• Imaging Science in Dentistry
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• v.52 no.4
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• pp.399-408
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• 2022

Purpose: The purpose of this study was to compare volume measurements obtained using 2 image software packages on Digital Imaging and Communications in Medicine (DICOM) images acquired from 1 multidetector computed tomography and 5 cone-beam computed tomography devices, using different protocols for physical volume measurements. Materials and Methods: Four pieces of bovine leg were prepared. Marrow was removed from 3 pieces, leaving cortical bone exposed. The resulting space of 1 piece was filled with water, another was filled with propylene glycol, and the third was left unfilled. The marrow in the fourth sample was left fully intact. Volume measurements were obtained after importing DICOM images into the Dolphin Imaging 11.95 and ITK-SNAP software programs. Data were analyzed using 3-way analysis of variance with a generalized linear model to determine the effects of voxel size, software, and content on percentage mean volume differences between tomographic protocols. A significance level of 0.05 was used. Results: The intraclass correlation coefficients for intraobserver and interobserver reliability were, respectively, 0.915 and 0.764 for the Dolphin software and 0.894 and 0.766 for the ITK-SNAP software. Three sources of statistically significant variation were identified: the interaction between software and content (P=0.001), the main effect of content (P=0.014), and the main effect of software (P=0.001). Voxel size was not associated with statistically significant differences in volume measurements. Conclusion: Both content and software influenced the accuracy of volume measurements, especially when the content had gray values similar to those of the adjacent tissues.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.161-169
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• 2019

Objective: To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images. Methods: Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment. Results: The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by $2.25^{\circ}$, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by $2.76^{\circ}$ (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01). Conclusions: The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.

• The korean journal of orthodontics
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• v.43 no.4
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• pp.160-167
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• 2013

Objective: To evaluate the shapes and sizes of nasopharyngeal airways by using cone-beam computed tomography and to assess the relationship between nasopharyngeal airway shape and adenoid hypertrophy in children. Methods: Linear and cross-sectional measurements on frontal and sagittal cross-sections containing the most enlarged adenoids and nasopharyngeal airway volumes were obtained from cone-beam computed tomography scans of 64 healthy children ($11.0{\pm}1.8$ years), and the interrelationships of these measurements were evaluated. Results: On the basis of frontal section images, the subjects' nasopharyngeal airways were divided into the following 2 types: the broad and long type and the narrow and flat type. The nasopharyngeal airway sizes and volumes were smaller in subjects with narrow and flat airways than in those with broad and long airways (p < 0.01). Children who showed high adenoid-nasopharyngeal ratios on sagittal imaging, indicating moderate to severe adenoid hypertrophy, had the narrow and flat type nasopharyngeal airway (p < 0.01). Conclusions: Cone-beam computed tomography is a clinically simple, reliable, and noninvasive tool that can simultaneously visualize the entire structure and a cross section of the nasopharyngeal airway and help in measurement of adenoid size as well as airway volume in children with adenoid hypertrophy.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.1-9
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• 2022

Purpose: This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods: This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was "healing assessment of endodontic surgery using cone-beam computed tomography." The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results: The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion: Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.407-412
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• 2021

Purpose: The purpose of this study was to evaluate the accuracy of virtual 3-dimensional (3D) cephalograms constructed using the principle of biplanar radiography by comparing them with cone-beam computed tomography (CBCT) images. Materials and Methods: Thirty orthodontic patients were enrolled in this study. Frontal and lateral cephalograms were obtained with the use of a head posture aligner and reconstructed into 3D cephalograms using biplanar radiography software. Thirty-four measurements representing the height, width, depth, and oblique distance were computed in 3 dimensions, and compared with the measurements from the 3D images obtained by CBCT, using the paired t-test and Bland-Altman analysis. Results: Comparison of height, width, depth, and oblique measurements showed no statistically significant differences between the measurements obtained from 3D cephalograms and those from CBCT images (P>0.05). Bland-Altman plots also showed high agreement between the 3D cephalograms and CBCT images. Conclusion: Accurate 3D cephalograms can be constructed using the principle of biplanar radiography if frontal and lateral cephalograms can be obtained with a head posture aligner. Three-dimensional cephalograms generated using biplanar radiography can replace CBCT images taken for diagnostic purposes.

• The korean journal of orthodontics
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• v.46 no.3
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• pp.129-136
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• 2016

Objective: To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. Methods: Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study. Results: All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions. Conclusions: The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken.

