Cone Beam Computed Tomography Scans Research Articles

Verifying the accuracy and precision of foot bone segmentation from fan beam and cone beam computed tomography scans.

Verifying the accuracy and precision of foot bone segmentation from fan beam and cone beam computed tomography scans.

How to predict the future face? A 3D methodology to forecast the aspect of patients after orthognathic surgeries.

How to predict the future face? A 3D methodology to forecast the aspect of patients after orthognathic surgeries.

Machine Learning Models in the Detection of MB2 Canal Orifice in CBCT Images.

Machine Learning Models in the Detection of MB2 Canal Orifice in CBCT Images.

Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study.

To assess the biomechanical performance of cantilevered 2-unit implant-supported prostheses with zirconia and polyetherketoneketone (PEKK) under 3 loading conditions. A cone beam computer tomography (CBCT) scan of an edentulous mandible was segmented using Mimics software and refined in 3-Matic software to create trabecular and cortical bone structures. Implant CAD files were integrated using SolidWorks software, generating 4 models with varying implant positions: M1 (first premolar implant supporting a second premolar), M2 (second premolar implant supporting a first premolar), M3 (second premolar implant supporting a first molar), and M4 (first molar implant supporting a second premolar). Prostheses were constructed from zirconia or PEKK. Finite element analysis (FEA) in ANSYS software simulated static loading: vertical (100 N) and oblique (30° and 45°, 50 N). von Mises stress and total deformation were analyzed. Vertical loading showed the highest von Mises stress at cantilever connectors, with M3 displaying the highest cortical bone stress (117 MPa). Zirconia models had slightly higher prosthetic stress, while PEKK models exhibited greater implant and cortical bone stress. Oblique loading caused higher stress in implants and prostheses but remained below yield limits. Maximum deformation was under 25 micrometers for the implant and bone, and 65 micrometers for the prosthesis. Single implants can support 2-unit cantilevered prostheses when additional implants are unfeasible. The location of the cantilever has minimal impact compared to its size, as a larger cantilevered part increases stress. Zirconia better resists bending forces and reduces implant stress compared to PEKK. This study guides prosthodontists in designing 2-unit implant-supported prostheses, emphasizing that multiple implants optimize stress distribution, and that zirconia is preferable for cantilevered designs.

Cervical spine pneumatocysts in cone beam CT scan volumes: Looking beyond the Jaws

Cervical spine pneumatocysts in cone beam CT scan volumes: Looking beyond the Jaws

Advancing radiation safety in dental CBCT scans: Assessing the efficacy of barium sulfate shields in protecting the thyroid and eyes

Advancing radiation safety in dental CBCT scans: Assessing the efficacy of barium sulfate shields in protecting the thyroid and eyes

Establishment of diagnostic reference levels for dental cone beam computed tomography in Tabriz, Iran.

Cone beam computed tomography (CBCT) scans, essential for medical imaging, expose patients to radiation. To ensure safety, this study aimed to establish typical diagnostic reference levels (DRLs) and estimate median organ doses and cancer risks associated with CBCT scans in the Tabriz region, Iran. Patient data from 196 individuals undergoing common CBCT procedures were collected. Effective and organ doses were estimated using VirtualDoseCT software. Lifetime attributable risk of cancer incidence was estimated using BEIR VII report. DRL values were established based on gender and indication. Indication based values were 341mGy.cm2 for implants, 387mGy.cm2 for lesions, and 342mGy.cm2 for sinus scans. Effective doses (EDs) were analyzed, yielding values of 30μSv for males and 20μSv for females. Organ doses analysis revealed that salivary glands received the highest dose, while thymus had the lowest in both genders. Lifetime attributable risk of cancer incidence was evaluated and found to be 0.0027 in 100000 for male patients and 0.0084 in 100000 for female patients. The study highlights the importance of minimizing radiation exposure in CBCT examinations to reduce the risk of cancer and heritable effects. Tailored scan protocols and optimization measures can enhance patient safety by lowering doses. The results offer valuable guidance for dental and maxillofacial imaging practices on radiation doses and DRLs in CBCT examinations.

