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Liu N, Homann C, Morfin S, Kesanakurti MS, Calvert ND, Shuhendler AJ, Al T, Hemmer E. Core-multi-shell design: unlocking multimodal capabilities in lanthanide-based nanoparticles as upconverting, T2-weighted MRI and CT probes. NANOSCALE 2023. [PMID: 37982139 DOI: 10.1039/d3nr05380f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Multimodal bioimaging probes merging optical imaging, magnetic resonance imaging (MRI), and X-ray computed tomography (CT) capabilities have attracted considerable attention due to their potential biomedical applications. Lanthanide-based nanoparticles are promising candidates for multimodal imaging because of their optical, magnetic and X-ray attenuation properties. We prepared a set of hexagonal-phase (β)-NaGdF4:Yb,Er/NaGdF4/NaDyF4 core/shell/shell nanoparticles (Dy-CSS NPs) and demonstrated their optical/T2-weighted MRI/CT multimodal capabilities. A known drawback of multimodal probes that merge the upconverting Er3+/Yb3+ ion pair with magnetic Dy3+ ions for T2-weighted MRI is the loss of upconversion (UC) emission due to Dy3+ poisoning. Particular attention was paid to controlled nanoparticle architectures with tuned inner shell thicknesses separating Dy3+ and Er3+/Yb3+ to shed light on the distance-dependent loss of UC due to Yb3+ → Dy3+ energy transfer. Based on the Er3+ UC spectra and the excited state lifetime of Yb3+, a 4 nm thick NaGdF4 inner shell did not only restore but enhanced the UC emission. We further investigated the effect of the outer NaDyF4 shell thickness on the particles' magnetic and CT performance. MRI T2 relaxivity measurements in vitro at a magnetic field of 7 T performed on citrate-capped Dy-CSS NPs revealed that NPs with the thickest outer shell thickness (4 nm) exhibited the highest r2 value, with a superior T2 contrast effect compared to commercial iron oxide and other Dy-based T2 contrast agents. In addition, the citrate-capped Dy-CSS NPs were demonstrated suitable for CT in in vitro imaging phantoms at X-ray energies of 110 keV, rendering them interesting alternatives to clinically used iodine-based agents that operate at lower energies.
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Affiliation(s)
- Nan Liu
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Christian Homann
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Samuel Morfin
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Meghana S Kesanakurti
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Nicholas D Calvert
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
- University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Adam J Shuhendler
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
- University of Ottawa Heart Institute, Ottawa, ON, Canada
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Tom Al
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Eva Hemmer
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, Canada.
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Taxis J, Platz Batista da Silva N, Grau E, Spanier G, Nieberle F, Maurer M, Spoerl S, Meier JK, Ettl T, Reichert TE, Ludwig N. Novel Three-Dimensional and Non-Invasive Diagnostic Approach for Distinction between Odontogenic Keratocysts and Ameloblastomas. Dent J (Basel) 2023; 11:193. [PMID: 37623289 PMCID: PMC10453484 DOI: 10.3390/dj11080193] [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: 07/07/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Aim of this study was to demonstrate the diagnostic ability to differentiate odontogenic keratocysts (OKCs) from ameloblastomas (AMs) based on computed tomography (CT) or cone beam computed tomography (CBCT) scans. Preoperative CT and CBCT scans from 2004 to 2019 of OKCs and AMs were analyzed in 51 participants. Lesions were three-dimensionally (3D) assessed and Hounsfield units (HU) as well as gray scale values (GSV) were quantified. Calculated HU spectra were compared within the same imaging modalities using unpaired t-tests and correlated with participants characteristics by calculating Pearsons correlation coefficients. Within the CT scans, AMs had highly significantly higher HU values compared to OKCs (43.52 HU and 19.79 HU, respectively; p < 0.0001). Analogous, within the CBCT scans, AMs had significantly higher GSV compared to OKCs (-413.76 HU and -564.76 HU, respectively; p = 0.0376). These findings were independent from participants' gender and age, anatomical site, and lesion size, indicating that the HU- and GSV-based difference reflects an individual configuration of the lesion. HU and GSV spectra calculated from CT and CBCT scans can be used to discriminate between OKCs and AMs. This diagnostic approach represents a faster and non-invasive option for preoperative diagnosis of such entities and has potential to facilitate therapeutic decision making.
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Affiliation(s)
- Juergen Taxis
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | | | - Elisabeth Grau
- Department of Oral and Maxillofacial Surgery, Leipzig University Medical Center, Liebigstraße 12, 04103 Leipzig, Germany;
| | - Gerrit Spanier
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Felix Nieberle
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Michael Maurer
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Steffen Spoerl
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Johannes K. Meier
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Tobias Ettl
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Torsten E. Reichert
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
| | - Nils Ludwig
- Department of Cranio- and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (G.S.); (F.N.); (M.M.); (S.S.); (J.K.M.); (T.E.); (T.E.R.); (N.L.)
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Górski K, Borowska M, Turek B, Pawlikowski M, Jankowski K, Bereznowski A, Polkowska I, Domino M. An application of the density standard and scaled-pixel-counting protocol to assess the radiodensity of equine incisor teeth affected by resorption and hypercementosis: preliminary advancement in dental radiography. BMC Vet Res 2023; 19:116. [PMID: 37559089 PMCID: PMC10413604 DOI: 10.1186/s12917-023-03675-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) syndrome is a dental disease where the radiographic signs may be quantified using radiographic texture features. This study aimed to implement the scaled-pixel-counting protocol to quantify and compare the image structure of teeth and the density standard in order to improve the identification of the radiographic signs of tooth resorption and hypercementosis using the EOTRH syndrome model. METHODS AND RESULTS A detailed examination of the oral cavity was performed in 80 horses and maxillary incisor teeth were evaluated radiographically, including an assessment of the density standard. On each of the radiographs, pixel brightness (PB) was extracted for each of the ten steps of the density standard (S1-S10). Then, each evaluated incisor tooth was assigned to one of 0-3 EOTRH grade-related groups and annotated using region of interest (ROI). For each ROI, the number of pixels (NP) from each range was calculated. The linear relation between an original X-ray beam attenuation and PB was confirmed for the density standard. The NP values increased with the number of steps of the density standard as well as with EOTRH degrees. Similar accuracy of the EOTRH grade differentiation was noted for data pairs EOTRH 0-3 and EOTRH 0-1, allowing for the differentiation of both late and early radiographic signs of EOTRH. CONCLUSION The scaled-pixel-counting protocol based on the use of density standard has been successfully implemented for the differentiation of radiographic signs of EOTRH degrees.
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Affiliation(s)
- Kamil Górski
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Nowoursynowska 100, 02-797, Warsaw, Poland
| | - Marta Borowska
- Institute of Biomedical Engineering, Faculty of Mechanical Engineering, Białystok University of Technology, Wiejska 45C, 15-351, Bialystok, Poland
| | - Bernard Turek
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Nowoursynowska 100, 02-797, Warsaw, Poland
| | - Marek Pawlikowski
- Institute of Mechanics and Printing, Warsaw University of Technology, Narbutta 85, 02-524, Warsaw, Poland
| | - Krzysztof Jankowski
- Institute of Mechanics and Printing, Warsaw University of Technology, Narbutta 85, 02-524, Warsaw, Poland
| | - Andrzej Bereznowski
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159C, 02-776, Warsaw, Poland
| | - Izabela Polkowska
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Głęboka 30, 20-950, Lublin, Poland
| | - Małgorzata Domino
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Nowoursynowska 100, 02-797, Warsaw, Poland.
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Park CS, Kang SR, Kim JE, Huh KH, Lee SS, Heo MS, Han JJ, Yi WJ. Validation of bone mineral density measurement using quantitative CBCT image based on deep learning. Sci Rep 2023; 13:11921. [PMID: 37488135 PMCID: PMC10366160 DOI: 10.1038/s41598-023-38943-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023] Open
Abstract
The bone mineral density (BMD) measurement is a direct method of estimating human bone mass for diagnosing osteoporosis, and performed to objectively evaluate bone quality before implant surgery in dental clinics. The objective of this study was to validate the accuracy and reliability of BMD measurements made using quantitative cone-beam CT (CBCT) image based on deep learning by applying the method to clinical data from actual patients. Datasets containing 7500 pairs of CT and CBCT axial slice images from 30 patients were used to train a previously developed deep-learning model (QCBCT-NET). We selected 36 volumes of interest in the CBCT images for each patient in the bone regions of potential implants sites on the maxilla and mandible. We compared the BMDs shown in the quantitative CBCT (QCBCT) images with those in the conventional CBCT (CAL_CBCT) images at the various bone sites of interest across the entire field of view (FOV) using the performance metrics of the MAE, RMSE, MAPE (mean absolute percentage error), R2 (coefficient of determination), and SEE (standard error of estimation). Compared with the ground truth (QCT) images, the accuracy of the BMD measurements from the QCBCT images showed an RMSE of 83.41 mg/cm3, MAE of 67.94 mg/cm3, and MAPE of 8.32% across all the bone sites of interest, whereas for the CAL_CBCT images, those values were 491.15 mg/cm3, 460.52 mg/cm3, and 54.29%, respectively. The linear regression between the QCBCT and QCT images showed a slope of 1.00 and a R2 of 0.85, whereas for the CAL_CBCT images, those values were 0.32 and 0.24, respectively. The overall SEE between the QCBCT images and QCT images was 81.06 mg/cm3, whereas the SEE for the CAL_CBCT images was 109.32 mg/cm3. The QCBCT images thus showed better accuracy, linearity, and uniformity than the CAL_CBCT images across the entire FOV. The BMD measurements from the quantitative CBCT images showed high accuracy, linearity, and uniformity regardless of the relative geometric positions of the bone in the potential implant site. When applied to actual patient CBCT images, the CBCT-based quantitative BMD measurement based on deep learning demonstrated high accuracy and reliability across the entire FOV.
