Imaging Science in Dentistry最新文献

Purpose: This systematic review aimed to investigate the correlation between chronological age and dental pulp volume in cone-beam computed tomography (CBCT).

Materials and methods: The literature was searched in 4 databases (PubMed, Scopus, Web of Science, and Google Scholar). Within each study, the outcome of interest was the correlation (r) between chronological age and pulp volume. A random-effect meta-analysis was conducted. Subgroup analysis was carried out according to sex and tooth type.

Results: Of 5693 identified studies, 27 fulfilled the inclusion criteria and were selected for meta-analysis. These articles focused on single-rooted teeth (n=21), multi-rooted teeth (n=6), maxillary teeth (n=14), mandibular teeth (n=6), and maxillary and mandibular teeth (n=12). The relationship between chronological age and dental pulp volume was examined in the entire population (r=-0.67), men (r=-0.75), and women (r=-0.77) in single- and multi-rooted teeth. The results of the total population analysis showed a relatively strong negative relationship between age and pulp volume.

Conclusion: This study suggested that CBCT is a reliable and repeatable tool for dental age estimation. A strong inverse relationship was observed between pulp chamber volume and age. Further studies on the correlation between chronological age and pulp volume of multi-rooted teeth may be beneficial.

Purpose: This study assessed the intensity of artifacts produced by 2 metal posts, 2 cements, and different exposure parameters using 2 cone-beam computed tomography (CBCT) units.

Materials and methods: The sample was composed of 20 single-rooted premolars, divided into 4 groups: Ni-Cr/zinc phosphate, Ni-Cr/resin cement, Ag-Pd/zinc phosphate, and Ag-Pd/resin cement. Samples were scanned before and after post insertion and cementation using a CS9000 3D scanner with 4 exposure parameters (85/90 kV and 6.3/10 mA) and an i-CAT scanner with 120 kV and 5 mA. The presence of artifacts was assessed subjectively by 2 observers and objectively by a trained observer using ImageJ software. The Mann-Whitney, Wilcoxon, weighted kappa, and chi-square tests were used to assess data at a 95% confidence level (α<0.05).

Results: In the subjective analyses, AgPd presented more hypodense and hyperdense lines than NiCr (P<0.05), and more hypodense halos were found using i-CAT (P<0.05) than using CS9000 3D. More hypodense halos, hypodense lines, and hyperdense lines were observed at 10 mA than at 6.3 mA (P<0.05). More hypodense halos were observed at 85 kV than at 90 kV (P<0.05). CS9000 3D presented more hypodense and hyperdense lines than i-CAT (P<0.05). In the objective analyses, AgPd presented higher percentages of hyperdense and hypodense artifacts than NiCr (P<0.05). Zinc phosphate cement presented higher hyperdense artifact percentages on CS9000 3D scans (P<0.05). CS9000 3D presented higher artifact percentages than i-CAT (P<0.05).

Conclusion: High-atomic-number alloys, higher tube current, and lower tube voltage may increase the artifacts present in CBCT images.

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning.

Materials and methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication.

Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal.

Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.

Purpose: The aim of this study was to conduct a scoping review and meta-analysis to provide overall estimates of the recall and precision of artificial intelligence for detection and segmentation using oral and maxillofacial cone-beam computed tomography (CBCT) scans.

Materials and methods: A literature search was done in Embase, PubMed, and Scopus through October 31, 2022 to identify studies that reported the recall and precision values of artificial intelligence systems using oral and maxillofacial CBCT images for the automatic detection or segmentation of anatomical landmarks or pathological lesions. Recall (sensitivity) indicates the percentage of certain structures that are correctly detected. Precision (positive predictive value) indicates the percentage of accurately identified structures out of all detected structures. The performance values were extracted and pooled, and the estimates were presented with 95% confidence intervals (CIs).

Results: In total, 12 eligible studies were finally included. The overall pooled recall for artificial intelligence was 0.91 (95% CI: 0.87-0.94). In a subgroup analysis, the pooled recall was 0.88 (95% CI: 0.77-0.94) for detection and 0.92 (95% CI: 0.87-0.96) for segmentation. The overall pooled precision for artificial intelligence was 0.93 (95% CI: 0.88-0.95). A subgroup analysis showed that the pooled precision value was 0.90 (95% CI: 0.77-0.96) for detection and 0.94 (95% CI: 0.89-0.97) for segmentation.

Conclusion: Excellent performance was found for artificial intelligence using oral and maxillofacial CBCT images.