Evaluation of Orbital Asymmetry in Patients with Unilateral Cleft Lip and Palate Using Cone Beam Computed Tomography.

AimThe aim of this study was to evaluate and quantify orbital asymmetry in unilateral cleft lip and palate (UCLP) patients using cone beam computed tomography (CBCT), comparing the cleft and non-cleft sides.Materials and MethodsThis study retrospectively analyzed CBCT scans from 30 patients with UCLP (aged 12-30 years) and 30 non-cleft controls. The scans were acquired using standardized CBCT protocols with isotropic voxel resolution (0.3 mm). Key orbital dimensions, including height, width, and depth were measured bilaterally. Positional parameters, such as the distance from the infraorbital canal to the sella turcica and the cranio-lateral orientation of the orbit, were also evaluated. Data were analyzed with SPSS v25.ResultsPositional analysis revealed a significant infer-posterior displacement of the cleft side orbit compared to the non-cleft side (P < .05). Although height, width, and depth were largely symmetrical between sides, when compared to controls, both sides in patients with UCLP demonstrated significantly lower dimensions, indicating a bilateral effect. The intraclass correlation coefficient scores (>0.90) confirmed the reliability of measurements.ConclusionAlthough the variations in height, width, and depth were negligible when comparing the cleft and non-cleft sides, considerable differences were identified in contrast to the control groups, underscoring the bilateral effect of UCLP.

Predictability of Periodontal Surgical Guides Manufactured by Digital Flow in Clinical Crown Lengthening. A Randomized Trial.

This randomized controlled trial aimed to evaluate the effectiveness of periodontal surgical guides manufactured using a digital workflow in aesthetic clinical crown lengthening procedures. Twenty patients with altered passive eruption in the anterior maxilla requiring clinical crown lengthening were randomly divided into two groups: control group-free hand and test group-periodontal surgical guides. All patients underwent CBCT and intraoral digital scanning (IOS) examinations before the surgical procedure. Virtual planning was carried out in both groups, measuring the height of the gingival tissue to be removed. However, the surgical guides were only printed in the test group. IOS was performed on all patients 6 and 12 months after the surgical procedure to verify the predictability of the surgical technique in relation to the initial plan. Patients also answered a visual analog scale to measure postoperative pain. The comparative analysis between the test and control groups showed no statistical difference in the amount of tissue planned to be removed, and the result obtained after 6 months and 1 year (Control group: median of -0.09 to 0.29 mm in 6 months and 0.00 to 0.55 mm in 12 months. Test group: median of -0.05 to 0.70 mm in 6 months and 0.00 to 0.81 mm in 12 months). No differences were noticed between the techniques tested concerning the positioning of the gingival margin in the 6- or 12-month periods in relation to the marginal tissues observed at the baseline period (p > 0.05). The level of pain presented by patients was low in both groups, with reports of minimal discomfort after the 15-day follow-up period. Patients demonstrated high satisfaction levels with the procedure regardless of the surgical technique. Both guided and conventional surgery techniques are effective for treating altered passive eruption. However, the painful sensation and tendency for recurrence of the coronal positioning of the marginal tissues were lower when the guided surgery technique was applied. This study will help clinicians understand which surgical technique for treating altered passive eruptions is more appropriate for their clinical case.

The relationship between enamel and dentin calibrated-radiographic-density measured by cone beam computed tomography and dental caries status in young adults