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Grants
- Project Number: 1711174552, KMDF_PR_20200901_0147 Korea Medical Device Development Fund Grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety)
- Project Number: 1711174543, KMDF_PR_20200901_0011 Korea Medical Device Development Fund Grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety)
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Affiliation(s)
- Chan-Soo Park
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Se-Ryong Kang
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jeong-Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Won-Jin Yi
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
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Antoniou A, Nikolaou A, Georgiou A, Evripidou N, Damianou C. Development of an US, MRI, and CT imaging compatible realistic mouse phantom for thermal ablation and focused ultrasound evaluation. ULTRASONICS 2023; 131:106955. [PMID: 36854247 DOI: 10.1016/j.ultras.2023.106955] [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: 06/30/2022] [Revised: 11/09/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Tissue mimicking phantoms (TMPs) play an essential role in modern biomedical research as cost-effective quality assurance and training tools, simultaneously contributing to the reduction of animal use. Herein, we present the development and evaluation of an anatomically accurate mouse phantom intended for image-guided thermal ablation and Focused Ultrasound (FUS) applications. The proposed mouse model consists of skeletal and soft tissue mimics, whose design was based on the Computed tomography (CT) scans data of a live mouse. Advantageously, it is compatible with US, CT, and Magnetic Resonance Imaging (MRI). The compatibility assessment was focused on the radiological behavior of the phantom due to the lack of relevant literature. The X-ray linear attenuation coefficient of candidate materials was estimated to assess the one that matches best the radiological behavior of living tissues. The bone part was manufactured by Fused Deposition Modeling (FDM) printing using Acrylonitrile styrene acrylate (ASA) material. For the soft-tissue mimic, a special mold was 3D printed having a cavity with the unique shape of the mouse body and filled with an agar-based silica-doped gel. The mouse phantom accurately matched the size and reproduced the body surface of the imaged mouse. Tissue-equivalency in terms of X-ray attenuation was demonstrated for the agar-based soft-tissue mimic. The phantom demonstrated excellent MRI visibility of the skeletal and soft-tissue mimics. Good radiological contrast between the skeletal and soft-tissue models was also observed in the CT scans. The model was also able to reproduce realistic behavior during trans-skull sonication as proved by thermocouple measurements. Overall, the proposed phantom is inexpensive, ergonomic, and realistic. It could constitute a powerful tool for image-guided thermal ablation and FUS studies in terms of testing and optimizing the performance of relevant equipment and protocols. It also possess great potential for use in transcranial FUS applications, including the emerging topic of FUS-mediated blood brain barrier (BBB) disruption.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
| | - Anastasia Nikolaou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
| | - Andreas Georgiou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
| | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus.
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Musa M, Zhang Q, Awad R, Wang W, Ahmed MMS, Zhao Y, Almashraqi AA, Chen X, Alhammadi MS. Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders. Clin Oral Investig 2023; 27:2299-2310. [PMID: 37039959 DOI: 10.1007/s00784-023-04963-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/19/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). MATERIALS AND METHODS In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35 years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal-Wallis test, respectively. RESULTS The course of treatment was 6-12 months, with an average of 9.1 months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. CONCLUSION In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. CLINICAL RELEVANCE This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.
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Affiliation(s)
- Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Al Tagana Dental Teaching Hospital, Faculty of Dentistry, University of Science and Technology Omdurman, Omdurman, 11111, Khartoum, Sudan
| | - Qianqian Zhang
- Department of Stomatology, Shaan'xi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Riham Awad
- Department of Pediatrics Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Wenfang Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Abeer A Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Daljeet M, Warunek S, Covell DA, Monegro A, Giangreco T, Al-Jewair T. Association between obstructive sleep apnea syndrome and bone mineral density in adult orthodontic populations. Cranio 2022:1-11. [PMID: 36368042 DOI: 10.1080/08869634.2022.2142724] [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: 11/13/2022]
Abstract
OBJECTIVE To determine the association between obstructive sleep apnea syndrome (OSAS) and predicted bone mineral density (BMD) in adults presenting for orthodontic treatment. METHODS This retrospective cross-sectional study included 38 adults divided into OSAS and non-OSAS groups. Using pre-treatment CBCT images, radiographic density (RD) of left and right lateral regions of the 1st cervical vertebrae and dens of the 2nd cervical vertebrae were measured as an indicator for BMD. RESULTS When controlling for age, sex, and BMI, the mean RD was significantly lower in the OSAS group compared to the non-OSAS group (left CV1: 36.69 ± 84.50 vs. 81.67 ± 93.25 Hounsfield Units [HU], respectively, p = 0.031; right CV1: 30.59 ± 81.18 vs. 74.26 ± 91.81 HU, p = 0.045; dens: 159.25 ± 115.96 vs. 223.94 ± 106.09 HU, p = 0.038). CONCLUSION Adults with OSAS have lower values for predicted BMD than those without OSAS.
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Affiliation(s)
| | - Stephen Warunek
- Department of Orthodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - David A Covell
- Department of Orthodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Alberto Monegro
- Pediatric Sleep Center, School of Medicine, University at Buffalo, Buffalo, NY, USA
| | | | - Thikriat Al-Jewair
- Department of Orthodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
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Eguren M, Holguin A, Diaz K, Vidalon J, Linan C, Pacheco-Pereira C, Lagravere Vich MO. Can gray values be converted to Hounsfield units? A systematic review. Dentomaxillofac Radiol 2022; 51:20210140. [PMID: 34148350 PMCID: PMC8693322 DOI: 10.1259/dmfr.20210140] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The purpose of this systematic review was to answer the focus question: "Could the gray values (GVs) from CBCT (cone beam computed tomography) be converted to Hounsfield units (HUs) in multidetector computed tomography (MDCT)?" METHODS The included studies try to answer the research question according to the PICO strategy. Studies were gathered by searching several electronic databases and partial grey literature up to January 2021 without language or time restrictions. The methodological assessment of the studies was performed using The Oral Health Assessment Tool (OHAT) for in vitro studies and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) for in vivo studies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE system) instrument was applied to assess the level of evidence across the studies. RESULTS 2710 articles were obtained in Phase 1, and 623 citations remained after removing duplicates. Only three studies were included in this review using a two-phase selection process and after applying the eligibility criteria. All studies were methodologically acceptable, although in general terms with low risks of bias. There are some included studies with quite low and limited evidence estimations and recommendation forces; evidencing the need for clinical studies with diagnostic capacity to support its use. CONCLUSIONS This systematic review demonstrated that the GVs from CBCT cannot be converted to HUs due to the lack of clinical studies with diagnostic capacity to support its use. However, it is evidenced that three conversion steps (equipment calibration, prediction equation models, and a standard formula (converting GVs to HUs)) are needed to obtain pseudo Hounsfield values instead of only obtaining them from a regression or directly from the software.
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Affiliation(s)
- Marjorie Eguren
- Master in Orthodontic Graduate Program, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Anderson Holguin
- Program of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Karla Diaz
- Stomatology Second Specialty, Universidad Privada San Juan Bautista, Lima, Perú
| | - Jose Vidalon
- Department of Stomatology, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Carlos Linan
- Department of Orthodontics, Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Camila Pacheco-Pereira
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Dental Radiology, 11405-87 Ave, Edmonton, Canada
| | - Manuel Oscar Lagravere Vich
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Orthodontic Graduate Program, ECHA 5-524, 11405-87 Ave, Edmonton, Canada
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Yong TH, Yang S, Lee SJ, Park C, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ. QCBCT-NET for direct measurement of bone mineral density from quantitative cone-beam CT: a human skull phantom study. Sci Rep 2021; 11:15083. [PMID: 34301984 PMCID: PMC8302740 DOI: 10.1038/s41598-021-94359-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to directly and quantitatively measure BMD from Cone-beam CT (CBCT) images by enhancing the linearity and uniformity of the bone intensities based on a hybrid deep-learning model (QCBCT-NET) of combining the generative adversarial network (Cycle-GAN) and U-Net, and to compare the bone images enhanced by the QCBCT-NET with those by Cycle-GAN and U-Net. We used two phantoms of human skulls encased in acrylic, one for the training and validation datasets, and the other for the test dataset. We proposed the QCBCT-NET consisting of Cycle-GAN with residual blocks and a multi-channel U-Net using paired training data of quantitative CT (QCT) and CBCT images. The BMD images produced by QCBCT-NET significantly outperformed the images produced by the Cycle-GAN or the U-Net in mean absolute difference (MAD), peak signal to noise ratio (PSNR), normalized cross-correlation (NCC), structural similarity (SSIM), and linearity when compared to the original QCT image. The QCBCT-NET improved the contrast of the bone images by reflecting the original BMD distribution of the QCT image locally using the Cycle-GAN, and also spatial uniformity of the bone images by globally suppressing image artifacts and noise using the two-channel U-Net. The QCBCT-NET substantially enhanced the linearity, uniformity, and contrast as well as the anatomical and quantitative accuracy of the bone images, and demonstrated more accuracy than the Cycle-GAN and the U-Net for quantitatively measuring BMD in CBCT.
