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Falek S, Regmi R, Herault J, Dore M, Vela A, Dutheil P, Moignier C, Marcy PY, Drouet J, Beddok A, Letwin NE, Epstein J, Parvathaneni U, Thariat J. Dental management in head and neck cancers: from intensity-modulated radiotherapy with photons to proton therapy. Support Care Cancer 2022; 30:8377-8389. [PMID: 35513755 DOI: 10.1007/s00520-022-07076-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Despite reduction of xerostomia with intensity-modulated compared to conformal X-ray radiotherapy, radiation-induced dental complications continue to occur. Proton therapy is promising in head and neck cancers to further reduce radiation-induced side-effects, but the optimal dental management has not been defined. MATERIAL AND METHODS Dental management before proton therapy was assessed compared to intensity-modulated radiotherapy based on a bicentric experience, a literature review and illustrative cases. RESULTS Preserved teeth frequently contain metallic dental restorations (amalgams, crowns, implants). Metals blur CT images, introducing errors in tumour and organ contour during radiotherapy planning. Due to their physical interactions with matter, protons are more sensitive than photons to tissue composition. The composition of restorative materials is rarely documented during radiotherapy planning, introducing dose errors. Manual artefact recontouring, metal artefact-reduction CT algorithms, dual or multi-energy CT and appropriate dose calculation algorithms insufficiently compensate for contour and dose errors during proton therapy. Physical uncertainties may be associated with lower tumour control probability and more side-effects after proton therapy. Metal-induced errors should be quantified and removal of metal restorations discussed on a case by case basis between dental care specialists, radiation oncologists and physicists. Metallic amalgams can be replaced with water-equivalent materials and crowns temporarily removed depending on rehabilitation potential, dental condition and cost. Implants might contraindicate proton therapy if they are in the proton beam path. CONCLUSION Metallic restorations may more severely affect proton than photon radiotherapy quality. Personalized dental care prior to proton therapy requires multidisciplinary assessment of metal-induced errors before choice of conservation/removal of dental metals and optimal radiotherapy.
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Affiliation(s)
- Sabah Falek
- Department of Oral and Maxillo-Facial Surgery, Francois Baclesse Center, Caen, France
| | - Rajesh Regmi
- Seattle Cancer Care Alliance Proton Therapy Center, Seattle, WA, USA
| | - Joel Herault
- Institut Méditerranéen de Protonthérapie, Antoine Lacassagne Center, Nice, France
| | - Melanie Dore
- Department of Radiation Oncology, Institut de Cancérologie de L'Ouest, Nantes, France
| | - Anthony Vela
- Department of Medical Physics, François Baclesse Center / Proton Therapy Center, Caen, France
| | - Pauline Dutheil
- Department of Medical Physics, François Baclesse Center / Proton Therapy Center, Caen, France
| | - Cyril Moignier
- Department of Medical Physics, François Baclesse Center / Proton Therapy Center, Caen, France
| | - Pierre-Yves Marcy
- Radiodiagnostics and Interventional Radiology, Polyclinique ELSAN, Ollioules, France
| | - Julien Drouet
- Department of Oral and Maxillo-Facial Surgery, Francois Baclesse Center, Caen, France
| | - Arnaud Beddok
- Department of Radiation Oncology, Curie Institute, Paris, France
| | - Noah E Letwin
- Swedish Medical Center General Practice Residency, Seattle, WA and owner Seattle Special Care Dentistry, Seattle, WA, USA
| | - Joel Epstein
- City of Hope Comprehensive Cancer Center, Duarte CA and Cedars-Sinai Medical System, Los Angeles, CA, USA
| | - Upendra Parvathaneni
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, USA
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François Baclesse, Caen, France.
- Laboratoire de Physique Corpusculaire, IN2P3/ENISAEN-CNRS, Caen, France.
- Normandie Universite, Caen, France.
- SAS Cyclhad, Hérouville-Saint-Clair, France.
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Köse TE, Günaçar DN, Ateş SM, Çağlar İ. Artifact expression of polyetheretherketone in cone beam computed tomography: An in vitro study. J Prosthet Dent 2021; 126:793.e1-793.e5. [PMID: 34674841 DOI: 10.1016/j.prosdent.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Dental prosthetic materials can cause artifacts in cone beam computed tomography (CBCT) images, adversely affecting diagnostic quality, although the problem may be less with polyetheretherketone (PEEK). Studies evaluating the artifacts caused by frequently used prosthetic materials are lacking. PURPOSE The purpose of this in vitro study was to compare the artifacts in CBCT images caused by PEEK, zirconia, cobalt-chromium (Co-Cr) alloy, and titanium (Ti). MATERIAL AND METHODS A polymethylmethacrylate phantom (Ø4.0×4.0 cm) with a central cylindrical aperture (Ø0.5×0.5 cm) was produced. Co-Cr, Ti, zirconia, and PEEK cylinders (0.5×0.5 cm) were manufactured, and CBCT images of the empty phantom (control group) with the test cylinders inside were made 3 times. In all images, the axial sections passing through the middle of the materials were evaluated. Eight regions of interest (ROI) area were determined around the materials (0.5×0.5 cm). The presence of artifacts was evaluated by making gray value standard deviation (SD) calculations in these ROI areas. The average SD values of 8 ROI fields from the 3 CBCT scans were made, and the materials were compared with each other in terms of the presence of artifacts by using 1-way analysis of variance (α=.05). RESULTS The difference between the SD values of the control and the PEEK cylinder was not statistically significant (P>.05). The SD values of both the control and PEEK groups were significantly lower than those of the zirconia, Co-Cr, and Ti groups (P<.05). CONCLUSIONS Zirconia, Ti, and Co-Cr caused artifacts in CBCT images, but the artifacts with PEEK were similar to those in the control group, suggesting it was the optimal choice in terms of achieving diagnostic quality.
