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Jadhav TS, Sansare K, Sreenivasan V, Unnikrishnan A, Vahanwala S. A systematic review and meta-analysis of the genotoxic and cytotoxic effects on oral epithelium induced by cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:324-334. [PMID: 38570275 DOI: 10.1016/j.oooo.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To evaluate the occurrence of genotoxic and cytotoxic effects in oral epithelium after exposure of patients to cone beam computed tomography (CBCT). METHODS A systematic review (SR) was conducted following the PECO (Population, Exposure, Comparison, Outcome) criteria. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). A search was performed on the PubMed, Scopus, ScienceDirect, and Google Scholar databases. Effect size and heterogeneity of data were evaluated statistically. The Joanna Briggs Institute questionnaire for observational studies was utilized to assess the risk of bias. The GRADE tool was applied for the assessment of the quality of evidence. Begg's funnel plot was used to evaluate publication bias. RESULTS In total, 10 full-text articles were included in the SR, with 6 of them in the meta-analysis. The SR showed a significant increase in micronuclei after exposure, with a large effect size of 1.03. For genotoxicity, the tau2 for heterogeneity was 0.96, the chi-squared test for heterogeneity P < .00001, the I2 statistics for random effects was 91%, and the overall effect for Z value was 2.46 (P = .01). The risk of bias was low, the quality of evidence was strong, and publication bias was absent. CONCLUSION CBCT can cause genotoxicity in the oral epithelium with a large effect size. The measure of cytotoxicity after CBCT exposure was not possible due to the lack of homogeneity of the included articles.
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Affiliation(s)
- Tanushree S Jadhav
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India.
| | - Kaustubh Sansare
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India
| | - Venkatraman Sreenivasan
- Oral Medicine and Maxillofacial Radiology, Bharathi Vidyapeeth Dental College and Hospital, Navi Mumbai, India
| | - Aswathi Unnikrishnan
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India
| | - Sonal Vahanwala
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India
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Lundberg J, Al-Taai N, Levring Jäghagen E, Ransjö M, Sjöström M. Skeletal stability after maxillary distraction osteogenesis or conventional Le Fort I osteotomy in patients with cleft lip and palate: A superimposition-based cephalometric analysis. Oral Maxillofac Surg 2024; 28:925-934. [PMID: 38363518 PMCID: PMC11144679 DOI: 10.1007/s10006-024-01227-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE The aim was to assess skeletal stability after maxillary advancement using either distraction osteogenesis (DO) or conventional Le Fort I osteotomy (CO) in patients with cleft lip and palate (CLP) or cleft palate (CP) utilising a new superimposition-based cephalometric method. METHOD This retrospective study included patients who were treated with DO (N = 12) or CO (N = 9). Sagittal and vertical changes after surgery, and skeletal stability at 18 months post-operatively were assessed with superimposition-based cephalometry, comparing lateral cephalograms performed pre-operatively (T0), post-operatively after CO or immediately after completed distraction in DO (T1), and at 18 months of follow-up (T2). RESULTS The mean sagittal movements from T0 to T2 in the DO and CO groups were 5.9 mm and 2.2 mm, respectively, with a skeletal relapse rate of 16% in the DO group and 15% in the CO group between T1 and T2. The vertical mean movement from T0 to T2 in the DO and CO groups was 2.8 mm and 2.0 mm, respectively, and the skeletal relapse rate between T1 and T2 was 36% in the DO group and 32% in the CO group. CONCLUSION Sagittal advancement of the maxilla was stable, in contrast to the vertical downward movement, which showed more-extensive relapse in both groups. Despite more-extensive maxillary advancement in the DO group, the rates of skeletal relapse were similar.
