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Taeby A, Seyyedi SA, Mostafavi M. In vitro accuracy of ultra-low dose cone-beam CT for detection of proximal caries. Dentomaxillofac Radiol 2024; 53:459-467. [PMID: 38976634 DOI: 10.1093/dmfr/twae030] [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: 12/04/2023] [Revised: 03/24/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVES This study aimed to assess the accuracy of ultra-low dose (ULD) cone-beam CT (CBCT) for detection of proximal caries. METHODS This in vitro study evaluated 104 molar and premolar teeth. The teeth were mounted in dry skulls and underwent CBCT with 4 protocols of high-resolution (HR), normal (NORM), ULD-HR, and ULD-NORM; 78 CBCT images were scored by 3 observers for the presence and penetration depth of caries twice with a 2-week interval using a 5-point Likert scale. The teeth were then sectioned and observed under a stereomicroscope (gold standard). The 4 protocols were compared with each other and with the gold standard. The receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated and compared by the Chi-square test (alpha = .05). RESULTS The interobserver agreement ranged from 0.5233 to 0.6034 for ULD-NORM, 0.5380 to 0.6279 for NORM, 0.5856 to 0.6300 for ULD-HR, and 0.6614 to 0.7707 for HR images. The intra-observer agreement ranged from 0.6027 to 0.8812 for ULD-HR, 0.7083 to 0.7556 for HR, 0.6076 to 0.9452 for ULD-NORM, and 0.7012 to 0.9221 for NORM images. Comparison of AUC revealed no significant difference between NORM and ULD-NORM (P > .05), or HR and ULD-HR (P > .05). The highest AUC belonged to HR (0.8529) and the lowest to NORM (0.7774). CONCLUSIONS Considering the significant reduction in radiation dose in ULD CBCT and its acceptable diagnostic accuracy for detection of proximal caries, this protocol may be used for detection of proximal carious lesions and assessment of their depth.
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Affiliation(s)
- Aria Taeby
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Urmia University of Medical Sciences, Orzhans Alley, Resalat St., Urmia, west Azerbaijan Province, 5714783734, Iran
| | - Seyyed Amir Seyyedi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Urmia University of Medical Sciences, Orzhans Alley, Resalat St., Urmia, west Azerbaijan Province, 5714783734, Iran
| | - Maryam Mostafavi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Urmia University of Medical Sciences, Orzhans Alley, Resalat St., Urmia, west Azerbaijan Province, 5714783734, Iran
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Chen X, Liu SQ, Wang XX, Liu W, Zhou X, Wang X. Effect of Orthodontic Treatment on the Outcomes of Endodontically Treated Teeth: A Cone-Beam Computed Tomography Analysis. J Endod 2024; 50:1091-1099. [PMID: 38763483 DOI: 10.1016/j.joen.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Often there is the need of moving endodontically treated teeth. Orthodontic movement may have no effect on the prognosis of teeth with root canal treatment (RCT). To verify this subject, we evaluated the effect of orthodontic movement on the prognosis of RCT teeth using cone-beam computed tomography (CBCT) and further explored the influence of orthodontic movement on the prognosis of RCT teeth with and without apical periodontitis (AP). METHODS This retrospective study was conducted by evaluating 169 RCT teeth of 100 patients who had undergone fixed orthodontic treatment. AP was assessed and classified using the CBCT periapical index. Univariate analysis of RCT outcome was performed for the total RCT group, RCT without AP group and RCT with AP group. Multivariate logistic regression was performed for the total RCT group and RCT without AP group, respectively, but not for the RCT with AP group. Variables related to the prognosis of RCT were included, such as age, gender, tooth position, RCT quality, coronal restoration quality, periodontal condition, orthodontic traction distance, and orthodontic rotation angle. RESULTS The orthodontic traction distance and rotation angle were not significantly correlated to the RCT outcomes, regardless of the presence of AP. Among the total RCT group, teeth with unqualified RCT (odds ratio = 3.42, P = .004) and inadequate coronal restoration (odds ratio = 4.40, P = .031) had a lower success rate. Of the 97 RCT teeth without AP, unqualified RCT was a risk factor for treatment failure (odds ratio = 3.55, P = .041). Of the 72 RCT teeth with AP, the univariate analysis showed that RCT quality were significantly related to the outcome (P = .042). CONCLUSIONS Orthodontic movement had no effect on the prognosis of RCT teeth regardless of the presence of AP.
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Affiliation(s)
- Xue Chen
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Shao-Qing Liu
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xiao-Xiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Wei Liu
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xin Zhou
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xiao Wang
- Department of Stomatology, Peking University Third Hospital, Beijing, China.
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Kumar N, Malik B, Dubey A, Kaur H, Mujoo S, Jugade SC, Gulia SK. Long-Term Trends in the Utilization of Cone Beam Computed Tomography in Oral and Maxillofacial Radiology. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2585-S2587. [PMID: 39346142 PMCID: PMC11426885 DOI: 10.4103/jpbs.jpbs_295_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 10/01/2024] Open
Abstract
Background Cone beam computed tomography (CBCT) has become a cornerstone in oral and maxillofacial radiology due to its high-resolution, three-dimensional imaging capabilities and lower radiation exposure compared to traditional computed tomography (CT). The purpose of this retrospective study is to examine long-term patterns in the use of CBCT in a tertiary care context, with an emphasis on patient characteristics, CBCT indications, and variations in use patterns over time. Methods During the course of 5 years, a tertiary care facility performed 500 CBCT scans, all of which were included in the study. Information on the age, sex, and source of referral for each patient was gathered from their electronic medical records. Radiology data were used to categorize CBCT indications, which included implant planning, impacted tooth assessment, and pathology evaluation. Regression analysis and descriptive statistics were used to examine utilization trends. Results Throughout the study period, there was a consistent rise in the use of CBCT, with implant planning being the most often cited indication. Impacted tooth assessment and pathology evaluation were next in line. Considerable differences were noted in the use of CBCT for various age groups and indications. The results demonstrate how CBCT is improving oral and maxillofacial radiology's diagnostic precision and treatment planning. In summary, this study offers a significant understanding of the long-term patterns in CBCT use in a tertiary care context. With ramifications for resource allocation, patient care, and future research objectives, the observed trends highlight the increasing acceptability and incorporation of CBCT into standard clinical practice.
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Affiliation(s)
- Nithin Kumar
- School of Dentistry, Central Asian University, Tashkent, Uzbekistan
| | - Bhavna Malik
- Department of Dentistry, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Alok Dubey
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Harveen Kaur
- Department of Oral Medicine and Radiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Sheetal Mujoo
- Division of Oral Medicine and Radiology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shraddha C. Jugade
- Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Sunil K. Gulia
- Oral and Maxillofacial Surgery, SGT University, Jhajjar, Haryana, India
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Baraka M, Cevidanes L, Ruellas A, Benavides E, Aly N, Fontana M. Comparison of two CBCT analysis techniques with conventional periapical radiographs in assessment of tertiary dentin after indirect pulp capping in young permanent teeth. Int J Paediatr Dent 2024. [PMID: 38937920 DOI: 10.1111/ipd.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/09/2024] [Accepted: 05/22/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND AND AIM To compare two cone beam computed tomography (CBCT) analysis techniques for measuring tertiary dentin (TD) volume, density, and root length increase, after indirect pulp therapy (IPT) in young permanent teeth with conventional periapical radiographs. DESIGN Comparative study design: Sixty-nine CBCT scans were taken initially (T1) and after 1 year (T2) of IPT. New CBCT analysis technique A, standardization, segmentation, and registration of T1 and T2 scans were performed using ITK-SNAP and 3D Slicer CMF to measure TD volume (mm3), density (gray-level intensity), and root length increase (mm). In the traditional CBCT analysis technique B, analyses were conducted using the In-Vivo software to calculate TD thickness (mm), radiodensity (HU%), and root length increase (mm). Paired t-test and the intraclass correlation coefficient were calculated to compare and assess the reliability of all techniques. RESULTS No significant difference between the two techniques existed in the measurement of TD mineral density (Mean [SD]:A = 22.4 [15.4]; B = 24.4 [15.4]; p = .47). Technique A resulted in significantly higher root length increase values (Mean [SD]: A = 1.3 [0.6]; B = 1.1 [0.5]; p = .03). The two techniques showed acceptable reliability levels (0.76-0.99). CONCLUSION CBCT analysis techniques yielded similar findings for mineral density. The new CBCT volumetric analysis technique, although more laborious, produced higher values for root length increase, and allowed for measurement of dentin volume.
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Affiliation(s)
- Marwa Baraka
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Antonio Ruellas
- Department of Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Nourhan Aly
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Reinert CP, Pfannenberg C, Gückel B, Dittmann H, la Fougère C, Nikolaou K, Reinert S, Schönhof R, Hoefert S. Preoperative Assessment of Medication-Related Osteonecrosis of the Jaw Using [18F]fluoride Positron Emission Tomography (PET)/CT and [18F]fluorodeoxyglucose PET/MRI in Correlation with Histomorphometry and Micro-CT-A Prospective Comparative Study. Diagnostics (Basel) 2024; 14:428. [PMID: 38396467 PMCID: PMC10888075 DOI: 10.3390/diagnostics14040428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the imaging characteristics of medication-related osteonecrosis of the jaw (MRONJ) using [18F]fluoride positron emission tomography/computed tomography (PET/CT) and [18F]fluorodeoxyglucose (FDG) PET/magnetic resonance imaging (MRI) for preoperative assessment and to correlate them with microarchitectural and histomorphometric data with respect to clinical findings. METHODS Twelve patients (five female; mean age 75 ± 7.6 yr) with symptomatic MRONJ underwent both scans on the same day, and imaging findings were used to plan surgical interventions for seven patients. Bone tracer uptake was classified as high, medium, or low, and surgical samples were evaluated using Micro-CT and histomorphometric analysis. RESULTS CT showed medullary sclerosis in all patients, and MRI revealed gadolinium enhancement in four patients. PET imaging revealed remarkably elevated [18F]fluoride uptake and moderately increased [18F]FDG uptake in MRONJ compared to healthy jawbones, with both differences being statistically significant. [18F]fluoride uptake was associated with necrosis, bacteria, and inflammatory tissue. Micro-CT data did not show significant differences, but histomorphometric analysis revealed higher osteocyte and lacunae densities in the high [18F]fluoride uptake group, and more necrotic bone in the medium [18F]fluoride uptake group. Bacteria were observed in all areas. CONCLUSIONS In summary, [18F]fluoride PET accurately identified MRONJ extent, revealing functional changes in jawbone remodeling not visible on CT. [18F]FDG PET showed differences in bone and soft tissue, though less pronounced. This method aids in evaluating disease activity and guiding treatment planning, requiring further research for optimal surgical approaches based on tracer uptake.
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Affiliation(s)
- Christian Philipp Reinert
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, 72076 Tübingen, Germany; (C.P.); (B.G.); (K.N.)
| | - Christina Pfannenberg
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, 72076 Tübingen, Germany; (C.P.); (B.G.); (K.N.)
| | - Brigitte Gückel
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, 72076 Tübingen, Germany; (C.P.); (B.G.); (K.N.)
| | - Helmut Dittmann
- Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen, 72076 Tübingen, Germany; (H.D.); (C.l.F.)
| | - Christian la Fougère
- Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen, 72076 Tübingen, Germany; (H.D.); (C.l.F.)
- Cluster of Excellence iFIT (EXC 2180) “Image Guided and Functionally Instructed Tumor, Therapies”, University of Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tübingen, 72076 Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, 72076 Tübingen, Germany; (C.P.); (B.G.); (K.N.)
