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Saalim M, Sansare K, Karjodkar FR, Farman AG, Goyal SN, Sharma SR. Recurrence rate of odontogenic myxoma after different treatments: a systematic review. Br J Oral Maxillofac Surg 2019; 57:985-991. [PMID: 31551163 DOI: 10.1016/j.bjoms.2019.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 09/06/2019] [Indexed: 01/20/2023]
Abstract
Our aim was to establish the recurrence rate of odontogenic myxoma after different treatments. Our search covered papers from 1972-2017 from different sources. The papers were evaluated and critically appraised by two independent investigators. The recurrence rate and 95% CI were calculated in relation to each specific treatment, and the chi squared test was calculated to find out if there was any significant difference in the recurrence rate between conservative treatment and resection. The overall recurrence rate was 5 of 39 patients (13%) during a mean follow up period of 10 years. With conservative treatment the recurrence rate was 4/22 (19%) (mean follow up 11 years) and after resection it was 1/17 (6%) (mean follow up nine years). Maxillary lesions were more likely to recur than mandibular ones. Quality of life variables such as disfigurement and neural deficit were more common after resection than with conservative treatment. The frequency of recurrence was relatively low over 10 years' follow up, irrespective of whether resection or a more conservative approach was used, despite being slightly lower (as might be expected) after resection. Conservative treatment should be considered first to avoid resection-associated morbidity and the effect on the quality of life. Maxillary lesions have more room to spread before they are clinically evident, making them difficult to treat optimally and contributing to the recurrence rate.
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Affiliation(s)
- M Saalim
- Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India.
| | - K Sansare
- Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India.
| | - F R Karjodkar
- Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India.
| | - A G Farman
- University of Louisville, Independent Consultant in Maxillofacial Imaging Science based in Chicago.
| | - S N Goyal
- Oral Medicine and Radiology, Government Dental College, Mumbai, India.
| | - S R Sharma
- Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India.
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Abstract
Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process. Specific recommendations provide selection guidance based on variables such as phase of treatment, clinically-assessed treatment difficulty, the presence of dental and/or skeletal modifying conditions, and pathology. CBCT imaging in orthodontics should always be considered wisely as children have conservatively, on average, a three to five times greater radiation risk compared with adults for the same exposure. The purpose of this paper is to provide an understanding of the operation of CBCT equipment as it relates to image quality and dose, highlight the benefits of the technique in orthodontic practice, and provide guidance on appropriate clinical use with respect to radiation dose and relative risk, particularly for the paediatric patient.
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Affiliation(s)
- W C Scarfe
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - B Azevedo
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - S Toghyani
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - A G Farman
- University of Louisville School of Dentistry and Independent Consultant in Oral and Maxillofacial Radiology, Chicago, Illinois, USA
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Farman AG. Never routine: diagnostic imaging should be individualized and based on professional judgment. Cranio 2016; 34:142-3. [DOI: 10.1080/08869634.2016.1162956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
BACKGROUND Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant number of dentists continue to prescribe antibiotics to stop the pain of irreversible pulpitis.This review updates the previous version published in 2013. OBJECTIVES To assess the effects of systemic antibiotics for irreversible pulpitis. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 27 January 2016); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 12); MEDLINE via Ovid (1946 to 27 January 2016); EMBASE via Ovid (1980 to 27 January 2016), ClinicalTrials.gov (to 27 January 2016) and the WHO International Clinical Trials Registry Platform (to 27 January 2016). There were no language restrictions in the searches of the electronic databases. SELECTION CRITERIA Randomised controlled trials which compared pain relief with systemic antibiotics and analgesics, against placebo and analgesics in the acute preoperative phase of irreversible pulpitis. DATA COLLECTION AND ANALYSIS Two review authors screened studies and extracted data independently. We assessed the quality of the evidence of included studies using GRADEpro software. Pooling of data was not possible and a descriptive summary is presented. MAIN RESULTS One trial assessed at low risk of bias, involving 40 participants was included in this update of the review. The quality of the body of evidence was rated low for the different outcomes. There was a close parallel distribution of the pain ratings in both the intervention and placebo groups over the seven-day study period. There was insufficient evidence to claim or refute a benefit for penicillin for pain intensity. There was no significant difference in the mean total number of ibuprofen tablets over the study period: 9.2 (standard deviation (SD) 6.02) in the penicillin group versus 9.6 (SD 6.34) in the placebo group; mean difference -0.40 (95% confidence interval (CI) -4.23 to 3.43; P value = 0.84). This applied equally for the mean total number of Tylenol tablets: 6.9 (SD 6.87) used in the penicillin group versus 4.45 (SD 4.82) in the placebo group; mean difference 2.45 (95% CI -1.23 to 6.13; P value = 0.19). Our secondary outcome on reporting of adverse events was not addressed in this study. AUTHORS' CONCLUSIONS This systematic review which was based on one low powered small sample trial assessed as at low risk of bias, illustrates that there is insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics. The results of this review confirm the necessity for further larger sample and methodologically sound trials that can provide additional evidence as to whether antibiotics, prescribed in the preoperative phase, can affect treatment outcomes for irreversible pulpitis.
