Conventional Panoramic Radiography Research Articles

Comparison of the accuracy of bracket axial positioning with and without radiographic support and according to practitioner experience: A three-dimensional study

Accurate bracket positioning remains challenging. To avoid angulation errors, some recommend examining the panoramic radiograph during bonding. However, it can cause distortions. Cone-beam computed tomography (CBCT) provides a more precise panoramic reconstruction but with higher radiation doses. The main objective of this study is to compare the accuracy of axial positioning between direct bonding without radiography, with conventional panoramic radiograph, and with panoramic reconstruction from CBCT. The secondary objectives are to evaluate positioning accuracy of each tooth and to assess the influence of practitioner level of experience. Thirty practitioners, divided into two groups based on their experience performed direct bonding on a model thrice: without radiography, then with the conventional panoramic radiograph, then with the panoramic reconstruction from CBCT. Models were scanned, and angulation errors were measured using OrthoAnalyzer. Values were compared using the Friedman's test followed by the Bonferroni correction for multiple comparisons (P-value = 0.05). For the low level of experience group, angulation errors were significantly greater than the accepted limit without radiographic reference, and significantly lower with CBCT reconstruction. For the high level of experience group, angulation errors were significantly lower than the accepted limit for the three bonding methods. For every tooth, using the panoramic reconstruction from CBCT as a reference, was the most accurate method, regardless of the level of experience. More experienced practitioners made fewer errors for the three methods. Panoramic reconstruction from CBCT is the most accurate method to limit angulation errors during direct bonding. Conventional panoramic radiography remains a reliable tool if used with caution. Bonding without any radiographic reference should be avoided especially for less experienced practitioners.

Evaluation of Spectral X-Ray Imaging for Panoramic Dental Images Based on a Simulation Framework.

Modern photon counting detectors allow the calculation of virtual monoenergetic or material decomposed X-ray images but are not yet used for dental panoramic radiography systems. To assess the diagnostic potential and image quality of photon counting detectors in dental panoramic radiography, ethics approval from the local ethics committee was obtained for this retrospective study. Conventional CT scans of the head and neck region were segmented into bone and soft tissue. The resulting datasets were used to calculate panoramic equivalent thickness bone and soft tissue images by forward projection, using a geometry like that of conventional panoramic radiographic systems. The panoramic equivalent thickness images were utilized to generate synthetic conventional panoramic radiographs and panoramic virtual monoenergetic radiographs at various energies. The conventional, two virtual monoenergetic images at 40keV and 60keV, and material-separated bone and soft tissue panoramic equivalent thickness X-ray images simulated from 17 head CTs were evaluated in a reader study involving three experienced radiologists regarding their diagnostic value and image quality. Compared to conventional panoramic radiographs, the material-separated bone panoramic equivalent thickness image exhibits a higher image quality and diagnostic value in assessing the bone structure and details such as teeth or root canals . Panoramic virtual monoenergetic radiographs do not show a significant advantage over conventional panoramic radiographs. The conducted reader study shows the potential of spectral X-ray imaging for dental panoramic imaging to improve the diagnostic value and image quality.

Radiographic evaluation of mandibular third molars: an ex vivo comparative study between multilayer and conventional panoramic radiography.