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Affiliation(s)
- Tae-Hoon Yong
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Su Yang
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Sang-Jeong Lee
- grid.31501.360000 0004 0470 5905Dental Research Institute, Seoul National University, Seoul, Korea
| | - Chansoo Park
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jo-Eun Kim
- grid.459982.b0000 0004 0647 7483Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Kyung-Hoe Huh
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sam-Sun Lee
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Won-Jin Yi
- grid.31501.360000 0004 0470 5905Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea ,grid.31501.360000 0004 0470 5905Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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10
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Choi B, Lee YC, Oh KC, Lee JH. Effects of photofunctionalization on early osseointegration of titanium dental implants in the maxillary posterior region: a randomized double-blinded clinical trial. Int J Implant Dent 2021; 7:37. [PMID: 33969450 PMCID: PMC8107060 DOI: 10.1186/s40729-021-00318-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the effects of ultraviolet (UV) photofunctionalization on the stability of implants during the early phase in the posterior region of the maxilla. The study was a randomized double-blinded clinical trial. Half of the participants received conventional commercial implants while the other half received UV-irradiated implants. The surgical sites were classified into three bone quality groups (II, III, IV) based on the grayscale value measured on cone-beam computed tomography. The values obtained from resonance frequency analysis were recorded immediately after implant placement and at 4 weeks and at 4 months postoperatively. The marginal bone level of the implants was evaluated using periapical radiographs at 4 weeks, 4 months, and 1 year postoperatively. Results Fifty-seven implants placed in 34 participants were analyzed in this study. In group III, significant differences were observed in terms of the differences of resonance frequency analysis values at 4 weeks (p = 0.004) and 4 months (p = 0.017) postoperatively. In group II, the UV-treated group showed significantly lesser bone loss at 4 weeks post-operatively (p = 0.037). Conclusions Within the limitation of the present study, we concluded that UV surface treatment on implants may increase the initial stability in the region of the maxilla with poor bone quality.
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Affiliation(s)
- Bada Choi
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Ye Chan Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Kyung Chul Oh
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Jae Hoon Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea.
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11
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Khosravifard A, Saberi BV, Khosravifard N, Motallebi S, Kajan ZD, Ghaffari ME. Application of an auto-edge counting method for quantification of metal artifacts in CBCT images: a multivariate analysis of object position, field of view size, tube voltage, and metal artifact reduction algorithm. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:735-743. [PMID: 33975812 DOI: 10.1016/j.oooo.2021.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective was to assess the effects of object position, field of view (FOV) size, peak kilovoltage (kVp), and a metal artifact reduction (MAR) algorithm on metal artifacts in cone beam computed tomography (CBCT) as measured with an auto-edge counting method. STUDY DESIGN A titanium implant and a stainless steel intracanal post in a root were inserted in bovine rib blocks. CBCT scans were acquired with changes in object position (incisor, canine, and premolar-molar areas), FOV, kVp, and MAR (on or off) mode. Images were quantitatively analyzed in MATLAB by using the Canny edge detection algorithm. Four-way analysis of variance and Tukey tests were applied for data analysis. RESULTS The implant produced no significant differences in number of artifacts among the object positions through changing the kVp and MAR mode for all FOV sizes (P > .05). The intracanal post scanned with the medium-sized FOV, high kVp, and MAR off mode generated significant differences among object positions (P = .033). Among the variables assessed, FOV size and MAR mode had a significant influence on the number of artifacts (P ≤ .039). CONCLUSION Reduction of FOV size and application of the MAR tool significantly decreased the number of streak artifacts. The Canny edge detection algorithm could be an efficient method of metal artifact quantification.
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Affiliation(s)
- Amir Khosravifard
- Department of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Bardia Vadiati Saberi
- Dental Sciences Research Center, Department of Periodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Samaneh Motallebi
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ebrahim Ghaffari
- Dental Sciences Research Center, Department of Biostatistics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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12
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Vidalón JA, Liñan C, Tay LY, Meneses A, Lagravère M. Evaluation of the palatal bone in different facial patterns for orthodontic mini-implants insertion: A cone-beam computed tomography study. Dental Press J Orthod 2021; 26:e2119204. [PMID: 33759963 PMCID: PMC8018748 DOI: 10.1590/2177-6709.26.1.e2119204.oar] [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: 06/18/2019] [Accepted: 11/05/2019] [Indexed: 12/04/2022] Open
Abstract
Objective: Evaluate the height, thickness and cortical density of the palatal bone of adults with different vertical facial patterns using Cone-Beam Computed Tomography (CBCT). Methods: This study analyzed 75 CBCTs of patients between 18 and 35 years old (45 men and 30 women). The CBCTs were classified into three groups based on their facial pattern: normodivergent, hypodivergent and hyperdivergent as determined from lateral cephalograms synthesized from the CBCTs. The height, cortical thickness and cortical density of the palatal bone were measured at 4, 8, 12, 16 and 20mm posterior to the incisive foramen, and at 3, 6 and 9mm lateral to the midpalatal suture. ANOVA with Tukey post-hoc tests were used for analysis of the data, at significance level of p< 0.05. Results: The hypodivergent pattern had a significant difference and the greatest height and cortical thickness of the palatal bone, followed by the hyperdivergent and the normodivergent patterns. No significant differences were found in minimum and maximum values of cortical density. Conclusion: The palatal bone is a favorable anatomical area to install different orthodontic temporary anchorage devices (TADs), where individuals with the hypodivergent vertical facial pattern have a higher height and cortical thickness of the palatal bone, followed by the hyperdivergent pattern and finally the normodivergent pattern. No significant differences in the cortical density of the palatal bone in the three facial patterns were found.
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Affiliation(s)
- José Antonio Vidalón
- Peruvian Cayetano Heredia University, Faculty of Dentistry, Department of Orthodontics (Lima, Peru)
| | - Carlos Liñan
- Peruvian Cayetano Heredia University, Faculty of Dentistry, Master Program in Orthodontics (Lima, Peru)
| | - Lidia Yileng Tay
- Peruvian Cayetano Heredia University, Faculty of Dentistry, Master Program in Orthodontics (Lima, Peru)
| | - Abraham Meneses
- Peruvian Cayetano Heredia University, Faculty of Dentistry, Department of Orthodontics (Lima, Peru)
| | - Manuel Lagravère
- University of Alberta, Graduate Program of Medicine and Dentistry (Edmonton, Canada)
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ElNaghy R, Bous R, Chinoy A, Kumar A, Valiathan M. A Qualitative Assessment of Bone Mineral Density in Individuals With Hemifacial Microsomia: A Cone-Beam Computed Tomography Study. Cleft Palate Craniofac J 2020; 58:1086-1093. [PMID: 33251829 DOI: 10.1177/1055665620975638] [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: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study is to utilize cone-beam computed tomography (CBCT) to compare the bone mineral density (BMD) on the affected versus nonaffected side, among individuals with hemifacial microsomia (HFM). METHODS This retrospective study included 9 patients with HFM. Pretreatment CBCT volumes were imported into Invivo5 software, which was used to measure BMD through Hounsfield units (HU) in 3 regions of the mandible; inferior to the lower lateral incisors, inferior to the first molar and at the ramus inferior to the sigmoid notch. Each region was measured at the buccal cortical bone, lingual cortical bone, and cancellous bone. The densities on the right and left sides were compared by Wilcoxon signed-rank test. RESULTS Overall, the BMD on the affected side tended to show slightly lower values when compared with the nonaffected side. Differences ranged from 14 HU at the lingual cortical plate of the first molar region to 234 HU at the buccal cortical plate of the ramus region. Differences were only statistically significant at the ramus region for the buccal (P = .002) and lingual (P < .001) cortical plates and at the lower incisor region at the buccal cortical plate (P = .016) and cancellous bone (P = .044). The differences, however, did not seem to be clinically significant. CONCLUSIONS The current study shows that the quality of bone on the affected side may be slightly reduced but did not seem to be clinically significant. This should be accounted for during surgical and orthodontic planning for patients with HFM.
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Affiliation(s)
- Rahma ElNaghy
- Craniofacial, Surgical and Special Care Orthodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA
| | - Rany Bous
- Craniofacial, Surgical and Special Care Orthodontics, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA
| | | | - Anand Kumar
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA.,Pediatric Plastic Surgery, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Manish Valiathan
- Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA
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Arsan B, Yalcin-Ülker GM, Meral DG, Erdem TL. Is there any predictive bone parameter for implant stability in 2-dimensional and 3-dimensional radiologic images? Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:371-379. [PMID: 32891573 DOI: 10.1016/j.oooo.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/26/2020] [Accepted: 08/07/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This ex vivo study aimed to compare radiomorphometric parameters between 2-dimensional (2-D) and 3-dimensional (3-D) radiographs and evaluate the influence of preoperative radiologic bone parameters on the clinical outcomes of implant stability. STUDY DESIGN Implant recipient sites in fresh bovine blocks were evaluated on panoramic radiographs for gray value (GV), fractal dimension (FD), number of connected trabeculae (Co), and density of connected trabeculae (CoD). Cone beam computed tomography (CBCT) scans were evaluated for trabecular thickness (TbTh), cortical thickness (CTh), degree of anisotropy (DA), FD, and Co. Insertion torque (IT) and implant stability quotient (ISQ) were measured. RESULTS GV was significantly correlated with all parameters in 2-D and 3-D images except FD in 2-D and Co in 3-D, and with all surgical parameters (P ≤ .029). Co and CoD values on panoramic radiographs had significant correlation with TbTh, CTh, and DA values on CBCT images (P < .001). All 2-D parameters and TbTh and CTh in the CBCT data were significantly correlated with IT only (P ≤ .047). Only GV was correlated with ISQ measurements (P ≤ .029). CONCLUSIONS GV, Co, and CoD values on panoramic radiographs reflect the architecture of trabecular bone and the thickness of cortical bone, and might help predict implant stability in clinical situations.
