• Imaging Science in Dentistry
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• v.48 no.2
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• pp.121-125
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• 2018

Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.442-452
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• 2022

The purpose of this study was to compare the mesio-distal and vertical position of impacted maxillary canines on panoramic radiographs with the labio-palatal position of impacted canines and root resorption of adjacent teeth on CBCT (Cone-Beam Computed Tomography). A total of 54 patients with 69 impacted maxillary canines were included in this study. On panoramic radiographs, the mesio-distal (Sector I - V), and vertical position, and angulation of impacted maxillary canines were evaluated. Labio-palatal position and root resorption of adjacent teeth were evaluated on CBCT. Labial impaction of canines was most frequent in panoramic sector I. Impaction within the arch was most frequent in sector I and II. Palatal impaction was most frequent in sector III, IV, and V. Mesially positioned canines on panoramic radiographs tended to be palatally impacted. Most of the root resorption of adjacent teeth occurred in sector III, IV, and V (p < 0.05). Canines with low angulation on panoramic radiographs tended to be palatally impacted and resorb the roots of adjacent teeth. The vertical position of impacted canines on panoramic radiographs was not statistically significant with respect to labio-palatal position and root resorption of adjacent teeth on CBCT. Analysis of the mesio-distal position and angulation of impacted maxillary canines on panoramic radiographs can be used to predict the labio-palatal position of impacted canines and root resorption of adjacent teeth.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.65-70
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• 2019

Purpose: To determine whether calcified carotid atherosclerotic plaques(CCAPs) and mineralized laryngeal cartilages (MLCs) were more frequently detected on digital or film-based panoramic radiographs. The clinical relevance of this question is that some radiopacities seen on digital radiographs may correspond to medium-density tissues that are not necessarily mineralized. Materials and Methods: Data were collected from panoramic radiographs and the respective reports issued by 2 private oral radiology centers. A total of 388 radiographs and reports were divided into film-based (group A) and digital (group D) radiographs. The frequencies of CCAPs and MLCs were analyzed using the Fisher exact test, and odds ratios were also calculated (${\alpha}=1%$). Results: The mean age of patients whose reports and radiographs showed CCAPs and/or MLCs ranged from 50.1 to 54.1 years. There was a predominance of females. A higher frequency of CCAPs and MLCs was observed in group D than in group A at both centers(P<0.01). CCAPs and MLCs were detected 4 times more frequently in group D than in group A at one of the centers. Conclusion: CCAPs and MLCs were more frequently detected on digital than on film-based panoramic radiographs. Further studies are needed to determine whether such radiopacities do indeed correspond to mineralized, rather than medium-density, tissues.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.187-193
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• 2021

Purpose: This study aimed to assess the usefulness of machine learning and automation techniques to match pairs of panoramic radiographs for personal identification. Materials and Methods: Two hundred panoramic radiographs from 100 patients (50 males and 50 females) were randomly selected from a private radiological service database. Initially, 14 linear and angular measurements of the radiographs were made by an expert. Eight ratio indices derived from the original measurements were applied to a statistical algorithm to match radiographs from the same patients, simulating a semi-automated personal identification process. Subsequently, measurements were automatically generated using a deep neural network for image recognition, simulating a fully automated personal identification process. Results: Approximately 85% of the radiographs were correctly matched by the automated personal identification process. In a limited number of cases, the image recognition algorithm identified 2 potential matches for the same individual. No statistically significant differences were found between measurements performed by the expert on panoramic radiographs from the same patients. Conclusion: Personal identification might be performed with the aid of image recognition algorithms and machine learning techniques. This approach will likely facilitate the complex task of personal identification by performing an initial screening of radiographs and matching ante-mortem and post-mortem images from the same individuals.

• Imaging Science in Dentistry
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• v.35 no.3
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• pp.115-119
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• 2005

Purpose : To evaluate the magnification error percentage in repeatedly taken panoramic radiographs of same patient and machine. Materials and Methods : 92 panoramic radiographs from 46 patients were traced and 30 horizontal and vertical measurements were made with digital sliding caliper. The results were compared with paired t-test. Results : There was no statistically significant difference between the two measurements. The overall difference as percentage error was $6.19\pm5.60\%$. The largest error as $14.61\pm12.44\%$ was found at condylar height 1, and smallest as $1.86\pm1.61\%$ at mandibular height. Overall vertical error excluding condylar height 1 was $3.76\pm3.97\%$, and the horizontal error $6.88\pm5.92\%$. Conclusion . Repeatedly taken panoramic radiographs of the same patient and machine was reliable since there was no significant percentage error difference but the percentage error ranged from $1.86\pm1.61\%\;to\;14.61\pm12.44\%$ indicating the error depends on the measuring site.

