• Imaging Science in Dentistry
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• v.38 no.4
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• pp.215-218
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• 2008

Purpose : To evaluate the value of panoramic radiography in diagnosing maxillary sinus inflammation. Materials and Methods : A total of 214 maxillary sinuses from 114 panoramic radiographs were assessed in this study. Two independent experienced oral radiologists evaluated the images in random order for sinus inflammation. Using Cone beam CT images as the gold standard, the sensitivity and specificity of panoramic radiography were calculated, and inter- and intraobserver agreement for panoramic interpretation were obtained. Results : The mean sensitivity and specificity of panoramic radiography were 81.0% and 85.6%, respectively. The weighted kappas for inter- and intraobserver agreement of panoramic radiography were 0.56 and 0.60, respectively. Conclusion : Panoramic radiography is a reasonably accurate method for diagnosing maxillary sinus inflammation and can be used for screening. However, additional examinations should be considered in patients with potentially significant pathology. (Korean J Oral Maxillofac Radiol 2008; 38: 215-8)

• Imaging Science in Dentistry
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• v.41 no.2
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• pp.63-69
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• 2011

Purpose : The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. Materials and Methods : Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. Results : The smallest difference between the calculated and the actual distance was $0.1{\pm}0.7 \;mm$ in Group 1/ Method 3. The largest difference was $-4.2{\pm}1.6 \;mm$ in Group 3/Method 2. In all groups, method 3 was the most accurate. Conclusion : Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.

• 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.

• Imaging Science in Dentistry
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• v.44 no.1
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• pp.7-13
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• 2014

Purpose: This study was performed to evaluate the prevalence of all types and subtypes of dental anomalies among 7- to 35-year-old patients by using panoramic radiographs. Materials and Methods: This cross-sectional study was conducted on 1649 people in Hamadan City, in 2012-2013. The prevalence of four types and 12 subtypes of dental anomalies was evaluated by two observers separately by using panoramic radiography. Dental anomalies were divided into four types: (a) shape (including fusion, taurodontism, and dens invagination); (b) number (including hypodontia, oligodontia, and hyperdontia); (c) structure (including amelogenesis imperfecta, dentinogenesis imperfecta, and dentin dysplasia); and (d) position (including displacement, impaction, and dilacerations). Results: The reliability between the two observers was 79.56% according to the Kappa statistics. The prevalence of dental anomalies diagnosed by panoramic radiographs was 29%. Anomalies of position and number were the most common types of abnormalities, and anomalies of shape and structure were the least in both genders. Anomalies of impaction (44.76%), dilacerations (21.11%), hypodontia (15.88%), taurodontism (9.29%), and hyperdontia (6.76%) were the most common subtypes of dental anomalies. The anomalies of shape and number were more common in the age groups of 7-12 years and 13-15 years, respectively, while the anomalies of structure and position were more common among the other age groups. Conclusion: Anomalies of tooth position were the most common type of dental anomalies, and structure anomalies were the least in this Iranian population. The frequency and type of dental anomalies vary within and between populations, confirming the role of racial factors in the prevalence of dental anomalies.

• Imaging Science in Dentistry
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• v.46 no.1
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• pp.63-68
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• 2016

Panoramic radiographs are a relatively simple technique that is commonly used in all dental specialties. In panoramic radiographs, in addition to the formation of real images of metal objects, ghost images may also form, and these ghost images can hinder an accurate diagnosis and interfere with the accuracy of radiology reports. Dentists must understand the formation of these images in order to avoid making incorrect radiographic diagnoses. Therefore, the present study sought to present a study of the formation of panoramic radiograph ghost images caused by metal objects in the head and neck region of a dry skull, as well as to report a clinical case in order to warn dentists about ghost images and to raise awareness thereof. An understanding of the principles of the formation of ghost images in panoramic radiographs helps prevent incorrect diagnoses.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.21-32
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• 2021

