• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.35.1-35.7
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• 2018

The aim of this article was to showcase the endodontic management of a maxillary first molar with an unusual crown and root anatomy. Clinical diagnosis of the roots and root canal configuration was confirmed by a cone-beam computed tomography (CBCT) and the detection of the canals was made using a dental operating microscope. CBCT images revealed the presence of 5 roots with Vertucci type I canal configuration in all, except, in the middle root which had 2 canals with type IV configuration. The 6 canal orifices were clinically visualized under the dental operating microscope. Clinicians should familiarize themselves with the latest technologies to get additional information in endodontic practice in order to enhance the outcomes of endodontic therapy.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.333-336
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• 2021

Rhinoliths are foreign bodies composed of mineralised deposits in the nasal cavity that are rarely encountered in routine dental practice. The current report presents a case of a 77-year-old female patient who visited a dental treatment centre for a routine dental check-up and prophylaxis. On the clinical examination, the patient did not report any breathing difficulty, nasal obstruction, or any form of discharge. Panoramic radiography showed a horizontally magnified radiopaque structure in the right nasal fossa region. Cone-beam computed tomography (CBCT) revealed a hyperdense entity with a laminated presentation in the right nasal fossa. The hyperdense entity was diagnosed as a rhinolith based on the radiographic findings. Although the patient was asymptomatic, a referral was made to an ear, nose, and throat surgeon for a further evaluation. This report highlights the importance of CBCT imaging in the diagnosis of soft-tissue calcifications.

• Imaging Science in Dentistry
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• v.50 no.4
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• pp.353-357
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• 2020

The canalis sinuosus (CS) and its accessory canals (ACs) are anatomical structures in the anterior maxilla. These structures are often neglected when planning implant surgery because their clinical significance is still not well-defined. After a retrospective evaluation of 194 patients rehabilitated with dental implants in the anterior maxilla, 3 patients were identified who presented unexpected chronic neurosensory disturbances without any clinical signs supportive of implant failure. Tomographic assessment using cone-beam computed tomography (CBCT) revealed the invasion of the CS and ACs by dental implants, which appeared to explain the patients' symptoms. The purpose of this report was to familiarize practicing dentists and specialists with the CS and its ACs. Unanticipated neurosensory symptoms after implant placement in the anterior maxilla justify the use of CBCT to rule out an injury to this neurovascular bundle.

• Imaging Science in Dentistry
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• v.44 no.2
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• pp.171-175
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• 2014

One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.364-372
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• 2010

Objective: This study was designed to assess the diagnostic validity of digital panoramic radiographs compared to cone beam computed tomography (CBCT) in patients with temporomandibular joint disorders. Methods: Panoramic radiograph and CBCT were taken from a total of 212 joints from 106 subjects. The joints were examined by two dentists and divided into the following six groups: normal, flattening, osteophyte formation, erosion, sclerosis, and unclassified. The sensitivity and specificity of each observer and inter-observer reliability were statistically analyzed. Results: The results showed relatively high intra-observer reliability in the diagnosis of both panoramic and CBCT images and the weighted Kappa indices of panoramic and CBCT images were 0.714 and 0.727, respectively. The sensitivities of panoramic images of observer A and B to CBCT images was 82.35% and 84.30%, respectively, while the specificity of observer A and B was 58.06% and 61.54%, respectively. However, guided diagnosis from panoramic and CBCT images were statistically different (p < 0.05). Conclusions: The present study suggests that the panoramic radiograph could be used as a primary diagnostic device to detect bony changes of temporomandibular joints in clinical orthodontics, because panoramic images showed relatively high sensitivity compared to CBCT images. However, CBCT images may be one of the best choices when a more accurate diagnosis is necessary.

• Imaging Science in Dentistry
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• v.44 no.2
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• pp.121-128
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• 2014

Purpose: The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. Materials and Methods: One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image data-sets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. Results: All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Conclusion: Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

• Imaging Science in Dentistry
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• v.40 no.2
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• pp.63-68
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• 2010

Purpose : To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Materials and Methods : Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, $\rho$ ($g/cm^3$), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. Results : CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were $\rho$=0.001H+1.07 with $R^2$ value of 0.999 for Somatom Emotion, $\rho$=0.002H+1.09 with $R^2$ value of 0.991 for Alphard VEGA, $\rho$=0.001H+1.43 with $R^2$ value of 0.980 for i-CAT and $\rho$=0.001H+1.30 with $R^2$ value of 0.975 for Implagraphy. Conclusion: CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.161-169
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• 2017

The cone beam computed tomography(CBCT) which can acquire 3-dimensions images is widely used for confirmation of patient position before radiation therapy. In this study, through the simulation using the Monte Carlo technique, we will analyze the exposure dose by cone beam computed tomography and present the standardized data. For the experiment, MCNPX(ver. 2.5.0) was used and the photon beam spectrum was analyzed after Cone beam was simulated. As a result of analyzing the photon beam spectrum, the average energy ranged from 25.7 to 37.6 keV at the tube voltage of 80 ~ 120 kVp and the characteristic X-ray energy was 9, 60, 68 and 70 keV. As a result of using the water phantom, the percentage depth dose was measured, and the maximum dose appeared on the surface and decreased with depth. The absorbed dose also decreased as the depth increased. The absorbed dose of the whole phantom was 9.7 ~ 18.7 mGy. This is a dose which accounts for 0.2% of about 10 Gy, which is generally used for radiation therapy per week, which is not expected to have a significant effect on the treatment effect. However, it should not be overlooked even if it is small compared with prescription dose.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.123-131
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• 2022

Purpose: The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods: This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results: In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion: CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.187-195
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• 2022

Purpose: This study developed a convolutional neural network (CNN) model to diagnose maxillary sinusitis on panoramic radiographs(PRs) and cone-beam computed tomographic (CBCT) images and evaluated its performance. Materials and Methods: A CNN model, which is an artificial intelligence method, was utilized. The model was trained and tested by applying 5-fold cross-validation to a dataset of 148 healthy and 148 inflamed sinus images. The CNN model was implemented using the PyTorch library of the Python programming language. A receiver operating characteristic curve was plotted, and the area under the curve, accuracy, sensitivity, specificity, positive predictive value, and negative predictive values for both imaging techniques were calculated to evaluate the model. Results: The average accuracy, sensitivity, and specificity of the model in diagnosing sinusitis from PRs were 75.7%, 75.7%, and 75.7%, respectively. The accuracy, sensitivity, and specificity of the deep-learning system in diagnosing sinusitis from CBCT images were 99.7%, 100%, and 99.3%, respectively. Conclusion: The diagnostic performance of the CNN for maxillary sinusitis from PRs was moderately high, whereas it was clearly higher with CBCT images. Three-dimensional images are accepted as the "gold standard" for diagnosis; therefore, this was not an unexpected result. Based on these results, deep-learning systems could be used as an effective guide in assisting with diagnoses, especially for less experienced practitioners.