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Affiliation(s)
- Joakim Lundberg
- Oral and Maxillofacial Surgery, Department of Odontology, Umeå University, 90185, Umeå, Sweden.
| | - Nameer Al-Taai
- Orthodontics, Department of Odontology, Umeå University, SE-90185 Umeå, Sweden and Hamdan Bin Mohammed College of Dental Medicine, MBRU University, Dubai, UAE
| | - Eva Levring Jäghagen
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, 90185, Umeå, Sweden
| | - Maria Ransjö
- Orthodontics, Department of Odontology, Umeå University, 90185, Umeå, Sweden
| | - Mats Sjöström
- Oral and Maxillofacial Surgery, Department of Odontology, Umeå University, 90185, Umeå, Sweden
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Pereira R, Sabri H, Pereira P, Wang HL. Associated risks with periodontal x-rays or CBCT scans: Are there any? Clin Adv Periodontics 2024; 14:121-126. [PMID: 37470472 DOI: 10.1002/cap.10261] [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: 05/05/2023] [Revised: 07/01/2023] [Accepted: 07/16/2023] [Indexed: 07/21/2023]
Abstract
Periodontal and implant radiography, mainly including intra-oral peri-apical and cone beam computed tomography images, are crucial in the diagnosis and treatment planning process. However, radiation safety concerns have been a chronic concern over the years, leading to uncomfortable situations. It is therefore crucial to understand the actual radiation exposure to determine if the patients' fear of necessary diagnostic exams is justified. In this perspective article, we aimed to provide concise information on dental imaging exposure, risks, and benefits, comparing them to that of absorbed radiation from daily life activities; and secondarily, to help periodontists choose the best option for each case and become more confident in addressing patients' concerns and providing a summary of safety guidelines as a reference for them.
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Affiliation(s)
- Rafael Pereira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hamoun Sabri
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration, (CRITERION), Ann Arbor, Michigan, USA
| | - Patricia Pereira
- Department of Cariology, Restorative Science and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Poletto MC, Thomazi E, Zorzi JE, Gamba TO, Perottoni CA. Development of an open project rectangular collimator for use with intraoral dental X-ray unit. Radiol Phys Technol 2024; 17:315-321. [PMID: 38265510 DOI: 10.1007/s12194-023-00772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
In this work, an open beam-limiting device, consisting of a rectangular collimator to be coupled to an intraoral dental X-ray device, was made using recycled lead sheets as a radiation-absorbing element. The collimator was designed for 3D printing, and using Spektr 3.0 software, the number of lead sheets needed to absorb excess radiation was calculated. The rectangular collimator reduced the radiation dose to patients by 65% when using four layers of recycled lead sheets (saturating with a 70% reduction in radiation dose at the limit of eight or more sheets of lead). The rectangular collimator does not negatively impact the quality of the radiological image, is available as an open design for 3D printing, and can be built with materials that are easily accessible to the dentist, facilitating its use in clinical practice and reducing the patient's exposure to ionizing radiation.
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Affiliation(s)
- Marina C Poletto
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
| | - Eduardo Thomazi
- Federal Institute of Education, Science and Technology of Rio Grande do Sul (IFRS), Campus Caxias do Sul, Avelino Antônio de Souza, 1730, Caxias do Sul, RS, 95043-700, Brazil.
| | - Janete E Zorzi
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
| | - Thiago O Gamba
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
- Surgery and Orthopedics Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Cláudio A Perottoni
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
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Becking BE, Fledderus AC, van Merkesteyn JPR, Jonkman REG. The accuracy of photographic soft-tissue profile analysis to determine Class II and vertical skeletal relationships in children. Eur J Orthod 2023; 45:703-711. [PMID: 37255251 DOI: 10.1093/ejo/cjad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Lateral cephalometric analysis (LCA) is the reference standard for identifying common skeletal relationships in orthodontics, such as Cl II and hyperdivergent skeletal discrepancies, but it entails radiation exposure. Therefore, photographic soft-tissue profile analysis (PSPA) could be a useful alternative for these diagnoses, particularly for paediatric patients. This study aims to estimate the accuracy of PSPA for determining common skeletal discrepancies in children. METHODS Cephalometric radiographs and profile photographs of a consecutive series of 100 children (8.0-17.6 years old) made on the same day were included. The validity of PSPA was verified against comparable LCA. First, by assessing the Pearson correlation and then estimating the sensitivity, specificity, receiver operating characteristic (ROC) curves and area under the curve (AUC) in sample A (n = 50). After external validation in a new sample B (n = 50), the ROC-AUC, diagnostic odds ratio, best cut-off points and discriminative validity were assessed in the total sample. Interrater reliability was estimated using the intraclass correlation coefficient, the standard error of measurement and Bland-Altman plots. RESULTS The measurement properties of the PSPA angles A'N'B', Gl'-Sn-Pog, N'-Sn-Pog', and N'-Tra-Me' were valid (ROC-AUC > 0.7) and reliable (ICCs > 0.92). The angles A'N'B', Gl'-Sn-Pog', and N'-Sn-Pog', with the respective cut-off points ≥7.7', ≥12.8', and ≤163.5', were accurate values for determining Cl II discrepancy. The N'-Tra-Me'-angle (≥63') was an accurate estimate for a hyperdivergent discrepancy. CONCLUSIONS These validated PSPA angles could be used in clinical settings as a minimally invasive diagnostic tool to screen children suspected of having skeletal Cl II and hyperdivergent discrepancies.