- Cluster of Excellence iFIT (EXC 2180) “Image Guided and Functionally Instructed Tumor, Therapies”, University of Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tübingen, 72076 Tübingen, Germany
| | - Siegmar Reinert
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, 72076 Tübingen, Germany; (S.R.); (R.S.); (S.H.)
| | - Rouven Schönhof
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, 72076 Tübingen, Germany; (S.R.); (R.S.); (S.H.)
| | - Sebastian Hoefert
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, 72076 Tübingen, Germany; (S.R.); (R.S.); (S.H.)
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Das M, Shahnawaz K, Raghavendra K, Kavitha R, Nagareddy B, Murugesan S. Evaluating the Accuracy of AI-Based Software vs Human Interpretation in the Diagnosis of Dental Caries Using Intraoral Radiographs: An RCT. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S812-S814. [PMID: 38595404 PMCID: PMC11001121 DOI: 10.4103/jpbs.jpbs_1029_23] [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: 10/11/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background Dental caries is a prevalent oral health issue, often diagnosed through intraoral radiographs. The accuracy of Artificial Intelligence (AI) in diagnosing dental caries from these radiographs is a subject of growing interest. Materials and Methods In this RCT, 200 intraoral radiographs were collected from patients seeking dental care. These radiographs were independently evaluated by both AI-based software and experienced human dentists. The software utilized deep learning algorithms to analyze the radiographs for signs of dental caries. The performance of both AI and human interpretations was compared by calculating sensitivity, specificity, and overall accuracy. Arbitrary values of 85% sensitivity, 90% specificity, and 88% overall accuracy were set as benchmarks. Results The AI-based software demonstrated a sensitivity of 88%, a specificity of 91%, and an overall accuracy of 89% in diagnosing dental caries from intraoral radiographs. Human interpretation, however, yielded a sensitivity of 84%, a specificity of 88%, and an overall accuracy of 86%. The AI-based software performed consistently close to or above the predefined benchmarks, while human interpretation showed slightly lower accuracy rates. Conclusion This RCT suggests that AI-based software is a valuable tool for diagnosing dental caries from intraoral radiographs, with performance comparable to or exceeding that of experienced human dentists. The consistent accuracy of AI in this context highlights its potential as an adjunctive diagnostic tool, which can aid dental professionals in more efficient and precise caries detection.
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Affiliation(s)
- Maneesha Das
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha, India
| | - Kamil Shahnawaz
- Department of Conservative and Endodontics, Darbhanga Medical College, Laheriasarai, Darbhanga, Bihar, India
| | - Koti Raghavendra
- Department of Endodontics, MNR Dental College, Sangareddy, Telangana, India
| | - R. Kavitha
- Department of Conservative and Endodontics, Ragas Dental College and Hospital, East Coast Road, Uthandi, Chennai, Tamil Nadu, India
| | - Bharath Nagareddy
- Department of Conservative Dentistry and Endodontics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | - Sabari Murugesan
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
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Hora BS, Varghese AS, Patil P, Anbalagan S, Chandarani S, Shaik N. The Role of Three-Dimensional Imaging (CBCT) in Enhancing Diagnostic Accuracy in Endodontics: A Randomized Controlled Trial. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S871-S873. [PMID: 38595528 PMCID: PMC11001081 DOI: 10.4103/jpbs.jpbs_1066_23] [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: 10/16/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background In the field of endodontics, accurate diagnosis is pivotal for successful treatment outcomes. This randomized controlled trial (RCT) explores the potential of cone-beam computed tomography (CBCT) as a tool to enhance diagnostic accuracy in endodontic procedures. Materials and Methods An RCT was conducted with a sample of 120 patients presenting with endodontic issues. The patients were divided into two groups: Group A received traditional two-dimensional radiography, while group B underwent CBCT scans. The diagnostic accuracy was assessed by comparing the radiographic findings with the clinical evaluation by experienced endodontists. Results The results indicated a significant improvement in diagnostic accuracy in the CBCT group (group B) with an arbitrary value of 88% accuracy, compared with the traditional radiography group (group A) with only 65% accuracy. The CBCT group showed a clearer visualization of root canal anatomy, periapical lesions, and the presence of additional canals, contributing to the enhanced diagnostic capability. Conclusion This RCT demonstrates that CBCT significantly enhances diagnostic accuracy in endodontics compared with traditional two-dimensional radiography. The improved visualization of root canal anatomy and periapical regions allows for more precise treatment planning, ultimately leading to better treatment outcomes.
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Affiliation(s)
- Baljeet Singh Hora
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Anil Samson Varghese
- Department of Conservative Dentistry and Endodontics, Pushpagiri College of Dental Sciences, Kerala, India
| | - Pranav Patil
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
| | - Sakthivel Anbalagan
- Department of Dentistry, Associate Director of Validation (Cell and Gene Therapy), Lonza, USA
| | - Sagolsem Chandarani
- Department of Conservative Dentistry and Endodontics, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Naseemoon Shaik
- Department of Pedodontics and Preventive Dentistry, MNR Dental College and Hospital, Sangareddy, Telangana, India
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Ateş Yıldırım E, Türker N, Göller Bulut D, Ustaoğlu G. The relationship of the position of mandibular third molar impaction with the development of dental and periodontal lesions in adjacent second molars. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101610. [PMID: 37633358 DOI: 10.1016/j.jormas.2023.101610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/12/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age. MATERIALS AND METHODS This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis. RESULTS Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively). CONCLUSIONS The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.
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Affiliation(s)
- Esra Ateş Yıldırım
- Department of Periodontology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Nurşat Türker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Duygu Göller Bulut
- Department of Dentomaxsillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Gülbahar Ustaoğlu
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
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Romano A, Norino G, Dell’Aversana Orabona G, Barone S, Ordano D, Calvanese C, Troise S, Califano L, Iaconetta G. A Large Follicular Dentigerous Cyst: A New Multi-portal Access: Intraoral and Endoscopic Technique. J Maxillofac Oral Surg 2024; 23:189-192. [PMID: 38312981 PMCID: PMC10830927 DOI: 10.1007/s12663-023-01885-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
Background The standard treatment for a dentigerous cyst of maxilla is a surgical enucleation, the extraction of the tooth. In the case of cysts involving the maxillary sinus, a Caldwell-Luc approach is used. In case of large cysts, its marsupialization is carried out in order to reduce the bone defect, followed by enucleation and extraction of the tooth. Methods This is a case of a large follicular dentigerous cyst of upper jaw with 18 ectopic tooth within the maxillary sinus, treated in our Unit. Results We decided to perform a multi-portal access, the intraoral endoscopic-assisted technique; an intraoral approach has been performed, but less demolishing than the routine intraoral approach, through the anterior wall of the maxillary sinus, already eroded by the lesion. The lesion was very large, occupying the entire maxillary cavity. For this reason, by means of the intraoral approach alone, it was extremely difficult to remove the lesion in its entirety. The endoscopic-assisted technique was combined with intraoral approach. The lesion extended to the maxillary ostium. This did not allow to reach the ostium through the classic endoscopic approach. Endonasal endoscopic access was used both to enucleate the cyst, that was adherent to the orbital floor and soft tissues of the OMC (osteomeatal complex), and to restore the physiological drainage of the maxillary sinus. Conclusions We decided to perform a combined intraoral and endoscopic approach to allow a complete excision of the cystic lesion, without being very demolishing and taking advantage of the bone erosion already caused by the large cyst.
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Affiliation(s)
- A. Romano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Norino
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Dell’Aversana Orabona
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - S. Barone
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - D. Ordano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - C. Calvanese
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - S. Troise
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - L. Califano
- Division of Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - G. Iaconetta
- Department of Neurosurgery, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
- Department of Medicine, Surgery and Odontoiatrics, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Salerno Italy
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Gurjar BS, Sharma V, Paliwal J, Kalla R, Meena KK, Tahir M. The role of implants and implant prostheses on the accuracy and artifacts of cone-beam computed tomography: an in-vitro study. Sci Rep 2024; 14:704. [PMID: 38184751 PMCID: PMC10771465 DOI: 10.1038/s41598-024-51293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024] Open
Abstract
To assess the accuracy of CBCT in implant-supported prostheses and to evaluate metal artifacts with and without implants or implant prostheses. Accuracy and artifacts were assessed in the dried mandible at three points on the buccal and lingual cortical plates on the mandible's body near the crest and the base. On the buccal cortical plate, these points were labelled as A, B and C near the crest and D, E and F near the base of the body of the mandible. Similarly, points a to f were marked on the lingual cortical plate corresponding to points A to F. The study had two control groups, C0 for physical linear measurement (PLM) and C1 for radiographic linear measurement (RLM) and artifact assessment. There were seven test groups, TG 1 to 7, progressing from a single implant to implant full-arch prosthesis. For accuracy assessment, PLM was compared to RLM. CBCT artifacts were investigated in images integrated at 0.25 mm, 10 mm, and 20 mm at regions of interest on concentric circles at different intersecting angles by comparing grayscale values at C1 and TG1 to 7. The data were collected and statistically analyzed. A significant difference was observed between C0 and C1, and RLM in test groups at the superior axial plane. Similarly, PLM and test RLM in the sagittal plane at A-B, B-C, and D-E were statistically significant. A significant difference between PLM and RLM was also observed in the vertical plane at A-D, B-E, and C-F. Quantification of CBCT artifacts in the presence of implants or prostheses revealed that full-arch prostheses had the highest mean grayscale value, whereas single implants with a prosthesis had the lowest. The mean grayscale change was greatest around the implant and implant prosthesis. The mean grayscale value was maximum at 20 mm voxel integration scales (VIS) and lowest at 0.25 mm. CBCT is a clinically reliable device. Metal in implants or implant-supported prostheses prevents true assessment of the peri-implant area; therefore, lower VIS is suggested in the presence of implants or implant prostheses.
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Affiliation(s)
| | - Vineet Sharma
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Jyoti Paliwal
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India.
| | - Rajani Kalla
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Kamal Kumar Meena
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Mohammed Tahir
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
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Talachi F, Abesi F, Ezoji F, Mahjoub S, Ghorbani H, Bijani A. Comparison of accuracy cone-beam computed tomography and digital bitewing radiography for detection of recurrent caries under various restorative materials: in vitro study. Oral Radiol 2023; 39:722-730. [PMID: 37335388 DOI: 10.1007/s11282-023-00690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE The aim of this study was to compare and evaluate diagnostic accuracy of two different CBCT scan modes and digital bitewing radiography for detection of recurrent caries under five different restorative materials, and determine the relationship between the types of restorative materials. MATERIALS AND METHODS In this in vitro study, 200 caries-free upper and lower premolars and molars were selected. A standard deep Class II cavities was created in the middle of the mesial surface of all teeth. In 100 teeth of the experimental and control groups, secondary caries was artificially demineralized. All teeth were filled with five types of restorative material including two types of conventional composite resins, flow composite resin, glass ionomer and amalgam. The teeth were imaged with high resolution (HIRes) and standard CBCT scan modes and digital bitewing. The AUC, sensitivity, specificity and areas under the ROC curve were calculated and verified through SPSS. RESULTS CBCT technique was the best option in diagnosing recurrent caries. The diagnostic accuracy and specificity of HIRes CBCT scan mode was significantly higher than standard mode (P = 0.031) and bitewing (P = 0.029) for detection of recurrent caries, especially under composite group. There were no significant differences in accuracy value of bitewing and standard CBCT scan mode. CONCLUSION CBCT showed higher accuracy and specificity on the detection of recurrent caries which was more accurate than bitewing radiography. The HIRes CBCT scan mode achieved the highest accuracy and performed the best in recurrent caries detection.
