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Popkowski A, Rhodes SC, Hatton JF. Proposed Diagnostic Reference Levels in the Missouri/Southern Illinois Region Associated with Cone-beam Computed Tomography Use in Endodontics. J Endod 2024; 50:966-975. [PMID: 38382736 DOI: 10.1016/j.joen.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Diagnostic reference levels (DRLs) are intended to improve patient safety and ensure that patient ionizing radiation doses are as low as reasonably achievable. The purpose of this dosimetry study was to establish regional DRL levels for cone-beam computed tomography (CBCT) imaging for specialty endodontics. Another aim was to compare phantom-measured ionizing radiation dose index 1 (DI1) index doses to the manufacturer-provided dose area product (DAP) radiation output values for each of the CBCT machines studied, to ascertain their degree of correlation. DAP refers to the dose area product, a measure of radiation dose monitoring which represents the dose within the beam times the area within the beam at that position. METHODS A thimble ionization chamber and polymethyl methacrylate phantom were used to obtain DI1 values using the SEDENTEXTCT method from 21 different CBCT units. DRLs were calculated based on the 75th percentile (third quartile) of the median output values. RESULTS The proposed DRL from the CBCT units surveyed has a DAP value of 838 mGy cm2 and a DI1 value of 3.924 mGy. DAP versus DI1 values of 500.6 mGy cm2 versus 2.006 mGy, and 838 mGy cm2 versus 3.906 mGy represented the third quartile of the median values for the 4-cm × 4-cm and 5-cm × 5-cm field of views (FOVs), respectively. CONCLUSIONS The DI1 and DAP values strongly correlated when 3 outlier CBCT machines (J Morita Veraview X800) using a novel 360° (full rotation) acquisition mode were excluded. The importance of selectable exposure parameters as directly related to ionizing radiation output is illustrated among the CBCT units surveyed. Although the actual FOV that is selected is ultimately dictated by the specific clinical requirements, a 4-cm × 4-cm FOV is recommended for specialist endodontics practice, whenever clinically practical, based on the decreased ionizing radiation output, as compared to that from a 5-cm × 5-cm FOV.
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Affiliation(s)
- Arthur Popkowski
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
| | - S Craig Rhodes
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri.
| | - John F Hatton
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
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Yavuz E, Yardimci S. Comparison of periapical radiography, panoramic radiography, and CBCT in the evaluation of trabecular bone structure using fractal analysis. Oral Radiol 2024; 40:394-400. [PMID: 38407759 DOI: 10.1007/s11282-024-00743-9] [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: 08/25/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim of this study is to compare imaging techniques to evaluate trabecular bone structure using Fractal Analysis (FA). METHODS Fifteen sheep hemimandibles were used for this study. Digital images were obtained using periapical radiography, panoramic radiography, and cone-beam computed tomography (CBCT). CBCT imaging was performed in standard (STD) and high-resolution (HR) modes. FA was conducted using ImageJ 1.3 software with the box-counting method on the images. The fractal dimension (FD) values were analyzed by the statistical software Jamovi 1.6.23. Statistical significance was accepted as p < 0.05. RESULTS The highest mean FD value was the FD on digital periapical radiographs (PaFD) (1.28 ± 0.04), and the lowest mean FD value was the FD on standard resolution cone-beam computed tomography images (STD-CBCTFD) (1.12 ± 0.10). Although there was no statistically significant difference between the PaFD and the FD on digital panoramic radiographs (PanFD) (p = 0.485), the PaFD was found to be significantly higher than STD-CBCTFD (p < 0.001), and the FD on high-resolution cone-beam computed tomography images (HR-CBCTFD) (p = 0.007). The PanFD was found to be significantly higher than the STD-CBCTFD (p = 0.004). CONCLUSION According to our results, in the evaluation of trabecular bone structure using FA, periapical radiographs and panoramic radiographs have similar image quality for assessment of the FD. On the other hand, CBCT results did not correlate with results from any of the other techniques in this study.
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Affiliation(s)
- Esra Yavuz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Selmi Yardimci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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La Rosa GRM, Peditto M, Venticinque A, Marcianò A, Bianchi A, Pedullà E. Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications. AUST ENDOD J 2024. [PMID: 38887152 DOI: 10.1111/aej.12865] [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: 02/09/2024] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Peditto
- Postgraduate School of Oral Surgery, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Venticinque
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonia Marcianò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Rodriguez A, Kripfgans O, 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 2024:105136. [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] [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
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA; Department of Periodontics, University of Illinois Chicago, College of Dentistry, Chicago, Illinois, USA.
| | - Oliver Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
| | - Priscila Ceolin Meneghetti
- Department of Restorative Sciences, University of Alabama School of Dentistry, Birmingham, Alabama, USA; Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Gustavo Mendonça
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA; Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA.
| | - Rafael Pereira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Wendel Teixeira
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Nataly Zambrana
- Department of Biologic and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
| | - Ankita Samal
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA; Division of Periodontology, the Ohio State University, College of Dentistry, Columbus, Ohio, USA.
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Burck I, Yel I, Martin S, Albrecht MH, Koch V, Booz C, Pinto Dos Santos D, Kaltenbach B, Ackermann H, Koivisto J, Helbig S, Stöver T, Vogl TJ, Scholtz JE. Comparison of 96-kV and 120-kV cone-beam CT for the assessment of cochlear implants. BMC Med Imaging 2024; 24:145. [PMID: 38872126 DOI: 10.1186/s12880-024-01322-4] [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: 05/04/2023] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND To compare the diagnostic value of 120-kV with conventional 96-kV Cone-Beam CT (CBCT) of the temporal bone after cochlear implant (CI) surgery. METHODS This retrospective study included CBCT scans after CI surgery between 06/17 and 01/18. CBCT allowed examinations with 96-kV or 120-kV; other parameters were the same. Two radiologists independently evaluated following criteria on 5-point Likert scales: osseous spiral lamina, inner and outer cochlear wall, semi-circular canals, mastoid trabecular structure, overall image quality, metal and motion artefacts, depiction of intracochlear electrode position and visualisation of single electrode contacts. Effective radiation dose was assessed. RESULTS Seventy-five patients (females, n = 39 [52.0%], mean age, 55.8 ± 16.5 years) were scanned with 96-kV (n = 32, 42.7%) and 120-kV (n = 43, 57.3%) protocols including CI models from three vendors (vendor A n = 7; vendor B n = 43; vendor C n = 25). Overall image quality, depiction of anatomical structures, and electrode position were rated significantly better in 120-kV images compared to 96-kV (all p < = 0.018). Anatomical structures and electrode position were rated significantly better in 120-kV CBCT for CI models from vendor A and C, while 120-kV did not provide improved image quality in CI models from vendor B. Radiation doses were significantly higher for 120-kV scans compared to 96-kV (0.15 vs. 0.08 mSv, p < 0.001). CONCLUSIONS 120-kV and 96-kV CBCT provide good diagnostic images for the postoperative CI evaluation. While 120-kV showed improved depiction of temporal bone and CI electrode position compared to 96-kV in most CI models, the 120-kV protocol should be chosen wisely due to a substantially higher radiation exposure.
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Affiliation(s)
- Iris Burck
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Ibrahim Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Simon Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Moritz H Albrecht
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Vitali Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Christian Booz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Daniel Pinto Dos Santos
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Benjamin Kaltenbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, University Hospital Frankfurt, Frankfurt, Germany
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Silke Helbig
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | - Timo Stöver
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Jan-Erik Scholtz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
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Dogan OB, Boyacioglu H. Medial sigmoid depression prevalence and association with a sigmoid notch: cone beam computed tomography and panoramic image study. Sci Rep 2024; 14:11554. [PMID: 38773238 PMCID: PMC11109133 DOI: 10.1038/s41598-024-62490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024] Open
Abstract
This study aims to determine whether and how the data of the medial sigmoid depression (MSD) area via cone beam computed tomography (CBCT) differs from panoramic radiography. This study also aims to evaluate various sigmoid notch types and assess the relationship between sigmoid depression and notch morphology. A total of 129 individuals consisting of 258 sides were evaluated. Chi-Square/Fisher Exact tests were used to assess parameters on a categorical scale between two or more groups. McNemar's test compared the findings detected on panoramic and CBCT images. MSD was more prevalent in females than males in both techniques, but this difference was not statistically significant. There was no association between the prevalence of MSD and the morphology of the sigmoid notch. The incidence of MSD shape was not significantly different between both imaging modalities. In both panoramic and CBCT, we found a high and similar prevalence of MSD. While the MSD prevalence was 66.7% for CBCT, it was 58.1% for panoramic. The shape or prevalence of MSDs in either approach did not correlate with sigmoid notch morphology. The two approaches' identical prevalence indicates that the panoramic image has adequately defines MSD. The high prevalence of MSD demonstrated how important it is for clinicians to characterize this anatomical variation accurately for the surgical treatment.
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Affiliation(s)
- Ozlem Busra Dogan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye, Ankara, Turkey.
| | - Hatice Boyacioglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hacettepe University, 06230, Sihhiye, Ankara, Turkey
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Mihailidis DN, Stratis A, Gingold E, Carlson R, DeForest W, Gray J, Lally MT, Pizzutiello R, Rong J, Spelic D, Hilohi MC, Massoth R. AAPM Task Group Report 261: Comprehensive quality control methodology and management of dental and maxillofacial cone beam computed tomography (CBCT) systems. Med Phys 2024; 51:3134-3164. [PMID: 38285566 DOI: 10.1002/mp.16911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/31/2024] Open
Abstract
Cone-beam computed tomography (CBCT) systems specifically designed and manufactured for dental, maxillofacial imaging (MFI) and otolaryngology (OLR) applications have been commercially available in the United States since 2001 and have been in widespread clinical use since. Until recently, there has been a lack of professional guidance available for medical physicists about how to assess and evaluate the performance of these systems and about the establishment and management of quality control (QC) programs. The owners and users of dental CBCT systems may have only a rudimentary understanding of this technology, including how it differs from conventional multidetector CT (MDCT) in terms of acceptable radiation safety practices. Dental CBCT systems differ from MDCT in several ways and these differences are described. This report provides guidance to medical physicists and serves as a basis for stakeholders to make informed decisions regarding how to manage and develop a QC program for dental CBCT systems. It is important that a medical physicist with experience in dental CBCT serves as a resource on this technology and the associated radiation protection best practices. The medical physicist should be involved at the pre-installation stage to ensure that a CBCT room configuration allows for a safe and efficient workflow and that structural shielding, if needed, is designed into the architectural plans. Acceptance testing of new installations should include assessment of mechanical alignment of patient positioning lasers and x-ray beam collimation and benchmarking of essential image quality performance parameters such as image uniformity, noise, contrast-to-noise ratio (CNR), spatial resolution, and artifacts. Several approaches for quantifying radiation output from these systems are described, including simply measuring the incident air-kerma (Kair) at the entrance surface of the image receptor. These measurements are to be repeated at least annually as part of routine QC by the medical physicist. QC programs for dental CBCT, at least in the United States, are often driven by state regulations, accreditation program requirements, or manufacturer recommendations.
