Cone Beam Computed Tomography Research Articles

Bone dimensions relationship with gingival phenotype in smokers and nonsmokers using cone-beam computed tomography.

This study aimed to assess the relationship of maxillary alveolar bone thickness (BT) and height (BH) with gingival phenotype (GP) in smokers and nonsmokers using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 60 participants. The participants underwent periodontal examination, and their GP was determined by placing a periodontal probe in the gingival sulcus at the midline and observing the transparency. The participants were then assigned to four groups (n=15) based on their smoking status and GP: thin phenotype/smoker, thick phenotype/smoker, thin phenotype/nonsmoker, and thick phenotype/nonsmoker. BT and BH of the participants were measured in the sagittal plane on CBCT scans at the bone crest and at 2, 4, and 6mm apical to the crest at the site of maxillary central and lateral incisors. Data were analyzed by two-way ANOVA and LSD test (alpha=0.05). The distance between the cementoenamel junction (CEJ) of maxillary central and lateral incisors and alveolar bone crest in smokers was significantly greater than that in nonsmokers (p<0.001). Smoking had no significant effect on alveolar BT at the crestal level or 2, 4, and 6mm apical to the crest. BT at the crest and 2, 4, and 6mm apical to the crest was significantly greater in thick, versus thin, GP (p<0.001). Smoking significantly increased the distance between the CEJ and alveolar crest at the site of central and lateral incisors but had no significant effect on BT. This study found that smoking significantly increased the distance between the cementoenamel junction and the alveolar bone crest in maxillary incisors but did not affect alveolar bone thickness, which was greater in individuals with a thick gingival phenotype compared to those with a thin gingival phenotype.

Preliminary study: Evaluating the reliability of cone-beam computed tomography images for upper airway volume in orthodontics

Objectives: The primary aim of this study was to evaluate the reliability of cone-beam computed tomography (CBCT) in measuring upper airway volume in orthodontics. The secondary aim was to compare the upper airway volumes between laypeople and military personnel (physically fit individuals). Material and Methods: This study included 36 male participants aged 21–29 years who had no upper airway pathology or history of upper airway surgery. CBCT scans had been previously obtained as part of routine dental checkups using a standardized protocol by the same operator. The digital imaging and communications in the medicine files of the subjects were imported into the 3D analysis software SimPlant® 17 Pro (Materialize Dental, Leuven, Belgium) to facilitate the measurement of upper airway volume. The upper airway volume was divided into three sections and measured on days 0 and 14 by the same operator. The intrarater intra-class correlation coefficient (ICC) and Bland-Altman plot were used to assess reliability. The upper airway volumes of the laypeople and military personnel were compared using Tukey’s pairwise test. Results: The variables demonstrated excellent reliability across all sections of the upper airway; the Superior part of the upper airway has an ICC of 0.993, the middle part of the upper airway has an ICC of 0.995, and the inferior part of the upper airway has an ICC of 0.989. The ICC for the entire upper airway was 0.987. The intrarater plot for superior airway measurement showed that 8 out of 8 measurements (100%) fell within the limits of agreement. Similarly, the intrarater plot for the middle airway measurements indicated that 8 out of 8 measurements (100%) fell within the limits of agreement. For inferior airway measurement, the intrarater plot revealed that 7 out of 8 measurements (87.5%) fell within the limits of agreement. No significant differences were found between the upper airway volumes of the laypeople and military personnel. Conclusion: Preliminary evidence suggests that CBCT using a standardized protocol is reliable for measuring upper airway volume. Separating the upper airway into three different parts also demonstrated high reliability and reproducibility among the raters. The ability to accurately measure the upper airway enhances the evaluation of the effects of orthodontic treatment by comparing the pre-and post-upper airway volume.

