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Van Acker JWG, Yvergneaux C, Jacquet W, Dierens M, Hommez G, Van Acker J, Boone M, Rajasekharan S, Martens LC. Vertical root fracture detection with cone-beam computed tomography in Biodentine™ filled teeth. BMC Oral Health 2024; 24:1178. [PMID: 39367348 PMCID: PMC11453024 DOI: 10.1186/s12903-024-04947-7] [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: 06/28/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
PURPOSE This study aimed to evaluate the accuracy of detecting vertical root fractures in Biodentine™-filled teeth using the Promax 3Dmax cone-beam computed tomography (CBCT) unit compared to periapical radiographs. It tested hypotheses regarding CBCT's diagnostic superiority in non-root-filled and Biodentine™-root-filled maxillary central incisors and assessed the impact of smaller field of view and lower intensity settings on detection accuracy. MATERIALS AND METHODS Extracted maxillary incisors were divided into groups based on fracture status and root filling material, then placed in a Thiel-embalmed skull to simulate clinical conditions. The teeth were imaged using periapical radiographs and the CBCT unit under different settings. Fracture thickness was measured with microcomputed tomography for accuracy benchmarking. Multiple observers assessed the images, and statistical analyses were conducted to evaluate diagnostic performance. RESULTS Intra-rater reliabilities of consensus scores ranged from good to very good. Specificities were generally higher than sensitivities across all imaging modalities, but sensitivities remained constantly low. None of the Area Under the Curve scores exceeded 0.6, indicating poor overall accuracy for all imaging modalities. Paired comparisons of the area differences under Receiver Operator Characteristic curves revealed no significant differences between the CBCT and periapical radiograph techniques for detecting vertical root fractures in either Biodentine™-filled or non-root-filled teeth. CONCLUSIONS There was no significant accuracy improvement of the current CBCT device (Promax 3Dmax, Planmeca, Finland) over periapical radiographs in detecting small vertical root fractures in both non-root-filled and Biodentine™-root-filled maxillary central incisors. A smaller field of view with lower intensity did not enhance detection accuracy. These results highlight the challenges in accurately detecting small VRFs, emphasizing the need for further research and technological advancements in this domain.
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Affiliation(s)
- Jakob W G Van Acker
- ELOHA (Equal Lifelong Oral Health for All) research group, Paediatric Dentistry, Oral Health Sciences, Ghent University, Ghent, Belgium.
| | - Charlotte Yvergneaux
- ELOHA (Equal Lifelong Oral Health for All) research group, Paediatric Dentistry, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Wolfgang Jacquet
- Localities Ontologies Commons Integrated (LOCI), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Melissa Dierens
- Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Geert Hommez
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
| | - Joris Van Acker
- UGent-Woodlab - Laboratory of Wood Technology, Department of Environment, Ghent University, Coupure links 653, Ghent, 9000, Belgium
- Centre for X-ray Tomography, Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Matthieu Boone
- Centre for X-ray Tomography, Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Sivaprakash Rajasekharan
- ELOHA (Equal Lifelong Oral Health for All) research group, Paediatric Dentistry, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Luc C Martens
- ELOHA (Equal Lifelong Oral Health for All) research group, Paediatric Dentistry, Oral Health Sciences, Ghent University, Ghent, Belgium
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Bozok E, Ozel A, Akkoyun EF, Dolanmaz E. Mandible-First and Maxilla-First Sequencing in Virtual Surgical Planning for Orthognathic Surgery: Comparison of Planned and Actual Outcomes. EAR, NOSE & THROAT JOURNAL 2024:1455613241280003. [PMID: 39314059 DOI: 10.1177/01455613241280003] [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: 09/25/2024] Open
Abstract
Background: Recent studies have shown that virtual planning for orthognathic surgery is an accurate and repeatable method. It is also a fact that surgical sequence can affect the results in terms of accuracy. Various studies stated that both approaches offer comparable results when properly planned and implemented; however, further clinical studies are still needed. This study aims to evaluate the effect of virtual surgical planning (VSP) on surgical outcomes and whether it is affected by mandible-first or maxilla-first approaches. Methods: This study analyzed data from 45 patients who underwent orthognathic surgery due to dentofacial deformity. Six of these patients underwent single-jaw orthognathic surgery, and 39 underwent bimaxillary orthognathic surgery (Maxilla-first group: 21, mandible-first group: 18). The displacements of specific landmarks were assessed by comparing preoperative and postoperative conventional computed tomographies with VSP data. Results: This study showed a statistically significant relationship between the measurements made with the 2 methods (r = .944; P = .0001). The fact that the intra-class correlation coefficient value is statistically significant and relatively high and that most of the differences in the Bland-Altman chart fall between the limits of compliance indicates a correlation between the virtual plan and surgical outcomes. In addition, in vertical measurements, the absolute mean difference of the B point and the Pogonion in the Maxilla-first group were statistically significantly higher than in the Mandible-first group (P = .038, P = .011). Conclusions: Our findings corroborate the high accuracy of the VSP reported in previous studies and also demonstrate that VSP with both maxilla-first and mandible-first sequencing achieves high accuracy in the sagittal and coronal planes. Although virtual planning significantly influences accurate surgical outcomes, it is not the sole determinant. Factors like condylar positioning and fixation methods can also impact the final results.
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Affiliation(s)
- Ece Bozok
- Department of Orthodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye
- Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye
| | - Abdullah Ozel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye
| | - Emine Fulya Akkoyun
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Türkiye
| | - Elvan Dolanmaz
- Department of Orthodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye
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Rodriguez Betancourt A, Kripfgans OD, Meneghetti PC, Mendonça G, Pereira R, Teixeira W, Zambrana N, Samal A, Chan HL. Intraoral ultrasonography image registration for evaluation of partial edentulous ridge: A methodology and validation study. J Dent 2024; 148:105136. [PMID: 38885734 DOI: 10.1016/j.jdent.2024.105136] [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: 11/23/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Ultrasound (US) reveals details for diagnosing soft- and hard-tissue dimensions around teeth, implants, and the edentulous ridge, not seen in 2D radiographs. Co-registering free-hand US scans with other 3D modalities presents reliability challenges. This study first aims to develop and validate a registration method to longitudinally reproduce US images of the jawbone on a simulator. In addition, it also evaluates the degree of the anatomical match in humans between US images acquired by the proposed registration method and the commonly used freehand acquisitions in comparison to cone beam computed tomography (CBCT) and intra-oral optical scan (IOS), used as references. METHODS A previously introduced ultrasound phantom was employed as a CBCT-US hybrid, suitable for training and technique development of US guides in edentulous ridges. After establishing feasibility in the phantom, the methodology was validated in a cohort of 24 human subjects (26 cases). Soft tissues were delineated on US and IOS, and hard tissues on US and CBCT. US accuracy and repeatability from both guided and freehand scans (non-guided) was assessed as the average distance between US and the references. RESULTS Guided US images resembled the references more closely than freehand (non-guided) scans. Notably, delineation of soft and hard tissues was significantly more accurate when employing guides. In the phantom, guided scans exhibited an absolute mean deviation of 81.8 µm for gingiva and 90.4 µm for bone, whereas non-guided scans showed deviations of 150.4 µm and 177.2 µm, respectively. Similarly, in vivo, guided US outperformed non-guided US, with gingiva deviations of 125 µm and 196 µm, and bone deviations of 354 µm and 554 µm, respectively. CONCLUSIONS By using a registration method, guided US scans improved repeatability and accuracy of mapping hard and soft tissue of the edentulous ridge when compared to non-guided scans. CLINICAL RELEVANCE This guided US imaging method could lay the foundation for longitudinal evaluation of tissue behavior and dimensional changes with improved accuracy.
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Affiliation(s)
- Amanda Rodriguez Betancourt
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, University of Illinois Chicago, College of Dentistry, Chicago, IL, USA
| | - Oliver D Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Priscila Ceolin Meneghetti
- Department of Restorative Sciences, University of Alabama School of Dentistry, Birmingham, AL, USA; Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Gustavo Mendonça
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Rafael Pereira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Wendel Teixeira
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nataly Zambrana
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Ankita Samal
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA; Division of Periodontology, the Ohio State University, College of Dentistry, Columbus, OH, USA.
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Fuglsig JMDCES, Reis INRD, Yeung AWK, Bornstein MM, Spin-Neto R. The current role and future potential of digital diagnostic imaging in implant dentistry: A scoping review. Clin Oral Implants Res 2024; 35:793-809. [PMID: 37990981 DOI: 10.1111/clr.14212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Diagnostic imaging is crucial for implant dentistry. This review provides an up-to-date perspective on the application of digital diagnostic imaging in implant dentistry. METHODS Electronic searches were conducted in PubMed focusing on the question 'when (and why) do we need diagnostic imaging in implant dentistry?' The search results were summarised to identify different applications of digital diagnostic imaging in implant dentistry. RESULTS The most used imaging modalities in implant dentistry include intraoral periapical radiographs, panoramic views and cone beam computed tomography (CBCT). These are dependent on acquisition standardisation to optimise image quality. Particularly for CBCT, other technical parameters (i.e., tube current, tube voltage, field-of-view, voxel size) are relevant minimising the occurrence of artefacts. There is a growing interest in digital workflows, integrating diagnostic imaging and automation. Artificial intelligence (AI) has been incorporated into these workflows and is expected to play a significant role in the future of implant dentistry. Preliminary evidence supports the use of ionising-radiation-free imaging modalities (e.g., MRI and ultrasound) that can add value in terms of soft tissue visualisation. CONCLUSIONS Digital diagnostic imaging is the sine qua non in implant dentistry. Image acquisition protocols must be tailored to the patient's needs and clinical indication, considering the trade-off between radiation exposure and needed information. growing evidence supporting the benefits of digital workflows, from planning to execution, and the future of implant dentistry will likely involve a synergy between human expertise and AI-driven intelligence. Transiting into ionising-radiation-free imaging modalities is feasible, but these must be further developed before clinical implementation.
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Affiliation(s)
| | | | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Rubens Spin-Neto
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Ruetters M, Alexandrou K, Ciardo A, Awounvo S, Gehrig H, Kim TS, Lux CJ, Sen S. Influence of Examiner Experience on the Measurement of Bone-Loss by Low-Dose Cone-Beam Computed Tomography: An Ex Vivo Study. J Imaging 2024; 10:177. [PMID: 39194966 DOI: 10.3390/jimaging10080177] [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: 06/18/2024] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024] Open
Abstract
The aim of this study was to investigate the influence of examiner experience on measurements of bone-loss using high-dose (HD) and low-dose (LD) CBCT. Three diagnosticians with varying levels of CBCT interpretation experience measured bone-loss from CBCT scans of three cadaveric heads at 30 sites, conducting measurements twice. Between the first and second measurements, diagnostician 2 and diagnostician 3 received training in LD-CBCT diagnostics. The diagnosticians also classified the certainty of their measurements using a three-grade scale. The accuracy of bone-loss measurements was assessed using the absolute difference between observed and clinical measurements and compared among diagnosticians with different experience levels for both HD and LD-CBCT. At baseline, there was a significant difference in measurement accuracy between diagnostician 1 and diagnostician 2, and between diagnostician 1 and diagnostician 3, but not between diagnostician 2 and diagnostician 3. Training improved the accuracy of both HD-CBCT and LD-CBCT measurements in diagnostician 2, and of LD-CBCT measurements in diagnostician 3. Regarding measurement certainty, there was a significant difference among diagnosticians before training. Training enhanced the certainty for diagnosticians 2 and 3, with a significant improvement noted only for diagnostician 3. Examiner experience level significantly impacts the accuracy and certainty of bone-loss measurements using HD- and LD-CBCT.