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Affiliation(s)
- Anirudha Agnihotry
- Section of Restorative Dentistry, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, USA, CA 90095-1668
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Farman AG, Levato CM, Miles DA. Coming of Age: Digital Imaging Taking Root After Decades of Progress. Compend Contin Educ Dent 2016; 37:80-82. [PMID: 27337747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Levato CM, Farman AG, Miles DA. The "inevitability" of digital radiography in dentistry. Compend Contin Educ Dent 2015; 36:238-240. [PMID: 25997200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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7
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Law CS, Douglass JM, Farman AG, White SC, Zeller GG, Lurie AG, Goske MJ. The image gently in dentistry campaign: partnering with parents to promote the responsible use of x-rays in pediatric dentistry. Pediatr Dent 2014; 36:458-459. [PMID: 25514072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
| | - Joanna M Douglass
- University of Connecticut School of Dental Medicine, Farmington, Conn., USA
| | - Allan G Farman
- Independent Consultant in Maxillofacial Imaging Science, Chicago, Ill, USA
| | | | - Gregory G Zeller
- University of Kentucky College of Dentistry, Lexington, K.Y., USA
| | - Alan G Lurie
- University of Connecticut School of Dental Medicine, Farmington, Conn., USA
| | - Marilyn J Goske
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., USA
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White SC, Scarfe WC, Schulze RK, Lurie AG, Douglass JM, Farman AG, Law CS, Levin MD, Sauer RA, Valachovic RW, Zeller GG, Goske MJ. The Image Gently in Dentistry campaign: promotion of responsible use of maxillofacial radiology in dentistry for children. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:257-61. [DOI: 10.1016/j.oooo.2014.06.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 06/02/2014] [Indexed: 11/27/2022]
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Farman AG. Image gently: enhancing radiation protection during pediatric imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:657-8. [DOI: 10.1016/j.oooo.2014.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
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Abstract
BACKGROUND Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, a significant number of dentists continue to prescribe antibiotics to stop the pain of irreversible pulpitis. OBJECTIVES To assess the effects of systemic antibiotics for irreversible pulpitis. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 5 September 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9); MEDLINE via OVID (1946 to 5 September 2013); EMBASE via OVID (1980 to 5 September 2013) and the US National Institutes of Health Trials Register (http://clinicaltrials.gov). There were no language restrictions in the searches of the electronic databases. SELECTION CRITERIA Randomised controlled trials which compared pain relief with systemic antibiotics and analgesics, against placebo and analgesics in the acute preoperative phase of irreversible pulpitis. DATA COLLECTION AND ANALYSIS Two review authors screened studies and extracted data independently. We assessed the quality of the evidence of included studies using GRADEPro software. Pooling of data was not possible and a descriptive summary is presented. MAIN RESULTS One trial assessed at low risk of bias, involving 40 participants was included in this update of the review. The quality of the body of evidence was rated low for the different outcomes. There was a close parallel distribution of the pain ratings in both the intervention and placebo groups over the seven-day study period. There was insufficient evidence to claim or refute a benefit for penicillin for pain intensity. There was no significant difference in the mean total number of ibuprofen tablets over the study period: 9.2 (standard deviation (SD) 6.02) in the penicillin group versus 9.6 (SD 6.34) in the placebo group; mean difference -0.40 (95% confidence interval (CI) -4.23 to 3.43; P value = 0.84). This applied equally for the mean total number of Tylenol tablets: 6.9 (SD 6.87) used in the penicillin group versus 4.45 (SD 4.82) in the placebo group; mean difference 2.45 (95% CI -1.23 to 6.13; P value = 0.19). Our secondary outcome on reporting of adverse events was not addressed in this study. AUTHORS' CONCLUSIONS This systematic review which was based on one low powered small sample trial assessed as a low risk of bias, illustrates that there is insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics. The results of this review confirm the necessity for further larger sample and methodologically sound trials that can provide additional evidence as to whether antibiotics, prescribed in the preoperative phase, can affect treatment outcomes for irreversible pulpitis.
