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Greiser A, Christensen J, Fuglsig JMCS, Johannsen KM, Nixdorf DR, Burzan K, Lauer L, Krueger G, Hayes C, Kettless K, Ulrici J, Spin-Neto R. Dental-dedicated MRI, a novel approach for dentomaxillofacial diagnostic imaging: technical specifications and feasibility. Dentomaxillofac Radiol 2024; 53:74-85. [PMID: 38214941 PMCID: PMC11003656 DOI: 10.1093/dmfr/twad004] [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: 08/03/2023] [Revised: 09/12/2023] [Accepted: 10/06/2023] [Indexed: 01/13/2024] Open
Abstract
MRI is a noninvasive, ionizing radiation-free imaging modality that has become an indispensable medical diagnostic method. The literature suggests MRI as a potential diagnostic modality in dentomaxillofacial radiology. However, current MRI equipment is designed for medical imaging (eg, brain and body imaging), with general-purpose use in radiology. Hence, it appears expensive for dentists to purchase and maintain, besides being complex to operate. In recent years, MRI has entered some areas of dentistry and has reached a point in which it can be provided following a tailored approach. This technical report introduces a dental-dedicated MRI (ddMRI) system, describing how MRI can be adapted to fit dentomaxillofacial radiology through the appropriate choice of field strength, dental radiofrequency surface coil, and pulse sequences. Also, this technical report illustrates the possible application and feasibility of the suggested ddMRI system in some relevant diagnostic tasks in dentistry. Based on the presented cases, it is fair to consider the suggested ddMRI system as a feasible approach to introducing MRI to dentists and dentomaxillofacial radiology specialists. Further studies are needed to clarify the diagnostic accuracy of ddMRI considering the various diagnostic tasks relevant to the practice of dentistry.
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Affiliation(s)
| | - Jennifer Christensen
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
| | - João M C S Fuglsig
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
| | - Katrine M Johannsen
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
| | - Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry, University of Minnesota Twin Cities, MN, 55455, United States
- Department of Radiology, Medical School, University of Minnesota Twin Cities, MN, 55455, United States
| | - Kim Burzan
- Sirona Dental Systems GmbH, Bensheim, 64625, Germany
| | - Lars Lauer
- Siemens Healthcare GmbH, Erlangen, 91052, Germany
| | | | - Carmel Hayes
- Siemens Healthcare GmbH, Erlangen, 91052, Germany
| | | | | | - Rubens Spin-Neto
- Section for Oral Radiology and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
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Nguyen KCT, Le LH, Kaipatur NR, Almeida FT, Lai H, Lou EHM, Major PW. Measuring the alveolar bone level in adolescents: A comparison between ultrasound and cone beam computed tomography. Int J Paediatr Dent 2023; 33:487-497. [PMID: 37386727 DOI: 10.1111/ipd.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Cone beam computed tomography (CBCT) is an imaging modality, which is used routinely in orthodontic diagnosis and treatment planning but delivers much higher radiation than conventional dental radiographs. Ultrasound is a noninvasive imaging method that creates an image without ionizing radiation. AIM To investigate the reliability of ultrasound and the agreement between ultrasound and CBCT in measuring the alveolar bone level (ABL) on the buccal/labial side of the incisors in adolescent orthodontic patients. DESIGN One hundred and eighteen incisors from 30 orthodontic adolescent patients were scanned by CBCT with 0.3-mm voxel size and ultrasound at 20 MHz frequency. The ABL, distance from the cementoenamel junction (CEJ) to the alveolar bone crest (ABC), was measured twice to evaluate the agreement between ultrasound and CBCT. In addition, the intra- and inter-rater reliabilities in measuring the ABL by four raters were compared. RESULTS The mean difference (MD) in the ABL between ultrasound and CBCT was -0.07 mm with 95% limit of agreement (LoA) from -0.47 to 0.32 mm for all teeth. For each jaw, the MDs between the ultrasound and CBCT were -0.18 mm (for mandible with 95% LoA from -0.53 to 0.18 mm) and 0.03 mm (for maxilla with 95% LoA from -0.28 to 0.35 mm). In comparison, ultrasound had higher intra-rater (ICC = 0.83-0.90) and inter-rater reliabilities (ICC = 0.97) in ABL measurement than CBCT (ICC = 0.56-0.78 for intra-rater and ICC = 0.69 for inter-rater reliabilities). CONCLUSION CBCT parameters used in orthodontic diagnosis and treatment planning in adolescents may not be a reliable tool to assess the ABL for the mandibular incisors. On the contrary, ultrasound imaging, an ionizing radiation-free, inexpensive, and portable diagnostic tool, has potential to be a reliable diagnostic tool in assessing the ABL in adolescent patients.