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Affiliation(s)
- Maurice Ruetters
- Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Korallia Alexandrou
- Department of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Antonio Ciardo
- Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Sinclair Awounvo
- Institute of Medical Biometry, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Holger Gehrig
- Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Ti-Sun Kim
- Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital Schleswig Holstein, Arnold-Heller-Straße 3, 24105 Kiel, Germany
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Kaaber L, Matzen LH, Spin-Neto R, Schropp L. Low-dose, standard, and high-resolution cone beam computed tomography for alveolar bone measurements related to implant planning: An ex vivo study in human specimens. Clin Oral Implants Res 2024. [PMID: 38970301 DOI: 10.1111/clr.14326] [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: 04/23/2024] [Revised: 05/24/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024]
Abstract
AIM To evaluate the performance of low-dose cone beam computed tomography (CBCT) protocols with regard to linear bone measurements in the posterior mandible for implant planning compared with higher dose protocols. MATERIALS AND METHODS Forty-two edentulous posterior sites in human cadaveric mandibles were imaged in three CBCT scanners using three or four protocols with varying exposure parameters to achieve lower dose. Co-registration was performed to generate sagittal and cross-sectional image sections representative of the implant site. Three observers measured bone height, from the alveolar crest to the mandibular canal, and width, three mm from the top of the alveolar crest. Intra- and interobserver reproducibility were assessed for the cases rated as nonmeasurable as well as for completed measurements. The measurements were analyzed using paired t-tests for differences among the CBCT protocols and the frequency distribution of nonmeasurable cases with a Pearson Chi-square test. RESULTS Reproducibility for registering nonmeasurable cases varied among observers; however, no consistent significant differences were found in the frequency distribution of these cases among observers, units, and protocols. Intraclass correlation coefficients (ICC) were >0.9 for all measurements of bone height and width. Mean differences of <0.5 mm were found regardless of protocol; however, one observer did in some cases produce larger differences. CONCLUSION Linear bone measurements did not differ significantly and could be performed with excellent reliability, using low-dose CBCT protocols compared with standard and high-resolution ones. Varying approaches for rating nonmeasurable cases were found, indicating differences in diagnostic strategies related to implant planning among observers.
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Affiliation(s)
- Laurits Kaaber
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus C, Denmark
| | - Louise Hauge Matzen
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus C, Denmark
| | - Rubens Spin-Neto
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus C, Denmark
| | - Lars Schropp
- Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus C, Denmark
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Alshomrani F. Cone-Beam Computed Tomography (CBCT)-Based Diagnosis of Dental Bone Defects. Diagnostics (Basel) 2024; 14:1404. [PMID: 39001294 PMCID: PMC11241660 DOI: 10.3390/diagnostics14131404] [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: 05/29/2024] [Revised: 06/15/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024] Open
Abstract
Cone Beam Computed Tomography (CBCT) has completely changed the way that bone disorders are diagnosed and treated, especially in the dental and maxillofacial domains. This article examines the diverse applications of computed tomography (CBCT) in the diagnosis and treatment of facial trauma, including mandibular, dentoalveolar, and other facial fractures, as well as bone abnormalities like dislocations and fractures. CBCT is useful for a wide range of dental conditions and greatly improves diagnostic accuracy in periodontics, orthodontics, endodontics, and dental implantology. Additionally, a comparison between CBCT and conventional imaging methods was conducted, emphasizing the latter's inferior 3D imaging capabilities, allowing for more precise treatment planning and better patient outcomes with CBCT. Although CBCT has many benefits, it also has some drawbacks, such as requiring specific training for accurate interpretation, cost considerations, and a higher radiation exposure than with traditional dental X-rays. In order to optimize benefits and reduce risks, the conclusion highlights CBCT's revolutionary influence on clinical practice while arguing for its prudent and responsible application.
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Affiliation(s)
- Faisal Alshomrani
- Department of Diagnostic Radiology Technology, College of Applied Medical Science, Taibah University, Medinah 41477, Saudi Arabia
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Jacobs R, Fontenele RC, Lahoud P, Shujaat S, Bornstein MM. Radiographic diagnosis of periodontal diseases - Current evidence versus innovations. Periodontol 2000 2024; 95:51-69. [PMID: 38831570 DOI: 10.1111/prd.12580] [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: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
Accurate diagnosis of periodontal and peri-implant diseases relies significantly on radiographic examination, especially for assessing alveolar bone levels, bone defect morphology, and bone quality. This narrative review aimed to comprehensively outline the current state-of-the-art in radiographic diagnosis of alveolar bone diseases, covering both two-dimensional (2D) and three-dimensional (3D) modalities. Additionally, this review explores recent technological advances in periodontal imaging diagnosis, focusing on their potential integration into clinical practice. Clinical probing and intraoral radiography, while crucial, encounter limitations in effectively assessing complex periodontal bone defects. Recognizing these challenges, 3D imaging modalities, such as cone beam computed tomography (CBCT), have been explored for a more comprehensive understanding of periodontal structures. The significance of the radiographic assessment approach is evidenced by its ability to offer an objective and standardized means of evaluating hard tissues, reducing variability associated with manual clinical measurements and contributing to a more precise diagnosis of periodontal health. However, clinicians should be aware of challenges related to CBCT imaging assessment, including beam-hardening artifacts generated by the high-density materials present in the field of view, which might affect image quality. Integration of digital technologies, such as artificial intelligence-based tools in intraoral radiography software, the enhances the diagnostic process. The overarching recommendation is a judicious combination of CBCT and digital intraoral radiography for enhanced periodontal bone assessment. Therefore, it is crucial for clinicians to weigh the benefits against the risks associated with higher radiation exposure on a case-by-case basis, prioritizing patient safety and treatment outcomes.
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Affiliation(s)
- Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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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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Chen D, Yu MQ, Li QJ, He X, Liu F, Shen JF. Precise tooth design using deep learning-based templates. J Dent 2024; 144:104971. [PMID: 38548165 DOI: 10.1016/j.jdent.2024.104971] [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: 10/14/2023] [Revised: 03/06/2024] [Accepted: 03/24/2024] [Indexed: 04/01/2024] Open
Abstract
OBJECTIVES In prosthodontic procedures, traditional computer-aided design (CAD) is often time-consuming and lacks accuracy in shape restoration. In this study, we combined implicit template and deep learning (DL) to construct a precise neural network for personalized tooth defect restoration. METHODS Ninety models of right maxillary central incisor (80 for training, 10 for validation) were collected. A DL model named ToothDIT was trained to establish an implicit template and a neural network capable of predicting unique identifications. In the validation stage, teeth in validation set were processed into corner, incisive, and medium defects. The defective teeth were inputted into ToothDIT to predict the unique identification, which actuated the deformation of the implicit template to generate the highly customized template (DIT) for the target tooth. Morphological restorations were executed with templates from template shape library (TSL), average tooth template (ATT), and DIT in Exocad (GmbH, Germany). RMSestimate, width, length, aspect ratio, incisal edge curvature, incisive end retraction, and guiding inclination were introduced to assess the restorative accuracy. Statistical analysis was conducted using two-way ANOVA and paired t-test for overall and detailed differences. RESULTS DIT displayed significantly smaller RMSestimate than TSL and ATT. In 2D detailed analysis, DIT exhibited significantly less deviations from the natural teeth compared to TSL and ATT. CONCLUSION The proposed DL model successfully reconstructed the morphology of anterior teeth with various degrees of defects and achieved satisfactory accuracy. This approach provides a more reliable reference for prostheses design, resulting in enhanced accuracy in morphological restoration. CLINICAL SIGNIFICANCE This DL model holds promise in assisting dentists and technicians in obtaining morphology templates that closely resemble the original shape of the defective teeth. These customized templates serve as a foundation for enhancing the efficiency and precision of digital restorative design for defective teeth.
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Affiliation(s)
- Du Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, PR China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
| | - Mei-Qi Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, PR China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
| | - Qi-Jing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, PR China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China
| | - Xiang He
- College of Computer Science, Sichuan University, Chengdu 610065, PR China
| | - Fei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, PR China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China.
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, National Center for Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, PR China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, PR China.
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Rytky SJO, Tiulpin A, Finnilä MAJ, Karhula SS, Sipola A, Kurttila V, Valkealahti M, Lehenkari P, Joukainen A, Kröger H, Korhonen RK, Saarakkala S, Niinimäki J. Clinical Super-Resolution Computed Tomography of Bone Microstructure: Application in Musculoskeletal and Dental Imaging. Ann Biomed Eng 2024; 52:1255-1269. [PMID: 38361137 PMCID: PMC10995025 DOI: 10.1007/s10439-024-03450-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/09/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Clinical cone-beam computed tomography (CBCT) devices are limited to imaging features of half a millimeter in size and cannot quantify the tissue microstructure. We demonstrate a robust deep-learning method for enhancing clinical CT images, only requiring a limited set of easy-to-acquire training data. METHODS Knee tissue from five cadavers and six total knee replacement patients, and 14 teeth from eight patients were scanned using laboratory CT as training data for the developed super-resolution (SR) technique. The method was benchmarked against ex vivo test set, 52 osteochondral samples are imaged with clinical and laboratory CT. A quality assurance phantom was imaged with clinical CT to quantify the technical image quality. To visually assess the clinical image quality, musculoskeletal and maxillofacial CBCT studies were enhanced with SR and contrasted to interpolated images. A dental radiologist and surgeon reviewed the maxillofacial images. RESULTS The SR models predicted the bone morphological parameters on the ex vivo test set more accurately than conventional image processing. The phantom analysis confirmed higher spatial resolution on the SR images than interpolation, but image grayscales were modified. Musculoskeletal and maxillofacial CBCT images showed more details on SR than interpolation; however, artifacts were observed near the crown of the teeth. The readers assessed mediocre overall scores for both SR and interpolation. The source code and pretrained networks are publicly available. CONCLUSION Model training with laboratory modalities could push the resolution limit beyond state-of-the-art clinical musculoskeletal and dental CBCT. A larger maxillofacial training dataset is recommended for dental applications.