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Affiliation(s)
- Zbys Fedorowicz
- Bahrain Branch, The Cochrane Collaboration, Box 25438, Awali, Bahrain
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Melo SLS, Haiter-Neto F, Correa LR, Scarfe WC, Farman AG. Comparative diagnostic yield of cone beam CT reconstruction using various software programs on the detection of vertical root fractures. Dentomaxillofac Radiol 2013; 42:20120459. [PMID: 23906974 DOI: 10.1259/dmfr.20120459] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the effect on diagnostic yield in the detection of experimentally induced vertical root fractures on cone beam CT images using four dental software program. METHODS 190 single-rooted extracted human teeth were divided into three groups according to the pulp canal status: unrestored (UR), filled with gutta-percha (GP) and restored with a metallic custom post (Post). One-half of the sample of each group was artificially fractured and the segments repositioned. All teeth were scanned on a cone beam CT device at 0.2 mm nominal voxel resolution (i-CAT Platinum; Imaging Sciences International, Hatfield, PA). The data were exported as digital imaging and communications in medicine files and imported into Dolphin Imaging & Management Solutions, v. 11.5 (Patterson Dental Supply Inc., St Paul, MN), InVivoDental, v. 5.0 (Anatomage Inc., San Jose, CA) and Kodak Dental Imaging Software 3D module, v. 2.1.11 (Carestream Health Inc., Rochester, NY) software. Cross-sectional images in the acquisition (using Xoran CAT™, v. 3.0.34 software; Xoran Technologies, Ann Arbor, MI) and additional software were presented to three calibrated oral radiologists who rated the presence or absence of root fracture on a five-point scale. Receiver operating characteristic analysis was performed, and treatment comparisons compared by analysis of variance and pairwise comparisons were performed using Tukey's test at an a priori value of α < 0.05%. RESULTS All dental software performed equally at detecting fractures. Fractures were significantly more difficult to detect when posts were present. CONCLUSIONS The diagnosis of root fracture is software-independent. The presence of an intracanal metallic post significantly decreases the detection of artificially created root fractures.
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Affiliation(s)
- S L S Melo
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Noffke CEE, Farman AG, Van der Linde A, Nel S. Responsible use of cone beam computed tomography: minimising medico-legal risks. SADJ 2013; 68:256-259. [PMID: 23971277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This communication highlights some of the ethical and possible legal responsibilities which pertain to the taking, reading, reporting, and communication of findings from cone-beam computed tomography (CBCT) scans. The importance of knowledge of head and neck anatomy and pathology to reduce the likelihood of incorrect interpretation is emphasised. Failure to detect critical findings in any diagnostic image can potentially result in medico-legal consequences. CBCT is no exception to this rule. Dental schools are advised to include CBCT imaging as a diagnostic tool in their under- and postgraduate curricula thereby equipping graduates to use 3D imaging in general and CBCT in particular. Existing dental practitioners are advised to seek continuing education on 3D imaging as part of their required lifelong learning.
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Affiliation(s)
- C E E Noffke
- Maxillofacial and Oral Radiology, School of Oral Health Sciences, Medunsa Campus, University of Limpopo, 0204, South Africa.
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MacDonald D, Chan A, Harris A, Vertinsky T, Farman AG, Scarfe WC. Diagnosis and management of calcified carotid artery atheroma: dental perspectives. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:533-47. [PMID: 22986250 DOI: 10.1016/j.oooo.2012.06.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 06/26/2012] [Accepted: 07/09/2012] [Indexed: 10/27/2022]
Abstract
The calcification of cervical carotid artery atheroma (CCAA) represents maturation of a lumenal atherosclerotic plaque that has been associated with a high risk of cerebral stroke. The demonstration of CCAA on rotational panoramic images has received increasing attention in dentistry since it was first described in 1981. The purposes of this article are to provide a background to the mechanism of arterial calcification, to review the clinical diagnostic and management algorithms for dental practitioners when CCAA are identified radiologically, and to describe and illustrate current appropriate radiographic modalities and medical management strategies used to confirm and assess stenosis associated with CCAA.
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Affiliation(s)
- David MacDonald
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.
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MacDonald D, Chan A, Harris A, Vertinsky T, Farman AG, Scarfe WC. In Reply. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:700-1. [DOI: 10.1016/j.oooo.2013.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 01/22/2013] [Indexed: 11/16/2022]
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Scarfe WC, Li Z, Aboelmaaty W, Scott SA, Farman AG. Maxillofacial cone beam computed tomography: essence, elements and steps to interpretation. Aust Dent J 2012; 57 Suppl 1:46-60. [PMID: 22376097 DOI: 10.1111/j.1834-7819.2011.01657.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Maxillofacial cone beam computed tomography (CBCT) is one of the most significant advances in dental imaging since rotational panoramic radiography. While the acquisition of CBCT data is technically simple, numerous parameters should be considered so that CBCT imaging is performed appropriately and 'task specific'. This involves an understanding of not only exposure (e.g. geometric and software parameters to minimize patient dose, while sustaining diagnostic image quality) but also image formatting options to maximize image display. CBCT images contain far more detailed information of the maxillofacial region than do panoramic or other 2-D images and necessitate a thorough knowledge of the 3-D anatomy of the region and considerations of variability in the range of the anatomically normal. These principles, procedures and protocols, together with the interpretation of CBCT images form the basis of best practices in maxillofacial CBCT imaging. This communication aims to provide: (1) an overview of the fundamental principles of operation of maxillofacial CBCT technology; (2) an understanding of 'task specific' equipment, image selection and image display modes; and (3) a systematic methodology for sequencing interpretation of CBCT images.