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Affiliation(s)
- Dimitris N Mihailidis
- University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Eric Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ray Carlson
- Radiological Physics Services, Inc, Plymouth, Michigan, USA
| | | | | | - Mary T Lally
- Intersocietal Accreditation Commission, Ellicott City, Maryland, USA
| | | | - John Rong
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - David Spelic
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Mike C Hilohi
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Richard Massoth
- Sunflower Medical Physics, LLC, Sioux Falls, South Dakota, USA
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Carneiro ALE, Reis INR, Bitencourt FV, Salgado DMRA, Costa C, Spin-Neto R. Accuracy of linear measurements for implant planning based on low-dose cone beam CT protocols: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:207-221. [PMID: 38429951 PMCID: PMC11056743 DOI: 10.1093/dmfr/twae007] [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: 08/02/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES The aim of this systematic review was to verify the accuracy of linear measurements performed on low-dose CBCT protocols for implant planning, in comparison with those performed on standard and high-resolution CBCT protocols. METHODS The literature search included four databases (Pubmed, Web of Science, Embase, and Scopus). Two reviewers independently screened titles/abstracts and full texts according to eligibility criteria, extracted the data, and examined the methodological quality. Risk of bias assessment was performed using the Quality Assessment Tool For In Vitro Studies. Random-effects meta-analysis was used for pooling measurement error data. RESULTS The initial search yielded 4684 titles. In total, 13 studies were included in the systematic review, representing a total of 81 samples, while 9 studies were included in the meta-analysis. The risk of bias ranged from medium to low. The main results across the studies indicate a strong consistency in linear measurements performed on low-dose images in relation to the reference methods. The overall pooled planning measurement error from low-dose CBCT protocols was -0.24 mm (95% CI, -0.52 to 0.04) with a high level of heterogeneity, showing a tendency for underestimation of real values. Various studies found no significant differences in measurements across different protocols (eg, voxel sizes, mA settings, or dose levels), regions (incisor, premolar, molar) and types (height vs. width). Some studies, however, noted exceptions in measurements performed on the posterior mandible. CONCLUSION Low-dose CBCT protocols offer adequate precision and accuracy of linear measurements for implant planning. Nevertheless, diagnostic image quality needs must be taken into consideration when choosing a low-dose CBCT protocol.
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Affiliation(s)
- Ana Luiza E Carneiro
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Isabella N R Reis
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Fernando Valentim Bitencourt
- Section for Oral Ecology and Inflammation, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
- Steno Diabetes Center Aarhus, Aarhus, 8200, Denmark
| | - Daniela M R A Salgado
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health—Section for Oral Radiology and Endodontics, Aarhus University, Aarhus, 8000, Denmark
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Mladenovic M, Freezer S, Dreyer C, Meade MJ. The orthodontic extraction of second premolars: The influence on airway volume. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00112-4. [PMID: 38678455 DOI: 10.1016/j.ajodo.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION The extraction of second premolars and associated changes in the volume of the airway have not been previously explored. This retrospective study aimed to compare the volumetric changes of the airway preorthodontic and postorthodontic treatment in relevant extraction and control samples and to identify variables that may influence the outcome. METHODS Cone-beam computed radiography scans of 54 patients with second premolar extraction and 59 nonextraction patients treated in a private orthodontic practice were matched for crowding. The average age for both samples was 15 years. The images were individually landmarked and measured by applying volumetric, linear, and angular parameters. The results were analyzed using repeated measures, such as variance analysis, correlation testing, and regression statistical analyses. RESULTS There was a statistically significant increase in the airway volume for both groups (P <0.05). The difference in increase between the groups was not statistically significant. Seven variables demonstrated a collectively significant effect on changes to airway volume (F[7,112] = 38.48; P <0.001; r2 = 0.701), with 70% of the variation predicted by the variables. Multiple regression analyses indicated that changes to the area of minimum constriction (B = 32.45; t = 11.95; P <0.001) and changes to airway length (B = 94.75; t = 7.79; P <0.001) had a statistically significant effect on airway volume. CONCLUSIONS The volume of the airway increased in both the extraction and nonextraction samples. The biggest contributors to the increase were an increase in airway length and an increase in the area of minimum constriction, which likely occurred as a result of natural growth.
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Affiliation(s)
- Miodrag Mladenovic
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Simon Freezer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Craig Dreyer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
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Zheng Q, Gao Y, Zhou M, Li H, Lin J, Zhang W, Chen X. Semi or fully automatic tooth segmentation in CBCT images: a review. PeerJ Comput Sci 2024; 10:e1994. [PMID: 38660190 PMCID: PMC11041986 DOI: 10.7717/peerj-cs.1994] [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: 09/18/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Cone beam computed tomography (CBCT) is widely employed in modern dentistry, and tooth segmentation constitutes an integral part of the digital workflow based on these imaging data. Previous methodologies rely heavily on manual segmentation and are time-consuming and labor-intensive in clinical practice. Recently, with advancements in computer vision technology, scholars have conducted in-depth research, proposing various fast and accurate tooth segmentation methods. In this review, we review 55 articles in this field and discuss the effectiveness, advantages, and disadvantages of each approach. In addition to simple classification and discussion, this review aims to reveal how tooth segmentation methods can be improved by the application and refinement of existing image segmentation algorithms to solve problems such as irregular morphology and fuzzy boundaries of teeth. It is assumed that with the optimization of these methods, manual operation will be reduced, and greater accuracy and robustness in tooth segmentation will be achieved. Finally, we highlight the challenges that still exist in this field and provide prospects for future directions.
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Affiliation(s)
- Qianhan Zheng
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Gao
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengqi Zhou
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huimin Li
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Lin
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weifang Zhang
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Social Medicine & Health Affairs Administration, Zhejiang University, Hangzhou, China
| | - Xuepeng Chen
- Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Clinical Research Center for Oral Diseases of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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11
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Kaaber L, Matzen LH, Schropp L, Spin-Neto R. Low-dose CBCT protocols in implant dentistry: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00132-9. [PMID: 38679501 DOI: 10.1016/j.oooo.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To evaluate the state-of-the-art evidence for applying low-dose CBCT protocols in 3 stages of implant therapy (planning, insertion, and follow-up examination of peri-implantitis) and assess the overall body of evidence presented in the literature. STUDY DESIGN The search was conducted in the MEDLINE/Pubmed and Scopus databases. Studies comparing low-dose CBCT protocols to a relevant reference standard in relation to any stage of implant therapy were included. Data extraction and quality assessment were performed for all included studies. RESULTS Sixteen studies were included. Low-dose protocols were reported to result from reduction of the exposure parameters of kV, mA, resolution (through increased voxel size), exposure time, and scanning trajectory. The current literature suggests that low-dose CBCT protocols perform similarly in the 3 stages of implant therapy compared to higher resolution protocols regarding objective measurements, with adverse impacts mostly on subjective assessment of image quality. The results also suggest that CBCT-based bone measurements are similar to direct measurements, independent of the imaging protocol. Reduction in all parameters except kV seems feasible as the basis of low-dose CBCT protocols for implant therapy. CONCLUSIONS The use of low-dose CBCT protocols does not impact objective image quality assessment in any stage of implant therapy. Clinical studies are needed to indicate if the reported results can be extrapolated to improve patient care in relation to the responsible use of ionizing radiation.
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Affiliation(s)
- Laurits Kaaber
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark.
| | - Louise Hauge Matzen
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
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12
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Johnston A, Mahesh M, Uneri A, Rypinski TA, Boone JM, Siewerdsen JH. Objective image quality assurance in cone-beam CT: Test methods, analysis, and workflow in longitudinal studies. Med Phys 2024; 51:2424-2443. [PMID: 38354310 DOI: 10.1002/mp.16983] [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: 09/22/2023] [Revised: 12/20/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Standards for image quality evaluation in multi-detector CT (MDCT) and cone-beam CT (CBCT) are evolving to keep pace with technological advances. A clear need is emerging for methods that facilitate rigorous quality assurance (QA) with up-to-date metrology and streamlined workflow suitable to a range of MDCT and CBCT systems. PURPOSE To evaluate the feasibility and workflow associated with image quality (IQ) assessment in longitudinal studies for MDCT and CBCT with a single test phantom and semiautomated analysis of objective, quantitative IQ metrology. METHODS A test phantom (CorgiTM Phantom, The Phantom Lab, Greenwich, New York, USA) was used in monthly IQ testing over the course of 1 year for three MDCT scanners (one of which presented helical and volumetric scan modes) and four CBCT scanners. Semiautomated software analyzed image uniformity, linearity, contrast, noise, contrast-to-noise ratio (CNR), 3D noise-power spectrum (NPS), modulation transfer function (MTF) in axial and oblique directions, and cone-beam artifact magnitude. The workflow was evaluated using methods adapted from systems/industrial engineering, including value stream process modeling (VSPM), standard work layout (SWL), and standard work control charts (SWCT) to quantify and optimize test methodology in routine practice. The completeness and consistency of DICOM data from each system was also evaluated. RESULTS Quantitative IQ metrology provided valuable insight in longitudinal quality assurance (QA), with metrics such as NPS and MTF providing insight on root cause for various forms of system failure-for example, detector calibration and geometric calibration. Monthly constancy testing showed variations in IQ test metrics owing to system performance as well as phantom setup and provided initial estimates of upper and lower control limits appropriate to QA action levels. Rigorous evaluation of QA workflow identified methods to reduce total cycle time to ∼10 min for each system-viz., use of a single phantom configuration appropriate to all scanners and Head or Body scan protocols. Numerous gaps in the completeness and consistency of DICOM data were observed for CBCT systems. CONCLUSION An IQ phantom and test methodology was found to be suitable to QA of MDCT and CBCT systems with streamlined workflow appropriate to busy clinical settings.