ObjectiveTo evaluate the relationship between caries experience measured by the decayed missing filled teeth (DMFT) index and the radiographic density of dental hard tissues measured by cone beam computed tomography (CBCT) with a novel calibration tool for individuals aged > 20 to 25 years.Materials and methodsThe sample consisted of 40 patients. Their DMFT ranged from 1 to 16 (mean = 6.5, standard deviation = 3.4). CBCT was performed for all patients, and an extracted tooth covered with self-cured acrylic resin was used as a radiographic density calibration tool. The gray values of the enamel, coronal and radical dentine regions of all the teeth were measured by two examiners. The average values of enamel and dentine radiographic density of incisors, canines, premolars and molars in each jaw and both jaws were calculated, and correlated with DMFT.ResultsThe radiographic density of mandibular incisors and all incisors of both jaws had the highest Pearson correlation coefficients with DMFT (0.33 < r < 0.42, P-value = 0.016). Neither the coronal nor the radicular dentine radiographic density was correlated with the DMFT according to any examiner.ConclusionEnamel, not dentine, radiographic density calculated from incisors via CBCT scans was correlated with DMFT in individuals aged > 20 to 25 years. The strengths of these correlations were moderate.Clinical relevanceThe enamel radiographic density of incisors, measured by CBCT using a novel calibration tool, was correlated with dental caries status in young adults aged 20–25 years. Thus, this study provides deeper insight into the radiographic density of dental hard tissues as a determinant of dental caries. This factor is also measurable in a clinical setting.

Cone-Beam Computed Tomography Prescriptions in Pediatric Dentistry

Introduction: Cone Beam Computed Tomography (CBCT) is increasingly used in pediatric dentistry for better diagnostics and treatment, but concerns about its potential harm to children remain. This study evaluates CBCT indications and the appropriateness of the Field of View (FOV) in pediatric patients at Mashhad Dental School. Materials and Methods: This retrospective study analyzed CBCT radiographs and patient records of individuals aged 18 years or younger who visited the Radiology Department of Mashhad Dental School from April 2018 to the end of 2022. Patients were categorized into three age groups: under 6 years, 7-12 years, and 13-18 years. The study recorded patient age, gender, CBCT indication, anatomical region examined, and FOV used. The appropriateness of the FOV was assessed based on SEDENTEX-CT guidelines. Results: Out of 4285 patient records, 199 pediatric patients (102 girls and 97 boys) with a mean age of 13.42±3.59 years were included. The most common indication for CBCT was dental impaction (48.2%), particularly of the canine teeth, followed by pathological lesions (19.6%). The majority of CBCT scans used a medium-sized FOV (8x5 cm), which was appropriate in 67.8% of cases. There was a significant relationship between the indication for CBCT and the appropriateness of the FOV (p&lt;0.001). Conclusion: CBCT is a valuable diagnostic tool in pediatric dentistry, particularly for evaluating dental impactions and pathological lesions. However, careful consideration of the FOV is crucial to minimize radiation exposure. Adherence to guidelines can enhance the safe and effective use of CBCT in pediatric patients.

‘Diagnostic Approach’ for Fixed Prosthodontic Treatment- A Descriptive Review

In order to ensure optimal function, aesthetics, and patient comfort, accurate diagnosis is essential for prosthodontic rehabilitation in fixed partial dentures (FPDs), implant prosthodontics, and temporomandibular joint (TMJ) disorders. Diagnostic techniques used in FPDs, such as bitewing radiographs, intraoral periapical (IOPA) radiographs, and cone beam computed tomography (CBCT), evaluate the pulp anatomy, periodontal bone support, and abutment tooth health in order to inform crown and bridge design. Digital intraoral scanners and occlusal analysis tools (such as T-Scan and articulating paper) improve occlusal harmony and preparation precision, extending the life of restorations. In order to enable precise implant placement and prosthetically driven restorations, CBCT, panoramic radiographs (OPG), and digital scanners assess bone volume, density (e.g., Lekholm &amp; Zarb classification), and anatomical landmarks (e.g., inferior alveolar nerve) in implant prosthodontics. Resonance frequency analysis (RFA) and surgical guides help to further maximize implant stability and osseointegration. In TMJ disorders, electromyography (EMG) and psychometric questionnaires (e.g., DC/TMD Axis II) measure muscle activity and pain, guiding occlusal splint therapy or prosthetic adjustments, while magnetic resonance imaging (MRI), CBCT, and joint vibration analysis (JVA) diagnose disc displacement, bony changes, and joint dysfunction. Workflows in these fields are streamlined by digital innovations like CAD/CAM and 3D imaging, which enhance accuracy and patient outcomes. Together, these diagnostic instruments guarantee customized treatment planning, reduce complications, and improve prosthodontics' functional and aesthetic rehabilitation.