Nasopalatine duct cysts (NPDCs), the most common non-odontogenic cysts of maxilla, are often incidental findings on diagnostic imaging. When symptomatic, they usually present as a painless swelling with possible fistula. Conventional radiography shows a round-to-ovoid or heart-shaped radiolucency between the roots of central maxillary incisors. While the radiographic features of NPDCs in X-ray-based modalities have been well described, their magnetic resonance imaging (MRI) features have rarely been reported. Developments in dental MRI in recent years and the introduction of various dental MRI protocols now allow a wide range of applications in dental medicine. MRI is becoming an important tool for the detection and diagnosis of incidental or non-incidental dentomaxillofacial cysts. This report presented and discussed the characteristics of 2 NPDC cases visualized on MRI using both conventional and newly implemented specific dental MRI protocols with a novel 15-channel mandibular coil, demonstrating the use of these protocols for radiation-free maxillofacial diagnoses.

Nodular fasciitis (NF) is a benign myofibroblastic proliferation that grows very rapidly, mimicking a sarcoma on imaging. It is treated by local excision, and recurrence has been reported in only a few cases, even when excised incompletely. The most prevalent diagnoses of temporomandibular joint (TMJ) masses include synovial chondromatosis, pigmented villonodular synovitis, and sarcomas. Cases of NF in the TMJ are extremely rare, and only 3 cases have been reported to date. Due to its destructive features and rarity, NF has often been misdiagnosed as a more aggressive lesion, which could expose patients to unnecessary and invasive treatment approaches beyond repair. This report presents a case of NF in the TMJ, focusing on various imaging features, along with a literature review aiming to determine the hallmark features of NF in the TMJ and highlight the diagnostic challenges.

Purpose: This study aimed to assess texture analysis (TA) of cone-beam computed tomography (CBCT) images as a quantitative tool for the differential diagnosis of odontogenic and non-odontogenic maxillary sinusitis (OS and NOS, respectively).

Materials and methods: CBCT images of 40 patients diagnosed with OS (N=20) and NOS (N=20) were evaluated. The gray level co-occurrence (GLCM) matrix parameters, and gray level run length matrix texture (GLRLM) parameters were extracted using manually placed regions of interest on lesion images. Seven texture parameters were calculated using GLCM and 4 parameters using GLRLM. The Mann-Whitney test was used for comparisons between the groups, and the Levene test was performed to confirm the homogeneity of variance (α=5%).

Results: The results showed statistically significant differences (P<0.05) between the OS and NOS patients regarding 3 TA parameters. NOS patients presented higher values for contrast, while OS patients presented higher values for correlation and inverse difference moment. Greater textural homogeneity was observed in the OS patients than in the NOS patients, with statistically significant differences in standard deviations between the groups for correlation, sum of squares, sum of entropy, and entropy.

Conclusion: TA enabled quantitative differentiation between OS and NOS on CBCT images by using the parameters of contrast, correlation, and inverse difference moment.

Purpose: This study evaluated anatomical variations in the root canals of the lower premolars and molars in a Brazilian sub-population using cone-beam computed tomography (CBCT).

Materials and methods: In total, 121 CBCT images of patients were selected from a database. All images contained lower first and second premolars and molars on both sides of the arch, fully developed roots, and no treatment, resorption, or calcifications. In each image, the root canals of the lower premolars and molars were evaluated according to the Vertucci classification in On-Demand 3D software in the multiplanar reconstruction with dynamic navigation. Twenty-five percent of the images were re-assessed to analyze intraobserver confidence with the kappa test. Data were statistically evaluated with linear regression to evaluate the correlations of anatomic variations with age and sex, and the Wilcoxon test to analyze the laterality of variations, with a significance level of 5%.

Results: The intraobserver agreement (0.94) was excellent. In general, the root canals of lower premolars and molars showed a higher prevalence of type I than other Vertucci classification types, followed by type V in premolars and type II in molars. When the molar roots were evaluated separately, type II was more frequent in mesial roots and type I in distal roots. Although age showed no correlations with the results, sex and laterality showed correlations with tooth 45 and the lower second premolars, respectively.

Conclusion: The lower premolars and molars of a Brazilian sub-population showed a wide range of root canal anatomic variations.

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT.

Materials and methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated.

Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other.

Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

Purpose: The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST).

Materials and methods: Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured.

Results: An average alveolar bone gain >0.5 mm following PST was identified using CBCT (P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years.

Conclusion: PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.