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Oral radiology. Principles and interpretation, 6th edition (2008)
Abstract
Editors: Stuart C. White, and Michael J. Pharoah. Publisher: Mosby Elsevier, Jordan Hill, Oxford, UK Price: £61.99 ISBN: 978-0-323-04983-2
The old classic of oral radiology has accompanied and provided advice to a great number of dental students and professionals around the world. Since the 5th edition in 2003, the field of oral and maxillofacial radiology has changed tremendously regarding topics such as digital imaging, advanced imaging, and cone-beam computed tomography (CBCT), whereas some …
... Указанный дефект является вдавлением в границах нормально расположенной поднижнечелюстной ямки (fovea submandibularis) -анатомического образования тела нижней челюсти в месте прилегания поднижнечелюстной слюнной железы. В литературе также имеются другие термины: киста Стафне, статическая ямка челюсти, идиопатическая ямка челюсти, дефект развития ямки подчелюстной слюнной железы [2][3][4][5]. ...
... Относительно этиологии формирования дефекта Стафне выдвинуто несколько гипотез. Наиболее часто авторами приводится объяснение, что дефект формируется под давлением капсулы поднижнечелюстной слюнной железы [1][2][3][4][5], а также окружающих ее сосудов. Кроме того, выдвигается предположение, что дефект формируется от прилежащей липомы и вторичного давления на нее тканей железы [2]. ...
... Наиболее часто авторами приводится объяснение, что дефект формируется под давлением капсулы поднижнечелюстной слюнной железы [1][2][3][4][5], а также окружающих ее сосудов. Кроме того, выдвигается предположение, что дефект формируется от прилежащей липомы и вторичного давления на нее тканей железы [2]. ...
Defects in mandible growth are of undoubted interest for practical healthcare. During the diagnosis, for a more accurate diagnosis and differential diagnosis, it is necessary to understand the criteria for the norm and pathology of diseases of the jaw bones. Often in the body of the mandible at the level of the lower molars, slightly below the maxillofacial line, defects are detected in the form of a depression of the cortical layer towards the unchanged buccal cortical plate. These defects, being the clinical norm, need to be differentiated with many tumor diseases of the maxillofacial region. The literature sources indicate that the cause of these defects is the pressure of the capsule of the submandibular salivary gland in the area of the fossa on the lower jaw. Modern additional diagnostic methods, for example, CBCT and MRI, make it possible to identify a Stafne defect.
... CBCT (cone beam computed tomography) provides accurate images of the target area using a cone beam and a two-dimensional detector. Advantages include high-speed CT-level scanning, high resolution, lower exposure dose than CT, and the ability to accurately view and assess the TMJ [10][11] . CBCT has proven to be a highly cost-effective method for radiographic evaluation of the TMJ 12 . ...
... In the examination of joint spaces, the anterior joint space is reduced, which indicates the forward displacement of the disc and condyle. The results of other studies also suggest that the condyle moves forward in the joint space [6][7][8][9][10][11][12][13][14][15][16][17][18][19] . The results of Kim et al. study showed that the condyle remains in an anterior position 6 months after surgery and then returns to its previous position. ...
... [ DOI:10.52547/wjps.11.2.110 ] [ Downloaded from wjps.ir on 2022-08-22 ] The Clinical and Radiographic Changes... ...
Background:
Bilateral Sagittal Split Osteotomy (BSSO) is one of the treatment options for Class III maxillary deficiency which may affect the condylar position and the patient's occlusion. We aimed to evaluate the clinical and radiographic changes of temporomandibular joint (TMJ) following mandibular set back surgery by BSSO.
Methods:
In this retrospective study, All Class III patients, aged between 18-30 years old who underwent bimaxillary orthognathic surgery in the Oral and Maxillofacial Surgery Ward of Ghaem Hospital, Mashhad, Iran from January 2018- January 2020 were enrolled. Radiographic changes of joint space, condylar position and clinical changes for maximal mouth opening and joint sound were examined before and 6 months after surgery. Data were analyzed by SPSS16 software and the significance level of the data was set at P-value < 0.05.
Results:
Twenty-five patients were recruited. The axial angle of the left and right condyle and condylar inclination on both sides reduced but this reduction was not statistically significant. While the anterior joint space was reduced and posterior joint space was increased in both sides, the changes on the right side were only significant (P = 0.039). In clinical examinations maximum mouth opening, lateral and protrusive movements were also decreased but this reduction was not statistically significant.
Conclusion:
The mandibular set back with BSSO surgery in class III skeletal patients had no significant effect on the position of the condyle in the glenoid fossa as well as clinical symptoms.
... Lesi ini dapat mewakili variasi anatomi atau merupakan proses lesi inflamasi, jinak hingga ganas. 1,2 Kista radikular adalah jenis kista odontogenik yang paling umum di rahang, seringkali tidak menunjukkan adanya gejala kecuali terjadi infeksi sekunder. 2,3 Kista radikular cenderung bertumbuh lambat, namun tergantung pada ukuran lesi dan hubungannya dengan jaringan sekitar. ...
... 1,2 Kista radikular adalah jenis kista odontogenik yang paling umum di rahang, seringkali tidak menunjukkan adanya gejala kecuali terjadi infeksi sekunder. 2,3 Kista radikular cenderung bertumbuh lambat, namun tergantung pada ukuran lesi dan hubungannya dengan jaringan sekitar. Kista radikular dapat menyebabkan mobilitas gigi, resorpsi akar, perpindahan gigi hingga parestesia. ...
