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Boubaris M, Cameron A, Manakil J, George R. Artificial intelligence vs. semi-automated segmentation for assessment of dental periapical lesion volume index score: A cone-beam CT study. Comput Biol Med 2024; 175:108527. [PMID: 38714047 DOI: 10.1016/j.compbiomed.2024.108527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/09/2024]
Abstract
INTRODUCTION Cone beam computed tomography periapical volume index (CBCTPAVI) is a categorisation tool to assess periapical lesion size in three-dimensions and predict treatment outcomes. This index was determined using a time-consuming semi-automatic segmentation technique. This study compared artificial intelligence (AI) with semi-automated segmentation to determine AI's ability to accurately determine CBCTPAVI score. METHODS CBCTPAVI scores for 500 tooth roots were determined using both the semi-automatic segmentation technique in three-dimensional imaging analysis software (Mimics Research™) and AI (Diagnocat™). A confusion matrix was created to compare the CBCTPAVI score by the AI with the semi-automatic segmentation technique. Evaluation metrics, precision, recall, F1-score (2×precision×recallprecision+recall), and overall accuracy were determined. RESULTS In 84.4 % (n = 422) of cases the AI classified CBCTPAVI score the same as the semi-automated technique. AI was unable to classify any lesion as index 1 or 2, due to its limitation in small volume measurement. When lesions classified as index 1 and 2 by the semi-automatic segmentation technique were excluded, the AI demonstrated levels of precision, recall and F1-score, all above 0.85, for indices 0, 3-6; and accuracy over 90 %. CONCLUSIONS Diagnocat™ with its ability to determine CBCTPAVI score in approximately 2 min following upload of the CBCT could be an excellent and efficient tool to facilitate better monitoring and assessment of periapical lesions in everyday clinical practice and/or radiographic reporting. However, to assess three-dimensional healing of smaller lesions (with scores 1 and 2), further advancements in AI technologies are needed.
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Affiliation(s)
- Matthew Boubaris
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Andrew Cameron
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Jane Manakil
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Roy George
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia.
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Baek HJ, Lee H, Lee JR, Park JH, Kim KS, Kwoen MJ, Lee TY, Kim JW, Lee HJ. Pulp and periapical disease as a risk factor for osteonecrosis of the jaw: a national cohort-based study in Korea. J Periodontal Implant Sci 2024; 54:65-74. [PMID: 37524381 PMCID: PMC11065535 DOI: 10.5051/jpis.2300120006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 03/06/2023] [Accepted: 04/03/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE This longitudinal cohort study aimed to evaluate the relationship between osteonecrosis of the jaw and pulp and periapical disease in patients who were administered bisphosphonates. METHODS Using data from a nationwide cohort, we examined the association among dental caries, pulp and periapical disease, and osteonecrosis of the jaw in women aged >50 years who received bisphosphonates for more than 1 year between 2002 and 2015. Because of ambiguities in the diagnosis of osteonecrosis of the jaw in population-based data, we operationally defined and categorized the condition into established and potential osteonecrosis of the jaw. RESULTS Pulp and periapical disease significantly increased the development of both established and potential osteonecrosis of the jaw (hazard ratio, 2.21; 95% confidence interval, 1.40-3.48; and hazard ratio, 2.22; 95% confidence interval, 1.65-2.98, respectively). Root canal treatment did not have any influence on the development of osteonecrosis of the jaw. CONCLUSIONS Pulp and periapical disease may be a major risk factor for osteonecrosis of the jaw. The study findings suggest that patients should undergo regular dental examinations to detect pulp and periapical disease before or during the administration of bisphosphonates and that root canal treatment should be considered to decrease the risk of osteonecrosis of the jaw.
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Affiliation(s)
- Hyeong-Jin Baek
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Hyun Park
- Department of Oral and Maxillofacial Surgery, Research Institute for Intractable Osteonecrosis of the Jaw, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Keun-Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Jeong Kwoen
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae-Yeon Lee
- Department of Conservative Dentistry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Research Institute for Intractable Osteonecrosis of the Jaw, College of Medicine, Ewha Womans University, Seoul, Korea.
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
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Algahtani FN, Almohareb R, Aljamie M, Alkhunaini N, ALHarthi SS, Barakat R. Application of advanced platelet-rich fibrin for through-and-through bony defect during endodontic surgery: Three case reports and review of the literature. World J Clin Cases 2023; 11:4168-4178. [PMID: 37388804 PMCID: PMC10303602 DOI: 10.12998/wjcc.v11.i17.4168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/01/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The use of advanced platelet-rich fibrin (A-PRF) membranes for guided bone and tissue regeneration in through-and-through defects after endodontic surgery was explored in three cases.