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Affiliation(s)
- Santeri J O Rytky
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland.
| | - Aleksei Tiulpin
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Neurocenter Oulu, Oulu University Hospital, Oulu, Finland
| | - Mikko A J Finnilä
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Medical Research Center, University of Oulu, Oulu, Finland
| | - Sakari S Karhula
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Annina Sipola
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Väinö Kurttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Maarit Valkealahti
- Department of Surgery and Intensive Care, Oulu University Hospital, Oulu, Finland
| | - Petri Lehenkari
- Department of Surgery and Intensive Care, Oulu University Hospital, Oulu, Finland
- Cancer and Translational Medical Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Antti Joukainen
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Kröger
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Simo Saarakkala
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Health Sciences and Technology, University of Oulu, POB 5000, 90014, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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12
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Ruetters M, Alexandrou K, Gehrig H, Awounvo S, Kim TS, Felten A, Lux C, Sen S. Impact of acquisition volume on cone beam computed tomography imaging of marginal bone: an ex vivo study. Acta Odontol Scand 2024; 83:204-209. [PMID: 38661245 PMCID: PMC11302637 DOI: 10.2340/aos.v83.40494] [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: 01/23/2024] [Accepted: 03/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The current study explores whether there is a clinically relevant distinction in the measurement of marginal bone loss when comparing high-dose (HD) versus low-dose (LD) cone beam computed tomography (CBCT) protocols in small and large acquisition volumes. Material and Methods: CBCTs of four human cadaveric preparates were taken in HD and LD mode in two different fields of view 8 × 8 cm2 (LV) and 5 × 5 cm2 (SV). In total, 43 sites of 15 teeth were randomly chosen, and marginal bone loss was measured twice in all protocols at 43 sites of 15 teeth by one calibrated investigator. Bland-Altman plots and Lin's concordance correlation coefficient (CCC) were calculated to assess the extent of agreement of the measurements. Additionally, the rater scored the certainty in each of the measurements. RESULTS For HD-CBCT CCC of measurements obtained using SV versus LV was 0.991. CCC of measurements obtained using SV versus LV of LD-CBCT was 0.963. Both CCC values indicated excellent agreement between the two volumes in both protocols. CCC also indicated high intramodality correlation between HD-CBCT and LD-CBCT independent of the acquisition volume (0.963 - 0.992). Bland-Altman plots also indicated no substantial differences. Results of certainty scoring showed significant differences (p = 0.004 (LV), p < 0.001(SV)) between the LD and HD-CBCT. CONCLUSIONS Accuracy of measurements of bone loss shows no clinical noticeable effects depending on the CBCT volume in this ex vivo study. There appears to be no relevant advantage of SV over LV, neither in HD-CBCT nor in LD-CBCT and additionally no relevant advantage of HD versus LD in visualizing marginal bone loss.
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Affiliation(s)
- Maurice Ruetters
- Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany.
| | - Korallia Alexandrou
- Department of Orthodontics, University Hospital Heidelberg, Heidelberg, Germany
| | - Holger Gehrig
- Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Sinclair Awounvo
- Institute of Medical Biometry, University Hospital Heidelberg, Heidelberg, Germany
| | - Ti-Sun Kim
- Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Felten
- Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Christopher Lux
- Department of Orthodontics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital Schleswig Holstein, Kiel, Germany
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13
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Arkhipova A, Bovanova N, Lastovichek D, Ramonova A, Generalov E, Byakova S. Radiographic Criteria for Differential Diagnosis Between Vertical Root Fracture and Apical Periodontitis in Single-Rooted Endodontically Treated Premolars Using Cone-Beam Computed Tomography. J Endod 2024; 50:329-335. [PMID: 38185244 DOI: 10.1016/j.joen.2023.12.008] [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: 09/26/2023] [Revised: 12/26/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION This study explores the differences between the patterns of bone defects associated with vertical root fracture (VRF) and apical periodontitis (AP) in single-rooted endodontically treated premolars (SRETPs) based on cone-beam computed tomography (CBCT) data. METHODS Eighty-four SRETPs were extracted and categorized into the VRF and AP groups. On preoperative CBCT images, the location of bone defects according to the root thirds in buccolingual and mesiodistal directions across the study groups were compared. RESULTS The majority of bone defects in the VRF group were longitudinal and combined, involving more than one root thirds in buccolingual and mesiodistal directions simultaneously. A uniform approach to comparing bone defects using the sites of periradicular area with bone loss as a comparison unit was developed. In the VRF group, bone loss sites in the middle and coronal thirds were detected more often and were located mainly buccolingually compared with the AP group (P < .001). CONCLUSION Bone defects in the middle or middle and coronal root thirds in the buccolingual direction may be potential radiographic signs useful in differentiating between VRF and AP in SRETPs. The introduction of the uniform approach to assessment of bone loss patterns will give practitioners a single simple tool and improve the quality of endodontic treatment.
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Affiliation(s)
| | | | | | | | - Evgenii Generalov
- Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia
| | - Svetlana Byakova
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow, Russia
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14
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Ríos-Osorio N, Quijano-Guauque S, Briñez-Rodríguez S, Velasco-Flechas G, Muñoz-Solís A, Chávez C, Fernandez-Grisales R. Cone-beam computed tomography in endodontics: from the specific technical considerations of acquisition parameters and interpretation to advanced clinical applications. Restor Dent Endod 2024; 49:e1. [PMID: 38449497 PMCID: PMC10912545 DOI: 10.5395/rde.2024.49.e1] [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: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024] Open
Abstract
The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.
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Affiliation(s)
- Néstor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sara Quijano-Guauque
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Sandra Briñez-Rodríguez
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Gustavo Velasco-Flechas
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | | | - Carlos Chávez
- Postgraduate Endodontics Department, IMED, Guadalajara, México
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Georgi GM, Knauth S, Hirsch E, Schulz-Kornas E, Kahl-Nieke B, Püschel K, Amling M, Koehne T, Korbmacher-Steiner H, Petersen J. Age-related changes in the midpalatal suture: Comparison between CBCT staging and bone micromorphology. Bone 2024; 179:116984. [PMID: 38013020 DOI: 10.1016/j.bone.2023.116984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023]
Abstract
The age-related maturation of the human midpalatal suture is challenging to predict, but critical for successful non-surgical rapid maxillary expansion (RME). While cone-beam computed tomography (CBCT) can be used to categorize the suture into stages, it remains unclear how well the stages predict the actual micromorphology of the palate. To address this clinically relevant question, we used CBCT together with three-dimensional micro-computed tomography (μCT) analysis on 24 human palate specimens from individuals aged 14-34 years. We first classified the specimens into stages (A-E) using CBCT images and then correlated the results with our comprehensive μCT analysis. Our analysis focused on several factors, including bone volume fraction (BV/TV), sutural width, volume, interdigitation, ossification, and their associations with age, CBCT stage, and sex. Our μCT analysis revealed a decrease in sutural width and volume after the age of 20 years, accompanied by sutural closure beginning in the palatal segment. The overall rate of ossification remained low but increased after the age of 20 years. No significant differences were found between males and females. Importantly, we also found no correlation between individual age and CBCT stages. Furthermore, there was no association between CBCT stages and patalal suture volume, ossification and interdigitation. Taken together, our findings cast doubt on the reliability of CBCT stage as a means of predicting skeletal maturity of the palatal suture, as it appears to lack the precision required to accurately assess the true micromorphology of the palatal suture. Future investigations should explore whether alternative CBCT parameters may be more useful in addressing the challenging question of whether RME requires surgical bone weakening.
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Affiliation(s)
- Gina Marie Georgi
- Department of Orthodontics, University Hospital Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| | - Sarah Knauth
- Department of Orthodontics, University Hospital Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| | - Edgar Hirsch
- Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| | - Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Bärbel Kahl-Nieke
- Department of Orthodontics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Klaus Püschel
- Department of Legal Medicine, University Medical Center of Hamburg-Eppendorf, Butenfeld 34, 22529 Hamburg, Germany
| | - Michael Amling
- Institute of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Till Koehne
- Department of Orthodontics, University Hospital Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| | - Heike Korbmacher-Steiner
- Department of Orthodontics, Medical Faculty, Dental School, Philipps-University Marburg, 35037 Marburg, Germany.
| | - Julian Petersen
- Department of Orthodontics, University Hospital Leipzig, Liebigstraße 12, 04103 Leipzig, Germany.
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Arnold EL, Elarnaut F, Downes D, Evans JPO, Greenwood C, Rogers KD. Conical shell X-ray beam tomosynthesis and micro-computed tomography for microarchitectural characterisation. Sci Rep 2023; 13:21480. [PMID: 38057401 PMCID: PMC10700317 DOI: 10.1038/s41598-023-48851-6] [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: 06/19/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
Bone quality is commonly used to diagnose bone diseases such as osteoporosis, with many studies focusing on microarchitecture for fracture prediction. In this study a bovine distal femur was imaged using both micro-computed tomography (µCT) and tomosynthesis using focal construct geometry (FCG) for comparison of microarchitectural parameters. Six regions of interest (ROIs) were compared between the two imaging modalities, with both global and adaptive methods used to binarize the images. FCG images were downsampled to the same pixel size as the µCT images. Bone morphometrics were determined using BoneJ, for each imaging modality, binarization technique and ROI. Bone area/total area was found to have few significant differences between FCG and µCT (p < 0.05 for two of six ROIs). Fractal Dimension had only one significant difference (p < 0.05 for one of six ROIs) between µCT and downsampled FCG (where pixel size was equalized). Trabecular thickness and trabecular spacing were observed to follow trends as observed for the corresponding µCT images, although many absolute values were significantly different (p < 0.05 for between one and six ROIs depending on image types used). This study demonstrates the utility of tomosynthesis for measurement of microarchitectural morphometrics.
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Affiliation(s)
- Emily L Arnold
- Cranfield Forensic Institute, Cranfield University, Shrivenham, SN6 8LA, Wiltshire, UK.