... Kista akan terasa sakit dan tidak nyaman jika disertai dengan adanya infeksi akut. 2,13 Cairan pada kista dikeluarkan oleh sel-sel yang melapisi rongga atau berasal dari cairan jaringan sekitar. Kista odontogenik merupakan bentuk paling umum dari lesi kista yang mempengaruhi wilayah maksilofasial. ...
Latar belakang: Lesi radiolusen pada rahang dapat terjadi dalam berbagai bentuk. Lesi ini dapat mewakili variasi anatomi atau merupakan proses lesi inflamasi, benign hingga malignant.1,2 Kista adalah lesi radiolusen patologis yang paling sering ditemukan pada rahang.1 Kista radikular adalah jenis kista odontogenik yang paling umum di rahang, seringkali tidak menunjukkan adanya gejala kecuali terjadi infeksi sekunder.2,3 Laporan kasus: Seorang pasien laki-laki berusia 32 tahun datang ke Instalasi Radiologi Kedokteran Gigi di Rumah Sakit Gigi dan Mulut (RSGM) Universitas Padjajaran (Unpad) dengan membawa surat rujukan untuk dilakukan pemeriksaan penunjang radiografi panoramik. Pada pemeriksaan ekstra oral pasien menunjukkan adanya asimetris wajah. Palpasi menunjukkan adanya krepitasi. Tidak ada kelainan kelenjar getah bening. Pemeriksaan intra oral tampak kavitas di oklusal gigi 47, bengkak, gigi 46 missing, mukosa regio 47 tampak normal sama dengan tampilan mukosa sekitar. Kesimpulan: Investigasi klinis dan radiografi diperlukan untuk menegakkan diagnosis yang tepat serta memungkinkan dokter mencapai perawatan yang lebih konservatif untuk menyelamatkan integritas baik jaringan lunak dan keras.
... Histolojik görünüm esas olarak fibroblastlardan, çok sayıda vasküler kanaldan, çok çekirdekli dev hücrelerden, makrofajlardan ve iğsi hücre stromasından oluşur. Immünohistokimyasal incelemeler, dev hücrelerin aslında osteoklastlar olduğunu, iğsi hücrelerin ise bu lezyonun muhtemel orijin hücresi olduğunu göstermektedir (4,6). ...
... Tedavide enükleasyon, küretaj ve bazı durumlarda (agresif lezyonlarda) rezeksiyon uygulanabilir (4,6). Küretaj sonrası %15-20 oranında rekürrens riski mevcuttur (4). ...
... Küretaj sonrası %15-20 oranında rekürrens riski mevcuttur (4). Özellikle konservatif tedavi uygulandığı zaman rekürrens riskine karşı hasta dikkatli bir şekilde takip edilmelidir (6). ...
... Stafne bone cavity (SBC) is a bone depression of the mandible representing a group of concavities especially in the lingual surface of the mandible, where the depression is lined with an intact outer cortex (1)(2)(3). SBC is generally encountered incidentally on plain film radiographs with a cyst-like appearance and thus, they were referred to as pseudocysts historically; they are not true cysts because they do not have epithelial lining (2,4). Plain film radiographs are often sufficient for diagnosis of SBC, but they may not be definitive when the lesion is atypical. ...
... Stafne bone cavity (SBC) is a bone depression of the mandible representing a group of concavities especially in the lingual surface of the mandible, where the depression is lined with an intact outer cortex (1)(2)(3). SBC is generally encountered incidentally on plain film radiographs with a cyst-like appearance and thus, they were referred to as pseudocysts historically; they are not true cysts because they do not have epithelial lining (2,4). Plain film radiographs are often sufficient for diagnosis of SBC, but they may not be definitive when the lesion is atypical. ...
... A description of 35 cases of lingual posterior variant of SBC was first given by Stafne in 1942 and then the author's name was linked to this bone depression (2,4). The terms that have been used to describe this entity are Stafne bone defect, Stafne cyst, static bone cavity, static bone defect, lingual mandibular bony defect, and lingual mandibular salivary gland defect (2,3,5,6,11,12). ...
Background: Stafne bone cavities (SBCs) are typically seen on panoramic radiographs as unilocular, rounded or ovoid shaped, well-defined corticated radiolucencies that are located between the mandibular first molar and the angle of the mandible below the inferior alveolar canal, but they may rarely have different radiographic appearances and locations. Objectives: The purpose of this study was to evaluate the imaging features of SBC presenting various typical and atypical features and to show the contribution of different imaging techniques to diagnosis. Patients and Methods: Seventeen patients who had a panoramic radiograph that revealed an image compatible with SBC were investigated in this study. In addition to panoramic radiography, lateral oblique mandible projection for three patients, cone beam computed tomography (CBCT) for nine patients, magnetic resonance imaging (MRI) for two patients were performed to determine the exact location of the cavity and to confirm the diagnosis. Results: Seventeen patients were diagnosed with SBC. Two patients had bilobed SBC, one patient had a SBC on the buccal surface of the posterior mandible, one patient had a SBC located in the ramus mandible, one patient had a SBC located in the canine-premolar region namely anterior lingual variant as rare conditions. Conclusion: Imaging techniques such as CBCT and MRI have provided detailed information about definitive diagnosis of SBC in addition to panoramic radiographs. These techniques show the size, location and content of the SBC. If the SBC is atypical, complementary imaging techniques gain more importance. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.