Evaluation of root and root canal morphology of mandibular and maxillary canine teeth in Turkish subpopulation by cone beam computed tomography with using two classification systems

BackgroundKnowledge of root and canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The aim of this cone beam computed tomography (CBCT) study was to evaluate the root canal morphology of permanent canines in a Turkish subpopulation using two classification systems.MethodsA total of 2,000 canine teeth were examined. The number of roots was identified, and root canal configurations were classified according to Vertucci’s classification and a new system for classifying root and canal morphology. Fisher’s exact test was used for statistical analysis, and the level of significance was set at 0.05 (p = 0.05).ResultsThe canal configuration type I was the most common in all canines, while type III was the second most common. According to the new system, the code 1C1−1 was the most common, whilst 1C1 (A1) codes were the second most common for all canines. In this study, more than 10% morphology that did not fit the Vertucci classification was detected. In the categorization of accessory canals based on the new classification, the most common type in all canines was 1C1,1 (A1). Age had an effect only on the morphology of the left maxillary canine (p < 0.05).ConclusionCanines in the Turkish subpopulation showed a relatively high degree of variation in root and canal anatomical variations. Clinicians should be aware of where canals converge or diverge to avoid missing canals. The new system for classifying canal morphology describes root and canal configurations more accurately and practically compared to the Vertucci classification.

Clinical study of two mandibular advancement devices in the treatment of Obstructive Sleep Apnea: a pilot randomized controlled trial

ObjectiveA preliminary clinical evaluation of the efficacy, comfort, and adverse reactions of two mandibular advancement devices (MADs) in the treatment of Obstructive Sleep Apnea (OSA).MethodsForty patients with mild-to-severe OSA were recruited and randomly divided into two groups. They were treated with Shark-fin or Silensor MAD, respectively. Treatment efficacy was evaluated by home sleep apnea tests, the snoring scale, Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A comfort scale questionnaire was applied. Cone beam computed tomography (CBCT), cephalometric radiography, and intraoral scanning were made before and after 3-month treatment to detect temporomandibular joints (TMJ), dental and skeletal changes. All data were assessed as normal distributed and analyzed by t test. The significance level was defined as α = 0.05.ResultsThe effective rate, defined as a decrease in Respiratory Event Index (REI) to less than 5 events per hour or a decrease of more than 50%, was 70% in the Shark-fin MAD group and 50% in the Silensor MAD group. REI, lowest oxygen saturation and maximum apnea and hypoventilation time were significantly improved in Shark-fin MAD group (P < 0.01), and the proportion of non-rapid eye movement (REM) sleep stage 3 was higher than before use (P < 0.05), while only REI and lowest oxygen saturation were significantly improved in Silensor MAD group (P < 0.05). The loudness of snoring was significantly decreased after one day using Shark-fin MAD (P < 0.05), and further decreased after one month (P < 0.01). Conversely, Silensor MAD exhibited inferior efficacy in mitigating snoring compared to Shark-fin MAD. Upon wearing the Shark-fin MAD, ESS were significantly improved after one month and three months (P < 0.05), and PSQI improved after three months (P < 0.05). Additionally, the Shark-fin MAD group had a significantly better comfort score compared to the Silensor MAD group (P < 0.05). There was no significant difference in TMJ, dental and skeletal structures in the two groups before and after treatment (P > 0.05).ConclusionBoth two MADs were effective in reducing REI and increasing lowest oxygen saturation on OSA patients, and Shark-fin MAD has better improvement effect and faster onset of action. In addition, Shark-fin MAD was superior to Silensor MAD in improving snoring loudness, daytime sleepiness, sleep quality and wearing comfort. There were no significant dental or skeletal changes, and no alterations in occlusion or temporomandibular joint function in the short term.Trial registrationClinical Trials.gov Registration ID ChiCTR2400086628. Registered 08/07/ 2024-Retrospectively registered, https://register.clinicaltrials.gov.

Artificial intelligence versus semi-automatic segmentation of the inferior alveolar canal on cone-beam computed tomography scans: A pilot study.