| | - Farid Elarnaut
- Imaging Science Group, Nottingham Trent University, Rosalind Franklin Building, Nottingham, NG11 8NS, UK
| | - David Downes
- Imaging Science Group, Nottingham Trent University, Rosalind Franklin Building, Nottingham, NG11 8NS, UK
| | - J Paul O Evans
- Imaging Science Group, Nottingham Trent University, Rosalind Franklin Building, Nottingham, NG11 8NS, UK
| | - Charlene Greenwood
- School of Chemical and Physical Sciences, Keele University, Keele, ST5 5BJ, Staffordshire, UK
| | - Keith D Rogers
- Cranfield Forensic Institute, Cranfield University, Shrivenham, SN6 8LA, Wiltshire, UK
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Lin ST, Foote AK, Bolas NM, Peter VG, Pokora R, Patrick H, Sargan DR, Murray RC. Three-Dimensional Imaging and Histopathological Features of Third Metacarpal/Tarsal Parasagittal Groove and Proximal Phalanx Sagittal Groove Fissures in Thoroughbred Horses. Animals (Basel) 2023; 13:2912. [PMID: 37760312 PMCID: PMC10525482 DOI: 10.3390/ani13182912] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological findings were scored and compared between locations with and without fissures on CT. Microscopic examination identified 114/291 locations with fissures. The diagnostic sensitivity and specificity were 88.5% and 61.3% for CBCT, 84.1% and 72.3% for FBCT, and 43.6% and 85.2% for MRI. Four types of imaging features of fissures were characterised on CT: (1) CBCT/FBCT hypoattenuating linear defects, (2) CBCT/FBCT striated hypoattenuated lines, (3) CBCT/FBCT subchondral irregularity, and (4) CBCT striated hypoattenuating lines and FBCT subchondral irregularity. Fissures on MRI appeared as subchondral bone hypo-/hyperintense defects. Microscopic scores of subchondral bone sclerosis, microcracks, and collapse were significantly higher in locations with CT-identified fissures. All imaging modalities were able to identify fissures. Fissures identified on CT were associated with histopathology of fatigue injuries.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Madingley Rd., Cambridge CB3 0ES, UK;
| | - Alastair K. Foote
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Nicholas M. Bolas
- Hallmarq Veterinary Imaging, Unit 5 Bridge Park, Merrow Lane, Guildford GU4 7BF, UK;
| | - Vanessa G. Peter
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Rachel Pokora
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Hayley Patrick
- Swayne and Partners Veterinary Surgeons, Western Way, Bury St Edmunds IP33 3SP, UK;
| | - David R. Sargan
- Department of Veterinary Medicine, University of Cambridge, Madingley Rd., Cambridge CB3 0ES, UK;
| | - Rachel C. Murray
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
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18
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Bai B, Tang Y, Wu Y, Pei F, Zhu Q, Zhu P, Gu Y. Ex vivo detection of mandibular incisors' root canal morphology using cone-beam computed tomography with 4 different voxel sizes and micro-computed tomography. BMC Oral Health 2023; 23:656. [PMID: 37689620 PMCID: PMC10492267 DOI: 10.1186/s12903-023-03376-2] [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: 04/23/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND In recent years, cone-beam computed tomography (CBCT) has been widely used to evaluate patients' root canal anatomy due to its high resolution and noninvasive nature. As voxel size is one of the most important parameters affecting CBCT image quality, the current study evaluated the diagnostic potential of CBCT with 4 different voxel sizes in the detection of double root canal systems and accessory canals (ACs) in permanent mandibular incisors. METHODS A total of 106 extracted mandibular permanent incisors were collected from the dental clinics, and then were scanned by using micro-CT with a voxel size of 9 μm. The teeth were then fixed in the tooth sockets of human dry mandibles and scanned by using a CBCT device with 4 different voxel sizes (300, 200, 250, and 125 μm). Four observers detected in blind the root canal morphology of the teeth according to the CBCT images, and the presence or absence of a double root canal system, and the presence or absence of ACs, were scored according to a 5-point scale, respectively. Receiver operating characteristic (ROC) analysis was performed, and DeLong test was used to compare the area under the curve (AUC) values and the micro-CT data was taken as a gold standard. RESULTS Among 106 sample teeth, 25 specimens with a double root canal system were identified by the micro-CT. ROC curve analysis of the data obtained by the four observers showed that in the detection of double root canal systems, the AUC values ranged from 0.765 to 0.889 for 300 μm voxel size, from 0.877 to 0.926 for 250 μm voxel size, from 0.893 to 0.967 for 200 μm voxel size, and from 0.914 to 0.967 for 125 μm voxel size (all p < 0.01). In general, we observed a trend that the AUC values, sensitivity, and specialty increased with the decrease in the voxel size, and significantly higher AUC values were detected in 125 μm voxel size images. In the detection of ACs, ROC curve analysis showed that among the four observers, the AUC values ranged from 0.554 to 0.639 for 300 μm voxel size, from 0.532 to 0.654 for 250 μm voxel size, from 0.567 to 0.626 for 200 μm voxel size, and from 0.638 to 0.678 for 125 μm voxel size. CBCT images at a voxel size of 125 μm had a weak diagnostic potential (AUC: 0.5-0.7, all p < 0.05) in the detection of AC, with a lower sensitivity ranging from 36.8 to 57.9% and a higher specialty ranging from 73.6 to 98.8%. CONCLUSIONS CBCT with 300 μm voxel size could only provide moderate diagnostic accuracy in the detection of a double canal system in mandibular incisors. CBCT with a voxel size of 125 μm exhibited high diagnostic value in the detection of double canal systems, while showing low but statistically significant value in the detection of ACs.
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Affiliation(s)
- Bingbing Bai
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Ying Tang
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Yihan Wu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Fan Pei
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Qi Zhu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China
| | - Peng Zhu
- The Stomatology Hospital Affiliated of Suzhou Vocational Health College, Renmin Road 829#, Gusu Dist, Suzhou, 215002, China
| | - Yongchun Gu
- Department of Central Laboratory and Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666#, Wujiang Dist, Suzhou, 215200, China.
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Jadhav A, Desai NG, Tadinada A. Accuracy of Anatomical Depictions in Cone Beam Computed Tomography (CBCT)-Reconstructed Panoramic Projections Compared to Conventional Panoramic Radiographs: A Clinical Risk-Benefit Analysis. Cureus 2023; 15:e44723. [PMID: 37809250 PMCID: PMC10552931 DOI: 10.7759/cureus.44723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Two-dimensional (2D) radiographs are the standard of care for diagnosis and treatment planning in the day-to-day practice of dentistry. With the growing popularity of cone beam computed tomography (CBCT), it is now becoming the standard of care in many areas of general dentistry due to its ability to create non-linear projections from volumetric data. The CBCT-generated non-orthogonal radiographs can serve as easy-to-use 2D and three-dimensional (3D) diagnostic tools and offer a similar experience for diagnosis as conventional 2D images. The aim of this study is to compare the accuracy of conventional radiographs and CBCT-generated projections to identify relevant anatomic landmarks and their associated variants. METHODS Thirty-two patients referred to the University of Connecticut School of Dental Medicine's Advanced Imaging Center were selected for this retrospective analysis. Nineteen anatomical landmarks were retrospectively assessed on conventional panoramic and CBCT scans generated panoramic radiographs using two different digital imaging and communications in medicine viewers. A total of 1,216 anatomical landmarks were evaluated by two oral and maxillofacial radiologists to assess the accuracy and consistency of the depiction of radiographic anatomy. RESULTS There was a very good agreement between the two evaluators with a Cohen's kappa value of 0.934. McNemar change test concluded that the anatomical assessment values compared between conventional panoramic and CBCT-generated panoramic radiographs are similar. CONCLUSION This study showed that CBCT-generated panoramic images are comparable to conventional panoramic radiographs in identifying anatomical landmarks typically evaluated using a conventional panoramic projection. In addition, they have the added advantage of having 3D information in the acquired volume to better evaluate the area of interest. In clinical situations where a mid- to large-volume CBCT scan is available, a simulated panoramic image can be generated using the CBCT volume, leaving exposure of the patient to the additional radiation of a panoramic image unnecessary.
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Affiliation(s)
- Aniket Jadhav
- Oral and Maxillofacial Radiology, Virginia Commonwealth University School of Dentistry, Richmond, USA
| | - Neha G Desai
- Dentistry and Public Health, Jefferson Dental Care (JDC) Healthcare, Houston, USA
| | - Aditya Tadinada
- Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
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Kolsuz ME, Evli C, Aksoy U, Koohnavard M, Aksoy S, Orhan K. Influence of voxel size and filter type on detecting vertical root fracture using cone-beam computed tomography. AUST ENDOD J 2023; 49 Suppl 1:439-446. [PMID: 37133318 DOI: 10.1111/aej.12761] [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: 02/11/2022] [Revised: 03/25/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
Vertical root fractures (VRFs) can start at any level of the root and progress longitudinally to the coronal attachment. This study aimed to investigate the effects of different exposure parameters used when obtaining CBCT scans in detecting simulated VRFs. Hence, 80 intact human mandibular single-rooted pre-molar teeth without root fractures were included in the study. No statistically significant difference was found between the filters in terms of VRF detection in the group with the roots with only root canal filling (Groups 1 and 5); however, 100 voxels were found to be more successful in terms of VRF detection than other voxel sizes. Results of this study suggest that using lower voxel sizes leads to an accurate diagnosis of vertical root fracture, in addition, our results revealed that using AR filters did not improve the diagnostic accuracy in detecting VRFs.
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Affiliation(s)
- Mehmet Eray Kolsuz
- Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
| | - Cengiz Evli
- Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
| | - Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | | | - Seçil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Lublin, Poland
- Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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21
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Schulze R. The problem in visualization and measuring tiny structures on CBCT-images. J Orofac Orthop 2023; 84:340-341. [PMID: 37353684 DOI: 10.1007/s00056-023-00477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Affiliation(s)
- R Schulze
- Head Division of Oral Diagnostic Sciences, School of Dental Medicine, University of Bern, Freiburgstr. 7, 3010, Bern, Switzerland.
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22
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Polizzi A, Quinzi V, Ronsivalle V, Venezia P, Santonocito S, Lo Giudice A, Leonardi R, Isola G. Tooth automatic segmentation from CBCT images: a systematic review. Clin Oral Investig 2023:10.1007/s00784-023-05048-5. [PMID: 37148371 DOI: 10.1007/s00784-023-05048-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES To describe the current state of the art regarding technological advances in full-automatic tooth segmentation approaches from 3D cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS In March 2023, a search strategy without a timeline setting was carried out through a combination of MeSH terms and free text words pooled through Boolean operators ('AND', 'OR') on the following databases: PubMed, Scopus, Web of Science and IEEE Explore. Randomized and non-randomized controlled trials, cohort, case-control, cross-sectional and retrospective studies in the English language only were included. RESULTS The search strategy identified 541 articles, of which 23 have been selected. The most employed segmentation methods were based on deep learning approaches. One article exposed an automatic approach for tooth segmentation based on a watershed algorithm and another article used an improved level set method. Four studies presented classical machine learning and thresholding approaches. The most employed metric for evaluating segmentation performance was the Dice similarity index which ranged from 90 ± 3% to 97.9 ± 1.5%. CONCLUSIONS Thresholding appeared not reliable for tooth segmentation from CBCT images, whereas convolutional neural networks (CNNs) have been demonstrated as the most promising approach. CNNs could help overcome tooth segmentation's main limitations from CBCT images related to root anatomy, heavy scattering, immature teeth, metal artifacts and time consumption. New studies with uniform protocols and evaluation metrics with random sampling and blinding for data analysis are encouraged to objectively compare the different deep learning architectures' reliability. CLINICAL RELEVANCE Automatic tooth segmentation's best performance has been obtained through CNNs for the different ambits of digital dentistry.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy.
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, 67100, L'Aquila, Italy.
| | - Vincenzo Quinzi
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, 67100, L'Aquila, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Pietro Venezia
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
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23
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Amuk M, Saribal GS, Ersu N, Yilmaz S. The effects of technical factors on the fractal dimension in different dental radiographic images. Eur Oral Res 2023; 57:68-74. [PMID: 37525855 PMCID: PMC10387138 DOI: 10.26650/eor.2023984422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/31/2022] [Accepted: 06/24/2022] [Indexed: 08/02/2023] Open
Abstract
Purpose The aim of this study was to assess the impact of exposure parameters and image formats on fractal dimension (FD) values in periapical, panoramic, and CBCT images. Materials and methods Seven dry male mandibles were selected, and a Gutta-Percha was used to identify identical regions of interest. A periapical radiograph was taken with 60 kVp/7 mA and exported in DICOM, JPEG, TIFF, and PNG formats. Nine periapical radiographs (60, 65, 70 kVp; 4, 5, 6 mA) were taken from seven dry human mandibles. Additionally, 12 panoramic radiographs (60, 70, 81, 90 kVp; 5, 8, 13 mA) and 10 CBCT images (with different scanning options and FOVs) were taken from each mandible. FDs were measured from a standard area. Results The intra-class correlation coefficient demonstrated a high degree of agreement between observers. No significant difference was found between TIFF and PNG formats (p > 0.05). The highest FD mean was found in TIFF format, while the lowest FD mean was found in JPEG format (p<0.001). There was no significant difference between kVp and mA settings in periapical images. In panoramic images, a significant difference was found at 90 kVp (p = 0.001) and 13 mA (p<0.001), with lower FD values observed at these settings. There was no significant difference between FOV and resolution in CBCT images (p > 0.05). Conclusion The format of the image can influence FD. For periapical and panoramic radiographs, kVp and mA settings do not have a significant impact on FD. However, fractal analysis may not be an ideal method for evaluating three-dimensional images, such as those obtained with CBCT.