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Affiliation(s)
- Ashley Johnston
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mahadevappa Mahesh
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ali Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tatiana A Rypinski
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - John M Boone
- Department of Radiology, University of California - Davis, Davis, California, USA
| | - Jeffrey H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Imaging Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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13
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Sawall S, Maier J, Sen S, Gehrig H, Kim TS, Schlemmer HP, Schönberg SO, Kachelrieß M, Rütters M. Dental imaging in clinical photon-counting CT at a quarter of DVT dose. J Dent 2024; 142:104859. [PMID: 38272436 DOI: 10.1016/j.jdent.2024.104859] [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: 10/31/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To investigate the image quality of a low-dose dental imaging protocol in the first clinical photon-counting computed tomography (PCCT) system in comparison to a normal-dose acquisition in a digital volume tomography (DVT) system. MATERIALS AND METHODS Clinical PCCT systems offer an increased spatial resolution compared to previous generations of clinical systems. Their spatial resolution is in the order of dental DVT systems. Resolution-matched acquisitions of ten porcine jaws were performed in a PCCT (Naeotom Alpha, Siemens Healthineers) and in a DVT (Orthophos XL, Dentsply Sirona). PCCT images were acquired with 90 kV at a dose of 1 mGy CTDI16 cm. DVT used 85 kV at 4 mGy. Image reconstruction was performed using the standard algorithms of each system to a voxel size of 160 × 160 × 200 µm. The dose-normalized contrast-to-noise ratio (CNRD) was measured between dentine and enamel and dentine and bone. Two readers evaluated overall diagnostic quality of images and quality of relevant structures such as root channels and dentine. RESULTS CNRD is higher in all PCCT acquisitions. CNRD is 37 % higher for the contrast dentine-enamel and 31 % higher for the dentine-bone contrast (p < 0.05). Overall diagnostic image quality was higher for PCCT over DVT (p < 0.02 and p < 0.04 for readers 1 and 2). Quality scores for anatomical structures were higher in PCCT compared to DVT (all p < 0.05). Inter- and intrareader reproducibility were acceptable (all ICC>0.64). CONCLUSIONS PCCT provides an increased image quality over DVT even at a lower dose level and might enable complex dental imaging protocols in the future. CLINICAL SIGNIFICANCE The evolution of photon-counting technology and it's optimization will increasingly move dental imaging towards standardized 3D visualizations providing both minimal radiation exposure and high diagnostic accuracy.
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Affiliation(s)
- Stefan Sawall
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany; Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg 69120, Germany.
| | - Joscha Maier
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Sinan Sen
- Department of Orthodontics, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, Kiel 24105, Germany
| | - Holger Gehrig
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
| | - Ti-Sun Kim
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
| | - Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Stefan O Schönberg
- Department of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Theodor-Kurz-Ufer 1-3, Mannheim 68167, Germany
| | - Marc Kachelrieß
- Division of X-Ray Imaging and CT, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany; Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg 69120, Germany
| | - Maurice Rütters
- Department of Operative Dentistry, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, Heidelberg 69120, Germany
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Lucca LV, Cascante-Sequeira D, Coelho-Silva F, Ruiz-Imbert AC, Freitas DQ, Haiter-Neto F, de-Azevedo-Vaz SL. The effect of voxel and field of view size on the volumetric alteration artifact of high-density materials with 2 cone beam computed tomography devices. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:290-300. [PMID: 37980244 DOI: 10.1016/j.oooo.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/28/2023] [Accepted: 10/07/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE We investigated the influence of voxel and field of view (FOV) sizes on expression of the volumetric alteration artifact (VAA) of 5 high-density materials in 2 cone beam computed tomography (CBCT) devices. STUDY DESIGN Cylinders of amalgam, cobalt-chromium, gutta-percha, titanium, and zirconium were individually positioned in a polymethyl methacrylate phantom. OP300 Maxio and ProMax 3D Classic CBCT devices were used to acquire images with varying voxel and FOV sizes, totaling 585 scans. Two evaluators segmented the high-density cylinder images to obtain the tomographic volumes. The difference between the tomographic and physical volume of each cylinder (i.e., volumetric alteration) was calculated. Statistical analysis was conducted with multiway ANOVA and the Tukey post hoc test (α = 5%). Evaluator reliability was measured with the intraclass correlation coefficient (ICC). RESULTS All studied parameters and nearly all interactions influenced the VAA (P < .05). The post hoc test demonstrated less volumetric alteration for the smallest voxel sizes, 61 × 78 mm FOV, and gutta-percha for OP300, and for the smallest voxel sizes, 80 × 80 mm FOV, and gutta-percha and titanium for ProMax 3D (P < .05). The ICC demonstrated perfect reliability (1.00). CONCLUSIONS Voxel and FOV sizes influenced VAA expression. Using smaller voxel sizes, the 61 × 78 mm FOV for OP300 and the 80 × 80 mm FOV for ProMax 3D, and materials with lower density and lower atomic number reduced VAA expression.
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Affiliation(s)
- Luiza Valdemarca Lucca
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
| | - Deivi Cascante-Sequeira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Coelho-Silva
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Ana Cecilia Ruiz-Imbert
- Department of Diagnostic Sciences, Oral Radiology Section, Dentistry Faculty, Universidad de Costa Rica, San José, Costa Rica
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Department of Clinical Dentistry, Federal University of Espírito Santo, Espírito Santo, Brazil
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15
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Abramson Z, Oh C, Wells M, Choudhri AF, Whitehead MT. CT and MR Appearance of Teeth: Analysis of Anatomy and Embryology and Implications for Disease. J Clin Med 2024; 13:1187. [PMID: 38592028 PMCID: PMC10932355 DOI: 10.3390/jcm13051187] [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: 02/02/2024] [Revised: 02/12/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various stages of maturation are required for the appreciation of abnormal dental development. While many tooth abnormalities are well-depicted on dedicated dental radiographs, the first encounter with a dental anomaly may be by a radiologist on a computed tomographic (CT) or magnetic resonance (MR) exam performed for other reasons. This article depicts normal dental anatomy and development, describing the appearance of the neonatal dentition on CT and MRI, the modalities most often encountered by clinical radiologists. The radiology and dental literature are reviewed, and key concepts are illustrated with supplemental cases from our institution. The value of knowledge of dental development is investigated using the analysis of consecutive MR brain examinations. Finally, the anatomical principles are applied to the diagnosis of odontogenic infection on CT. Through analysis of the literature and case data, the contrast of dental pathology with normal anatomy and development facilitates the detection and characterization of both congenital and acquired dental disease.
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Affiliation(s)
- Zachary Abramson
- Clinical Radiology, Radiologist, Body Imaging, Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Chris Oh
- Quantum Radiology, 790 Church St., Suite 400, Marietta, GA 30060, USA;
| | - Martha Wells
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Asim F. Choudhri
- Department of Radiology, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, 50 N. Dunlap St., Memphis, TN 38103, USA;
| | - Matthew T. Whitehead
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Division of Neuroradiology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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16
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Russe MF, Rau A, Ermer MA, Rothweiler R, Wenger S, Klöble K, Schulze RKW, Bamberg F, Schmelzeisen R, Reisert M, Semper-Hogg W. A content-aware chatbot based on GPT 4 provides trustworthy recommendations for Cone-Beam CT guidelines in dental imaging. Dentomaxillofac Radiol 2024; 53:109-114. [PMID: 38180877 PMCID: PMC11003655 DOI: 10.1093/dmfr/twad015] [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: 10/30/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVES To develop a content-aware chatbot based on GPT-3.5-Turbo and GPT-4 with specialized knowledge on the German S2 Cone-Beam CT (CBCT) dental imaging guideline and to compare the performance against humans. METHODS The LlamaIndex software library was used to integrate the guideline context into the chatbots. Based on the CBCT S2 guideline, 40 questions were posed to content-aware chatbots and early career and senior practitioners with different levels of experience served as reference. The chatbots' performance was compared in terms of recommendation accuracy and explanation quality. Chi-square test and one-tailed Wilcoxon signed rank test evaluated accuracy and explanation quality, respectively. RESULTS The GPT-4 based chatbot provided 100% correct recommendations and superior explanation quality compared to the one based on GPT3.5-Turbo (87.5% vs. 57.5% for GPT-3.5-Turbo; P = .003). Moreover, it outperformed early career practitioners in correct answers (P = .002 and P = .032) and earned higher trust than the chatbot using GPT-3.5-Turbo (P = 0.006). CONCLUSIONS A content-aware chatbot using GPT-4 reliably provided recommendations according to current consensus guidelines. The responses were deemed trustworthy and transparent, and therefore facilitate the integration of artificial intelligence into clinical decision-making.
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Affiliation(s)
- Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Alexander Rau
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
- Department of Neuroradiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Michael Andreas Ermer
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - René Rothweiler
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Sina Wenger
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Klara Klöble
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Ralf K W Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Bern 3010, Switzerland
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Marco Reisert
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
- Department of Stereotactic and Functional Neurosurgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Wiebke Semper-Hogg
- Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
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17
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Alrashed S, Dutra V, Chu TMG, Yang CC, Lin WS. Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial-intelligence-based system. J Prosthodont 2024. [PMID: 38305665 DOI: 10.1111/jopr.13827] [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: 06/28/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
PURPOSE To evaluate the effects of exposure protocol, voxel sizes, and artifact removal algorithms on the trueness of segmentation in various mandible regions using an artificial intelligence (AI)-based system. MATERIALS AND METHODS Eleven dry human mandibles were scanned using a cone beam computed tomography (CBCT) scanner under differing exposure protocols (standard and ultra-low), voxel sizes (0.15 mm, 0.3 mm, and 0.45 mm), and with or without artifact removal algorithm. The resulting datasets were segmented using an AI-based system, exported as 3D models, and compared to reference files derived from a white-light laboratory scanner. Deviation measurement was performed using a computer-aided design (CAD) program and recorded as root mean square (RMS). The RMS values were used as a representation of the trueness of the AI-segmented 3D models. A 4-way ANOVA was used to assess the impact of voxel size, exposure protocol, artifact removal algorithm, and location on RMS values (α = 0.05). RESULTS Significant effects were found with voxel size (p < 0.001) and location (p < 0.001), but not with exposure protocol (p = 0.259) or artifact removal algorithm (p = 0.752). Standard exposure groups had significantly lower RMS values than the ultra-low exposure groups in the mandible body with 0.3 mm (p = 0.014) or 0.45 mm (p < 0.001) voxel sizes, the symphysis with a 0.45 mm voxel size (p = 0.011), and the whole mandible with a 0.45 mm voxel size (p = 0.001). Exposure protocol did not affect RMS values at teeth and alveolar bone (p = 0.544), mandible angles (p = 0.380), condyles (p = 0.114), and coronoids (p = 0.806) locations. CONCLUSION This study informs optimal exposure protocol and voxel size choices in CBCT imaging for true AI-based automatic segmentation with minimal radiation. The artifact removal algorithm did not influence the trueness of AI segmentation. When using an ultra-low exposure protocol to minimize patient radiation exposure in AI segmentations, a voxel size of 0.15 mm is recommended, while a voxel size of 0.45 mm should be avoided.