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Affiliation(s)
- William C Scarfe
- Radiology and Imaging Science Division, Department of Surgical and Hospital Dentistry, School of Dentistry, The University of Louisville, Kentucky 40292, USA.
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Scarfe W, Vaughn WS, Farman AG, Harris BT, Paris MM. Comparison of restoratively projected and surgically acceptable virtual implant position for mandibular overdentures. Int J Oral Maxillofac Implants 2012; 27:111-118. [PMID: 22299087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
PURPOSE To compare differences between restoratively projected and surgically acceptable virtual implant positions at sites identified by cylindric radiopaque markers on diagnostic templates for implant-retained mandibular overdentures using cone beam computed tomography (CBCT). MATERIALS AND METHODS A retrospective chart audit of a CBCT database identified 77 subjects who had been imaged to assess the residual alveolar ridge in the completely edentulous mandible prior to implant placement for mandibular overdentures. Individuals had been scanned with a diagnostic template using cylindric markers to identify the restoratively derived locations and trajectories for implants. Qualitative and quantitative differences between restoratively projected and surgically acceptable positions on transaxial CBCT images were recorded using implant planning software based on a standard implant. RESULTS Only 6.4% of restoratively projected positions were within the criteria for surgically acceptable implant placement. However, most implant placement plans (77.9%) could be modified to fulfill surgically acceptable criteria. Of the projected implant positions, 15.7% were deemed inadvisable because of potential anatomical complications. Restoratively projected implant position was more likely to deviate buccally than lingually to the available residual alveolar ridge, as determined by CBCT. The mean angular deviation of the clinical prediction from ideal was 14.0 ± 5.5 degrees, the mean platform translation was 2.1 ± 1.3 mm, and the mean apex translation was 2.3 ± 1.5 mm. The average residual alveolar ridge reduction required in the posterior segment was 3.9 ± 2.5 mm. CONCLUSION The restoratively projected trajectory for implant placement determined by visual inspection, diagnostic casts, and panoramic radiography deviated from the surgically acceptable location determined using CBCT data sets.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alveolar Process/diagnostic imaging
- Alveoloplasty
- Cone-Beam Computed Tomography
- Dental Audit
- Dental Implantation, Endosseous/methods
- Dental Prosthesis, Implant-Supported
- Denture, Overlay
- Female
- Fiducial Markers
- Humans
- Imaging, Three-Dimensional
- Jaw, Edentulous/diagnostic imaging
- Jaw, Edentulous/rehabilitation
- Male
- Mandible
- Middle Aged
- Models, Anatomic
- Patient Care Planning
- Radiography, Panoramic
- Retrospective Studies
- Surgery, Computer-Assisted
- User-Computer Interface
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Farman AG. Biomedical Image Processing DesernoThomas M (Ed). Heiledberg: Springer Verlag, 2011. pp. 632 £126/$199 ISBN 978-3-642-15815-5. Dentomaxillofac Radiol 2011. [DOI: 10.1259/dmfr.8.dmf-40-08-536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Matsushita T, Miyati T, Nakayama K, Hamaguchi T, Hayakawa Y, Farman AG, Ohtake S. Qualitative near-infrared vascular imaging system with tuned aperture computed tomography. J Biomed Opt 2011; 16:076004. [PMID: 21806265 DOI: 10.1117/1.3595424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We developed a novel system for imaging and qualitatively analyzing the surface vessels using near-infrared (NIR) radiation using tuned aperture computed tomography (TACT(®)). The system consisted of a NIR-sensitive CCD camera surrounded by sixty light emitting diodes (with wavelengths alternating between 700 or 810 nm). This system produced thin NIR tomograms, under 0.5 mm in slice thickness. The venous oxygenation index reflecting oxygen saturation levels calculated from NIR tomograms was more sensitive than that from the NIR images. This novel system makes it possible to noninvasively obtain NIR tomograms and accurately analyze changes in oxygen saturation.
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Affiliation(s)
- Tatsuhiko Matsushita
- Kanazawa University, Graduate School of Medical Science, Division of Health Science, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
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Tracy KD, Dykstra BA, Gakenheimer DC, Scheetz JP, Lacina S, Scarfe WC, Farman AG. Utility and effectiveness of computer-aided diagnosis of dental caries. Gen Dent 2011; 59:136-144. [PMID: 21903524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Digital radiography has created a growing opportunity for computer-aided diagnostic (CAD) tools. The Logicon Caries Detector (LCD), with upgraded CAD software based on user feedback, was re-evaluated for its effectiveness via a retrospective clinical study. Using the upgraded LCD software, 12 dentists (evaluators) blindly assessed 17 radiographs taken by another (attending) dentist, who restored 28 proximal surfaces. The attending dentist confirmed the presence of early dentinal caries, as well as identifying 48 surfaces as caries-free or with enamel caries only subject to noninvasive treatment. The radiographs, imported into the software using a digital imaging and communications in medicine (DICOM) reader, were visually assessed under typical operatory lighting conditions, then with the aid of the software's density analysis tool. The effectiveness of the evaluators was gauged by calculating two measures of performance, sensitivity and specificity, for the detection and classification of dentinal caries. Sensitivity among all evaluator dentists was 30% with the initial image; 34% with the brightness and contrast adjusted image; 39% when the image was sharpened; and 69% when the density analysis tool was utilized. Specificity was found to be 97% with the initial image; 95% with the brightness and contrast adjusted image; 93% with the sharpened image; and 94% when the density analysis tool was used. Compared to the unaided eye, the LCD can significantly improve dentists' ability to detect and classify caries. Dentists may be able to find twice as much early dentinal caries requiring restoration (or at least aggressive noninvasive treatment) than previously, while not unnecessarily restoring additional healthy teeth. The LCD enables dentists to obtain more information from dental digital radiography than is possible with the unaided eye, leading to improved patient care.
