Dento maxillo facial radiology最新文献

Objectives: This study aimed to assess whether texture feature maps (TFMs) derived from CBCT images improve the detection of small simulated condylar defects and to examine the influence of voxel size.

Methods: Eight dry mandibles received three spherical defects (0.9, 1.0, 1.2 mm) in each condyle. CBCT scans were performed at voxel sizes of 0.20 mm and 0.40 mm. Sagittal and coronal slices were exported and processed in MaZda software to generate GLCM-based texture maps (contrast, entropy, etc). Three experienced radiologists independently evaluated randomized images for the presence of cortical defects. Kappa, McNemar, and Fisher tests (α = 0.05) were used.

Results: Contrast-based TFMs yielded the highest diagnostic performance, with Kappa values ranging from 0.78-1.00 and significant improvement over unprocessed images (p < 0.05). Entropy maps showed the poorest performance. There was no significant effect of voxel size or defect dimension. TFMs enhanced interobserver agreement.

Conclusions: Texture feature maps, especially based on contrast, may enhance visualization of subtle condylar bone defects independent of voxel size. This post-processing approach could provide a low-dose adjunct to improve CBCT diagnostic confidence in TMJ imaging.

Advances in knowledge: This study introduces the use of texture feature maps in CBCT evaluation of the mandibular condyle, demonstrating that contrast-based mapping enhances detection of subtle bone defects and may support early TMJ diagnosis.

Objectives: Upper airway assessment is crucial due to its impact on craniofacial growth and airway-related disorders. This retrospective observational cross-sectional study aimed to evaluate the upper pharyngeal airway space volume and minimum cross-sectional area in a normal sample from Upper Egypt population, analyzing age and gender-related variations using cone-beam computed tomography.

Methods: Ninety cone beam computed tomography scans of patients aged 18 to 60 years were evaluated. The sample was divided into three groups (Group I: ≤20 years, Group II: 21-40 years, and Group III: >40 years). Each group was further divided into two subgroups according to gender. Nasopharyngeal, oropharyngeal, hypopharyngeal, and total airway volumes, as well as the minimum cross-sectional area, were calculated using Dolphin 3D® software. Two-way ANOVA with Bonferroni post hoc test was used for statistical analysis.

Results: The findings revealed significant gender differences. Males exhibited larger airway dimensions across all age groups except for nasopharyngeal volumes in adults over 20 years. A decline in airway volumes and minimum cross-sectional area in individuals over 40 years. The most constricted airway area predominantly occurred in the oropharynx. A strong positive correlation exists between minimum cross-sectional area and airway volumes. Very good inter- and intra-observer agreement.

Conclusions: Upper pharyngeal airway dimensions in a sample of the Upper Egyptian population are influenced by age and gender, highlighting the need for age and gender specific considerations in the diagnosis and treatment.

Advances in knowledge: This study is the first to evaluate age and gender-related variations in upper pharyngeal airway volume within the Upper Egypt population. Also, it introduces a discriminant model that provides a probabilistic classification of the site of minimum cross-sectional area with 62.2% accuracy.

Objectives: To evaluate image quality of radiographs obtained with photostimulable phosphor (PSP) plates after cleaning with 2% chlorhexidine.

Methods: Eight PSP plates were used: four from Express system and four from VistaScan system. Two plates from each system were wiped with 2% chlorhexidine in aqueous solution (CHX AQ), and the other two plates from each system with 2% chlorhexidine in alcoholic solution (CHX AL). Before cleaning and after every five cleaning cycles (up to 100 cleanings), two radiographs of an acrylic block and two of an aluminum step wedge were acquired with each PSP plate. The image's gray values were measured to assess image brightness, noise, uniformity, and contrast. Two-way repeated measures ANOVA followed by Sidak's post hoc test analyzed the influence of the number of cleanings and substance type on these parameters (α = 0.05).

Results: Considering the number of cleanings, image brightness varied for CHX AL in the Express system and CHX AQ in the VistaScan system, with no consistent pattern (p < 0.05). Noise varied for both substances in the VistaScan system, also without a clear pattern (p < 0.05). In the Express system, regarding the substance type, CHX AL resulted in lower brightness and CHX AQ in lower noise after 75 cleanings (p < 0.05). Contrast and uniformity were not affected by either the number of cleanings or the substance type (p > 0.05). Despite numerical variations in some objective parameters, overall image quality remained stable across all cleanings for both substances. No artefacts were observed in the images.

Conclusion: Regarding image quality, 2% chlorhexidine-whether aqueous or alcohol-based-can be recommended for PSP plates cleaning.

Objective: This review aims to systematically summarize the current studies on the correlation between different degrees of anterior disc displacement (ADD) and temporomandibular joint (TMJ) space.