The inferior alveolar canal (IAC) is a fundamental mandibular structure. It is important to conduct a precise pre-surgical evaluation of the IAC to prevent complications. Recently, the use of artificial intelligence (AI) has demonstrated potential as a valuable tool for dentists, particularly in the field of oral and maxillofacial radiology. The aim of the study was to compare the segmentation time and accuracy of AI-based IAC segmentation with semi-automatic segmentation performed by a specialist. Thirty individual IACs from 15 anonymized cone-beam computed tomography (CBCT) scans of patients with at least 1 lower third molar were collected from the database of Poznan University of Medical Sciences, Poland. The IACs were segmented by a trainee in the field of oral and maxillofacial radiology using a semi-automatic method and automatically by an AI-based platform (Diagnocat). The resulting segmentations were overlapped with the use of Geomagic Studio, reverse engineering software, and then subjected to a statistical analysis. The AI-based segmentation closely matched the semi-automatic method, with an average deviation of 0.275 ±0.475 mm between the overlapped segmentations. The mean segmentation time for the AI-based method (175.00 s) was similar to that of the semi-automatic method (175.67 s). The results of the study indicate that AI-based tools may offer a reliable approach for the segmentation of the IAC in the context of dental pre-surgical planning. However, further comprehensive studies are required to compare the methods and consider their limitations more comprehensively.

Accuracy of the Hounsfield Unit Values Measured by Implant Planning Software

Background: The measurement of Hounsfield units (HU) during implant treatment planning is important. Currently, various manufacturers’ implant planning software programs offer HU capabilities; however, their accuracy remains unverified. In this study, we aimed to validate the accuracy of HU values measured by implant planning software programs. Methods: This study used one type of multidetector computed tomography (MDCT), two types of cone–beam computed tomography (CBCT), and four implant planning software packages. Three specimens were prepared for the evaluation of HUs, and the standard values of the HUs were measured. Digital Imaging and Communications in Medicine (DICOM) data obtained from MDCT and CBCT were loaded into four implant planning software packages to measure the HU values. The HU and reference values of the four implant planning software programs obtained from MDCT and CBCT were compared. Additionally, the HU values between each implant planning software program were compared. Results: The HU values of the three specimens, as measured using the four implant planning software programs utilizing MDCT, did not exhibit a significant difference from the standard values. Conversely, those obtained from CBCT were significantly different. The measured HU values after the MDCT imaging of the specimens were not significantly different between the implant planning software programs; however, they differed after CBCT imaging. Conclusions: The results of this study indicate that it is not possible to measure HU values using CBCT with implant planning software programs. However, HU values can be measured by any implant planning software using MDCT.

Navigated and minimally invasive screw osteosynthesis of atalus fracture

The aim of this surgery is to safeguard the multifragmentary and nondisplaced talus fracture (body and neck) against secondary dislocation in anavigated and minimally invasive manner using screw osteosynthesis. Due to the young age of the patient in the presented case and the risk of apossible secondary dislocation, the decision was made in favor of surgical treatment. Soft tissue swelling, wound infections and allergies to the osteosynthesis material. The video is available online (in English) and shows the individual surgical steps in detail. Preoperative computed tomography (CT) imaging and screw planning. Attachment of the reference array. 1) Cone beam CT (CBCT) scan, image fusion and fusion control. Planning of the minimally invasive skin incisions. Skin incision, navigated drilling and insertion of the K‑wires. 2) CBCT scan and position check of the K‑wires, fine adjustment if necessary. Insertion of the screws. 3) CBCT scan with subsequent position check of the screws, retightening of the screws if necessary. Performed in the Robotic Suite (Brainlab, Munich, Germany) using the following elements: navigation unit curve navigation system, movable robotic 3D CBCT, "Loop-X" and wall monitor "BUZZ". Postoperative X‑ray and CT to control the position of the implants. Partial weight-bearing of the foot with 10 kg sole contact for 6weeks. Physiotherapy with active and passive joint mobilization. Thrombosis prophylaxis with enoxaparin sodium. Optional implant removal after approximately 1year. Navigated operations are routine, so far mainly in the area of the spine. This article shows that navigated extremity surgery can be successfully performed in hybrid operating theaters.