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Affiliation(s)
- Safa Alrashed
- Oral Biology PhD program in the College of Dentistry, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vinicius Dutra
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Chao-Chieh Yang
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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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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Ruiz DC, Reis LDO, Fontenele RC, Miranda-Viana M, Farias-Gomes A, Freitas DQ. Influence of an adjacent zirconium implant, tube current, and metal artifact reduction algorithm on horizontal root fracture diagnosis in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:190-198. [PMID: 37940483 DOI: 10.1016/j.oooo.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE We evaluated the influence of an adjacent zirconium implant, tube current (mA), and a metal artifact reduction algorithm (MARA) on horizontal root fracture (HRF) diagnosis in cone beam computed tomography (CBCT). STUDY DESIGN Nineteen teeth (9 with HRF, 10 without) were individually placed in a human maxilla. Scan volumes were acquired without and with a zirconium implant adjacent to the tooth at settings of 4, 8, and 10 mA, with MARA disabled and enabled, using a 5×5 cm field of view, 0.085-mm voxel size, and 90 kV. Four maxillofacial radiologists individually assessed the scans. Diagnostic metrics were compared by multiway analysis of variance (α=5%). Inter- and intraexaminer agreements for HRF diagnosis were evaluated with the weighted kappa test. RESULTS Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were significantly lower in the presence of the implant (P≤.005). AUC values were higher in scans obtained with 8 and 10 mA compared with 4 mA (P=0.010), but 10 mA without MARA was better with the implant present. MARA did not significantly influence outcomes (P≥0.240). Inter- and intraexaminer agreements ranged from moderate to almost perfect. CONCLUSIONS The presence of the zirconium implant impairs HRF detection. Settings of 8 or 10 mA improve HRF detection regardless MARA condition without the implant. With an adjacent implant, 10 mA without MARA is recommended to improve diagnostic performance.
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Affiliation(s)
- Débora Costa Ruiz
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Murilo Miranda-Viana
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Amanda Farias-Gomes
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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20
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Zaman MU. Comparing Radiation Doses in CBCT and Medical CT Imaging for Dental Applications. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S883-S885. [PMID: 38595575 PMCID: PMC11001137 DOI: 10.4103/jpbs.jpbs_1077_23] [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: 10/18/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background We are always concerned about radiation exposure during dental imaging procedures. We explore the crucial differences in radiation doses between Cone Beam Computed Tomography (CBCT) and Medical computed tomography (CT) imaging, aiming to shed light on the safety and efficiency of these techniques. Materials and Methods In this study, we conducted a comprehensive analysis using state-of-the-art dental imaging equipment. We employed phantoms that simulated real dental scenarios, ensuring accuracy in our measurements. The radiation doses were measured with precision dosimeters, and various exposure settings were tested to obtain a comprehensive dataset. Results Our findings reveal substantial differences in radiation doses between CBCT and Medical CT for dental applications. In the case of CBCT, the average effective dose was found to be approximately 100 microsieverts (μSv), making it a preferable choice for routine dental imaging. Medical CT, on the other hand, yielded significantly higher radiation exposure, with an average effective dose exceeding 500 μSv, emphasizing its need for specific clinical scenarios. Conclusion In conclusion, the choice between CBCT and Medical CT for dental applications should be made with careful consideration of radiation dose implications. CBCT emerges as the safer and more efficient option for routine dental imaging, offering a lower radiation burden to patients while still delivering high-quality diagnostic images. However, Medical CT may be necessary for specialized cases where the additional radiation risk is justified by diagnostic requirements.
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Affiliation(s)
- Mahmud U. Zaman
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Al-Kharj, Saudi Arabia
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Heller ZA, Hogge M, Ragan MR, Portnof JE. Applications of Cone Beam Computed Tomography Scans in Dental Medicine and Potential Medicolegal Issues. Dent Clin North Am 2024; 68:55-65. [PMID: 37951637 DOI: 10.1016/j.cden.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
A cone beam central tomography (CBCT) scan produces images in orthogonal and non-orthogonal with great spatial resolution. When a dental health care practitioner (DHP) orders a CBCT scan, they should consider if it is truly indicated, as CBCT scans carry up to four times the dosage of radiation compared to panoramic radiographs. Any diagnostic imaging obtained of a patient should include a formal interpretive report commenting on the findings within the imaging. Ordering of limited field of view (FOV) CBCT scans and failing to report on abnormal findings present outside of the region of interest (ROI) is a potential medicolegal issue.
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Affiliation(s)
- Zachary A Heller
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA.
| | - Maritzabel Hogge
- Department of Maxillofacial Medicine, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Michael R Ragan
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Jason E Portnof
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA; Private Practice, 9980 North Central Park Boulevard, Suite 113, Boca Raton, FL 33428, USA
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22
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Li J, Joda T, Revilla-León M, Saleh MHA, Chen Z, Wang HL. Recommendations for successful virtual patient-assisted esthetic implant rehabilitation: A guide for optimal function and clinical efficiency. J ESTHET RESTOR DENT 2024; 36:186-196. [PMID: 37792734 DOI: 10.1111/jerd.13142] [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: 07/15/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Complete arch implant rehabilitation necessitates meticulous treatment planning and high-level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient-assisted esthetic implant rehabilitation workflow. OVERVIEW This article summarizes recommendations for virtual patient-assisted esthetic implant rehabilitation in the following five aspects: three-dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face- and prosthetic-driven surgical planning, reuse of presurgical data ("Copy & Paste"), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete-mouth implant rehabilitation completed within six visits using this virtual patient workflow is presented. CONCLUSION The virtual patient workflow serves as an invaluable tool to perform treatment planning, enhance efficiency, and ensure predictable outcomes in esthetic complete arch implant rehabilitation. CLINICAL SIGNIFICANCE Virtual workflows are increasingly prevalent in esthetic implant rehabilitation. Nevertheless, these workflows necessitate a distinct set of knowledge and tools divergent from conventional dentistry practices. This article offers guidelines and recommendations for dental clinicians who are new to this field.
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Affiliation(s)
- Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Graduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Adames C, Gaêta-Araujo H, Franco A, Soares MQS, Junqueira JLC, Oenning AC. Influence of CBCT-derived panoramic curve variability in the measurements for dental implant planning. Oral Radiol 2024; 40:30-36. [PMID: 37540349 DOI: 10.1007/s11282-023-00703-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. METHODS Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. RESULTS The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68-100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). CONCLUSION Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning.
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Affiliation(s)
- Cyntia Adames
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Hugo Gaêta-Araujo
- Division of Oral Radiology, School of Dentistry, University of São Paulo (FORP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Ademir Franco
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil.
| | - Mariana Quirino Silveira Soares
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
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Xavier PNI, Vizzotto MB, Arús NA, Tiecher PFDS, Gamba TDO, Fontana MP, Beltrão RG, da Silveira HLD. Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study. Clin Oral Implants Res 2023; 34:1385-1394. [PMID: 37752682 DOI: 10.1111/clr.14182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/23/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. METHODS Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. RESULTS There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). CONCLUSION The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.
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Affiliation(s)
- Paula N I Xavier
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana B Vizzotto
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Nádia Assein Arús
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Priscila F da S Tiecher
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Thiago de Oliveira Gamba
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mathias Pante Fontana
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Heraldo L D da Silveira
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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25
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Ghamri M, Dritsas K, Probst J, Jäggi M, Psomiadis S, Schulze R, Verna C, Katsaros C, Halazonetis D, Gkantidis N. Accuracy of facial skeletal surfaces segmented from CT and CBCT radiographs. Sci Rep 2023; 13:21002. [PMID: 38017262 PMCID: PMC10684569 DOI: 10.1038/s41598-023-48320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
The accuracy of three-dimensional (3D) facial skeletal surface models derived from radiographic volumes has not been extensively investigated yet. For this, ten human dry skulls were scanned with two Cone Beam Computed Tomography (CBCT) units, a CT unit, and a highly accurate optical surface scanner that provided the true reference models. Water-filled head shells were used for soft tissue simulation during radiographic imaging. The 3D surface models that were repeatedly segmented from the radiographic volumes through a single-threshold approach were used for reproducibility testing. Additionally, they were compared to the true reference model for trueness measurement. Comparisons were performed through 3D surface approximation techniques, using an iterative closest point algorithm. Differences between surface models were assessed through the calculation of mean absolute distances (MAD) between corresponding surfaces and through visual inspection of facial surface colour-coded distance maps. There was very high reproducibility (approximately 0.07 mm) and trueness (0.12 mm on average, with deviations extending locally to 0.5 mm), and no difference between radiographic scanners or settings. The present findings establish the validity of lower radiation CBCT imaging protocols at a similar level to the conventional CT images, when 3D surface models are required for the assessment of facial morphology.
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Affiliation(s)
- Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Jeddah Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Jannis Probst
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Maurus Jäggi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Symeon Psomiadis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Ralf Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058, Basel, Switzerland
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland.
