• 대한치과의사협회지
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• 제54권9호
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• pp.704-711
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• 2016

Radiologic images in dentistry are essential to perform the diagnosis, treatment, and tracking process of prognosis, thus the ability of accurate evaluation in the diagnostic images is requested for dental clinician. Radiologic interpretation means recognition of a normality and an abnormality and to report the possible diagnosis and differential diagnosis list. Therefore, dental clinicians should be familiar with the basic principle of interpretation of intraoral and extraoral radiographic images primarily used in dental clinics. Recently, dental cone beam CT is widely used for diagnositc process, thus understanding the three dimensional images is requested. The objective of this manuscript is to help the dental clinicians to interpret accurately the diagnostic images by introducing the basic principles of the step by step analytic process in the appearance of a lesion.

• Imaging Science in Dentistry
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• 제49권4호
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• pp.287-294
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• 2019

Purpose: This study was performed to analyze the clinical and imaging features of contemporary osteomyelitis(OM) and to investigate differences in these features on panoramic radiography according to patients' history of use of medication affecting bone metabolism. Materials and Methods: The records of 364 patients(241 female and 123 male, average age 66.8±14.9 years) with OM were retrospectively reviewed. Panoramic imaging features were analyzed and compared between patients with medication-related OM(m-OM) and those with conventional, medication-unrelated OM(c-OM). Results: The age of onset of OM tended to be high, with the largest number of patients experiencing onset in their 70s. The 2 most frequent presumed causes were antiresorptive medication use (44.2%) and odontogenic origin (34.6%). On panoramic radiographs, a mix of osteolysis and sclerosis was the most common lesion pattern observed (68.6%). Sequestrum, extraction socket, and periosteal new bone formation were found in 143(42.1%), 79 (23.2%), and 24 (7.1%) cases, respectively. The m-OM group exhibited sequestrum and extraction socket more frequently and displayed significantly higher mandibular cortical index values than the c-OM group. Conclusion: We observed some differences in imaging features as shown on panoramic radiography according to the history of antiresorptive medication use. This study may help elucidate the predictive imaging features of medication-related osteonecrosis of the jaw.

• 대한치과교정학회지
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• 제50권5호
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• pp.314-323
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• 2020

Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: post-expansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences post-expansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.

• Imaging Science in Dentistry
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• 제46권4호
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• pp.285-290
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• 2016

In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long­standing human papilloma virus (HPV­16)­positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

• Imaging Science in Dentistry
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• 제45권3호
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• pp.169-174
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• 2015

Purpose: This study was performed to evaluate the diagnostic efficacy of panoramic radiography and cone-beam computed tomography (CBCT) in detecting sinus pathology. Materials and Methods: This study was based on a retrospective evaluation of patients who had undergone both a panoramic radiograph and a CBCT exam. A total of 100 maxillary sinuses were evaluated. Four examiners with various levels of expertise evaluated the images using a five-point scoring system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of the two modalities. The image analysis was repeated twice, with at least two weeks between the evaluation sessions. Interobserver reliability was assessed using Cronbach's alpha, and intraobserver reliability was assessed using Cohen's kappa. Results: Maxillary sinus pathology was detected in 72% of the patients. High interobserver and intraobserver reliability were observed for both imaging modalities and among the four examiners. Statistical analyses using ROC curves demonstrated that the CBCT images had a larger area under the curve (0.940) than the panoramic radiographs (0.579). Conclusion: Three-dimensional evaluation of the sinus with CBCT was significantly more reliable in detecting pathology than panoramic imaging.