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Affiliation(s)
- Bibi E Becking
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
- Private practice, The Haque, The Netherlands
| | - Anne C Fledderus
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - J P Richard van Merkesteyn
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Ronald E G Jonkman
- Department of Orthodontics, Academic Center for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
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Cao J, Fang Y, Liao Y, Wang Y, Yang R, Zhang Y, Zhang Q, Zou J. Clinical validation of near-infrared imaging for early detection of proximal caries in primary molars. J Dent 2023; 138:104658. [PMID: 37597688 DOI: 10.1016/j.jdent.2023.104658] [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: 05/24/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVES The aim of this study was to validate the near-infrared imaging (NIRI) in comparison with visual inspection (VI) for early detection of proximal caries in primary molars. METHODS VI and intraoral scans were performed on 126 patients aged 3-12 years with at least one non-cavitied and non-restored proximal tooth surface, who were scheduled for bite wing radiography (BWR) as part of their standard care. Teeth with signs of proximal cavities, restorations or residual caries were excluded in this study. BWR, a gold standard to diagnose proximal caries in primary molars, was used to validate the findings of NIRI and VI. The accuracy, sensitivity, specificity and the area under the curve (AUC) of NIRI and VI were calculated. RESULTS The accuracy, sensitivity and specificity of NIRI were 82.89%, 74.10% and 90.97%, while those of VI were 71.64%, 43.88% and 97.14%, respectively. NIRI showed higher accuracy and sensitivity, and lower specificity (P < 0.001). The AUC of NIRI was higher than that of VI (0.826 vs 0.706; P < 0.05). CONCLUSIONS NIRI showed higher sensitivity and lower specificity compared with VI when detecting proximal caries in primary molars. Therefore, it is recommended to use NIRI in combination with BWR to improve the detection rate of proximal caries in primary molars. CLINICAL SIGNIFICANCE In children, there is a high incidence of proximal caries in primary molars, which require high technical sensitivity for detection. NIRI shows high sensitivity in detecting proximal caries, which may improve their detection rate in primary molars. THE CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2300070916.
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Affiliation(s)
- Jingwei Cao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yuwen Fang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yue Liao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ran Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | | | - Qiong Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jing Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Schüler IM, Hennig CL, Buschek R, Scherbaum R, Jacobs C, Scheithauer M, Mentzel HJ. Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents. J Pers Med 2023; 13:jpm13040692. [PMID: 37109079 PMCID: PMC10141634 DOI: 10.3390/jpm13040692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm2 and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm2 and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics-reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.