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Affiliation(s)
- Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of
Dentistry, Erciyes University, KayseriTurkiye
| | - Gamze Sirin Saribal
- Department of Oral and Maxillofacial Radiology, Faculty of
Dentistry, Erciyes University, KayseriTurkiye
| | - Nihal Ersu
- Department of Oral and Maxillofacial Radiology, Faculty of
Dentistry, Erciyes University, KayseriTurkiye
| | - Serkan Yilmaz
- Department of Oral and Maxillofacial Radiology, Faculty of
Dentistry, Erciyes University, KayseriTurkiye
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24
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Fontenele RC, Picoli FF, Pinto JC, Coudyzer W, de Faria Vasconcelos K, Farias Gomes A, Binst J, Jacobs R. Feasibility of photon-counting computed tomography as a novel imaging modality for challenging endodontic diagnostic tasks. Sci Rep 2023; 13:6266. [PMID: 37069172 PMCID: PMC10110619 DOI: 10.1038/s41598-023-33322-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/11/2023] [Indexed: 04/19/2023] Open
Abstract
Photon-counting computed tomography (PCCT) is an innovative technological advancement in relation to x-ray detectors which offers ultra-high-resolution images. The current study aimed to evaluate the visualization ability of PCCT compared to cone-beam computed tomographic (CBCT) devices for challenging endodontic diagnostic tasks. A reference image of an anthropomorphic phantom was acquired using an industrial micro-CT device. Thereafter, the phantom was scanned with three imaging devices, which included PCCT scanner (NAEOTOM Alpha) and two CBCT devices (3D Accuitomo 170 and NewTom VGi evo) having standard and high-resolution acquisition protocols. The diagnostic tasks involved visualizing fine endodontic structures (apical delta, narrow canal, and isthmus) and root cracks. Three experienced examiners assessed the images and were blinded to the PCCT and CBCT devices. Each image was rated according to a three-grade scale (appropriate, acceptable, or inappropriate) for the diagnostic tasks. In relation to fine endodontic structures grouped together, PCCT showed similar diagnostic performance compared to the reference image (p > 0.05). As for the CBCT devices, an excellent performance was only observed with the 3D Accuitomo 170 device at a high-resolution acquisition mode (p > 0.05). The visualization of root cracks was also better with 3D Accuitomo 170 compared to other devices (p < 0.05). Overall, PCCT and 3D Accuitomo 170 at a high-resolution setting showed similar performance for visualizing fine endodontic structures. In addition, the high-resolution CBCT protocol was superior for visualizing root cracks compared to both PCCT and other standard- and high-resolution CBCT protocols.
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Affiliation(s)
- Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fernando Fortes Picoli
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Jader Camilo Pinto
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Joke Binst
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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25
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Fuglsig JMDCES, Hansen B, Schropp L, Nixdorf DR, Wenzel A, Spin-Neto R. Alveolar bone measurements in magnetic resonance imaging compared with cone beam computed tomography: a pilot, ex-vivo study. Acta Odontol Scand 2023; 81:241-248. [PMID: 36112428 DOI: 10.1080/00016357.2022.2121321] [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: 11/01/2022]
Abstract
OBJECTIVES To compare alveolar bone height and width measurements from zero-echo-time MRI (ZTE-MRI) and cone beam CT (CBCT), in human specimens. MATERIAL AND METHODS Twenty posterior edentulous sites in human cadaver specimens were imaged with CBCT and ZTE-MRI. Bone height and width at 1, 3, 5, 7 and 9 mm from the top of the alveolar ridge was measured by two trained observers in cross-sections of a site where an implant was to be planned. Twenty percent of the sample was measured in duplicate to assess method error and intra-observer reproducibility (ICC). The differences between CBCT and ZTE-MRI measurements were compared (t-test). RESULTS Inter- and intra-observer reproducibility was >0.90. The method error (average between observers) for bone height was 0.45 mm and 0.39 mm, and for bone width (average) was 0.52 mm and 0.80 mm (CBCT and ZTE-MRI, respectively). The majority of the bone measurement differences were statistically insignificant, except bone width measurements at 5 mm (p ≤ .05 for both observers). Mean measurement differences were not larger than the method error. CONCLUSION ZTE-MRI is not significantly different from CBCT when comparing measurements of alveolar bone height and width.
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Affiliation(s)
| | - Brian Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
- Department of Radiology, Medical School, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
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26
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Pertek Hatipoğlu F, Mağat G, Hatipoğlu Ö, Taha N, Alfirjani S, Abidin IZ, Lehmann AP, Alkhawas MBAM, Buchanan GD, Kopbayeva M, Surendar S, Javed MQ, Madfa AA, Donnermeyer D, Krmek SJ, Bhatti UA, Palma PJ, Brochado Martins JF. Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis. J Endod 2023; 49:549-558. [PMID: 36863567 DOI: 10.1016/j.joen.2023.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence. METHODS Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. RESULTS In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P < .05). MMC prevalence ranged from 1% to 23%, and the overall prevalence was 7% (95% confidence interval [CI]: 5%-9%). No significant differences were found between the left and right M1M (odds ratio = 1.09, 95% CI: 0.93, 1.27; P > .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). CONCLUSIONS The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral.
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Affiliation(s)
| | - Güldane Mağat
- Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey.
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya
| | | | - Anna Paulina Lehmann
- Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań, Poznań, Poland
| | | | - Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Maira Kopbayeva
- Kazakh National Medical University Asfendiyarov, Almaty, Kazakhstan
| | - Sugumaran Surendar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Saudi Arabia; Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry and Endodontics, Riphah International University, Pakistan
| | - Paulo J Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Filipe Brochado Martins
- Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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27
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Grassi R, Guerra E, Berritto D. Bone fractures difficult to recognize in emergency: May be cone beam computed tomography (CBCT) the solution? LA RADIOLOGIA MEDICA 2023; 128:1-5. [PMID: 36683134 DOI: 10.1007/s11547-022-01584-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/20/2022] [Indexed: 01/23/2023]
Abstract
CBCT is an imaging tool represented by an X-ray computed tomography delivering a conic-shape X-rays source. This system produces volumetric data during a single rotation of both X-ray beam and detector around the stationary patient. CBCT is able to produce three-dimensional images as for MDCT, however, accounting some advantages over it: lower radiation dose, faster volumetric dataset acquisition, higher spatial resolution and bone contrast. For these reasons, CBCT has recently been described and adopted for extremities imaging in orthopedics. Misinterpretation of fractures may determine a delayed treatment and poor outcome for patients treated in the ED. CBCT, by easily identifying occult cortical fractures and using a lower dose of radiation, is proposed as an alternative or supplement to direct radiograms, optimizing the cost-effectiveness ratio and limiting the number of unnecessary immobilizations. The first experiences document excellent performance of CBCT in emergency radiology departments, especially thanks to transverse imaging in trauma of the extremities.
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Affiliation(s)
- Roberto Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Egidio Guerra
- Division of Radiology, "Ospedale Policlinico di Foggia", Foggia, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
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28
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Galvão ADM, Gonzaga RCDQ, de Oliveira MAVC, Machado AC, Barbosa GLDR, Soares PV, da Silva GR. Can non-carious cervical lesions depth affect clinical response in pain intensity and remaining dentin thickness? Braz Dent J 2022; 33:108-115. [PMID: 36287492 PMCID: PMC9645175 DOI: 10.1590/0103-6440202204789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Non-carious Cervical Lesions (NCCL) are dental tissue defects, non-related to caries, frequently observed in the dental practice. The aim of this study was to evaluate the effects of NCCL on dentin depth and thickness and the response to dental pain by means of clinical diagnostic tests. 86 teeth from 14 patients with NCCL were assessed by: depth of NCCL, clinical tests (evaporative stimulus, to detect pain levels of dentin hypersensitivity, cold thermal test to classify pulp health, percussive stimuli to evaluate the periradicular tissues and cone beam computed tomography (tomography to evaluate remaining dentin thickness (RDT). In terms of depth, the sample was divided into two groups: G1- teeth with NCCLs ≤1.0mm and G2- teeth with NCCLs between 1.1-2.0 mm. Dental pain data were compared by Mann-Whitney test and RDT by Student's t-test and correlations by the Pearson test (p<0.05). The depth of NCCL does not influence dental pain response to evaporative stimulus (p=0.129), cold thermal test (p = 0.125), vertical (p = 0.317) and horizontal (p = 0.119) percussion clinical diagnostic tests. However, G1 showed more RDT (p<0.001), and the correlation test showed that deeper NCCL presents smaller remaining dentin thickness (p=0.011/r=-0.273). In conclusion, tooth with NCCL up to 2mm-depth presents similar levels of pain for dentin hypersensitivity, pulp and periradicular tissue independent to NCCL depth, however, lesions with ≤1.0mm-depth showed greater RDT in tomographic findings.
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Affiliation(s)
- Alexia da Mata Galvão
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
| | - Ramon Corrêa de Queiroz Gonzaga
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
| | | | - Alexandre Coelho Machado
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
| | - Gabriella Lopes de Rezende Barbosa
- Department of Oral Diagnosis, School of Dentistry,FederalUniversity of Uberlandia; Av. Pará, 1720, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Paulo Vinicius Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
| | - Gisele Rodrigues da Silva
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
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29
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Palczewska-Komsa MP, Gapiński B, Nowicka A. The Influence of New Bioactive Materials on Pulp–Dentin Complex Regeneration in the Assessment of Cone Bone Computed Tomography (CBCT) and Computed Micro-Tomography (Micro-CT) from a Present and Future Perspective—A Systematic Review. J Clin Med 2022; 11:jcm11113091. [PMID: 35683478 PMCID: PMC9181092 DOI: 10.3390/jcm11113091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
The present paper is the first article providing a systematic literature review on the visualization of tertiary dentin influenced by modern bioactive materials in CBCT and micro-CT. Six database searches of studies on tertiary dentin visualization using CBCT produced 622 records in total, and the search of the studies on tertiary dentin using micro-CT produced 502 records in total. The results were thoroughly selected considering the inclusion criteria, and five research papers using CBCT and nine research papers using micro-CT for visualization of tertiary dentin were eventually qualified for the analysis. All the non-randomized and randomized studies presented good and high levels of quality evidence, respectively. Among the bioactive materials used, the most frequently analysed were: MTA, Biodentine dentin matrix hydrogel, Pro Root MTA, and EndoSequence root repair material. The highest thickness of the tertiary dentin was achieved after the use of MTA material in both imaging techniques. The remaining parameters had different results, taking into account the CBCT and micro-CT analysis. The possibilities of the qualitative and quantitative assessment of the particular parameters of tertiary dentin using CBCT and micro-CT techniques were presented and analysed. CBCT and micro-CT analyses can be useful in the assessment of tertiary dentin formed beneath the bioactive material applied during vital pulp treatment. The research argues that the presented results differ depending on the material applied to the pulp, the study duration (4–6 weeks), difference in teeth, species (rats, human), as well as the applied technique and differences in computer software used for the analysis.