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Affiliation(s)
- Kyle D Tracy
- School of Dentistry, University of Louisville, KY, USA
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Farman AG, Feuerstein P, Levato CM. Using CBCT in the general practice. Compend Contin Educ Dent 2011; 32:14-16. [PMID: 21473296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Allan G Farman
- Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA
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Farman AG, Scarfe WC, Ahmad M. American Academy of Oral and Maxillofacial Radiology commentary: position papers in perspective. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111:238. [PMID: 21237440 DOI: 10.1016/j.tripleo.2010.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 11/10/2010] [Indexed: 05/30/2023]
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Farman AG, Scarfe WC, van Genuchten M. Multidimensional imaging: immediate and imminent issues. Compend Contin Educ Dent 2010; 31:648-651. [PMID: 20960995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Allan G Farman
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky, USA
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Abstract
Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics.
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Affiliation(s)
- William C. Scarfe
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY 40292, USA
| | - Martin D. Levin
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19103, USA
| | - David Gane
- Kodak Dental Imaging/Practiceworks, 1765 The Exchange, Atlanta, GA 30339, USA
| | - Allan G. Farman
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY 40292, USA
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Farman AG. Guest editorial--Self-referral: an ethical concern with respect to multidimensional imaging in dentistry? J Appl Oral Sci 2010; 17:S1678-77572009000500001. [PMID: 19936508 PMCID: PMC4327655 DOI: 10.1590/s1678-77572009000500001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Farman AG. Dr. Allan G. Farman installed as President, American Academy of Oral and Maxillofacial Radiology, October 2009. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108:580-582. [PMID: 19778744 DOI: 10.1016/j.tripleo.2009.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Accepted: 07/04/2009] [Indexed: 05/28/2023]
Affiliation(s)
- Allan G Farman
- Division of Radiology and Imaging Science, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, KY 40292, USA.
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Haskell JA, McCrillis J, Haskell BS, Scheetz JP, Scarfe WC, Farman AG. Effects of Mandibular Advancement Device (MAD) on Airway Dimensions Assessed With Cone-Beam Computed Tomography. Semin Orthod 2009. [DOI: 10.1053/j.sodo.2009.02.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Brown AA, Scarfe WC, Scheetz JP, Silveira AM, Farman AG. Linear accuracy of cone beam CT derived 3D images. Angle Orthod 2009; 79:150-7. [PMID: 19123719 DOI: 10.2319/122407-599.1] [Citation(s) in RCA: 126] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2007] [Accepted: 03/01/2008] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the in vitro reliability and accuracy of linear measurements between cephalometric landmarks on cone beam computed tomography (CBCT) 3D volumetric images with varying basis projection images to direct measurements on human skulls. MATERIALS AND METHODS Sixteen linear dimensions between 24 anatomic sites marked on 19 human skulls were directly measured. The skulls were imaged with CBCT (i-CAT, Imaging Sciences International, Hatfield, Pa) at three settings: (a) 153 projections, (b) 306 projections, and (c) 612 projections. The mean absolute error and modality mean (+/- SD) of linear measurements between landmarks on volumetric renderings were compared to the anatomic truth using repeated measures general linear model (P < or = .05). RESULTS No difference in mean absolute error between the scan settings was found for almost all measurements. The average skull absolute error between marked reference points was less than the distances between unmarked reference sites. CBCT resulted in lower measurements for nine dimensions (mean difference range: 3.1 mm +/- 0.12 mm to 0.56 mm +/- 0.07 mm) and a greater measurement for one dimension (mean difference 3.3 mm +/- 0.12 mm). No differences were detected between CBCT scan sequences. CONCLUSIONS CBCT measurements were consistent between scan sequences and for direct measurements between marked reference points. Reducing the number of projections for 3D reconstruction did not lead to reduced dimensional accuracy and potentially provides reduced patient radiation exposure. Because the fiducial landmarks on the skulls were not radio-opaque, the inaccuracies found in measurement could be due to the methods applied rather than to innate inaccuracies in the CBCT scan reconstructions or 3D software employed.
