• Title/Summary/Keyword: Computer tomography

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Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

  • Jeong, Woo Shik;Choi, Jong Woo;Choi, Seung Ho
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.584-587
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    • 2014
  • In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

The application of "bone window technique" using piezoelectric saws and a CAD/CAM-guided surgical stent in endodontic microsurgery on a mandibular molar case

  • Kim, Ukseong;Kim, Sunil;Kim, Euiseong
    • Restorative Dentistry and Endodontics
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    • v.45 no.3
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    • pp.27.1-27.9
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    • 2020
  • Apical surgery for a mandibular molar is still challenging for many reasons. This report describes the applications of computer-guided cortical 'bone-window technique' using piezoelectric saws that prevented any nerve damage in performing endodontic microsurgery of a mandibular molar. A 49-year-old woman presented with gumboil on tooth #36 (previously endodontically treated tooth) and was diagnosed with chronic apical abscess. Periapical lesions were confirmed using cone-beam computed tomography (CBCT). Endodontic microsurgery for the mesial and distal roots of tooth #36 was planned. Following the transfer of data of the CBCT images and the scanned cast to an implant surgical planning program, data from both devices were merged. A surgical stent was designed, on the superimposed three-dimensional model, to guide the preparation of a cortical window on the buccal side of tooth #36. Endodontic microsurgery was performed with a printed surgical template. Minimal osteotomy was required and preservation of the buccal cortical plate rendered this endodontic surgery less traumatic. No postoperative complications such as mental nerve damage were reported. Window technique guided by a computer-aided design/computer-aided manufacture based surgical template can be considerably useful in endodontic microsurgery in complicated cases.

Implant-assisted full denture using digital guide: a case report (무치악 환자에서 디지털 가이드를 이용한 임플란트 수복증례)

  • Kim, Wook Tae
    • Journal of Technologic Dentistry
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    • v.43 no.4
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    • pp.202-209
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    • 2021
  • By classifying temporary denture production for surgical guides, digital guide-based surgery, and final prosthesis production, the problems of each process were assessed in advance and the factors that could be improved were confirmed in this study. The manufacturing process of fusion dental prosthesis uses virtual programs and computed tomography images to manufacture devices using the latest technologies of computer-aided design/computer-aided manufacturing and three-dimensional printing, which enables implants to be placed in the desired location in advance. Moreover, implant placement is not dependent on the skill and condition of the dentist, and because it uses a computer system, it can always be performed at a constant and optimal position. This can reduce the remanufacturing rate compared with the general method, shorten the treatment period, and eliminate patient discomfort. Unlike the traditional method of using impression materials and plaster models, digital fusion dental prostheses would be evaluated as a technology for producing prosthesis through professional design technology and communication.

THE DIAGNOSIS OF IMPACTED MAXILLARY MESIODENS USING 3-DIMENSIONAL COMPUTED TOMOGRAPHY : A CASE REPORT (3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단)

  • Hong, Young-Woo;Kim, Seong-Oh;Sohn, Hyung-Kyu;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.549-554
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    • 1998
  • The prevalence of the supernumerary tooth is $1{\sim}4%$. It usually occurs in the permanent dentition. It frequently occurs in the maxillary mid palatal area. The presence of the supernumerary tooth causes the following problems ; (1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be removed as soon as possible. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography equipped with dental softwares can show the position of the impacted supernumerally tooth in 3-dimentional position. It has an advantage to eliminate the subjective opinion of the operator. With a fast computer this techenique is done in a relatively short period of time. The rationale of this methods is relatively simple. After tacking X-ray and reconstructing the data 3-dimentionally, sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2, the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

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Radiation Protective Effect of the Thyroid Gland Using Bolus Protector in the Dental Cone Beam Computed Tomography (치과 콘빔 전산화단층검사 시 보루스 차폐체를 이용한 갑상선의 방사선 차폐효과)