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Affiliation(s)
- Belde Arsan
- Assistant Professor, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey.
| | - Gül Merve Yalcin-Ülker
- Assistant Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Istanbul Okan University, Istanbul
| | - Deniz Gökce Meral
- Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Istanbul Okan University, Istanbul
| | - Tamer Lütfi Erdem
- Professor, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Beykent University, Istanbul
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15
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Etöz M, Amuk M, Avcı F, Yabacı A. Investigation of the effectiveness of CBCT and gray scale values in the differential diagnosis of apical cysts and granulomas. Oral Radiol 2020; 37:109-117. [PMID: 32613300 DOI: 10.1007/s11282-020-00459-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The aim of this study was to investigate the effectiveness of cone-beam CT (CBCT) findings and gray scale values (GSV) in the differential diagnosis of apical cysts and granulomas. METHODS Two independent researchers retrospectively analyzed the CBCT images of 21 teeth and histopathologically diagnosed them as having radicular cysts or apical granulomas. In the CBCT images, apical lesions were evaluated and categorized according to 7 criteria. These criteria were determined as relationship of lesions with dental roots, periphery of the lesion, shape, darker focus in the center, root resorption, displacement in related teeth, and cortical bone perforation. In addition, the minimum and maximum gray scale values of the lesions were measured and compared. RESULTS There was a statistically significant relationship between histopathological (HP) diagnosis and well-defined cortical border and lesion shape (p = 0.003, p = 0.014, respectively). According to the HP diagnosis, no statistically significant difference was found among other variables (p > 0.05) CONCLUSION: The presence of a well-defined cortical border or partial cortical border is a distinctive criterion for cysts. Additionally, the shape of the lesion was found to be a significant criterion for the separation of the two lesions. The shape of cystic lesions was circular and apical granulomas had a more curved shape. There was no relationship between the histopathological diagnosis of lesions and CBCT gray scale values.
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Affiliation(s)
- Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Fatma Avcı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey
| | - Ayşegül Yabacı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- Department of Biostatistics, Faculty of Medicine, Uludag University, Bursa, Turkey
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16
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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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17
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Gold Exploration in Two and Three Dimensions: Improved and Correlative Insights from Microscopy and X-Ray Computed Tomography. MINERALS 2020. [DOI: 10.3390/min10050476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this contribution, we highlight a correlative approach in which three-dimensional structural/positional data are combined with two dimensional chemical and mineralogical data to understand a complex orogenic gold mineralization system; we use the Kirk Range (southern Malawi) as a case study. Three dimensional structures and semi-quantitative mineral distributions were evaluated using X-ray Computed Tomography (XCT) and this was augmented with textural, mineralogical and chemical imaging using Scanning Electron Microscopy (SEM) and optical microscopy as well as fire assay. Our results detail the utility of the correlative approach both for quantifying gold concentrations in core samples (which is often nuggety and may thus be misrepresented by quarter- or half-core assays), and for understanding the spatial distribution of gold and associated structures and microstructures in 3D space. This approach overlays complementary datasets from 2D and 3D analytical protocols, thereby allowing a better and more comprehensive understanding on the distribution and structures controlling gold mineralization. Combining 3D XCT analyses with conventional 2D microscopies derive the full value out of a given exploration drilling program and it provides an excellent tool for understanding gold mineralization. Understanding the spatial distribution of gold and associated structures and microstructures in 3D space holds vast potential for exploration practitioners, especially if the correlative approach can be automated and if the resultant spatially-constrained microstructural information can be fed directly into commercially available geological modelling software. The extra layers of information provided by using correlative 2D and 3D microscopies offer an exciting new tool to enhance and optimize mineral exploration workflows, given that modern exploration efforts are targeting increasingly complex and low-grade ore deposits.
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Asgary S, Emadi N. Cone-beam computed tomography analysis of lingual mandibular bone depression in the premolar region: A case report. Clin Case Rep 2020; 8:523-526. [PMID: 32185050 PMCID: PMC7069851 DOI: 10.1002/ccr3.2713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/10/2019] [Accepted: 12/24/2019] [Indexed: 11/09/2022] Open
Abstract
Asymptomatic lingual depression in the mandible should be evaluated with advanced radiographic modalities such as cone-beam computed tomography (CBCT) using the software features to achieve correct diagnosis and avoid unnecessary endodontic and/or surgical interventions.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic ResearchResearch Institute of Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Naghmeh Emadi
- Dentofacial Deformity Research CenterResearch Institute of Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
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Manacorda M, Poletti de Chaurand B, Merlone A, Tetè G, Mottola F, Vinci R. Virtual Implant Rehabilitation of the Severely Atrophic Maxilla: A Radiographic Study. Dent J (Basel) 2020; 8:dj8010014. [PMID: 32024286 PMCID: PMC7148484 DOI: 10.3390/dj8010014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/21/2020] [Accepted: 01/21/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Advanced maxillary atrophy is one of the most common clinical scenarios where implant placement could become difficult. Nevertheless, a volumetric evaluation using a suitable diagnostic software could facilitate the implant planning. The purpose of the present study is to suggest the potential application of the maxillary retro-canine area as the designated location for virtual tilted implants. METHODS A sample of Cone Beam Computed Tomography (CBCT) images from the Department of Dentistry (IRCSS San Raffaele, Milan, Italy) was evaluated. After a 3D anatomical evaluation, tilted implants were virtually positioned in the retro-canine regions. All the implants were inserted using the same procedure at 30° and 45° degrees of tilting. The length, palatal angulation and diameter of the placed implant were identified. RESULTS A total of 220 tilted implants were placed. An average implant measurement of 13.51 mm in length and 3.42 mm in diameter were calculated. Additionally, an average buccal-palatal angulation of 6° was identified. Upon statistical analysis, the implant length was found to be significantly higher at 45° degrees of mesio-distal angulation than at 30° degrees (<0.0001). CONCLUSIONS A considerable number of patients show a significant degree of bone atrophy. The implant-supported treatment plan can rely on three-dimensional imaging of the residual bone as a guiding tool to establish the most effective implant position for each specific case. In this study, it was found that an implant could have a greater length if its mesio-distal angulation was more accentuated. In addition, owing to the volumetric evaluation, it was possible to virtually insert tilted implants in almost all of the cases of atrophy. This could lead clinicians to consider the retro-canine area as a viable place to insert a longer tilted implant.
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Razi T, Emamverdizadeh P, Nilavar N, Razi S. Comparison of the Hounsfield unit in CT scan with the gray level in cone-beam CT. J Dent Res Dent Clin Dent Prospects 2019; 13:177-182. [PMID: 31857863 PMCID: PMC6904917 DOI: 10.15171/joddd.2019.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/23/2019] [Indexed: 12/27/2022] Open
Abstract
Background. The present study was undertaken to compare the Hounsfield Unit (HU) in computed tomography (CT) with the gray level in CBCT in human tissues. Methods. In this study, 25 different soft and hard tissues were evaluated in 21 patients. CBCT images were taken with Newtom VGi machine (Verona, Italy) and CT images were prepared with Somatom Sensation unit (Siemens, Germany). The HU values of soft and hard tissues were compared with the gray level values of CBCT images. Results. There was a strong correlation between the HU in CT and the gray level in CBCT in soft tissues (P<0.001, R2 = 0.85) and hard tissues (P<0.001, R2 = 0.74) and in general (P<0.001, R2 = 0.91). Conclusion. A high degree of agreement was seen between HU in CT and gray level in CBCT in both hard and soft tissues. Since the gray level in CBCT was similar to HU in CT and can be used as a parameter determine bone density in implant treatment and also to determine the bone type, the CBCT technique is recommended in such cases due to its low radiation dose, short time and low cost compared to CT.
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Affiliation(s)
- Tahmineh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parya Emamverdizadeh
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nadia Nilavar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sedigheh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Shipley T, Farouk K, El-Bialy T. Effect of high-frequency vibration on orthodontic tooth movement and bone density. J Orthod Sci 2019; 8:15. [PMID: 31497574 PMCID: PMC6702681 DOI: 10.4103/jos.jos_17_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES: Previous reports have shown that high-frequency vibration can increase bone remodeling and accelerate tooth movement. The aim of this study was to evaluate the effects of high-frequency vibration on treatment phase tooth movement, and post-treatment bone density at initiation of retention, with cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty patients with initial Class I skeletal relationships, initial minimum-moderate crowding (3–5 mm), treated to completion with clear aligners and adjunctive high-frequency vibration, (HFV group) or no vibration, (Control group) were evaluated. The patients were instructed to change aligners as soon as they become loose. Changes in bone density associated with orthodontic treatment were evaluated using i-CAT cone-beam computed tomography (CBCT) and InVivo Anatomage® software to quantify density using Hounsfield units (HU) between treated teeth in 10 different regions. HU values were averaged and compared against baseline (T1) and between the groups at initiation of retention (T2). RESULTS: The average time for aligner change was 5.2 days in the HFV group, and 8.7 days in the control group (P = 0.0001). There was significant T1 to T2 increase of HU values in the upper arch (P = 0.0001) and the lower arch (P = 0.008) in the HFV group. There was no significant change in average HU values in the upper (P = 0.83) or lower arches (P = 0.33) in the control group. The intergroup comparison revealed a significant difference in the upper, (P = 0.0001) and lower arches (P = 0.007). CONCLUSION: High-frequency vibration adjunctive to clear aligners, allowed early aligner changes that led to shorter treatment time in minimum-moderate crowded cases. At initiation of retention, the HFV group demonstrated statistically significant increase as compared with pre-treatment bone density, whereas control subjects showed no significant change from pre-treatment bone density.