Dental Imaging in Singapore: A Survey of 2D Radiographic Techniques and CBCT Practices.

This survey was conducted to identify dental radiography practices and knowledge gaps among dentists in Singapore with respect to both 2D and 3D imaging. This was a cross-sectional survey conducted via an electronic platform from May to June 2023. All Singapore Dental Council-registered dentists were eligible to participate. We gathered data on demographics, intraoral (IO) radiography usage, cone beam computed tomography (CBCT) training, current CBCT usage and interpretation. 305 out of 2605 registered dentists completed the online survey (11.7% response rate). Radiograph positioning holders, digital imaging and round collimation were used by most respondents for IO radiography (85.6%, 88.9% and 89.2% respectively). 142 participants (46.6%) underwent CBCT training, and most lacked training in image acquisition. Dentists expressed interest in CBCT interpretation and the use of viewing software. 219 dentists (71.8%) are CBCT users. Most (74.9%) took 0 to 5 CBCT scans monthly. Implant planning was the most common indication (24.8%). 85.9% of CBCT users report some or all their own scans while 70.7% would engage a reporting service if available. This survey provides insights in dental imaging that require increased educational efforts in Singapore. For IO radiography, there should be greater emphasis on rectangular collimation. With CBCT, there is potential for training in image acquisition, interpretation and the use of viewing software. Identifying knowledge and training gaps in dental imaging is critical to ensure the safe use of ionizing radiation on patients.

CBCT Evaluation of Maxillary Incisive Canal Characteristics Among Population in Regard to Possibility of Implant Cortical Anchorage-A Multicenter Study.

Background/Objectives: Implant placement in cases of severe bone atrophy or compromised alveolar bone requires careful planning, especially in the anterior maxilla. The nasopalatine canal (NPC) and its cortical walls offer potential anchorage sites. This study evaluates the NPC's anatomical characteristics using cone beam computed tomography (CBCT) to assess its suitability for implant anchorage. Methods: A retrospective analysis of 150 CBCT scans from three dental clinics in Poland was conducted. NPC measurements-including length, width, number of canals, and distances to adjacent anatomical structures-were taken in the sagittal, coronal, and axial planes. Statistical tests included Pearson correlation and Student's t-test to explore relationships between NPC dimensions and gender. Results: The mean NPC length was 10.27 mm and mean width 3.55 mm. Significant gender differences were observed in the canal length, width, and distances to the labial and palatal plates (p < 0.05). Strong positive correlations were found between the canal width at the palate base and other parameters, such as the midpoint width (r = 0.58) and diameter (r = 0.44). The distance from the palatal opening to the labial plate showed the strongest correlation (r = 0.67), indicating enhanced cortical anchorage potential with increased canal dimensions. Discussion: NPC morphology varied (cylindrical, funnel-like, hourglass), aligning with prior studies. Larger diameters were linked to single-canal configurations. Implant placement strategies-such as direct canal insertion or lateralization-can be effective, especially with polished, single-piece implants that reduce soft tissue ingrowth and improve primary stability. Conclusions: Understanding NPC anatomy is crucial for implant planning in atrophic maxillae. With the proper technique, NPC use for cortical anchorage is a viable treatment option.

Intraoperative Cone Beam Computed Tomography Increases Single Procedure Stone-Free Rates in Percutaneous Nephrolithotomy: Results of a Randomized Controlled Trial.

Introduction: Achieving a stone-free status during percutaneous nephrolithotomy (PCNL) is crucial to prevent additional morbidity or stone growth. Cone beam computed tomography (CBCT) in a hybrid operating room provides intraoperative imaging of the urinary tract, improving stone-free status assessment and enabling additional stone extraction. This study aimed to determine whether intraoperative CBCT leads to increased stone-free rates (SFR) after PCNL. Materials and Methods: We conducted a two-arm randomized trial involving adult patients undergoing PCNL at a tertiary referral center for complex kidney stone treatment. Intraoperative randomization took place when the kidney was deemed endoscopically stone free. Patients were assigned to either undergo an intraoperative CBCT scan or be placed in a control group, in which the procedure was ended without a CBCT scan. All patients underwent a low-dose noncontrast abdominal CT scan 4 weeks postoperatively. The primary outcome measure was the stone-free status evaluated by this scan. Results: This trial was prematurely terminated because of reaching the predefined criteria for superiority upon interim analysis, with 160 randomizations up to this point. SFR was 15% higher in the CBCT group (76% vs 61%, p = 0.04) using a 4-mm cut-off. With a 2-mm cut-off, the SFR difference was 14% (58% vs 44%, p = 0.08). Using a 0-mm cut-off, the difference was 9% (50% vs 41%, p = 0.27). Residual fragments were identified in 56% of CBCT scans, with additional extraction in 49% of these cases. No significant difference in 30-day postoperative complications was observed. Conclusion: Intraoperative CBCT during PCNL significantly increases single procedure SFR. Trial registration: Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Prospectively registered on 15 October 2019.

Fluid-Dynamic Crestal Sinus Floor Elevation in Atrophic Posterior Maxilla Implant Rehabilitation with Hyaluronic Acid: A Prospective Study.

Implant-prosthetic rehabilitation of the posterior edentulous maxilla is challenging due to inadequate bone volume resulting from alveolar ridge resorption and maxillary sinus pneumatization. This study explores the use of hyaluronic acid (HA) as a biomaterial in maxillary sinus elevation, particularly in combination with a fluid dynamic approach, as an alternative to traditional lateral approaches and granular biomaterials. Methods: A prospective study was conducted on 58 patients with posterior maxillary edentulism. Preoperative CBCT scans assessed residual bone height and sinus width. A minimally invasive surgical protocol utilizing a device for fluid-dynamic membrane elevation and injection of 2% cross-linked hyaluronic acid was employed, followed by simultaneous implant placement. Postoperative follow-up included a CBCT scan at 12 months to evaluate new bone height, measured mesially and distally. Implant stability was assessed using resonance frequency analysis at second-stage surgery. Results: A significant increase in bone height was observed at 12 months post-surgery, with an average bone gain of 7.5 mm. All 58 implants achieved primary stability, and no implant failures or signs of peri-implantitis were noted during the follow-up period. Higher bone gain was observed in wider sinuses. Conclusions: The fluid-dynamic transcrestal sinus floor elevation technique combined with hyaluronic acid appears to be a minimally invasive and effective method for achieving significant bone regeneration in the posterior maxilla, facilitating implant-prosthetic rehabilitation with potentially low risks and morbidity. Further large-scale studies are warranted to validate these findings across diverse clinical scenarios.

Anatomical Variation in the Position of Mandibular Foramen with Gender, using Cone Beam Computed Tomographic Images

Background: It is impossible to clinically palpate the mandibular foramen (MF), which is located near the mandibular ramus's medial surface. Objective: The objective of this research was to use cone-beam computed tomography scans to evaluate the position of the mandibular foramen based on gender.Materials and Method: This radio-anatomical study assessed 1000 CBCT images from patients who received testing over a two-year period. A level of significance of P≤0.05 was applied to all statistical analyses of the data.Results: One hundred thirty-four mandibular foramens total; 66 (33.0%) were found in females and 134 (67.0%) in males. Men range in age from 15 to 70 years old, with a mean age (SD) of 39.81±14.71. The experiment's findings demonstrated that gender had no impact on the location the mandibular foramen.Conclusion: The study's findings showed that gender had no effect on the positioning of the mandibular foramen.Keywords: CBCT, Mandibular foramen, Orthognathic.