• Journal of Oral Medicine and Pain
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• 제44권4호
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• pp.189-194
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• 2019

Perforation of articular disc of temporomandibular joint is a unusual condition and diagnosed through magnetic resonance imaging (MRI), arthrography or arthroscopic surgery. We attempted to investigate the suspicious findings of articular disc perforation through examination commonly used in temporomandibular disorder (TMD) patients. We retrospectively analyzed the clinical and imaging findings of five TMD patients whose articular discs were perforated based on MRI. The most meaningful finding was the abnormal width of the joint space in cone-beam computed tomography. Thus, the clinician should perform a thorough assessment of the joint space in TMD patients and conduct additional investigation to determine what caused the abnormal joint space.

• Imaging Science in Dentistry
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• 제46권3호
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• pp.173-178
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• 2016

Purpose: Optical coherence tomography (OCT) has been investigated as a novel diagnostic imaging tool. The utilisation of this equipment has been evaluated through several studies in the field of dentistry. The aim of this preliminary study was to determine through basic experiments the effectiveness of OCT in implant dentistry. Materials and Methods: To assess detection ability, we captured OCT images of implants in each of the following situations: (1) implants covered with mucosae of various thicknesses that were harvested from the mandibles of pigs; (2) implants installed in the mandibles of pigs; and (3) implants with abutments and crowns fixed with temporary cement. The OCT images were captured before cementation, after cementation, and after removing the excess submucosal cement. Results: If the thickness of the mucosa covering the implant body was less than 1 mm, the images of the implants were clearly detected by OCT. In the implants were installed in pigs' mandibles, it was difficult to capture clear images of the implant and alveolar bone in most of the samples. Remnants of excess cement around the implants were visible in most samples that had a mucosa thickness of less than 3 mm. Conclusion: Currently, OCT imaging of implants is limited. Cement remnants at the submucosal area can be detected in some cases, which can be helpful in preventing peri-implant diseases. Still, though there are some restrictions to its application, OCT could have potential as an effective diagnostic instrument in the field of implant dentistry as well.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.181-186
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• 2022

Purpose: This study aimed to investigate inter-observer reliability among observers with different levels of proficiency and the diagnostic imaging reliability of cone-beam computed tomography (CBCT) images of the retromolar canal. Materials and Methods: CBCT images of 307 patients were assessed for the presence of retromolar canals(RMCs) by 3 observers independently. Diagnoses were made twice by each observer at intervals of more than 3 weeks. Interobserver reliability was assessed using the kappa coefficient. One observer had no experience in diagnosis using CBCT images. Therefore, a specialist in diagnostic imaging explained the CBCT images for interpretation and practiced diagnostic imaging together with this observer, while the other observer interpreted the images independently. Thereafter, the observers re-evaluated the images. Results: The interobserver kappa coefficients (including bilateral RMCs) calculated at the first reading were low, ranging from 0.21 to 0.61. Their values ranged from 0.95 (right side) to 1.00 (left side) after one-on-one practice with a diagnostic imaging specialist, while the values ranged from 0.65 (right side) to 0.66 (left side) without one-on-one practice. Conclusion: Diagnostic accuracy was improved through diagnostic imaging practice. To improve the anatomical interpretation of images, it is important to practice diagnostic imaging with a specialist in diagnostic imaging. One-on-one instruction about diagnostic imaging was an effective method of training.

• Imaging Science in Dentistry
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• 제53권2호
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• pp.169-174
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• 2023

Gardner syndrome has head and neck manifestations that may be recognized during dental visits. Features such as multiple gnathic osteomas, impacted supernumerary teeth, and multiple foci of idiopathic osteosclerosis can be easily identified on dental radiographs, prompting the clinician to refer the patient for further investigation. A dental examination and routine radiographs play a vital role in revealing the extracolonic presentation of Gardner syndrome, which facilitates timely screening and detection of colorectal cancer and other malignancies associated with this condition. This report discusses the case of a 50-year-old Caucasian man who presented with a hard swelling of the left angle of the mandible and was diagnosed with Gardner syndrome based on abnormal findings from an oral examination, dental imaging, and medical and family history.

• Imaging Science in Dentistry
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• 제34권4호
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• pp.215-218
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• 2004

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29-year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.