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Affiliation(s)
- Thomas Shipley
- Department of Dentistry, Division of Orthodontics, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA.,Department of Orthodontics, Mesa, Arizona, USA
| | - Khaled Farouk
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt.,Department of Dentistry, Division of Orthodontics, University of Alberta, Edmonton, Canada
| | - Tarek El-Bialy
- Department of Dentistry, Division of Orthodontics, 7-020D Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta, Canada
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Jung H, Gonzalez Y, Shen C, Klages P, Albuquerque K, Jia X. Deep-learning-assisted automatic digitization of applicators in 3D CT image-based high-dose-rate brachytherapy of gynecological cancer. Brachytherapy 2019; 18:841-851. [PMID: 31345749 DOI: 10.1016/j.brachy.2019.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/22/2019] [Accepted: 06/07/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Applicator digitization is one of the most critical steps in 3D high-dose-rate brachytherapy (HDRBT) treatment planning. Motivated by recent advances in deep-learning, we propose a deep-learning-assisted applicator digitization method for 3D CT image-based HDRBT. This study demonstrates its feasibility and potential in gynecological cancer HDRBT. METHODS AND MATERIALS Our method consisted of two steps. The first step used a U-net to segment applicator regions. We trained the U-net using two-dimensional CT images with a tandem-and-ovoid (T&O) applicator and corresponding applicator mask images. The second step applied a spectral clustering method and a polynomial curve fitting method to extract applicator central paths. We evaluated the accuracy, efficiency, and robustness of our method in different scenarios including other T&O cases that were not used in training, a T&O case scanned with cone-beam CT, and Y-tandem and cylinder-applicator cases. RESULTS In test cases with a T&O applicator, average 3D Dice similarity coefficient between automatic and manual segmented applicator regions was 0.93. Average distance between tip positions and average Hausdorff distance between applicator channels determined by our method and manually were 0.64 mm and 0.68 mm, respectively. Although trained only using CT images of T&O cases, our tool can also digitize Y-tandem, cylinder applicator, and T&O applicator scanned in cone-beam CT with error of tip position and Hausdorff distance <1 mm. Computation time was ∼15 s per case. CONCLUSIONS We have developed a deep-learning-assisted applicator digitization tool for 3D CT image-based HDRBT of gynecological cancer. The achieved accuracy, efficiency, and robustness made our tool clinically attractive.
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Affiliation(s)
- Hyunuk Jung
- Innovation Technology of Radiotherapy Computation and Hardware (iTORCH) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Medical Artificial Intelligence and Automation (MAIA) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Yesenia Gonzalez
- Innovation Technology of Radiotherapy Computation and Hardware (iTORCH) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Medical Artificial Intelligence and Automation (MAIA) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Chenyang Shen
- Innovation Technology of Radiotherapy Computation and Hardware (iTORCH) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Medical Artificial Intelligence and Automation (MAIA) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Peter Klages
- Innovation Technology of Radiotherapy Computation and Hardware (iTORCH) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Medical Artificial Intelligence and Automation (MAIA) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kevin Albuquerque
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Xun Jia
- Innovation Technology of Radiotherapy Computation and Hardware (iTORCH) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Medical Artificial Intelligence and Automation (MAIA) Lab, University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX.
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Abstract
The digital workflow for computer-aided implant surgery includes a range of steps leading to generation of a prosthetically driven, 3-dimensional virtual plan, which is transitioned into the patient's mouth by the surgical guide and protocol. Guided implant surgery is believed to be accurate and reliable compared with free-handed implant surgery. However, deviation between implant virtual plan and implant real position may occur as a result of accumulated errors throughout the digital workflow. This article reviews the digital workflow of static computer-aided implant surgery. Factors that may affect the accuracy and clinical outcome of the guided surgery are also reviewed.
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Triches DF, Alonso FR, Mezzomo LA, Schneider DR, Villarinho EA, Rockenbach MI, Teixeira ER, Shinkai RS. Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants. Int J Implant Dent 2019; 5:9. [PMID: 30740630 PMCID: PMC6369231 DOI: 10.1186/s40729-019-0158-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/06/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality. Methods The consecutive sample was composed of 45 short implants (4.1 × 6 mm) placed in the posterior region of 20 patients. Intra-surgical tactile bone quality, based on the classification of bone types by Lekholm and Zarb, and insertion torque were recorded during the implant placement. Visual bone quality and normalized MGV were assessed in standardized axial, coronal, and sagittal sections of preoperative CT images. Data were analyzed by ANOVA and Spearman correlation (alpha = 0.05). Results Insertion torque was associated with all assessment methods of bone quality (tactile, CT visual, MGV). A moderate correlation was found among all methods of bone quality, except for CT visual assessment and tactile evaluation. MGVs varied as a function of arch, dental region, insertion torque, and bone types. Conclusions The results suggest that bone quality measures affect primary stability as recorded by insertion torque, and the assessment methods are consistently related.
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Affiliation(s)
- Diego Fernandes Triches
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil.
| | - Fernando Rizzo Alonso
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
| | - Luis André Mezzomo
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Danilo Renato Schneider
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
| | - Eduardo Aydos Villarinho
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
| | - Maria Ivete Rockenbach
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
| | - Eduardo Rolim Teixeira
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
| | - Rosemary Sadami Shinkai
- Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 - Prédio 6, Porto Alegre, RS, 90619-900, Brazil
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Reproducibility of CBCT image analysis: a clinical study on intrapersonal and interpersonal errors in bone structure determination. Oral Radiol 2018; 35:152-158. [PMID: 30484198 DOI: 10.1007/s11282-018-0340-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE For correct implant planning based on cone-beam computed tomography (CBCT), the bone contour must be accurately determined. Identification of the contour is difficult in bones with incomplete mineralization. In this clinical study, we investigated the intrapersonal and interpersonal reproducibilities of manual bone contour determination on CBCT images using a semi-automated computerized process. METHODS The bone surface level in the area of the socket in 20 patients who had undergone tooth extraction from the upper jaw at 10 ± 1 weeks previously was determined on CBCT images. Two investigators with different levels of experience determined the bone structure initially (T0) and repeated the procedure after 3 months (T1). The bone structure marked on CBCT images was converted into a surface data set. The resulting data sets were superimposed on one another. In the analyses, the shortest distances between the datasets were identified and measured. The average deviations were statistically evaluated. RESULTS The intrapersonal evaluation resulted in an average deviation of 0.18 mm across both investigators. The interpersonal analysis comparing the two investigators resulted in average deviations of 0.15 mm at T0 and 0.26 mm at T1. Significant differences were not found. CONCLUSIONS The low intrapersonal deviation indicates that the procedure has satisfactory reproducibility. All deviations were within the range of the selected resolution of the CBCT device. Application of a semi-automated procedure to detect the bone border in areas with incomplete mineralization is a predictable process. TRIAL REGISTRATION The study was registered in the German Clinical Trials Register and the International Clinical Trials Registry Platform of the WHO: DRKS00004769, date of registration: 28 February 2013; and DRKS00005978, date of registration: 09 November 2015.
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Kearney V, Haaf S, Sudhyadhom A, Valdes G, Solberg TD. An unsupervised convolutional neural network-based algorithm for deformable image registration. ACTA ACUST UNITED AC 2018; 63:185017. [DOI: 10.1088/1361-6560/aada66] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Yoda N, Zheng K, Chen J, Liao Z, Koyama S, Peck C, Swain M, Sasaki K, Li Q. Biomechanical analysis of bone remodeling following mandibular reconstruction using fibula free flap. Med Eng Phys 2018; 56:1-8. [DOI: 10.1016/j.medengphy.2018.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/24/2018] [Accepted: 03/13/2018] [Indexed: 02/06/2023]
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Klugmann A, Bier B, Müller K, Maier A, Unberath M. Deformable respiratory motion correction for hepatic rotational angiography. Comput Med Imaging Graph 2018; 66:82-89. [DOI: 10.1016/j.compmedimag.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 01/26/2018] [Accepted: 03/13/2018] [Indexed: 12/01/2022]
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Liu J, Chen HY, DoDo H, Yousef H, Firestone AR, Chaudhry J, Johnston WM, Lee DJ, Emam HA, Kim DG. Efficacy of Cone-Beam Computed Tomography in Evaluating Bone Quality for Optimum Implant Treatment Planning. IMPLANT DENT 2018; 26:405-411. [PMID: 28125517 DOI: 10.1097/id.0000000000000542] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE This study examined (1) if cone-beam computed tomography (CBCT) can determine relative differences in bone mineral density distribution using clinical images of patients' mandibular bone and (2) if the relative differences can be used to detect the effects of sex and age on bone mineral density distribution. MATERIALS AND METHODS Sixty-six clinical CBCT images from patients (36 females and 30 males) of 3 age groups (40, 50, and 60 years) were identified. Alveolar (AB) and basal cortical bone (CB) regions were digitally isolated. A histogram of gray levels, which are proportional to degrees of bone mineralization, was obtained from each region. Mean, variability (SD and coefficient of variation), and percentage differences of gray level parameters between AB and basal CBs were computed. RESULTS Significant sex differences in gray level variability were observed within the postmenopausal age group (P < 0.042). CONCLUSION These findings suggest that clinical CBCT images can be a valuable tool in providing information on bone quality, which is an important criterion for optimum planning for dental implant placement.