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Affiliation(s)
- Mirona Paula Palczewska-Komsa
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland;
- Correspondence:
| | - Bartosz Gapiński
- Division of Metrology and Measurement Systems, Institute of Mechanical Technology, Poznan University of Technology, Jana Pawła II 24, 60-965 Poznań, Poland;
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland;
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30
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Asif MK, Ibrahim N, Khan IM, Khan SS, Nambiar P. Dental age estimation of Malaysian children: A comparison of two-dimensional verses three-dimensional imaging analyses of the developing root apices. Ann Hum Biol 2022; 49:109-115. [PMID: 35535801 DOI: 10.1080/03014460.2022.2075034] [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: 11/01/2022]
Abstract
Aim: The current study compared the effectiveness of the three-dimensional (3D) cone beam computed tomography (CBCT) method of age estimation developed by Asif et al. (2020) with two-dimensional Cameriere's method.Subjects and methods: CBCT images belonging to 129 Malaysian Chinese and Malay ethnic groups aged 7 to 14 years were investigated and analysed.Results: The results indicated a strong correlation between chronological age and the predictor variables for both Cameriere's (r = 0.984) and Asif's (r = 0.988) methods of age estimation. Fisher Z-test analysis indicated no statistically significant difference in the correlation values between the two methods. Mean absolute error (MAE) value of 0.613 was observed for Cameriere's and 0.290 was observed for Asif's method.Conclusion: The results indicated that the methods of age estimation from both Asif et al. (2020) and Cameriere et al. (2006) are applicable on Malaysian children. However, Asif et al.'s (2020) 3D CBCT method of age estimation resulted in greater accuracy and reliability in estimating chronological age.
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Affiliation(s)
- Muhammad Khan Asif
- Department of Forensic Odontology, Shifa College of Dentistry, P, Pakistan.,Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Iqra Muhammad Khan
- Department of Community and Preventive Dentistry, Rehman College of Dentistry, Peshawar, Pakistan
| | - Shah Salman Khan
- Department of Oral Biology, Watim Dental College, Islamabad, Pakistan
| | - Phrabhakaran Nambiar
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.,Department of Oral Biology, Faculty of Dentistry, MAHSA University, Saujana Putra, Malaysia
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Cone-Beam Computed Tomography: A New Tool on the Horizon for Forensic Dentistry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095352. [PMID: 35564747 PMCID: PMC9104190 DOI: 10.3390/ijerph19095352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 12/15/2022]
Abstract
Teeth and bones of calvarium are important structures from a forensic point of view, as they are extremely resilient to destruction or decomposition, even under temperature variations. Radiology is inevitably an important tool in forensic investigations. Maxillofacial radiology provides a considerable amount of information for the identification of remains and evidence in case of legal matters. The advent of cone-beam computed tomography (CBCT) in the arena of maxillofacial 3D imaging has contributed immensely to forensic science such as the age estimation through teeth, analysis of bite marks, determination of race and sex, etc. The advantages of accuracy in imaging the anatomy, digitized technology favoring easier comparison of records and storage of records for a longer period, cost reduction, dose reduction, and easier portability have made it an unavoidable adjunct in forensic investigations. The aim of this paper is to review and highlight the importance of CBCT in successful forensic identification and analysis. This review is written to address the various aspects of CBCT as a recently developed technology that may be very useful in some forensic contexts, based on searches for current studies in the literature using PubMed, Scopus, Web of Science, and Google Scholar databases, to identify studies published since inception to December 2021, with no language restriction. In conclusion, CBCT is an accessible 3D imaging technology with many applications, one of them being in forensic sciences.
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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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Low-dose CBCT imaging of alveolar buccal bone adjacent to mandibular anterior teeth- a pilot study. Clin Oral Investig 2022; 26:4173-4182. [PMID: 35103838 PMCID: PMC9072474 DOI: 10.1007/s00784-022-04389-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022]
Abstract
Objectives Accurate description of buccal bone adjacent to mandibular anterior teeth is helpful for planning and monitoring periodontal and orthodontic treatment. Low-dose cone beam computed tomography (LD-CBCT) imaging has shown promising results for very small dental structures in animals. This study asserts that LD-CBCT is sufficiently accurate to measure buccal alveolar bone adjacent to human mandibular anterior teeth. Materials and methods Buccal bone level adjacent to 16 mandibular anterior teeth from four human cadavers was measured radiographically using one high-dose (HD) CBCT protocol and two LD-CBCT protocols. The resulting radiographic measurements of buccal bone height (bl) and thickness (bt) were compared with reference probe and reflected-light microscopy measurements. Measurement medians and Bland–Altman plots were calculated, and a linear mixed model was used to compare raters and imaging modalities. Results All regression coefficients were approximately 0, indicating high interrater, intrarater, and intermodality agreement. No significant differences were found between reference measurements and CBCT protocols. The mean differences for bl measurements were 0.07 mm (rater 1 [r1]) and 0.12 mm (rater 2 [r2]) for HD-CBCT; 0.07 mm (r1) and 0.13 mm (r2) for LD-CBCT-1; and 0.02 mm (r1) and 0.01 mm (r2) for LD-CBCT-2. For bt measurements, mean differences were 0.02 mm (r1) and 0.02 mm (r2) for HD-CBCT; 0.01 mm (r1) and 0.01 mm (r2) for LD-CBCT-1; and 0.00 mm (r1) and 0.01 mm (r2) for LD-CBCT-2. Conclusions Within the limitations of the present study, LD-CBCT seems to be a precise method for describing buccal bone and its thickness adjacent to mandibular anterior teeth in this experimental setting. Clinical relevance For the first time, this study showed LD-CBCT produces excellent results and is a reliable modality for imaging buccal bone in vitro. If clinical studies confirm these results, LD-CBCT could enable better treatment planning and monitoring at a radiation dose that is far lower than that of conventional HD-CBCT but similar to that of panoramic views. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-022-04389-x.
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Irie MS, Spin-Neto R, Borges JS, Wenzel A, Soares PBF. Effect of data binning and frame averaging for micro-CT image acquisition on the morphometric outcome of bone repair assessment. Sci Rep 2022; 12:1424. [PMID: 35082347 PMCID: PMC8791988 DOI: 10.1038/s41598-022-05459-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/05/2022] [Indexed: 11/09/2022] Open
Abstract
Despite the current advances in micro-CT analysis, the influence of some image acquisition parameters on the morphometric assessment outcome have not been fully elucidated. The aim of this study was to determine whether data binning and frame averaging affect the morphometric outcome of bone repair assessment using micro-CT. Four Wistar rats' tibiae with a surgically created bone defect were imaged with micro-CT six times each, frame averaging set to 1 and 2, and data binning set to 1, 2 and 4, for each of the averaging values. Two-way ANOVA followed by Bonferroni tests assessed the significance of frame averaging and data binning on a set of morphometric parameters assessed in the image volumes (p < 0.01). The effect of frame averaging was not significant for any of the assessed parameters. Increased data binning led to larger trabecular thickness. In contrast, smaller bone volume fraction and bone volume were found as data binning increased. Trabeculae number and trabecular separation were not influenced by any of the parameters. In conclusion, the morphometric outcome of bone repair assessment in micro-CT demonstrated dependency upon data binning, but not frame averaging. Therefore, image acquisition of small anatomical structures (e.g., rat trabeculae) should be performed without data binning.
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Affiliation(s)
- Milena Suemi Irie
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/no, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus C, Denmark
| | - Juliana Simeão Borges
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/no, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus C, Denmark
| | - Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará s/no, Campus Umuarama, Bloco 4L, Bairro Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil.
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Muñoz-Galván A, Fiori-Chíncaro GA, Agudelo-Botero AM. [Applications of cone beam computed tomography of the craneofacial structure in medical specialties. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e100. [PMID: 38389916 PMCID: PMC10880726 DOI: 10.21142/2523-2754-1001-2022-100] [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: 09/02/2021] [Accepted: 01/01/2022] [Indexed: 02/24/2024] Open
Abstract
Cone-beam computed tomography (CBCT) of the craniofacial structure has demonstrated its usefulness in the dental area during the last decades, thus it has become a fundamental tool in the diagnosis, planning, and evaluation of treatment, and although it was not developed for the exclusive use in dentistry, as it is commonly considered, it is used in other areas such as medicine. It is specifically used in the head and neck area where different medical specialties interact, and at the same time these interact with dental specialties, so knowing the advantages of CBCT over different imaging technologies in the medical area is necessary. The purpose of this review was to describe the applications of observation, diagnosis, planning, and evolution of treatments using maxillofacial HSCT in different medical specialties. This work highlights the use of TCHC in different medical applications and highlights where it is most useful compared to other technologies.
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Affiliation(s)
- Agustín Muñoz-Galván
- Division de Radiologia Bucal y Maxilofacial, Universidad Cientifica del Sur. Lima, Peru. Universidad Científica del Sur Division de Radiologia Bucal y Maxilofacial Universidad Cientifica del Sur Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
| | - Ana María Agudelo-Botero
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
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OUP accepted manuscript. Eur J Orthod 2022; 44:513-521. [DOI: 10.1093/ejo/cjac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Root Resorption of Adjacent Teeth Associated with Maxillary Canine Impaction in the Saudi Arabian Population: A Cross-Sectional Cone-Beam Computed Tomography Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app12010334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to identify the location of root resorption in relation to an impacted maxillary canine and grade its severity using cone-beam computed tomography (CBCT) in the Saudi Arabian population. Materials and Methods: CBCT scans of 169 patients with maxillary canine impaction were evaluated. The location and the severity of root resorption of the affected tooth in relation to the impacted maxillary canine were recorded for each patient. Results: a total 204 impacted maxillary canines caused root resorption in 218 adjacent teeth. Maximum root resorption was present in 63.3% of the apical one-third of the root and 37.6% of the palatal surfaces. There was mild root resorption in 55%, moderate in 10% and severe in 35%. There was no statistically significant difference between the gender, age, type of impaction, side of impaction, and the number, location, or degree of root resorption. Multiple logistic regression models showed significant association (p = 0.024) between gender, type of impaction, and root resorption. A significant correlation was found between the level and the surface of the root resorption (p = 0.018). Conclusion: In the Saudi population, apical one-third root levels and palatal surfaces were primarily involved in root resorption caused by impacted canines. The females with bilateral canine impaction were more likely affected by root resorption.
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Ou X, Chen X, Xu X, Xie L, Chen X, Hong Z, Bai H, Liu X, Chen Q, Li L, Yang H. Recent Development in X-Ray Imaging Technology: Future and Challenges. RESEARCH (WASHINGTON, D.C.) 2021; 2021:9892152. [PMID: 35028585 PMCID: PMC8724686 DOI: 10.34133/2021/9892152] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
X-ray imaging is a low-cost, powerful technology that has been extensively used in medical diagnosis and industrial nondestructive inspection. The ability of X-rays to penetrate through the body presents great advances for noninvasive imaging of its internal structure. In particular, the technological importance of X-ray imaging has led to the rapid development of high-performance X-ray detectors and the associated imaging applications. Here, we present an overview of the recent development of X-ray imaging-related technologies since the discovery of X-rays in the 1890s and discuss the fundamental mechanism of diverse X-ray imaging instruments, as well as their advantages and disadvantages on X-ray imaging performance. We also highlight various applications of advanced X-ray imaging in a diversity of fields. We further discuss future research directions and challenges in developing advanced next-generation materials that are crucial to the fabrication of flexible, low-dose, high-resolution X-ray imaging detectors.