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Affiliation(s)
- Taha Emre Köse
- Assistant Professor, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Dilara Nil Günaçar
- Assistant Professor, Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Sabit Melih Ateş
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - İpek Çağlar
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
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Candemil AP, Mangione F, Vasconcelos KF, Oenning AC, Jacobs R, Freitas DQ, Haiter-Neto F, Salmon B, Oliveira ML. Influence of the exomass on the detection of simulated root fracture in cone-beam CT - an ex-vivo study. Dentomaxillofac Radiol 2020; 50:20200450. [PMID: 33237809 DOI: 10.1259/dmfr.20200450] [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] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To evaluate the influence of exomass-related metal artefacts on the detection of simulated vertical root fracture (VRF) in cone-beam computed tomography (CBCT). METHODS 20 teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in an empty socket of a human mandible. Metallic materials were differently arranged in the exomass [zone outside of the field of view (FOV) but between the X-ray source and the receptor] and/or endomass (zone inside of the FOV), and CBCT scans were obtained. Four radiologists evaluated the presence of VRF using a 5-point scale. Sensitivity, specificity, and area under the receiver operating curve (AUC) were compared using ANOVA. Also, the tooth of interest was replaced with a tube filled with a radiopaque solution and all CBCT scans were repeated to analyse the data objectively. Mean grey and noise values were obtained from the tube and compared using ANOVA followed by Tukey's test (α = 0.05). RESULTS Mean grey values were significantly lower and noise was significantly higher when metallic materials were present in the endomass or both the exomass and endomass. Sensitivity, specificity, and AUC were not influenced by the artefacts from the metallic materials irrespective of the arrangement condition. CONCLUSIONS Exomass-related metal artefacts did not influence the diagnosis of simulated VRF in CBCT.
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Affiliation(s)
- Amanda Pelegrin Candemil
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francesca Mangione
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France
| | - Karla Farias Vasconcelos
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Anne Caroline Oenning
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France.,Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Benjamin Salmon
- Orofacial Pathologies, Imaging and Biotherapies Lab, Université de Paris, UR 2496, Montrouge, France.,Dental Medicine Departments, Bretonneau and Henri Mondor University Hospitals, AP-HP, Paris, France
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Misfit detection in implant-supported prostheses of different compositions by periapical radiography and cone beam computed tomography: An in vitro study. J Prosthet Dent 2020; 126:205-213. [PMID: 32723499 DOI: 10.1016/j.prosdent.2020.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Misfits at the implant-abutment joint (IAJ) can cause the biological and mechanical failure of implant therapy. Standard parallel periapical radiography (PERI) is the method of choice for assessing the fitting of implant-supported prostheses. Although current guidelines do not support the use of cone beam computed tomography (CBCT) solely for misfit detection, CBCT scans can also register misfits as imaging findings. Whether the material used for prostheses manufacturing influences misfit appearance in PERI and CBCT images is unknown. PURPOSE The purpose of this in vitro study was to assess the influence of the type of prosthesis material on misfit detection at the IAJ by using PERI and CBCT. MATERIAL AND METHODS Thirty-two implants with an external hexagon connection were placed in dried human mandibles. Implant-supported crowns were manufactured with different materials and allocated to 3 experimental groups: metal-ceramic (MC), titanium abutment veneered with acrylic resin (TIT), and zirconia abutment veneered with glass-ceramic (ZIR). All crowns were installed both with and without a simulated 200-μm-thick gap at the IAJ (n=64) and were assessed by PERI and CBCT scans. Four dentists evaluated the images for the presence or absence of misfit. Statistical analysis included the Kappa test and areas under the receiver operating characteristics curve (Az values) comparisons (α=.05). RESULTS Kappa values indicated almost perfect intraevaluator and interevaluator reproducibility for PERI and ranged from fair to almost perfect for CBCT. For PERI, Az values were not significantly different among the MC (0.995), TIT (0.997), and ZIR groups (1.000) (P>.05). Regarding CBCT, the Az values found for TIT (0.941) and MC (0.890) were significantly higher than for ZIR (0.762) (P<.05). Az values for PERI were significantly higher than for CBCT (P<.05). CONCLUSIONS The type of prosthesis material did not influence misfit detection at the IAJ with PERI; however, ZIR had lower diagnostic accuracy than TIT and MC implant-supported crowns with CBCT.
