Osteoarthritis is caused by joint degeneration, a process that includes progressive loss of articular cartilage accompanied by attempted repair of articular cartilage, remodeling and sclerosis of subchondral bone, and osteophyte formation. The most common causative factor that either causes or contributes to osteoarthritis is overloading of the articular structures of the joint. The diagnosis of temporomandibular joint(TMJ) osteoarthritis is based on the patient's history and clinical findings such as limited mandibular opening, crepitation and tenderness to palpation on TMJ. The diagnosis is usually confirmed by TMJ radiographs, which will reveal evidence of structural changes in the subarticular bone of the condyle or fossa. Plain radiography techniques such as panoramic, transcranial, transpharyngeal views can be used in most dental offices for evaluation of the TMJs. However, plain radiographs are often limited due to overlapping and distortion of anatomical structures. The aim of this study was to compare the clinical examination and panoramic view with computed tomography for diagnosis of temporomandibular degenerative joint disease, and to compare the findings of condylar bony changes through panoramic radiography with that of computed tomography, hence, to confirm the limitations of clinical and panoramic radiography, and the validity of the computed tomography for diagnosis of temporomandibular degenerative joint disease. The pathophysiology of the TMJ osteoarthritis remains poorly understood, and current treatments are based more on speculation than science, and symptomatic treatments often fail to provide satisfactory pain relief. For diagnosis of TMJ osteoarthritis, clinical examination and radiographic examination for confirmation of the bony changes are essential, and computed tomography are clearly superior to plain radiographs for their limitations.
Journal of Dental Rehabilitation and Applied Science
/
v.31
no.2
/
pp.86-95
/
2015
Purpose: The aim of the study was to evaluate the subjective symptoms and clinical signs through the TMD-questionnaire, clinical examination and radiography against the many instrumental performers and to investigate the association between playing instruments and TMDs. Materials and Methods: A total of 803 instrumental performers received TMD-related questionnaire and evaluations of prevalence and disease distribution were performed. Among those who reported at least one symptom of TMD, 70 volunteers visited in clinic then received clinical examination and radiography for diagnosis and evaluations of prevalence and disease distribution were performed. 70 subjects were divided into three groups as woodwind, brass wind, string. Comparative analysis of disease distribution was performed. Results: Among 803 instrumental performers, 610 people (75.97%) were reported to one or more symptoms of TMD. The most frequent symptom was click (29.68%).70 subjects underwent a clinical examination and radiography survey results, the most frequent symptom was a click (29.75%). Most commonly diagnosed disease was a myofacial pain (30.53%).Comparison of the three groups, a significant difference was not observed in the clinical sign. But among subject symptom, muscle pains howed significant differences in accordance with the Group (P = 0.024). During the 70 people who underwent clinical examination, 66 people (94.3%) showed moderate to severe attrition, mild to severe tongue ridging, mild to severe cheek ridging assigns of parafunction. Conclusion: Instrumental performers showed a high prevalence of TMD and the most of the musicians with temporomandibular disorder had bruxism or clenching habits.
Purpose : The purpose of this study was to investigate whether the fractal dimension and radiographic image brightness of periapical radiograph were useful in predicting osteoporosis. Materials and Methods : Ninety-two postmenopausal women were classified as normal, osteopenia and osteoporosis group according to the bone mineral density of lumbar vertebrae and periapical radiographs of both mandibular molar areas were taken. The ROIs of 358 areas were selected at periapical and interdental areas and fractal dimension and radiographic image brightness were measured. Results : The fractal dimension in normal group was significantly higher than that in osteoporosis group at periapical ROI (P < 0.05). The radiographic image brightness in normal group was higher than that in osteopenia and osteoporosis group. There was significant difference not only between normal and osteopenia group (P < 0.05) but also within osteopenia and osteoporosis group (P< 0.01) at periapical ROI. Significant difference was observed not only between normal and osteopenia group but also between normal and osteoporosis group at interdental ROI (P< 0.01). Positive linear relationship was weakly shown at Pearson correlation analysis between fractal dimension and radiographic image brightness. BMD significantly correlated with fractal dimension at periapical ROI (P< 0.01), and BMD and radiographic image brightness significantly correlated at both periapical and interdental ROIs (P< 0.01). Conclusion : This study suggests that the fractal dimension and radiographic image brightness of periapical ROI may predict BMD. (Korean J Oral Maxillofac Radiol 2005: 35 : 41-6)
Guerrero, Maria Eugenia;Noriega, Jorge;Jacobs, Reinhilde
Imaging Science in Dentistry
/
v.44
no.3
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pp.213-220
/
2014
Purpose: This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. Materials and Methods: One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. Results: In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Conclusion: Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.
66 patients with temporomandibular disorders were selected for experimental group, and 45 normal subjects who were Dental students were selected for control group. Average age of experimental group was 30.5 years, Male to Female ratio was 2 : 3, and their age distribution were teen-ages to seventh decades. Transcranial radiography (TR) with Denar Accurad 100 was used for each group to get the values of width in joint spaces and to investigate the bony changes of articular surfaces and relative condylar position to articular fossa. In addition to TR, clinical interview and routine charting about amount of mandibular movements and occlusal variations were carried out in experimental group. The obtained results were as follows : 1. The mean values of joint space with in control group were 2.15mm to anterior, 2.98mm to superior and 2.29mm to posterior and the value of relative condylar position to the deepest portion of articular fossa was 0.21mm to anterior. In experimental group, those values were 2.01mm, 2.14mm 2.22mm and 0.12mm to posterior in sequence, respectively. Joint spaces in experimental group, therefore, were inclined to decreased, and relative condylar position was inclined to retrude. Joint space in control group showed symmetric condylar position, but in experimental group showed asymmetry. 2. Non-affected joints with no bony changes in experimental group showed the narrowest joint spaces which were thought to manifest the abnormal stress to non-affected side to dysfunctional state of contralateral affected joints. 3. Amount of mandibular movements in experimental group were within normal values in lateral movements and in protrusive movement but in opening movement with or without passive stretch, those were lower than normal values. Frequency of occlusal variation, for example, protrusive posterior contacts, open bite, median line shift to lateral side were inclined to increase with bony changes and with crepitus.