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Affiliation(s)
- Xiangyu Ou
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
| | - Xue Chen
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, China
| | - Xianning Xu
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, China
| | - Lili Xie
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
| | - Xiaofeng Chen
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
| | - Zhongzhu Hong
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
| | - Hua Bai
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, China
| | - Xiaowang Liu
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, China
| | - Qiushui Chen
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
- Fujian Science & Technology Innovation Laboratory for Optoelectronic Information of China, Fuzhou 350108, China
| | - Lin Li
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an 710072, China
| | - Huanghao Yang
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, College of Chemistry, Fuzhou University, Fuzhou 350108, China
- Fujian Science & Technology Innovation Laboratory for Optoelectronic Information of China, Fuzhou 350108, China
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Kehrwald R, Castro HSD, Salmeron S, Matheus RA, Santaella GM, Queiroz PM. Influence of Voxel Size on CBCT Images for Dental Implants Planning. Eur J Dent 2021; 16:381-385. [PMID: 34902874 PMCID: PMC9339931 DOI: 10.1055/s-0041-1736388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective
This study was developed to evaluate the influence of voxel size on bone measurements for implant planning.
Materials and Methods
The research was performed by using edentulous synthetic human mandibles with different levels of bone resorption. For each mandible, height and bone thickness were measured with a digital caliper. The PaX-i3d device was used to acquire the volumes of the five mandibles, with 50kVp, 4 mA, and a voxel size of 0.08 mm. After the acquisition, the images were reconstructed in the software CS three-dimensional Imaging, with four different sizes of voxels: 0.1, 0.2, 0.3, and 0.4 mm. All volumes were analyzed by a single evaluator who performed measurements to obtain bone height and thickness, using the reference points that were considered in obtaining the gold standard. The data were analyzed by ANOVA with a significance level of 5%.
Results
There was no significant difference in the measurements obtained with different voxel sizes, both for bone height measurements and bone thickness. There was no statistically significant difference in measurements in thickness in comparison to the gold standard.
Conclusion
When necessary, to measure height and bone thickness, it is possible to recommend voxel images of larger size (0.40 mm) without compromising the quality of the patient's clinical planning.
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Affiliation(s)
- Ricardo Kehrwald
- Department of Dentistry, Area of Implantology, Ingá Center University Maringa, Parana, Brazil
| | | | - Samira Salmeron
- Department of Dentistry, Area of Implantology, Ingá Center University Maringa, Parana, Brazil
| | - Ricardo Alves Matheus
- Department of Oral Medicine, Division of Oral Radiology, State University of Londrina, Londrina, Parana, Brazil
| | - Gustavo Machado Santaella
- Department of Diagnosis and Oral Health, Division of Oral Radiology, University of Louisville, Louisville, Kentucky, United States
| | - Polyane Mazucatto Queiroz
- Department of Dentistry, Division Oral Radiology, Area of Oral Radiology, Ingá Center University Maringa, Parana, Brazil
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Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement. Am J Orthod Dentofacial Orthop 2021; 161:396-403.e1. [PMID: 34654602 DOI: 10.1016/j.ajodo.2020.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The objectives were to evaluate the morphologic changes of the incisive canal (IC) and the influence of IC proximity to apical root resorption of maxillary central incisors after anterior tooth movement. METHODS Pretreatment and posttreatment cone-beam computed tomography images of adults (aged 18-47 years) were retrospectively evaluated. Subjects were divided into control group with minimal incisor movement (n = 32; maxillary incisor tip movement <2 mm) and maximum retraction group (n = 35; maxillary incisor tip movement >4 mm). The shape, direction, morphologic changes of the IC, the proximity of the central incisor root to IC, and the amount of apical root resorption associated with the proximity after orthodontic treatment were compared. RESULTS Changes in the shape of the IC were not observed in both control and retraction groups. However, 11.4% (4 of 35 subjects) in the retraction group indicated changes in the direction of the IC from slanted-straight to slanted-curved type after the direction of anterior retraction. The thickness of the cortical bone surrounding the IC and the distance between the incisor root and IC significantly decreased after orthodontic treatment in both groups (P <0.05). However, these changes were significantly greater in the retraction group than in control (P <0.0001). Contact or invasion of the incisor root to the IC was more prominent in the retraction group (42.8%-54.3%) than the control (10.9%-12.5%) (P <0.0001). The amount of root resorption indicated a tendency to increase in the order of separation, approximation, contact, and invasion in relation to IC. CONCLUSIONS Although remodeling of IC was evident in some patients, contact or invasion of the maxillary central incisor roots to IC was fairly high after maximum anterior retraction.
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Lin X, Fu Y, Ren G, Yang X, Duan W, Chen Y, Zhang Q. Micro-Computed Tomography-Guided Artificial Intelligence for Pulp Cavity and Tooth Segmentation on Cone-beam Computed Tomography. J Endod 2021; 47:1933-1941. [PMID: 34520812 DOI: 10.1016/j.joen.2021.09.001] [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] [Received: 02/24/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study proposes a novel data pipeline based on micro-computed tomographic (micro-CT) data for training the U-Net network to realize the automatic and accurate segmentation of the pulp cavity and tooth on cone-beam computed tomographic (CBCT) images. METHODS We collected CBCT data and micro-CT data of 30 teeth. CBCT data were processed and transformed into small field of view and high-resolution CBCT images of each tooth. Twenty-five sets were randomly assigned to the training set and the remaining 5 sets to the test set. We used 2 data pipelines for U-Net network training: one manually labeled by an endodontic specialist as the control group and one processed from the micro-CT data as the experimental group. The 3-dimensional models constructed using micro-CT data in the test set were taken as the ground truth. The Dice similarity coefficient, precision rate, recall rate, average symmetric surface distance, Hausdorff distance, and morphologic analysis were used for performance evaluation. RESULTS The segmentation accuracy of the experimental group measured by the Dice similarity coefficient, precision rate, recall rate, average symmetric surface distance, and Hausdorff distance were 96.20% ± 0.58%, 97.31% ± 0.38%, 95.11% ± 0.97%, 0.09 ± 0.01 mm, and 1.54 ± 0.51 mm in the tooth and 86.75% ± 2.42%, 84.45% ± 7.77%, 89.94% ± 4.56%, 0.08 ± 0.02 mm, and 1.99 ± 0.67 mm in the pulp cavity, respectively, which were better than the control group. Morphologic analysis suggested the segmentation results of the experimental group were better than those of the control group. CONCLUSIONS This study proposed an automatic and accurate approach for tooth and pulp cavity segmentation on CBCT images, which can be applied in research and clinical tasks.
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Affiliation(s)
- Xiang Lin
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yujie Fu
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Genqiang Ren
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Xiaoyu Yang
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Wei Duan
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Yufei Chen
- College of Electronics and Information Engineering, Tongji University, Shanghai, China.
| | - Qi Zhang
- Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.
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Basic Knowledge and New Advances in Panoramic Radiography Imaging Techniques: A Narrative Review on What Dentists and Radiologists Should Know. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11177858] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: A panoramic radiograph (PAN) is the most frequently diagnostic imaging technique carried out in dentistry and oral surgery. The correct performance of image acquisition is crucial to obtain adequate image quality. The aim of the present study is to (i) review the principles of PAN image acquisition and (ii) describe positioning errors and artefacts that may affect PAN image quality. Methods: Articles regarding PAN acquisition principles, patient’s positioning errors, artefacts, and image quality were retrieved from the literature. Results: Head orientation is of the utmost importance in guaranteeing correct image acquisition. Symmetry, occlusal plane inclination, mandibular condyles localization, cervical spine position, aspect of upper teeth root apexes, exposure parameters, and metal and motion artefacts are factors that greatly affect the image quality of a successful PAN. Conclusions: Several factors are the basis for PAN performance; therefore, a systematic approach that takes into account correct patient positioning and preparation is strongly suggested to improve overall examination quality.
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Bianchi J, Roberto Gonçalves J, Carlos de Oliveira Ruellas A, Vieira Pastana Bianchi J, Ashman LM, Yatabe M, Benavides E, Soki FN, Cevidanes LHS. Radiographic interpretation using high-resolution Cbct to diagnose degenerative temporomandibular joint disease. PLoS One 2021; 16:e0255937. [PMID: 34375354 PMCID: PMC8354480 DOI: 10.1371/journal.pone.0255937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to use high-resolution cone-beam computed images (hr- CBCT) to diagnose degenerative joint disease in asymptomatic and symptomatic subjects using the Diagnostic Criteria for Temporomandibular Disorders DC/TMD imaging criteria. This observational study comprised of 92 subjects age-sex matched and divided into two groups: clinical degenerative joint disease (c-DJD, n = 46) and asymptomatic control group (n = 46). Clinical assessment of the DJD and high-resolution CBCT images (isotropic voxel size of 0.08mm) of the temporomandibular joints were performed for each participant. An American Board of Oral and Maxillofacial Radiology certified radiologist and a maxillofacial radiologist used the DC/TMD imaging criteria to evaluate the radiographic findings, followed by a consensus of the radiographic evaluation. The two radiologists presented a high agreement (Cohen's Kappa ranging from 0.80 to 0.87) for all radiographic findings (osteophyte, erosion, cysts, flattening, and sclerosis). Five patients from the c- DJD group did not present radiographic findings, being then classified as arthralgia. In the asymptomatic control group, 82.6% of the patients presented radiographic findings determinant of DJD and were then classified as osteoarthrosis or overdiagnosis. In conclusion, our results showed a high number of radiographic findings in the asymptomatic control group, and for this reason, we suggest that there is a need for additional imaging criteria to classify DJD properly in hr-CBCT images.
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Affiliation(s)
- Jonas Bianchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, United States of America
- Department of Pediatric Dentistry, São Paulo State University (Unesp), School of Dentist, Araraquara, São Paulo, Brazil
| | - João Roberto Gonçalves
- Department of Pediatric Dentistry, São Paulo State University (Unesp), School of Dentist, Araraquara, São Paulo, Brazil
| | - Antônio Carlos de Oliveira Ruellas
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, United States of America
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Júlia Vieira Pastana Bianchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lawrence M. Ashman
- Oral & Maxillofacial Surgery, Hospital Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Fabiana Naomi Soki
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lucia Helena Soares Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Tokuc B, Kan B. The effect of triangular cross-section neck design on crestal bone stability in the anterior mandible: A randomized, controlled, split-mouth clinical trial. Clin Oral Implants Res 2021; 32:1241-1250. [PMID: 34352125 DOI: 10.1111/clr.13821] [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] [Received: 12/18/2020] [Revised: 06/05/2021] [Accepted: 07/22/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This randomized controlled trial aimed to compare crestal bone loss (CBL) and buccal bone thickness (BBT) around triangular cross-section neck (TN) to round neck (RN) implants retaining mandibular overdentures one year after loading, using cone beam computed tomography (CBCT). MATERIAL AND METHODS Twenty edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN and TN groups. Clinical buccal bone thickness (CBBT) around the implants was measured with a caliper at baseline. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the baseline and two months after insertion. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also recorded at postoperative months 2, 6, and 12. CBCT was used to evaluate proximal CBL and BBT at three levels (0, -2, and -4 mm) one year after loading. RESULTS No implant loss was observed during the follow-up period. No significant differences in CBBT, ISQ values, and scores for PPD, PI, and GI between the two groups were observed at any time (p > .05). BBT was also comparable one year after loading (p > .05). The mean ± SD proximal CBL one year after loading was 0.58 ± 0.36 mm for TN and 0.91 ± 0.59 mm for RN (p < .01). CONCLUSIONS This study found better crestal bone preservation in the implants with the novel neck design than conventional neck design in the anterior mandible after a follow-up of one year. However, it may not be clinically noticeable.
