• Imaging Science in Dentistry
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• 제48권2호
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• pp.131-137
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• 2018

Cemento-osseous dysplasia (COD) is a benign fibro-osseous lesion of bone, in which normal bone is replaced by fibrous tissue, followed by calcification with osseous and cementum-like tissue. COD is classified into 3 categories according to its location: periapical, focal, and florid COD (FCOD). On radiography, FCOD appears radiolucent in its early stages. As it matures, radiopacities appear within the lesion, causing them to show a mixed appearance of radiolucency and radiopacity. Because FCOD is usually asymptomatic and grows in a self-limited manner, it does not require treatment. Secondary infection is the most frequent cause of symptomatic cases. We report a case of FCOD with symptoms that appeared after a dental restoration procedure and persisted after repeated operations. The purpose of this report is to emphasize the importance of thorough radiological evaluations of patients with FCOD before treatment.

• Restorative Dentistry and Endodontics
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• 제40권1호
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• pp.58-67
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• 2015

Objectives: This study aimed to compare the accuracy of conventional intraoral (CI) radiography, photostimulable phosphor (PSP) radiography, cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) for detection of strip and root perforations in endodontically treated teeth. Materials and Methods: Mesial and distal roots of 72 recently extracted molar were endodontically prepared. Perforations were created in 0.2, 0.3, or 0.4 mm diameter around the furcation of 48 roots (strip perforation) and at the external surface of 48 roots (root perforation); 48 roots were not perforated (control group). After root obturation, intraoral radiography, CBCT and MDCT were taken. Discontinuity in the root structure was interpreted as perforation. Two observers examined the images. Data were analyzed using Stata software and Chi-square test. Results: The sensitivity and specificity of CI, PSP, CBCT and MDCT in detection of strip perforations were 81.25% and 93.75%, 85.42% and 91.67%, 97.92% and 85.42%, and 72.92% and 87.50%, respectively. For diagnosis of root perforation, the sensitivity and specificity were 87.50% and 93.75%, 89.58% and 91.67%, 97.92% and 85.42%, and 81.25% and 87.50%, respectively. For detection of strip perforation, the difference between CBCT and all other methods including CI, PSP and MDCT was significant (p < 0.05). For detection of root perforation, only the difference between CBCT and MDCT was significant, and for all the other methods no statistically significant difference was observed. Conclusions: If it is not possible to diagnose the root perforations by periapical radiographs, CBCT is the best radiographic technique while MDCT is not recommended.

• Imaging Science in Dentistry
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• 제32권1호
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• pp.19-25
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• 2002

Purpose: To evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus and periapical, periodontal lesions and to clarify the usefulness of the reconstructed 3-dimensional images to the dental clinical aspects. Materials and Methods: 33 sides of maxillae of the hemi-sectioned Korean heads were used in this study. Periapical radiographs, computed tomography and DentaScan reformatted cross-sectional images were taken for the radiographic evaluation of the peiapical and peiodontal lesions of the maxillary teeth and inferior wall of maxillary sinus. Results : Compared the degree of accuracy and findings of dental and periapical pathoses on the intraoral radiographs and DentaScan reformatted images with the cross-sectioned specimens, the DentaScan reformatted cross-sectional images were more accurate and more effective than the intraoral radiography with a viewpoint of the detection of dental and periapical pathoses. Conclusion: Comparing the lesions of specimens with intraoral radiographies and DentaScan reformatted images, the dental and periodontal pathoses and topographical structures were more clearly observed in the DentaScan reformatted images, providing the possibility of more applications of reformatted images to clinical dentistry.

• The Korean Journal of Legal Medicine
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• 제42권4호
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• pp.141-145
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• 2018

There have been many radiographic studies on age estimation that evaluate reduction in size of dental pulp cavity with secondary dentin formation. The Paewinsky method reported high accuracy in estimating ages by measuring the width of the pulp cavity in panoramic radiographs. The aim of this study was to evaluate the application of the Paewinsky method to digital periapical radiographs. This study was conducted on 103 cases that reported to the Section of Human Identification of the National Forensic Service. The age was calculated by applying the Paewinsky method that measures the root and pulp canal width at three points in a tooth. The estimation results were compared with those calculated by the Johanson method. When the Paewinsky models were applied to digital periapical radiographs, the errors were significantly greater as compared to the original study. The errors of the maxillary second premolar and mandibular lateral incisor were greater than those of the maxillary central incisor, lateral incisor, mandibular canine, and first premolar. Furthermore, errors of the age estimation models in level C were greater than those in levels A and B. This study could be a reference for the application of the Paewinsky method to digital periapical radiographs.