• Imaging Science in Dentistry
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• v.48 no.2
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• pp.111-119
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• 2018

Purpose: This study was conducted to evaluate the accuracy of linear measurements of 3-dimensional (3D) images generated by cone-beam computed tomography (CBCT) and facial scanning systems, and to assess the effect of scanning parameters, such as CBCT exposure settings, on image quality. Materials and Methods: CBCT and facial scanning images of an anthropomorphic phantom showing 13 soft-tissue anatomical landmarks were used in the study. The distances between the anatomical landmarks on the phantom were measured to obtain a reference for evaluating the accuracy of the 3D facial soft-tissue images. The distances between the 3D image landmarks were measured using a 3D distance measurement tool. The effect of scanning parameters on CBCT image quality was evaluated by visually comparing images acquired under different exposure conditions, but at a constant threshold. Results: Comparison of the repeated direct phantom and image-based measurements revealed good reproducibility. There were no significant differences between the direct phantom and image-based measurements of the CBCT surface volume-rendered images. Five of the 15 measurements of the 3D facial scans were found to be significantly different from their corresponding direct phantom measurements(P<.05). The quality of the CBCT surface volume-rendered images acquired at a constant threshold varied across different exposure conditions. Conclusion: These results proved that existing 3D imaging techniques were satisfactorily accurate for clinical applications, and that optimizing the variables that affected image quality, such as the exposure parameters, was critical for image acquisition.

• The korean journal of orthodontics
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• v.43 no.5
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• pp.209-217
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• 2013

Objective: This study investigated whether temporomandibular joint (TMJ) condyle-fossa relationships are bilaterally symmetric in class III malocclusion patients with and without asymmetry and compared to those with normal occlusion. The hypothesis was a difference in condyle-fossa relationships exists in asymmetric patients. Methods: Group 1 comprised 40 Korean normal occlusion subjects. Groups 2 and 3 comprised patients diagnosed with skeletal class III malocclusion, who were grouped according to the presence of mandibular asymmetry: Group 2 included symmetric mandibles, while group 3 included asymmetric mandibles. Pretreatment three-dimensional cone-beam computed tomography (3D CBCT) images were obtained. Right- and left-sided TMJ spaces in groups 1 and 2 or deviated and non-deviated sides in group 3 were evaluated, and the axial condylar angle was compared. Results: The TMJ spaces demonstrated no significant bilateral differences in any group. Only group 3 had slightly narrower superior spaces (p < 0.001). The axial condylar angles between group 1 and 2 were not significant. However, group 3 showed a statistically significant bilateral difference (p < 0.001); toward the deviated side, the axial condylar angle was steeper. Conclusions: Even in the asymmetric group, the TMJ spaces were similar between deviated and non-deviated sides, indicating a bilateral condyle-fossa relationship in patients with asymmetry that may be as symmetrical as that in patients with symmetry. However, the axial condylar angle had bilateral differences only in asymmetric groups. The mean TMJ space value and the bilateral difference may be used for evaluating condyle-fossa relationships with CBCT.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.139-144
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• 2012

The purpose of this study was to evaluate the accuracy and reproducibility of measuring the size of unerupted permanent tooth via cone beam computed tomography(CBCT). Ten children were scanned with dental CBCT, and 3-dimensional reconstruction of the dentitions were generated CBCT. Mesio-distal dimension and buccolingual dimension of the teeth were made directly on the model with a high-precision digitalcaliper and on the CBCT by using three-dimensional dental imaging software. Reliability and accuracy were assessed by using intraclass correlation and paired $t$-tests. ($p$ <0.05) The results were as follows : 1. Intraclass correlations were above 0.9 for Both the CBCT and the model measurements, showinghigh reliability. 2. Although there were high correlation values(r=0.91) between CBCT and model messurement methods, comparisons between the CBCT and model messurement methods showed a statistically significant difference($p$ <0.05). 3. The CBCT measurements tended to slightly underestimate by 0.2 mm. But, the systematic difference of CBCT measurements were clinically acceptable Therefore, CBCT measurement method can be used to measure the size of unerupted teeth in a sufficiently accurate way.

• Imaging Science in Dentistry
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• v.43 no.3
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• pp.163-169
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• 2013

Purpose: Tonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs. Materials and Methods: The sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm3 of the segmented three dimensional models were obtained. Results: CBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to $302.5mm^3$. The patients with bilaterally multiple and large calcifications were found to be symptomatic. Conclusion: The cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies.