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Solomonov M, Hadad A, Ben Itzhak J, Lvovsky A, Azizi H. Is a Pre-Existent Cone-Beam Computed Tomography Able to Detect Metal Dental Posts? Dent J (Basel) 2024; 12:229. [PMID: 39057016 PMCID: PMC11276458 DOI: 10.3390/dj12070229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/30/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: In this study, the efficacy of cone-beam computed tomography (CBCT) in detecting dental posts was compared to periapical radiography. (2) Methods: A retrospective evaluation of 53 patients' periapical radiographs and CBCT images was performed. The presence and type of the intra-canal dental post were initially determined on the periapical images (PA) radiographs' examination and were then compared to the observer's ability to detect the dental post on a CBCT image. The effect of the post's type (metal cast or prefabricated) on its detection on CBCT images was determined. (3) Results: 10.5% of teeth that were identified as having a post on a PA radiograph were not identified as having a post on the CBCT examination (p < 0.05). Approximately 17.6% of teeth that were identified as not having a post on a PA radiograph were identified as having a post on the CBCT examination (p < 0.05). Moreover, 16.3% and 50% of teeth with a prefabricated or cast posts on PA radiographs were falsely identified on the CBCT examination, respectively (p < 0.05). (4) Conclusions: A CBCT image is an insufficient tool for the identification of metal prefabricated and cast posts. A PA image is the recommended radiographic tool for achieving information about the post-endodontic restoration status of teeth candidates for endodontic retreatment in patients with a former CBCT scan.
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Affiliation(s)
- Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Avi Hadad
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Alex Lvovsky
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
| | - Hadas Azizi
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Ramat Gan, Israel
- “Bina” Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271 Jerusalem, Israel
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Alrashed S, Dutra V, Chu TMG, Yang CC, Lin WS. Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial-intelligence-based system. J Prosthodont 2024; 33:574-583. [PMID: 38305665 DOI: 10.1111/jopr.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
PURPOSE To evaluate the effects of exposure protocol, voxel sizes, and artifact removal algorithms on the trueness of segmentation in various mandible regions using an artificial intelligence (AI)-based system. MATERIALS AND METHODS Eleven dry human mandibles were scanned using a cone beam computed tomography (CBCT) scanner under differing exposure protocols (standard and ultra-low), voxel sizes (0.15 mm, 0.3 mm, and 0.45 mm), and with or without artifact removal algorithm. The resulting datasets were segmented using an AI-based system, exported as 3D models, and compared to reference files derived from a white-light laboratory scanner. Deviation measurement was performed using a computer-aided design (CAD) program and recorded as root mean square (RMS). The RMS values were used as a representation of the trueness of the AI-segmented 3D models. A 4-way ANOVA was used to assess the impact of voxel size, exposure protocol, artifact removal algorithm, and location on RMS values (α = 0.05). RESULTS Significant effects were found with voxel size (p < 0.001) and location (p < 0.001), but not with exposure protocol (p = 0.259) or artifact removal algorithm (p = 0.752). Standard exposure groups had significantly lower RMS values than the ultra-low exposure groups in the mandible body with 0.3 mm (p = 0.014) or 0.45 mm (p < 0.001) voxel sizes, the symphysis with a 0.45 mm voxel size (p = 0.011), and the whole mandible with a 0.45 mm voxel size (p = 0.001). Exposure protocol did not affect RMS values at teeth and alveolar bone (p = 0.544), mandible angles (p = 0.380), condyles (p = 0.114), and coronoids (p = 0.806) locations. CONCLUSION This study informs optimal exposure protocol and voxel size choices in CBCT imaging for true AI-based automatic segmentation with minimal radiation. The artifact removal algorithm did not influence the trueness of AI segmentation. When using an ultra-low exposure protocol to minimize patient radiation exposure in AI segmentations, a voxel size of 0.15 mm is recommended, while a voxel size of 0.45 mm should be avoided.
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Affiliation(s)
- Safa Alrashed
- Oral Biology PhD program in the College of Dentistry, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vinicius Dutra
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Chao-Chieh Yang
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Rosado LPL, Fontenele RC, Farias-Gomes A, Freitas DQ, Neves FS. Influence of the metal post material, tooth location in the dental arch, and metal artifact reduction tool on vertical root fracture diagnosis in cone beam CT. Odontology 2024; 112:959-965. [PMID: 38214844 DOI: 10.1007/s10266-023-00889-8] [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: 04/25/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024]
Abstract
This study aimed to evaluate the influence of the metal post composition, tooth location in the dental arch, and metal artifact reduction (MAR) on vertical root fracture (VRF) diagnosis in cone beam computed tomography (CBCT). Twenty-two unirradicular premolars (12 sound and 10 fractured) and two alveolar sockets of a mandible (anterior and posterior regions) composed the sample. CBCT scans of each tooth with a metal post placed into the root canal-silver-palladium (Ag-Pd), cobalt-chromium (Co-Cr), or nickel-chromium (Ni-Cr)-were individually acquired for each mandibular region, and two conditions of MAR, using a OP300 device (Instrumentarium, Finland). Images were assessed by five evaluators independently for VRF detection. Diagnostic values were calculated and compared among all groups using multi-way ANOVA with Tukey post hoc test to investigate the effect of post material, anatomical region, and MAR on VRF diagnosis (α = 0.05). Values of area under the receiver operating curve and specificity were not influenced by the studied factors (p > 0.05). Sensitivity was influenced by the MAR in both mandibular regions (p < 0.05). In the anterior region, sensitivity values increased when the MAR was enabled, regardless of the metal post material (p < 0.05). Similar behavior was noticed in the posterior region for Ni-Cr (p < 0.05) but not for Ag-Pd and Co-Cr posts (p > 0.05). The MAR improved the sensitivity in VRF diagnosis for all tested metal posts in the mandibular anterior region and for the Ni-Cr post in the mandibular posterior region. Therefore, for images obtained in the OP300 CBCT device, activation of the MAR is suggested in these cases.
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Affiliation(s)
- Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
- Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, ES, Brazil.
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Amanda Farias-Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Frederico Sampaio Neves
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
- Department of Propedeutics and Integrated Clinic, Division of Oral Radiology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, BA, Brazil
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Bastos MF, Visconti MA, Pinto RR, Junqueira RB, Verner FS. Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study. J Endod 2024; 50:835-843. [PMID: 38395388 DOI: 10.1016/j.joen.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Considering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. METHODS This ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. RESULTS In the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). CONCLUSIONS The MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.
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Affiliation(s)
- Mayara Fidelis Bastos
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rocha Pinto
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora/GV Campus, Governador Valadares, Brazil
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Abesi F. Effect of auto-adaptive metal artifact reduction (aMAR) program in cone-beam computed tomography on assessing pre-implant bone levels. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:1-3. [PMID: 39027211 PMCID: PMC11252154 DOI: 10.34172/japid.2024.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/18/2024] [Indexed: 07/20/2024]
Abstract
This research aimed to introduce an auto-adaptive metal artifact reduction (aMAR) algorithm in cone-beam computed tomography (CBCT) to assess the levels of the pre-implant alveolar crest. Dental implants as a treatment modality for edentulous patients consist of a titanium alloy, which creates a metal artifact, resulting in a dark dental structure in the CBCT scans. Metallic artifacts are limiting factors for the precise detection in CBCT images. These are related to the dark areas around materials and metallic structures (e.g., restorations, implants, and endodontic instruments). To overcome this problem, the metal artifact reduction (MAR) program has been recommended as a post-procedure stage for CBCT image reconstruction. Recent developments offer CBCT scanners with an aMAR option with a greater dynamic range to help overcome the challenges of peri-implant bone evaluation to reach accurate dental diagnoses.
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Affiliation(s)
- Farida Abesi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Saeed KMM, Al-Zahawi AR. A conservative approach to localize loose implant screw through cemented crown: an in vitro experimental study. BMC Oral Health 2024; 24:617. [PMID: 38807096 PMCID: PMC11131170 DOI: 10.1186/s12903-024-04369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Retrieval of cement-retained implant-supported restorations is intriguing in cases of screw loosening. Detecting the estimated size of the screw access hole (SAH) could decrease destruction to the prosthesis and preserve the crown. OBJECTIVES To precisely localize loose implant screws through cemented crowns to reduce crown damage after screw loosening. MATERIALS AND METHODS In this in vitro study, 60 cement-retained implants supported 30 zirconia-based, and 30 ceramics fused to metal (CFM) lower molar crowns were invented, and each was subdivided into three subgroups (10 each). In group I (AI/BI) (control), SAH was created with the aid of orthopantomography (OPG). In contrast, in group II (zirconia-crown), SAH was created with the aid of CBCT + 3D printed surgical guide with a 2 mm metal sleeve in subgroups IIA/IIIA and CBCT + MAR was used to develop SAH in subgroups IIB/IIIB. SEM and Micro-CT scanned the SAH openings to determine the diameter of the hole, cracking, chipping, and chipping volume. RESULTS Regarding the effect of plane CBCT and CBCT + MAR on prepared crowns, a highly significant association between group I with group II (p = 0.001) and group III (p = 0.002) was detected. Regarding the cracking of SAH, significant differences between the zirconium crown and CFM restoration (p = 0.009) were found, while for the chipping, no significant association was seen between groups (p = 0.19). CONCLUSIONS CBCT, either as a plane CBCT or with MAR, significantly improved the accuracy of drilling the screw channel and decreased injury to the existing restoration and abutment, aiding in better localization of SAH in loosened implant abutment screws.
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Affiliation(s)
- Kale Masoud Mohammad Saeed
- Department of Conservative Dentistry, College of Dentistry, University of Sulaimani, Sulaimaniyah, 46001, Iraq.