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Affiliation(s)
| | - Farida Abesi
- Dental Materials Research Center, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Fariba Ezoji
- Department of Restorative Dentistry, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Soleiman Mahjoub
- Department of Clinical Biochemistry, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hakimeh Ghorbani
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Patil AB, Patil N, Singh R, Razdan P, Singh S, Mathew RA, Banerjee S. Comparative Assessment of Reliability and Accuracy of Cone-Beam Computed Tomography (CBCT) Over Direct Surgical Measurement for Periodontal Bone Loss: A Prospective, Cross-Sectional Study. Cureus 2023; 15:e44608. [PMID: 37795054 PMCID: PMC10547079 DOI: 10.7759/cureus.44608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION Assessing bone condition holds significant value in the diagnosis, treatment planning, and prognosing the periodontal disease; its importance is undeniable. The main aim of the present study was to evaluate the accuracy of alveolar bone measurements due to periodontal disease using cone-beam computed tomography (CBCT), by comparing with surgical measurements, considered as the gold standard. MATERIALS AND METHODS A prospective cross-sectional study included a sample of 40 individuals diagnosed with chronic periodontitis who required periodontal surgery. A total of 202 sites were assessed for vertical and horizontal bone loss in the anterior (76 sites) and posterior (126 sites) teeth. Bone loss was measured using CBCT and a UNC 15 periodontal probe during the surgical intervention, and then compared. The statistical analysis involved employing a Student's t-test to compare measurements. Unpaired t-tests and correlation analyses were conducted using Pearson's correlation coefficient test. To establish statistical significance, a threshold of p<0.05 was considered appropriate. RESULTS The statistical analysis carried out on the mean values of CBCT and direct surgical measurements for vertical bone loss demonstrated a significant difference (p<0.01). However, the values obtained for horizontal bone loss did not display statistical significance. A strong correlation of 0.94-0.99 existed between surgical and CBCT measurements. A statistically significant distinction was observed between the two methods in measuring bone loss at the distal and palatal sites of the anterior teeth. CONCLUSION Both CBCT and direct surgical measurement exhibit comparable accuracy potential in assessing alveolar bone loss. CBCT provides an accessibility advantage by enhancing visual access to challenging sites during surgical interventions, including palatal and distal areas of the teeth.
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Affiliation(s)
- Anshuman B Patil
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Nileshrao Patil
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Romalpreet Singh
- Department of Conservative Dentistry and Endodontics, Desh Bhagat Dental College, Malout, IND
| | - Priyanka Razdan
- Department of Paediatric and Preventive Dentistry, Yogita Dental College and Hospital, Khed, IND
| | - Sneha Singh
- Department of Conservative Dentistry and Endodontics, Rungta College of Dental Sciences, Bhilai, IND
| | - Rinnu A Mathew
- Department of Periodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Satyabrat Banerjee
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
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Xu S, Li B, Inscoe CR, Bastawros D, Tyndall DA, Lee YZ, Lu J, Zhou O. Evaluation of the feasibility of a multisource CBCT for maxillofacial imaging. Phys Med Biol 2023; 68:10.1088/1361-6560/acea17. [PMID: 37487498 PMCID: PMC10460191 DOI: 10.1088/1361-6560/acea17] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/24/2023] [Indexed: 07/26/2023]
Abstract
Objective. The aim of this study was to investigate the feasibility of improving the image quality and accuracy of cone beam computed tomography (CBCT) by replacing the conventional wide cone angle x-ray tube with a distributed x-ray source array positioned in the axial direction.Approach. The multisource CBCT (ms-CBCT) design was experimentally simulated using a benchtop scanner with a carbon nanotube x-ray tube and a flat-panel detector. The source was collimated and translated in the axial direction to simulate a source array with a reduced cone angle for each beam. An adjacent scatter ratio subtraction (ASRS) method was implemented for residual scatter reduction. Several phantoms were imaged using the ms-CBCT and conventional CBCT configurations under otherwise similar conditions. The Requirements of the ms-CBCT design on the x-ray source and detector were evaluated.Main results. Compared to the conventional CBCT, the ms-CBCT design with 8 sources and ASRS significantly improved the image quality and accuracy, including: (1) reducing the cupping artifact from 15% to 3.5%; (2) reducing the spatial nonuniformity of the CT Hounsfield unit values from 38.0 to 9.2; (3) improving the contrast-to-noise ratio of the low contrast objects (acrylic and low density polyethylene inserts) against the water-equivalent background by ∼20% and (4) reducing the root-mean-square error of the HU values by 70%, from 420.1 to 124.4. The imaging dose and scanning time used by the current clinical CBCT for maxillofacial imaging can be achieved by current source and detector technologies.Significance. The ms-CBCT design significantly reduces the scatter and improves the image quality and accuracy compared to the conventional CBCT.
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Affiliation(s)
- Shuang Xu
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Boyuan Li
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Christina R Inscoe
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Daniel Bastawros
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Donald A Tyndall
- Department of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Yueh Z Lee
- Department of Radiology, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Jianping Lu
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
| | - Otto Zhou
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill; Chapel Hill, NC 27599, United States of America
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Boitor AA, Varvară EB, Prodan CM, Sava S, Dudea D, Objelean A. The Impact of Simulated Bruxism Forces and Surface Aging Treatments on Two Dental Nano-Biocomposites-A Radiographic and Tomographic Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020360. [PMID: 36837561 PMCID: PMC9965443 DOI: 10.3390/medicina59020360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives: Nowadays, indication of composite materials for various clinical situations has increased significantly. However, in the oral environment, these biomaterials are subjected (abnormal occlusal forces, external bleaching, consumption of carbonated beverages, etc.) to changes in their functional and mechanical behavior when indicated primarily for patients with masticatory habits. The study aimed to recreate in our lab one of the most common situations nowadays-in-office activity of a young patient suffering from specific parafunctional occlusal stress (bruxism) who consumes acidic beverages and is using at-home dental bleaching. Materials and Methods: Sixty standardized class II cavities were restored with two nanohybrid biocomposite materials (Filtek Z550, 3M ESPE, and Evetric, Ivoclar Vivadent); the restored teeth were immersed in sports drinks and carbonated beverages and exposed to an at-home teeth bleaching agent. The samples were subjected to parafunctional mechanical loads using a dual-axis chewing simulator. A grading evaluation system was conducted to assess the defects of the restorations using different examination devices: a CBCT, a high-resolution digital camera, and periapical X-rays. Results: Before mechanical loading, the CBCT analysis revealed substantially fewer interfacial defects between the two resin-based composites (p > 0.05), whereas, after bruxism forces simulation, significantly more defects were identified (p < 0.05). Qualitative examination of the restorations showed more occlusal defects for the Evetric than the other nanohybrid composite. Conclusions: There were different behaviors observed regarding the studied nanocomposites when simulation of parafunctional masticatory forces was associated with aging treatments.
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Affiliation(s)
- Amelia Anita Boitor
- Department of Dental Propaedeutics and Esthetics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400006 Cluj-Napoca, Romania
| | - Elena Bianca Varvară
- Department of Dental Propaedeutics and Esthetics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400006 Cluj-Napoca, Romania
| | - Corina Mirela Prodan
- Department of Dental Propaedeutics and Esthetics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400006 Cluj-Napoca, Romania
| | - Sorina Sava
- Department of Dental Materials and Ergonomics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400083 Cluj-Napoca, Romania
| | - Diana Dudea
- Department of Dental Propaedeutics and Esthetics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400006 Cluj-Napoca, Romania
| | - Adriana Objelean
- Department of Dental Materials and Ergonomics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400083 Cluj-Napoca, Romania
- Correspondence:
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Charuakkra A, Mahasantipiya P, Lehtinen A, Koivisto J, Järnstedt J. Comparison of subjective image analysis and effective dose between low-dose cone-beam computed tomography machines. Dentomaxillofac Radiol 2023; 52:20220176. [PMID: 36168973 PMCID: PMC9974239 DOI: 10.1259/dmfr.20220176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To compare the cone-beam computed tomography (CBCT) image quality and effective dose between low-dose scanning and standard manufacturer-recommended protocols among different CBCT units. METHODS Three human-equivalent phantoms were scanned using the ultra-low-dose (ULD), low dose (LD), and standard dose (STD) modes of ProMax 3D Mid (Planmeca Oy, Helsinki, Finland) and Orthophos SL (Sirona, Bensheim, German) for the CBCT images. The quality of the dental anatomical images was assessed by four experienced oral and maxillofacial radiologists using a 5-point Likert scale. OnDemand3D (Cybermed Co., Seoul, Korea) was used as the third-party software for viewing. The percentage of absolute agreement was calculated to determine intra- and interrater agreements among the observers. The effective doses for all CBCT scanning protocols were also calculated. RESULTS The STD protocol yielded a higher image quality than did the ULD and LD protocols in both ProMax 3D Mid and Orthophos SL. The ULD and LD protocols demonstrated an "acceptable-to-good" sense of visual perception of the CBCT images. The visibility scores significantly differed between the ULD and LD and the STD protocols in ProMax 3D Mid and Orthophos SL, except for the 120-kVp setting in ProMax 3D Mid. The average intra- and interrater agreement scores ranged from 0.63 to 0.89 and from 0.44 to 0.76, respectively. The ULD and LD protocols reduced the radiation dose sixfold compared with the STD protocol. CONCLUSIONS High-tube-voltage protocols could remarkably reduce the imaging dose without degrading the image quality. Specifically, ULD and LD CBCT protocols may be adopted as routine practice for diagnosis and treatment planning.
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Affiliation(s)
- Arnon Charuakkra
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Phattaranant Mahasantipiya
- Division of Oral and Maxillofacial Radiology, Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Antti Lehtinen
- Medical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - Juha Koivisto
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Jorma Järnstedt
- Medical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, Finland
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Huang W, Tan P, Zhang H, Li Z, Lin H, Wu Y, Du Q, Wu Q, Cheng J, Liang Y, Pan Y. Skeletal Muscle Mass Measurement Using Cone-Beam Computed Tomography in Patients With Head and Neck Cancer. Front Oncol 2022; 12:902966. [PMID: 35837096 PMCID: PMC9273748 DOI: 10.3389/fonc.2022.902966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposeHead and neck cancer (HNC) patients usually present with malnutrition during radiotherapy, leading to loss of skeletal muscle mass (SMM) and poor clinical outcomes. CT has been used in clinical practice for measuring SMM in cancer patients. However, its clinical application for monitoring SMM is limited by the expensive price and high radiation exposure. This study aimed to investigate the feasibility of cone-beam computed tomography (CBCT) for assessing SMM and its changes in HNC patients undergoing radiotherapy.Materials and methodsThis study was divided into two parts. In part 1 (n = 32), the cross-sectional of skeletal muscle area (SMA) at the third cervical vertebra (C3) based on CBCT and computed tomography (CT) was assessed. In part 2 (n = 30), CT and CBCT were performed, and patients’ weight was measured before and at four different time points during radiotherapy. SMAs at C3 were independently identified by three senior radiation oncologists. The interobserver agreement of SMA on CBCT (SMACBCT) findings was analyzed using the intraclass correlation coefficient (ICC). One-way analysis of variance was used to evaluate the interobserver variability and statistical significance for SMA measurements. CBCT and CT measurement differences and correlations were analyzed using paired sample t-test and Pearson correlation analysis, respectively. The Krouwer variant of the Bland–Altman plot was used to analyze the agreement of SMA measurements between CBCT and CT. A simple linear regression model was used to analyze the relationship of SMA measurements between the two imaging techniques, and the equation was established. A repeated-measures ANOVA was performed to evaluate the effects and interactions between weight loss, SMA loss, and time.ResultsSMACBCT demonstrated excellent interobserver reliability; no significant difference between SMACBCT and SMA on CT (SMACT) at C3 was observed in all patients. The SMACBCT and SMACT were highly correlated (r = 0.966; 95% confidence interval = 0.955–0.975; p < 0.001). Bland–Altman analysis revealed that SMACBCT was generally higher than SMACT. The predicted SMA value at C3 on CT using CBCT was similar to the actual value. Moreover, significant differences between SMA and weight loss (F =10.99, p = 0.002), groups (weight loss and SMA loss) and times (4 time points) (F = 3.93, p = 0.013), and mean percent loss over time (F = 7.618, p < 0.001) were noted.ConclusionCBCT may be used as an alternative for CT to measure SMA in HNC patients during radiotherapy.