Automated bone property analysis using corrected in vivo dental cone-beam CT data of human wrists

Fracture liaison services are essential to mitigate underdiagnosis and undertreatment of osteoporosis-related fractures. However, it often suffers from limited access to dual-energy X-ray absorptiometry (DXA) or high-resolution peripheral quantitative CT equipment. This in vivo study of 21 patients aims to evaluate the feasibility of dental cone beam CT (dCBCT) to analyse bone properties of human wrists, comparing with DXA and finite element (FE) analysis. dCBCT grey-scale values were transformed to HU using a phantom containing materials with known HU values. Strong correlations were found between bone mineral content (BMC) from dCBCT and DXA (r = 0.78 to 0.84, p < 0.001), as well as between BMC from dCBCT FE-predicted stiffness (r = 0.91) and maximum force (r = 0.93), p < 0.001. BMC values from dCBCT were higher than DXA measurements (2.34 g vs. 1.5 g, p < 0.001). Cortical thickness strongly correlated to bone mineral density (BMD) from dCBCT (r = 0.83, p < 0.001). No statistically significant correlations were found between trabecular bone microstructure and FE predictions. The results indicate the feasibility to analyse osteoporosis related bone properties of human wrists from corrected dCBCT data. The dCBCT values of BMD and BMC were strongly correlated with DXA.

CBCT evaluation of the shaping characteristics of five different file systems in mesial canals of mandibular first molars – An ex vivo study

Cone-Beam Computed Tomography (CBCT) has revolutionized endodontic research by providing detailed 3D imaging, crucial for assessing the shaping characteristics of endodontic file systems. In the challenging mesial canals of mandibular first molars, where complex anatomy often complicates treatment, CBCT offers precise evaluation of how different file systems shape these canals. This ex vivo study compares five distinct file systems, analysing their ability to maintain the original canal curvature and ensure effective cleaning. The study aims to identify the most effective file systems, potentially improving clinical outcomes in endodontic therapy. This ex vivo study compared the shaping characterstics of five Ni-Ti rotary File Systems, File Univesal X7 Edge Endo, Bassilogic ProDesign Logic, Gen Endo Coltene Whaledent Pvt. Ltd., Endo Star E3 Azure Basic, Mani Jizai using Cone Beam Computed Tomography (CBCT). One hundred extracted human permanent mandibular first molars with mesial root curvature angles ranging from 20-30 degrees were divided into five groups (n=20 each). The teeth were imaged using CBCT with CS9300 equipment, set at 84 kV, 5 mA, and a 10.8-second exposure, achieving a resolution of 90 microns and a slice thickness of 76 microns to obtain a pretreatment outline of the root canals. All scans were reoriented along the x, y, and z axes. Canal transportation and root canal volume were evaluated at 0.0, 1.0, 2.0, 3.0, 4.0, and 5.0 mm intervals. The mean differences in volume and area were analyzed using one-way ANOVA to determine the variance between the five different file groups. Gen Endo File System did the least modifications in the Canal Area and Volume. Within the parameters of this study it was concluded that GEN ENDO Files did the least modifications in canal anatomy as compared to other groups.