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Mello HN, Bonadiman EA, Bruneli GL, Pitol GA, de-Azevedo-Vaz SL. Influence of CBCT filters and contrast adjustments on peri-implant buccal bone thickness measurement and blooming expression. Clin Oral Investig 2024; 28:315. [PMID: 38748313 DOI: 10.1007/s00784-024-05712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/07/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To assess whether filter and contrast adjustments can improve the accuracy of CBCT in measuring the buccal bone thickness (BBT) adjacent to dental implants by reducing blooming artifacts. MATERIALS AND METHODS Homogeneous bone blocks with peri-implant BBT of 0.3 mm, 0.5 mm, and 1 mm were scanned using the Orthophos SL system. Three dentists measured the BBT in 234 CBCT scans under different settings of contrast adjustments and 'Sharpen' filter activation. Additionally, implant diameter measurements were taken to assess blooming artifact expression. The differences between tomographic and actual measurements of BBT and implant diameter [(CBCT - actual) * 100 / actual] were subjected to Mixed ANOVA (α = 0.05). RESULTS The group with the thinnest BBT (0.3 mm) had the greatest difference between tomographic and actual measurements (79.9% ± 29.0%). Conversely, the 0.5 mm (36.1% ± 38.4%) and 1 mm (29.4% ± 12.3%) groups exhibited lower differences (p < 0.05). 'Sharpen' filter activation reduced blooming expression since it resulted in a lower difference for implant diameter (p < 0.05), but it did not influence BBT measurements (p = 0.673). Contrast settings had no impact on BBT (p = 0.054) or implant diameter measurements (p = 0.079). CONCLUSION Although filter activation reduced blooming artifacts, neither filter nor contrast adjustments improved the accuracy of CBCT in measuring peri-implant BBT; actual BBT influenced this task. CLINICAL RELEVANCE When assessing the peri-implant buccal bone plate in the CBCT system studied, dental surgeons may find it beneficial to adjust contrast and apply filters according to their preferences, since such adjustments were found to have no adverse effects on the diagnostic accuracy of this task. The use of the 'Sharpen' filter may lead to improved representation of implant dimensions.
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Affiliation(s)
| | | | | | | | - Sergio Lins de-Azevedo-Vaz
- Dental Sciences Graduate Program, Federal University of Espírito Santo (UFES), Av. Marechal Campos 1468, Maruípe Vitória, ES, 29043900, Brazil.
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Mihailidis DN, Stratis A, Gingold E, Carlson R, DeForest W, Gray J, Lally MT, Pizzutiello R, Rong J, Spelic D, Hilohi MC, Massoth R. AAPM Task Group Report 261: Comprehensive quality control methodology and management of dental and maxillofacial cone beam computed tomography (CBCT) systems. Med Phys 2024; 51:3134-3164. [PMID: 38285566 DOI: 10.1002/mp.16911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/31/2024] Open
Abstract
Cone-beam computed tomography (CBCT) systems specifically designed and manufactured for dental, maxillofacial imaging (MFI) and otolaryngology (OLR) applications have been commercially available in the United States since 2001 and have been in widespread clinical use since. Until recently, there has been a lack of professional guidance available for medical physicists about how to assess and evaluate the performance of these systems and about the establishment and management of quality control (QC) programs. The owners and users of dental CBCT systems may have only a rudimentary understanding of this technology, including how it differs from conventional multidetector CT (MDCT) in terms of acceptable radiation safety practices. Dental CBCT systems differ from MDCT in several ways and these differences are described. This report provides guidance to medical physicists and serves as a basis for stakeholders to make informed decisions regarding how to manage and develop a QC program for dental CBCT systems. It is important that a medical physicist with experience in dental CBCT serves as a resource on this technology and the associated radiation protection best practices. The medical physicist should be involved at the pre-installation stage to ensure that a CBCT room configuration allows for a safe and efficient workflow and that structural shielding, if needed, is designed into the architectural plans. Acceptance testing of new installations should include assessment of mechanical alignment of patient positioning lasers and x-ray beam collimation and benchmarking of essential image quality performance parameters such as image uniformity, noise, contrast-to-noise ratio (CNR), spatial resolution, and artifacts. Several approaches for quantifying radiation output from these systems are described, including simply measuring the incident air-kerma (Kair) at the entrance surface of the image receptor. These measurements are to be repeated at least annually as part of routine QC by the medical physicist. QC programs for dental CBCT, at least in the United States, are often driven by state regulations, accreditation program requirements, or manufacturer recommendations.
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Affiliation(s)
- Dimitris N Mihailidis
- University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Eric Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ray Carlson
- Radiological Physics Services, Inc, Plymouth, Michigan, USA
| | | | | | - Mary T Lally
- Intersocietal Accreditation Commission, Ellicott City, Maryland, USA
| | | | - John Rong
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - David Spelic
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Mike C Hilohi
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Richard Massoth
- Sunflower Medical Physics, LLC, Sioux Falls, South Dakota, USA
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Capel CP, da Motta RJG, Pauwels R, Gaêta-Araujo H, Oliveira-Santos C, Tirapelli C. Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography. Dentomaxillofac Radiol 2024; 53:233-239. [PMID: 38466923 PMCID: PMC11056797 DOI: 10.1093/dmfr/twae008] [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: 01/05/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES This study evaluated the effect of metal artefact reduction (MAR) level and tube current on the assessment of dental implant positioning relative to the mandibular canal (MC) through cone-beam computed tomography (CBCT). METHODS Titanium dental implants were placed in dried mandibles at 0.5-mm superior to the MC (group 1/n = 8) and 0.5-mm inside the MC with perforation of the cortex (group 2/n = 10). CBCT scans were obtained with different levels of MAR (off, medium, and high) and 2 tube currents (4 and 8 mA). Four examiners analysed the images and scored the contact between the implant and the MC using a 5-point scale. Sensitivity, specificity, area under receiver operating characteristic curve (ROC), and frequency of scores were calculated. Data were compared with analysis of variance 2-way and Tukey's test and scores with Chi-square test. RESULTS Specificity and area under ROC curve decreased significantly when MAR level was high compared with MAR-medium and MAR-off. The frequency of score 3 (inconclusive) was the highest, and scores 1 and 5 (definitely no contact and definitely contact, respectively) were the lowest with MAR-high, regardless of the tube current. When MAR was off, there were higher frequencies of scores 1 and 5. CONCLUSIONS The level of MAR influences the assessment of the relationship between the dental implant and the MC. MAR-high led to lower diagnostic accuracy compared with MAR-medium and off. ADVANCES IN KNOWLEDGE This article shows that high level of MAR can interfere in the diagnostic of dental implant positioning relative to the MC, decreasing its accuracy.
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Affiliation(s)
- Camila Porto Capel
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Raphael Jurca Gonçalves da Motta
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, 10330 Bangkok, Thailand
| | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville, School of Dentistry, 40202-1701, Louisville, KY, United States
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
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Michelinakis G, Apostolakis D, Nikolidakis D, Blum IR. A comprehensive review and update on the current state of computer-assisted rehabilitation in implant dentistry. Prim Dent J 2024; 13:64-73. [PMID: 38424692 DOI: 10.1177/20501684241231672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
AIM This paper provides a comprehensive review of the established concepts and newer developments related to computer-assisted implant rehabilitation. METHODS Two independent researchers searched the English literature published to 31st December 2023 in the PubMed/Medline database for primary and secondary research and related publications on computer-assisted implant planning, computer-assisted implant placement and computer-assisted implant restoration. RESULTS A total of 58,923 papers were identified, 198 relevant papers were read in full text and 110 studies were finally included. Computer-assisted implant rehabilitation was found to result in more precise implant positioning than freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. CONCLUSION Computer-assisted surgery is particularly indicated in cases of critical anatomy, but may encounter limitations in terms of cost, restricted mouth opening, visibility and adjustment of the surgical guides and the need for prior familiarisation with the procedure. Nonetheless, this surgical technique reduces the post-implant placement complication rate.
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Affiliation(s)
- George Michelinakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Apostolakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Nikolidakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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11
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Peng J, Qiu RLJ, Wynne JF, Chang CW, Pan S, Wang T, Roper J, Liu T, Patel PR, Yu DS, Yang X. CBCT-Based synthetic CT image generation using conditional denoising diffusion probabilistic model. Med Phys 2024; 51:1847-1859. [PMID: 37646491 DOI: 10.1002/mp.16704] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Daily or weekly cone-beam computed tomography (CBCT) scans are commonly used for accurate patient positioning during the image-guided radiotherapy (IGRT) process, making it an ideal option for adaptive radiotherapy (ART) replanning. However, the presence of severe artifacts and inaccurate Hounsfield unit (HU) values prevent its use for quantitative applications such as organ segmentation and dose calculation. To enable the clinical practice of online ART, it is crucial to obtain CBCT scans with a quality comparable to that of a CT scan. PURPOSE This work aims to develop a conditional diffusion model to perform image translation from the CBCT to the CT distribution for the image quality improvement of CBCT. METHODS The proposed method is a conditional denoising diffusion probabilistic model (DDPM) that utilizes a time-embedded U-net architecture with residual and attention blocks to gradually transform the white Gaussian noise sample to the target CT distribution conditioned on the CBCT. The model was trained on deformed planning CT (dpCT) and CBCT image pairs, and its feasibility was verified in brain patient study and head-and-neck (H&N) patient study. The performance of the proposed algorithm was evaluated using mean absolute error (MAE), peak signal-to-noise ratio (PSNR) and normalized cross-correlation (NCC) metrics on generated synthetic CT (sCT) samples. The proposed method was also compared to four other diffusion model-based sCT generation methods. RESULTS In the brain patient study, the MAE, PSNR, and NCC of the generated sCT were 25.99 HU, 30.49 dB, and 0.99, respectively, compared to 40.63 HU, 27.87 dB, and 0.98 of the CBCT images. In the H&N patient study, the metrics were 32.56 HU, 27.65 dB, 0.98 and 38.99 HU, 27.00, 0.98 for sCT and CBCT, respectively. Compared to the other four diffusion models and one Cycle generative adversarial network (Cycle GAN), the proposed method showed superior results in both visual quality and quantitative analysis. CONCLUSIONS The proposed conditional DDPM method can generate sCT from CBCT with accurate HU numbers and reduced artifacts, enabling accurate CBCT-based organ segmentation and dose calculation for online ART.
