Dento maxillo facial radiology最新文献

Objectives: This study evaluated the influence of cognitive aids, including machine learning (ML) algorithms and checklists, on the diagnostic accuracy and confidence of dental students in detecting dental caries on bitewing radiographs.

Methods: Fifty-two third-year dental students were randomly assigned to control, ML, or checklist groups. The participants recorded their caries diagnoses (charting) on 10 bitewing radiographs and rated their confidence. Diagnostic accuracy and reliability were compared between groups for caries detection (present/absent). The inter-rater reliability for International Caries Detection and Assessment System II (ICDAS II) caries grading was assessed using weighted kappa. Participants also completed questionnaires on their perceptions of cognitive aids.

Results: ML group showed the highest diagnostic accuracy and confidence levels. For caries detection, the ML group achieved the highest sensitivity (79%) and diagnostic odds ratio (20.3), while the checklist group had the highest specificity (90.9%) (P < .001). The control group showed moderate sensitivity (67.9%) but outperformed the checklist group in this metric. Inter-rater agreement for caries detection was highest in the ML group (κ = 0.702, 95% CI: 0.692-0.713; P < .001), followed by the checklist group. The ML group also had the highest weighted kappa for ICDAS II grading (κ = 0.520, P < .001). Confidence levels differed significantly between groups (P < .001), with the ML group reporting the highest confidence.

Conclusion: ML algorithms may enhance diagnostic accuracy and confidence, possibly by reducing cognitive load. While standardizing the diagnostic process, checklists were less effective, likely due to their lack of flexibility and clinical context. Further research is needed to better understand our findings and translate them into clinical workflows.

Objectives: To investigate the clinical efficiency of an artificial intelligence-based metal artefact correction algorithm (AI-MAC) for reducing dental metal artefacts in head and neck CT, compared to conventional interpolation-based metal artefact correction (MAC).

Methods: We retrospectively collected 41 patients with non-removal dental hardware who underwent non-contrast head and neck CT prior to radiotherapy. All images were reconstructed with the standard reconstruction algorithm (SRA) and were additionally processed with both conventional MAC and AI-MAC. The image quality of SRA, MAC, and AI-MAC was compared by qualitative scoring on a 5-point scale, with scores ≥ 3 considered interpretable. This was followed by a quantitative evaluation, including signal-to-noise ratio (SNR) and artefact index (Idxartefact). Organ contouring accuracy was quantified via calculating the dice similarity coefficient (DSC) and hausdorff distance (HD) for the oral cavity and teeth, using the clinically accepted contouring as reference. Moreover, the treatment planning dose distribution for the oral cavity was assessed.

Results: AI-MAC yielded superior qualitative image quality as well as quantitative metrics, including SNR and Idxartefact, to SRA and MAC. The image interpretability significantly improved from 41.46% for SRA and 56.10% for MAC to 92.68% for AI-MAC (P < .05). Compared to SRA and MAC, the best DSC and HD for both oral cavity and teeth were obtained on AI-MAC (all P < .05). No significant differences for dose distribution were found among the 3 image sets.

Conclusion: AI-MAC outperforms conventional MAC in metal artefact reduction, achieving superior image quality with high image interpretability for patients with dental hardware undergoing head and neck CT. Furthermore, the use of AI-MAC improves the accuracy of organ contouring while providing consistent dose calculation against metal artefacts in radiotherapy.

Advances in knowledge: AI-MAC is a novel deep learning-based technique for reducing metal artefacts on CT. This in vivo study demonstrated its capability of reducing metal artefacts while preserving organ visualization, as compared with conventional MAC.

Objectives: This research focuses on detecting the orthogonal plane to the jaw and the dental arch curve on this plane so that high-quality panoramic images can be reconstructed from cone beam CT images.

Methods: The movement trajectory of panoramic reconstruction, known as the dental arch curve, determines the quality of the reconstructed panoramic image. In traditional methods, the dental arch curve is detected on 1 transversal slice using interpolation methods. However, these methods may fail to capture the actual dental arch since the jaw is not usually perpendicular to the transversal slice and the interpolation methods tend to ignore local anatomical information of the jaw and teeth. To improve detection of the actual dental arch, we define the jaw orthogonal plane by establishing a relationship between the plane variables and the jaw's left-to-right and the anterior-and-posterior tilts. On this plane, the dental arch curve is first initialized and then moved to match the actual dental arch.

Results: Experimental results demonstrate that our method accurately detects dental arch curves. Panoramic images reconstructed using these curves effectively display the true anatomical features of the jaw and teeth with less distortion compared to those reconstructed by traditional methods.

Conclusions: Our detected dental arch curve on the jaw orthogonal plane is more accurately located in the middle of the jaw and teeth. Anatomic information of the jaw and teeth around the detected dental curve is rightly employed to reconstruct high-quality panoramic images.

