features of adenomatoid odontogenic tumour (AOT) on CBCT. METHODS The archived CBCT and panoramic radiographs of eight patients histopathologically diagnosed as AOT were analysed. The radiographic features displayed on both radiographic images were carefully described and compared. RESULTS All eight AOT cases presented as unilocular and well-demarcated lesions on both CBCT and panoramic images. CBCT images displayed three-dimensional interpretation of AOT lesions, especially the detailed intralesional radiopacities. Numerous discrete radiopaque foci scattered in the lesion with evident contrast to the radiolucent background could be considered as one of the characteristic features of AOT on CBCT. CONCLUSIONS Compared with panoramic radiography, CBCT seems to possess better potential in diagnosing AOT.
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Affiliation(s)
- M Jiang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Rondon RHN, Pereira YCL, do Nascimento GC. Common positioning errors in panoramic radiography: A review. Imaging Sci Dent 2014; 44:1-6. [PMID: 24701452 PMCID: PMC3972400 DOI: 10.5624/isd.2014.44.1.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/11/2013] [Accepted: 09/25/2013] [Indexed: 11/21/2022] Open
Abstract
Professionals performing radiographic examinations are responsible for maintaining optimal image quality for accurate diagnoses. These professionals must competently execute techniques such as film manipulation and processing to minimize patient exposure to radiation. Improper performance by the professional and/or patient may result in a radiographic image of unsatisfactory quality that can also lead to a misdiagnosis and the development of an inadequate treatment plan. Currently, the most commonly performed extraoral examination is panoramic radiography. The invention of panoramic radiography has resulted in improvements in image quality with decreased exposure to radiation and at a low cost. However, this technique requires careful, accurate positioning of the patient's teeth and surrounding maxillofacial bone structure within the focal trough. Therefore, we reviewed the literature for the most common types of positioning errors in panoramic radiography to suggest the correct techniques. We would also discuss how to determine if the most common positioning errors occurred in panoramic radiography, such as in the positioning of the patient's head, tongue, chin, or body.
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Affiliation(s)
- Rafael Henrique Nunes Rondon
- Stomathology and Oral Diagnostic Program, School of Dentistry of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Yamba Carla Lara Pereira
- Biology Dental Buco Graduate Program, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Brazil
| | - Glauce Crivelaro do Nascimento
- Psychobiology Graduate Program, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Celikoglu M, Halicioglu K, Buyuk SK, Sekerci AE, Ucar FI. Condylar and ramal vertical asymmetry in adolescent patients with cleft lip and palate evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2013; 144:691-7. [DOI: 10.1016/j.ajodo.2013.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 07/01/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
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Moll MA, Seuthe M, von See C, Zapf A, Hornecker E, Mausberg RF, Ziebolz D. Comparison of clinical and dental panoramic findings: a practice-based crossover study. BMC Oral Health 2013; 13:48. [PMID: 24066660 PMCID: PMC4015768 DOI: 10.1186/1472-6831-13-48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 09/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated. METHODS Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes. RESULTS Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes. CONCLUSIONS With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found.
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Affiliation(s)
- Marc A Moll
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Centre, Robert-Koch Str, 40, Goettingen D-37075, Germany.
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Dry skull positioning device for extra-oral radiology and cone-beam CT. Int J Legal Med 2013; 128:235-41. [DOI: 10.1007/s00414-013-0905-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 08/13/2013] [Indexed: 11/26/2022]
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Dhillon M, Raju SM, Verma S, Tomar D, Mohan RS, Lakhanpal M, Krishnamoorthy B. Positioning errors and quality assessment in panoramic radiography. Imaging Sci Dent 2012; 42:207-12. [PMID: 23301205 PMCID: PMC3534173 DOI: 10.5624/isd.2012.42.4.207] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/02/2012] [Accepted: 05/18/2012] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college. MATERIALS AND METHODS This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'. RESULTS Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable. CONCLUSION The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.
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Affiliation(s)
- Manu Dhillon
- Department of Oral Medicine and Radiology, ITS Centre for Dental Studies and Research, Ghaziabad, India
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Initial evaluation of linear and spatially oriented planar images from a new dental panoramic system based on tomosynthesis. ACTA ACUST UNITED AC 2012; 112:375-82. [PMID: 21827959 DOI: 10.1016/j.tripleo.2011.04.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/17/2011] [Accepted: 04/14/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this study was to describe a newly developed dental panoramic system based on the tomosynthesis method and to validate the accuracy of linear and spatially oriented planar images. STUDY DESIGN An original robotic mechanism incorporating a new high-speed cadmium-telluride (CdTe) semiconductor detector was fabricated to acquire panoramic images (raw data). The shift-and-add tomosynthesis method was applied to facilitate changes in the depth of the panoramic imaging layer. Using the texture mapping method, planar and spatially oriented images were reconstructed along a custom curved imaging plane. Using a custom phantom and dry skulls, the accuracy of selected linear measurements was evaluated. RESULTS Preliminary measurements demonstrated acceptable linear accuracy in reconstructed panoramic images with variations <5%. CONCLUSIONS This preliminary investigation demonstrates that dental panoramic images acquired by a novel robotic mechanism and CdTe detector using a tomosynthesis method provides planar and spatially oriented images with an image quality that may be acceptable for dental practice.