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Affiliation(s)
- Junbo Peng
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
- Nuclear and Radiological Engineering and Medical physics Programs, George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Richard L J Qiu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Jacob F Wynne
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Chih-Wei Chang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Shaoyan Pan
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Tonghe Wang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Justin Roper
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Tian Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Pretesh R Patel
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - David S Yu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
- Nuclear and Radiological Engineering and Medical physics Programs, George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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12
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Groh J, Schramm S, Renner N, Krause J, Perl M. [Innovative 3D imaging]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:921-927. [PMID: 37851089 DOI: 10.1007/s00113-023-01372-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/19/2023]
Abstract
Intraoperative 2D fluoroscopy is often performed for repositioning and implant control. However, this does not always provide the details needed to reliably detect joint steps or incorrect repositioning. Over the last few years, intraoperative 3D imaging has been established and further developed. Multiple studies demonstrate an advantage and better intraoperative control through 3D imaging. Examples are the upper ankle, the proximal tibia and the distal radius; the rates of intraoperative revisions with digital volume tomography (DVT) are between 20-30%. Technical advancements, such as metal artifact reductions, automated plane setting, automated screw detection, and robotic DVT devices, facilitate intraoperative operation, shorten surgical time, and provide improved image quality. By processing the data sets in the form of an immersive, computer-simulated image in terms of "augmented reality" (AR), increased precision can be achieved intraoperatively while reducing radiation exposure. The implementation of these systems is associated with costs, which are offset by cost savings from avoided revisions. Adequate counter-financing is still lacking at the present time. Intraoperative 3D imaging represents an important tool for intraoperative control. The current data situation makes it necessary to address the routine use of 3D procedures, especially in the joint area. The indications are becoming increasingly broader. Technical innovations such as robotics and AR have significantly improved 3D devices in recent years and offer high potential for integration into the OR.
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Affiliation(s)
- J Groh
- Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - S Schramm
- Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - N Renner
- Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - J Krause
- Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - M Perl
- Klinik für Unfallchirurgie und Orthopädie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Deutschland.
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13
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Wetzl M, Wenkel E, Steiding C, Ruth V, Emons J, Wasser MN, Uder M, Ohlmeyer S. Feasibility of In Vivo Metal Artifact Reduction in Contrast-Enhanced Dedicated Spiral Breast Computed Tomography. Diagnostics (Basel) 2023; 13:3062. [PMID: 37835805 PMCID: PMC10572310 DOI: 10.3390/diagnostics13193062] [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: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Radiopaque breast markers cause artifacts in dedicated spiral breast-computed tomography (SBCT). This study investigates the extent of artifacts in different marker types and the feasibility of reducing artifacts through a metal artifact reduction (MAR) algorithm. METHODS The pilot study included 18 women who underwent contrast-enhanced SBCT. In total, 20 markers of 4 different types were analyzed for artifacts. The extent of artifacts with and without MAR was measured via the consensus of two readers. Image noise was quantitatively evaluated, and the effect of MAR on the detectability of breast lesions was evaluated on a 3-point Likert scale. RESULTS Breast markers caused significant artifacts that impaired image quality and the detectability of lesions. MAR decreased artifact size in all analyzed cases, even in cases with multiple markers in a single slice. The median length of in-plain artifacts significantly decreased from 31 mm (range 11-51 mm) in uncorrected to 2 mm (range 1-5 mm) in corrected images (p ≤ 0.05). Artifact size was dependent on marker size. Image noise in slices affected by artifacts was significantly lower in corrected (13.6 ± 2.2 HU) than in uncorrected images (19.2 ± 6.8 HU, p ≤ 0.05). MAR improved the detectability of lesions affected by artifacts in 5 out of 11 cases. CONCLUSION MAR is feasible in SBCT and improves the image quality and detectability of lesions.
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Affiliation(s)
- Matthias Wetzl
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany (S.O.)
| | - Evelyn Wenkel
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany (S.O.)
| | | | - Veikko Ruth
- AB-CT–Advanced Breast-CT GmbH, Henkestrasse 91, 91052 Erlangen, Germany
| | - Julius Emons
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Universitätsstraße 21/23, 91054 Erlangen, Germany
| | - Martin N. Wasser
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany (S.O.)
| | - Sabine Ohlmeyer
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany (S.O.)
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Sayin H, Aksoy B, Özsoy K. Optimization of CBCT data with image processing methods and production with fused deposition modeling 3D printing. Med Biol Eng Comput 2023:10.1007/s11517-023-02889-w. [PMID: 37505414 DOI: 10.1007/s11517-023-02889-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
The present study has investigated the effect of the removal of artifacts in cone beam computed tomography (CBCT) images with image processing techniques to dental implant planning. The aim of this study has been to benefit from the novel image processing techniques and additive manufacturing technologies in order to change the existing approach in the usage of the 3D model in the orthogonal surgery, traumatic cases, and tumor operations and to solve the restrictions in surgical operations. In the study, firstly, 3 × 3, 5 × 5, and 7 × 7 kernel values were determined on the CBCT image data of the patient. The determined kernel values were applied on CBCT images by choosing median, median-mean-Gaussian (MMG), and bilateral filters, which are quite successful in removing noise in medical images. A thresholding process to separate teeth and bones from soft tissue regions on CBCT images, histogram normalization for a balanced color distribution, morphology operations to reduce noise areas, and tooth and bone boundaries were determined as closely as possible to patient anatomy. The original image and the images obtained from image enhancement techniques were compared. Results showed that the 3 × 3 median filtering method from three different kernel values out of three different image processing methods used in the study greatly improved the artifacts. It has also been shown that the availability of image processing and additive manufacturing methods on CBCT images has been shown to be a highly important factor before dental surgery planning.
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Affiliation(s)
- Hamdi Sayin
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, Turkey
| | - Bekir Aksoy
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, Turkey.
| | - Koray Özsoy
- Department of Machine and Metal Technologies, Isparta OSB Vocational School, Isparta University of Applied Sciences, Isparta, Turkey
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15
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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: 1] [Impact Index Per Article: 1.0] [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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16
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Lagos de Melo LP, Queiroz PM, Moreira-Souza L, Nadaes MR, Santaella GM, Oliveira ML, Freitas DQ. Influence of CBCT parameters on image quality and the diagnosis of vertical root fractures in teeth with metallic posts: an ex vivo study. Restor Dent Endod 2023; 48:e16. [PMID: 37284345 PMCID: PMC10240088 DOI: 10.5395/rde.2023.48.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%). Results The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts. Conclusions Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.
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Affiliation(s)
- Larissa Pereira Lagos de Melo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Polyane Mazucatto Queiroz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Mariana Rocha Nadaes
- Dental Clinic Department, Division of Oral Radiology, Dental School, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gustavo Machado Santaella
- Department of Diagnosis and Oral Health, University of Louisville, School of Dentistry, Louisville, KY, USA
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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17
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Khurana S, Parasher P, Creanga AG, Geha H. Effect of Mandible Phantom Inclination in the Axial Plane on Image Quality in the Presence of Implant Using Cone-Beam Computer Tomography. Cureus 2023; 15:e36630. [PMID: 37155440 PMCID: PMC10122839 DOI: 10.7759/cureus.36630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
Purpose To assess the effect of 30° phantom inclination on image quality in the presence of an implant using cone-beam computed tomography (CBCT). Materials and methods Three series of eight scans were taken and categorized by a range of 87-90 kVp and 7.1 mA, and 8 mA. For the first CBCT series, the phantom was placed on a flat plane. For the second series, the phantom was inclined at 30° in the axial plane. For the third series, inclined scans were re-oriented and included for statistics. In total, 24 scans were used for statistics. i.e., eight scans at three different planes (flat plane, inclined plane, and re-oriented inclined plane). All the images were analyzed for artifact and contrast-to-noise ratio (CNR) on ImageJ software. Results The inclination of the dry human mandible phantom by 30° reduces the artifact (p <0.05). However, the CNR was not affected by the phantom inclination. Conclusion The appropriate inclination of the head can significantly reduce the metal artifact in the presence of implants and thus improve the CBCT image quality for post-operative follow-up.
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Affiliation(s)
- Sonam Khurana
- Oral Pathology, Radiology, and Medicine, New York University College of Dentistry, New York City, USA
| | - Pranav Parasher
- Diagnostic Radiology, Rutgers School of Dental Medicine, Newark, USA
| | - Adriana G Creanga
- Oral and Maxillofacial Radiology, Rutgers School of Dental Medicine, Newark, USA
| | - Hassem Geha
- Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio, San Antonio, USA
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18
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Almeshari A, Abdelkarim AZ, Geha H, Khan AA, Ruparel N. Assessing the Efficacy of Planmeca ProMax® 3D Cone-Beam CT Machine in the Detection of Root Fractures With Varied Metal Artifact Reduction Settings and Three Kilovoltage Peak Levels. Cureus 2023; 15:e35647. [PMID: 37009371 PMCID: PMC10065128 DOI: 10.7759/cureus.35647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND This study aims to examine the accuracy of cone-beam computed tomography (CBCT) machines in detecting root fracture when using different metal artifact reduction (MAR) settings at different kilovoltage peak (kVp) levels. METHODOLOGY Sixty-six tooth roots were treated endodontically using a standardized technique. Of these, 33 roots were randomly selected to be fractured; the other 33 roots were intact and used as controls. The roots were placed randomly in prepared beef ribs to mimic the alveolar bone. Imaging was performed by Planmeca ProMax® 3D (Planmeca, Helsinki, Finland) using different MAR settings (no, low, mid, and high) at three different levels of kVp: 70, 80, and 90. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated. RESULTS There was a significant difference in accuracy when using different MAR settings within the group of 70 kVp. Likewise, within the group of 90 kVp. There was no significant difference between different MAR settings at 80 kVp. Using low MAR/90 kVp had significantly higher accuracy relative to other MAR settings at 90 kVp; it also had the highest values of sensitivity, specificity, and AUC in the study. Using mid and high MAR at 70 kVp or 90 kVp decreased accuracy significantly. Mid MAR/90 kVp was the least effective setting in this study. CONCLUSIONS Using low MAR at 90 kVp significantly increased the accuracy within the group of 90 kVp. In contrast, mid MAR and high MAR in 70 and 90 kVp, respectively, decreased accuracy significantly.