Exploring maxillary molar root morphology: A case of extra palatal canal

: A fundamental requirement for successful endodontic treatment is understanding the tooth's root canal anatomy. The pulp chamber represents the most intricate part of the tooth. Effective treatment depends on accurately diagnosing and identifying all canals, performing thorough cleaning and shaping, and completing a three-dimensional (3D) filling while preserving the natural structure of the root canal system.: A 35-year-old male patient presented with apical periodontitis in relation to maxillary first molar. Radiographic examination revealed widening of periodontal ligament. Following local anaesthesia via PSA nerve block and infiltration, rubber dam isolation was done. An access cavity was created, and upon locating the canal orifices, an additional, separate palatal canal was identified. Cone Beam Computed Tomography (CBCT) was advised to confirm. Using a microscope, the MB2 orifice was carefully exposed by troughing along the groove between the MB1 and palatal canals with long-shank burs and a DG-16 explorer. All five canals were meticulously cleaned and shaped with NiTi rotary files, followed by 3D obturation. The significance of identifying anatomical changes, such as the extra-palatal canal in maxillary first molars with MB2, is highlighted in this case report. Endodontic results are improved by successful management using precise procedures and modern imaging, highlighting the importance of careful evaluation in complex cases.

Advancements in periodontal pathology: A systematic review and meta-analysis of molecular diagnostics, imaging techniques, regenerative therapies, and artificial intelligence

: Periodontal diseases, such as gingivitis and periodontitis, are prevalent conditions that adversely affect the supporting structures of teeth. Recent advancements in the field of periodontal pathology have enhanced understanding of disease mechanisms and improved diagnostic and therapeutic strategies.: To provide a comprehensive review of current innovations in periodontal pathology and explore emerging technologies and future directions that could revolutionize periodontal care.: This review synthesizes findings from recent literature on advancements in periodontal pathology, including molecular diagnostics, imaging techniques, regenerative therapies, and the application of artificial intelligence (AI). A systematic approach was adopted to identify and analyze relevant studies, focusing on their clinical relevance and potential for transforming periodontal care.: Key advancements include: 1. Molecular Diagnostics: Improved identification of biomarkers for early detection and disease progression monitoring. 2. Imaging Techniques: Enhanced visualization of periodontal structures using advanced modalities like cone-beam computed tomography (CBCT) and optical coherence tomography (OCT). 3. Regenerative Therapies: Breakthroughs in tissue engineering, stem cell therapy, and biomaterials for periodontal regeneration. 4. Artificial Intelligence: Integration of AI for predictive modeling, diagnostic support, and personalized treatment planning.: Recent innovations in periodontal pathology have significantly expanded diagnostic and therapeutic possibilities. Emerging technologies, including AI and regenerative approaches, hold immense potential for future advancements. Continued research and clinical integration of these innovations are critical for enhancing periodontal care and improving patient outcomes.

Assessment of the pterygoid hamulus dimensions and morphology in Iranian women using cone-beam computed tomography

Background. Understanding the characteristics of the pterygoid hamulus (PH) is crucial for diagnosing and treating various oropharyngeal and craniofacial conditions. It also aids in interpreting radiographs and diagnosing unexplained oropharyngeal pains. Cone-beam computed tomography (CBCT) is a valuable tool, offering clinical insights into this previously understudied area. Accordingly, this study aimed to evaluate the morphology and dimensions of the PH and its changes by ageing in 20-40-year-old women in the Dental Branch of Islamic Azad University of Sciences, Tehran, Iran. Methods. This cross-sectional study was conducted on CBCT scans from 258 women aged 20-40. The morphology, length, width, and angle of the PH in coronal and sagittal planes were investigated. Results. The average length of the right and left hamulus was 5.50±1.37 and 5.37±1.36 mm. The average width of the right and left hamulus was 2.16±0.72 and 2.11±1.06 mm. The average coronal angle of the right and left hamulus was 22.3±9.79° and 30.16±8.99°. The average sagittal angle of the right and left hamulus was 26.11±7.26° and 26.34±7.63°. In contrast with the sagittal angle, the right and left hamulus’s length, width, and coronal angles were not symmetrical. Slender morphology was the most frequent morphology, and it was symmetrical only in the 20-30-year-old age group. Finally, no variable was affected by ageing. Conclusion. Hamulus dimensions and morphology did not change with ageing in women aged 20-40. The PH symmetry varied by age group. Also, CBCT was a suitable tool for investigating hamulus changes.