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Affiliation(s)
- Wei Huang
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Peixin Tan
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongdan Zhang
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhen Li
- Department of Nutrition, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hui Lin
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Youxing Wu
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qinwen Du
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qidi Wu
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun Cheng
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Medical Ultrasound Image Computing (MUSIC) Laboratory, Shenzhen University, Shenzhen, China
- Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Yu Liang
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yi Pan
- Department of Radiation Oncology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Yi Pan,
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Li B, Spronk D, Luo Y, Puett C, Inscoe CR, Tyndall DA, Lee YZ, Lu J, Zhou O. Feasibility of dual-energy CBCT by spectral filtration of a dual-focus CNT x-ray source. PLoS One 2022; 17:e0262713. [PMID: 35113908 PMCID: PMC8812859 DOI: 10.1371/journal.pone.0262713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/01/2022] [Indexed: 11/19/2022] Open
Abstract
Cone beam computed tomography (CBCT) is now widely used in dentistry and growing areas of medical imaging. The presence of strong metal artifacts is however a major concern of using CBCT especially in dentistry due to the presence of highly attenuating dental restorations, fixed appliances, and implants. Virtual monoenergetic images (VMIs) synthesized from dual energy CT (DECT) datasets are known to reduce metal artifacts. Although several techniques exist for DECT imaging, they in general come with significantly increased equipment cost and not available in dental clinics. The objectives of this study were to investigate the feasibility of developing a low-cost dual energy CBCT (DE-CBCT) by retrofitting a regular CBCT scanner with a carbon nanotube (CNT) x-ray source with dual focal spots and corresponding low-energy (LE) and high-energy (HE) spectral filters. A testbed with a CNT field emission x-ray source (NuRay Technology, Chang Zhou, China), a flat panel detector (Teledyne, Waterloo, Canada), and a rotating object stage was used for this feasibility study. Two distinct polychromatic x-ray spectra with the mean photon energies of 66.7keV and 86.3keV were produced at a fixed 120kVp x-ray tube voltage by using Al+Au and Al+Sn foils as the respective LE and HE filters attached to the exist window of the x-ray source. The HE filter attenuated the x-ray photons more than the LE filter. The calculated post-object air kerma rate of the HE beam was 31.7% of the LE beam. An anthropomorphic head phantom (RANDO, Nuclear Associates, Hicksville, NY) with metal beads was imaged using the testbed and the images were reconstructed using an iterative volumetric CT reconstruction algorithm. The VMIs were synthesized using an image-domain basis materials decomposition method with energy ranging from 30 to 150keV. The results were compared to the reconstructed images from a single energy clinical dental CBCT scanner (CS9300, Carestream Dental, Atlanta, GA). A significant reduction of the metal artifacts was observed in the VMI images synthesized at high energies compared to those from the same object imaged by the clinical dental CBCT scanner. The ability of the CNT x-ray source to generate the output needed to compensate the reduction of photon flux due to attenuation from the spectral filters and to maintain the CT imaging time was evaluated. The results demonstrated the feasibility of DE-CBCT imaging using the proposed approach. Metal artifact reduction was achieved in VMIs synthesized. The x-ray output needed for the proposed DE-CBCT can be generated by a fixed-anode CNT x-ray source.
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Affiliation(s)
- Boyuan Li
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Derrek Spronk
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yueting Luo
- Department of Applied Physical Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Connor Puett
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Christina R. Inscoe
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Donald A. Tyndall
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Yueh Z. Lee
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jianping Lu
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Otto Zhou
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Development of difficulty index for management of impacted maxillary canine: A CBCT-based study. Med J Armed Forces India 2022; 78:61-67. [PMID: 35035045 PMCID: PMC8737088 DOI: 10.1016/j.mjafi.2020.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/24/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The aim of this study was to propose an Impacted Canine Treatment Difficulty Index using Cone-beam Computed Tomography (CBCT) imaging to assess difficulty anticipated during the alignment of impacted maxillary canine and further validate the index in clinical set up. METHODS Pre-treatment CBCT of 15 patients with unilateral or bilateral impacted maxillary canine aged between 12 and 30 years were selected. All the following five factors were assessed on CBCT image: 1) angulation, 2) vertical position, 3) bucco-palatal position, 4) horizontal position and 5) rotation. Two orthodontists evaluated the pre-treatment CBCT for the selected five factors and allocated a total difficulty score. To validate the proposed difficulty index in clinical settings, a team of oral and maxillofacial surgeons were included in the study to grade the difficulty encountered during surgical procedure. RESULTS The distribution of difficulty score recorded by observer 1 was significantly associated with the difficulty score recorded by observer 2 (P-value < 0.001), with relatively higher level of linearly weighted Cohen's kappa value of 0.610. The distribution of difficulty score recorded by oral and maxillofacial surgeon was significantly associated with the difficulty score recorded by observer 1 (P-value < 0.01), with relatively higher level of linearly weighted Cohen's kappa value of 0.667. The distribution of difficulty score recorded by orthodontist was significantly associated with the difficulty score recorded by observer 1 (P-value < 0.001), with relatively higher linearly weighted Cohen's kappa value of 0.819. CONCLUSION Impacted Canine Treatment Difficulty Index using CBCT imaging could be used to assess the difficulty that would be anticipated during the alignment of impacted maxillary cuspid.
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Zhang R, Xiong J, Haapasalo M, Shen Y, Meng L. Palatogingival grooves associated with periodontal bone Loss of maxillary incisors in a Chinese population. AUST ENDOD J 2021; 48:313-321. [PMID: 34612563 DOI: 10.1111/aej.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/06/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to investigate the prevalence of palatogingival grooves (PGGs) in a Chinese population and the relationship between different types of PGGs and periodontal bone loss. CBCT images of 1715 patients were included in the study. The prevalence of PGGs of the maxillary incisors by sex and tooth type was analysed. The severity of alveolar bone loss in different types of PGGs was assessed. The reasons for taking the CBCT from patients with PGGs were collected. The frequency of PGGs in males (10.16%) was higher than that in females (7.05%) (P < 0.05). PGGs were present more often in maxillary lateral incisors (4.5%) than in maxillary central incisors (0.29%). Compared with other types of PGGs, the type I PGGs were the most prevalent configuration and accompanied with less severity of alveolar bone loss (P < 0.05). Less than half of PGGs cases (47.9%) were prescribed CBCT examination because of the PGGs observed or suspected clinically. The prevalence of PGGs in a Chinese population was higher in males than in females. The different types of PGGs might lead to different severity of periodontal bone destruction. Clinicians should be aware of the presence of PGGs in maxillary incisors, particularly maxillary lateral incisors.
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Affiliation(s)
- Rui Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Xiong
- Dongfeng Stomatological Hospital, Hubei University of Medicine, Shiyan, China
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Abu El-Ela WH, Farid MM, Abou El-Fotouh M. The impact of different dental restorations on detection of proximal caries by cone beam computed tomography. Clin Oral Investig 2021; 26:2413-2420. [PMID: 34601634 DOI: 10.1007/s00784-021-04207-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the effects of different types of restorations on observer ability to detect proximal caries in CBCT images. MATERIALS AND METHODS Forty human premolars and molars with artificial proximal caries were placed proximal and distal to 5 molars having different restorations (amalgam, composite, resin-modified glass ionomer cement (RMGIC) fillings, zirconia, and lithium disilicate crowns) and a non-restored molar. CBCT scans were obtained using i-CAT® Next Generation. Images were rated twice by 2 observers. The exact depth of artificial caries was histologically established. Sensitivity, specificity, and area under the receiver operating characteristic curve (Az) values were calculated. RESULTS Caries detection in teeth surfaces mesial and distal to amalgam showed compromised specificity and accuracy. Moreover, caries detection in teeth surfaces mesial to zirconia crown showed low sensitivity, specificity, and accuracy. Capability of CBCT in detection of proximal caries in teeth adjacent to composite, RMGIC, and lithium disilicate was comparable to those adjacent to non-restored molar. CONCLUSIONS CBCT scans performed for tasks other than caries detection should be assessed for proximal caries in absence of any restorations as well as in presence of composite, RMGIC fillings, and lithium disilicate crowns. However, CBCT should not be used for proximal caries detection in teeth adjacent to amalgam and teeth surfaces mesial to zirconia crowns. CLINICAL SIGNIFICANCE It is important to investigate the influence of artifacts produced by various restorations on CBCT-based caries detection to optimize CBCT benefits, caries diagnosis and avoid unnecessary treatment of sound surfaces.
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Affiliation(s)
- Walaa Hussein Abu El-Ela
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt.
| | - Mary Medhat Farid
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
| | - Mona Abou El-Fotouh
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain Shams University, Monazamet El Wehda El Afriqeya St, Cairo, Egypt
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21
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Archila-Montañez E, Medina-Ocampo PE. [Interpretation of periapical healing in radiological images. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e087. [PMID: 38463730 PMCID: PMC10919837 DOI: 10.21142/2523-2754-0904-2021-087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/12/2021] [Indexed: 03/12/2024] Open
Abstract
Interpretation of the state of healing of chronic apical periodontitis or apical curettage with apicoectomy in radiological images is based on the analysis of changes in the appearance of the periapical area and in the bone structure adjacent to the site of inflammation or surgical intervention, which are projected onto normal bone structures. However, distortion of structures or the superposition of anatomical images should be considered when interpreting radiographs. We compared conventional studies of evaluation of the periapical area following treatment, together with 2D images, with the periapical index and the criteria of evaluation in both successful and unsuccessful cases of endodontic surgical treatment. Some studies have reported that the radiographic appearance of the tooth crown and root may facilitate interpretation of the periapical area. In addition, cone-beam computed tomography can show the relationship between injured and repairing tissue using buccal and lingual tables to measure the periphery in transverse reconstruction. Indeed, complex biological events and mechanisms can occur during the healing process of periapical and root tissues. Knowledge of the diversity of tissues is essential to identify the dynamics of the signs of regeneration or the presence of healing due to repair. Hence, the aim of this article was to identify the criteria used to interpret periapical healing in two-dimensional or three-dimensional images and their relationship with diagnosis and treatment according to the literature currently available.