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Nomier AS, Gaweesh YSED, Taalab MR, El Sadat SA. Efficacy of low-dose cone beam computed tomography and metal artifact reduction tool for assessment of peri-implant bone defects: an in vitro study. BMC Oral Health 2022; 22:615. [PMID: 36528573 PMCID: PMC9759909 DOI: 10.1186/s12903-022-02663-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Early accurate radiographic assessment of peri-implant bone condition is highly important to avoid excessive loss of supporting bone and implant failure. Cone beam computed tomography (CBCT) is the radiographic technique of choice if peri-implant dehiscence and fenestration defects are suspected. The higher radiation dose and the presence of beam hardening artifacts are the main drawbacks of CBCT imaging techniques. This study aims to evaluate the influence of low-dose cone beam computed tomography (LD-CBCT) and metal artifact reduction (MAR) tool on the assessment of peri-implant dehiscence and fenestration. METHODOLOGY Thirty titanium implants were inserted into bovine rib blocks. Twenty had standardized bone defects (10 with dehiscence and 10 with fenestration), while the remaining 10 were used as control group with no defects. Radiographic examinations held with high-definition CBCT (HD-CBCT) and LD-CBCT with and without application of MAR tool. Images were assessed by four examiners for the presence or absence of peri-implant defects. The area under the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and accuracy were calculated for all radiographic protocols. RESULTS In the absence of MAR tool, there was no difference in AUC and diagnostic values between LD-CBCT and HD-CBCT for detection of both defects. When the MAR tool was applied, the AUC values, sensitivity, and accuracy were higher in HD-CBCT than in LD-CBCT for the detection of both defects, especially for the dehiscence, while specificity remained the same. CONCLUSION LD-CBCT can be used in the evaluation of peri-implant dehiscence and fenestration without any decrease in diagnostic accuracy. The application of MAR tool decrease the diagnostic ability of both defects, especially for the detection of dehiscence defects.
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Affiliation(s)
- Alaa Shafiek Nomier
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Yousria Salah El-Din Gaweesh
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Maha R. Taalab
- grid.7155.60000 0001 2260 6941Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521 Egypt
| | - Shaimaa Abu El Sadat
- grid.7269.a0000 0004 0621 1570Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Niktash A, Mehralizadeh S, Talaeipour A. The Effect of Different Field of View Sizes on Contrast-to-Noise Ratio of Cone-Beam Computed Tomography Units: An In-Vitro Study. Front Dent 2022; 19:32. [PMID: 36865948 PMCID: PMC9971646 DOI: 10.18502/fid.v19i32.10804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/28/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives: 'Field of view (FOV) size' affects the quality of radiographic images and the radiation dose received by patients. In cone-beam computed tomography (CBCT) FOV should be selected according to therapeutic purposes. While aiming for the highest diagnostic image quality, the radiation dose should be kept to a minimum to reduce the risk for patients. The purpose of this study was to assess the effect of different sizes of FOV on contrast-to-noise ratio (CNR) in five different CBCT units. Materials and Methods: In this experimental study, CBCT scans were taken from a dried human mandible containing a resin block fixed to the lingual cortex and a resin ring was used to simulate soft tissue during scans. Five CBCT units including, NewTom VGi, NewTom GiANO, Soredex SCANORA 3D, Planmeca ProMax, and Asahi Alphard 3030 were evaluated. Each unit had 3 to 5 different FOVs. Images were obtained and analyzed with ImageJ software and CNR was calculated in each image. ANOVA and T-test were used for statistical analysis (P<0.05). Results: Comparison among different FOVs of each unit showed significant CNR reductions in small FOVs (P<0.05). Similar FOV sizes of different CBCT devices were also compared and demonstrated significant differences (P<0.05). Conclusion: A direct relationship between FOV size and CNR was observed in all five CBCT units, but differences in exposure parameters of these units led to variable CNR in FOVs with similar sizes.
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Affiliation(s)
| | - Sandra Mehralizadeh
- Maxillofacial Radiology Department, Dental School Tehran Islamic Azad University of Medical Sciences, Tehran, Iran,Corresponding author: Maxillofacial Radiology Department, Dental School Tehran Islamic Azad University of Medical Sciences, Tehran, Iran.
| | - Ahmadreza Talaeipour
- Maxillofacial Radiology Department, Dental School Tehran Islamic Azad University of Medical Sciences, Tehran, Iran
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Vitulli I, Fontenele RC, Nascimento EHL, Freitas DQ. Influence of artefacts generated by titanium and zirconium implants in the study of trabecular bone architecture in cone-beam CT images. Dentomaxillofac Radiol 2022; 51:20220066. [PMID: 35466693 PMCID: PMC10043622 DOI: 10.1259/dmfr.20220066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts generated by titanium and zirconium implants on trabecular bone architecture assessment through cone-beam CT (CBCT). The influence of kilovoltage (kVp) and metal artefact reduction (MAR) in such analysis was also assessed. METHODS CBCT scans were obtained with Picasso Trio with or without a titanium or zirconium implants in a posterior region of a mandible using 70, 80 or 90 kVp, with or without MAR. The other acquisition settings were constant: field of view 8 × 5 cm, voxel size 0.2 mm, 5 mA, 24 s and 720 frames. Two volumes of interest (VOIs) were determined comprising trabecular bone mesial and distal to the implant area. The following morphometric parameters were measured: connectivity density (Conn. Dn.), fractal dimension (FD), bone volume fraction (BV/TV), bone surface density (BS/TV), trabecular thickness (Tb. Th.), and trabecular spacing (Tb. Sp.), and compared by multiway ANOVA (α = 0.05). RESULTS For Conn. Dn. and FD, with MAR, the zirconium group showed values significantly lower than the other groups (p < 0.05). For BV/TV, BS/TV, Tb. Th. and Tb. Sp., the zirconium group showed the highest values, regardless of MAR condition (p < 0.05). MAR increased BS/TV and Tb. Th. values, and decreased FD values for zirconium group. In general, the kVp level did not influence trabecular morphometric parameters. CONCLUSION The assessment of the trabecular bone architecture was mainly influenced by the expression of the artefacts generated by zirconium implants. MAR decreased the FD and increased the BS/TV and Tb.Th. values regardless of the kVp level.
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Affiliation(s)
- Ivana Vitulli
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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22
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Moshfeghi M, Safi Y, Różyło-Kalinowska I, Gandomi S. Does the size of an object containing dental implant affect the expression of artifacts in cone beam computed tomography imaging? Head Face Med 2022; 18:20. [PMID: 35765076 PMCID: PMC9241278 DOI: 10.1186/s13005-022-00326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Artifacts fault image quality but handling several factors can affect it. This study was conducted to investigate the effect of object size on artifacts in cone-beam computed tomography systems. Methods Five phantoms, each containing a titanium implant in a sheep bone block, were fabricated of various sizes ranging from XS to XL: The M phantom was the same size as the device’s field of view (FOV). The L and XL phantoms were 20 and 40% larger than the FOV while the S and XS phantoms were 20 and 40% smaller than FOV, respectively. Ballistic gelatin was used to fill the phantoms. Phantoms were scanned by NewTom VGI and HDXWill Q-FACE. The mean and standard deviation (SD) of gray values in each 120 ROI was obtained by OnDemand software. The contrast to noise ratio (CNR) was also calculated. Results The gray value in S and M phantoms were more homogenous. The lowest SD value (10.20) was found in S phantom. The highest value for SD (125.16) was observed in XL phantom. The lowest (4.47) and highest (9.92) CNR were obtained in XL and S phantoms, respectively. HDXWill Q-FACE recorded a higher SD and a lower CNR than NewTom VGI (P < 0.05). Conclusion Object dimensions of the FOV size or up to 20% smaller provided better image quality. Since the dimensions of soft tissue in most patients are larger than the selective FOV, it is recommended that in CBCT artifacts studies, an object with dimensions closer to the patient’s dimensions be used to better relate the results with the clinical condition, because the sample dimensions affect the amount of artifacts.
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Affiliation(s)
- Mahkameh Moshfeghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ingrid Różyło-Kalinowska
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Lublin, Poland
| | - Shiva Gandomi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Exploring the use of enhanced cone-beam CT technique to diagnose vertical root fracture. J Mech Behav Biomed Mater 2022; 130:105175. [DOI: 10.1016/j.jmbbm.2022.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/20/2022]
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Sawicki P, Zawadzki PJ, Regulski P. The Impact of Cone-Beam Computed Tomography Exposure Parameters on Peri-Implant Artifacts: A Literature Review. Cureus 2022; 14:e23035. [PMID: 35419219 PMCID: PMC8994570 DOI: 10.7759/cureus.23035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 01/09/2023] Open
Abstract
Cone-beam computed tomography (CBCT) amounts to an excellent diagnostic tool to evaluate the peri-implant bone thickness in all dimensions. Despite the unquestionable advantages of CBCT, potential artifacts around dental implants might disturb the proper assessment of the surrounding structures. The artifacts may mask osseointegration, shallow bone defects, and other types of radiolucency, which make it difficult to establish an early diagnosis of bone loss. Proper diagnosis of bone defect is necessary to decide about surgical intervention. The aim of this literature review is to assess the CBCT exposure causing artifacts on the peri-implant structures. An electronic search of MEDLINE (PubMed) database includes studies published before July 2021 and supplemented by manual research. Clinical, ex vivo, in vitro, and animal studies evaluating the relationship between exposition parameters and occurrence of artifacts around the dental implant in CBCT studies were included. A literature review revealed that kilovoltage, tube current, and field of view may affect the occurrence of artifacts around dental implants, all of which would compromise radiological evaluation. Therefore, it is feasible to reduce the incidence of artifacts and improve the image quality by appropriate modification of the exposure parameters. However, the reduction of artifacts is often associated with a significant increase in radiation exposure; hence, an effort should be made to minimize the radiation dose in line with the ALARA (as low as reasonably achievable) principle.