... Pemeriksaan radiografi merupakan salah satu disiplin ilmu dalam dunia kedokteran gigi yang semakin berkembang seiring waktu dan menjadi alat bantu diagnosis utama dalam menentukan keadaan penyakit yang terdapat dalam rongga mulut melalui pendekatan radiografi intra oral (Periapikal Bisecting, paralleling dan Bitewing) dan ekstraoral (Sefalometrik dan Panoramik). 1,2,3 Radiografi kedokteran gigi sering digunakan karena memiliki gambaran yang dapat diterima dengan hasil yang lebih cepat dan akurat, mengurangi perawatan yang tidak perlu, serta kondisi rongga mulut secara umum dapat dievaluasi. 4 Berdasarkan beberapa survey menyebutkan bahwa hanya sekitar 10.8% tenaga kesehatan gigi yang jarang menggunakan unit radiografi. ...
... Radiografi periapikal meskipun berperan penting dalam menegakkan diagnosis, masih banyak kekurangan yang terjadi dalam hasil foto radiografi pada saat pengambilan gambar. 1,2,4 Menurut Khan SQ dkk dalam penelitian yang dilakukannya mengungkapkan bahwa 79% dari hasil radiografi yang diperiksa, mempunyai satu atau lebih kesalahan sehingga mengurangi hasil dari diagnostik gambar radiografi. 6.7 Dalam dunia kedokteran gigi khususnya mengenai pelayanan pasien pada Rumas Sakit saat ini masih membutuhkan kualitas pelayanan radiografi foto periapikal yang lebih baik. ...
Pendahuluan: Pemeriksaan radiografi periapikal merupakan salah satu pemeriksaan rutin yang dilakukan untuk membantu menegakkan diagnosis dan rencana perawatan, salah satunya dengan teknik bisecting. Pada pemeriksaan bisecting memiliki bermacam-macam potensi terjadinya kesalahan dalam pengambilan yang menyebabkan pengulangan pengambilan radiograf dan memberikan paparan radiasi yang tidak perlu. Tujuan: untuk mengidentifikasi kemungkinan kesalahan pemeriksaan radiografi periapikal khususnya teknik bisecting. Metode: studi literatur yang mengumpulkan literatur dari database jurnal yang memenuhi topik penelitian ini. Hasil: 11 artikel melaporkan kesalahan hasil teknik periapikal bisecting seperti Overlapping, Apex dan Crown Cutting, Blurred, Cone Cutting, Elongation, Foreshortening dan Double Expossure, jenis kesalahan pemeriksaan teknik periapikal membagi dua adalah kesalahan posisi, kesalahan eksposur, kesalahan teknis dan kesalahan pasien. Kesimpulan: Jenis dan penyebab kesalahan dari radiografi periapikal digital dengan teknik Bisecting memiliki peran penting dalam meningkatkan prinsip ALARA (As Low as Achievable Reasonable) kepada pasien, klinisi dan teknisi untuk mengurangi paparan radiasi dan meningkatkan kualitas radiografi.
... In some systems, image enhancement is also performed automatically by the software, after image acquisition, but before it is displayed on the monitor, through an image pre-processing tool called Automatic Exposure Compensation (AEC) [4][5][6]. This tool increases image contrast, modifying pixel values non-linearly, producing high-contrast radiographs [7,8]. ...
... In theory, the increase in kV qualitatively modifies the X-ray photons, increasing their capability to pass through the tissues. In systems without the AEC, this also results, although indirectly, in the darkening of the radiograph (reduction of gray values), since more X-ray photons will reach the image receiver [5]. As this is expected when the AEC function is not present but also occurred in systems with AEC, it seems that the AEC does not interfere so strongly in the changes caused by kV in the image. ...
Background
This study aimed to investigate the effect of automatic exposure compensation (AEC) of intraoral radiographic systems on the gray values of dental tissues in images acquired with or without high-density material in the exposed region using different exposure times and kilovoltages. The influence of the distance of the high-density material was also investigated.
Methods
Radiographs from the molar region of two mandibles were obtained using the RVG 6100 and the Express systems, operating at 60 and 70 kV and 0.06, 0.10, and 0.16 s. Subsequently, a titanium implant was inserted in the premolar’s socket and other images were acquired. Using the ImageJ software, two regions of interest were determined on the enamel, coronary dentine, root dentine, and pulp of the first and second molars to obtain their gray values.
Results
In the RVG 6100, the implant did not affect the gray values (p > 0.05); the increase in kV decreased it in all tissues (p < 0.05), and the exposure time affected only the root dentine and pulp. In the Express, only enamel and coronary dentine values changed (p < 0.05), decreasing with the implant presence and/or with the increase in exposure factors. The distance of the implant did not affect the results (p > 0.05).
Conclusions
AEC’s performance varies between the radiographic systems. Its effect on the gray values depends not only on the presence or absence of high-density material but also on the kV and exposure time used.
... However, there is little mineral density variation in demineralized tissue of deep carious lesions, which increases the difficulty of accurate clinical diagnosis from radiographs (5). It has been found that carious lesions may not be evident on radiographs until the demineralization is greater than 40% (6). Therefore, the accuracy of visual inspection of the radiographic penetration depth can be significantly influenced by a dental practitioner's clinical experience; the accuracy rate of experienced clinicians is nearly four times greater than that of inexperienced clinicians (6,7). ...
... It has been found that carious lesions may not be evident on radiographs until the demineralization is greater than 40% (6). Therefore, the accuracy of visual inspection of the radiographic penetration depth can be significantly influenced by a dental practitioner's clinical experience; the accuracy rate of experienced clinicians is nearly four times greater than that of inexperienced clinicians (6,7). ...