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Affiliation(s)
- Kim-Cuong T Nguyen
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Lawrence H Le
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Fabiana T Almeida
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Hollis Lai
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Edmond H M Lou
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W Major
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Klingler S, Biel P, Tschanz M, Schulze R. CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria. Clin Oral Investig 2023; 27:5627-5636. [PMID: 37522991 PMCID: PMC10492752 DOI: 10.1007/s00784-023-05184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice.
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Affiliation(s)
- Samuel Klingler
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Philippe Biel
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Moses Tschanz
- Information Technology (IT) Group, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Ralf Schulze
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Schulze R. The problem in visualization and measuring tiny structures on CBCT-images. J Orofac Orthop 2023; 84:340-341. [PMID: 37353684 DOI: 10.1007/s00056-023-00477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Affiliation(s)
- R Schulze
- Head Division of Oral Diagnostic Sciences, School of Dental Medicine, University of Bern, Freiburgstr. 7, 3010, Bern, Switzerland.
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Tamminen P, Järnstedt J, Lehtinen A, Numminen J, Lehtimäki L, Rautiainen M, Kivekäs I. Ultra-low-dose CBCT scan: rational map for ear surgery. Eur Arch Otorhinolaryngol 2023; 280:1161-1168. [PMID: 36112187 PMCID: PMC9483469 DOI: 10.1007/s00405-022-07592-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/04/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE This study will evaluate the clinical quality and usability of peripheral image data from the temporal bone area obtained using a sinonasal ultra-low-dose (ULD) cone-beam computed tomography (CBCT) scan and compare them to those obtained using a high-resolution (HR) CBCT. METHODS The population consisted of 66 anatomical sites (ears of 33 subjects) imaged using two modalities: an HR CBCT (Scanora 3Dx scanner; Soredex, Tuusula, Finland) and a ULD CBCT (Promax 3D Mid scanner; Plandent, Helsinki, Finland). The image quality (IQ) for every anatomical site in each image was rated using a Likert scale from 0 to 5. RESULTS The quality of ULD CBCT scans was clinically sufficient in over 95% of the assessed images of the sigmoid sinus, jugular bulb, epitympanum and mastoid antrum as well as external acoustic meatus (all p > 0.05 compared to HR CBCT). The IQ was clinically sufficient in 75-94% of the assessed images of the scutum, mastoid segment of the facial nerve, cochlea and semicircular canals (all p < 0.05 compared to HR CBCT). The overall IQ of the HR CBCT scans was good or excellent. CONCLUSION CBCT imaging and the data at image margins are underutilized. CBCT can produce excellent structural resolution with conventional imaging parameters, even with off-focus images. Using ultra-low doses of radiation, the produced IQ is clinically sufficient. We encourage ear surgeons to check the patients' imaging history and to consider the use of imaging modalities that involve lower radiation doses especially when conducting repetitive investigations and with children.
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Affiliation(s)
- Pekka Tamminen
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland.
- Department of Otorhinolaryngology, Satasairaala, Sairaalantie 3, 28500, Pori, Finland.
- Department of Internal Medicine, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland.
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland.
| | - Jorma Järnstedt
- Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Teiskontie 35, 33520, Tampere, Finland
| | - Antti Lehtinen
- Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Teiskontie 35, 33520, Tampere, Finland
| | - Jura Numminen
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland
| | - Lauri Lehtimäki
- Allergy Centre, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Markus Rautiainen
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520, Tampere, Finland
| | - Ilkka Kivekäs
- Department of Otorhinolaryngology-Head and Neck Surgery, Tampere University Hospital, Elämänaukio 2, 33520, Tampere, Finland
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Yeung AWK, Wong NSM. Reject Rates of Radiographic Images in Dentomaxillofacial Radiology: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158076. [PMID: 34360368 PMCID: PMC8345626 DOI: 10.3390/ijerph18158076] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023]
Abstract
This report surveyed the image reject rates of intra-oral, extra-oral, and cone-beam computed tomography (CBCT) imaging in the academic literature. PubMed, Web of Science, and Scopus databases were queried in mid-April 2021. Manual screening of the reference lists of the identified publications was performed to identify papers missed from the database search. All publications returned by the searches were initially included. Exclusion criteria included irrelevance, no reporting of reject rate, no access to the article, and not original article. The total number of images and the number of rejects were recorded for each type of radiographic images. Factors and commonest errors associated with the rejects were recorded. Twenty-six original articles were identified and reviewed. The average reject rate was 11.25% for bitewings, 16.38% for periapicals, 4.10% for panoramics, 6.08% for lateral cephalography, and 2.77% for CBCT. Positioning error and patient movement were two common reasons for the rejects. The average reject rates computed from data pooled across studies should form the reference values for quality assurance programs to follow. Future reject analysis studies should report more radiographic parameters such as type of collimation for intra-oral radiography and patient posture for CBCT.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Correspondence:
| | - Natalie Sui Miu Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
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