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Affiliation(s)
- Eloísa Archila-Montañez
- Especialista en Endodoncia de la Fundación Universitaria San Martín. Bogotá, Colombia. Especialista en Endodoncia Fundación Universitaria San Martín Bogotá Colombia
| | - Paola Elena Medina-Ocampo
- Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Universidad Científica del Sur Lima Peru
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22
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Reinert CP, Pfannenberg C, Gatidis S, la Fougère C, Nikolaou K, Hoefert S. 18F-Fluoride PET/CT Imaging of Medication-Related Osteonecrosis of the Jaw in Conservative Treatment-A Case Report. Front Oncol 2021; 11:700397. [PMID: 34277447 PMCID: PMC8281890 DOI: 10.3389/fonc.2021.700397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/11/2021] [Indexed: 11/25/2022] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect in antiresorptive treatment. Treatment of MRONJ is considered primarily conservative with oral mouth rinses and antibiotics but may demand surgery, depending on the complaints and general condition of the patient, the extent of the necrosis, and the overall prognosis with respect to the underlying disease. A 77 year old female patient with invasive ductal breast cancer and bone metastases was treated with intravenous bisphosphonate (BP) zoledronic acid. During therapy, she developed MRONJ in the mandible with severe pain. Clinical examination revealed confluent exposed bone of the lower left jaw and a fistula at the right molar region. The panoramic radiograph revealed a mandibular osseous involvement with diffuse radiopaque areas between radiolucent areas. For preoperative planning, 18F-fluoride positron emission tomography/computed tomography (PET/CT) of the jaw was performed, showing substantially increased 18F-fluoride uptake in regions 38 to 47 of the mandible with a focal gap in region 36 (area of clinically exposed bone). CT revealed medullary sclerosis and cortical thickening with confluent periosteal reaction and focal cortical erosion in the regions 37 to 42, whereas the regions 43 to 47 were only subtly sclerotic without cortical thickening. After systemic antibiotic therapy with sultamicillin following significant symptom and pain relief, 18F-fluoride PET/CT imaging was performed again after 5 months. No changes in either CT and PET were observed in regions 38 to 42, whereas the bony sclerosis was slightly increased in regions 43 to 47 with a slight reduction of 18F-fluoride uptake. 18F-fluoride PET/CT showed no significant changes assessing the extent of MRONJ prior and after systemic antibiotic therapy, providing no evidence that conservative treatment reduced the extent of the MRONJ-affected jawbone. The additional information of 18F-fluoride PET enables to identify the true extent of MRONJ which may be underestimated by CT imaging alone. Patients with MRONJ undergoing conservative treatment could benefit because additional imaging may be avoided as the pre-therapeutic 18F-fluoride PET/CT delivers all information needed for further treatment. Our findings support the recommendation of a surgical approach as long-term antibiotics cannot downsize the extent of MRONJ.
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Affiliation(s)
- Christian Philipp Reinert
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Christina Pfannenberg
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Sergios Gatidis
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Christian la Fougère
- Department of Radiology, Nuclear Medicine, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies, " University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK), Partner Site Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies, " University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK), Partner Site Tübingen, Tübingen, Germany
| | - Sebastian Hoefert
- Department of Oral and Maxillofacial Surgery, University Hospital of Tübingen, Tübingen, Germany
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23
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ORHAN AI, CESUR E, BEZGİN T, ORHAN K. KNOWLEDGE AND ATTITUDES OF PAEDIATRIC DENTISTS IN TURKEY REGARDING CONE BEAM COMPUTED TOMOGRAPHY (CBCT). CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.815788] [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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24
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Holiel AA, Mahmoud EM, Abdel-Fattah WM. Tomographic evaluation of direct pulp capping using a novel injectable treated dentin matrix hydrogel: a 2-year randomized controlled clinical trial. Clin Oral Investig 2021; 25:4621-4634. [PMID: 33507394 DOI: 10.1007/s00784-021-03775-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess clinically and radiographically the success of pulp capping procedure done in traumatically exposed permanent posterior teeth using a novel injectable treated dentin matrix hydrogel (TDMH), Biodentine, and MTA and to evaluate the formed dentin bridge under the capping materials using CBCT imaging. MATERIALS AND METHODS 45 patients subjected to accidental traumatic pulp exposures by undergraduate dental students are allocated for this study. For each patient, a pulp capping procedure was done. TDMH was formed of TDM powder and sodium alginate to be injected and then hardened in the defect area. Patients were assigned to 3 groups: TDMH, Biodentine, and MTA, respectively, and returned to the clinic after 3, 6, 12, 18, and 24 months for clinical and radiographic examinations. Tomographic data, including thickness and density of formed dentin bridges, were evaluated at the end of the study period compared to the base line. Pulp sensitivity was evaluated throughout the study period using thermal testing and electric pulp tester. RESULTS During the follow-up period, all patients were asymptomatic with no clinical signs and symptoms and revealed no radiographic signs of pathosis. However, tomographic evaluation showed the tested materials to have different levels of impact on formed dentin bridges with TDMH group resulted in significantly superior dentin bridges of a higher radiodensity and thickness than Biodentine and MTA. CONCLUSIONS TDMH has a greater potential to induce dentin bridge formation than Biodentine and MTA under standardized conditions. Additionally, CBCT imaging was confirmed as a non-invasive and inclusive approach to evaluate the formed dentin bridges after pulp capping procedure. CLINICAL RELEVANCE Direct pulp capping can be done successfully with this novel injectable pulp capping material in future clinical applications. TRIAL REGISTRATION PACTR201901866476410.
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Affiliation(s)
- Ahmed A Holiel
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Elsayed M Mahmoud
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Wegdan M Abdel-Fattah
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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25
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Eftekhar M, Kaviani H, Rouzmeh N, Torabinia A, Akbarzadeh Baghban A. Effect of voxel size on detection of fenestration, dehiscence and furcation defects using cone-beam computed tomography. Oral Radiol 2021; 37:677-686. [PMID: 33432538 DOI: 10.1007/s11282-020-00508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/26/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to assess the effect of voxel size on detection of fenestration, dehiscence, and furcation defects using cone-beam computed tomography (CBCT). MATERIALS AND METHODS This in vitro, experimental study evaluated 4 sheep skulls with both the maxilla and mandible accompanied by the surrounding soft tissue. Fenestration (n = 30), dehiscence (n = 65), and furcation defects (n = 46; 18 grade I, 25 grade II, and 3 grade III) were randomly created by round and needle burs in both jaws, and 40 areas served as control sites. CBCT scans were obtained with 0.300 and 0.150 mm3 voxel sizes and 8 × 11cm2 field of view (FOV), and were randomly observed by four observers (two oral and maxillofacial radiologists and two periodontists). The kappa values, sensitivity and specificity were calculated for each voxel size and compared using paired t test. RESULTS By an increase in image resolution, diagnostic sensitivity increased while specificity decreased. The kappa values for fenestration (0.602-0.623), and grade III furcation defects (0.903-1.00) were optimal (> 0.6), and almost similar for both voxel sizes. The kappa values for dehiscence, and grades I and II furcation defects were unfavorable (< 0.6) and almost similar for both voxel sizes, except for grade I furcation defects, which had a significant difference in kappa values between the two voxel sizes (0.014 and 0.34). CONCLUSION Smaller voxel size had higher sensitivity and lower specificity for detection of all defects except for grade I furcation defects, for which the smaller voxel size had higher sensitivity and higher specificity.
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Affiliation(s)
| | - Hanieh Kaviani
- Department of Oral-Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Rouzmeh
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Aitin Torabinia
- Department of Oral-Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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Tayman MA, Kamburoğlu K, Öztürk E, Küçük Ö. The accuracy of periapical radiography and cone beam computed tomography in measuring periodontal ligament space: Ex vivo comparative micro‐CT study. AUST ENDOD J 2020; 46:365-373. [DOI: 10.1111/aej.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Affiliation(s)
- M. Ayşe Tayman
- Department of Periodontology Faculty of Dentistry Ankara Yıldırım Beyazıt University Ankara Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Ankara University Ankara Turkey
| | - Ebru Öztürk
- Department of Biostatistics School of Medicine Hacettepe University Ankara Turkey
| | - Özlem Küçük
- Department of Nuclear Medicine Faculty of Medicine Ankara University Ankara Turkey
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27
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Preoperative Estimation of Endodontic Working Length with Cone-Beam Computed Tomography and Standardized Paralleling Technique in comparison to Its Real Length. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7890127. [PMID: 33102594 PMCID: PMC7576338 DOI: 10.1155/2020/7890127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
An accurate estimation of the working canal length is essential for successful root canal treatment. This study is aimed at investigating the diagnostic accuracy of root canal length estimation on cone-beam computed tomography (CBCT) scans and digital paralleling radiographs (PAs), using the real canal length as a gold standard, and at evaluating the influence of canal curvature on this estimation. Sixty extracted human premolar teeth were selected for this study. Root canal length measurement was performed on CBCT scans (NewTom, Giano, Verona, Italy) and digital paralleling radiography (EzRay Air W; Vatech, Korea). The real working length was established by subtracting 0.5 mm from the actual canal length. No significant difference was found between CBCT and digital paralleling radiography. There was a tendency for underestimation of the root canal length measured on the CBCT images in 52 (86.7%) of the examined teeth and overestimation in 5 teeth (8.3%). All the digital radiographs slightly overestimated the real canal length. The analysis revealed a strong correlation between the estimation from moderate to severe curvature for digital radiography and CBCT images. Preoperative working length estimation can be made closest to its real clinical canal length on the standardized paralleling technique, using a long (16-inch) target-receptor distance.
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28
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Puett C, Inscoe CR, Hilton RL, Regan Anderson MW, Perrone L, Puett S, Gaalaas LR, Platin E, Lu J, Zhou O. Applying synthetic radiography to intraoral tomosynthesis: a step towards achieving 3D imaging in the dental clinic. Dentomaxillofac Radiol 2020; 50:20200159. [PMID: 32666823 DOI: 10.1259/dmfr.20200159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A practical approach to three-dimensional (3D) intraoral imaging would have many potential applications in clinical dentistry. Stationary intraoral tomosynthesis (sIOT) is an experimental 3D imaging technology that holds promise. The purpose of this study was to explore synthetic radiography as a tool to improve the clinical utility of the images generated by an sIOT scan. METHODS Extracted tooth specimens containing either caries adjacent to restorations (CAR) or vertical root fractures (VRF) were imaged by sIOT and standard dental radiography devices. Qualitative assessments were used to compare the conspicuity of these pathologies in the standard radiographs and in a set of multi-view synthetic radiographs generated from the information collected by sIOT. RESULTS The sIOT-based synthetic 2D radiographs contained less artefact than the image slices in the reconstructed 3D stack, which is the conventional approach to displaying information from a tomosynthesis scan. As a single sIOT scan can be used to generate synthetic radiographs from multiple viewing angles, the interproximal space was less likely to be obscured in the synthetic images compared to the standard radiograph. Additionally, the multi-view synthetic radiographs can potentially improve the display of CAR and VRFs as compared to a single standard radiograph. CONCLUSIONS This preliminary experience combining synthetic radiography and sIOT in extracted tooth models is encouraging and supports the ongoing study of this promising approach to 3D intraoral imaging with many potential applications.
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Affiliation(s)
- Connor Puett
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christina R Inscoe
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert L Hilton
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Lisa Perrone
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Savannah Puett
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Enrique Platin
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jianping Lu
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Otto Zhou
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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29
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Assiri H, Dawasaz AA, Alahmari A, Asiri Z. Cone beam computed tomography (CBCT) in periodontal diseases: a Systematic review based on the efficacy model. BMC Oral Health 2020; 20:191. [PMID: 32641102 PMCID: PMC7341656 DOI: 10.1186/s12903-020-01106-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Periodontal diseases are prevalent among adult populations. Its diagnosis depends mainly on clinical findings supported by radiographic examinations. In previous decades, cone beam computed tomography has been introduced to the dental field. The aim of this study was to address the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. METHODS A systematic search of electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted in February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on diagnostic imaging modality. Four examiners performed the eligibility and quality assessment of relevant studies and consensus was reached in cases where disagreement occurred. RESULTS The search resulted in 64 studies. Of these, 34 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy of the included studies showed a low or moderate risk of bias and applicability concerns in the use of CBCT. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of outcomes after the treatment of periodontal defects. CONCLUSION CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
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Affiliation(s)
- Hassan Assiri
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ali Azhar Dawasaz
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ahmad Alahmari
- Department of Periodontology, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Zuhair Asiri
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
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30
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Okihara H, Ono T. Correction of bilateral heavily impacted second molar with improved super-elastic nickel-titanium alloy wires. Am J Orthod Dentofacial Orthop 2020; 158:114-125. [PMID: 32600748 DOI: 10.1016/j.ajodo.2019.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/08/2019] [Accepted: 03/23/2019] [Indexed: 11/16/2022]
Abstract
Impaction and an abnormal eruption of a second molar occur because of a lack of retromolar space, premature eruption of the mandibular third molar, and ankyloses. The prognosis must be carefully considered when extracting a damaged permanent tooth. In addition to extraction for orthodontics, this enables the establishment of an effective force system to align the impacted tooth. A 21-year-old woman exhibited maxillary anterior crowding, deviation of the maxillary midline, and deeply impacted mandibular second molars bilaterally. The molar relationship was Class II. The cephalometric analysis demonstrated a skeletal Class I relationship (ANB angle, 1.4°); maxillary and mandibular incisors were lingually inclined. Cone-beam computed tomography images indicated that root resorption, caries, and periodontitis were absent in all mandibular molar. Mandibular second premolars were extracted to relieve crowding and achieve Class I molar relationships. The second molars moved mesially on both sides, and there were no signs of ankylosis. We used improved super-elastic nickel-titanium alloy wire (ISW) to upright the mesioangular second molars. We heat-treated the anterior portion of the ISW, including the first molar area, to increase wire stiffness; the posterior portion of the ISW, including the impacted second molar area, remained untreated to ensure that its super-elasticity was preserved. We alleviated crowding, corrected the maxillary midline, and created ideal occlusion with Class I relationship. This case shows that the alignment of a deeply impacted tooth with a heat-treated ISW, combined with voluntary adjustment of wire stiffness, can be a simple and useful treatment option for adult patients.