Purpose: The purpose of the present study was to investigate the correlation between age and 34 radiomorphometric parameters on panoramic radiographs, and to provide generalized linear models (GLMs) as a non-invasive, inexpensive, and accurate method to the forensic judgement of living individual's age. Methods: The study included 417 digital panoramic radiographs of Korean individuals (178 males and 239 females, mean age: 32.57±17.81 years). Considering the skeletal differences between the sexes, GLMs were obtained separately according to sex, as well as across the total sample. For statistical analysis and to predict the accuracy of the new GLMs, root mean squared error (RMSE) and adjusted R-squared (R²) were calculated. Results: The adjusted R²-values of the developed GLMs in the total sample, and male and female groups were 0.623, 0.637, and 0.660, respectively (p<0.001), while the allowable RMSE values were 8.80, 8.42, and 8.53 years, respectively. In the GLM of the total sample, the most influential predictor of greater age was decreased pulp area in the #36 first molar (beta=-26.52; p<0.01), followed by the presence of periodontitis (beta=10.24; p<0.01). In males, the most influential factor was the presence of periodontitis (beta=9.20; p<0.05), followed by the number of full veneer crowns (beta=2.19; p<0.001). In females, the most influential predictor was the presence of periodontitis (beta=18.10; p<0.001), followed by the tooth area of the #16 first molar (beta=-11.57; p<0.001). Conclusions: We established acceptable GLM for each sex and found out the predictors necessary to age estimation which can be easily found in panoramic radiographs. Our study provides reference that parameters such as the area of tooth and pulp, the number of teeth treated, and the presence of periodontitis should be considered in estimating age.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.421-427
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• 2021

Purpose: The pulp length to width (PL/W) ratio of the maxillary lateral incisor can be used as an age determination method. This study aimed to investigate the correlation between the PL/W ratio of the maxillary lateral incisor on panoramic radiographs and human chronological age in Indonesian subjects. Materials and Methods: This study analyzed with 134 maxillary lateral incisors on 113 panoramic radiographs from patients who visited the Oral and Maxillofacial Radiology Unit of Dental Hospital Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia, from 2013 to 2018 (age range: between 11 to 60 years). The pulp length was measured from the pulp chamber roof to the apical foramen, and the pulp width was measured on the cervical area of the cementoenamel junction in millimeters using Fiji ImageJ open-source software. Simple linear regression (in SPSS) was used to analyze the results. The reliability of the observers was evaluated. Results: The PL/W ratio of the maxillary lateral incisor was significantly correlated with chronological age (P<0.01). No statistically significant difference was found in the PL/W ratio between the left and right maxillary lateral incisors(P=0.333). There was a very strong correlation (r=0.939) between the PL/W ratio of the maxillary lateral incisor and human chronological age, with the following formula: age= -3.057+1.875×PL/W ratio (R²=0.882, standard error of estimate: 4.659). Conclusion: The PL/W ratio of the maxillary lateral incisor on panoramic radiograph can be used for age determination in Indonesian subjects.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.383-391
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• 2022

Purpose: Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Materials and Methods: Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. Results: The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics(i.e., dice coefficient and intersection-over-union [IoU] score). MultiLabel U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Conclusion: Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.351-357
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• 2022

Purpose: Convolutional neural networks (CNNs) have rapidly emerged as one of the most promising artificial intelligence methods in the field of medical and dental research. CNNs can provide an effective diagnostic methodology allowing for the detection of early-staged diseases. Therefore, this study aimed to evaluate the performance of a deep CNN algorithm for apical lesion segmentation from panoramic radiographs. Materials and Methods: A total of 1000 panoramic images showing apical lesions were separated into training (n=800, 80%), validation (n=100, 10%), and test (n=100, 10%) datasets. The performance of identifying apical lesions was evaluated by calculating the precision, recall, and F1-score. Results: In the test group of 180 apical lesions, 147 lesions were segmented from panoramic radiographs with an intersection over union (IoU) threshold of 0.3. The F1-score values, as a measure of performance, were 0.828, 0.815, and 0.742, respectively, with IoU thresholds of 0.3, 0.4, and 0.5. Conclusion: This study showed the potential utility of a deep learning-guided approach for the segmentation of apical lesions. The deep CNN algorithm using U-Net demonstrated considerably high performance in detecting apical lesions.

• Imaging Science in Dentistry
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• v.35 no.3
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• pp.121-125
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• 2005

Purpose : The purpose of this study was to investigate whether the fractal dimension of successive panoramic radiographs of bone after implant placement is useful in the characterization of structural change in alveolar bone. Materials and Methods. Twelve subjects with thirty-five implants were retrospectively followed-up from one week to six months after implantation. Thirty-six panoramic radiographs from twelve patients were classified into 1 week, 1-2 months and 3-6 months after implantation and digitized. The windows of bone apical and mesial or distal to the implant were defined as periapical region of interest (ROI) and interdental ROI; the fractal dimension of the image was calculated. Results There was not a statistically significant difference in fractal dimensions during the period up to 6 months after implantation. The fractal dimensions were higher in 13 and 15mm than 10 and 11.5mm implant length at interdental ROIs in 3-6 months after implantation (P<0.01). Conclusion : Longer fixtures showed the higher fractal dimension of bone around implant. This investigation needs further exploration with large numbers of implants for longer follow-up periods.