Objectives: To investigate the correlation between elastography values, age, and duration of bruxism by quantitatively measuring masseter muscle (MM) stiffness with shear wave elastography (SWE) in adolescents with bruxism.

Methods: This prospective study evaluated 132 MMs from 66 adolescents: 33 controls and 33 with bruxism. The thickness and stiffness of the MM were measured. The SWE values (metres/second; m/s) and kilopascals (kPa) of the patient and control groups were quantitatively compared.

Results: The elastic and velocity values of the MM in both closed and open positions were higher in bruxism patients compared to controls (P < .001, for each). No significant difference existed in MM thickness (P = .904). The receiver operating characteristic analysis for different SWE values found a sensitivity and specificity at baseline of 0.81 kPa, 0.60 m/s and 0.76 kPa, 0.67 m/s with the mouth closed. The values found with the mouth open were 0.76 kPa, 0.64 m/s and 0.76 kPa, 0.61 m/s.

Conclusions: Adolescents with bruxism had higher MM hardness values in closed and open positions compared to the control group. SWE can be used as an effective imaging method to measure MM hardness. No relationship existed between SWE values and the patient's age or duration of bruxism.

Objective: The aim of this study was to evaluate the impact of a 3D-printed model with simulated oral changes on the teaching of radiographic evaluation.

Method: A model of an adult patient with several simulated alterations was designed, including impacted teeth, dentigerous cyst, mesiodens, coronal fractures, periodontal resorptions, periapical lesions, and exostoses. The radiographic images obtained were evaluated by postgraduate students using a questionnaire. The data obtained were analysed with descriptive and inferential statistics.

Results: The 3D model produced satisfactory images for the simulation of the proposed alterations. The general perception of the participants was positive, but there were significant differences between master's and doctoral students regarding the clinical-radiographic relationship of the simulated changes in general (P = .037) and the radiographic image of impacted canine (P = .032).

Conclusions: The 3D model was positively evaluated in most of the simulated alterations, demonstrating its potential as a pedagogical tool. These results reinforce the feasibility of 3D printing for producing models for radiographic assessment, offering image quality and versatility for the development of complex training.

Advances in knowledge: This is the first study to develop and evaluate a 3D-printed model with complex anatomical and pathological alterations for preclinical training in Oral and Maxillofacial Radiology.

Objective: The aim of this study was to investigate MR sialography and SPECT/CT for parotid glands in Sjögren's syndrome patients.

Methods: Thirty Sjögren's syndrome patients underwent MR sialography and SPECT/CT. The MR sialographic stagings of Sjögren's syndrome were determined by the criteria (stage 0: normal; stage 1: punctate appearance; stage 2: globular appearance; stage 3: cavitary appearance; stage 4: destructive appearance). The maximum standardized uptake value (SUVmax) of the right and left parotid glands with SPECT/CT was obtained using a workstation and software. MR sialographic stagings and SUVmax of parotid glands were evaluated at pre- and post-stimulation and ratio of pre- to post-stimulation.

Results: Regarding pre-stimulation, the SUVmax of stage 0 (31.9 ± 19.3) was significantly higher than that of stage 2 (19.7 ± 7.5, P = .046), stage 3 (10.2 ± 7.1, P < .001) and stage 4 (6.8 ± 4.3, P < .001). Furthermore, the SUVmax at ratio of pre- to post-stimulation of stage 0 (1.87 ± 0.55) was significantly higher than that of stage 3 (1.16 ± 0.30, P = .001) and stage 4 (1.16 ± 0.40, P < .001).

Conclusion: This study suggests that MR sialography and SPECT/CT SUV are effective tool for the management of Sjögren's syndrome patients.

Objectives: To assess the influence of disinfecting a photostimulable phosphor plate (PSP) receptor with 0.2% peracetic acid on the vertical root fracture (VRF) diagnosis.

Methods: Baseline radiographs of 20 single-rooted teeth (10 without VRF and 10 with VRF) inserted in an alveolar socket of a human mandible were obtained with an unused PSP receptor of the Express digital system (Instrumentarium Dental Inc., Milwaukee, United States) and a Focus X-ray unit (Instrumentarium, Tuusula, Finland) set at 70 kVp, 7 mA, and an exposure time of 0.125 s. Then, 20 disinfections were performed on the PSP receptor, representing one disinfection cycle. Each disinfection lasted 30 s and the interval between them was 40 min. Subsequently, another 20 radiographs were obtained. This process occurred 9 more times, resulting in 200 disinfections (10 cycles × 20 disinfections) and 220 radiographs ([10 cycles × 20 teeth] + 20 baseline radiographs). All 220 radiographs were assessed independently by 5 examiners for VRF diagnosis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated and compared among the number of disinfections by analysis of variance. The significance level was set at 5%. Weighted Kappa test evaluated intra- and inter-examiner agreements.