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Romagna C, Dufour L, Troisgros O, Lorgis L, Richard C, Buffet P, Soulat G, Casillas JM, Rioufol G, Touzery C, Zeller M, Laurent Y, Cottin Y. Periodontal disease: a new factor associated with the presence of multiple complex coronary lesions. J Clin Periodontol 2011; 39:38-44. [PMID: 22092604 DOI: 10.1111/j.1600-051x.2011.01802.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Periodontal disease, including bone loss, is thought to be involved in coronary artery disease. Multiple complex coronary lesions relate to multifocal destabilization of coronary plaques. We investigated whether bone loss could be associated with the presence of multiple complex coronary lesions. METHODS This cross-sectional study included 150 patients with recent myocardial infarction (<1 month). Multiple complex coronary lesions were determined at coronary angiography. A panoramic dental X-ray including bone loss >50% was performed. Patients with no or simple complex lesions were compared to patients with multiple complex lesions. RESULTS Over 20% of patients had multiple complex coronary lesions. Patients with multiple complex lesion were less likely to be women and more likely to have multivessel disease or elevated C-reactive protein (CRP) than patients with no or single complex lesion. Bone loss >50% tended to be more frequent in patients with multiple complex lesions (p = 0.063). In multivariate analysis, multivessel disease, gender and CRP were associated with multiple complex lesion. Bone loss >50% increased the risk of multiple complex lesion. CONCLUSION Bone loss was associated with complex multiple coronary lesions, beyond systemic inflammation. These findings may bear important clinical implications for the prevention and treatment of coronary artery disease.
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The impact of digital image processing artefacts mimicking pathological features associated with restorations. Br Dent J 2011; 211:167-70. [DOI: 10.1038/sj.bdj.2011.676] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2011] [Indexed: 11/08/2022]
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Choi JW. Assessment of panoramic radiography as a national oral examination tool: review of the literature. Imaging Sci Dent 2011; 41:1-6. [PMID: 21977466 PMCID: PMC3174459 DOI: 10.5624/isd.2011.41.1.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 02/12/2011] [Accepted: 02/23/2011] [Indexed: 01/03/2023] Open
Abstract
Purpose The purpose of this review is to evaluate the possibility of panoramic radiography as a national oral examination tool. Materials and Methods This report was carried out by review of the literatures. Results Panoramic radiography has sufficient diagnostic accuracy in dental caries, periodontal diseases, and other lesions. Also, the effective dose of panoramic radiography is lower than traditional full-mouth periapical radiography. Conclusion Panoramic radiography will improve the efficacy of dental examination in national oral examination. However, more studies are required to evaluate the benefit, financial cost, and operation time and also to make selection criteria and quality management program.
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Affiliation(s)
- Jin-Woo Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Ziebolz D, Szabadi I, Rinke S, Hornecker E, Mausberg RF. Initial periodontal screening and radiographic findings--a comparison of two methods to evaluate the periodontal situation. BMC Oral Health 2011; 11:3. [PMID: 21235747 PMCID: PMC3025926 DOI: 10.1186/1472-6831-11-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 01/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The periodontal screening index (PSI) is an element of the initial dental examination. The PSI provides information on the periodontal situation and allows a first estimation of the treatment required. The dental panoramic tomography (DPT) indicates the proximal bone loss, thus also allowing conclusions on the periodontal situation. In this study, the results of both methods in determining the periodontal situation are compared. METHODS The clinical examination covered DMF-T, QHI, and PSI scores at four proximal sites per tooth; the examining dentist was unaware of the radiographic finding. Based on the PSI scores, the findings were diagnosed as follows: score 0 - 2 "no periodontitis", score 3 and 4 "periodontitis". Independent of the locality and time of the clinical evaluation, two dentists examined the DPTs of the subjects. The results were classified as follows: no bone loss = "no periodontitis", and bone loss = "periodontitis". RESULTS 112 male subjects (age 18 to 58, Ø 37.7 ± 8 years) were examined. Regarding the PSI, 17 subjects were diagnosed "no periodontitis" and 95 subjects "periodontitis". According to the evaluation of the DPTs, 70 subjects were diagnosed "no periodontitis" and 42 "periodontitis". A comparison of both methods revealed that the diagnosis "no periodontitis" corresponded in 17 cases and "periodontitis" in 42 cases (53%). In 47% (53 cases) the results were not congruent. The difference between both methods was statistically significant (p < 0.001; kappa = 0.194). CONCLUSION The present study shows that the initial assessment of the periodontal situation significantly depends on the method of evaluation.
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Affiliation(s)
- Dirk Ziebolz
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Centre Goettingen, Germany.