Materials and methods: Study protocol was carried out based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA). The PubMed, Scopus, Web of Science and China National Knowledge Infrastructure (CNKI) databases were searched to find the relevant articles from database up to February 13, 2025. Studies that evaluated the correlation between ADD and TMJ spaces were included. We excluded intervention studies, case reports, case series, reviews, systematic reviews, opinion articles, book chapters, and studies involving populations with comorbidities potentially affecting the joints. The risk of bias was assessed using the QUADAS-2 tool.

Results: Of the 1109 articles retrieved, a total of 10 articles on the correlation between different degrees of ADD and TMJ spaces were included after evaluation of the title, abstract, and full text. Throughout different degree of anterior disc displacement (ADD), variations in anterior joint space (AJS) and posterior joint space (PJS) exist due to condyle displacement. When the progresses further to anterior disc displacement without reduction (ADDWoR), the superior joint space (SJS) becomes narrow.

Conclusion: There was a stepwise correlation between the TMJ spaces and the degree of ADD. The AJS and PJS tends to be various in different ADD groups, and the SJS tends to be narrowed in ADDWoR patients. Future studies should standardize methodologies to validate its clinical applicability.

Objectives: Precise 3D segmentation of paranasal sinuses is essential for accurate diagnosis and treatment. This study aimed to develop a fully automated segmentation algorithm for the paranasal sinuses using the nnU-Net v2 architecture.

Methods: The nnU-Net v2-based segmentation algorithm was developed using Python 3.6.1 and the PyTorch library, and its performance was evaluated on a dataset of 97 cone beam CT (CBCT) scans. Ground truth annotations were manually generated by expert radiologists using the 3D Slicer software, employing a polygonal labelling technique across sagittal, coronal, and axial planes. Model performance was assessed using several quantitative metrics, including accuracy, Dice coefficient (DC), sensitivity, precision, Jaccard index, area under the curve (AUC), and 95% Hausdorff distance (95% HD).

Results: The nnU-Net v2-based algorithm demonstrated high segmentation performance across all paranasal sinuses. DC values were 0.94 for the frontal, 0.95 for the sphenoid, 0.97 for the maxillary, and 0.88 for the ethmoid sinuses. Accuracy scores exceeded 99% for all sinuses. The 95% HD values were 0.51 mm for both the frontal and maxillary sinuses, 0.85 mm for the sphenoid sinus, and 1.17 mm for the ethmoid sinus. Jaccard indices were 0.90, 0.91, 0.94, and 0.80, respectively.

Conclusions: This study highlights the high accuracy and precision of the nnU-Net v2-based CNN model in the fully automated segmentation of paranasal sinuses from CBCT images. The results suggest that the proposed model can significantly contribute to clinical decision-making processes, facilitating diagnostic and therapeutic procedures.

Objective: This study aimed to develop a fully automated and explainable framework for dental age estimation from panoramic radiographs in young individuals.

Methods: A dataset of 1639 radiographs from individuals aged 8 to 23 years was used. The proposed 2-stage pipeline involved: (1) oriented tooth detection using the YOLO11-OBB model and (2) age estimation using deep learning-based regression models with an attention-weighting module to aggregate predictions from individual teeth. Auxiliary features, including the presence of deciduous teeth and sex, were also evaluated for their impact on model performance.

Results: For the first stage, the tooth detection model achieved an F1 score of 0.981, demonstrating accurate tooth localization and identification. In the later stage, the best-performing model, DenseNet-121 with the deciduous teeth feature, achieved a mean absolute error (MAE) of 1.05 ± 0.95 years. Compared to traditional methods, the proposed framework significantly reduced the MAE.

Conclusions: This study developed an explainable, high-performing deep learning framework that offers a promising solution for real-world age estimation in the forensic domain.

Objectives: To compare the number of dissected cervical lymph nodes in the anatomical level III with that in supraomohyoid neck dissection (SOHND) level III affected by the anatomical relationship between the omohyoid muscle and cricoid cartilage using contrast-enhanced CT (CE-CT) images to assess the validity of the current SOHND.

Methods: CE-CT images of the patients who suffered from malignant tumours in the oral and maxillofacial regions were reviewed. The number of cervical lymph nodes both in the anatomical level III (area between the centre of the inferior border of the hyoid bone [HB] and the inferior border of the cricoid cartilage [CC]) and SOHND level III (area between HB and the intersection of the omohyoid muscle and internal jugular vein [OM-IJ]) were recorded, respectively.

Results: The rate of patients whose number of lymph nodes in level III was affected by the positional relationship between the OM-IJ and CC was almost equal in males and females. As for the patients with OM-IJ below the CC, the number of lymph nodes in SOHND level III increased from that of anatomical level III. Females showed significantly higher values than males (P < .05). Meanwhile, for patients with OM-IJ at or above the CC, the number of lymph nodes in SOHND level III decreased from that of anatomical level III.