CASE SUMMARY Herein, three patients presented to the endodontic clinic suffering from apical periodontitis, associated with large bone resorption and related to previously endodontically treated teeth. Periapical surgery was indicated in these cases and the osteotomy site was covered by A-PRF membrane. Cone-beam computed tomography (CBCT) was used to assess the cases before and after the surgery.
CONCLUSION Four months post-surgery, the recall CBCT scan showed complete obliteration of the osteotomy with newly formed bone. A-PRF membrane showed promising results and was an advantageous addition to surgical endodontic treatment.
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Affiliation(s)
- Fahda N Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Rahaf Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Manar Aljamie
- Department of Endodontics, Vision Colleges of Dentistry and Nursing, Riyadh 11671, Saudi Arabia
| | - Nouf Alkhunaini
- Department of Dental, Specialized Medical Center Hospitals, Riyadh 11671, Saudi Arabia
| | - Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Reem Barakat
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
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Kateb NME, Fata MM. Influence of periapical lesion size on healing outcome following regenerative endodontic procedures: a clinical investigation. Oral Radiol 2022; 38:480-489. [PMID: 34826060 DOI: 10.1007/s11282-021-00578-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The current study aimed to investigate the influence of the periapical lesion size on healing outcome following Regenerative Endodontic Procedures (REPs) in mature teeth using cone-beam computed tomography (CBCT) and Mimics software. METHODS The study included ten mature necrotic maxillary anterior teeth with periapical lesions ≥ 3 CBCT Periapical index score (CBCTPAI). REPs via blood clots were performed for all the teeth. CBCT scans were taken pre and postoperatively after 12 months follow-up periods and transferred to Mimics for volume measurements and comparison. Statistical analysis was performed using the Wilcoxon signed-rank test. RESULT All teeth were symptom-free with a statistically significant decrease in the volume of the periapical lesion (P < 0.05) after 12 months except for one case. CONCLUSION The study concluded that REPs could be a successful treatment modality for mature necrotic teeth with periapical lesions however the size of the preoperative periapical lesion could affect the outcome of the periapical healing. TRIAL REGISTRATION The study was registered in ClinicalTrials.gov (ID: NCT04646538).
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Affiliation(s)
- Noha Mohamed El Kateb
- Conservative Department, Endodontic Division, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mahmoud Mostafa Fata
- Department of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Haereid MK, Stangvaltaite-Mouhat L, Ansteinsson V, Mdala I, Ørstavik D. Periapical status transitions in teeth with posts versus without posts: a retrospective longitudinal radiographic study. Acta Odontol Scand 2022; 80:561-568. [PMID: 35350966 DOI: 10.1080/00016357.2022.2049865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/01/2022]
Abstract
OBJECTIVES The aim of this study was to compare periapical status transitions in teeth after post placement compared with other post-endodontic treatments in root-filled teeth. MATERIAL AND METHODS This retrospective longitudinal radiographic study included radiographs of 284 patients with root filled and restored teeth with composite fillings (Endo-fill group, n = 100), crown or fixed prosthesis (Endo-crown group, n = 82) or post and core restorations (Endo-post group, n = 102). All post and core restorations were made of gold alloy. The radiographs taken at the end of endodontic treatment, at the end of post-endodontic treatment and at least 8 months after post-endodontic treatment were evaluated. Post-operative periapical status was assessed according to the periapical index (PAI) and all teeth included in the study had no apical periodontitis preoperatively. Multi-state Markov analysis was used to assess periapical status transitions among the treatment groups. RESULTS Of 284 root-filled teeth without apical periodontitis at baseline, 7.7% developed clear apical pathology within a minimum of 8 months observational period. In the Endo-post group 11 (10.78%) teeth transited from Healthy (PAI 1) to Disease (PAI 2-4) state compared with eight (9.75%) in the Endo-crown group and four (4%) in the Endo-fill group. The transition probabilities from Healthy (PAI 1) to Mild diseased (PAI 2) were 17.5% in the Endo-post group, 13.1% in the Endo-crown group and 5.3% in the Endo-fill group. Multivariate analysis showed that teeth in the Endo-fill group had 60% lower hazard to transit from Healthy (PAI 1) to Mild diseased (PAI 2) state [HR 0.40; 95% CI 0.12, 0.94]. A period exceeding 8 months between the end of the endodontic treatment and prosthetic treatment significantly increased the hazard of disease progression by three times compared with a period of ≤8 months [HR 3.16; 95% CI 1.06, 9.42]. CONCLUSIONS Teeth without radiographic lesions at baseline and restored with posts had higher hazard to transit from healthy to diseased periapical status compared with teeth restored with composite restorations. Controlled clinical trials with longer follow-up periods are needed to validate these findings.