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Affiliation(s)
- Jie Liu
- *Private Practice, Former Resident, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH. †Undergraduate Student, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH. ‡Predoctoral Student, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH. §Master Student, Clinical and Translational Science, College of Medicine, Ohio State University, Columbus, OH. ¶Associate Professor, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH. ‖Clinical Associate Professor, Department of Oral Pathology, Medicine and Radiology, School of Dentistry, Indiana University, Indianapolis, IN. #Professor Emeritus, Division of General Practice and Materials Science, College of Dentistry, Ohio State University, Columbus, OH. **Assistant Professor, Division of Restorative Sciences and Prosthodontics, College of Dentistry, The Ohio State University, Columbus, OH. ††Division of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, OH
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Kim EK, Han WJ, Choi JW, Battulga B. Estimation of the effective dose of dental cone-beam computed tomography using personal computer-based Monte Carlo software. Imaging Sci Dent 2018; 48:21-30. [PMID: 29581946 PMCID: PMC5863016 DOI: 10.5624/isd.2018.48.1.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/22/2017] [Accepted: 12/28/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To calculate the effective doses of cone-beam computed tomography (CBCT) using personal computer-based Monte Carlo (PCXMC) software (Radiation and Nuclear Safety Authority, Helsinki, Finland) and to compare the calculated effective doses with those measured using thermoluminescent dosimeters (TLDs) and an anthropomorphic phantom. Materials and Methods An Alphard VEGA CBCT scanner (Asahi Roentgen Ind. Co., Kyoto, Japan) with multiple fields of view (FOVs) was used for this study. The effective doses of the scout and main projections of CBCT using 1 large and 2 medium FOVs with a height >10 cm were calculated using PCXMC and PCXMCRotation software and then were compared with the doses obtained using TLD-100 LiF and an anthropomorphic adult human male phantom. Furthermore, it was described how to determine the reference points on the Y- and Z-axes in PCXMC, the important dose-determining factors in this software. Results The effective doses at CBCT for 1 large (20.0 cm×17.9 cm) and 2 medium FOVs (15.4 cm×15.4 cm and 10.2 cm×10.2 cm) calculated by the PCXMC software were 181, 300, and 158 µSv, respectively. These values were comparable (16%–18% smaller) to those obtained through TLD measurements in each mode. Conclusion The use of PCXMC software could be an alternative to the TLD measurement method for effective dose estimation in CBCT with large and medium FOVs.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Won-Jeong Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Jin-Woo Choi
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Bulgan Battulga
- Dental Hospital, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Bastami F, Shahab S, Parsa A, Abbas FM, Noori Kooshki MH, Namdari M, Lisar HA, Rafiei T, Fahimipour F, Salehi M, Jafari M. Can gray values derived from CT and cone beam CT estimate new bone formation? An in vivo study. Oral Maxillofac Surg 2018; 22:13-20. [PMID: 29086089 DOI: 10.1007/s10006-017-0657-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 09/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The main aim of this study was to investigate whether Hounsfield unit derived from computed tomography (HU/CT) and gray value derived from cone beam computed tomography (GV/CBCT) can predict the amount of new bone formation (NBF) in the defects after bone reconstruction surgeries. MATERIALS AND METHODS Thirty calvaria defects created in 5 rabbits and grafted with both radiolucent (RL, n = 15) and radiopaque (RO, n = 15) bone substitute materials were evaluated, 8 weeks postoperatively. The defects were scanned by multislice computed tomography (Somatom®, Siemens Healthineers, Erlangen, Germany) and CBCT (NewTom VG®, Qualitative Radiology, Verona, Italy). MSCT and CBCT scans were matched to select the exact region of interest (ROI, diameter = 5 mm and height = 1 mm). HU/CT and GV/CBCT of each ROI were obtained. Mean amount of NBF in whole of the defects was measured using serial histomorphometric assessment. We investigated the correlation between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF generally, and separately among the RL or RO grafted defects, by linear generalized estimating equation modeling. Receiver operation characteristic analysis was performed to check the accuracy of HU/CT and GV/CBCT in diagnosing more than 10% NBF in the samples. RESULTS There were linear correlations between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF. CONCLUSION According to the results, both HU/CT and GV/CBCT can be considered as fairly good predictors for assessment of the amount of NBF following bone reconstruction surgeries.
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Affiliation(s)
- Farshid Bastami
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahriar Shahab
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahed University, Tehran, Iran.
| | - Azin Parsa
- Department of Oral Radiology, Department of General and Specialized Dentistry, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | - Fatemeh Mashhadi Abbas
- Department of Oral Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mahshid Namdari
- Department of Biostatistics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Azimi Lisar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahed University, Tehran, Iran
| | - Tohid Rafiei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahed University, Tehran, Iran
| | - Farahnaz Fahimipour
- Department of Developmental Sciences, School of Dentistry, Marquette University, Milwaukee, WI, USA
| | - Majid Salehi
- Department of Tissue Engineering and Cell Therapy, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maissa Jafari
- Department of Oral Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Campos MJDS, Silva KS, Lupatini PM, Fraga MR, Vitral RWF. Tooth root and alveolar bone grey values derived from cone-beam CT imaging in maxillary incisor teeth with and without apical root resorption. J Orthod 2017; 45:23-28. [PMID: 29280412 DOI: 10.1080/14653125.2017.1417780] [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: 10/18/2022]
Abstract
INTRODUCTION In orthodontic treatment, an increased bone mineral density of the alveolar bone is considered as a risk factor for apical root resorption (ARR), whereas the mineral density of cementum has been associated with root protection against resorption. METHODS This study aimed at evaluating the grey values (GVs) of the apical third of the root and of the alveolar bone adjacent to maxillary incisors with and without ARR in orthodontic patients. Twenty-one patients under treatment who presented one incisor with ARR and its corresponding contralateral without ARR were selected and submitted to cone-beam computed tomography. GVs were evaluated on the images obtained of four areas of the apical third of the root and of four areas of the adjacent alveolar bone. RESULTS AND CONCLUSIONS The radicular tissue of the apical third of the incisors with ARR showed greater root GV (p < .05) than that of the incisors without ARR. Supra-apical alveolar bone exhibited greater GV in the incisors without ARR than incisors with ARR (p < .05). Root GV was not associated with root protection, but rather seemed to have facilitated the process of resorption. The GV of the lingual bone was associated with a higher progression of ARR in the incisors.
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Affiliation(s)
| | - Karine Simões Silva
- a Department of Orthodontics , Juiz de Fora Federal University , Juiz de Fora , Brazil
| | - Paula Moraes Lupatini
- a Department of Orthodontics , Juiz de Fora Federal University , Juiz de Fora , Brazil
| | - Marcelo Reis Fraga
- a Department of Orthodontics , Juiz de Fora Federal University , Juiz de Fora , Brazil
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Magill D, Beckmann N, Felice MA, Yoo T, Luo M, Mupparapu M. Investigation of dental cone-beam CT pixel data and a modified method for conversion to Hounsfield unit (HU). Dentomaxillofac Radiol 2017; 47:20170321. [PMID: 29076750 DOI: 10.1259/dmfr.20170321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the relationship in dental cone-beam CT (CBCT) between the manufacturer-reported image pixel data and a modified conversion to CT number densities in Hounsfield unit (HU). METHODS A standardized CT phantom was imaged using typical clinical parameters on CBCT from three manufacturers (Carestream 9300®, Carestream Health, Rochester, NY; J Morita 3D Accutomo®, J. Morita Mfg. Corp., Kyoto, Japan; and Planmeca Promax 3D®, Planmeca Helsinki, OY, Finland). Reconstructed axial slices were evaluated using regions of interest to ascertain the mean pixel value in five materials in the phantom. The Digital Imaging and Communications in Medicine data were also evaluated to determine if raw pixel data had been adjusted during the image reconstruction. A modified version of the existing manual HU conversion technique was applied, and the resultant slope and y-intercept were used to scale the pixel values ultimately to HU for all images. RESULTS The DICOM header data show that a modified rescale y-intercept was applied to both the Carestream and Planmeca image data yielding manufacturer-produced results in HU. The Morita pixel data were unmodified and report in shades of grey or grey values (GV). The Carestream manufacturer-derived HU measurements showed good correlation in air (-1000 HU), but all other materials ranged from 2.6 to 13.5 σ from the specified phantom value. Results in the modified conversion technique images fell within 1.0-2.4 σ from the specified phantom values. CONCLUSIONS While more studies are needed to test for regularity, this study suggests that our modified technique could be a means of getting more accurate quantitative data from dental CBCTs.
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Affiliation(s)
- Dennise Magill
- Environmental Health & Radiation Safety, University of Pennsylvania, Philadelphia, PA, USA
| | - Natalie Beckmann
- Environmental Health & Radiation Safety, University of Pennsylvania, Philadelphia, PA, USA
| | - Marc A Felice
- Environmental Health & Radiation Safety, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas Yoo
- DMD Candidate Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Minou Luo
- DMD Candidate Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mel Mupparapu
- Professor & Director of Radiology, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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de Oliveira MVL, Santos AC, Paulo G, Campos PSF, Santos J. Application of a newly developed software program for image quality assessment in cone-beam computed tomography. Imaging Sci Dent 2017; 47:75-86. [PMID: 28680843 PMCID: PMC5489672 DOI: 10.5624/isd.2017.47.2.75] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/01/2017] [Accepted: 04/24/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study was to apply a newly developed free software program, at low cost and with minimal time, to evaluate the quality of dental and maxillofacial cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS A polymethyl methacrylate (PMMA) phantom, CQP-IFBA, was scanned in 3 CBCT units with 7 protocols. A macro program was developed, using the free software ImageJ, to automatically evaluate the image quality parameters. The image quality evaluation was based on 8 parameters: uniformity, the signal-to-noise ratio (SNR), noise, the contrast-to-noise ratio (CNR), spatial resolution, the artifact index, geometric accuracy, and low-contrast resolution. RESULTS The image uniformity and noise depended on the protocol that was applied. Regarding the CNR, high-density structures were more sensitive to the effect of scanning parameters. There were no significant differences between SNR and CNR in centered and peripheral objects. The geometric accuracy assessment showed that all the distance measurements were lower than the real values. Low-contrast resolution was influenced by the scanning parameters, and the 1-mm rod present in the phantom was not depicted in any of the 3 CBCT units. Smaller voxel sizes presented higher spatial resolution. There were no significant differences among the protocols regarding artifact presence. CONCLUSION This software package provided a fast, low-cost, and feasible method for the evaluation of image quality parameters in CBCT.