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Affiliation(s)
- Ina Manuela Schüler
- Section Preventive Dentistry and Pediatric Dentistry, Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
| | | | - Rika Buschek
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
| | - Rebecca Scherbaum
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Jena University Hospital, 07743 Jena, Germany
| | - Marcel Scheithauer
- Radiation Protection, Centre for Health and Safety Management, Jena University Hospital, 07747 Jena, Germany
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, Germany
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Yeung AWK, Parvanov ED, Horbańczuk JO, Kletecka-Pulker M, Kimberger O, Willschke H, Atanasov AG. Are dental x-rays safe? Content analysis of English and Chinese YouTube videos. Digit Health 2023; 9:20552076231179053. [PMID: 37312949 PMCID: PMC10259113 DOI: 10.1177/20552076231179053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Objective This study provided a content analysis of English and Chinese YouTube videos related to dental radiation safety. Method The search string, entered in English and Chinese respectively, was: (dental x-ray safe). The searches were performed and exported with Apify YouTube scraper. By screening the resultant videos and their related videos (as recommended by YouTube), a total of 89 videos were screened. Finally, 45 videos (36 English and nine Chinese) were included and analyzed. The specific information regarding dental radiation was evaluated. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability. Results There was no significant difference between the English and Chinese videos in terms of view count, like count, comment count, and video duration. Half of the videos explicitly reassured the audience that dental x-rays are safe. Two of the English videos specifically stated that dental x-rays do not cause cancers. Numerous analogies were made in regard to radiation dose, such as equivalence to taking a flight or eating some bananas. About 41.7% of the English videos and 33.3% of the Chinese videos mentioned that patients could be further protected from scatter radiation by wearing a lead apron and thyroid collar. Videos had a good understandability score (91.3) but a poor actionability score (0). Conclusions Some of the analogies and the claimed radiation dose were questionable. One Chinese video even wrongly stated that dental x-rays are nonionizing radiation. The videos generally did not mention their information sources or the underlying radiation protection principles.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Emil D Parvanov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Jarosław Olav Horbańczuk
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Oliver Kimberger
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland
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Malmvind D, Golež A, Magnuson A, Ovsenik M, Bazargani F. Three-dimensional assessment of palatal area changes after posterior crossbite correction with tooth-borne and tooth bone-borne rapid maxillary expansion. Angle Orthod 2022; 92:483352. [PMID: 35793528 PMCID: PMC9374361 DOI: 10.2319/012822-85.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess and compare the three-dimensional treatment changes in palatal surface area and volume using either tooth-borne (TB) or tooth bone-borne (TBB) rapid maxillary expanders and to evaluate the long-term effects of the two devices and the incidence of the relapse between the groups. MATERIALS AND METHODS A total of 52 consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years (standard deviation [SD], 1.3), or the TBB group, mean age 9.5 years (SD, 1.2). Study casts were taken before, directly after, 1 year after, and 5 years after expansion. Study casts were digitized, superimposed, and evaluated. Participants were randomly allocated in blocks of different sizes using the concealed allocation principle in a 1:1 ratio. RESULTS Changes in palatal volume, palatal surface area, and palatal projection area within and between the groups up to 5 years after expansion followed the same pattern and did not show any statistically significant differences between the groups. Relapse was seen in 15% of the patients. It seemed that open-bite and a Class III growth pattern could be assumed as prognosis-deteriorating factors in regard to stability of the treatment. CONCLUSIONS There were no significant differences between the TB and TBB groups in palatal volume, palatal shell area, or palatal projection area directly after expansion or at 1 year and 5 years after expansion, which implies that the two devices gave rise to the same immediate and long-term outcomes.
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10
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Benn DK. Response to Letter to the Editor “Now is the time to reconsider our radiation risk paradigm!”. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:411. [PMID: 35902356 DOI: 10.1016/j.oooo.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
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The Reliability of Two- and Three-Dimensional Cephalometric Measurements: A CBCT Study. Diagnostics (Basel) 2021; 11:diagnostics11122292. [PMID: 34943528 PMCID: PMC8700671 DOI: 10.3390/diagnostics11122292] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/21/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed tomography (CBCT) images not only allow three-dimensional (3D) analysis, but also enable the extraction of two-dimensional (2D) images without magnification. To evaluate the most reliable cephalometric analysis method, we extracted 2D lateral cephalometric images with and without magnification from twenty full-cranium CBCT datasets; images were extracted with magnification to mimic traditional lateral cephalograms. Cephalometric tracings were performed on the two types of extracted 2D lateral cephalograms and on the reconstructed 3D full cranium images by two examiners. The intra- and inter-examiner intraclass correlation coefficients (ICC) were compared between linear and angular parameters, as well as between CBCT datasets of adults and children. Our results showed that overall, tracing on 2D cephalometric images without magnification increased intra- and inter-examiner reliability, while 3D tracing reduced inter-examiner reliability. Angular parameters and children's images had the lowest inter- and intra-examiner ICCs compared with adult samples and linear parameters. In summary, using lateral cephalograms extracted from CBCT without magnification for tracing/analysis increased reliability. Special attention is needed when analyzing young patients' images and measuring angular parameters.