To compare the multilayer panoramic radiography (MPAN) and conventional panoramic radiography (CPAN) in the evaluation of mandibular third molars using cone-beam computed tomography (CBCT) as a reference. CPAN, MPAN, and CBCT scans from 33 dry human mandibles were acquired using the OP300 Maxio unit, totalizing 56 mandibular third molars to be evaluated. Three examiners evaluated each third molar according to their position, depth of impaction in the mandibular ramus, proximity between the dental root apexes and the mandibular canal, and the presence of radiographic signs of proximity to the mandibular canal. In addition, when there was a distance between the root apexes and the mandibular canal, it was measured. As a reference, these same parameters were assessed in the CBCT scans by a fourth examiner. For the statistical analysis, the weighted Kappa, Bland Altman, and Wilcoxon tests were performed (α = 0.05). The agreement between the assessments performed in the panoramic modalities with the CBCT ranged from 66.1% to 100.0% for the categorical variables. Overall, the agreement values of CPAN and MPAN with CBCT were similar. The distances between the dental root apex and the mandibular canal for both CPAN and MPAN were significantly underestimated compared to CBCT (p < 0.05). The intra- and interexaminer agreements of the examiners ranged from poor to almost perfect; in general, the agreements were higher in the evaluation performed in the MPAN than in the CPAN. The MPAN performs similarly to CPAN for evaluating mandibular third molars and their proximity relationship to the mandibular canal. Preoperative evaluation of lower mandibular third molars is usually performed using CPAN. Recently, a new tool, MPAN, was developed, which has not yet been tested for the evaluation of mandibular third molars and showed similar performance to CPAN in the present study. Future studies using MPAN are encouraged to evaluate other diagnostic tasks.

Accuracy of Anatomical Depictions in Cone Beam Computed Tomography (CBCT)-Reconstructed Panoramic Projections Compared to Conventional Panoramic Radiographs: A Clinical Risk-Benefit Analysis.

Two-dimensional (2D) radiographs are the standard of care for diagnosis and treatment planning in the day-to-day practice of dentistry. With the growing popularity of cone beam computed tomography (CBCT), it is now becoming the standard of care in many areas of general dentistry due to its ability to create non-linear projections from volumetric data. The CBCT-generated non-orthogonal radiographs can serve as easy-to-use 2D and three-dimensional (3D) diagnostic tools and offer a similar experience for diagnosis as conventional 2D images. The aim of this study is to compare the accuracy of conventional radiographs and CBCT-generated projections to identify relevant anatomic landmarks and their associated variants. Thirty-two patients referred to the University of Connecticut School of Dental Medicine's Advanced Imaging Center were selected for this retrospective analysis. Nineteen anatomical landmarks were retrospectively assessed on conventional panoramic and CBCT scans generated panoramic radiographs using two different digital imaging and communications in medicine viewers. A total of 1,216 anatomical landmarks were evaluated by two oral and maxillofacial radiologists to assess the accuracy and consistency of the depiction of radiographic anatomy. There was a very good agreement between the two evaluators with a Cohen's kappa value of 0.934. McNemar change test concluded that the anatomical assessment values compared between conventional panoramic and CBCT-generated panoramic radiographs are similar. This study showed that CBCT-generated panoramic images are comparable to conventional panoramic radiographs in identifying anatomical landmarks typically evaluated using a conventional panoramic projection. In addition, they have the added advantage of having 3D information in the acquired volume to better evaluate the area of interest. In clinical situations where a mid- to large-volume CBCT scan is available, a simulated panoramic image can be generated using the CBCT volume, leaving exposure of the patient to the additional radiation of a panoramic image unnecessary.

Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis.

To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis. Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI). In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02). Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs.

Evaluation of sex dimorphism of the mandible with geometric morphometric analysis: conventional and reconstructed panoramic radiography study.

The purpose of the study was to investigate the mandible shape dimorphism between males and females both on conventional panoramic radiographs (cPR) and reconstructed panoramic radiographs obtained from cone beam computed tomography (rPR) with geometric morphometric method. Panoramic radiographs and cone beam computed tomography scans were performed on 33 males and 35 females with median age 23.0 (13.0-57.0) years old. The mandibular shape comparisons between genders were examined with Procrustes analysis, mandible shape classification analysis was made with principal component analysis and shape deformations were concluded from thin plate spline (TPS) analysis. Age had no statistically significant difference between gender (p = 0.580). For the shape of mandible on cPR and rPR, there were statistically significant differences between males and females (p = 0.002, p = 0.032, respectively). The shape variabilities of mandible on cPR for females were 0.054 and for males 0.053. The shape variabilities of mandible on rPR for females were 0.051 and for males 0.049. Both on cPR and rPR, the shape variability of the females' mandible was similar within their group, the shape variability of the males' mandible was similar within their group. In the examination of mandibular dimorphism in cPR, maximal deformations were seen in the region between the mandibular notch, posterior ramus, anterior ramus, gonion, in both sides, in TPS graphs. On the other hand, a high level of deformations was observed in all landmarks that define the mandibular shape on rPR. The mandible dimorphism can be detected in the examination performed with geometric morphometric methods on cPR and rPR. While mandible shape differences according to gender are seen most in the ramus region in cPR, differences can be detected in all landmarks in rRP.