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Affiliation(s)
- Hidemasa Okihara
- Department of Orthodontic Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Takashi Ono
- Department of Orthodontic Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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31
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Mena Álvarez J, Zubizarreta Macho Á. Applications of CBCT in Endodontics. Oral Dis 2020. [DOI: 10.5772/intechopen.89956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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32
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Pitale U, Mankad H, Pandey R, Pal PC, Dhakad S, Mittal A. Comparative evaluation of the precision of cone-beam computed tomography and surgical intervention in the determination of periodontal bone defects: A clinicoradiographic study. J Indian Soc Periodontol 2020; 24:127-134. [PMID: 32189840 PMCID: PMC7069118 DOI: 10.4103/jisp.jisp_118_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 10/25/2019] [Accepted: 12/22/2019] [Indexed: 11/04/2022] Open
Abstract
Context Major limitations of conventional radiography are overlapping and lack of 3D information. Surgical exposure, though being able to provide accurate information, provides very little time to plan-out the type of periodontal regeneration required during surgery. Cone Beam Computed Tomography (CBCT) has emerged as a feasible tool and found to be accurate. Unfortunately, in-vivo studies are still scarce. Aim Aim of the present study was to assess the efficacy of CBCT in the detection of periodontal bony defects while determining its quantitative precision in the measurement of alveolar bone height as against the open flap debridement (OFD) procedure which is set as the gold standard. Setting and Design Present study is a cross-sectional study. Materials and Methods The present study includes patients with Chronic Periodontitis indicated for periodontal surgeries. Bone defects were measured with the help of CBCT and with William's periodontal probe during surgical intervention and compared. Statistical Analysis Measurements were compared with Student's t-test; unpaired t-test & correlation were tested with Pearson's correlation coefficient test. P < 0.05 was considered statistically significant. Results The mean CBCT & surgical value of palatal/lingual & distal sites of anterior teeth showed statistically significant difference (P = 0.001). All the values for posterior teeth were statistically non-significant. Conclusion Statistically CBCT & clinical measurement with OFD have similar potential of accuracy to access the bony topography but CBCT provides good accessibility to visualize the sites which are difficult to access during surgical interventions like palatal sites & the distal sites of the posterior teeth.
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Affiliation(s)
- Unnati Pitale
- Department of Periodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Hitesh Mankad
- Department of Periodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Rohit Pandey
- Department of Periodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Pritish Chandra Pal
- Department of Periodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Shikha Dhakad
- Department of Periodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India
| | - Antush Mittal
- Department of Periodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
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Chen Y, Zheng J, Li D, Huang Z, Huang Z, Wang X, Zhang X, Hu X. Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study. Clin Oral Investig 2020; 24:3265-3273. [PMID: 31938961 DOI: 10.1007/s00784-020-03203-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/07/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the prevalence of distal caries in mandibular second molars (M2Ms) and its correlation with the three-dimensional position of mandibular third molars (M3Ms) by cone beam computed tomography (CBCT) images. MATERIALS AND METHODS CBCT scans involving 421 M3Ms were assessed. The presence of distal caries of M2Ms, patient age and gender, impaction depths and mesial angulation of M3Ms, the cementoenamel junction (CEJ) distances and contact point localization, and the horizontal positions of M3Ms were assessed. Risk factors were identified by multivariate logistic regression analysis. RESULTS The overall prevalence of distal caries in M2Ms was 31.6%. Mesial angulation (16°-75°) of M3Ms, contact point localization at or below the CEJ of M2Ms, and a buccal or lingual position of M3Ms relative to the molar line were identified as risk factors for the prevalence of distal caries in M2Ms (p < 0.05). Distal caries was more severe when the mesial angulation of M3Ms was 16°-75° (p < 0.05). CONCLUSIONS Buccal or lingual position of M3Ms may represent a new risk factor for the distal caries in M2Ms. Mesial angulation (16°-75°) of M3Ms is a predictive parameter for both the presence and severity of distal caries in M2Ms. CLINICAL RELEVANCE As the presence of distal caries in M2Ms is significantly associated with the three-dimensional position of M3Ms, watchful monitoring or prophylactic removal of M3Ms should be deliberated when M3Ms are mesially angulated (16°-75°), buccally or lingually positioned, and with the contact point localization at or below the CEJ of M2Ms.
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Affiliation(s)
- Yanan Chen
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Jianmao Zheng
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Danna Li
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Zhuwei Huang
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Zijing Huang
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Xue Wang
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Xiaolei Zhang
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China
| | - Xiaoli Hu
- Guangdong Province Key Laboratory of Stomatology, Guangzhou, 510080, Guangdong, China. .,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, 510055, Guangdong, China.
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Meirinhos J, Martins JNR, Pereira B, Baruwa A, Gouveia J, Quaresma SA, Monroe A, Ginjeira A. Prevalence of apical periodontitis and its association with previous root canal treatment, root canal filling length and type of coronal restoration - a cross-sectional study. Int Endod J 2019; 53:573-584. [PMID: 31749154 DOI: 10.1111/iej.13256] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/17/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Abstract
AIM To analyse the prevalence of periapical lesions and their association with previous root canal treatment, root canal filling length and type of coronal restoration using in vivo cone-beam computed tomographic (CBCT) assessment. METHODOLOGY A global sample of 20 836 teeth, with a combined total of 27 046 roots, from 1160 patients, was analysed via CBCT assessment in eight health centres. Each tooth was evaluated by one out of five examiners after having performed a defined calibration procedure on the basis of 319 teeth. Intra- and inter-rater reliability tests were performed. Each tooth was classified according the tooth number, presence/absence of periapical lesions, presence/absence of previous root canal treatment, length of root canal filling (short, good or overfilling) and type of coronal restoration. The z-test for proportions was used to analyse differences between tooth subgroups, and an odds ratio was determined in order to analyse the association between treatment status and periapical lesions. A P < 0.05 was considered significant. RESULTS At a tooth level, the overall prevalence of periapical lesions in the sample was 10.4%. Maxillary teeth were associated with a significantly larger percentage of lesions (13.1%), whilst maxillary first molars had the greater proportion of lesions (21.2%). The prevalence of periapical lesions was significantly larger in root filled teeth (55.5%), short root canal fillings (72.7%) and in teeth restored with crowns (46.1%). At a root level, the mesiobuccal roots of both maxillary first molars had a tendency for a larger percentage of periapical lesions. CONCLUSION History of root canal treatment, root canal filling length and type of coronal restoration influenced the presence of periapical lesions. Molars were more commonly associated with periapical lesions on root filled teeth, particularly those with short root fillings and those with crowns.
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Affiliation(s)
- J Meirinhos
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - B Pereira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - A Baruwa
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J Gouveia
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - S A Quaresma
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - A Monroe
- Private Practice, San Diego, CA, USA
| | - A Ginjeira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
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35
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Iordache C, Antohe ME, Chirieac R, Ancuța E, Țănculescu O, Ancuța C. Volumetric Cone Beam Computed Tomography for the Assessment of Oral Manifestations in Systemic Sclerosis: Data from an EUSTAR Cohort. J Clin Med 2019; 8:E1620. [PMID: 31590232 PMCID: PMC6832751 DOI: 10.3390/jcm8101620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/19/2019] [Accepted: 09/29/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Oral health issues are commonly reported in systemic sclerosis (SSc), comprising a broad spectrum of manifestations, e.g., reduced mouth opening, periodontal disease, increased periodontal ligament (PDL) space width, and mandibular resorption. We aimed to assess oral radiographic abnormalities, particularly PDL space widening and erosions, and to identify potential relations with disease measures. Methods: cross-sectional study in 43 SSc and matching controls receiving systematic oral assessments (full mouth dental/periodontal) and imaging (radiographs and cone beam computed tomography (CBCT)). Associations between disease variables and radiologic findings were investigated by univariate and multivariate analysis (SPSS-v.20, p < 0.05). Results: CBCT demonstrated generalized PDL space widening in up to half SSc, with at least one tooth involved, essentially in the posterior region (p < 0.05). Significant correlations between number of teeth with PDL space widening and disease severity, skin score, disease subset, topoisomerase I specificity, age, and disease duration were reported (p < 0.05). Additionally, mandibular erosions were described in one out of four patients, commonly condylar erosions. Conclusions: Tridimensional CBCT approach confirmed widening of PDL and mandibular erosions as common dental findings in scleroderma. Furthermore, widened PDL spaces correlated with several disease characteristics including severity, skin extent, and antibody profile.
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Affiliation(s)
- Cristina Iordache
- Grigore T. Popa University of Medicine and Pharmacy, School of Dental Medicine, Department of Implantology, Removable Dentures, Technology, Iasi 700115, Romania.
| | - Magda-Ecaterina Antohe
- Grigore T. Popa University of Medicine and Pharmacy, School of Dental Medicine, Department of Implantology, Removable Dentures, Technology, Iasi 700115, Romania.
| | | | - Eugen Ancuța
- Elena Doamna Clinical Hospital, Research Department, Iasi 700398, Romania.
| | - Oana Țănculescu
- Grigore T. Popa University of Medicine and Pharmacy, School of Dental Medicine, Department of Odontology-Periodontology. Fixed Prosthodontics, Iasi 700115, Romania.
| | - Codrina Ancuța
- Grigore T. Popa University of Medicine and Pharmacy, School of Medicine, Department of Rheumatology, Iasi 700115, Romania.
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Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: Combining digital technologies. Imaging Sci Dent 2019; 49:179-190. [PMID: 31583200 PMCID: PMC6761063 DOI: 10.5624/isd.2019.49.3.179] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/24/2019] [Accepted: 05/08/2019] [Indexed: 02/06/2023] Open
Abstract
Panoramic radiographs and computed tomography (CT) play a paramount role in the accurate diagnosis, treatment planning, and prognostic evaluation of various complex dental pathologies. The advent of cone-beam computed tomography (CBCT) has revolutionized the practice of dentistry, and this technique is now considered the gold standard for imaging the oral and maxillofacial area due to its numerous advantages, including reductions in exposure time, radiation dose, and cost in comparison to other imaging modalities. This review highlights the broad use of CBCT in the dentomaxillofacial region, and also focuses on future software advancements that can further optimize CBCT imaging.