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12
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Campbell RE, Anderson D, Strauss K, Brown C, Fenchel M, Wilson S, Scarfe W. Comparison of technical errors in pediatric bitewing radiographs acquired with round vs rectangular collimation. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:333-342. [PMID: 34627711 DOI: 10.1016/j.oooo.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/30/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare technical errors in bitewing radiographs acquired with round vs rectangular collimation in a hospital-based pediatric dentistry training program. STUDY DESIGN A retrospective chart review was conducted of 176 digital bitewing radiographs exposed with round collimation and 106 exposed with rectangular collimation. The number of re-exposures was calculated, and errors in central ray entry (CRE; "cone cuts"), horizontal and vertical positioning, and angulation were measured. RESULTS There were no greater re-exposures but significantly more CRE errors with rectangular collimation (21.7%; n = 23; 95% confidence interval [CI], 13.9%-30.0%) than with round collimation (3.4%; n = 6; 95% CI, 0.7%-6.1%). CRE error location, horizontal positioning errors, and size of horizontal overlapped contacts were statistically different but not clinically important. CONCLUSIONS Use of rectangular collimation resulted in increased CRE errors but no other clinically significant problems. This technique should be used to reduce radiation exposure to patients.
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Affiliation(s)
- Richard E Campbell
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Dave Anderson
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Keith Strauss
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Carolyn Brown
- Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Matthew Fenchel
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stephen Wilson
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - William Scarfe
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA
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13
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Belmans N, Oenning AC, Salmon B, Baselet B, Tabury K, Lucas S, Lambrichts I, Moreels M, Jacobs R, Baatout S. Radiobiological risks following dentomaxillofacial imaging: should we be concerned? Dentomaxillofac Radiol 2021; 50:20210153. [PMID: 33989056 PMCID: PMC8404518 DOI: 10.1259/dmfr.20210153] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR). METHODS Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields. RESULTS There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children. CONCLUSIONS In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.
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Affiliation(s)
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São, Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | | | - Bjorn Baselet
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
| | | | - Stéphane Lucas
- Laboratory of Analysis by Nuclear Reaction (LARN/PMR), Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Ivo Lambrichts
- Morphology Group, Biomedical Research Institute, Hasselt University, Agoralaan Building C, Diepenbeek, Belgium
| | - Marjan Moreels
- Belgian Nuclear Research Centre (SCK CEN), Radiobiology Unit, Boeretang 200, Mol, Belgium
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14
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van Bunningen RH, Dijkstra PU, Dieters A, van der Meer WJ, Kuijpers-Jagtman AM, Ren Y. Precision of orthodontic cephalometric measurements on ultra low dose-low dose CBCT reconstructed cephalograms. Clin Oral Investig 2021; 26:1543-1550. [PMID: 34453209 PMCID: PMC8816531 DOI: 10.1007/s00784-021-04127-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/03/2021] [Indexed: 12/01/2022]
Abstract
Objectives To analyze differences in variation of orthodontic diagnostic measurements on lateral cephalograms reconstructed from ultra low dose-low dose (ULD-LD) cone beam computed tomography (CBCT) scans (RLC) as compared to variation of measurements on standard lateral cephalograms (SLC), and to determine if it is justifiable to replace a traditional orthodontic image set for an ULD-LD CBCT with a reconstructed lateral cephalogram. Material and methods ULD-LD CBCT images and SLCs were made of forty-three dry human skulls. From the ULD-LD CBCT dataset, a lateral cephalogram was reconstructed (RLC). Cephalometric landmarks (13 skeletal and 7 dental) were identified on both SLC and RLC twice in two sessions by two calibrated observers. Thirteen cephalometric variables were calculated. Variations of measurements, expressed as standard deviations of the 4 measurements on SLC and RLC, were analyzed using a paired sample t-test. Differences in the number of observations deviating ≥ 2.0 mm or degrees from the grand mean between SLC and RLC were analyzed using a McNemar test. Results Mean SDs for 7 out of 13 variables were significantly smaller for SLCs than those for RLCs, but differences were small. For 9 out of 13 variables, there was no significant difference between SLC and RLC for the number of measurements outside the range of 2 mm or degrees. Conclusions Based on the lower radiation dose and the small differences in variation in cephalometric measurements on reconstructed LC compared to standard dose LC, ULD-LD CBCT with reconstructed LC should be considered for orthodontic diagnostic purposes. Clinical relevance ULD-LD CBCT with reconstructed LC should be considered for orthodontic purposes. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04127-9.