Background:
An accurate diagnosis of deep caries and pulpitis on periapical radiographs is a clinical challenge.
Methods:
A total of 844 radiographs were included in this study. Of the 844, 717 (85%) were used for training and 127 (15%) were used for testing the three convolutional neural networks (CNNs) (VGG19, Inception V3, and ResNet18). The performance [accuracy, precision, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC)] of the CNNs were evaluated and compared. The CNN model with the best performance was further integrated with clinical parameters to see whether multi-modal CNN could provide an enhanced performance. The Gradient-weighted Class Activation Mapping (Grad-CAM) technique illustrates what image feature was the most important for the CNNs.
Results:
The CNN of ResNet18 demonstrated the best performance [accuracy =0.82, 95% confidence interval (CI): 0.80-0.84; precision =0.81, 95% CI: 0.73-0.89; sensitivity =0.85, 95% CI: 0.79-0.91; specificity =0.82, 95% CI: 0.76-0.88; and AUC =0.89, 95% CI: 0.86-0.92], compared with VGG19 and Inception V3 as well as the comparator dentists. Therefore, ResNet18 was chosen to integrate with clinical parameters to produce the multi-modal CNN of ResNet18 + C, which showed a significantly enhanced performance (accuracy =0.86, 95% CI: 0.84-0.88; precision =0.85, 95% CI: 0.76-0.94; sensitivity =0.89, 95% CI: 0.83-0.95; specificity =0.86, 95% CI: 0.79-0.93; and AUC =0.94, 95% CI: 0.91-0.97).
Conclusions:
The CNN of ResNet18 showed good performance (accuracy, precision, sensitivity, specificity, and AUC) for the diagnosis of deep caries and pulpitis. The multi-modal CNN of ResNet18 + C (ResNet18 integrated with clinical parameters) demonstrated a significantly enhanced performance, with promising potential for the diagnosis of deep caries and pulpitis.
... Generally, they present circular, oval or elongated shape. They mainly affect the major salivary glands, however minor glands can also be affected 10 . ...
... The patient might refer pain and swelling and report a lesion of hard consistency at palpation. At the radiographic examination, the clinician will see a lesion of homogenous radiopacity 10 . ...
Background:
The orthopantomography is a diagnostic tool with a relevant role in the precocious detection of pathologies and anomalies of the head and neck, such as calcifications of the soft tissues. The digital orthopantomography is the most used image diagnostic tool in dentistry. It is a low cost easily taken radiography that allows the visualization of the mandible, maxillae, and other craniofacial structures without exposing the patient to high doses of radiation. Given the exposed, the aim of this study has a great relevance since it aims to evaluate the prevalence of atheroma plaques and tonsilloliths with digital panoramic radiography in Northeast Brazilian population.
Methods:
A total of 500 digital orthopantomography were evaluated, but only 365 were eligible to be included in this study. The soft tissue calcification was classified in tonsilolith and atherosclerosis. Sex and age were correlated with calcification using Fisher´s test. Following an interexaminer analysis was perfomed using the kappa test.
Results:
Calcifications were diagnosed in 6 radiographics, being 3 tonsiloliths and 3 Atherosclerosis. Atherosclerosis was found only in patients over 40 years old. This finding was statistically significant P≤0.05.
Conclusions:
Although, the prevalence of calcifications in soft tissues is low, the detection of these pathologies through the digital panoramic radiography becomes relevant once vascular diseases could be diagnosed at early stages, enabling thus an adequate management of the underlying clinical condition.
... 19 İmplant planlamasında kullanılan başlıca üç boyutlu görüntüleme teknikleri BT ve DVT dir. [24][25][26] DVT'nin BT'ye göre daha küçük kesit kalınlığı ile görüntülerin elde edilmesine olanak sağlaması, daha kısa sürede, gerçek boyutta ve yüksek çözünürlükte görüntüler elde edilmesi, 20,26 hastanın maruz kaldığı radyasyon miktarının da BT cihazlarından yaklaşık 15-20 kat daha az olması gibi önemli üstünlükleri olduğu bilinmektedir. 20,[27][28][29] Cihazın tipine ve modeline göre değişmekle birlikte DVT'nin etkili dozu 52-1025 µSv arasındadır; BT cihazlarında ise bu değer 860-2100 µSv arasında değişmektedir. ...
... 20,[27][28][29] Cihazın tipine ve modeline göre değişmekle birlikte DVT'nin etkili dozu 52-1025 µSv arasındadır; BT cihazlarında ise bu değer 860-2100 µSv arasında değişmektedir. 26,30 Ayrıca görüntülenen yapıların etrafında hayali gölgelerin oluşumu BT'nin diğer bir dezavantajıdır. 19 DVT teknolojisi kraniyofasiyal kemik yapıların ve dişlerin, iki boyutlu radyografilerle elde edilemeyen, yüksek kontrastlı çok sayıda kesitsel ve sefalometrik görüntülerin elde edilmesini sağlar. ...
Aim: The aim of this study was to investigate the
indications of dental volumetric tomography
prescriptions performed in İzmir Kâtip Çelebi
University, Faculty of Dentistry and to examine the
age and gender distribution of the patients.
Material and Method: In this study, 470 dental
volumetric tomography data (NewTom 5G,
QR, Verona, Italy) obtained from patients who
attended to İzmir Katip Çelebi University, Faculty of
Dentistry for their dental problems between October
2012 and October 2013 were retrospectively
evaluated.