An evaluation and correlation of airway space of pharynx, mandibular morphology, and tongue volume in skeletal classes and facial patterns – A cone beam computed tomography study

Objectives: Respiration and its function have a direct relationship with the pharyngeal airway, mandibular morphology, and tongue. The objective of this study was to evaluate and correlate pharyngeal airway space, mandibular morphology, and tongue volume in various skeletal classes and facial patterns. Material and Methods: A total of 120 pre-treatment cone beam computed tomography (CBCT) images were randomly classified into 3 skeletal classes (40/group). Each class was further categorized into hyperdivergent and hypodivergent growth patterns. Linear and angular measurements were estimated using three-dimensional digital imaging programs (Kavo 3D OnDemand software), and pharyngeal airway and tongue space were volumetrically analyzed by ITK-SNAP segmentation software. Results: All the measured variables showed highly significant differences except for the anterior-posterior angle of the mandible, which was statistically insignificant with P = 0.675. The simple regression was formulated to assess the volume of airway space. Conclusion: Hyperdivergent subjects had reduced pharyngeal airway space and tongue volume when compared to hypodivergent subjects. Among all the subgroups, Class III hypodivergent showed the highest pharyngeal airway volume and tongue volume, and the least was found in Class II hypodivergent. A direct relationship was estimated between airway mandibular morphology and tongue volume, recommending thorough analysis of oropharyngeal structures in a non-individualized way for orthodontic diagnosis and treatment planning.

Toward Closing the Loop in Image-to-Image Conversion in Radiotherapy: A Quality Control Tool to Predict Synthetic Computed Tomography Hounsfield Unit Accuracy

In recent years, synthetic Computed Tomography (CT) images generated from Magnetic Resonance (MR) or Cone Beam Computed Tomography (CBCT) acquisitions have been shown to be comparable to real CT images in terms of dose computation for radiotherapy simulation. However, until now, there has been no independent strategy to assess the quality of each synthetic image in the absence of ground truth. In this work, we propose a Deep Learning (DL)-based framework to predict the accuracy of synthetic CT in terms of Mean Absolute Error (MAE) without the need for a ground truth (GT). The proposed algorithm generates a volumetric map as an output, informing clinicians of the predicted MAE slice-by-slice. A cascading multi-model architecture was used to deal with the complexity of the MAE prediction task. The workflow was trained and tested on two cohorts of head and neck cancer patients with different imaging modalities: 27 MR scans and 33 CBCT. The algorithm evaluation revealed an accurate HU prediction (a median absolute prediction deviation equal to 4 HU for CBCT-based synthetic CTs and 6 HU for MR-based synthetic CTs), with discrepancies that do not affect the clinical decisions made on the basis of the proposed estimation. The workflow exhibited no systematic error in MAE prediction. This work represents a proof of concept about the feasibility of synthetic CT evaluation in daily clinical practice, and it paves the way for future patient-specific quality assessment strategies.

Uncommon Nasal Mass Presentation: A Radiological Case Series

Background: Nasal and paranasal sinus masses can arise from a wide range of conditions, both benign and malignant, as well as congenital or acquired. Diagnosing these masses is often challenging, requiring a combination of nasal endoscopy, imaging studies, and histopathological analysis. Initial imaging frequently involves computed tomography or cone beam computed tomography (CBCT) to evaluate the bony anatomy of the nasal cavity and surrounding sinuses, while magnetic resonance imaging (MRI) is typically used for detailed assessment of soft tissues and to aid in differential diagnosis when the findings are inconclusive. Methods: This review examines nasal masses evaluated using CT, CBCT, and MRI, highlighting key imaging features that may assist in differential diagnosis. Results: For non-neoplastic lesions, examples include conditions such as rhinoliths, inverted mesiodens, and septal mucoceles. Benign and borderline tumors discussed encompass lobular capillary hemangioma, inverted papilloma, septal osteoma, chondromesenchymal hamartoma, hemangioma, hemangiopericytoma, antrochoanal polyp, sinonasal angiofibroma, ossifying fibroma, and lipoma. Malignant tumors addressed in this review include adenocarcinoma, esthesioneuroblastoma, non-Hodgkin lymphoma, melanoma, and sarcoma. Conclusions: Diagnosing nasal lesions represent a significant challenge for otolaryngologists. Imaging characteristics of nasal masses play a crucial role in narrowing down differential diagnoses before surgery. However, nasal endoscopy combined with biopsy remains the definitive diagnostic approach.

Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 498 patients with maxillofacial diseases

PurposeThe purpose of this study was to assess the structural characteristics of the styloid process (SP) using cone-beam computed tomography (CBCT) examination in patients with maxillofacial diseases. The study aimed to determine the prevalence of elongated styloid process (ESP) and its relationship to gender in the study population. Radiographic records of 498 subjects were evaluated retrospectively. Radiological examinations including measurements of the structure, length, volume, and angulations of styloid process were performed on CBCT images. Males had significantly longer styloid process in both sides than females in the study population and a strong positive linear relationship was found between left and right sides’ process length (r = 0.83; p < 0.001). The mean internal oblique angle of styloid process differed between genders, but there were no statistically significant differences in the mean anterior oblique angle. Out of 498 subjects, 62 (24.13%) females and 101 (41.91%) males had elongated left styloid process (≥ 30 mm), while 75 (29.18%) and 90 (37.34%) had right side respectively.MethodsRadiographic records of 498 subjects were evaluated retrospectively. Radiological examinations including measurements of the structure, length, volume, and angulations of styloid process were performed on CBCT images.ResultsMales had significantly longer styloid process in both sides than females in the study population and a strong positive linear relationship was found between left and right sides’ process length (r = 0.83;p < 0.001). The mean internal oblique angle of styloid process differed between genders, but there were no statistically significant differences in the mean anterior oblique angle. Out of 498 subjects, 62 (24.13%) females and 101 (41.91%) males had elongated left styloid process (≥30 mm), while 75 (29.18%) and 90 (37.34%) had right side respectively.ConclusionsThis study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Within the study in 498 subjects in China, it was observed that the males, on average, had significantly longer styloid process and narrower internal oblique angle than females either in left or right side. Around 33% of the study population had ESP.

AVALIAÇÃO TOMOGRÁFICA DO REPARO DE PERFURAÇÃO CORONÁRIA INTRAÓSSEA UTILIZANDO AGREGADO TRIÓXIDO MINERAL: RELATO DE CASO

This clinical case report shows the repair of intraosseous coronary perforation in a maxillary canine, treated with Mineral Trioxide Aggregate (MTA), through clinical evaluation and cone beam computed tomography (CBCT) after 6 and 12 months of follow-up. Case report: The perforation occurred in the second session of endodontic treatment during the preparation of the access cavity and was located in the cervical region of the vestibular wall of the pulp chamber, communicating it with the bone tissue, at the subcristal level. Immediately after the accident, the area was cleaned with 2% chlorhexidine digluconate, the perforation was sealed with MTA Angelus and the vestibular wall of the pulp chamber was sealed with composite resin. Discussion: Intraosseous coronary perforation is an accident that occurs during the coronal opening stage, characterized by communication between the pulp cavity and the periradicular tissues, including the periodontal ligament, alveolar bone and/or gingival tissue. Sealing intraosseous perforations with bioactive materials such as MTA increases the success rate of treating these perforations. However, the long-term prognosis is not yet well established in the literature and few studies have evaluated the success of treating perforations with MTA using CBCT. Conclusion: Clinical and tomographic evaluation after 6 and 12 months showed bone healing and periodontal tissue health, demonstrating success in the treatment of intraosseous coronary perforation.