• 치과방사선
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• 제29권2호
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• pp.417-422
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• 1999

Purpose : The aim of this study was to assess the validity of standard deviation of gray scale histogram in digital subtraction radiography as a test parameter for superimposition error. Materials and Methods : Twenty periapical radiographs were used as baseline images and they were copied to exclude the influence of exposure geomety and contrast differences. These subsequent images were linearly displaced by 0.1-0.5 mm in the x-. y- and xy-directions, rotated by 0.5-3° and distorted by angular contraction of 1-5° in x- and y-axis before subtraction. The standard deviations of gray levels in the subtraction images were obtained and paired t-tests were performed. Pearson correlation coefficients(r) were calculated between the standard deviations and the superimposition errors. Results : Linear displacement showed high correlation coefficients of 0.997, 0.997 and 0.995 in x-. y- and xy-axis respectively. Statistically significant different standard deviation existed among all linearly displaced groups(p<0.05). Distortion showed relatively low correlation coefficients of 0.982 and 0.959 in x- and y-axis. The standard deviations between the two distortion groups were statistically significant different(p<0.05). Conclusion : Standard deviation of gray level distribution in digital subtraction images is satisfactory but not perfect similarity measure to assess the superimposition errors.

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.797-809
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• 1998

The purposes of this study were to develop the computer program for the contrast and geometric correction in digital subtration radiography with the IDL (Interactive Data Language) and compare the results with this program for the correction of the non-standardized radiographs to those of standardized radiographs and those with "Emago" software, the commercial program for the correction. The procedures were written for the contrast correction and subtraction with the geometric correction, using IDL. 32 pairs of periapical radiographs of premolar and molar portion of two dry human mandibles were taken at two different occasions with XCP film holder(nonstandardized films) and another 32 pairs with customized XCP film holder(standardized films). Subtraction of standardized film pairs was performed. Subtraction after the contrast and geometric correction of non-standardized films was performed using the newly developed program and Emago software. Standard deviations of grey levels of the subtracted images by the newly developed program were compared with those of the standardized group and Emago-corrected group. Standard deviations of grey levels of new program-corrected group were much smaller than those of the Emago-corrected group (p<0.001) and slightly larger than those of standardized group (p<0.05). However, the difference was very minute. This study indicates that the newly developed program written with IDL may substitute the mechanical standardization for digital subtraction radiography.

• Restorative Dentistry and Endodontics
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• 제46권3호
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• pp.43.1-43.9
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• 2021

Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth-285 roots) and PERI+CBCT (94 teeth-115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.

• Imaging Science in Dentistry
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• 제32권3호
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• pp.147-151
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• 2002

Purpose: To compare the standard deviation of gray levels on digital subtracted images obtained by different dental subtraction programs. Materials and Methods: Paired periapical films were taken at the lower premolar and molar areas of the phantoms involving human mandible. The bite registration group used Rinn XCP equipment and bite registration material, based on polyvinyl siloxane, for standardization. The no bite registration group used only Rinn XCP equipment. The periapical film images were digitized at 1200 dpi resolution and 256 gray levels by a flat bed scanner with transparency unit. Dental digital subtraction programs used for this study were Subtractor (Biomedisys Co., Korea) and Emago (Oral Diagnostic Systems, The Netherlands). To measure the similarities between the subtracted images, the standard deviations of the gray levels were obtained using a histogram of subtracted images, which were then analyzed statistically. Results: Subtracted images obtained by using the Emago program without manual selection of corresponding points showed the lowest standard deviation of gray levels (p<0.01). And the standard deviation of gray levels was lower in subtracted images in the group of a bite registration than in the group of no use of bite registration (p < 0.01). Conclusion: Digital radiographic subtraction without manual selection of reference points was found to be a convenient and superior method.

• 치과방사선
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• 제24권1호
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• pp.137-147
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• 1994

A digital imaging system using Machintosh Ⅱ ci computer, high resolution Sony XC-77 CCD camera, Quickcapture Frame Grabber Board was evaluated for quantitative analysis of standardized periapical film with aluminum step wedge. The results were as follows: 1. Correlation between Al thickness and gray level was high-positively associated(r²=0.99, p<0.001). 2. Correlation between measured weight of experimental lesion and estimated relative lesion volume by digital subtracted radiography was also high-positively associated (r²=0.98, p<0.001). 3. As exposure time was increased, mean gray level was decreased(p<0.01) and slope of regression line between Al thickness and gray level was also decreased (p<0.01). And when the exposure time was shorter than 0.2 second, the value of r² was relatively low. On the basis of the above results, it is considered that this digital imaging system using a Macintosh Ⅱ ci computer & a high resolution CCD monochrome camera will be useful in evaluating digitized image from standardized periapical film quantitatively.

• Restorative Dentistry and Endodontics
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• 제41권2호
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• pp.148-153
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• 2016

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.