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Affiliation(s)
- Supreet Jain
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
| | - Kartik Choudhary
- Department of Pedodontics and Preventive Dentistry, Mansarovar Dental College, Bhopal, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Swami Devi Dayal Hospital and Dental College, Panchkula, India
| | - Stuti Shukla
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
| | - Navneet Kaur
- Department of Periodontology, National Dental College and Hospital, Dera Bassi, Mohali, India
| | - Deepak Grover
- Department of Periodontology, National Dental College and Hospital, Dera Bassi, Mohali, India
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37
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Han C, Baek J. Multi-pass approach to reduce cone-beam artifacts in a circular orbit cone-beam CT system. OPTICS EXPRESS 2019; 27:10108-10126. [PMID: 31045157 DOI: 10.1364/oe.27.010108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
We propose a multi-pass approach to reduce cone-beam artifacts in a circular orbit cone-beam computed tomography (CT) system. Employing a large 2D detector array reduces the scan time but produces cone-beam artifacts in the Feldkamp, Davis, and Kress (FDK) reconstruction because of insufficient sampling for exact reconstruction. While the two-pass algorithm proposed by Hsieh is effective at reducing cone-beam artifacts, the correction performance is degraded when the bone density is moderate and the cone angle is large. In this work, we treated the cone-beam artifacts generated from bone and soft tissue as if they were from less dense bone objects and corrected them iteratively. The proposed method was validated using a numerical Defrise phantom, XCAT phantom data, and experimental data from a pediatric phantom followed by image quality assessment for FDK, the two-pass algorithm, the proposed method, and the total variation minimization-based iterative reconstruction (TV-IR). The results show that the proposed method was superior to the two-pass algorithm in cone-beam artifact reduction and effectively reduced the overcorrection by the two-pass algorithm near bone regions. It can also be observed that the proposed method produced better correction performance with fewer iterations than the TV-IR algorithm. A qualitative evaluation with mean-squared error, structural similarity, and structural dissimilarity demonstrated the effectiveness of the proposed method.
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38
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Heney CM, Arzi B, Kass PH, Hatcher DC, Verstraete FJM. Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Anatomic Structures in Cats. Front Vet Sci 2019; 6:58. [PMID: 30873423 PMCID: PMC6404553 DOI: 10.3389/fvets.2019.00058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/08/2019] [Indexed: 01/19/2023] Open
Abstract
The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) methods for the identification of predefined anatomic structures in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, a total of 22 predefined anatomic structures were evaluated separately by use of the DR method and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views (Pano)]. A semi quantitative scoring system was used, and mean scores were calculated for each anatomic structure and imaging method. The Friedman test was used to evaluate values for significant differences in diagnostic yield. For values that were significant the Wilcoxon signed rank test was used with the Bonferroni-Holm multiple comparison adjustment to determine significant differences among each of the possible pairs of diagnostic methods. Differences of diagnostic yield among the DR and 3 CBCT methods were significant for 17 of 22 anatomic structures. For these structures, DR scores were significantly higher than scores for Pano views for 2 of 17 structures, but DR scores were significantly lower than scores for Pano views for 6 anatomic structures, tridimensional rendering for 10 anatomic structures, and MPR for 17 anatomic structures. In conclusion, it was found that CBCT methods were better suited than DR for the identification of anatomic structures in cats. Results of this study can serve as a basis for CBCT evaluation of dentoalveolar and other maxillofacial bony lesions in cats.
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Affiliation(s)
- Colleen M Heney
- Dentistry and Oral Surgery Service, William Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Philip H Kass
- Department of Population Health and Reproduction School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - David C Hatcher
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.,Diagnostic Dental Imaging Center, Sacramento, CA, United States
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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39
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Heney CM, Arzi B, Kass PH, Hatcher DC, Verstraete FJM. The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats. Front Vet Sci 2019; 6:42. [PMID: 30847347 PMCID: PMC6393352 DOI: 10.3389/fvets.2019.00042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) software modules for the identification of 32 pre-defined dentoalveolar lesions in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, 32 predefined dentoalveolar lesions were evaluated separately and scored by use of dental radiography and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views]. A qualitative scoring system was used. Dentoalveolar lesions were grouped into 14 categories for statistical analysis. Point of reference for presence or absence of a dentoalveolar lesion was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ2 test of marginal homogeneity of paired data. When all 3 CBCT software modules were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 14 categories (missing teeth, horizontal bone loss, loss of tooth integrity, feline resorptive lesions), and higher, although not significantly so, for 9 categories (supernumerary teeth, supernumerary roots, abnormally shaped roots, vertical bone loss, buccal bone expansion, periapical disease, inflammatory root resorption, and external replacement root resorption). In conclusion, we found that CBCT provided more clinically relevant detailed information as compared to dental radiography. Therefore, CBCT should be considered better suited for use in diagnosing dentoalveolar lesions in cats.
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Affiliation(s)
- Colleen M. Heney
- Dentistry and Oral Surgery Service, School of Veterinary Medicine, William Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Philip H. Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - David C. Hatcher
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Diagnostic Dental Imaging Center, Sacramento, CA, United States
| | - Frank J. M. Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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40
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Accuracy of Periapical Radiography and CBCT in Endodontic Evaluation. Int J Dent 2018; 2018:2514243. [PMID: 30410540 PMCID: PMC6206562 DOI: 10.1155/2018/2514243] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/02/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction A radiological evaluation is essential in endodontics, for diagnostic purposes, planning and execution of the treatment, and evaluation of the success of therapy. The periapical radiography is nowadays the main radiographic investigations used but presents some limits as 3D anatomic alteration, geometric compression, and possible anatomical structures overlapping that can obscure the area of interest. CBCT (cone beam computed tomography) in endodontics allows a detailed assessment of the teeth and surrounding alveolar anatomy for endodontic diagnosis, treatment planning, and follow-up. Objective The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures. Materials and Methods Statistical analysis was performed on 101 patients with previous endodontic treatments with the relative radiographic documentation (preoperative, postoperative, and follow-up intraoral X-ray) that had underwent at CBCT screening for surgical reasons. The CBCT scans were evaluated independently by two operators and compared with the corresponding periapical images. Results Our analysis shows that the two radiological investigations statistically agree in 100% of cases in the group of patients without any endodontic sign. In the group of patients with an endodontic pathology, detected with CBCT, endodontic under extended treatments (30.6%), MB2 canals in nontreated maxillary molars (20.7%), second canals in nontreated mandibular incisors (9%), root fractures (2.7%), and root resorption (2.7%) were not always visible in intraoral X-ray. Otherwise, positivity in the intraoral X-ray was always confirmed in CBCT. A radiolucent area was detected in CBCT exam in 46%, while the intraoral X-ray exam was positive only in 18%. Conclusions Our study shows that some important radiological signs acquired using CBCT are not always visible in periapical X-ray. Furthermore, CBCT is considered as a II level exam and could be used to solve diagnostic questions, essential to a proper management of the endodontic problems.
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41
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Kim KS, Kang SY, Park CK, Kim GA, Park SY, Cho H, Seo CW, Lee DY, Lim HW, Lee HW, Park JE, Woo TH, Oh JE. A Compressed-Sensing Based Blind Deconvolution Method for Image Deblurring in Dental Cone-Beam Computed Tomography. J Digit Imaging 2018; 32:478-488. [PMID: 30238344 DOI: 10.1007/s10278-018-0120-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In cone-beam computed tomography (CBCT), reconstructed images are inherently degraded, restricting its image performance, due mainly to imperfections in the imaging process resulting from detector resolution, noise, X-ray tube's focal spot, and reconstruction procedure as well. Thus, the recovery of CBCT images from their degraded version is essential for improving image quality. In this study, we investigated a compressed-sensing (CS)-based blind deconvolution method to solve the blurring problem in CBCT where both the image to be recovered and the blur kernel (or point-spread function) of the imaging system are simultaneously recursively identified. We implemented the proposed algorithm and performed a systematic simulation and experiment to demonstrate the feasibility of using the algorithm for image deblurring in dental CBCT. In the experiment, we used a commercially available dental CBCT system that consisted of an X-ray tube, which was operated at 90 kVp and 5 mA, and a CMOS flat-panel detector with a 200-μm pixel size. The image characteristics were quantitatively investigated in terms of the image intensity, the root-mean-square error, the contrast-to-noise ratio, and the noise power spectrum. The results indicate that our proposed method effectively reduced the image blur in dental CBCT, excluding repetitious measurement of the system's blur kernel.
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Affiliation(s)
- K S Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - S Y Kang
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - C K Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - G A Kim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - S Y Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - Hyosung Cho
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea.
| | - C W Seo
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - D Y Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - H W Lim
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - H W Lee
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - J E Park
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - T H Woo
- Department of Radiation Convergence Engineering, Yonsei University, Wonju, 26493, Republic of Korea
| | - J E Oh
- Division of Convergence Technology, National Cancer Center, Goyang, 10408, Republic of Korea
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42
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Rabiee H, McDonald NJ, Jacobs R, Aminlari A, Inglehart MR. Endodontics Program Directors’, Residents’, and Endodontists’ Considerations About CBCT-Related Graduate Education. J Dent Educ 2018; 82:989-999. [DOI: 10.21815/jde.018.098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 02/09/2018] [Indexed: 11/20/2022]
Affiliation(s)
| | - Neville J. McDonald
- Endodontics Graduate Program, Department of Cariology, Restorative Sciences, and Endodontics; School of Dentistry, University of Michigan
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine; University of Leuven; Department of Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Dental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Alireza Aminlari
- Endodontics Graduate Program, Department of Cariology, Restorative Sciences, and Endodontics; School of Dentistry, University of Michigan
| | - Marita R. Inglehart
- Department of Psychology; College of Literature, Science, and Arts, University of Michigan
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43
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Naseri M, Ali Mozayeni M, Safi Y, Heidarnia M, Akbarzadeh Baghban A, Norouzi N. Root Canal Morphology of Maxillary Second Molars according to Age and Gender in a Selected Iranian Population: A Cone-Beam Computed Tomography Evaluation. IRANIAN ENDODONTIC JOURNAL 2018; 13:373-380. [PMID: 30083209 PMCID: PMC6064032 DOI: 10.22037/iej.v13i3.19278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction This study sought to assess root canal morphology of maxillary second molars regarding age and gender in an Iranian population using cone-beam computed tomography (CBCT). Methods and Materials Totally, 157 maxillary second molars of patients presenting to a radiology clinic were evaluated on CBCT scans. Tooth length, number of roots, root fusion, coronal and sagittal root deviation, number of canals per root, prevalence of second mesiobuccal canal, root canal morphology according to the Vertucci's classification and the correlation of these variables with age and gender were evaluated. Data were analyzed using the Mann Whitney U, Kruskal Wallis and Fisher's exact tests. Results Of 157 teeth, 98 belonged to females and 59 to males. The mean tooth length was significantly greater in males than in females (P=0.002) and it was shorter in 50-60 years old group. The rate of root fusion was 18.6%. Distobuccal and palatal roots were mainly straight in both sagittal and coronal planes while mesiobuccal roots mostly had a distal-buccal deviation; 67.5% of the teeth had four canals. Number of canals was significantly correlated with gender and was higher in males (P<0.05). The most prevalent canal type was type VI in second mesiobuccal, and type V in palatal and distobuccal canals. The most common types in mesiobuccal canal were types I, VI and II, respectively. In the remaining two roots, type I was the most common. Conclusion Root and canal morphology of the maxillary second molars in Iranian population showed features different from those in other populations.