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Affiliation(s)
- Paweł Sawicki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery, and Implantology, Medical University of Warsaw, Warsaw, POL
| | - Paweł J Zawadzki
- Department of Cranio-Maxillofacial Surgery, Oral Surgery, and Implantology, Medical University of Warsaw, Warsaw, POL
| | - Piotr Regulski
- Department of Dental and Maxillofacial Radiology, Medical University of Warsaw, Warsaw, POL.,Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, POL
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In Vitro Quantitative Evaluation of Postprocessing Filter for Metal Artifact Reduction in Cone Beam Computed Tomography Images of Titanium and Zirconium Dioxide Implants. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1362473. [PMID: 35295958 PMCID: PMC8920685 DOI: 10.1155/2022/1362473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/25/2022] [Accepted: 02/16/2022] [Indexed: 11/17/2022]
Abstract
Objective To evaluate a postprocessing filter of a new imaging-processing software for analysis of metal artifact reduction. Methods Eight artificial edentulous mandibles (phantoms), where titanium and zirconium dioxide implants had been installed in four different regions (i.e., incisors, canine, premolars, and molars). CBCT volume was acquired, and then, four types of filters were applied to the images: BAR filter and Multi-CDT NR filter (e-Vol DX) and Sharpening Filters 1x and 2x (OnDemand). Artifact was assessed by measuring the standard deviation (SD) of the gray values of filtered and unfiltered images. The comparison between implant material, teeth, and filters was performed by using ANOVA, whereas multiple comparisons were performed by using Bonferroni's test. The level of significance adopted was 5%. Results The results showing higher SD values, which suggests a worse image, were obtained with titanium implants compared to zirconium dioxide ones. With regard to the four filters used, it can be seen that the lowest SD values were obtained with BAR and Multi-CDT NR filters and the highest with Sharpening Filters 1x and 2x, with no statistical difference between them, except regarding the molar region in titanium implants. Conclusion The highest SD values were seen in zirconium dioxide implants, mainly in the region of anterior teeth. The BAR filter was found to be the most effective as its SD value decreased significantly, indicating that the image quality was improved.
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AlMohareb RA, Barakat RM, Mehanny M. Quantitative Analysis of Cone-Beam Computed Tomography Artifacts Induced by Nonmetallic Root Canal Filling Materials Using Different Fields of View: In Vitro Study. SCANNING 2022; 2022:4829475. [PMID: 35282567 PMCID: PMC8888051 DOI: 10.1155/2022/4829475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 06/14/2023]
Abstract
Cone-beam computed tomography (CBCT) imaging artifacts can hinder accurate diagnosis of several conditions. The aim of this study was to quantify CBCT artifacts created by nonmetallic root canal filling materials using two fields of view (FOV). Root canals of twenty extracted maxillary central incisors (n = 20) were instrumented and randomly divided into four equal groups: canals in Group 1 were filled with gutta-percha, canals in Group 2 with mineral trioxide aggregate (MTA) and gutta-percha, canals in Group 3 with gutta-percha and glass-fiber posts, and canals in Group 4 with MTA and glass-fiber posts. Each tooth was mounted on a silicon block and scanned three times using a CBCT machine, first with a prefilling scan (control) and then with postfilling scans, using two different FOV (40∗50 mm and 80∗50 mm). Imaging software was used to measure grayscale pixel values of canal cross sections. Data were analyzed using t-test and paired t-test statistical tests, with statistical significance set at p ≤ 0.05. Dentin at the apical and middle third of the teeth showed a significant decrease in minimum grayscale values in association with gutta-percha (p = 0.027, p = 0.034). However, a wide 80∗50 FOV showed a significant increase in maximum grayscale values of coronal (p = 0.048) and apical dentin (p = 0.049). Glass-fiber posts in middle third cross sections also corresponded to an increase in maximum grayscale values (p = 0.018). Gutta-percha produced dark band artifacts in the root's middle and apical thirds, whereas white streak artifacts were produced by gutta-percha in the coronal third and glass-fiber posts in the coronal and middle thirds when imaged with a wider FOV. A smaller FOV is therefore recommended for CBCT imaging, as it produces fewer artifacts.
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Affiliation(s)
- Rahaf A AlMohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Reem M Barakat
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Mohamed Mehanny
- Basic Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Wang AHT, Panzarella FK, Fontana CE, Junqueira JLC, da Silveira Bueno CE. Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures. Imaging Sci Dent 2022; 53:11-19. [PMID: 37006793 PMCID: PMC10060756 DOI: 10.5624/isd.20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.
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Affiliation(s)
- Andréa Huey Tsu Wang
- Division of Endodontics, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Francine Kühl Panzarella
- Division of Oral Radiology, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Carlos Eduardo Fontana
- Division of Endodontics, Centre for Health Sciences, Pontifical Catholic University of Campinas, Campinas, Brazil
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Gregoris Rabelo LE, Bueno MDR, Costa MVCD, de Musis CR, Estrela CRDA, Guedes OA, Gavini G, Estrela C. Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts. Comput Biol Med 2021; 136:104679. [DOI: 10.1016/j.compbiomed.2021.104679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
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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: 15] [Impact Index Per Article: 5.0] [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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Coelho-Silva F, Gaêta-Araujo H, Rosado LPL, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. Distortion or magnification? An in vitro cone-beam CT study of dimensional changes of objects with different compositions. Dentomaxillofac Radiol 2021; 50:20210063. [PMID: 34111368 DOI: 10.1259/dmfr.20210063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess whether dimensional changes occur as shape distortion (unevenly), contraction or magnification (evenly) in cone beam computed tomography (CBCT) considering materials, anatomical regions and metal artefact reduction algorithms. METHODS Four cylinders of amalgam (Am), cobalt-chromium (Co-Cr), gutta-percha (Gu), titanium (Ti) and zirconium (Zi) were inserted inside a polymethylmethacrylate phantom in anterior and posterior regions for acquisitions in Picasso Trio and OP300 with MAR enabled and disabled. Two observers measured the dimensions of each cylinder in three axes: Y (height), Z (antero posterior diameter) and X (latero-lateral diameter). Repeated measures ANOVA with Tukey post-hoc test compared the data (α = 5%). RESULTS Shape distortion occurred for all materials in anterior region of Picasso Trio without MAR (p < 0.05). With MAR enabled, Gu and Ti contracted (p ≥ 0.05), while the others showed distortion (p < 0.05). In posterior region, all materials distorted in both MAR conditions (p < 0.05), except Gu, which magnified without MAR (p ≥ 0.05) and contracted unevenly with MAR (p < 0.05). In anterior region of OP300, all materials magnified without MAR, (p ≥ 0.05) and had shape distortion with MAR (p < 0.05). In posterior region, only Am showed magnification without MAR (p ≥ 0.05), while all materials presented shape distortion with MAR (p < 0.05). CONCLUSION Dimensional changes of high-density materials in CBCT can be either a magnification, a contraction or a distortion; the last condition is the most prevalent. Furthermore, changes differ considering material, anatomical region and MAR condition.
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Affiliation(s)
- Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Hugo Gaêta-Araujo
- Oral Radiology Section, School of Dentistry, Federal University of Alfenas, Minas Gerais, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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Salemi F, Jamalpour MR, Eskandarloo A, Tapak L, Rahimi N. Efficacy of Metal Artifact Reduction Algorithm of Cone-Beam Computed Tomography for Detection of Fenestration and Dehiscence around Dental Implants. J Biomed Phys Eng 2021; 11:305-314. [PMID: 34189119 PMCID: PMC8236107 DOI: 10.31661/jbpe.v0i0.2102-1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022]
Abstract
Background: Beam hardening and scattering artifacts from high-density objects such as dental implants adversely affect the image quality and subsequently the detection of fenestration or dehiscence around dental implants. Objective: This study aimed to assess the efficacy of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) systems for detection of peri-implant fenestration and dehiscence. Material and Methods: In this experimental study, thirty-six titanium implants were placed in bone blocks of bovine ribs. Fenestration and dehiscence were created in the buccal bone around implants.
CBCT images were obtained using Cranex 3D and ProMax 3D CBCT systems with and without MAR algorithm. Two experienced radiologists observed the images. Data were analyzed using SPSS software.
The Kappa coefficient of agreement, the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and accuracy of different imaging modalities were calculated and analyzed. Results: In both CBCT systems, the use of MAR algorithm decreased the area under the ROC curve and subsequently the diagnostic accuracy for the detection of fenestration and dehiscence.
The sensitivity, specificity and accuracy of both CBCT systems were higher in absence of the MAR algorithm. The specificity of ProMax 3D for detection of fenestration was equal with/without the MAR algorithm. Conclusion: Although CBCT is suitable for detection of peri-implant defects, the application of the MAR algorithm does not enhance the detection of peri-implant fenestration and dehiscence.