Quantitative analysis and clinical determinants of orthodontically induced root resorption using automated tooth segmentation from CBCT imaging

BackgroundOrthodontically induced root resorption (OIRR) is difficult to assess accurately using traditional 2D imaging due to distortion and low sensitivity. While CBCT offers more precise 3D evaluation, manual segmentation remains labor-intensive and prone to variability. Recent advances in deep learning enable automatic, accurate tooth segmentation from CBCT images. This study applies deep learning and CBCT technology to quantify OIRR and analyze its risk factors, aiming to improve assessment accuracy, efficiency, and clinical decision-making.MethodThis study retrospectively analyzed CBCT scans of 108 orthodontic patients to assess OIRR using deep learning-based tooth segmentation and volumetric analysis. Statistical analysis was performed using linear regression to evaluate the influence of patient-related factors. A significance level of p < 0.05 was considered statistically significant.ResultsRoot volume significantly decreased after orthodontic treatment (p < 0.001). Age, gender, open (deep) bite, severe crowding, and other factors significantly influenced root resorption rates in different tooth positions. Multivariable regression analysis showed these factors can predict root resorption, explaining 3% to 15.4% of the variance.ConclusionThis study applied a deep learning model to accurately assess root volume changes using CBCT, revealing significant root volume reduction after orthodontic treatment. It found that underage patients experienced less root resorption, while factors like anterior open bite and deep overbite influenced resorption in specific teeth, though skeletal pattern, overjet, and underbite were not significant predictors.

CONE BEAM COMPUTERED TOMOGRAPHY EVALUATION OF THE ROOT CANAL OBTURATION OF PREMOLARS WITH ATYPICAL ANATOMY

Purpose: The aim of the study is to evaluate, by cone beam computed tomography, the quality of obturation of the root canal system using the hydraulic condensation method and three preparation methods of printed 3D replicas of human premolars with Vertucci type III, IV and V configuration. Materials and methods: The printed 3D replicas of human premolar teeth (n=45) are divided into three groups, depending on the morphology of their root-canal system and the method of preparation: Group 1: 15 specimens with Vertucci type III, IV, and V configuration (5 for each configuration), using a standard preparation technique with a .02 taper; group 2: 15 specimens with Vertucci type III, IV, and V configuration (5 for each configuration), Crown down preparation technique with .06 taper and group 3: 15 specimens with Vertucci type III, IV and V configuration (5 for each configuration), by hybrid preparation technique. All root canals of all specimens were obturated using the hydraulic condensation method. Cone beam computed tomography scans of the obturated endodontic spaces were compared using HOROS software. Results: The quality of the root canal filling did not differ significantly in the three studied groups, with 3D obturation having the highest results in group 3 of the studied. Conclusion: Obturation of premolars with atypical anatomy by the method of hydraulic condensation gives good results in three methods of preparation of the root canal system.

Effect of high-speed exercise on subchondral bone in the metacarpo-/metatarsophalangeal joints of 2-year-old Thoroughbred racehorses in their first year of training.

Stress-induced bone injury can lead to catastrophic injuries in Thoroughbred racehorses. Accumulation of high-speed exercise can increase the risk of subchondral bone injury. To investigate the effect of high-speed exercise on the subchondral bone of the metacarpo-metatarsophalangeal (MCP/MTP) joints using standing cone-beam computed tomography (CBCT) in young racing Thoroughbreds. Observational cohort study. Forty-one 2-year-old Thoroughbred racehorses during their first year of training were evaluated at 0, 6 and 12 months. Horses were evaluated for lameness and effusion of the MCP/MTP joints, and then standing CBCT was performed of the MCP/MTP joints. Subchondral bone hyperdensity (sclerosis) was measured (mm) at defined locations in the distal aspect of the third metacarpal (MC3)/metatarsal (MT3) bone and proximal phalanx (P1). CBCT scans were evaluated for subchondral bone hypodensity (pathology) in MC3/MT3, P1 and proximal sesamoid bones. Racing and training records were obtained from a national online database and trainers. Subchondral bone sclerosis (coefficient = 0.45; p < 0.003; 95% confidence interval [CI] 0.16-0.74) and pathology (IRR = 1.01; p < 0.001; 95% CI 1.00-1.01) increased significantly with the number of high-speed furlongs accumulated. Lameness was not associated with sclerosis or pathology; however, joint effusion was associated with both sclerosis (IRR = 1.01; p = 0.02; 95% CI 1.00-1.02) and pathology lesion (IRR = 1.14; p < 0.01; 95% CI 1.04-1.25). Limitations include attrition of horses over time and lack of control over training and husbandry. An increase in high-speed work was associated with both an increase in subchondral bone sclerosis and pathology.