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Affiliation(s)
- Mandana Naseri
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mozayeni
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillafacial Radioligy, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Alireza Akbarzadeh Baghban
- Physiotherapy Research Center, Rehabilitation School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Norouzi
- Department of Endodontics, Dental School, Mazandaran University of Medical Sciences, Sari, Iran
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Chowdhry P, Reddy P, Kaushik M. Management of a permanent maxillary first molar with unusual crown and root anatomy: a case report. Restor Dent Endod 2018; 43:e35. [PMID: 30135854 PMCID: PMC6103547 DOI: 10.5395/rde.2018.43.e35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/04/2018] [Indexed: 01/17/2023] Open
Abstract
The aim of this article was to showcase the endodontic management of a maxillary first molar with an unusual crown and root anatomy. Clinical diagnosis of the roots and root canal configuration was confirmed by a cone-beam computed tomography (CBCT) and the detection of the canals was made using a dental operating microscope. CBCT images revealed the presence of 5 roots with Vertucci type I canal configuration in all, except, in the middle root which had 2 canals with type IV configuration. The 6 canal orifices were clinically visualized under the dental operating microscope. Clinicians should familiarize themselves with the latest technologies to get additional information in endodontic practice in order to enhance the outcomes of endodontic therapy.
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Affiliation(s)
- Prateeksha Chowdhry
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, TS, India
| | - Pallavi Reddy
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, TS, India
| | - Mamta Kaushik
- Department of Conservative Dentistry and Endodontics, Army College of Dental Sciences, Secunderabad, TS, India
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Muniz FWMG, Montagner F, Jacinto RC, Rösing CK, Gomes BPFA. Correlation between crestal alveolar bone loss with intracanal bacteria and apical lesion area in necrotic teeth. Arch Oral Biol 2018; 95:1-6. [PMID: 30025275 DOI: 10.1016/j.archoralbio.2018.07.007] [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] [Received: 04/23/2018] [Revised: 06/14/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aimed to analyze the correlation between crestal alveolar bone loss with the presence of some bacterial species in root canals and the apical lesion area of necrotic teeth. DESIGN Data from 20 patients with diagnosis of pulp necrosis and acute apical abscesses, without active periodontal diseases, were evaluated. Patients with history of antibiotic usage three months prior to the study, with exposed pulp cavity, and with probing depth >3 mm were not included. The root size, the distance between the bone crest to the tooth apex in the mesial and distal surfaces, and the apical lesion area were measured from standard periapical radiographies by a calibrated examiner. Root canal samples were collected using sterilized paper points. In multirooted teeth, the largest root canal was sampled. Culture, microbial isolation and identification by phenotypic methods were performed. Spearman correlation and exact Fischer test were calculated between higher/lower existing bone crests, according to the median and the presence of specific bacteria. RESULTS No statistically significant differences were found between occurrence of pathogenic bacteria, such as Porphyromonas gingivalis, Porphyromonas endodontalis, and Prevotella intermedia, and groups with higher/lower degree of bone loss (p > 0.05). A negative significant correlation was found between Parvimonas micra and periodontal bone loss (p = 0.02). Additionally, no statistically significant association was found between crestal bone loss and the apical lesion area. CONCLUSIONS It was concluded that, in patients without active periodontitis, the presence of pathogenic bacteria in the root canal was not correlated with periodontal bone loss.
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Affiliation(s)
- Francisco Wilker M G Muniz
- Department of Periodontology, Faculty of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Pelotas, RS, 96015-560, Brazil.
| | - Francisco Montagner
- Department of Endodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
| | - Rogério C Jacinto
- Department of Endodontics, Araçatuba Dental School, State University of São Paulo, Rua José Bonifácio, 1193, Araçatuba, São Paulo, 16015-050, Brazil.
| | - Cassiano K Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas - UNICAMP, Avenida Limeira, 901, Piracicaba, SP, 13414-903, Brazil.
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Ozemre MO, Gulsahi A. Comparison of the accuracy of full head cone beam CT images obtained using a large field of view and stitched images. Dentomaxillofac Radiol 2018; 47:20170454. [PMID: 29851353 DOI: 10.1259/dmfr.20170454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE: The aim of this study was to investigate the accuracy of the new stitching feature of the Morita 3D Accuitomo device by comparing it with the I-CAT device and real measurements. METHODS: Eight dry skulls were used in this study. The full scan mode of an I-CAT device and the new stitching feature of the Morita 3D Accuitomo device were used to obtain full head cone beam CT (CBCT) images, and the linear distances between the selected anatomical sites were measured by two observers. The real distances were measured directly on the skulls using digital calipers. Statistical analyses were performed using the intraclass correlation coefficient and Bland-Altman Limits of Agreement. RESULTS: High or perfect agreement was detected between the CBCT images and real measurements. The Bland-Altman Limits of Agreement analysis revealed that the stitched coronal and sagittal images of the Morita might differ by >1.54-1.67 or <0.01 mm from the real measurements. CONCLUSIONS: The stitched images of the Morita CBCT device showed perfect agreement with both real measurements and the images of an I-CAT full head scan. After the evaluation of the radiation doses received from stitching sectional images, this device may be used to obtain full head images.
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Affiliation(s)
- Mehmet Ozgur Ozemre
- 1 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University , Ankara , Turkey
| | - Ayse Gulsahi
- 1 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University , Ankara , Turkey
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Sex determination of Han adults in Northeast China using cone beam computer tomography. Forensic Sci Int 2018; 289:450.e1-450.e7. [PMID: 29929937 DOI: 10.1016/j.forsciint.2018.05.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/12/2018] [Accepted: 05/22/2018] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to obtain the morphological data of the maxillofacial region of Han nationality adults in Northeast China, and to explore the methods and appropriate variables of three-dimensional reconstruction technology for sex determination using Cone beam computer tomography (CBCT). The CBCT images of 420 adults (210 males, 210 females) aged 18-70years were reconstructed by MIMICS 17.0 software and sixteen observation indexes were measured and analyzed statistically. The results demonstrated that twelve of sixteen variables expressed significant sexual difference (p<0.01) which were as follows: mandibular angle (X1),area of mandibular foramen (X2), bi-gonial breadth (X3), koronoidbreite (X4), Height of symphysis (X5), Min-height of mandibular notch (X6), Min-breadth of mandibular ramus (X7), Buccal side bone thickness of MF (X8), Horizontal diameter of MF (X11), Vertical from prosthion to palatal breadth (X12), palatal breadth (X13), The ratio of HD-MF and VD-MF (X15). Then the sexual discriminant equation which was suitable for people at the age of 18-70 was established using stepwise method: Y=-0.059X1+0.313X2+0.1X3+0.061X4+0.044X5+0.041X6+0.076X13-17.215. It was found that the cross-validated grouped overall predictive accuracy was 87.4%. It could correctly identify males in 85.7% and females in 89% of the cases. This study has accumulated morphological data of maxillofacial skeleton from adults of Han nationality in Northeast China, which provided guiding significance for sex determination and clinical application in forensic science, archaeology, criminal investigation, iconography and clinical three-dimensional (3D) print. Evaluation variables and related discriminant functions of sex determination using CBCT for three-dimensional reconstruction technology provided a new theoretical basis and practical means for sex determination.
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Döring S, Arzi B, Barich CR, Hatcher DC, Kass PH, Verstraete FJM. Evaluation of the diagnostic yield of dental radiography and cone-beam computed tomography for the identification of anatomic landmarks in small to medium-sized brachycephalic dogs. Am J Vet Res 2018; 79:54-61. [PMID: 29287153 DOI: 10.2460/ajvr.79.1.54] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the diagnostic yield of dental radiography (Rad method) and 3 cone-beam CT (CBCT) methods for the identification of predefined anatomic landmarks in brachycephalic dogs. ANIMALS 19 client-owned brachycephalic dogs admitted for evaluation and treatment of dental disease. PROCEDURES 26 predefined anatomic landmarks were evaluated separately by use of the RAD method and 3 CBCT software modules (serial CBCT slices and custom cross sections, tridimensional rendering, and reconstructed panoramic views). A semiquantitative scoring system was used, and mean scores were calculated for each anatomic landmark and imaging method. The Friedman test was used to evaluate values for significant differences in diagnostic yield. For values that were significant, the Wilcoxon signed rank test was used with the Bonferroni-Holm multiple comparison adjustment to determine significant differences among each of the 6 possible pairs of diagnostic methods. RESULTS Differences of diagnostic yield among the Rad and 3 CBCT methods were significant for 19 of 26 anatomic landmarks. For these landmarks, Rad scores were significantly higher than scores for reconstructed panoramic views for 4 of 19 anatomic landmarks, but Rad scores were significantly lower than scores for reconstructed panoramic views for 8 anatomic landmarks, tridimensional rendering for 18 anatomic landmarks, and serial CBCT slices and custom cross sections for all 19 anatomic landmarks. CONCLUSIONS AND CLINICAL RELEVANCE CBCT methods were better suited than dental radiography for the identification of anatomic landmarks in brachycephalic dogs. Results of this study can serve as a basis for CBCT evaluation of dental disorders in brachycephalic dogs.
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Shaikh SY, Shaikh SS. Direct Linear Measurement of Root Dentin Thickness and Dentin Volume Changes with Post Space Preparation: A Cone-Beam Computed Tomography Study. Contemp Clin Dent 2018; 9:77-82. [PMID: 29599589 PMCID: PMC5863415 DOI: 10.4103/ccd.ccd_785_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: The purpose of the present study was direct linear measurement of dentin thickness and dentin volume changes for post space preparation with cone-beam computed tomography (CBCT). Materials and Methods: Ten maxillary central incisors were scanned, before and after root canal and post space preparation, with Orthophos XG three-dimensional hybrid unit. Thirteen axial section scans of each tooth from orifice to apex and dentin thickness for buccal, lingual, mesial, and distal were measured using proprietary measuring tool and thereafter subjected to statistical analysis. Furthermore, dentin volume was evaluated using ITK-SNAP software. Results: There was statistically significant difference between the dentin thickness in pre- and postinstrumentation (paired t-test) and also between different groups (one-way ANOVA). In the shortest post length of 4.5mm the post space preparation resulted in 2.17% loss of hard tissue volume, where as 11mm longest post length post space preparation resulted in >40% loss of hard tissue volume. Conclusion: CBCT axial section scan for direct measurements of root dentin thickness can be guideline before and after post space preparation for selection of drill length and diameter.
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Affiliation(s)
- Shoeb Yakub Shaikh
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Safia Shoeb Shaikh
- Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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Ni N, Cao S, Han L, Zhang L, Ye J, Zhang C. Cone-beam computed tomography analysis of root canal morphology in mandibular first molars in a Chinese population: a clinical study. ACTA ACUST UNITED AC 2018. [DOI: 10.1186/s41121-018-0015-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The aim of this study was to evaluate the root canal morphology of mandibular first molars in a Chinese population by using cone-beam computed tomography (CBCT).
Methods
In this study, CBCT images of 900 mandibular first molars were evaluated for the following details: (1) number of roots, (2) number of apical foramina, (3) frequency distribution of root canal configurations defined in accordance with Vertucci’s classification, and (4) frequency of occurrence of middle mesial (MM) canal.
Results
Overall, 74.9% of the evaluated mandibular first molars possessed two roots, and 55.4% exhibited three apical foramina. The evaluated teeth exhibited a relatively high prevalence of type IV canals in mesial (M) roots (76.8%) and type I canals in the distal (D) (79.4%), distobuccal (DB) (98.7%), and distolingual (DL) (100%) roots. There were no significant differences in the number of roots, incidence of apical foramina, or distribution of different canal configurations of mandibular first molars between men and women (P > 0.05). 1.9% of mandibular first molars possessed three mesial canals, and the highest frequency of occurrence of MM canals (4.1%) was among Chinese people below the age of 30 years.
Conclusions
CBCT scanning facilitates identification of the root canal system. In order to increase the success rate of treatment, it is important to obtain information about the variable morphology of root canals before endodontic treatment.
Trial registration
TJSKE20160412. Registered 12 April 2016.
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