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Affiliation(s)
- Fatemeh Salemi
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Mohamad Reza Jamalpour
- MScD, Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, School of Dentistry, Hamadan university of Medical Science. Hamadan, Iran
| | - Amir Eskandarloo
- PhD, Department of Oral & Maxillofacial Radiology, School of Dentistry, Hamadan university of Medical Science, Hamadan, Iran
| | - Leili Tapak
- PhD, Department of Biostatistics, School of Health Modeling of Noncommunicable Diseases Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Rahimi
- DMD, General Dentist, Hamadan University of Medical Sciences, Hamadan, Iran
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Chen L, Liang X, Shen C, Nguyen D, Jiang S, Wang J. Synthetic CT generation from CBCT images via unsupervised deep learning. Phys Med Biol 2021; 66. [PMID: 34061043 DOI: 10.1088/1361-6560/ac01b6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/14/2021] [Indexed: 11/12/2022]
Abstract
Adaptive-radiation-therapy (ART) is applied to account for anatomical variations observed over the treatment course. Daily or weekly cone-beam computed tomography (CBCT) is commonly used in clinic for patient positioning, but CBCT's inaccuracy in Hounsfield units (HU) prevents its application to dose calculation and treatment planning. Adaptive re-planning can be performed by deformably registering planning CT (pCT) to CBCT. However, scattering artifacts and noise in CBCT decrease the accuracy of deformable registration and induce uncertainty in treatment plan. Hence, generating from CBCT a synthetic CT (sCT) that has the same anatomical structure as CBCT but accurate HU values is desirable for ART. We proposed an unsupervised style-transfer-based approach to generate sCT based on CBCT and pCT. Unsupervised learning was desired because exactly matched CBCT and CT are rarely available, even when they are taken a few minutes apart. In the proposed model, CBCT and pCT are two inputs that provide anatomical structure and accurate HU information, respectively. The training objective function is designed to simultaneously minimize (1) contextual loss between sCT and CBCT to maintain the content and structure of CBCT in sCT and (2) style loss between sCT and pCT to achieve pCT-like image quality in sCT. We used CBCT and pCT images of 114 patients to train and validate the designed model, and another 29 independent patient cases to test the model's effectiveness. We quantitatively compared the resulting sCT with the original CBCT using the deformed same-day pCT as reference. Structure-similarity-index, peak-signal-to-noise-ratio, and mean-absolute-error in HU of sCT were 0.9723, 33.68, and 28.52, respectively, while those of CBCT were 0.9182, 29.67, and 49.90, respectively. We have demonstrated the effectiveness of the proposed model in using CBCT and pCT to synthesize CT-quality images. This model may permit using CBCT for advanced applications such as adaptive treatment planning.
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Affiliation(s)
- Liyuan Chen
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
| | - Xiao Liang
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
| | - Chenyang Shen
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
| | - Dan Nguyen
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
| | - Steve Jiang
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
| | - Jing Wang
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX 75390 United States of America
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Gao A, Cao D, Lin Z. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience. Dentomaxillofac Radiol 2021; 50:20200407. [PMID: 33237813 DOI: 10.1259/dmfr.20200407] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cone-beam computed tomography (CBCT) has been widely used in diagnosis of vertical root fractures (VRFs) in recent years. According to the American Association of Endodontists (AAE) classification, there are five types of cracked teeth and VRF is one of them. Due to the variability and overlapping of the cracks and fractures, some narrow fractures on the roots of VRFs could not be detected by CBCT, and some wide cracks on the crown of cracked teeth could be detected by CBCT. In this review, we firstly discussed the value of CBCT in the diagnosis of the AAE five types of cracked teeth and presented CBCT manifestations of some typical cases. Secondly, we summarized the factors influencing the diagnosis of cracks/fractures using CBCT, namely, CBCT device-related factors, patient-related factors, and evaluator-related factors. The possible strategies to improve the diagnostic accuracy in the clinic practice are also discussed in this part. Finally, we compared the differences of root fractures with lateral canals and external root resorption on CBCT images.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dantong Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Oliveira MR, Sousa TO, Caetano AF, de Paiva RR, Valladares-Neto J, Yamamoto-Silva FP, Silva MAG. Influence of CBCT metal artifact reduction on vertical radicular fracture detection. Imaging Sci Dent 2021; 51:55-62. [PMID: 33828962 PMCID: PMC8007395 DOI: 10.5624/isd.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45–0.72), sensitivity (0.6–0.67), and specificity (0.23–0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68–0.77, 0.67–083, and 0.53–087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.
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Affiliation(s)
- Mariana Rodrigues Oliveira
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Aline Ferreira Caetano
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Rogério Ribeiro de Paiva
- Department of Oral Radiology, School of Dentistry, Anápolis University Centre, Anápolis, Goiás, Brazil
| | - José Valladares-Neto
- Department of Oral Rehabilitation, Division of Orthodontics, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Caetano AP, Sousa TO, Oliveira MR, Evanglista K, Bueno JM, Silva MA. Accuracy of three cone-beam CT devices and two software systems in the detection of vertical root fractures. Dentomaxillofac Radiol 2021; 50:20200334. [PMID: 33259236 DOI: 10.1259/dmfr.20200334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the accuracy of vertical root fracture (VRF) detection using three tomography devices and two software systems in teeth with different endodontic fillings. METHODS The sample consisted of 45 premolars divided into 3 groups: No filling (NF, n=15); Gutta percha (GP, n=15) and Metallic Post (MP, n=15). Cone-beam computed tomography (CBCT) images were acquired in Kodak 9000 3D, Orthopantomography 300 (OP300) and PreXion 3D devices, before and after induced root fractures. Two oral radiologists analyzed all images using InVivoDental and e-Vol DX software systems. The analysis was repeated after 15 days in 30% of the sample. Data analysis compared receiver operating characteristic (ROC) curves, as well the areas under the ROC curves. Accuracy, sensitivity, specificity, positive and negative predictive value were calculated according to each tomographic device and software. Intra- and interexaminer reliability were tested using the Kappa coefficient. RESULTS The highest accuracy was seen in the image set from the PreXion 3D, using InVivo (0.96) or e-Vol DX (0.92) in image analysis. The OP300 device presented a similar performance of the PreXion 3D in teeth with different endodontic fillings. When using e-Vol DX, the accuracy of Kodak 9000 3D improved from 0.62 to 0.74. CONCLUSIONS The PreXion 3D device is the most accurate when detecting VRF, with a performance similar to the OP300 in endodontic filled teeth. Kodak 9000 3D is indicated for teeth without fillings, with better accuracy using e-Vol DX software.
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Affiliation(s)
- Aline Pf Caetano
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Mariana R Oliveira
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Karine Evanglista
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Juliano M Bueno
- São Leopoldo Mandic, Private Practioner, Goiânia, Goiás, Brazil
| | - Maria Ag Silva
- Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Min CK, Kim KA. Quantitative analysis of metal artefacts of dental implant in CBCT image by correlation analysis to micro-CT: A microstructural study. Dentomaxillofac Radiol 2021; 50:20200365. [PMID: 33002369 DOI: 10.1259/dmfr.20200365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Quantification of dental implant metal artefacts in CBCT images using correlation analysis of trabecular microstructural parameters from CBCT and micro-CT, and analysis of the effect of varying the angular position of the subject. METHODS Polyurethane synthetic bone blocks were first scanned without implants by micro-CT and CBCT. Two dental implants were then placed parallel in the bone blocks and these specimens were scanned by CBCT with different alpha angles. Three volumes of interest (VOI) were set for further analysis. Six microstructural parameters were measured: trabecular thickness (TbTh), trabecular spacing (ThSp), bone volume per total volume (BV/TV), bone surface per total volume (BS/TV), connectivity density (CD) andfractal dimension (FD). Micro-CT measurements were used as a gold standard for CBCT. Spearman correlation coefficients for each microstructural parameter from CBCT and micro-CT were calculated and compared using Steiger's Z test. RESULTS Without the implants, in VOI1, the Spearman correlation coefficients of TbTh, TbSp, BV/TV, BS/TV, CD and FD were 0.599, 0.76, 0.552, 0.566, 0.664 and 0.607, respectively. With the implants, the correlation coefficients decreased sharply in VOI1. As the alpha angle increased from zero to 90°, the correlation coefficients increased and became significant. Similar results appeared in VOI2. In contrast, in VOI3, the correlation coefficient decreased as the alpha angle increased. CONCLUSIONS Metal artefacts were successfully quantified using microstructural parameters in terms of the image quality of the CBCT. Changes in alpha angle affected the quality of the CBCT image.
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Affiliation(s)
- Chang-Ki Min
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, South Korea.,Department of Oral and Maxillofacial Radiology, School of Dentistry, Backjedaero 567, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
| | - Kyoung-A Kim
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, South Korea.,Department of Oral and Maxillofacial Radiology, School of Dentistry, Backjedaero 567, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
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Shahmirzadi S, Sharaf RA, Saadat S, Moore WS, Geha H, Tamimi D, Demirturk Kocasarac H. Assessment of the efficiency of a pre- versus post-acquisition metal artifact reduction algorithm in the presence of 3 different dental implant materials using multiple CBCT settings: An in vitro study. Imaging Sci Dent 2021; 51:1-7. [PMID: 33828955 PMCID: PMC8007401 DOI: 10.5624/isd.20200094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose The aim of this study was to assess artifacts generated in cone-beam computed tomography (CBCT) of 3 types of dental implants using 3 metal artifact reduction (MAR) algorithm conditions (pre-acquisition MAR, postacquisition MAR, and no MAR), and 2 peak kilovoltage (kVp) settings. Materials and Methods Titanium-zirconium, titanium, and zirconium alloy implants were placed in a dry mandible. CBCT images were acquired using 84 and 90 kVp and at normal resolution for all 3 MAR conditions. The images were analyzed using ImageJ software (National Institutes of Health, Bethesda, MD) to calculate the intensity of artifacts for each combination of material and settings. A 3-factor analysis of variance model with up to 3-way interactions was used to determine whether there was a statistically significant difference in the mean intensity of artifacts associated with each factor. Results The analysis of all 3 MAR conditions showed that using no MAR resulted in substantially more severe artifacts than either of the 2 MAR algorithms for the 3 implant materials; however, there were no significant differences between pre- and post-acquisition MAR. The 90 kVp setting generated less intense artifacts on average than the 84 kVp setting. The titanium-zirconium alloy generated significantly less intense artifacts than zirconium. Titanium generated artifacts at an intermediate level relative to the other 2 implant materials, but was not statistically significantly different from either. Conclusion This in vitro study suggests that artifacts can be minimized by using a titanium-zirconium alloy at the 90 kVp setting, with either MAR setting.