Results: The disinfections did not affect the AUC, sensitivity and specificity values for VRF diagnosis (P > 0.05). Moreover, the intra- and inter-examiner agreements ranged from moderate to perfect (0.55-1.00) and from fair to moderate (0.22-0.49), respectively.

Conclusions: Disinfecting a PSP receptor with 0.2% peracetic acid did not affect the radiographic diagnosis of VRF.

To investigate the effectiveness of Virtual Reality (VR) simulations in improving learning outcomes in dental radiology in panoramic radiography. Thirty-two volunteer dental students (first and second year of study) had the same theoretical lecture about panoramic imaging. For practical training, students were randomly divided into 2 groups: G1: traditional educational method and G2: VR (Qbion AB software). Panoramic images of 2 anthropomorphic phantoms using a VistaVoxS 3D device were acquired. The type and number of positioning errors and the need for a retake were evaluated by 1 Oral Radiology teacher and 1 senior radiographer in consensus. To test the retention of knowledge, students from both groups had to identify the absence or presence of positioning errors. Data obtained were evaluated by a descriptive analysis and it considered the frequency of the categorical variables. The positioning error rate was higher for G1 (62.50%). Type error 3 (Patient's chin raised too high) was the most prevalent (47.06%) among the groups. The retake rate among all students was similar (25%). G2 was more able to detect patient's positioning errors (68.8%) than G1. The semi-immersive VR software demonstrated potential benefits for dental students. VR tools could be integrated into Oral Radiology preclinical simulations as an additional educational tool to help reduce patient positioning errors in panoramic radiography. This study highlights the effectiveness of semi-immersive VR in improving dental students' ability to detect and prevent positioning errors in panoramic radiography. VR training enhances knowledge retention and supports its integration into preclinical education as an additional educational tool to optimize radiographic training.

Objectives: This study aimed to investigate the vertical magnification ratios of various digital panoramic radiography devices and assess their consistency. It also examined the relationship between magnification ratios and Digital Imaging and Communications in Medicine (DICOM) header information to determine the potential use of key metadata in inferring or standardizing magnification corrections.

Methods: A ball phantom with metal spheres and an implant phantom were used to assess vertical magnification ratios. Eleven panoramic radiography systems were tested, and three DICOM tags-pixel spacing, imager pixel spacing, and aspect ratio-were analyzed. Three specialists measured phantom lengths in randomized DICOM images using PACS software, repeating measurements after 4 weeks. Magnification ratios were calculated by averaging 24 measurements per sample and comparing them to actual lengths.

Results: Intra- and interobserver reliability were high (ICC > 0.99). Most devices showed magnification ratios of 0.95-1.08, whereas those of devices 3 and 9 ranged from 1.21 to 1.30. Although some magnification ratios, which were used for system-based calibration, could be indirectly inferred by dividing the imager pixel spacing value by the pixel spacing value when both values were precisely recorded, no DICOM headers explicitly provided magnification ratios.

Conclusions: This study demonstrated that many digital panoramic radiography devices apply software-based corrections to achieve a vertical magnification ratio close to 1.0; however, inconsistencies remain across different systems. Measurement accuracy and clinical reliability can be enhanced by standardization of magnification correction methods and improved documentation in product specifications and DICOM headers, which is clinically relevant for increasing the accuracy of vertical measurements in procedures such as dental implant planning and thereby enhancing treatment predictability and patient safety.

To provide an overview of how Cone Beam Computed Tomography (CBCT) has been used in the assessment of degenerative changes of the temporomandibular joint (TMJ), with emphasis on image acquisition protocols, examiner calibration, and the criteria used for assessing and diagnosing TMJ structures. Searches were performed on PubMed, Embase, Scopus, and Web of Science databases on March 5, 2025. In vivo studies with a sample of adult individuals and which used CBCT to evaluate degenerative changes were included. Studies that did not discriminate voxel size, kV, or mA parameters and those without information on the degenerative changes assessed or the criteria used for image evaluation were excluded. Twenty-four studies were included. A wide variation in CBCT acquisition parameters was verified (voxel size varied from 0.076 mm to 0.3 mm, kV values were between 70 and 120, and mA between 3 and 38) which appear not to influence the detection of degenerative changes. The diverse criteria for CBCT assessment employed, many of which not validated, demonstrate a lack of standardization in TMJ assessment across the scientific literature. Furthermore, examiner calibration was not reported by 14 studies. Voxel size does not seem to significantly influence the detection of degenerative changes. The studies show a lack of examiner calibration, as well as inconsistencies in the standardization of acquisition parameters and evaluation protocols for CBCT imaging of the TMJ. Standardized and validated criteria are needed to enhance diagnostic accuracy and comparability among studies.