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Affiliation(s)
- April A Brown
- University of Louisville School of Dentistry, Louisville, KY, USA
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McCrillis JM, Haskell J, Haskell BS, Brammer M, Chenin D, Scarfe WC, Farman AG. Obstructive Sleep Apnea and the Use of Cone Beam Computed Tomography in Airway Imaging: A Review. Semin Orthod 2009. [DOI: 10.1053/j.sodo.2008.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
This article on x-ray cone-beam CT (CBCT) acquisition provides an overview of the fundamental principles of operation of this technology and the influence of geometric and software parameters on image quality and patient radiation dose. Advantages of the CBCT system and a summary of the uses and limitations of the images produced are discussed. All current generations of CBCT systems provide useful diagnostic images. Future enhancements most likely will be directed toward reducing scan time; providing multimodal imaging; improving image fidelity, including soft tissue contrast; and incorporating task-specific protocols to minimize patient dose.
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Affiliation(s)
- William C Scarfe
- Department of Surgical/Hospital Dentistry, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY 40292, USA.
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Horsley SH, Beckstrom B, Clark SJ, Scheetz JP, Khan Z, Farman AG. Prevalence of carotid and pulp calcifications: a correlation using digital panoramic radiographs. Int J Comput Assist Radiol Surg 2008; 4:169-73. [PMID: 20033616 DOI: 10.1007/s11548-008-0277-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 09/30/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the prevalence of pulp calcification with that of carotid calcification using digital panoramic dental radiographs. STUDY DESIGN Digital panoramic radiographs of patients at a dental oncology clinic were included if (1) the carotid artery bifurcation region was visible bilaterally and (2) the patient had non-restored or minimally restored molars and/or canines. An endodontist evaluated the images for pulpal calcifications in the selected teeth. An oral and maxillofacial radiologist independently evaluated the same images for calcifications in the carotid bifurcation region. Odds-ratio and Pearson chi(2) were used for data analysis. Presence of pulpal calcification was also evaluated as a screening test for the presence of carotid calcification. RESULTS A total of 247 panoramic radiographs were evaluated. 32% (n = 80) had pulpal calcifications and 25% (n = 61) had carotid calcifications with 12% (n = 29) having both carotid and pulp calcifications. A significantly higher prevalence of both pulp and carotid calcification was found in subjects older than age 60 years compared to younger age groups. Accuracy of pulpal calcification in screening for carotid calcification was 66.4%. CONCLUSIONS Both pulp and carotid calcifications were more prevalent in older individuals. The presence of pulp calcification was not a strong predictor for the presence of carotid calcification.
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Affiliation(s)
- Scott H Horsley
- Department of Periodontics, Endodontics and Dental Hygiene, School of Dentistry, University of Louisville, 501 South Preston Street, Room LL35, Louisville, KY 40292, USA
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Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, Hildebolt CF, Tyndall D, Shrout M. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. ACTA ACUST UNITED AC 2008; 106:561-2. [DOI: 10.1016/j.tripleo.2008.07.007] [Citation(s) in RCA: 132] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Accepted: 07/17/2008] [Indexed: 11/27/2022]
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Farman AG, Levato CM, Gane D, Scarfe WC. How going digital will affect the dental office. J Okla Dent Assoc 2008; 99:16-21. [PMID: 19093388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND OVERVIEW The impact of digital imaging on dental practice depends upon the degree of planning conducted before implementation. Digital technologies have the potential to improve diagnosis; facilitate patient treatment procedures; and streamline storage, transfer and retrieval. These technologies also provide for secure backup of patients' image data, critical to re-establishing the practice should fire, flood or earthquake occur. CONCLUSIONS The decision to invest in digital radiographic equipment should be a simple one for dental practitioners. Although digital x-ray sensors have long equaled analog film for diagnostic tasks, they have several advantages over film radiography, including immediate image production with solid-state devices; interactive display on a monitor with the ability to enhance image features and make direct measurements; integrated storage with access to images through practice management software systems; security of available backup and off-site archiving; perfect radiographic duplicates to accompany referrals; security mechanisms to identify original images and differentiate them from altered images; the ability to tag information such as a patient identifier, date of exposure and other relevant details; and interoperability of the Digital Imaging and Communications in Medicine file format. CLINICAL IMPLICATIONS Most clinicians should contemplate integrating, at a minimum, intraoral digital x-ray sensors and a digital panoramic system into their practices.
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Affiliation(s)
- Allan G Farman
- Department of Surgical/Hospital Dentistry, University of Louisville School of Dentistry, 501 S. Preston St., Louisville, KY 40292, USA.