Conclusions: The number of dissected cervical lymph nodes differed between the SOHND dissection area and levels I, II, and III. In most cases, SOHND dissects more cervical lymph nodes, especially in female patients.

Objectives: To investigate the impact of disinfecting a photostimulable phosphor plate (PSP) receptor with peracetic acid on proximal carious lesions diagnosis. Additionally, to evaluate and measure artefacts caused by disinfection.

Methods: The proximal surfaces of 40 posterior teeth were evaluated by microcomputed tomography to confirm whether they were sound or carious. These teeth were then mounted in 20 phantoms. Using a PSP receptor (Express System), 1 radiograph of each phantom was acquired. Then, 20 disinfections with peracetic acid were performed, corresponding to a disinfection cycle. After the first disinfection cycle, new radiographs were acquired. This process was repeated 9 times, totalling 200 disinfections (10 cycles × 20 disinfections) and 220 radiographs (200 radiographs + 20 baseline radiographs). The radiographs were assessed independently by 5 examiners for carious lesions diagnosis. A radiologist identified and measured the size of the artefacts. Area under the receiver-operating characteristic curve, sensitivity, and specificity were calculated and compared among the number of disinfections by analysis of variance (α = 0.05). The weighted Kappa index evaluated intra- and inter-examiner agreements.

Results: The disinfections did not affect the diagnostic metrics for detecting proximal carious lesions (P > .05). After 200 disinfections, the biggest artefact measured 0.24 cm. Intra- and inter-examiner agreements ranged from moderate to substantial (0.60-0.69) and from fair to moderate (0.34-0.60).

Conclusions: After 200 disinfections, the radiographic detection of proximal carious lesions remains unaffected by the disinfection with peracetic acid, and the artefacts are still small.

Objectives: To conduct a systematic review evaluating the performance of deep learning (DL) tools in osteoporosis screening using dental imaging and to assess whether these models have been implemented in dental practice.

Methods: Search was performed across 7 electronic databases and 2 sources of grey literature. Included studies applied DL algorithms to dental radiographs or CT in adults diagnosed with osteoporosis, using dual-energy X-ray absorptiometry (DXA) or expert assessment as the reference standard. Risk of bias was assessed using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool, alongside an AI-specific checklist and GRADE to evaluate certainty of evidence.

Results: Thirteen studies met the inclusion criteria. DXA was the most common reference standard (n = 08), and panoramic radiography was the predominant imaging modality (n = 12). Accuracy was the most frequently reported metric (n = 12). Most models used pretrained convolutional neural networks, such as VGG16, GoogleNet, ResNet, and AlexNet. ResNet and EfficientNet architectures showed superior performance, particularly when combined with ensemble techniques and clinical covariates. However, no study reported external validation or implementation in dental practice, limiting their applicability.

Conclusions: All DL models demonstrated potential as supportive tools for osteoporosis screening in dentistry. However, the absence of external validation and clinical integration limits their real-world use. Future research should focus on standardization and development of accessible, validated systems.

Advances in knowledge: This systematic review is the first to show that, despite advancements in DL for osteoporosis screening, clinical applicability remains limited. It underscores the need for robust, user-friendly interfaces to facilitate integration into routine dental practice.

Background: The aim of this study is to determine the prevalence, distribution, and follow-up recommendations of incidental findings in cone beam computed tomography (CBCT) scans acquired for endodontic treatment.

Methods: This was a retrospective review of limited field-of-view (FOV) CBCT images for endodontic evaluation obtained at the Stony Brook University School of Dental Medicine between 2018 and 2022. All scans were reviewed by 1 oral and maxillofacial radiology (OMR) resident and all incidental findings were corroborated with the radiology report approved by 1 of 2 board-certified OMRs. Data extracted for each case included age, gender, and reason for scan; and location, diagnosis, and recommended follow-up for each incidental finding. The recommended follow-up consisted of 5 categories: no recommendation, radiographic monitoring, dental specialty evaluation, medical evaluation, or immediate evaluation.

Results: Data was obtained from 565 CBCT scans with 219 males and 346 females. The mean age was 55.4 ± 18.38. There were 349 maxillary and 216 mandibular scans. The most common incidental finding was mild to moderate mucosal disease (21.4%), then periradicular/periapical odontogenic pathology unrelated to the indication for the scan (15.2%). The most common location for an incidental finding was the gnathic bones (62.2%), then the sino-nasal complex (32.5%). The most common follow-up recommendation was dental specialty evaluation (46.2%). Twenty-five findings (2.3%) were subject to immediate follow-up recommendation.

Conclusions: Incidental findings were found in 90.5% of CBCT scans acquired for endodontic purposes. Medical evaluation or immediate evaluation was recommended for a combined 6.4% of incidental findings. Together, these findings highlight the importance of a thorough review of the entire scan by a trained specialist.