Results: Out of 470 patients, 243 were female and
227 were male, whose ages ranged from 6-73 years
(mean= 32.56). The major indications for dental
volumetric tomography were for the evaluation of the
impacted teeth with a percentage of 32.13 %, which
was followed by the examination of bone pathologies
like cysts and tumors (23.62 %), the assessment for
implant planning (21.49 %), and the evaluation of
orthodontic anomalies and sinus pathologies
respectively.
Conclusions: Dental volumetric tomography has
become an indispensable diagnostic tool in clinical
practice for many professions where two-dimensional
radiography remains limited in many cases.
Key Words: Dental volumetric tomography,
indication, radiography.
... 3,6 The relationship of the maxillary sinus floor with the roots of the maxillary posterior teeth changes depending on the degree of alveolar pneumatization. 7 Understanding of the alveolar pneumatization and the relation between teeth roots and sinus is crucial and needs to be considered in order to prevent potential complications after surgical procedures (e.g. implantation, tooth extraction and treatment of lesions) involving maxillary posterior region. ...
... Radiographically, dilacerations are determined when there is a sharp angulation or deviation in the crown or root of a developed tooth with an angle of curvature 90º or more, although there is a controversy in the literature for this determination. Some of the experts believe that dilacerations represent a deviation from the normal axis of the tooth with an angle of curvature, 20 o more in the apical third of the root (Hamasha et al., 2002;White et al., 2004). There are two major reasons identified for this occurrence. ...
A thorough knowledge of external dental root morphology is fundamental for having successful endodontic, orthodontic and surgical treatments in dentistry. The aim of this anatomical study was to determine the incidence of tooth dilacerations in Kerman, a province in the Southeastern Islamic Republic of Iran. A cross-sectional study was performed on a total of 3150 teeth from 800 PA radiographs; 100 radiographs from each 8 anatomic divisions of the dental arch, within a Kerman population. The numbers of radiographs were equal between 2 genders; 400 from females and 400 from males. Radiographs were studied by 3 specialists in this field in order to determine and record the prevalence and distribution of dilacerations in different teeth of this population. Amongst the total of 3150 teeth from 800 radio-graphs, 52 teeth (1.65%) showed dilacerations. The prevalence of this anomaly was 7.5% in males and 5% in females, and the distribution was almost equal between different teeth of the maxilla (2%-4%); meanwhile in the mandible, the maximum prevalence was in third molars (14%) and the rate was nil in anterior teeth (Spss and Excel soft-wares, IBM). The prevalence of tooth dilacerations was almost equal between genders in the Kerman population that was studied. The findings indicated that the presence of dilacerated roots was more prevalent in females in the mandibular arch, while this anomaly was more prevalent in males in the maxillary arch. Interestingly, none of the mandibu-lar incisor teeth displayed this anomaly.
... Dental anomalies have been known to be congenital, developmental or acquired. They may be associated with defects in chromosomes or environmental factors (1). The occurrence of multiple dental anomalies is relatively common and have been reported especially in cases with other systemic alterations or syndromes. ...
Simultaneous occurrence of multiple dental anomalies is relatively common and has been reported particularly in cases with systemic alterations or syndromes. However, in 1974, Ekman-Westborg and Julin described a unique case of multiple macrodontia and multituberculism of posterior teeth accompanied by multiple dental malformations without other systemic anomalies. Here we report the case of a 20-year-old female patient who presented with macrodontia affecting her maxillary lateral teeth, mandibular incisors, and impacted multituberculated wisdom teeth accompanied by other dental anomalies that manifested itself as a variant of the Ekman-Westborg-Julin trait.
... 4,5 In order to visualize a carious lesion on a parallel radiograph (0° angle), it must have a minimum depth of 0.5 mm; a cavity has yet to be formed in 60% of such carious lesions. 1 The absence of a horizontal and vertical overlap is a primary requirement for an optimal bitewing radiograph, which is helpful for the correct detection of caries. 6 Despite the fact that the contact area of teeth must be open and overlaps must be absent on bitewing radiographs, in the current study bitewing radiographs were obtained at 0°, 5°, 10° and 15° horizontal angles to evaluate the effect of changing the horizontal angulation on the accuracy of detecting proximal enamel caries, since early detection of caries is absolutely necessary to take measures to cease the progression of carious lesions. In other words, we hypothesized that we might be able to disregard some degrees of overlap (caused by changing the horizontal angulation) in favor of enhancing early detection of proximal carious lesions shallower than 0.5 mm. ...
Background:
Bitewing radiography is an important modality useful for the evaluation of teeth in patients of various ages and in different stages of tooth eruption. Clinical examination of proximal surfaces for caries may result in false negative results, especially in tight contact areas. Thus, radiography, as an adjunct to clinical examination, is used as a routine diagnostic modality for caries detection.
Objectives:
The objective of this study was to assess the in vitro effect of changing the horizontal angulation of X-ray beam on the detection of proximal enamel caries in bitewing radiographs.
Material and methods:
This in vitro study was conducted on 150 caries-free human premolars (code: p/16/35/9/210). The teeth were randomly divided into 3 groups (n = 50). Group 1 served as the control group and no carious lesions were induced in this group. Teeth in groups 2 and 3 were immersed in demineralizing solution for 2 and 4 months, respectively. After induction of caries and its radiographic confirmation, the teeth were mounted in wax in groups of 3 and bitewing radiographs were obtained at 0°, 5°, 10° and 15° horizontal angles.