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Periago DR, Scarfe WC, Moshiri M, Scheetz JP, Silveira AM, Farman AG. Linear accuracy and reliability of cone beam CT derived 3-dimensional images constructed using an orthodontic volumetric rendering program. Angle Orthod 2008; 78:387-95. [PMID: 18416632 DOI: 10.2319/122106-52.1] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Accepted: 05/01/2007] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare accuracy of linear measurements made on cone beam computed tomographic (CBCT) derived 3-dimensional (3D) surface rendered volumetric images to direct measurements made on human skulls. MATERIALS AND METHODS Twenty orthodontic linear measurements between anatomical landmarks on 23 human skulls were measured by observers using a digital caliper. The skulls were imaged with CBCT and Dolphin 3D (version 2.3) software used to generate 3D volumetric reconstructions (3DCBCT). The linear measurements between landmarks were computed by a single observer three times and compared to anatomic dimensions using Student's t-test (P < or = .05). The intraclass correlation coefficient (ICC) and absolute linear and percentage error were calculated. RESULTS The ICC for 3DCBCT (0.975 +/- 0.016) was significantly less than for skull (0.996 +/- 0.007) measurements. Mean percentage measurement error for 3DCBCT (2.31% +/- 2.11%) was significantly higher than replicate skull measurements (0.63% +/- 0.51%). Statistical differences between 3DCBCT means and true dimensions were found for all of the midsagittal measurements except Na-A and six of the 12 bilateral measurements. The mean percentage difference between the mean skull and 3D-based linear measurements was -1.13% (SD +/- 1.47%). Ninety percent of mean differences were less than 2 mm, and 95% confidence intervals were all less than 2 mm except for Ba-ANS (3.32 mm) and Pog-Go(left) (2.42 mm). CONCLUSIONS While many linear measurements between cephalometric landmarks on 3D volumetric surface renderings obtained using Dolphin 3D software generated from CBCT datasets may be statistically significantly different from anatomic dimensions, most can be considered to be sufficiently clinically accurate for craniofacial analyses.
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Affiliation(s)
- Danielle R Periago
- Department of Orthodontic and Pediatric Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA
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Farman AG. These DisUnited States of Health Care: a call for improved patient convenience in access to oral and maxillofacial radiology services. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106:1-2. [PMID: 18400529 DOI: 10.1016/j.tripleo.2007.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 12/24/2007] [Indexed: 05/26/2023]
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Farman AG. Importance of the randomized controlled trial in providing evidence of treatment efficacy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105:410-411. [PMID: 18329577 DOI: 10.1016/j.tripleo.2007.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 12/24/2007] [Indexed: 05/26/2023]
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Friedlander AH, Farman AG. Dentists' scope of professional responsibilities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105:410. [PMID: 18329576 DOI: 10.1016/j.tripleo.2007.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 12/11/2007] [Indexed: 05/26/2023]
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Moshiri M, Scarfe WC, Hilgers ML, Scheetz JP, Silveira AM, Farman AG. Accuracy of linear measurements from imaging plate and lateral cephalometric images derived from cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2007; 132:550-60. [PMID: 17920510 DOI: 10.1016/j.ajodo.2006.09.046] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Revised: 09/13/2006] [Accepted: 09/28/2006] [Indexed: 11/18/2022]
Abstract
INTRODUCTION As orthodontic practice moves toward 3-dimensional cephalometric analyses, a solution is required to ensure sustained availability of well-established projected treatment outcomes based on 2-dimensional analyses. This ex-vivo study was conducted to compare the accuracy of linear measurements made on photostimulable phosphor cephalograms with 3 methods for simulating lateral cephalograms with cone-beam computed tomography (CBCT). METHODS The linear distances between anatomical landmarks on dentate dry human skulls were measured by observers using digital calipers for S-N, Ba-N, M-N, ANS-N, ANS-PNS, Pog-Go, Go-M, Po-Or, and Go-Co. The skulls were imaged with CBCT with a single 360 degrees rotation, producing 306 basis images and achieving 0.4 mm isotrophic voxel resolution on volumetric reconstruction for making ray-sum reconstructed cephalograms. Two other cephalogram approaches were used with the CBCT system--a single transmission image generated as a scout image designed to check patient positioning before CBCT, and a single-frame lateral basis image. Conventional digital lateral cephalograms (LCs) were acquired with the photostimulable phosphor system. Images were imported into a cephalometric analysis program (Dolphin Imaging Cephalometric and Tracing Software, Chatsworth, Calif) to compute the included linear measurements. Analyses were repeated 3 times and statistically compared with measured anatomic truth with ANOVA (P < or =.05). The intraclass correlation coefficient was determined as an index of intra- and interobserver reliability. RESULTS The intraclass correlation coefficient for the LCs was significantly less than for the measured anatomic truth and for all CBCT-derived images. CBCT images either produced with individual frames or reconstructed from the volumetric data set were accurate for all measurements except Pog-Go and Go-M. CBCT scout images had the second highest accuracy for all measurements except Pog-Go, Go-M, and Go-Co. Conventional LCs had the least accuracy; they were accurate only for Po-Or and ANS-N. CONCLUSIONS CBCT-derived 2-dimensional LCs proved to be more accurate than LCs for most linear measurements calculated in the sagittal plane. No advantage was found over single-frame basis images in using ray-sum generated cephalograms from the CBCT volumetric data set.