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Temmerman A, Hertelé S, Teughels W, Dekeyser C, Jacobs R, Quirynen M. Are panoramic images reliable in planning sinus augmentation procedures? Clin Oral Implants Res 2010; 22:189-94. [PMID: 20868452 DOI: 10.1111/j.1600-0501.2010.02000.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The inherent deformation and two-dimensional nature of panoramic radiographs jeopardise their interpretation and quantitative measurements. This study aims to estimate the degree of underestimation of available mesio-distal bone in the premolar area (comparing panoramic radiographs with multi-slice/cone-beam computer tomography [CT]) to determine the prevalence, width, length and position of the bony canal [artery] in the lateral sinus wall and to explore the prevalence, width and length of another (newly detected) bony canal at the palatal aspect of the upper canine. MATERIAL AND METHODS The distance between the distal side of the canine/first premolar and the mesial side of the first molar or the anterior wall of the maxillary sinus was measured on panoramic radiographs and corresponding multi-slice/cone-beam CT images (65 patients). Measurements were made at apical, mid-radicular and crestal regions, parallel to the occlusal plane. The presence and dimensions of the two above-mentioned intra-osseous canals were verified on multi-slice CT scans (144 patients) using reformatted cross-sectional images and/or axial slices. RESULTS For all 65 patients, panoramic radiographs underscored the mesio-distal distance of available bone in the upper premolar region (mean 2.9 mm, range 0.1-7.5 mm). An intra-osseous canal in the lateral maxillary sinus wall was clearly visible in 49.5% of the cases (mean diameter 1.4 mm). In the canine region, a bony canal was obvious in 32.9% of the cases, with a mean diameter of 1.23 mm. For both canals, there was no correlation between diameter and patient's age. CONCLUSIONS Based on the present data, cone-beam CT imaging can be recommended for visualising anatomical structures during planning of sinus augmentation procedures.
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Affiliation(s)
- Andy Temmerman
- Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-Facial Surgery, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium.
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Petersson A. What you can and cannot see in TMJ imaging - an overview related to the RDC/TMD diagnostic system. J Oral Rehabil 2010; 37:771-8. [PMID: 20492436 DOI: 10.1111/j.1365-2842.2010.02108.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Petersson
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
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A retrospective analysis of referral patterns for oral radiologic consultation over 3 years in Ontario, Canada. ACTA ACUST UNITED AC 2010; 109:e86-91. [PMID: 20123401 DOI: 10.1016/j.tripleo.2009.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 10/02/2009] [Accepted: 10/04/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine the types of practitioners who most commonly refer and the film type and diagnostic entities that are most frequently submitted for oral radiologic consultation in Ontario, Canada. STUDY DESIGN A total of 430 referral letters and responses from 2 Ontario oral radiologists from 2003 to 2005 were analyzed. Data collected included the specialty of the referring practitioner, the film type(s) submitted, the radiographic density of the entity of interest, and the interpretation by the radiologist. RESULTS General practitioners (58.9%) and oral surgeons (21.5%) were the most frequently referring practitioner types, representing 1.2% and 17.1% respectively of each group practicing in Ontario. Also, 18.2% of oral pathologists referred. Panoramic radiographs (79.5%) were included in referrals more often than intraoral radiographs (46.0%). Of the entities, 37.0% were radiopacities, 27.4% were radiolucencies, and 13.5% had mixed radiopaque-radiolucent density. The radiologists interpreted normal features (55.6%) most often. CONCLUSION Panoramic radiographs with normal findings were submitted to oral radiologists for consultation most frequently in Ontario.
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Thom AR, Isaacson K. Flawed conclusion. Br Dent J 2009; 207:408-9. [DOI: 10.1038/sj.bdj.2009.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ezoddini Ardakani F, Sarayesh V. Knowledge of Correct Prescription of Radiographs among Dentists in Yazd, Iran. J Dent Res Dent Clin Dent Prospects 2008; 2:95-8. [PMID: 23277853 PMCID: PMC3532731 DOI: 10.5681/joddd.2008.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Accepted: 12/27/2007] [Indexed: 11/28/2022] Open
Abstract
Background and aims
While the use of X-ray is increasing, professional responsibility of dentists entitles them to have sufficient and correct knowledge of using radiographs. The aim of this study was to assess the level of knowledge of correct prescription of radiographs among dentists in Yazd, Iran.
Materials and methods
This was a descriptive cross-sectional study including 134 general dentists and dental specialists. A self-administered questionnaire was used to assess their level of knowledge in various sections pertaining to prescription of radiographs. Their level of knowledge was compared in each section on the basis of gender and educational status.
Results
Participants showed a high level of awareness in prescription of panoramic, periapical radiographs, and computerized tomography, whereas it was moderate in the field of occlusal radiographs, susceptible patients to caries, patients with periodontal diseases, evaluation of growth condition and dental crypts and weak in the fields of bitewing radiographs and insusceptible patients to caries. There was no difference in level of knowledge between genders. The level of knowledge in specialists was higher than general dentists except for using X-ray for susceptible patients to caries where no significant difference was observed.
Conclusion Specialist dentists were more knowledgeable than general dentists in prescribing radiological examinations.
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Affiliation(s)
- Fatemeh Ezoddini Ardakani
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Yazd University of Medical Sciences, Yazd, Iran
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