Analysis of the Relationship Between Scale Invariant Feature Transform Keypoint Properties and Their Invariance to Geometrical Transformation Applied to Cone-Beam Computed Tomography Images

Image registration is a crucial post-processing technique in biomedical imaging, enabling the alignment and integration of images from various sources to facilitate accurate diagnosis, treatment planning, and longitudinal studies. This paper explores the application of Scale Invariant Feature Transform (SIFT), a robust feature-based method for the alignment of biomedical images. SIFT is particularly advantageous due to its invariance to scale, rotation, and affine transformations, making it well-suited for handling the diverse and complex nature of biomedical images. However, SIFT was not initially developed specifically for medical imaging applications, so it is necessary to adapt the algorithm to those kinds of images. In particular, this work was focused on images obtained with Cone-Beam Computed Tomography (CBCT) technology. Besides fine-tuning SIFT parameters on a case-by-case basis, the novelty of this work consists of finding the optimal SIFT parameters on the basis of the keypoints stability. A statistical analysis throughout a dataset of images obtained with CBCT technology was performed to find the best SIFT parameters setting, in terms of computational cost and result quality, compared to default presets.

Detection of three-rooted mandibular first molars on panoramic radiographs using deep learning

This study aimed to develop a deep learning system for the detection of three-rooted mandibular first molars (MFMs) on panoramic radiographs and to assess its diagnostic performance. Panoramic radiographs, together with cone beam computed tomographic (CBCT) images of the same subjects, were retrospectively collected from 730 patients, encompassing a total of 1444 MFMs (367 teeth were three-rooted and the remaining 1077 teeth were two-rooted). Five convolutional neural network (CNN) models (ResNet-101 and − 50, DenseNet-201, MobileNet-v3 and Inception-v3) were employed to classify three- and two-rooted MFMs on the panoramic radiographs. The diagnostic performance of each model was evaluated using standard metrics, including accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Receiver operating characteristic (ROC) curve analyses were performed, with the CBCT examination taken as the gold standard.Among the five CNN models evaluated, ResNet-101 demonstrated superior diagnostic performance, and the AUC value attained was 0.907, significantly higher than that of all other models (all P < 0.01). The accuracy, sensitivity, and specificity were 87.5%, 83.6%, and 88.9%, respectively. DenseNet-201, however, showed the lowest diagnostic performance among the five models (all P < 0.01), with an AUC value of 0.701 and an accuracy of 73.2%. Overall, the performance of the CNNs diminished when using image patches containing only the distal half of MFMs, with AUC values ranging between 0.680 and 0.800. In contrast, the diagnostic performance of the two clinicians was poorer, with AUC values of only 0.680 and 0.632, respectively. In conclusion, the CNN-based deep learning system exhibited a high level of accuracy in the detection of three-rooted MFMs on panoramic radiographs.

Ridge dimensional changes and implant stability utilizing the osseodensification protocol: A randomized clinical trial.

There is limited evidence on the effect of osseodensification drilling (OD) on alveolar ridge dimension changes and implant stability compared to standard drilling (SD). The purpose of this study was to compare the effect of both drilling protocols on ridge dimensional changes and implant stability. Fifteen patients were recruited for a total of 20 pairs of implants. Pre- and postdrilling ridge widths were measured at the crest and 5 and 10mm apical to the crest, using a premarked surgical guide as a reference to standardize recordings. Following implant placement, insertion torque and implant stability quotients (ISQ) were recorded. ISQ were also recorded at 3, 6, and 12weeks post-op. Six-month post-op changes in buccal bone thickness (BBT) were measured via pre-op and post-op cone beam computed tomography (CBCT) superimposition analysis. Greater ridge width changes were observed at the crest and 5mm apical from the crest, favoring OD, with no difference at 10mm. When comparing BBT 6months post-op, OD maintained BBT better than SD. Additionally, greater insertion torque, ISQ, and high implant stability (HIS) were observed following OD compared to SD. OD results in greater ridge dimensional changes compared to SD following osteotomy preparation, predictably maintains BBT and reduces the risk of buccal dehiscence and resorption, obtains superior torque at placement, higher ISQ values, and a greater number of implants achieving HIS, which is maintained throughout the entire healing period.