Results:
The sensitivity values of bitewing radiographs at 0°, 5°, 10° and 15° horizontal angles were 88%, 90%, 88%, 92% in group 2 and 88%, 94%, 94% and 94% in group 3, respectively. The specificity values of bitewing radiographs at 0°, 5°, 10° and 15° horizontal angles were 92%, 86%, 84% and 76%. The accuracy of bitewing radiographs at 0°, 5°, 10° and 15° horizontal angles was 89.3%, 90%, 88.7% and 87.3%, respectively. The highest diagnostic accuracy was obtained at 5° horizontal angle for caries detection; however, the difference in this regard among the tested horizontal angles was not statically significant (p = 0.846).
Conclusions:
Based on the results of this study, changing the horizontal angulation has no significant effect on the detection of proximal enamel caries in bitewing radiographs.
... Dental anomalies have been known to be congenital, developmental or acquired. They may be associated with defects in chromosomes or environmental factors (1). The occurrence of multiple dental anomalies is relatively common and have been reported especially in cases with other systemic alterations or syndromes. ...
DOI: 10.26650/eor.2018.25807Simultaneous occurrence of multiple dental
anomalies is relatively common and has been reported particularly in cases with
systemic alterations or syndromes. However, in 1974, Ekman-Westborg and Julin
described a unique case of multiple macrodontia and multituberculism of
posterior teeth accompanied by multiple dental malformations without other
systemic anomalies. Here we report the case of a 20-year-old female patient who
presented with macrodontia affecting her maxillary lateral teeth, mandibular
incisors, and impacted multituberculated wisdom teeth accompanied by other
dental anomalies that manifested itself as a variant of the
Ekman-Westborg–Julin trait.
... (2,12) In this study, there was no statistically significant difference between gender and the presence of PAT or PRGF, consistent with previous studies. (4,20) In the present study, only 51 (21.3%) patients had PAT. The prevalence of PAT was assessed in the previous study mostly on panoramic radiographs, and re-ported to be between 1 and 3.42%. ...
... Rectangular collimation has been recommended by the American Dental Association (ADA), the National Council on Radiation Protection and Measurement (NCRP), and the International Council on Radiation Protection (ICRP) for use in dental intraoral radiography to reduce patient exposure from ionizing radiation [1][2][3][4]. Over the past decades, various types of rectangular collimating devices have been developed to significantly reduce patient exposure [5][6][7]. However, organ dose reduction due to scatter of the primary radiation beam has not been evaluated for any of the rectangular collimation devices. ...
... Digital panoramic radiographs were taken immediately after surgery and 12 weeks postoperatively. Digital panoramic radiography was performed according to the standard procedure described by Stuart and Michael [11]. The radiographs were transferred to a computer and the densitometric and linear measurements were calculated using Digora software. ...
The aim of this study is to evaluate oroantral communication (OAC) repair using one bone substitute (Fisiograft) and platelets rich fibrin (PRF).
... Processing of one film in different solutions can lead to different contrast and density [6,7]. Syrtoponlos et al. and Framan et al. in their study concluded that processing solution had main role in quality of dental radiographies [8][9][10]. ...
... Because CT provides multiple sections through the sinuses in different planes, they may contribute significantly to delineating the extent of disease and the final diagnosis. Highresolution axial and coronal CT examinations are the most revealing imaging techniques for the paranasal sinuses and the adjacent structures and areas (3). ...
An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation.
120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT.
Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05).
The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.
... It is traditionally performed on a lateral and a frontal cephalogram. Although this widely accepted technique has been used as a standard tool for orthodontic treatment planning for several decades, known disadvantages of the technique are geometric distortion and the superimposition of structures on two-dimensional radiographs (3,4). ...
Objective: The aim of this study was to assess the reproducibility of identifying the sella turcica landmark in 3-dimensions by using a new landmark reference system.
Method: In total a sample of 30 CBCT scans from subjects, with a clinically justified need for 3D imaging, was retrospectively collected from the Oral Imaging Center, University Hospitals, KU Leuven. All CBCT images were taken by 3D Accuitomo 170 (J. Morita, Kyoto, Japan). CBCT data were exported from i-Dixel software (J. Morita, Kyoto, Japan) into DICOM format and then imported to Maxilim software (Medicim NV, Sint-Niklaas, Belgium). 3D models were created for each patient and then randomized. Three observers: one dentomaxillofacial radiologist, one maxillofacial surgeon and one orthodontist were calibrated prior to the observation. The observers had to identify 5 landmarks including the sella turcica. Coordinates (x, y, z) of each landmark were exported to excel files. The observation was repeated after 4 weeks. The intra- and inter-observer agreement was evaluated. Statistical analysis was performed.
Result: Good reliability was found for sella turcica landmark by using a newly developed landmark reference system. Both inter- and intra-observer agreement were high.
Conclusion: The sella turcica landmark is one of the most important cephalometric landmark although it is a floating landmark in nature. Identifying this landmark by using a newly developed reference system offers high reproducibility in 3-dimensions. This can effect and increase the reliability of the whole cephalometric analysis and other angular measurements related to the sella point.
The aim of this study was to develop an assessment tool for automatic detection of dental caries in periapical radiographs using convolutional neural network (CNN) architecture.
A novel diagnostic model named ResNet + SAM was established using numerous periapical radiographs (4278 images) annotated by medical experts to automatically detect dental caries. The performance of the model was compared to the traditional CNNs (VGG19, ResNet-50), and the dentists. The Gradient-weighted Class Activation Mapping (Grad-CAM) technique shows the region of interest in the image for the CNNs.