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Affiliation(s)
- Mazyar Moshiri
- School of Dentistry, University of Louisville, Louisville, Ky 40202, USA
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Farman AG. Technology continually transitions... research should keep pace with change. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104:149-50. [PMID: 17482852 DOI: 10.1016/j.tripleo.2007.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Accepted: 01/03/2007] [Indexed: 05/15/2023]
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Fullmer JM, Scarfe WC, Kushner GM, Alpert B, Farman AG. Cone beam computed tomographic findings in refractory chronic suppurative osteomyelitis of the mandible. Br J Oral Maxillofac Surg 2007; 45:364-71. [PMID: 17097778 DOI: 10.1016/j.bjoms.2006.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2006] [Indexed: 01/03/2023]
Abstract
AIMS To report the imaging features of osteomyelitis of the mandible in various two-dimensional multiplanar and three-dimensional reformations using cone beam computed tomography (CBCT). METHODS The images were 12-bit DICOM files acquired with a 10cm field of view and voxel resolution of 0.4mm. Two-dimensional multiplanar reformatted reconstructions included coronal, "panoramic" (variable thickness), and serial cross-sections. Three-dimensional reconstructions included surface renderings. Images were presented to referring oral and maxillofacial surgeons in "real time" immediately after acquisition. RESULTS The features of mandibular osteomyelitis seen on CBCT included: a peripheral sclerotic rim, cortical layering (involucrum), central loss of trabecular pattern with internal round radiolucent resorptive tracts, minimal jaw expansion, and reduction of the alveolar cortex. Sequestra were occasionally evident. The history and presentation of each case on CBCT were consistent with osteomyelitis of the mandible; however, the clinical differential diagnosis in each case had included malignancy. The definitive diagnosis was confirmed by histological examination of biopsy specimens. Two of the three cases were patients who had been treated with bisphosphonates. CONCLUSION CBCT facilitated comprehensive and dynamic imaging of the jaws based on surgical consultation, rather than inflexible imaging protocols. CBCT images guided operative planning.
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Affiliation(s)
- Joseph M Fullmer
- Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, KY 40292, USA
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Farman AG. Utility of panoramic radiographs in detecting cervical calcified carotid atheroma by Richard P. Madden et al. ACTA ACUST UNITED AC 2007; 103:549. [PMID: 17395070 DOI: 10.1016/j.tripleo.2006.06.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2006] [Accepted: 06/27/2006] [Indexed: 10/24/2022]
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Beckstrom BW, Horsley SH, Scheetz JP, Khan Z, Silveira AM, Clark SJ, Greenwell H, Farman AG. Correlation between carotid area calcifications and periodontitis: a retrospective study of digital panoramic radiographic findings in pretreatment cancer patients. ACTA ACUST UNITED AC 2007; 103:359-66. [PMID: 17145189 DOI: 10.1016/j.tripleo.2006.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 08/07/2006] [Accepted: 08/23/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objective of this study was to examine the prevalence of carotid area calcifications retrospectively detected on digital panoramic radiographs of pretreatment cancer subjects, and to correlate the finding of such calcifications with radiographic evidence of periodontal bone loss in the same subjects. STUDY DESIGN Digital panoramic radiographs of 201 subjects were evaluated for calcifications projected in the carotid artery bifurcation area as well as for alveolar bone loss as a result of periodontal disease. Inclusion criteria were unobscured carotid artery bifurcation regions bilaterally and sufficient index teeth present with a definable cemento-enamel junction and alveolar crest. Radiographs were independently observed for carotid area calcifications and for periodontal status. Image enhancements permitted for detection of calcifications projected in the carotid area included window/level, inverse, and emboss. Periodontal measurements were made on index teeth using proprietary imaging software and a mouse-driven measurement algorithm. A 3-factor analysis of variance was performed with 3 between-subjects comparisons. Percentage of bone loss was the dependent variable. Independent variables were age, subject sex, and the presence or absence of carotid area calcifications. RESULTS Differences measured in percentage of bone loss between sexes were not statistically significant. While bone loss did increase with age, comparison of the mean bone loss of each age category revealed no statistical significance. There was a highly significant correlation between carotid artery area calcifications visible on panoramic radiographs and percent alveolar bone loss. Radiographs showing unilateral and bilateral calcifications had a mean percent bone loss of 24.2% +/- 12.6% and 25.7% +/- 13.0% respectively, compared to those with no calcification at 10.4% +/- 9.9%. CONCLUSIONS Nearly 1 in 4 subjects in this study evidenced calcifications projected in the carotid bifurcation region. The finding of such calcifications was significantly related to the calculated percentage of alveolar bone loss.
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Affiliation(s)
- Brice W Beckstrom
- School of Dentistry, The University of Louisville, Louisville, KY 40292, USA
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