  • Lee, Tae Hui;Jeong, Seung Hun;Kim, Dong Woo;Park, Myeong Hwan;Kim, Tae-Hyung
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.459-464
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    • 2019
  • In order to minimize the radiation exposure dose of the thyroid site at dental cone-beam computer tomography, a protector using a Bolus was prepared, and the radiation shielding effect and the appropriateness of the image were evaluated. Using a dental cone-beam computed tomography (CBCT), a glass dosimeter was attached to the left and right sides of the thyroid for a dental radiation phantom, and the radiation dose was measured. The absorbed dose for each shield was measured by another method to 10 mm, 20 mm, and 30 mm-thickness, respectively. Eight evaluators evaluated whether or not the medical image is appropriate. When using a 30 mm Bolus shield at the left thyroid site, the resulting value is reduced by an average of $342.67{\mu}Gy$ by 20.7% from the average value of $431.22{\mu}Gy$ measured without using a Bolus shield, the right thyroid site In the case of using 30 mm Bolus shield, it showed a dose reduction effect of 21.9% with an average of $424.56{\mu}Gy$. The adequacy of the medical image was judged to be usable by both evaluators. In conclusion, the dental cone-beam computerized tomography can be used as a useful shielding material because it has a radiation shielding effect and it is possible to treat the diagnosis of the bolus protector in the thyroid without any obstruction shade in order to minimize the radiation dose.

High Resolution Computerized Tomography System Using the Microfocus X-Ray for Inspection of Small Specimens (소형 물체의 검사를 위한 고해상도 미세 초점 X선 단층 촬영 시스템)

  • Kim, Young-Joo;Koo, Ja-Yong;Lee, Seung-S.;Kim, Whan-W.
    • Journal of the Korean Society for Nondestructive Testing
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    • v.18 no.3
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    • pp.181-190
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    • 1998
  • A computerized tomography system was developed using the X-ray source that has diameter of 5 micrometer. The system is used for the nondestructive testing of specimens with diameter below 20 mm. The convolution back projection algorithm was adopted for the reconstruction of cross sectional image, and the shape of the X-ray beam was let parallel beam or fan beam to compare each resultant image. Our CT system was constructed to operate based on the personal computer. The sectional images of the fabricated specimens were reconstructed and analyzed. The reconstructed images well coincided with real images taken with optical microscope and gave us enough reports on the defects in the ceramic specimen. The resolution of the system regarded as about $20{\sim}30$ micrometers.

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Accuracy and reliability of stitched cone-beam computed tomography images

  • Egbert, Nicholas;Cagna, David R.;Ahuja, Swati;Wicks, Russell A.
    • Imaging Science in Dentistry
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    • v.45 no.1
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    • pp.41-47
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    • 2015
  • Purpose: This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. Material and Methods: Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. Results: The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. Conclusion: The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.

Morphological analysis of maxillary sinus septum using computed tomography (컴퓨터단층촬영을 이용한 상악동 중격의 형태학적 분석)

  • Chae, Jong-Beom;Lee, Sang-Han;Kim, Chin-Soo;Kim, Jong-Bae;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.36-42
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    • 2011
  • Introduction: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). Materials and Methods: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". Results: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. Conclusion: These results show that the maxillary sinus septum undergoes atrophy with age.

Predictive Factors for Cervical Spine Injury in Patients with Minor Head Injury (경증 두부 외상을 가진 환자의 경추 손상을 예측할 수 있는 관련 인자)

  • Park, Chul Woo;Sung, Ae Jin;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.154-160
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    • 2009
  • Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.

Improved accuracy in periodontal pocket depth measurement using optical coherence tomography

  • Kim, Sul-Hee;Kang, Se-Ryong;Park, Hee-Jung;Kim, Jun-Min;Yi, Won-Jin;Kim, Tae-Il
    • Journal of Periodontal and Implant Science
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    • v.47 no.1
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    • pp.13-19
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    • 2017
  • Purpose: The purpose of this study was to examine whether periodontal pocket could be satisfactorily visualized by optical coherence tomography (OCT) and to suggest quantitative methods for measuring periodontal pocket depth. Methods: We acquired OCT images of periodontal pockets in a porcine model and determined the actual axial resolution for measuring the exact periodontal pocket depth using a calibration method. Quantitative measurements of periodontal pockets were performed by real axial resolution and compared with the results from manual periodontal probing. Results: The average periodontal pocket depth measured by OCT was $3.10{\pm}0.15mm$, $4.11{\pm}0.17mm$, $5.09{\pm}0.17mm$, and $6.05{\pm}0.21mm$ for each periodontal pocket model, respectively. These values were similar to those obtained by manual periodontal probing. Conclusions: OCT was able to visualize periodontal pockets and show attachment loss. By calculating the calibration factor to determine the accurate axial resolution, quantitative standards for measuring periodontal pocket depth can be established regardless of the position of periodontal pocket in the OCT image.