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Affiliation(s)
| | | | - Vibeke Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - Ibrahimu Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - Dag Ørstavik
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Sáenz Aguirre M, Gómez Muga JJ, Antón Méndez L, Fornell Pérez R. CT findings for dental disease. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00118-1. [PMID: 34482955 DOI: 10.1016/j.rx.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/31/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
Traumatic and especially inflammatory-infectious dental lesions are very prevalent in our context. Inflammatory-infectious disease is usually discovered incidentally on imaging studies that include the orofacial region. Moreover, these conditions can result in potentially severe complications, so early diagnosis and treatment are important. Multidetector computed tomography offers good diagnostic performance for dental lesions, although the radiological findings can be subtle and can go undetected if the radiologist is not familiar with them. Likewise, invasive dental procedures are becoming increasingly common, and these can also result in complications. On the other hand, in daily practice a variety of radiolucent mandibular lesions or developmental anomalies can lead to erroneous interpretations. For these reasons, radiologists should be familiar with possible findings related with dental conditions.
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Affiliation(s)
- M Sáenz Aguirre
- Residente de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
| | - J J Gómez Muga
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - L Antón Méndez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - R Fornell Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Vizcaya, España
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Eggmann F, Connert T, Bühler J, Dagassan-Berndt D, Weiger R, Walter C. Do periapical and periodontal pathologies affect Schneiderian membrane appearance? Systematic review of studies using cone-beam computed tomography. Clin Oral Investig 2016; 21:1611-1630. [PMID: 27585589 DOI: 10.1007/s00784-016-1944-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 05/23/2016] [Accepted: 08/15/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This systematic review analyzed the relationship between periapical and periodontal pathologies in the posterior maxilla and the appearance of the Schneiderian membrane in cone-beam computed tomography (CBCT) compared with sound dentitions. METHODS Five electronic databases (Cochrane Library, Embase, OpenGrey, PubMed, Web of Science), complemented by hand searching, were screened up to May 9, 2016. Human clinical studies that used CBCT and contained information on the periapical/periodontal status in the posterior maxilla and Schneiderian membrane appearance were included. A weighted vote counting (WVC) method was applied to summarize results across studies. RESULTS Out of 413 records, 20 studies were included. In the WVC, the studies that observed a positive association between periapical lesions and the appearance of the Schneiderian membrane outweighed those that found no such association (WVC 51 % and WVC 33 %, respectively), with some studies yielding indeterminate results (WVC 16 %). Regarding the relation between periodontal pathologies and the appearance of the Schneiderian membrane, WVC produced a tie between studies demonstrating a positive association (WVC 46 %) and those showing no association (WVC 44 %); one study (WVC 10 %) reported indeterminate results. CONCLUSIONS On CBCT scans, periapical lesions in the posterior maxilla are likely to be associated with Schneiderian membrane thickening. In contrast, current evidence regarding the relation between periodontal diseases and the appearance of the Schneiderian membrane in CBCT is inconclusive. CLINICAL RELEVANCE Incidental maxillary sinus findings on CBCT scans warrant thorough differential diagnosis. Frequently, they may be related to dental pathologies.
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Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Julia Bühler
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Department of Oral Surgery, Oral Radiology and Oral Medicine, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland.
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Huh JK, Shin SJ. Misdiagnosis of florid cemento-osseous dysplasia leading to unnecessary root canal treatment: a case report. Restor Dent Endod 2013; 38:160-6. [PMID: 24010083 PMCID: PMC3761125 DOI: 10.5395/rde.2013.38.3.160] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/20/2013] [Accepted: 05/23/2013] [Indexed: 11/16/2022] Open
Abstract
This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.
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Affiliation(s)
- Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
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Seifi S, Fouroghi R. Central Giant Cell Granuloma: A potential endodontic misdiagnosis. Iran Endod J 2009; 4:158-60. [PMID: 24019839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Revised: 07/19/2009] [Accepted: 08/11/2009] [Indexed: 11/16/2022]
Abstract
Central Giant Cell Granulomas (CGCGs) may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periradicular area and mimic an endodontic lesion. This case report presents an uncommon location of CGCG which was not accurately diagnosed nor timely treated. Periodic follow ups of periapical radiolucencies after RCT are necessary. Dentists should include CGCG in differential diagnosis of lesions that are refractory to endodontic treatment. [Iranian Endodontic Journal 2009;4(4):158-60].
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