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Affiliation(s)
- Berkay Tokuc
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Bahadır Kan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Okan University, Istanbul, Turkey
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Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: An updated review. Phys Med 2021; 88:193-217. [PMID: 34284332 DOI: 10.1016/j.ejmp.2021.07.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/16/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Cone beam computed tomography (CBCT) is a diverse 3D x-ray imaging technique that has gained significant popularity in dental radiology in the last two decades. CBCT overcomes the limitations of traditional two-dimensional dental imaging and enables accurate depiction of multiplanar details of maxillofacial bony structures and surrounding soft tissues. In this review article, we provide an updated status on dental CBCT imaging and summarise the technical features of currently used CBCT scanner models, extending to recent developments in scanner technology, clinical aspects, and regulatory perspectives on dose optimisation, dosimetry, and diagnostic reference levels. We also consider the outlook of potential techniques along with issues that should be resolved in providing clinically more effective CBCT examinations that are optimised for the benefit of the patient.
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Affiliation(s)
- Touko Kaasalainen
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland.
| | - Marja Ekholm
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520 Turku, Finland; South West Finland Imaging Center, Turku University Hospital, Lemminkäisenkatu 2, 20520 Turku, Finland
| | - Teemu Siiskonen
- Radiation Practices Regulation, Radiation and Nuclear Safety Authority - STUK, P.O. Box 14, FI-00881 Helsinki, Finland
| | - Mika Kortesniemi
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland
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Barros de Oliveira ML, Junqueira RB, Kamburoğlu K, Eratam N, Çakmak EE, Sönmez G, Küçük Ö, Verner FS. Assessment of the Metal Artifact Reduction Tool for the Detection of Root Isthmus in Mandibular Molars with Intraradicular Posts in Cone-beam Computed Tomographic Scans. J Endod 2021; 47:1583-1591. [PMID: 34265325 DOI: 10.1016/j.joen.2021.07.003] [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] [Received: 03/08/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study evaluated the performance of the metal artifact reduction (MAR) tool in cone-beam computed tomographic scans using different fields of view (FOVs) in the detection of a root isthmus in mandibular molars with intraradicular posts. METHODS Twenty-eight teeth were scanned by micro-computed tomographic imaging (gold standard images). Thereafter, specimens were allocated into the following groups: gutta-percha (teeth without posts, n = 10), a prefabricated metal post (n = 9), and a fiberglass post (n = 9). Cone-beam computed tomographic scans were taken using 8 acquisition protocols, varying the size of the FOV (10 × 5.5 cm and 5 × 5.5 cm) and the MAR tool (disabled, low, normal, and high modes). A root isthmus was evaluated considering a 5-point scale. Data were analyzed considering a 5% significance level. RESULTS Intra- and interexaminer agreement varied from moderate to substantial. The frequency of correct diagnosis varied significantly in all groups regardless of the image acquisition protocol selected (P < .05). In the gutta-percha group, there was no difference in the accuracy, sensitivity, and specificity values between the tested protocols. In the metal and fiberglass post groups, the accuracy values were higher with the "disabled" and "low" modes of the MAR tool regardless of the FOV size. This was also observed for the sensitivity values in the metal post group (P < .05). CONCLUSIONS The size of the FOV did not affect the performance of the MAR tool in the diagnosis of a root isthmus in molars with intraradicular posts. Our findings suggest that the use of the tool in the "normal" and "high" modes is contraindicated for this purpose.
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Affiliation(s)
- Manuela Lima Barros de Oliveira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Özlem Küçük
- Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Francielle Silvestre Verner
- Applied Health Sciences Post-Graduate Program, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil; Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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Maret D, Vergnes JN, Peters OA, Peters C, Nasr K, Monsarrat P. Recent Advances in Cone-beam CT in Oral Medicine. Curr Med Imaging 2021; 16:553-564. [PMID: 32484089 DOI: 10.2174/1573405615666190114152003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Affiliation(s)
- Delphine Maret
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,AMIS Laboratory - Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean-Noel Vergnes
- Epidemiology and Public Health Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Christine Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States
| | - Karim Nasr
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France
| | - Paul Monsarrat
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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The Chairside Periodontal Diagnostic Toolkit: Past, Present, and Future. Diagnostics (Basel) 2021; 11:diagnostics11060932. [PMID: 34067332 PMCID: PMC8224643 DOI: 10.3390/diagnostics11060932] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Periodontal diseases comprise a group of globally prevalent, chronic oral inflammatory conditions caused by microbial dysbiosis and the host immune response. These diseases specifically affect the tooth-supporting tissues (i.e., the periodontium) but are also known to contribute to systemic inflammation. If left untreated, periodontal diseases can ultimately progress to tooth loss, lead to compromised oral function, and negatively impact the overall quality of life. Therefore, it is important for the clinician to accurately diagnose these diseases both early and accurately chairside. Currently, the staging and grading of periodontal diseases are based on recording medical and dental histories, thorough oral examination, and multiple clinical and radiographic analyses of the periodontium. There have been numerous attempts to improve, automate, and digitize the collection of this information with varied success. Recent studies focused on the subgingival microbiome and the host immune response suggest there is an untapped potential for non-invasive oral sampling to assist clinicians in the chairside diagnosis and, potentially, prognosis. Here, we review the available toolkit available for diagnosing periodontal diseases, discuss commercially available options, and highlight the need for collaborative research initiatives and state-of-the-art technology development across disciplines to overcome the challenges of rapid periodontal disease diagnosis.
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Conejo J, Dayo AF, Syed AZ, Mupparapu M. The Digital Clone: Intraoral Scanning, Face Scans and Cone Beam Computed Tomography Integration for Diagnosis and Treatment Planning. Dent Clin North Am 2021; 65:529-553. [PMID: 34051929 DOI: 10.1016/j.cden.2021.02.011] [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: 10/21/2022]
Abstract
The purpose of this article is to synthesize different technologies that are available for the creation of a virtual patient, "the digital clone" because the data can be used for diagnosis as well as treatment planning. The role of facial scans, 3-dimensional intraoral scans as well as the cone beam computed tomography in the creation of a digital clone is discussed in detail. A step-by-step guide is created for the reader for integration of the intraoral scan data with the cone beam computed tomography Dicom data to create a digital clone.
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Affiliation(s)
- Julian Conejo
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Robert Schattner Center, Suite #350, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Adeyinka F Dayo
- University of Pennsylvania School of Dental Medicine, Robert Schattner Center, 240 S 40th Street, Philadelphia, PA 10104, USA
| | - Ali Z Syed
- Admitting & Oral and Maxillofacial Radiology Clinics, Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Medicine & Diagnostic Sciences, CWRU School of Dental Medicine, Office # 245 C, 9601 Chester Avenue, Cleveland, OH 44106, USA
| | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, 240 S 40th Street, Suite 214, Philadelphia, PA 19104, USA.
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50
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Dartus J, Jacques T, Martinot P, Pasquier G, Cotten A, Migaud H, Morel V, Putman S. The advantages of cone-beam computerised tomography (CT) in pain management following total knee arthroplasty, in comparison with conventional multi-detector CT. Orthop Traumatol Surg Res 2021; 107:102874. [PMID: 33647454 DOI: 10.1016/j.otsr.2021.102874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Revision of total knee arthroplasty (TKA) requires preoperative assessment to identify the causes of failure. Multidetector computerised tomography (MDCT) is a commonly used imaging technique, but is sensitive to certain artifacts, such as metal implants, limiting its use. Cone-beam CT (CBCT) is a new technique dedicated to musculoskeletal imaging that is less sensitive to artifacts and could be utilised in knee implantation surgery. CBCT has not yet been validated for this indication, and we therefore undertook a retrospective assessment of MDCT versus CBCT, comparing: 1) image quality; 2) reproducibility of angle measurements; 3) effectiveness in screening for periprosthetic radiolucency and implant loosening; and 4) radiation dose. HYPOTHESIS This study hypothesised that CBCT provides better image quality, angle measurement reproducibility, and screening for radiolucency and implant loosening at lower doses of radiation than MDCT. PATIENTS AND METHOD Between October 2017 and March 2018, 28 patients, with a mean age of 61±11.6 years [range, 45-85 years] underwent both MDCT and CBCT for pain following TKA. Two radiologists performed angle measurements on both devices: patellofemoral tilt (PFT), rotation angle of the femoral component (RAFC) and rotation angle of the tibial component (RATC). They also screened for pathological radiolucency and/or implant loosening, and assessed image quality at the various bone/implant interfaces. The mean CT dose index per examination was recorded. RESULTS Intraclass correlation coefficients for angles and radiolucency screening on MDCT and on CBCT were respectively good (0.73) and excellent (0.82) for PFT, borderline (0.28) and moderate (0.44) for RAFC, excellent (0.82) and excellent (0.96) for RATC, and moderate (0.45) and excellent (0.84) for radiolucency screening. The inter-observer kappa correlation coefficients for diagnosis of implant loosening and image quality assessment for MDCT and CBCT were respectively moderate (0.45) and excellent (0.93) for tibial loosening and low (0.19) and borderline (0.38) for femoral loosening. The mean image quality at the various interfaces for MDCT and CBCT was respectively 2.2/3 and 2.75/3 at the tibia/tibial implant interface, 1/3 and 2.3/3 at the trochlear region/femoral implant interface, 0.9/3 and 2/3 at the femoral condyle/femoral implant interface, and 1.25/3 and 2.1/3 at the patella/patellar medallion interface. The mean CT dose index was significantly lower, by a factor of 1.24, on CBCT (4.138 mGy) than MDCT (5.125 mGy) (p<00396). CONCLUSION The results of the present study revealed added value for CBCT in the etiological work-up for pain following a TKA. It was reliable and reproducible for the rotation measurement and diagnosis of implant loosening, due to enhanced image quality despite a lower radiation dose than conventional MDCT. LEVEL OF EVIDENCE III; retrospective comparative study.
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Affiliation(s)
- Julien Dartus
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service de chirurgie orthopédique, CHU de Lille, Hôpital Roger-Salengro, 59000 Lille, France.
| | - Thibaut Jacques
- Service d'imagerie musculo-squelettique, CHU de Lille, Centre de consultations et d'imagerie de l'appareil locomoteur, 59000 Lille, France
| | - Pierre Martinot
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service de chirurgie orthopédique, CHU de Lille, Hôpital Roger-Salengro, 59000 Lille, France; Service d'imagerie musculo-squelettique, CHU de Lille, Centre de consultations et d'imagerie de l'appareil locomoteur, 59000 Lille, France
| | - Gilles Pasquier
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service de chirurgie orthopédique, CHU de Lille, Hôpital Roger-Salengro, 59000 Lille, France
| | - Anne Cotten
- Service d'imagerie musculo-squelettique, CHU de Lille, Centre de consultations et d'imagerie de l'appareil locomoteur, 59000 Lille, France
| | - Henri Migaud
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service de chirurgie orthopédique, CHU de Lille, Hôpital Roger-Salengro, 59000 Lille, France
| | - Vincent Morel
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service d'imagerie musculo-squelettique, CHU de Lille, Centre de consultations et d'imagerie de l'appareil locomoteur, 59000 Lille, France
| | - Sophie Putman
- Département universitaire de chirurgie orthopédique et traumatologique, Université de Lille, CHU de Lille, ULR 4490, 59000 Lille, France; Service de chirurgie orthopédique, CHU de Lille, Hôpital Roger-Salengro, 59000 Lille, France
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