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Affiliation(s)
- Solaleh Shahmirzadi
- Department of Diagnostic Sciences, Division of Oral and Maxillofacial Radiology, Texas A&M College of Dentistry, Dallas, TX, USA
| | - Rana A Sharaf
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Sarang Saadat
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center, San Antonio, TX, USA
| | - William S Moore
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Hassem Geha
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Dania Tamimi
- Private Practice, Oral and Maxillofacial Radiology, Orlando, FL, USA
| | - Husniye Demirturk Kocasarac
- Department of General Dental Sciences, Division of Oral and Maxillofacial Radiology, Marquette University School of Dentistry, Milwaukee, WI, USA
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Hedayatipanah M, Salemi F, Kamyari N, Yalpanian A. Measurement of Peri-Implant Bone Width with and without Metal Artifact Reduction Algorithm Using Two Cone-Beam Computed Tomography Software Programs. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Muellensiefen M, Tins B, Kuiper JH, Weber MA, Krakowski-Roosen H. Development of a total hip replacement phantom for the assessment of CT-image quality. Acta Radiol 2020; 61:1644-1652. [PMID: 32151141 DOI: 10.1177/0284185120907981] [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: 11/16/2022]
Abstract
BACKGROUND The quality of computed tomography (CT) imaging is important when used to judge the success of joint replacement surgery. Metal artefacts are a known source of error, typically compensated by noise reduction software. PURPOSE To develop a transportable and stable system for the assessment of image quality of bone lesions around orthopedic implants. MATERIAL AND METHODS The design and manufacture of a bone-implant-phantom is described, which is based on a calf acetabulum with surrounding pelvic bone structures. Bone lesions of several sizes were created in the acetabulum before implanting the cup of an uncemented hip prosthesis, which was fixed with a stainless-steel bone screw. Plastic strips were placed on a cobalt-chromium stemmed femoral component, simulating typical bone lesions around loosening or infected prostheses, before embedding the stem in material similar to bone and shaped like a femur. The head of the femoral component was then placed in the acetabular cup and CT scans were produced. RESULTS It was possible to construct a durable CT hip phantom for quality assurance work. The usability of different materials and the choices made for the phantom are discussed. CONCLUSION It is possible to construct a durable joint implant phantom for quality assurance and scanner hardware and software assessment with limited resources. The phantom was successfully used in the assessment of the hardware and software performance of different CT scanners.
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Affiliation(s)
- Mara Muellensiefen
- Applied Sport Sciences, University of Applied Sciences Hamm-Lippstadt, Hamm, Germany
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Bernhard Tins
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Jan-Herman Kuiper
- Institute for Science and Technology in Medicine, Keele University/Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany
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Estrela C, Costa MVC, Bueno MR, Rabelo LEG, Decurcio DA, Silva JA, Estrela CRA. Potential of a New Cone-Beam CT Software for Blooming Artifact Reduction. Braz Dent J 2020; 31:582-588. [DOI: 10.1590/0103-6440202005899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/01/2020] [Indexed: 12/19/2022] Open
Abstract
Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.
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Affiliation(s)
| | | | - Mike R Bueno
- Faculdade São Leopoldo Mandic, Brazil; CROIF Oral Radiology Center, Brazil
| | | | | | | | - Cyntia R A Estrela
- Universidade de Cuiabá, Brazil; Centro Universitário de Anápolis, Brazil
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A dual scan approach to creating an accurate dental surface for virtual implant planning: A dental technique. J Prosthet Dent 2020; 126:464-470. [PMID: 32972712 DOI: 10.1016/j.prosdent.2020.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022]
Abstract
Artifacts from metal restorations can make it challenging or impossible to accurately orient a digital dental cast to cone beam computed tomography (CBCT) scan data for virtual implant planning. A dual scan technique is described that uses an alginate impression with fiducial markers in a stock tray to create a digital dental cast that is precisely oriented to the scan in the same patient coordinate system for surgical guide design.
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Fontenele RC, Farias Gomes A, Nejaim Y, Freitas DQ. Do the tube current and metal artifact reduction influence the diagnosis of vertical root fracture in a tooth positioned in the vicinity of a zirconium implant? A CBCT study. Clin Oral Investig 2020; 25:2229-2235. [PMID: 32827079 DOI: 10.1007/s00784-020-03538-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
AIM To evaluate the influence of the tube current and metal artifact reduction (MAR) tool on the diagnosis of vertical root fractures (VRF) in a tooth adjacent to a zirconium implant, in cone-beam computed tomography (CBCT) images. METHODOLOGY Thirty single-rooted teeth (15 with VRF and 15 control group) were individually positioned in a mandible, and scanned with the OP300 CBCT unit. Images were acquired using a standardized protocol: 5 × 5 cm field of view, 0.08-mm voxel size, and 90 kVp. Each tooth was scanned with and without a zirconium implant in its vicinity, using different tube currents (4 mA, 8 mA, and 10 mA) and conditions of MAR (enabled × disabled). Diagnostic values were calculated for each protocol, and compared by multi-way analysis of variance. RESULTS The ROC curve and sensitivity values did not differ significantly among the tube currents, regardless of the presence of the implant and MAR condition (p > 0.05). There were also no significant differences among the tube currents for the specificity values (p > 0.05); however, the specificity differed significantly between the "with implant" and "without implant" conditions, within the same MAR condition and tube current (p < 0.05). Specificity was significantly lower when the implant was present (p < 0.05). CONCLUSION The presence of a zirconium implant impairs the diagnosis of VRF in teeth adjacent to the artifact-generator material. Neither the tube current nor the MAR tool is effective in improving this diagnostic task. Therefore, in this clinical scenario, the use of the lowest tube current (4 mA), without MAR activation, is recommended. CLINICAL RELEVANCE Considering that the tube current is one of the main factors that influence the radiation dose and image quality in CBCT, and that metal artifacts negatively influence the diagnosis of VRF in areas adjacent to the artifact-generator material, it is important to evaluate the effect of this energetic parameter in the diagnosis of VRF in teeth adjacent to zirconium implants.
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Affiliation(s)
- Rocharles C Fontenele
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Yuri Nejaim
- Oral Radiology Area, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Deborah Q Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Avenida Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
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Influence of the Intracanal Material and Metal Artifact Reduction Tool in the Detection of the Second Mesiobuccal Canal in Cone-beam Computed Tomographic Examinations. J Endod 2020; 46:1067-1073. [DOI: 10.1016/j.joen.2020.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 11/22/2022]
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Reducing metal artifacts between implants in cone-beam CT by adjusting angular position of the subject. Oral Radiol 2020; 37:385-394. [PMID: 32638201 DOI: 10.1007/s11282-020-00458-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/19/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To reduce inter-implant metal artifacts in cone-beam CT (CBCT) imaging by adjusting angular position of the subject relative to the source-detector plane. MATERIALS AND METHODS Two dental implants were placed in a block made of homogeneous dental impression material. Using a custom-made apparatus, the specimen was scanned with a CBCT machine at seven different angles (0°, 15°, 30°, 45°, 60°, 75°, and 90°) along three different spatial axes, yielding 21 experimental groups. Thirteen volumes of interest (VOI) including inter- and peri-implant areas were selected from each axial reconstruction perpendicular to the implants. Gray values (GVs) of each pixel within these VOIs were measured. Mean differences in GV (ΔGV) between the VOIs and control area were calculated and expressed as a percentage. These ΔGVs from different spatial angle were compared and analyzed by Welch's analysis of variance (ANOVA) and linear regression using SPSS 25.0 software. RESULTS As alpha angle increased, the ΔGV of the inter-implant area increased from - 62.02% to near-zero while the standard deviation decreased. Welch's ANOVA and linear regression analysis revealed ΔGV increased significantly with alpha angle (p < 0.001, R2 = 0.406). VOIs on the extension line of two implants showed similar results. After adjusting the beta and gamma angles, there was no significant change in ΔGV. CONCLUSIONS Increasing the alpha angle can reduce metal artifacts in the inter-implant area in CBCT images.
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Coelho-Silva F, Martins LAC, Braga DA, Zandonade E, Haiter-Neto F, de-Azevedo-Vaz SL. Influence of windowing and metal artefact reduction algorithms on the volumetric dimensions of five different high-density materials: a cone-beam CT study. Dentomaxillofac Radiol 2020; 49:20200039. [PMID: 32543940 DOI: 10.1259/dmfr.20200039] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To assess the influence of windowing and metal artefact reduction (MAR) algorithms on the volumetric dimensions of high-density materials using two CBCT systems. METHODS Four cylinders of amalgam, cobalt-chromium, gutta-percha, titanium and zirconium, were manufactured and their physical volumes (PV) were measured. A polymethyl methacrylate phantom containing the cylinders was submitted to CBCT acquisitions with Picasso Trio and OP300 units with their MAR enabled and disabled. The tomographic volume (TV) of all the cylinders was obtained by semi-automatic segmentation using two windowing adjustments: W1-large window width and upper window level; W2-narrow window width and low window level. Volumetric distortion was expressed as the difference between TV and PV. Statistics comprised intraclass correlation coefficient (ICC) and analysis of variance (ANOVA) for repeated measures with Tukey post hoc test (α = 5%). RESULTS The ICC values indicated excellent reproducibility of TV. Gutta-percha and titanium resulted in the smallest volumetric distortion. Using W1 provided less volumetric distortion for almost all experimental conditions (p < 0.05). Activating MAR algorithm of Picasso Trio underestimated gutta-percha and titanium TV (p < 0.05) and was inefficient in significantly reducing the volumetric distortion of the other materials (p > 0.05). Disabling MAR algorithm of OP300 resulted in smaller volumetric distortion for almost all experimental conditions (p < 0.05). CONCLUSIONS The TV of gutta-percha and titanium were closer to the PV. In general, the MAR algorithms of both systems were inefficient in significantly reducing the volumetric distortion of high-density materials. We encourage the use of large window width and upper window level to evaluate high-density materials.