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Affiliation(s)
- R H van Bunningen
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - P U Dijkstra
- Department of Rehabilitation and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - A Dieters
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - W J van der Meer
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - A M Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.,Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No. 4, Jakarta, 10430, Indonesia
| | - Y Ren
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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15
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Benn DK. Reply to "Details Matter when Estimating Radiation Risk"). Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:254-255. [PMID: 34753696 DOI: 10.1016/j.oooo.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Douglas K Benn
- Dental and Maxillofacial Radiology Omaha, Omaha, NE, USA.
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16
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Stonehouse-Smith D, Beale V, Bellardie H. Radiographic outcome of secondary alveolar bone grafting in patients with alveolar clefts. Orthod Craniofac Res 2021; 25:128-133. [PMID: 34101345 DOI: 10.1111/ocr.12508] [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: 05/10/2021] [Revised: 05/29/2021] [Accepted: 06/03/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the outcome of secondary alveolar bone grafting (SABG) in a series of consecutive patients with clefts involving the alveolus. DESIGN AND SETTING Retrospective cohort study of consecutive operations performed between June 2011 and September 2016 by a single surgeon at a single United Kingdom cleft center. PARTICIPANTS A total of 160 patients with a cleft/s involving the alveolus, inclusive of syndromic patients and those with atypical facial clefts. INTERVENTIONS A standard protocol involved an oral hygiene program, pre-surgical orthodontics where necessary and autologous bone grafting from the iliac crest. MAIN OUTCOME MEASURE(S) The Kindelan bone-fill index was used to evaluate success using occlusal radiographs. Weighted Cohen's kappa coefficient was used as a measure of intra- and inter-rater agreement. Fisher's exact test was used to examine the effects of type of cleft, pre-surgical orthodontics or age at time of SABG on radiographic outcome. RESULTS There were 200 SABGs assessed. Mean age at time of SABG was 9.1 years old (SD 1.1) with 99% (n = 198) of grafts deemed successful. There were two failures where re-graft was performed successfully during the study period. A grade 1 outcome was achieved for 92.5% (n = 185) of grafts and this did not appear to be affected by type of cleft (P = .290), pre-surgical orthodontics (P = .380) or age at time of SABG (P = .081). CONCLUSIONS The high success rate reported in this study supports the favorable outcomes of a high-volume cleft surgeon. These findings can be used for comparative audit with similar units providing cleft care.
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Affiliation(s)
- Daniel Stonehouse-Smith
- Cleft Lip and Palate Unit, Royal Manchester Children's Hospital, Manchester, UK.,Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Victoria Beale
- Cleft Lip and Palate Unit, Royal Manchester Children's Hospital, Manchester, UK
| | - Haydn Bellardie
- Cleft Lip and Palate Unit, Royal Manchester Children's Hospital, Manchester, UK.,Faculty of Dentistry, Department of Orthodontics, University of the Western Cape, Cape Town, South Africa
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