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Jahanshahiafshar Z, Ghorbani H, Seyedmajidi M, Nabahati M, Ebrahimnejad Gorji K, Seyedmajidi S, Moudi E. Genotoxic and Cytotoxic Effects of Cone Beam Computed Tomography and Multidetector Computed Tomography on Exfoliated Buccal Epithelial Cells. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:572-581. [PMID: 38094288 PMCID: PMC10715117 DOI: 10.30476/ijms.2023.96522.2807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/22/2022] [Accepted: 12/25/2022] [Indexed: 12/18/2023]
Abstract
Background Cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) are frequently used in dental and maxillofacial problems. This study aimed to assess the genotoxicity and cytotoxicity effects of CBCT and MDCT radiographies on exfoliated buccal epithelial cells during dental examinations. Methods This prospective experimental study was conducted at Babol University of Medical Sciences (Babol, Iran) from March 2021 to April 2021. Buccal mucosa smears were collected bilaterally pre-exposure and 12 days after CBCT or MDCT examinations. To compare the frequency of micronuclei and other cytotoxic cellular changes such as pyknosis, karyolysis, and karyorrhexis, the paired sample t test and Wilcoxon test were used. In addition, independent sample t test, Mann-Whitney, and Chi square tests were used to investigate the differences between the imaging methods and between men and women. All statistical analyses were performed using the SPSS software, and P≤0.05 was considered statistically significant. Results The current study included 60 adult patients (30 patients in each group), ranging in age from 21 to 50 years. The micronuclei and the other cytotoxic cellular changes increased significantly after CBCT and MDCT radiographic examinations on the 12th day compared to the pre-exposure results (P<0.001). MDCT had statistically higher cytotoxic and genotoxic effects than CBCT (9.4%, 23.1%, and 40% higher values in micronucleus frequency, the mean frequency of micronuclei, and other cytotoxic changes, respectively). There were no significant differences between men and women in the two examination methods (P=0.46 and P=0.49, respectively). Conclusion Dental examinations with CBCT and MDCT can increase cytotoxicity and chromosomal damage in both men and women. Due to its lower radiation toxicities, CBCT can be recommended as an alternative to MDCT for dental examinations.
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Affiliation(s)
| | - Hakimeh Ghorbani
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Seyedmajidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Nabahati
- Department of Radiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Kourosh Ebrahimnejad Gorji
- Department of Medical Physics, Radiobiology and Radiation Protection, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Seyedali Seyedmajidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Moudi
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Yeshua T, Ladyzhensky S, Abu-Nasser A, Abdalla-Aslan R, Boharon T, Itzhak-Pur A, Alexander A, Chaurasia A, Cohen A, Sosna J, Leichter I, Nadler C. Deep learning for detection and 3D segmentation of maxillofacial bone lesions in cone beam CT. Eur Radiol 2023; 33:7507-7518. [PMID: 37191921 DOI: 10.1007/s00330-023-09726-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To develop an automated deep-learning algorithm for detection and 3D segmentation of incidental bone lesions in maxillofacial CBCT scans. METHODS The dataset included 82 cone beam CT (CBCT) scans, 41 with histologically confirmed benign bone lesions (BL) and 41 control scans (without lesions), obtained using three CBCT devices with diverse imaging protocols. Lesions were marked in all axial slices by experienced maxillofacial radiologists. All cases were divided into sub-datasets: training (20,214 axial images), validation (4530 axial images), and testing (6795 axial images). A Mask-RCNN algorithm segmented the bone lesions in each axial slice. Analysis of sequential slices was used for improving the Mask-RCNN performance and classifying each CBCT scan as containing bone lesions or not. Finally, the algorithm generated 3D segmentations of the lesions and calculated their volumes. RESULTS The algorithm correctly classified all CBCT cases as containing bone lesions or not, with an accuracy of 100%. The algorithm detected the bone lesion in axial images with high sensitivity (95.9%) and high precision (98.9%) with an average dice coefficient of 83.5%. CONCLUSIONS The developed algorithm detected and segmented bone lesions in CBCT scans with high accuracy and may serve as a computerized tool for detecting incidental bone lesions in CBCT imaging. CLINICAL RELEVANCE Our novel deep-learning algorithm detects incidental hypodense bone lesions in cone beam CT scans, using various imaging devices and protocols. This algorithm may reduce patients' morbidity and mortality, particularly since currently, cone beam CT interpretation is not always preformed. KEY POINTS • A deep learning algorithm was developed for automatic detection and 3D segmentation of various maxillofacial bone lesions in CBCT scans, irrespective of the CBCT device or the scanning protocol. • The developed algorithm can detect incidental jaw lesions with high accuracy, generates a 3D segmentation of the lesion, and calculates the lesion volume.
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Affiliation(s)
- Talia Yeshua
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
| | - Shmuel Ladyzhensky
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
| | - Amal Abu-Nasser
- Oral Maxillofacial Imaging, Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ragda Abdalla-Aslan
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Tami Boharon
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Avital Itzhak-Pur
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Asher Alexander
- Department of Software Engineering, The Jerusalem College of Technology, Jerusalem, Israel
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Adir Cohen
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jacob Sosna
- Department of Radiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Isaac Leichter
- Department of Applied Physics, The Jerusalem College of Technology, Jerusalem, Israel
- Department of Radiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Chen Nadler
- Department of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
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Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. Saudi Dent J 2023; 35:780-784. [PMID: 38025595 PMCID: PMC10658366 DOI: 10.1016/j.sdentj.2023.07.005] [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: 04/09/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. AIM To understand the importance of root morphology in endodontic treatment. METHODOLOGY A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. RESULTS CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. CONCLUSION The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.
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Affiliation(s)
- Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudia Arabia
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29
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Biun J, Dudhia R, Arora H. The in-vitro accuracy of fiducial marker-based versus markerless registration of an intraoral scan with a cone-beam computed tomography scan in the presence of restoration artifact. Clin Oral Implants Res 2023; 34:1257-1266. [PMID: 37602506 DOI: 10.1111/clr.14166] [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: 05/24/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To determine the effect of restoration artifact ('metal artifact') on registration accuracy of an intraoral scan and cone-beam computed tomography (CBCT) scan, comparing fiducial marker-based registration with markerless registration. MATERIALS AND METHODS A maxillary model was fitted with multiple configurations of zirconia crowns to simulate various states of oral rehabilitation. Intraoral scans and CBCT scans (half and full rotation) were acquired. Registration was performed using markerless (point-based registration with surface-based refinement) and fiducial marker-based registration. Each experimental condition was repeated 10 times (n = 320). The absolute deviation was measured at the canines and first molars, and the average and maximum values were analysed using multiple linear regression. RESULTS R2 was 0.874 for average error and 0.858 for maximum error. For markerless registration, there were 0.041 mm (p < .001) and 0.045 mm (p < .001) increases in average and maximum error per crown, respectively. For fiducial marker-based registration, the effect of additional crowns was not statistically significant for average (p = .067) or maximum (p = .438) error. For a full arch of crowns, the regression model predicted average and maximum errors of 0.581 and 0.697 mm for the markerless technique, and 0.185 and 0.210 mm for the fiducial marker-based technique. Overall, the fiducial marker-based technique was more accurate for four or more crowns. The half rotation scan increased average error by 0.021 mm (p = .001) and maximum error by 0.029 mm (p < .001). CONCLUSIONS Under the present study's experimental conditions, the fiducial marker-based technique should be considered if four or more full-coverage highly radiopaque restorations are present.
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Affiliation(s)
- John Biun
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Raahib Dudhia
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Himanshu Arora
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Cascante-Sequeira D, Coelho-Silva F, Lopes Rosado LP, Lucca LV, Queiroz Freitas D, Lins de-Azevedo-Vaz S, Haiter-Neto F. Does cone-beam CT convex triangular field of view influence the image shape distortion of high-density materials? Dentomaxillofac Radiol 2023; 52:20230029. [PMID: 37427699 DOI: 10.1259/dmfr.20230029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES To assess the distortion of high-density materials using two CBCT devices presenting convex triangular and cylindrical fields of view (FOVs). METHODS AND MATERIALS Four high-density cylinders were individually placed in a polymethylmethacrylate phantom. 192 CBCT scans were acquired using the convex triangular and cylindrical FOVs of Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Using HorosTM's software, two oral radiologists determined the cylinders' horizontal and vertical dimensional alterations. Nine oral radiologists subjectively identified each cylinder's axial shape distortion. Statistical analysis comprised Multiway ANOVA (α = 5%), and the Kruskal-Wallis test. RESULTS The distortion in the axial plane was greater in the convex triangular FOVs for both devices in almost all the materials (p < 0.05). The evaluators subjectively identified a shape distortion in both FOVs for R100 device (p < 0.001), while no distortion was identified for X800 device (p = 0.620). A vertical magnification of all materials was observed in both FOVs for both devices (p < 0.05). No differences among vertical regions (p = 0.988) nor FOVs (p = 0.544) were found for the R100 device, while all materials showed higher magnification in all regions in the cylindrical FOV (p < 0.001) of the X800 device. CONCLUSIONS The convex triangular FOV influenced the axial distortion of the high-density materials in both devices. A vertical magnification was observed in both FOVs of both devices, but it was greater in the cylindrical FOV of the X800 device.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Coelho-Silva
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Surgery, Division of Oral Radiology, São Paulo State University (Unesp), School of Dentistry, Araçatuba, Brazil
| | - Lucas P Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Dentistry, University Center of Espírito Santo (UNESC), Colatina, Espírito Santo, Brazil
| | - Luiza Valdemarca Lucca
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sergio Lins de-Azevedo-Vaz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Clinical Dentistry, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Ramage A, Lopez Gutierrez B, Fischer K, Sekula M, Santaella GM, Scarfe W, Brasil DM, de Oliveira-Santos C. Filtered back projection vs. iterative reconstruction for CBCT: effects on image noise and processing time. Dentomaxillofac Radiol 2023; 52:20230109. [PMID: 37665027 DOI: 10.1259/dmfr.20230109] [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: 09/05/2023] Open
Abstract
OBJECTIVES To assess the effect of standard filtered back projection (FBP) and iterative reconstruction (IR) methods on CBCT image noise and processing time (PT), acquired with various acquisition parameters with and without metal artefact reduction (MAR). METHODS CBCT scans using the Midmark EIOS unit of a human mandible embedded in soft tissue equivalent material with and without the presence of an implant at mandibular first molar region were acquired at various acquisition settings (milliamperages [4mA-14mA], FOV [5 × 5, 6 × 8, 9 × 10 cm], and resolutions [low, standard, high] and reconstructed using standard FBP and IR, and with and without MAR. The processing time was recorded for each reconstruction. ImageJ was used to analyze specific axial images. Radial transaxial fiducial lines were created relative to the implant site. Standard deviations of the gray density values (image noise) were calculated at fixed distances on the fiducial lines on the buccal and lingual aspects at specific axial levels, and mean values for FBP and IR were compared using paired t-tests. Significance was defined as p < 0.05. RESULTS The overall mean for image noise (± SD) for FBP was 198.65 ± 55.58 and 99.84 ± 16.28 for IR. IR significantly decreased image noise compared to FBP at all acquisition parameters (p < 0.05). Noise reduction among different scanning protocols ranged between 29.7% (5 × 5 cm FOV) and 58.1% (5mA). IR increased processing time by an average of 35.1 s. CONCLUSIONS IR significantly reduces CBCT image noise compared to standard FBP without substantially increasing processing time.