Purpose : To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. Materials and Methods : Sixty Digora periapical images, sixty panoramic computed radiographic (CR) images, sixty computed tomographic (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5:1 to 50:1. To evaluate the lesion detectability, the images were graded with 5 levels (1 : definitely absent; 2: probably absent; 3: equivocal; 4: probably present; 5: definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1 definitely unacceptable; 2: probably unacceptable; 3: equivocal, 4: probably acceptable; 5· definitely acceptable), and then paired t-test was performed. Results : In Digora, CR panoramic and CT images, compressed images up to ratios of 15 : 1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25 : 1. In Digora and CR panoramic Images, compressed images up to ratios of 5 : 1 showed little difference between the original and reconstructed images in subjective assessment of image quality In CT images, compressed images did up to ratios of 10: 1 and in MR images up to ratios of 15 : 1 Conclusion : We considered compression ratios up to 5 : 1 in Digora and CR panoramic images, up to 10 : 1 in CT images, up to 15 : 1 in MR images as clinically applicable compression ratios.
Lee Mi-Ran;Cho Lee-Ra;Yi Yang-Jin;Choi Hang-Moon;Park Chan-Jin
The Journal of Korean Academy of Prosthodontics
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v.43
no.6
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pp.736-744
/
2005
Statement of problem. Initial stability of implant is an important factor for predicting osseointegration. It requires a rapid, non-invasive, user-friendly technique to frequently assess the implant stability and the degree of osseointegration. Purpose. The aim of this study was to evaluate the correlation between the resonance frequency analysis (RFA) and the radiographic method for peri-implant bone change under in vitro conditions. Material and Method. Twenty implants of 3.75 mm in diameter(Neoplant, Neobiotech, Korea) were used. To simulate peri-implant bone change, 2 mm-deep $45^{\circ}$ range horizontal defect and 2 mm-deep $90^{\circ}$ range horizontal defect area were serially prepared perpendicular to the X-ray beam after conventional implant insertion. Customized film holding device was fabricated to standardize the projection geometry for serial radiographs of implants and direct digital image was obtained. ISQ values and gray values inside threads were measured before and after peri-implant bone defect preparation. Results. Within a limitation of this study, ISQ value of resonance frequency analysis was changed according to peri-implant bone change (p<0.05) and gray value of radiographic method was changed according to peri-implant bone change (p<0.05). There was no correlation between the ISQ value and the gray value for peri-implant bone change (p>0.05). But, in horizontal defect condition, relatively positive correlation were between ISQ and gray values(r=0.663). Conclusion. This results provided a possibility that peri-implant bone change may be evaluated by both RFA and radiographic method.
The purpose of this study was to observe the effects of early loading on the surrounding bone tissue of the implants. 12 ITI HS implants (8 mm) were inserted on the mandible at 3 mongrel dogs. The implants were divided into two groups; the functional group was functioned with crown, and nonfunctional group was functioned without crown. After 3 and 5 months animals were sacrificed and specimens were examined using radiography, light microscopy, scanning electron microscopy. The following results were obtained. 1. On light microscopic and scanning electron microscopic examination, the difference in the amounts of bone attachment between 3 months loaded and unloaded implants were a little. Sometimes more bone attachment were observed in loaded implants. 2. Many osteoids surrounded the fibrous connective tissues indicating of bone remodeling were observed along the outer surface of the implants. 3. On clinical, radiographic, microscopic examination, epithelial downgrowths were not observed and bone attachments to the outer surface of the implants were observed in 3 months loaded and unloaded implants with good oral hygiene. 4. Epithelial downgrowths and crater-like bone resorptions were observed on 5 months loaded and unloaded implants with poor oral hygiene. 5. Many inflammatory cells in the epithelial tissue were packed in the hollow on 5 months loaded implants.
Kim, You-Hyun;Choi, Jong-Hak;Kim, Sung-Soo;Lee, Chanh-Yeup;Lee, Young-Bae;Kim, Chel-Min
Proceedings of the Korean Society of Medical Physics Conference
/
2004.11a
/
pp.59-63
/
2004
IAEA's Guidance Levels have been provided for Western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of korean people's proportions. Therefore, We need to develope the standard doses for korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in korea. 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. The results were as follows; 1) General radiographic equipments were 43%, fluoroscopic equipments 29%, dental equipments 13%, CT units 8% and mamographic units 7%. 2) According to classification by rectification way, three-phase equipments were 30%, inverter-type generators 29%, single- phase equipments 26%, unknown units 6%. 3) According to classification by receptor system, film-screen types were 46%, CR types 27%, OR types18% and unknown types 9%. 4) The number of examinations were chest 48%, spine 17% and abdomen 13%. 5) Patient doses were head AP 3.1 mGy, abdomen AP 3.5 mGy and chest PA 0.4 mGy.
Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.
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