ResNet + SAM demonstrated significantly improved performance compared to the modified ResNet-50 model, with an average F1 score of 0.886 (95% CI 0.855–0.918), accuracy of 0.885 (95% CI 0.862–0.901) and AUC of 0.954 (95% CI 0.924–0.980). The comparison between the performance of the model and the dentists revealed that the model achieved higher accuracy than that of the junior dentists. With the assist of the tool, the dentists achieved superior metrics with a mean F1 score of 0.827 and the interobserver agreement for dental caries is enhanced from 0.592/0.610 to 0.706/0.723.
According to the results obtained from the experiments, the automatic assessment tool using the ResNet + SAM model shows remarkable performance and has excellent possibilities in identifying dental caries. The use of the assessment tool in clinical practice can be of great benefit as a clinical decision-making support in dentistry and reduce the workload of dentists.
Background. The presence of white lesions in oral cavity can cause diagno-stic difficulties even for experienced clinicians. Multitude of diseases and simi-larities in their clinical manifestation can lead to misdiagnosis and ineffective treatment. Considering potentially malignant character of lesions like leuko-plakia and oral lichen planus (OLP), the proper diagnosis is crucial.
Objectives. The aim of this study was to assess the concordance of clinical and histopathological diagnoses of biopsied white lesions.
Material and methods. The results of 401 biopsies from oral cavity were re-trospectively analyzed. A total of 114 results with initial or histopathological diagnosis of leukoplakia (33 cases) or OLP (81 cases) were selected. The initial diagnosis was then compared with the histopathological result found in each patient’s records. The diagnosis was accepted for concordance if the histopathological result was decisive. In case of an indecisive histopathological result, the initial diagnosis was considered unlikely. If both diagnoses were different, the possibility of clinical or histopathological error was investigated. The correspondence of both diagnoses was evaluated as follows: 1. clinical initial diagnosis (ID); 2. final histopathological diagnosis (HD); 3. corresponding data (CD) – cases of both diagnoses overlapping. The result was calculated using the formula: final concordance FC = CD × 100%/ID, showing the percentage of corresponding data.
Results. The correspondence between clinical diagnosis of oral leukoplakia and histopathological results was 15.15%, and for OLP – 49.37%. Most commonly found histopathological diagnosis in clinical suspicion of leukoplakia was frictional keratosis (51.51%). In 16.46% cases of ID of OLP, frictional ke-ratosis was diagnosed histopathologically. In 1 case of initial suspicion of OLP, a squamous cell carcinoma was found (1.27%).
Conclusions. White lesions like leukoplakia and OLP can be challenging to diagnose only by their clinical features. Frictional keratosis could clinically resemble both leukoplakia and plaque-like OLP. Histopathological data should be considered an integral part of final diagnosis. Clinical evaluation of whi-te lesions still needs improvement, and histopathological criteria of diagnosis require further standardization. In future, molecular biomarkers may improve definitive diagnosis of both leukoplakia and OPL.
Statement of problem
Programming semiadjustable and fully adjustable articulators involves time-consuming clinical steps which can be avoided if an accurate radiographic method can accurately determine the condylar guidance angles.
Purpose
The purpose of this clinical study was to compare the sagittal condylar guidance in dentate individuals as determined by a clinical method, protrusive interocclusal record, and a radiographic method, cone beam computed tomography. If the methods show a correlation, then cone beam computed tomography can be used as a time-saving method of programming an articulator for patients requiring a cone beam computed tomography scan.
Material and methods
A total of 40 participants (20 men and 20 women) within the 20 to 40 years age group were enrolled according to the inclusion and exclusion criteria. Cone beam computed tomography scans were obtained, and by using appropriate software, the sagittal condylar guidance was measured for both sides. A protrusive interocclusal record was obtained by using polyvinyl siloxane material. The maxillary cast of each participant was mounted on a semiadjustable articulator with a facebow transfer, and the mandibular cast was mounted with a maximum intercuspal record. The protrusive record was then transferred to the articulator for programming.
Results
The right and left sagittal condylar guidance values obtained from both the protrusive interocclusal record and cone beam computed tomography method were comparable, with no significant differences (P>.05). The difference in condylar inclination values for both sexes obtained from both methods for both sides were not statistically different (P>.05). With increasing age, condylar inclination values obtained from both methods tended to decrease. The values for sagittal condylar guidance obtained from both methods (protrusive interocclusal record and cone beam computed tomography) were comparable and correlated.
Conclusions
Cone beam computed tomography measurement involves stable bony landmarks and can be standardized, whereas clinical methods are time consuming and can provide inaccurate results because of the instability of the materials used to register the maxillomandibular relationship. Thus, cone beam computed tomography can be used to obtain the sagittal horizontal guidance for programming semiadjustable and fully adjustable articulators for patients requiring a cone beam computed tomography scan.
Purpose:
The study sought to compare the usefulness of 4 imaging modalities in visualizing various intraorbital foreign bodies (IOFBs) in different sizes.
Methods:
Six different materials including metal, wood, plastic, stone, glass. and graphite were cut in cylindrical shapes in 4 sizes (dimensions: 0.5, 1, 2, and 3 mm) and placed intraorbitally in the extraocular space of fresh sheep's head. Four skilled radiologists rated the visibility of the objects individually using plain radiography, spiral computed tomography (CT), magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) in accordance with a previously described grading system.
Results:
Excluding wood, all embedded foreign bodies were best visualized in CT and CBCT images with almost equal accuracies. Wood could only be detected using MRI, and then only when fragments were more than 2 mm in size. There were 3 false-positive MRI reports, suggesting air bubbles as wood IOFBs.