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Affiliation(s)
- Marcus Vinicius Linhares de Oliveira
- Department of Health Technology and Biology, Federal Institute of Bahia, Salvador, BA, Brazil.,Department of Interactive Processes of Organs and Systems, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - António Carvalho Santos
- Department of Complementary Sciences, Coimbra Health School, Polytechnic Institute of Coimbra, Portugal
| | - Graciano Paulo
- Department of Medical Imaging and Radiotherapy, Coimbra Health School, Polytechnic Institute of Coimbra, Portugal
| | - Paulo Sergio Flores Campos
- Department of Interactive Processes of Organs and Systems, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Joana Santos
- Department of Medical Imaging and Radiotherapy, Coimbra Health School, Polytechnic Institute of Coimbra, Portugal
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Reliability and accuracy of cone-beam computed tomography voxel density and linear distance measurement at different voxel sizes: A study on sheep head cadaver. J Dent Sci 2017; 12:145-150. [PMID: 30895040 PMCID: PMC6395244 DOI: 10.1016/j.jds.2016.11.004] [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: 05/04/2016] [Revised: 09/26/2016] [Indexed: 11/23/2022] Open
Abstract
Background/purpose The reliability and accuracy of linear distance and voxel density (VD) measurements are very important in dentistry. The purpose of this study was to assess the accuracy and reliability of linear distances and VD measurements of cone-beam computed tomography (CBCT) at different voxel sizes. Materials and methods Eighteen-millimeter linears of size 40 gutta-percha were prepared in fresh sheep head. The head was scanned using CBCT with 0.25, 0.3, and 0.40 voxel sizes. Standard linear distances of gutta-percha were measured in panoramic CBCT images at 0.25, 0.3, and 0.4 voxel sizes. VD measurements were made separately on spongeous bone of palatal surfaces of the roots of teeth 4, 5, and 6 of maxilla and on cortical bone of teeth 4, 5, and 6 regions of the left and right hemimandibles through cross-sectional imaging. Results We found that linear distance measurements on panoramic image of CBCT were slightly lower than physical measurements. A significant difference was not found for the gutta-percha linear distances and cortical VD measurements at different voxel sizes (P ≥ 0.05). The correlation between measurements of VD at different voxels in cortical bone was greater than 0.85 (P = 0.000). Conclusion Linear distance measurements on the sheep head cadaver of 0.25, 0.3, and 0.4 voxel sizes were similar and reliable when compared with physical measurements. In minimizing radiation exposure, VD measurement of cortical bone at 0.4 voxel-based CBCT could be used to estimate cortical bone density. However, studies should be performed on the human head cadaver.
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de Oliveira MVL, Wenzel A, Campos PSF, Spin-Neto R. Quality assurance phantoms for cone beam computed tomography: a systematic literature review. Dentomaxillofac Radiol 2017; 46:20160329. [PMID: 28045345 DOI: 10.1259/dmfr.20160329] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES To undertake a systematic review on quality assurance (QA) phantoms for CBCT imaging, including studies on the development and application of phantoms. METHODS The MEDLINE (PubMed) bibliographic database was searched until May 2016 for studies evaluating the development and use of phantoms in CBCT image QA. The search strategy was restricted to English language publications using the following combined terms: (Cone Beam CT) OR (Cone Beam Computed Tomography) OR (Cone-Beam Computed Tomography) OR (CBCT) AND (quality OR phantom). It was assessed which of the six image quality parameters stated by the European Commission could be evaluated with each phantom and which of them actually were. RESULTS The search strategy yielded 37 studies, which had developed and used (25 studies) or only used (12 studies) a phantom in CBCT image QA. According to the literature, in 7 phantoms, it is possible to evaluate 4 or more image quality parameters while in 11 phantoms, merely 1 parameter can be evaluated. Only two phantoms permit the evaluation of the six image quality parameters stated by the European Commission. The parameters, which can most often be evaluated using a phantom, are image density values, spatial resolution and geometric accuracy. The SEDENTEXCT phantom was used most frequently. In two studies, all quality parameters suggested by the European Commission were evaluated. CONCLUSIONS QA phantoms rarely allow all image quality parameters stated by the European Commission to be evaluated. Furthermore, alternative phantoms, which allow all image quality parameters to be evaluated in a single exposure, even for a small field of view, should be developed.
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Affiliation(s)
- Marcus V L de Oliveira
- 1 Department of Health Technology and Biology, Federal Institute of Bahia, Salvador, Brazil.,2 Institute of Health Sciences, Department of Interactive, Processes of Organs and Systems, Federal University of Bahia, Salvador, Brazil
| | - Ann Wenzel
- 3 Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Paulo S F Campos
- 2 Institute of Health Sciences, Department of Interactive, Processes of Organs and Systems, Federal University of Bahia, Salvador, Brazil
| | - Rubens Spin-Neto
- 3 Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Al-Zahrani MS, Elfirt EY, Al-Ahmari MM, Yamany IA, Alabdulkarim MA, Zawawi KH. Comparison of Cone Beam Computed Tomography-Derived Alveolar Bone Density Between Subjects with and without Aggressive Periodontitis. J Clin Diagn Res 2017; 11:ZC118-ZC121. [PMID: 28274060 PMCID: PMC5324485 DOI: 10.7860/jcdr/2017/22767.9305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Understanding the changes in bone density of patients affected by aggressive periodontitis could be useful in early disease detection and proper treatment planning. AIM The aim of this study was to compare alveolar bone density in patients affected with aggressive periodontitis and periodontally healthy individuals using Cone Beam Computed Tomography (CBCT). MATERIALS AND METHODS This cross-sectional study was conducted on 20 patients with a confirmed diagnosis of aggressive periodontitis. Twenty periodontally healthy patients attending the dental clinics for implant placement or extraction of impacted third molars served as controls. Alveolar bone density was measured using CBCT scanning. Comparisons between aggressive periodontitis group and controls for age and alveolar bone density of the anterior and posterior regions were performed using an independent sample t-test. Multivariable linear regression models were also performed. RESULTS The differences between groups in regard to age, anterior and posterior alveolar bone density was not statistically significant (p<0.05). In the posterior region, the multivariable regression model showed that bone density was not associated with age, gender or the study groups. Whereas, in the anterior region, patient's age was found to be significantly associated with bone density, p=0.014. CONCLUSION Alveolar bone density as measured by CBCT in aggressive periodontitis patients was not different from periodontally healthy individuals. Further studies are needed to confirm these findings.
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Affiliation(s)
- Mohammad S. Al-Zahrani
- Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eman Y. Elfirt
- Associate Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia and Cairo University, Cairo, Egypt
| | - Manea M. Al-Ahmari
- Resident, Department of Periodontics, Assir Dental Center, Ministry of Health, Abha, Saudi Arabia
| | - Ibrahim A. Yamany
- Assistant Professor, Department of Oral Diagnostic Sciences, Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maher A. Alabdulkarim
- Consultant, Department of Periodontics, King Saud Medical Complex, Ministry of Health, Riyadh, Saudi Arabia
| | - Khalid H. Zawawi
- Professor, Department of Orthodntics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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The impact of manual threshold selection in medical additive manufacturing. Int J Comput Assist Radiol Surg 2016; 12:607-615. [PMID: 27718124 PMCID: PMC5362669 DOI: 10.1007/s11548-016-1490-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022]
Abstract
Purpose Medical additive manufacturing requires standard tessellation language (STL) models. Such models are commonly derived from computed tomography (CT) images using thresholding. Threshold selection can be performed manually or automatically. The aim of this study was to assess the impact of manual and default threshold selection on the reliability and accuracy of skull STL models using different CT technologies. Method One female and one male human cadaver head were imaged using multi-detector row CT, dual-energy CT, and two cone-beam CT scanners. Four medical engineers manually thresholded the bony structures on all CT images. The lowest and highest selected mean threshold values and the default threshold value were used to generate skull STL models. Geometric variations between all manually thresholded STL models were calculated. Furthermore, in order to calculate the accuracy of the manually and default thresholded STL models, all STL models were superimposed on an optical scan of the dry female and male skulls (“gold standard”). Results The intra- and inter-observer variability of the manual threshold selection was good (intra-class correlation coefficients >0.9). All engineers selected grey values closer to soft tissue to compensate for bone voids. Geometric variations between the manually thresholded STL models were 0.13 mm (multi-detector row CT), 0.59 mm (dual-energy CT), and 0.55 mm (cone-beam CT). All STL models demonstrated inaccuracies ranging from −0.8 to +1.1 mm (multi-detector row CT), −0.7 to +2.0 mm (dual-energy CT), and −2.3 to +4.8 mm (cone-beam CT). Conclusions This study demonstrates that manual threshold selection results in better STL models than default thresholding. The use of dual-energy CT and cone-beam CT technology in its present form does not deliver reliable or accurate STL models for medical additive manufacturing. New approaches are required that are based on pattern recognition and machine learning algorithms.
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Novel CBCT and optical scanner-based implant treatment planning using a stereolithographic surgical guide: a multipronged diagnostic approach. IMPLANT DENT 2016; 23:401-6. [PMID: 25051414 DOI: 10.1097/id.0000000000000128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report describes the use of the combination of 2 technologies (Cone-beam computed tomography and Optical 3-dimensional scan) to maximize accuracy of implant placement in an area where previous implants failed and had to be removed. This report also stresses the increased efficiency of combining technologies to fabricate stereolithographic surgical guide which, when used intraoperatively, can improve precision of placement.
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The anterior maxilla as a potential source of bone grafts: a morphometric cone beam computed tomography analysis of different anatomical areas. Int J Oral Maxillofac Surg 2016; 45:1049-56. [PMID: 26993106 DOI: 10.1016/j.ijom.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/06/2016] [Accepted: 03/01/2016] [Indexed: 11/23/2022]
Abstract
The aim of this research was to use cone beam computed tomography (CBCT) to analyze the volume, density, and morphology of the bone available in the anterior region of the maxilla, in order to investigate its potential as a source of bone grafts. Three independent zones were evaluated: the palatine process of the maxilla (PPM), anterior nasal spine (ANS), and subnasal bone (SN). The latter was analyzed bilaterally (SNR, SNL). One hundred CBCT scans were evaluated. The morphometric analysis comprised volumetric and subsequent automatic density calculations, as well as linear measurements. Potential correlations among these parameters, including demographic characteristics, were investigated. The study comprised 52 women and 48 men (mean age 49.6±14.5 years). The calculated bone volume averaged 2.41±0.72cm(3) for PPM, 0.46±0.16cm(3) for ANS, 0.58±0.2cm(3) for SNR, and 0.57±0.21cm(3) for SNL. The anterior region of the maxilla can provide a considerable amount of bone volume from different anatomical zones and should be regarded as a potential donor site for the regeneration of maxillary atrophic bones. Further investigation is required before these findings can be applied in the routine clinical setting.