• Imaging Science in Dentistry
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• v.43 no.3
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• pp.191-196
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• 2013

Purpose: This study assessed the accuracy of linear and angular measurements on panoramic radiographs taken at different positions in vitro. Materials and Methods: Two acrylic models were fabricated from a cast with normal occlusion. Straight and $75^{\circ}$ mesially and lingually angulated pins were placed, and standardized panoramic radiographs were taken at standard position, at an $8^{\circ}$ downward tilt of the occlusal plane compared to the standard position, at an $8^{\circ}$ upward tilt of the anterior occlusal plane, and at a $10^{\circ}$ downward tilt of the right and left sides of the model. On the radiographs, the length of the pins above (crown) and below (root) the occlusal plane, total pin length, crown-to-root ratio, and angulation of pins relative to the occlusal plane were calculated. The data were subjected to repeated measures ANOVA and LSD multiple comparisons tests. Results: Significant differences were noted between the radiographic measurements and true values in different positions on both models with linear (P<0.001) and those with angulated pins (P<0.005). No statistically significant differences were observed between the angular measurements and baselines of the natural head posture at different positions for the linear and angulated pins. Conclusion: Angular measurements on panoramic radiographs were sufficiently accurate and changes in the position of the occlusal plane equal to or less than $10^{\circ}$ had no significant effect on them. Some variations could exist in the pin positioning (head positioning), and they were tolerable while taking panoramic radiographs. Linear measurements showed the least errors in the standard position and $8^{\circ}$ upward tilt of the anterior part of the occlusal plane compared to other positions.

• Imaging Science in Dentistry
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• v.45 no.3
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• pp.175-180
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• 2015

Purpose: This study was performed to evaluate the reliability of the identification of anatomical landmarks in panoramic and lateral cephalometric radiographs on a standard medical grade picture archiving communication system (PACS) monitor and a tablet computer (iPad 5). Materials and Methods: A total of 1000 radiographs, including 500 panoramic and 500 lateral cephalometric radiographs, were retrieved from the de-identified dataset of the archive of the Section of Oral and Maxillofacial Radiology of the University Of Connecticut School Of Dental Medicine. Major radiographic anatomical landmarks were independently reviewed by two examiners on both displays. The examiners initially reviewed ten panoramic and ten lateral cephalometric radiographs using each imaging system, in order to verify interoperator agreement in landmark identification. The images were scored on a four-point scale reflecting the diagnostic image quality and exposure level of the images. Results: Statistical analysis showed no significant difference between the two displays regarding the visibility and clarity of the landmarks in either the panoramic or cephalometric radiographs. Conclusion: Tablet computers can reliably show anatomical landmarks in panoramic and lateral cephalometric radiographs.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.271-278
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• 2021

Purpose: This study aimed to investigate the panoramic imaging features of cleidocranial dysplasia (CCD) with a relatively large sample. Materials and Methods: The panoramic radiographs of 40 CCD patients who visited Seoul National University Dental Hospital between 2004 and 2018 were analyzed. Imaging features were recorded based on the consensus of 2 radiologists according to the following criteria: the number of supernumerary teeth and impacted teeth; the shape of the ascending ramus, condyle, coronoid process, sigmoid notch, antegonial notch, and hard palate; the mandibular midline suture; and the gonial angle. Results: The mean number of supernumerary teeth and impacted teeth were 6.1 and 8.3, respectively, and the supernumerary teeth and impacted teeth were concentrated in the anterior and premolar regions. Ramus parallelism was dominant (32 patients, 80.0%) and 5 patients (12.5%) showed a mandibular midline suture. The majority of mandibular condyles showed a rounded shape (61.2%), and most coronoid processes were triangular (43.8%) or round (37.5%). The mean gonial angle measured on panoramic radiographs was 122.6°. Conclusion: Panoramic radiographs were valuable for identifying the features of CCD and confirming the diagnosis. The presence of numerous supernumerary teeth and impacted teeth, especially in the anterior and premolar regions, and the characteristic shapes of the ramus, condyle, and coronoid process on panoramic radiographs may help to diagnose CCD.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.109-114
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• 1995

The purpose of this study was to investigate the changes of the shape of the panoramic innominate line and also to examine the relation of the panoramic innominate line to maxillary posterior wall according to positional changes in panoramic radiographs of the patients who had no pathoses in the maxillary sinus and adjacent bony structures. Thus these panoramic radiographs were obtained and evaluated in standard, forward 10mm, backward 10mm, chin down 10°, and chin up 10° positions. And the following results were obtained : 1. Panoramic innominate lines were not changed in shape according to various positional changes in panoramic radiography. 2. The panoramic innominate line was observed to be more clear images and decreased distance to the posterior wall of maxillary sinus at forward 10mm and chin down 10° positions. And the panoramic innominate line was observed more blurred images and increased distance to the posterior wall of maxillary sinus at backward 10mm and chin up 10° positions.

• Imaging Science in Dentistry
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• v.44 no.2
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• pp.137-141
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• 2014

Purpose: This study was performed to investigate the interobserver agreement on the detection of carotid artery calcifications on panoramic radiographs. Materials and Methods: This study consisted of panoramic radiographs acquired from 634 male patients of the age of 50 years or older. Having excluded carotids of no diagnostic quality, 1008 carotids from the panoramic radiographs of the patients were interpreted by two oral and maxillofacial radiologists independently for the presence of carotid artery calcifications. Statistical analysis was used to calculate the interobserver agreement. Results: Interobserver agreement was obtained for 932 carotids (92.4%). Inconsistent interpretation of 76 carotids (7.5%) between the two observers was found. Cohen's kappa value was 0.688 (p<0.001). Conclusion: The probability of a match between the two observers was substantially high.