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Affiliation(s)
- Amanda Ramage
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - Kathleen Fischer
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - William Scarfe
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Kuusisto N, Abushahba F, Syrjänen S, Huumonen S, Vallittu P, Närhi T. Zirconia implants interfere with the evaluation of peri-implant bone defects in cone beam computed tomography (CBCT) images even with artifact reduction, a pilot study. Dentomaxillofac Radiol 2023; 52:20230252. [PMID: 37641961 DOI: 10.1259/dmfr.20230252] [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: 08/31/2023] Open
Abstract
OBJECTIVES Three-dimensional cone beam computed tomography (CBCT) imaging can be considered, especially in patients with complicated peri-implantitis (PI). Artifacts induced by dense materials are the drawback of CBCT imaging and the peri-implant bone condition may not be assessed reliably because the artifacts are present in the same area. This pilot study investigates the performance of the artifact reduction algorithm (ARA) of the Planmeca Viso G7 CBCT device (Planmeca, Helsinki, Finland) with three different implant materials and imaging parameters. METHODS Three pairs of dental implants consisting of titanium, zirconia, and fiber reinforced composite (FRC) were set into a pig mandible. A vertical defect simulating peri-implantitis bone loss was made on the buccal side of one of each implant. The defect was identified and measured by two observers and compared to the actual dimensions. In addition, the bone structure and the marginal cortex visibility between the implants were estimated visually. RESULTS The bone defect and its dimensions with the zirconia implant could not be identified in any image with or without the metal artifact reduction algorithm. The bone defect of titanium and FRC implants were identified with all three imaging parameters or even without ARA. The interobserver agreement between the two observers was almost perfect for all categories analyzed. CONCLUSION Peri-implantitis defect of the zirconia implant and the peri-implant bone structure of the zirconia implants cannot be recognized reliably with any ARA levels, or any imaging parameters used with the Planmeca Viso G7. The need for ARA when imaging the peri-implant bone condition of the titanium and FRC implants may be unnecessary.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, City of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
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Halder M, Chhaparwal Y, Patil V, Smriti K, Chhaparwal S, Pentapati KC. Quantitative and Qualitative Correlation of Mandibular Lingual Bone with Risk Factors for Third Molar Using Cone Beam Computed Tomography. Clin Cosmet Investig Dent 2023; 15:267-277. [PMID: 37928771 PMCID: PMC10624182 DOI: 10.2147/ccide.s428908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/15/2023] [Indexed: 11/07/2023] Open
Abstract
Background Lingual plate thickness, density, and proximity to the tooth are linked as risk factors for various complications associated with third molar extraction. The present study aimed to assess the lingual plate thickness, and density in the mandibular third molar region using cone beam computed tomography and to estimate its correlation with type and level of impaction, number of roots, age, and gender as the risk factors. Methods This was a retrospective study on CBCT images of 648 mandibular third molars. The lingual plate thickness at three different root levels - cervical, mid-root, and apex along with the position of the tooth, number of roots, density of lingual plate, age, and gender were evaluated. The measurements were done on Invivo 5-Anatomage software. Statistical comparison of the categorical variables was done by Chi-square test, and Fisher's exact test, and univariate and multivariate analysis were done using binomial logistic regression. Results Lingual plate thickness of the third molars at the cervical, mid root, and apex were 1.28 mm, 1.42 mm and .01 mm (mean). A significantly higher proportion of subjects with thin lingual plates at mid-root (p-value=0.01) and apex (p-value=0.05) were in the 21-30 age group. Lingual bone density was significantly associated with the thickness of the lingual plate at the mid-root. A significantly higher proportion of thinner lingual plates at the mid-root level were associated with mesioangularly placed third molars (p-value=0.002). Conclusion Our study presented that lingual plate thickness has a strong association with age, angulation, and the number of roots. Knowledge about these risk factors is imperative during the management of third molar impactions.
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Affiliation(s)
- Mehuli Halder
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Yogesh Chhaparwal
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Komal Smriti
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shubha Chhaparwal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kalyana C Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Miragall MF, Knoedler S, Kauke-Navarro M, Saadoun R, Grabenhorst A, Grill FD, Ritschl LM, Fichter AM, Safi AF, Knoedler L. Face the Future-Artificial Intelligence in Oral and Maxillofacial Surgery. J Clin Med 2023; 12:6843. [PMID: 37959310 PMCID: PMC10649053 DOI: 10.3390/jcm12216843] [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: 10/06/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Artificial intelligence (AI) has emerged as a versatile health-technology tool revolutionizing medical services through the implementation of predictive, preventative, individualized, and participatory approaches. AI encompasses different computational concepts such as machine learning, deep learning techniques, and neural networks. AI also presents a broad platform for improving preoperative planning, intraoperative workflow, and postoperative patient outcomes in the field of oral and maxillofacial surgery (OMFS). The purpose of this review is to present a comprehensive summary of the existing scientific knowledge. The authors thoroughly reviewed English-language PubMed/MEDLINE and Embase papers from their establishment to 1 December 2022. The search terms were (1) "OMFS" OR "oral and maxillofacial" OR "oral and maxillofacial surgery" OR "oral surgery" AND (2) "AI" OR "artificial intelligence". The search format was tailored to each database's syntax. To find pertinent material, each retrieved article and systematic review's reference list was thoroughly examined. According to the literature, AI is already being used in certain areas of OMFS, such as radiographic image quality improvement, diagnosis of cysts and tumors, and localization of cephalometric landmarks. Through additional research, it may be possible to provide practitioners in numerous disciplines with additional assistance to enhance preoperative planning, intraoperative screening, and postoperative monitoring. Overall, AI carries promising potential to advance the field of OMFS and generate novel solution possibilities for persisting clinical challenges. Herein, this review provides a comprehensive summary of AI in OMFS and sheds light on future research efforts. Further, the advanced analysis of complex medical imaging data can support surgeons in preoperative assessments, virtual surgical simulations, and individualized treatment strategies. AI also assists surgeons during intraoperative decision-making by offering immediate feedback and guidance to enhance surgical accuracy and reduce complication rates, for instance by predicting the risk of bleeding.
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Affiliation(s)
- Maximilian F. Miragall
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Rakan Saadoun
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Alex Grabenhorst
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Florian D. Grill
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Lucas M. Ritschl
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Andreas M. Fichter
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Ali-Farid Safi
- Craniologicum, Center for Cranio-Maxillo-Facial Surgery, 3011 Bern, Switzerland;
- Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Issa J, Riad A, Olszewski R, Dyszkiewicz-Konwińska M. The Influence of Slice Thickness, Sharpness, and Contrast Adjustments on Inferior Alveolar Canal Segmentation on Cone-Beam Computed Tomography Scans: A Retrospective Study. J Pers Med 2023; 13:1518. [PMID: 37888129 PMCID: PMC10608141 DOI: 10.3390/jpm13101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023] Open
Abstract
This retrospective study aims to investigate the impact of cone-beam computed tomography (CBCT) viewing parameters such as contrast, slice thickness, and sharpness on the identification of the inferior alveolar nerve (IAC). A total of 25 CBCT scans, resulting in 50 IACs, were assessed by two investigators using a three-score system (good, average, and poor) on cross-sectional images. Slice thicknesses of 0.25 mm, 0.5 mm, and 1 mm were tested, along with varying sharpness (0, 6, 8, and 10) and contrast (0, 400, 800, and 1200) settings. The results were statistically analyzed to determine the optimal slice thickness for improved visibility of IAC, followed by evaluating the influence of sharpness and contrast using the optimal thickness. The identified parameters were then validated by performing semi-automated segmentation of the IACs and structure overlapping to evaluate the mean distance. Inter-rater and intra-rater reliability were assessed using Kappa statistics, and inferential statistics used Pearson's Chi-square test. Inter-rater and intra-rater reliability for all parameters were significant, ranging from 69% to 83%. A slice thickness of 0.25 mm showed consistently "good" visibility (80%). Sharpness values of zero and contrast values of 1200 also demonstrated high frequencies of "good" visibility. Overlap analysis resulted in an average mean distance of 0.295 mm and a standard deviation of 0.307 mm across all patients' sides. The study revealed that a slice thickness of 0.25 mm, zero sharpness value, and higher contrast value of 1200 improved the visibility and accuracy of IAC segmentation in CBCT scans. The individual patient's characteristics, such as anatomical variations, decreased bone density, and absence of canal walls cortication, should be considered when using these parameters.
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Affiliation(s)
- Julien Issa
- Department of Diagnostics, Poznań University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
- Doctoral School, Poznań University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, 35392 Giessen, Germany
| | - Raphael Olszewski
- Department of Oral and Maxilofacial Surgery, Cliniques Universitaires Saint Luc, UCLouvain, Av. Hippocrate 10, 1200 Brussels, Belgium
- Oral and Maxillofacial Surgery Research Lab (OMFS Lab), NMSK, Institut de Recherche Experimentale et Clinique, UCLouvain, Louvain-la-Neuve, 1348 Brussels, Belgium
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Cascante-Sequeira D, Fontenele RC, Martins LAC, Brasil DM, Oliveira ML, Freitas DQ, Haiter-Neto F. Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography? Dentomaxillofac Radiol 2023; 52:20230147. [PMID: 37493606 PMCID: PMC10552126 DOI: 10.1259/dmfr.20230147] [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: 03/29/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT). METHODS AND MATERIALS Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material. RESULTS The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p < 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p < 0.0001). CONCLUSION The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.
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Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, United States of America
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Alhossan A, Chang YC, Wang TJ, Wang YB, Fiorellini JP. Reliability of Cone Beam Computed Tomography in Predicting Implant Treatment Outcomes in Edentulous Patients. Diagnostics (Basel) 2023; 13:2843. [PMID: 37685381 PMCID: PMC10486987 DOI: 10.3390/diagnostics13172843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Since the development of CBCT has been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of radiology evaluation, implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement in edentulous patients digitally. CBCT images were analyzed by clinicians, measuring the maxillary and mandibular ridge heights and widths digitally of four predetermined implant sites in the maxillary and two selected implant sites in the mandibular arches of 91 patients planning for implant-supported overdenture. A total of 47 patients out of the 91 had completed implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). Both predictabilities are low, implying that CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The findings of this study indicate that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement in the edentulous ridge.
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Affiliation(s)
- Abdulaziz Alhossan
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.-J.W.); (J.P.F.)
- Department of Periodontics and Community Dentistry, Dental College, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.-J.W.); (J.P.F.)
| | - Tun-Jan Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.-J.W.); (J.P.F.)
| | - Yu-Bo Wang
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Joseph P. Fiorellini
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.-J.W.); (J.P.F.)
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Gharios M, El-Hajj VG, Frisk H, Ohlsson M, Omar A, Edström E, Elmi-Terander A. The use of hybrid operating rooms in neurosurgery, advantages, disadvantages, and future perspectives: a systematic review. Acta Neurochir (Wien) 2023; 165:2343-2358. [PMID: 37584860 PMCID: PMC10477240 DOI: 10.1007/s00701-023-05756-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Hybrid operating rooms (hybrid-ORs) combine the functionalities of a conventional surgical theater with the advanced imaging technologies of a radiological suite. Hybrid-ORs are usually equipped with CBCT devices providing both 2D and 3D imaging capability that can be used for both interventional radiology and image guided surgical applications. Across all fields of surgery, the use of hybrid-ORs is gaining in traction, and neurosurgery is no exception. We hence aimed to comprehensively review the use of hybrid-ORs, the associated advantages, and disadvantages specific to the field of neurosurgery. MATERIALS AND METHODS Electronic databases were searched for all studies on hybrid-ORs from inception to May 2022. Findings of matching studies were pooled to strengthen the current body of evidence. RESULTS Seventy-four studies were included in this review. Hybrid-ORs were mainly used in endovascular surgery (n = 41) and spine surgery (n = 33). Navigation systems were the most common additional technology employed along with the CBCT systems in the hybrid-ORs. Reported advantages of hybrid-ORs included immediate assessment of outcomes, reduced surgical revision rate, and the ability to perform combined open and endovascular procedures, among others. Concerns about increased radiation exposure and procedural time were some of the limitations mentioned. CONCLUSION In the field of neurosurgery, the use of hybrid-ORs for different applications is increasing. Hybrid-ORs provide preprocedure, intraprocedure, and end-of-procedure imaging capabilities, thereby increasing surgical precision, and reducing the need for postoperative imaging and correction surgeries. Despite these advantages, radiation exposure to patient and staff is an important concern.
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Affiliation(s)
- Maria Gharios
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Victor Gabriel El-Hajj
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurosurgery, Karolinska University Hospital, Eugeniavägen 6, 4Th Floor, Solna, 17164, Stockholm, Sweden.
| | - Henrik Frisk
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Ohlsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Artur Omar
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Edström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Adrian Elmi-Terander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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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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Christiaens V, Pauwels R, Mowafey B, Jacobs R. Accuracy of Intra-Oral Radiography and Cone Beam Computed Tomography in the Diagnosis of Buccal Bone Loss. J Imaging 2023; 9:164. [PMID: 37623696 PMCID: PMC10455186 DOI: 10.3390/jimaging9080164] [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: 06/28/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The use of cone beam computed tomography (CBCT) in dentistry started in the maxillofacial field, where it was used for complex and comprehensive treatment planning. Due to the use of reduced radiation dose compared to a computed tomography (CT) scan, CBCT has become a frequently used diagnostic tool in dental practice. However, published data on the accuracy of CBCT in the diagnosis of buccal bone level is lacking. The aim of this study was to compare the accuracy of intra-oral radiography (IOR) and CBCT in the diagnosis of the extent of buccal bone loss. METHODS A dry skull was used to create a buccal bone defect at the most coronal level of a first premolar; the defect was enlarged apically in steps of 1 mm. After each step, IOR and CBCT were taken. Based on the CBCT data, two observers jointly selected three axial slices at different levels of the buccal bone, as well as one transverse slice. Six dentists participated in the radiographic observations. First, all observers received the 10 intra-oral radiographs, and each observer was asked to rank the intra-oral radiographs on the extent of the buccal bone defect. Afterwards, the procedure was repeated with the CBCT scans based on a combination of axial and transverse information. For the second part of the study, each observer was asked to evaluate the axial and transverse CBCT slices on the presence or absence of a buccal bone defect. RESULTS The percentage of buccal bone defect progression rankings that were within 1 of the true rank was 32% for IOR and 42% for CBCT. On average, kappa values increased by 0.384 for CBCT compared to intra-oral radiography. The overall sensitivity and specificity of CBCT in the diagnosis of the presence or absence of a buccal bone defect was 0.89 and 0.85, respectively. The average area under the curve (AUC) of the receiver operating curve (ROC) was 0.892 for all observers. CONCLUSION When CBCT images are available for justified indications, other than bone level assessment, such 3D images are more accurate and thus preferred to 2D images to assess periodontal buccal bone. For other clinical applications, intra-oral radiography remains the standard method for radiographic evaluation.
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Affiliation(s)
- Véronique Christiaens
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Dental School, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark;
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Radiology, Chulalongkorn University, 10330 Bangkok, Thailand
| | - Bassant Mowafey
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Oral medicine, Periodontology, Diagnosis and Oral radiology, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | - Reinhilde Jacobs
- OMFS IMPATH, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- Department of Dental Medicine, Karolinska Institutet, 14152 Huddinge, Sweden
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Sayin H, Aksoy B, Özsoy K. Optimization of CBCT data with image processing methods and production with fused deposition modeling 3D printing. Med Biol Eng Comput 2023:10.1007/s11517-023-02889-w. [PMID: 37505414 DOI: 10.1007/s11517-023-02889-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
The present study has investigated the effect of the removal of artifacts in cone beam computed tomography (CBCT) images with image processing techniques to dental implant planning. The aim of this study has been to benefit from the novel image processing techniques and additive manufacturing technologies in order to change the existing approach in the usage of the 3D model in the orthogonal surgery, traumatic cases, and tumor operations and to solve the restrictions in surgical operations. In the study, firstly, 3 × 3, 5 × 5, and 7 × 7 kernel values were determined on the CBCT image data of the patient. The determined kernel values were applied on CBCT images by choosing median, median-mean-Gaussian (MMG), and bilateral filters, which are quite successful in removing noise in medical images. A thresholding process to separate teeth and bones from soft tissue regions on CBCT images, histogram normalization for a balanced color distribution, morphology operations to reduce noise areas, and tooth and bone boundaries were determined as closely as possible to patient anatomy. The original image and the images obtained from image enhancement techniques were compared. Results showed that the 3 × 3 median filtering method from three different kernel values out of three different image processing methods used in the study greatly improved the artifacts. It has also been shown that the availability of image processing and additive manufacturing methods on CBCT images has been shown to be a highly important factor before dental surgery planning.
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Affiliation(s)
- Hamdi Sayin
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, Turkey
| | - Bekir Aksoy
- Department of Mechatronics Engineering, Faculty of Technology, Isparta University of Applied Sciences, Isparta, Turkey.
| | - Koray Özsoy
- Department of Machine and Metal Technologies, Isparta OSB Vocational School, Isparta University of Applied Sciences, Isparta, Turkey
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Fan W, Zhang J, Wang N, Li J, Hu L. The Application of Deep Learning on CBCT in Dentistry. Diagnostics (Basel) 2023; 13:2056. [PMID: 37370951 DOI: 10.3390/diagnostics13122056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Cone beam computed tomography (CBCT) has become an essential tool in modern dentistry, allowing dentists to analyze the relationship between teeth and the surrounding tissues. However, traditional manual analysis can be time-consuming and its accuracy depends on the user's proficiency. To address these limitations, deep learning (DL) systems have been integrated into CBCT analysis to improve accuracy and efficiency. Numerous DL models have been developed for tasks such as automatic diagnosis, segmentation, classification of teeth, inferior alveolar nerve, bone, airway, and preoperative planning. All research articles summarized were from Pubmed, IEEE, Google Scholar, and Web of Science up to December 2022. Many studies have demonstrated that the application of deep learning technology in CBCT examination in dentistry has achieved significant progress, and its accuracy in radiology image analysis has reached the level of clinicians. However, in some fields, its accuracy still needs to be improved. Furthermore, ethical issues and CBCT device differences may prohibit its extensive use. DL models have the potential to be used clinically as medical decision-making aids. The combination of DL and CBCT can highly reduce the workload of image reading. This review provides an up-to-date overview of the current applications of DL on CBCT images in dentistry, highlighting its potential and suggesting directions for future research.
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Affiliation(s)
- Wenjie Fan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jiaqi Zhang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Nan Wang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jia Li
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Hu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Goodarzi Pour D, Emami Meybodi E, Sodagar K, Emami Meybodi ZA, Safari S. Effect of metal artifact removal modes on the accuracy of linear measurement around titanium implants by applying different voltages: an original article. BMC Med Imaging 2023; 23:74. [PMID: 37277737 DOI: 10.1186/s12880-023-01025-2] [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: 12/25/2022] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND This study aims to evaluate the effects of the artifact removal algorithm on linear measurements of the buccal cortical plate by altering the voltage. METHODS Ten titanium fixtures were inserted at the site of central, lateral, canine, premolars and molars of dry human mandibles. Vertical height of buccal plate was measured using a digital caliper as a gold standard. Mandibles were scanned with 54 and 58 kVp. Other parameters were constant. Images were reconstructed with none, low, medium and high artifact removal modes. Two Oromaxillofacial radiologists evaluated and measured the buccal plate height using Romexis software. Statistical package for the social sciences (SPSS) version 24 was used for data analysis. RESULTS In medium and high modes, the difference between 54 and 58 kVp was significant (p < 0.001). No significance was noted by using low ARM (artifact removal mode) at the 54 kVp and 58 kVp. CONCLUSION Using artifact removal in low voltage decreases the accuracy of linear measurement and buccal crest visibility. By using high voltage, artifact removal would have no significant effect on accuracy of linear measurements.
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Affiliation(s)
- Daryoush Goodarzi Pour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kosar Sodagar
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanaz Safari
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Wang Z, Guo X, Chen C, Qin L, Meng L. Effect of field of view and voxel size on CBCT-based accuracy of dynamic navigation in endodontic microsurgery: an in vitro study. J Endod 2023:S0099-2399(23)00290-X. [PMID: 37269977 DOI: 10.1016/j.joen.2023.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/20/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study aimed to evaluate the influence of field of view (FOV) and voxel size on the accuracy of dynamic navigation (DN)-assisted endodontic microsurgery (EMS). METHODS Nine sets of maxillary and mandibular three-dimensional-printed jaw models composed of 180 teeth were divided into nine groups with different FOVs (80 × 80 mm, 60 × 60 mm, and 40 × 40 mm) and voxel sizes (0.3, 0.16, and 0.08 mm). The endodontic DN system was used to plan and execute the EMS. The accuracy of the DN-EMS was represented by the platform deviation, end deviation, angular deviation, resection angle, and resection length deviation. Statistical analyses were performed using SPSS 24.0, and the significance level was set at p < 0.05. RESULTS The average platform, end, angular, resection angle, and resection length deviation were 0.69 ± 0.31 mm, 0.93 ± 0.44 mm, 3.47 ± 1.80°, 2.35 ± 1.76°, and 0.41 ± 0.29 mm, respectively. No statistically significant differences in accuracy were observed between the nine FOV and voxel size groups. CONCLUSION FOV and voxel size did not appear to play an important role in the accuracy of DN-EMS. Considering the image quality and radiation dose, it is reasonable to select a limited FOV (such as 40 × 40 mm and 60 × 60 mm) to cover only the registration device, involved teeth, and periapical lesion. The voxel size should be selected according to the required resolution and CBCT units.
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Affiliation(s)
- Zan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiaolong Guo
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China;.
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Habibzadeh S, Ghoncheh Z, Kabiri P, Mosaddad SA. Diagnostic efficacy of cone-beam computed tomography for detection of vertical root fractures in endodontically treated teeth: a systematic review. BMC Med Imaging 2023; 23:68. [PMID: 37264339 DOI: 10.1186/s12880-023-01024-3] [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: 02/02/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Vertical root fractures (VRFs) sometimes occur in endodontically treated teeth. They have a difficult diagnosis and a dismal result. The objective of this review was to evaluate the diagnostic performance of cone-beam computed tomography (CBCT) for detecting VRFs in teeth that had undergone endodontic treatment. METHODS Literature was reviewed from Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase databases between 2000 and 2022. The searched keywords included "endodontically treated teeth," "cone-beam computed tomography," "CBCT," "tooth fracture," "vertical root fracture," "VRF," "accuracy," "sensitivity," and "specificity." Only articles in the English language were included. The final analysis included 20 papers that satisfied the eligibility requirements. RESULTS The overall mean ± SD values (%) for the diagnostic sensitivity and specificity of CBCT for detection of VRFs in endodontically treated teeth in the presence of root-filling materials without an intracanal post were 71.50 ± 22.19 and 75.64 ± 19.41, respectively. The overall mean (SD) value (%) for the sensitivity of CBCT for the detection of VRFs in the presence of root-filling materials and intracanal posts was 72.76 (18.73), while the mean (SD) specificity was 75.44 (18.26). The accuracy of CBCT (mean ± SD) was 78.47 ± 17.19% and 74.02 ± 10.64%, respectively, for teeth without intracanal posts and those with posts. CONCLUSIONS Further clinical research is needed to validate the optimum efficiency of CBCT as a diagnostic technique for detecting VRFs in teeth that have had endodontic treatment, given the low sensitivity, significant heterogeneity of studies, and lack of in-vivo studies on the subject.
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Affiliation(s)
- Sareh Habibzadeh
- Associate Professor, Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghoncheh
- Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Associate Professor, Department of Oral & Maxillofacial Radiology, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Kabiri
- Dentist, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Kwon T, Choi DI, Hwang J, Lee T, Lee I, Cho S. Panoramic dental tomosynthesis imaging by use of CBCT projection data. Sci Rep 2023; 13:8817. [PMID: 37258603 DOI: 10.1038/s41598-023-35805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
Dental CBCT and panoramic images are important imaging modalities used in dental diagnosis and treatment planning. In order to acquire a panoramic image without an additional panoramic scan, in this study, we proposed a method of reconstructing a panoramic image by extracting panoramic projection data from dental CBCT projection data. After specifying the patient's dental arch from the patient's CBCT image, panoramic projection data are extracted from the CBCT projection data along the appropriate panoramic scan trajectory that fits the dental arch. A total of 40 clinical human datasets and one head phantom dataset were used to test the proposed method. The clinical human dataset used in this study includes cases in which it is difficult to reconstruct panoramic images from CBCT images, such as data with severe metal artifacts or data without teeth. As a result of applying the panoramic image reconstruction method proposed in this study, we were able to successfully acquire panoramic images from the CBCT projection data of various patients. The proposed method acquires a universally applicable panoramic image that is less affected by CBCT image quality and metal artifacts by extracting panoramic projection data from dental CBCT data and reconstructing a panoramic image.
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Affiliation(s)
- Taejin Kwon
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Da-In Choi
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Jaehong Hwang
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Taewon Lee
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Inje Lee
- Department of ICT, Dentium Co., Ltd., Suwon, Korea
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.
- KAIST Institutes for ITC and HST, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.
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Karobari MI, Iqbal A, Syed J, Batul R, Adil AH, Khawaji SA, Howait M, Khattak O, Noorani TY. Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study. BMC Oral Health 2023; 23:291. [PMID: 37189077 DOI: 10.1186/s12903-023-03002-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The clinician should have complete knowledge of the normal anatomy of the root as well as complexities in the root canal configuration for a better outcome, as missed or improper handling of the canal system can lead to the failure of an entire endodontic procedure. The present study aims to assess the morphology of roots and canals in permanent mandibular premolars in the Saudi subpopulation with a new classification system. METHODS The present study includes 1230 mandibular premolars (645 first premolars and 585-second premolars) from 500 CBCT images of the patients, including retrospective data. iCAT scanner system (Imaging Sciences International, Hatfield, PA, USA) was used to obtain the images; scanning of 8 × 8 cm images was performed at 120 KVp and 5-7 mA with a voxel size of 0.2 mm. The new method of classification presented by Ahmed et al. 2017 was used to record and classify the root canal morphology, followed by recording the differences regarding the age and gender of the patients. Comparison of canal morphology in lower permanent premolars and its association with gender and age of the patients was done by Chi-square test/ Fisher exact test; the significance level was set at 5% (p ≤ 0.05). RESULTS The left mandibular 1st and 2nd premolars with one root were 47.31%, with two roots were 2.19%. However, three roots (0.24%) and C-shaped canals (0.24%) were reported only in the left mandibular 2nd premolar. The right mandibular 1st and 2nd premolars with one root were 47.56%, with two roots were 2.03%. The overall percentage of the number of roots and canals in the first and second premolars 1 PM 1 (88.38%), 2 PM 1 B 1 L 1 (3.5%), 2 PM B 1 L 1 (0.65%), 1 PM 1-2-1 (3.08%), 1 PM 1-2 (3.17%), 1 PM 1-2-1-2 (0.24%), 3 PMMB 1 DB 1 L1 (0.48%). However, the C-shaped canals (0.40%) were reported in right and left mandibular second premolars. No statistically significant difference was reported between mandibular premolars and gender. A statistically significant difference was reported between mandibular premolars and the age of the study subjects. CONCLUSION Type I (1 TN 1) was the major root canal configuration in permanent mandibular premolars, which was higher among males. The CBCT imaging provides thorough details about the root canal morphology of lower premolars. These findings could support diagnosis, decision-making, and root canal treatment, for dental professionals.
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Affiliation(s)
- Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 12211, Cambodia.
- Department of Conservative Dentistry & Endodontics, Saveetha Institute of Medical and Technical Sciences University, Chennai 600077, Tamil Nadu, India.
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Jamaluddin Syed
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia.
| | - Rumesa Batul
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Abdul Habeeb Adil
- Department of Community Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
| | - Sara Akili Khawaji
- Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Mohammed Howait
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, p.o box 80209, Jeddah, Saudi Arabia
| | - Osama Khattak
- Department of Restorative Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Tahir Yusuf Noorani
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu, Kelantan, 16150, Malaysia
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:diagnostics13101684. [PMID: 37238169 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- 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 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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Kang SR, Shin W, Yang S, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ. Structure-preserving quality improvement of cone beam CT images using contrastive learning. Comput Biol Med 2023; 158:106803. [PMID: 36989743 DOI: 10.1016/j.compbiomed.2023.106803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/13/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Cone-beam CT (CBCT) is widely used in dental clinics but exhibits limitations in assessing soft tissue pathology because of its lack of contrast resolution and low Hounsfield Units (HU) quantification accuracy. We aimed to increase the image quality and HU accuracy of CBCTs while preserving anatomical structures. We generated CT-like images from CBCT images using a patchwise contrastive learning-based GAN model. Our model was trained on unpaired CT and CBCT datasets with the novel combination of losses and the feature extractor pretrained on our training dataset. We evaluated the quality of the images generated by our model in terms of Fréchet inception distance (FID), peak signal-to-noise ratio (PSNR), mean absolute error (MAE), and root mean square error (RMSE). Additionally, the structure preservation performance was assessed by the structure score. As a result, the generated CT-like images by our model were significantly superior to those generated by various baseline models in terms of FID, PSNR, MAE, RMSE, and structure score. Therefore, we demonstrated that our model provided the complementary benefits of preserving the anatomical structures of the input CBCT images and improving the image quality to be similar to those of CT images.
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Lagos de Melo LP, Queiroz PM, Moreira-Souza L, Nadaes MR, Santaella GM, Oliveira ML, Freitas DQ. Influence of CBCT parameters on image quality and the diagnosis of vertical root fractures in teeth with metallic posts: an ex vivo study. Restor Dent Endod 2023; 48:e16. [PMID: 37284345 PMCID: PMC10240088 DOI: 10.5395/rde.2023.48.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Materials and Methods Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%). Results The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts. Conclusions Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.
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Affiliation(s)
- Larissa Pereira Lagos de Melo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Polyane Mazucatto Queiroz
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Mariana Rocha Nadaes
- Dental Clinic Department, Division of Oral Radiology, Dental School, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gustavo Machado Santaella
- Department of Diagnosis and Oral Health, University of Louisville, School of Dentistry, Louisville, KY, USA
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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