Conclusions:
Because of lower cost and using less radiation in comparison with conventional CT, CBCT can be used as the initial imaging technique in cases with suspected IOFBs. Optimal imaging technique for wood IOFBs is yet to be defined.
Aims: An Odontoma is usually found in the surrounding area of the unerupted permanent tooth bud
and rarely adjacent to the primary central incisor. Histopathological examination of the Odontoma
revealed presence of surface invagination similar to Dens invaginatus.
Presentation of Case: A seven year-old healthy girl presented with an unerupted maxillary left
primary central incisor along with swelling of labial gingiva in that region. No history of traumatic
injury was recorded. Radiological examination revealed impacted primary maxillary left central
incisor and three irregular masses of calcified tooth like tissues.
Discussion: Odontomas are commonly occuring hamartomas associated with permanent dentition.
Odontomas are rarely associated with Primary dentition. Multiple Odontomas leading to impaction
Den røntgencefalometriske teknik blev introduceret for mere end 75 år siden. I dag anvendes profilrøntgenbilleder rutinemaessigt af special-tandlaeger i ortodonti over hele verden ifm. diagnostik, behandlings-planlaegning og follow-up. Denne artikel giver en oversigt over teknik-kens udvikling og anvendelse igennem tiden. Derudover gøres der sta-tus over teknikkens betydning for den kliniske ortodonti og ortodontisk forskning. Det konkluderes, at til trods for at teknikken i princippet er 2-dimensional, og at der inden for de senere år er udviklet 3-dimensi-onale teknikker til opmåling af ansigtets bløddele, kaebeskelet og taen-der, så vil profilrøntgenbilledet fortsat vaere et vigtigt hjaelpemiddel inden for den kliniske ortodonti i adskillige år fremover. Der gives i den forbindelse nogle anbefalinger til anvendelse ifm. anskaffelse af nyt cefalometrisk røntgenudstyr og software til cefalometrisk analyse. Inden for ortodontien anvendes røntgencefalometriske optagelser i lateral projektion og panoramarøntgenbilleder rutinemaessigt i forbindelse med diagnostik, behandlings-planlaegning og follow-up (1). Inden for de senere år er der derudover udviklet dels ikke-radiografiske cefalometriske målemetoder (fx 3D digitizer teknik (2) og 3D overflade-scanning (3)) dels scanningsmetoder som CBCT (Cone Beam CT scanning)(4,5). Af forskellige årsager har disse teknikker imidlertid endnu ikke vundet større udbredelse (2,6,7), og det ser ud til, at den kliniske ortodonti vil fortsaette med at anvende den røntgencefalometriske teknik i adskillige år fremover. Denne artikel vil alene fokusere på den røntgen-cefalometriske teknik, mens CBCT scanning vil blive behandlet i en anden artikel i dette tema.
Many investigators recommended a routine radiographic examination for the edentulous cases before denture treatment. Panoramic radiographs obtained from inactive files of 212 patients -of both sexes-who required treatment in the college of dentistry KSU. The radiographs were meticulously examined. The plan of this study was to examine panoramic radiographs of edentulous patients with emphasis on the incidence of five entities ; root fragments, impacted teeth, radiolucencies, radiopacities, and foreign bodies. Of the 212 panoramic radiographs examined, 180 were free of positive findings, and 32 (15.1%) have shown positive findings ,eighteen patients (8.5%) had one or more remaining root fragments, and this entity was statistically significant from the other entities. Three patients (1.4%) demonstrated impacted teeth. Five patients (2.4%) demonstrated radiopacities, two patients (1.9%) demonstrated radiolucencies. The radiographs of four patients (1.9%) demonstrated foreign bodies. The results of this study have proved the necessity of performing routine radiographic examination of the jaws for all edentulous patients before constructing complete dentures. It also indicates the need for a better extraction technique together with the use of radiographs before and after extraction. The need for radiographic examination of edentulous patients prior to denture construction was first reported by Logan and Eusterman in 1921 (1,2) . From that time and till the mean time, many investigators recommended a routine radiographic examination for the edentulous cases before denture treatment. This is based on the relatively high frequency of the positive radiographic findings detected in edentulous jaws. On the other hand, some investigators recommended the use of the radiographic examination when necessary, when there are symptoms or only when the needs call (3-12) .
A 49-year-old male with known history of end-stage renal disease (ESRD) presents with an intraoral exophytic mass of the right mandible. This lesion was given a histologic diagnosis of a Brown tumor. Purpose. To allow physicians to include this lesion in a differential diagnosis when evaluating patients with primary, secondary, or tertiary hyperparathyroidism.
A wireless CMOS (CDR Wireless) system was evaluated based on its physical properties and ease of operation.
The physical properties were assessed by dose-response curve, modulation transfer function, and detective quantum efficiency tests. The range of signal receptivity between the sensor and the antenna was also determined. The time required to make a radiograph was measured. Using a visual analog scale (VAS), 10 test patients were asked to evaluate the discomfort caused by having the sensor inserted and placed in the mouth. An intraoral x-ray film packet and a wired CDR sensor were also evaluated for comparison with the wireless system.
The physical properties of the wireless system and the wired CDR sensor were essentially equal. The antenna could receive the signal up to 3.5 m from the sensor. The wireless CMOS system required less time to perform the radiographic task than the other methods studied. The VAS scores for the wireless and wired CDR sensors were comparable.
The CDR Wireless sensor has equivalent physical properties to its wired counterpart and may be more convenient to use.
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