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Abstract
Few studies involving human participants have been conducted to investigate the effect of orthodontic treatment on alveolar bone density around the teeth. Our previous study revealed that patients who received 6 months of active orthodontic treatment exhibited an ∼24% decrease in alveolar bone density around the teeth. However, after an extensive retention period following orthodontic treatment, whether the bone density around the teeth can recover to its original state from before the treatment remains unclear, thus warranting further investigation.The purpose of this study was to assess the bone density changes around the teeth before, during, and after orthodontic treatment.Dental cone-beam computed tomography (CBCT) was used to measure the changes in bone density around 6 teeth in the anterior maxilla (maxilla central incisors, lateral incisors, and canines) of 8 patients before and after orthodontic treatment. Each patient underwent 3 dental CBCT scans: before treatment (T0); at the end of 7 months of active orthodontic treatment (T1); after several months (20-22 months) of retention (T2). The Friedman test was applied to evaluate the changes in the alveolar bone density around the teeth according to the 3 dental CBCT scans.From T0 to T1, a significant reduction in bone density was observed around the teeth (23.36 ± 10.33%); by contrast, a significant increase was observed from T1 to T2 (31.81 ± 23.80%). From the perspective of the overall orthodontic treatment, comparing the T0 and T2 scans revealed that the bone density around the teeth was relatively constant (a reduction of only 0.75 ± 19.85%). The results of the statistical test also confirmed that the difference in bone density between T0 and T2 was nonsignificant.During orthodontic tooth movement, the alveolar bone density around the teeth was reduced. However, after a period of bone recovery, the reduced bone density recovered to its previous state from before the orthodontic treatment. However, the bone density around ∼10% of the teeth in this region could not recover to 80% of its state from before the orthodontic treatment.
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Affiliation(s)
- Jian-Hong Yu
- From the School of Dentistry (J-HY, H-LH, C-FL, J-TH), College of Medicine China Medical University, Taichung; Department of Bioinformatics and Medical Engineering (H-LH, J-TH), Asia University, Taichung; Department of Biomedical Imaging and Radiological Sciences (JW), National Yang-Ming University, Taipei; Institute of Environmental Health (Y-FL), China Medical University; and Department of Biomedical Engineering (M-TT), Hungkuang University, Taichung, Taiwan, ROC
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Yepes JF, Al-Sabbagh M. Use of cone-beam computed tomography in early detection of implant failure. Dent Clin North Am 2016; 59:41-56. [PMID: 25434558 DOI: 10.1016/j.cden.2014.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Preimplant planning with complex imaging techniques has long been a recommended practice for assessing the quality and quantity of alveolar bone before dental implant placement. When maxillofacial imaging is necessary, static film or digital images lack the depth and dimension offered by computed tomography. Cone-beam computed tomography (CBCT) offers the dentist not only a radiographic volumetric view of alveolar bone but also a 3-dimensional reconstruction. This article reviews the use of CBCT for assessing implant placement and early detection of failure, and compares the performance of CBCT with that of other imaging modalities in the early detection of implant failure.
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Affiliation(s)
- Juan F Yepes
- Department of Pediatric Dentistry, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry, Indianapolis, IN 46202, USA.
| | - Mohanad Al-Sabbagh
- Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA
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Rostetter C, Metzler P, Schenkel JS, Seifert B, Luebbers HT. Comparison of in vivo cone-beam and multidetector computed tomographic scans by three-dimensional merging software. Br J Oral Maxillofac Surg 2015; 53:1021-6. [DOI: 10.1016/j.bjoms.2015.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 09/27/2015] [Indexed: 12/17/2022]
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Ray TJ, McGraw WS, Sun Z, Jeon M, Johnson T, Cheffins K, Daegling DJ, Kim DG. Mandibular bone mineral density variation in three West African Cercopithecoid monkey species: Associations with diet and feeding behavior. Arch Oral Biol 2015; 60:1714-20. [DOI: 10.1016/j.archoralbio.2015.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 09/08/2015] [Accepted: 09/15/2015] [Indexed: 11/29/2022]
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Lohse C, Catala-Lehnen P, Regier M, Heiland M. Superior performance of cone beam tomography in detecting a calcaneus fracture. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2015; 4:Doc09. [PMID: 26605132 PMCID: PMC4637842 DOI: 10.3205/iprs000068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cone beam computed tomography is a state-of-the-art imaging tool, initially developed for dental and maxillofacial application. With its high resolution and low radiation dose, cone beam tomography has been expanding its application fields, for example, to diagnosis of traumata and fractures in the head and neck area. In this study, we demonstrate superior and satisfactory performance of cone beam tomography for the imaging of a calcaneus fracture in comparison to conventional X-ray and computed tomography.
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Affiliation(s)
- Christian Lohse
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Marc Regier
- Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, University of Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Langlais R, Katsumata A, Naidoo S, Ogawa K, Fukui T, Shimoda S, Kobayashi K. The cadmium telluride photon counting sensor in panoramic radiology: gray value separation and its potential application for bone density evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:636-43. [PMID: 26324749 DOI: 10.1016/j.oooo.2015.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 06/15/2015] [Accepted: 07/02/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate whether bone mineral density can be evaluated more accurately using a panoramic device with a new cadmium telluride photon-counting sensor and software than 2 panoramic devices with a conventional semiconductor sensor. STUDY DESIGN A fiduciary test object with several known levels of hydroxy apatite mineral concentration was placed in a phantom on the mandibular occlusal plane. Panoramic images were acquired by changing the position of the test object within the dental arch. The gray value, the spectrum deformation index (SDI), and the relative attenuation index (RAI) of the test object were evaluated. The SDI and RAI represent unique energy information as acquired by the QR-Master panoramic machine and the corresponding special QR-MC analysis software. In order to compare the values expressed in the different units (gray, SDI, and RAI values), the percentage discrepancy was calculated. RESULTS The cadmium telluride photon-counting fitted machine more consistently separated each of the hydroxy apatite concentrations in all of the different positioning configurations and locations. The SDI function of the QR Master machine produced more stable values than the RAI value and the gray values of the 2 conventional panoramic machines. CONCLUSIONS The methodologies as developed for this study can be used to test more sophisticated analyses for the determination of bone density.
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Affiliation(s)
- Robert Langlais
- Professor Emeritus, University of Texas Health Science Center Dental School and CEO Emeritus Enterprises, San Antonio, TX, USA
| | - Akitoshi Katsumata
- Professor and Chair, Department of Oral Radiology, Asahi University School of Dentistry, Gifu, Japan.
| | - Sudeshni Naidoo
- Senior Professor and Principal Specialist, University of the Western Cape, Tygerberg, South Africa
| | - Koichi Ogawa
- Professor, Department of Applied Informatics, Faculty of Science and Engineering, Hosei University, Tokyo, Japan
| | - Tatsumasa Fukui
- Assistant, Department of Oral Radiology, Asahi University School of Dentistry, Gifu, Japan
| | - Shinji Shimoda
- Professor and Chair, Department of Oral Anatomy, Tsurumi University, School of Dental Medicine, Yokohama, Japan
| | - Kaoru Kobayashi
- Professor and Chair, Department of Oral Radiology, Tsurumi University School of Dental Medicine, Yokohama, Japan
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Barngkgei I, Joury E, Jawad A. An innovative approach in osteoporosis opportunistic screening by the dental practitioner: the use of cervical vertebrae and cone beam computed tomography with its viewer program. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:651-9. [PMID: 26453386 DOI: 10.1016/j.oooo.2015.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the use of cone beam computed tomography (CBCT) for predicting osteoporosis based on the cervical vertebrae CBCT-derived radiographic density (RD) using the CBCT-viewer program. STUDY DESIGN CBCT scans (WhiteFox, de Gotzen S.r.l device, distributed by Satelec-Acteon Group, Italy) and dual-energy X-ray absorptiometry examinations of 38 women who participated in an earlier investigation were examined. A coronal slice, subjectively determined from the cervical vertebrae, was selected and the RD as gray values for the first and second vertebrae, and the dens was calculated by using CBCT-viewer software (WhiteFox imaging). RESULTS The CBCT-derived RD values of the dens and the left part of the first cervical vertebra showed the strongest correlation coefficients (r=0.7, 0.6; P<.001) and the highest sensitivity (76.9%, 70%), specificity (92%, 92.9%), and accuracy (90.8%, 86.4%) in predicting osteoporosis in the lumbar vertebrae and the femoral neck, respectively. CONCLUSIONS CBCT-derived RD of cervical vertebrae can predict osteoporosis status using a CBCT-viewer program. This finding should be confirmed on other CBCT devices.
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Affiliation(s)
- Imad Barngkgei
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Easter Joury
- Assistant Professor of Dental Public Health and Oral Epidemiology, Oral Medicine Department, Faculty of Dentistry, Damascus University, Damascus, Syria; Centre for Oral Growth and Development, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ali Jawad
- William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Royal London Hospital, London, United Kingdom
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Pauwels R, Jacobs R, Singer SR, Mupparapu M. CBCT-based bone quality assessment: are Hounsfield units applicable? Dentomaxillofac Radiol 2015; 44:20140238. [PMID: 25315442 DOI: 10.1259/dmfr.20140238] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology.
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Affiliation(s)
- R Pauwels
- 1 Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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