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Affiliation(s)
- Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Daniela Azeredo Braga
- Bachelor of Statistics in progress, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Eliana Zandonade
- Department of Statistics, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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McGuigan MB, Theodorakou C, Duncan HF, Davies J, Sengupta A, Horner K. An investigation into dose optimisation for imaging root canal anatomy using cone beam CT. Dentomaxillofac Radiol 2020; 49:20200072. [PMID: 32464075 DOI: 10.1259/dmfr.20200072] [Citation(s) in RCA: 4] [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 identify a dose as low as diagnostically acceptable and a threshold level of image quality for cone beam CT (CBCT) imaging root canals, using maxillary first molar (M1M) second mesiobuccal (MB2) canals of varying complexity for two CBCT scanners. METHODS Dose-area product (DAP) and contrast-to-noise ratio (CNR) were measured for two scanners at a range of exposure parameters. Subjective-image-quality assessment at the same exposures was performed for three M1Ms of varying MB2 complexity, positioned in an anthropomorphic phantom. Nine raters (three endodontists, three dental radiologists and three junior staff) assessed canal visibility, using a 5-point confidence scale rating. RESULTS Identification of simple-moderate MB2 canal complexity was achieved at a range of protocols, with DAP values of ≥209.3 and ≥203.2 mGy cm² and CNRs of 3 and 7.6 for Promax®3D and Accuitomo-F170® respectively. For complex canal anatomy, target subjective image quality was not achieved, even at the highest DAP values for both scanners. Junior staff classified significantly more images as undiagnostic compared with senior staff (p = 0.043). CONCLUSIONS In this first study to address optimisation of CBCT imaging of root canal anatomy, a similar threshold dose for both scanners was identified for M1Ms with simple-moderate MB2 canal complexity. Increasing dose to enhance visualisation of more complex canal anatomy was ineffective. Selection of standard protocols (while avoiding lower kV/mA protocols) instead of high-resolution scans was a practical means of reducing patient dose. CNR is not a transferable measure of image quality.
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Affiliation(s)
| | - Christie Theodorakou
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
| | - Henry F Duncan
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Jonathan Davies
- Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anita Sengupta
- Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, UK
| | - Keith Horner
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland.,Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, UK
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de Faria Vasconcelos K, Queiroz PM, Codari M, Pinheiro Nicolielo LF, Freitas DQ, Jacobs R, Haiter-Neto F. A quantitative analysis of metal artifact reduction algorithm performance in volume correction with 3 CBCT devices. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:328-335. [PMID: 32439517 DOI: 10.1016/j.oooo.2020.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/20/2020] [Accepted: 03/31/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to quantitatively assess the performance of metal artifact reduction (MAR) algorithms on the volume of metal cylinders, considering the influence of materials, positions, and fields of view (FOVs), by using 3 cone beam computed tomography (CBCT) devices (NewTom VGi evo, Picasso Trio, and ProMax 3-D Max). STUDY DESIGN Nine phantoms containing cylinders of amalgam, copper-aluminum (CuAl) metal alloy, and titanium, combined in up to 3 positions, were scanned by using 2 different FOVs. MATLAB software was used to evaluate the differences between volumes before and after MAR application, and the possible interference of materials, positions, and FOVs. Wilcoxon's test and the Kruskal-Wallis test were used at a level of significance of 5%. RESULTS In general, images containing amalgam and CuAl showed a significant difference in volume before and after MAR application. However, no significant difference after MAR was observed (P > .05) relative to positions and FOVs. MAR had an impact on the cylinder volumes only in the NewTom VGi evo and ProMax 3-D Max scanners. CONCLUSIONS The performance of MAR algorithms in volume correction of metal objects is dependent on the materials and the CBCT unit.
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Affiliation(s)
- Karla de Faria Vasconcelos
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil.
| | - Polyane Mazucatto Queiroz
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Marina Codari
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Laura Ferreira Pinheiro Nicolielo
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Sao Paulo, Brazil
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Martins LAC, Queiroz PM, Nejaim Y, Vasconcelos KDF, Groppo FC, Haiter-Neto F. Evaluation of metal artefacts for two CBCT devices with a new dental arch phantom. Dentomaxillofac Radiol 2020; 49:20190385. [PMID: 32155087 DOI: 10.1259/dmfr.20190385] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To create a new phantom design to evaluate the real impact of artefacts caused by titanium on bone structures in cone beam CT images considering different positions and quantity of metals in the dental arch, with and without metal artefact reduction (MAR). METHODS A three cylindrical polymethyl methacrylate (PMMA) plate phantom was designed containing eight perforations arranged to simulate the lower dental arch in the intermediate plate. Three titanium cylinders were positioned in different locations and quantities to test different clinical conditions and to quantify the impact of the metal artefact around five bone cylinders. Scans were carried out in seven different protocols (Control, A-F) in two cone beam CT devices (OP300 Maxio and Picasso Trio). Eight regions of interest around each cortical and trabecular bone were used to measure the grey value standard deviation corresponding the artefact expression in the Image J software. Both the artefact expression and the MAR effect were assessed using the Wilcoxon, Friedman (Dunn) and Kruskal-Wallis tests (significance level of 5%). RESULTS For both devices, MAR was statistically efficient only for the protocols E, and F. Protocol F (three metals on the adjacent area of the analysis region) showed higher artefact expression when compared to the others. CONCLUSION In conclusion, the new phantom design allowed the quantification of the metal artefact expression caused by titanium. The metal artefact expression is higher when more metal objects are positioned in the adjacent bone structures. MAR may not be effective to reduce artefact expression on the adjacencies of those objects for the devices studied.
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Affiliation(s)
- Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Polyane Mazucatto Queiroz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Yuri Nejaim
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Karla de Faria Vasconcelos
- Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Division of Pharmacology, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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49
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Chen L, Liang X, Shen C, Jiang S, Wang J. Synthetic CT generation from CBCT images via deep learning. Med Phys 2020; 47:1115-1125. [PMID: 31853974 PMCID: PMC7067667 DOI: 10.1002/mp.13978] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 10/18/2019] [Accepted: 12/11/2019] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Cone-beam computed tomography (CBCT) scanning is used daily or weekly (i.e., on-treatment CBCT) for accurate patient setup in image-guided radiotherapy. However, inaccuracy of CT numbers prevents CBCT from performing advanced tasks such as dose calculation and treatment planning. Motivated by the promising performance of deep learning in medical imaging, we propose a deep U-net-based approach that synthesizes CT-like images with accurate numbers from planning CT, while keeping the same anatomical structure as on-treatment CBCT. METHODS We formulated the CT synthesis problem under a deep learning framework, where a deep U-net architecture was used to take advantage of the anatomical structure of on-treatment CBCT and image intensity information of planning CT. U-net was chosen because it exploits both global and local features in the image spatial domain, matching our task to suppress global scattering artifacts and local artifacts such as noise in CBCT. To train the synthetic CT generation U-net (sCTU-net), we include on-treatment CBCT and initial planning CT of 37 patients (30 for training, seven for validation) as the input. Additional replanning CT images acquired on the same day as CBCT after deformable registration are utilized as the corresponding reference. To demonstrate the effectiveness of the proposed sCTU-net, we use another seven independent patient cases (560 slices) for testing. RESULTS We quantitatively compared the resulting synthetic CT (sCT) with the original CBCT image using deformed same-day pCT images as reference. The averaged accuracy measured by mean absolute error (MAE) between sCT and reference CT (rCT) on testing data is 18.98 HU, while MAE between CBCT and rCT is 44.38 HU. CONCLUSIONS The proposed sCTU-net can synthesize CT-quality images with accurate CT numbers from on-treatment CBCT and planning CT. This potentially enables advanced CBCT applications for adaptive treatment planning.
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Affiliation(s)
- Liyuan Chen
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | | | - Chenyang Shen
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Steve Jiang
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Jing Wang
- Medical Artificial Intelligence and Automation (MAIA) Lab, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
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Candemil AP, Salmon B, Freitas DQ, Haiter-Neto F, Oliveira ML. Distribution of metal artifacts arising from the exomass in small field-of-view cone beam computed tomography scans. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:116-125. [PMID: 32057753 DOI: 10.1016/j.oooo.2020.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/11/2019] [Accepted: 01/10/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate the distribution of metal artifacts from the exomass in small field-of-view (FOV) cone beam computed tomography (CBCT) scans. STUDY DESIGN An image phantom was scanned by using 3 CBCT units. Metal objects were positioned in the exomass, and additional CBCT scans were obtained. Mean gray values were obtained from 16 homogeneous areas and the standard deviation was calculated to quantify gray level inhomogeneity according to distinct zones of the FOV: total area and outer, inner, right, left, and mid-zones. The discrepancy between each zone and the total area was calculated to compare different CBCT units. Mean gray, gray level inhomogeneity, and discrepancy values were separately assessed by using analysis of variance (ANOVA) and Tukey's test (α = 0.05). RESULTS Overall, the mean gray values were significantly lower in the inner zone, and the gray level inhomogeneity values were significantly higher in the inner and mid-zones irrespective of the presence of metal objects in the exomass. The 3 CBCT units presented significantly different discrepancy values in most conditions. CONCLUSIONS The distribution of metal artifacts from the exomass follows the inherent gray value dispersion of CBCT images, with greater inhomogeneity in the inner zone of the FOV. This is exacerbated when metal objects are in the exomass.
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Affiliation(s)
- Amanda P Candemil
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba (São Paulo), Brazil.
| | - Benjamin Salmon
- Université de Paris, Orofacial Pathologies, Imaging and Biotherapies EA2496 Lab, Montrouge, France; Dental Medicine Department, AP-HP, Bretonneau Hospital, Paris, France
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba (São Paulo), Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba (São Paulo), Brazil
| | - Matheus Lima Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba (São Paulo), Brazil
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