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Quantitative analysis of metal artifact reduction using the auto-edge counting method in cone-beam computed tomography. Sci Rep 2020; 10:8872. [PMID: 32483222 PMCID: PMC7264136 DOI: 10.1038/s41598-020-65644-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
The metal artifact reduction (MAR) algorithm is used in most CBCT unit to reduce artifact from various dental materials. The performance of MAR program of a CBCT unit according to the dental material type under different imaging mode was evaluated as introducing automatic quantification of the amount of artifact reduced. Four customized phantoms with different dental prostheses (amalgam, gold, porcelain-fused-metal, zirconia) underwent CBCT scanning with and without the MAR option. The imaging was performed under varied scanning conditions; 0.2 and 0.3 mm3 voxel sizes; 70 and 100 kVp. The amount of artifacts reduced by each prosthesis and scanning mode automatically counted using canny edge detection in MATLAB, and statistical analysis was performed. The overall artifact reduction ratio was ranged from 17.3% to 55.4%. The artifact caused by the gold crown was most effectively reduced compared to the other prostheses (p < 0.05, Welch’s ANOVA analysis). MAR showed higher performance in smaller voxel size mode for all prostheses (p < 0.05, independent t-test). Automatic quantification efficiently evaluated MAR performance in CBCT image. The impact of MAR was different according to the prostheses type and imaging mode, suggesting that thoughtful consideration is required when selecting the imaging mode of CBCT.
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Al Qabbani A, Al Kawas S, Enezei H, Razak NHA, Al Bayatti SW, Samsudin AR, Hamid SAB. Biomechanical and radiological assessment of immediate implants for alveolar ridge preservation. Dent Res J (Isfahan) 2018; 15:420-429. [PMID: 30534170 PMCID: PMC6243806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the stability of immediate implant placement for alveolar bone augmentation and preservation with bovine bone graft following atraumatic tooth extraction. MATERIALS AND METHODS This was a prospective interventional study with convenient sampling (n = 10). Thirty patients aged between 18 and 40 years, who needed noncomplicated tooth extraction of mandibular premolar tooth, were sequentially divided equally into three groups. In Group I, simple extraction was done and the empty extraction socket left to heal conventionally. In Group II, extraction sockets were filled with lyophilized bovine granules only. In Group III, immediate implants were placed into extraction sockets, and the buccal gap was also filled with bovine granules. All groups were subjected to cone beam computed tomography scan for radiological evaluation. Assessment of biomechanical stability (radiofrequency analysis [RFA] was performed at 9 months postoperative for Group III to assess the degree of secondary stability of the implants using Osstell. Repeated measure analysis of variance (ANOVA) test was applied when comparing within each group at three different time intervals, whereas one-way ANOVA was applied followed by post hoc-tukey test when comparing between groups. P < 0.05 was considered statistically significant. RESULTS Radiological assessment reveals a significant difference of bone resorption in alveolar dimension within Group I; 1.49 mm (P = 0.002), and 0.82 mm (P = 0.005), respectively, between day 0 and 3 months. Comparison between Group I and III showed a highly significant difference of bone resorption in ridge width at 3 months 2.56 mm (P = 0.001) and at 9 months interval 3.2 mm (P < 0.001). High RFA values demonstrating an excellent biomechanical stability were observed in Group III at 9 months postoperatively. CONCLUSION The insertion of immediate implants in extraction sockets with bovine bone augmentation of the buccal gap was able to preserve a greater amount of alveolar ridge volume.
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Affiliation(s)
- Ali Al Qabbani
- Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Hamid Enezei
- Department of Oral and Maxillofacial Surgery College of Dentistry, Anbar University, Ramadi, Iraq
| | - Noor Hayati A. Razak
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
| | - Saad Wahby Al Bayatti
- Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - A. Rani Samsudin
- Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
| | - Suzina A. B. Hamid
- Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Codari M, de Faria Vasconcelos K, Ferreira Pinheiro Nicolielo L, Haiter Neto F, Jacobs R. Quantitative evaluation of metal artifacts using different CBCT devices, high-density materials and field of views. Clin Oral Implants Res 2017; 28:1509-1514. [DOI: 10.1111/clr.13019] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Marina Codari
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Biomedical Sciences for Health; Faculty of Medicine and Surgery; Università degli Studi di Milano; Milano Italy
| | - Karla de Faria Vasconcelos
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Laura Ferreira Pinheiro Nicolielo
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
| | - Francisco Haiter Neto
- Division of Oral Radiology; Department of Oral Diagnosis; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Reinhilde Jacobs
- OIC; OMFS IMPATH Research Group; Department Imaging & Pathology; Faculty of Medicine; KU Leuven and Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
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