Mandibular radiomorphometry analysis of children with HIV and healthy individuals on digital panoramic radiographs by age and sex

Objectives: The chronic systemic inflammatory process of HIV Human Immunodeficiency Virus) infection in children leads B cell activity to accelerate the osteoclastogenesis process, which results in bone alterations. Long-term usage of highly active antiretroviral medication results in decreased bone quality in HIV patients (HAART). Digital panoramic images are useful for radiomorphometric analysis of the mandibular macrostructure. Mandibular bone is a bone quality analysis that is often performed.&#x0D; Materials and Methods: This study comprised 86 digital panoramic radiographs of pediatric HIV patients and healthy persons. Secondary data in the form of digitized conventional panoramic radiographs of 43 pediatric HIV patients and 43 healthy individuals without clinical symptoms of HIV disease were utilized as a reference.&#x0D; Results: Mandibular morphometry values by sex in children with HIV and healthy adults showed (MCI) p-value 0.009, (GMI) p-value 0.934, (GI) p-value 0.584, (Go-Co) p-value 0.090, and (Co-M) p-value 0.919. Meanwhile, the results of the study with mandibular morphometric values ​​between children with HIV and healthy individuals index based on age revealed (MCI) p-value 0.490, (GMI) p-value 0.657, (GI) p-value 0.080, (Go-Co) p-value 0.147, (Co-M) p-value 0.158&#x0D; Conclusion: Mandibular morphology differed between HIV-infected children and healthy persons as measured by digital panoramic radiographs, with changes in mandibular resorption thickness, mandibular bone width, and mandibular bone thickness. Furthermore, there were no differences in values, height, and length of the mandible, as well as variances based on age and sex.

English

BACKGROUND A serious complication of surgical removal of impacted lower third molars is inferior alveolar nerve (IAN) injury. Evaluation of radiographic factors to predict IAN injury using CT and panoramic radiography includes root morphology assessment, follicular sac size, mandibular bone density, inferior alveolar nerve and vessels, condition of the overlying tissues, relation of the impacted tooth with the body and ramus of the mandible and the adjacent teeth. This study was done to evaluate the radiological features of the impacted lower mandibular teeth and their relationship with IAN through panoramic radiography and CT and to assess the most predictable radiological criteria for inferior alveolar nerve injury in impacted third molar surgery. METHODS All the patients indicated for lower third molar extraction were included in the study and pre-operative conventional panoramic radiographs (Planmeca Proline PM 2002 CC, Helsinki, Finland) and CBCT (Kodak CBCT) were taken. Any post-operative nerve injuries detected were followed up after 15 days or 1 month. Fisher’s exact test was done to find the association between the outcome variable and explanatory variables. RESULTS Only 11.4 % (N = 4) of all participants had IAN injury following surgical disimpaction. All the participants with IAN injury showed narrowing of the canal on their preoperative panoramic radiographs and presence of nerve approximation with the tooth in cone beam computed tomography (CBCT) reports (P &lt; 0.05). CONCLUSIONS A statistically significant association exists between IAN injury and nerve exposure, radiographic signs of nerve involvement for panoramic radiograph, level of third molar impaction, and nerve approximation in CBCT. KEY WORDS Inferior Alveolar Nerve Injury, Lower Third Molar Impaction, Panoramic Radiography, CBCT

New Insight on Pathophysiology, Diagnosis, and Treatment of Odontogenic Maxillary Sinusitis

Odontogenic maxillary sinusitis is often ignored by otolaryngologists, dentists, and imageological diagnosis doctors. Traditional treatments are often frustrating for refractory maxillary sinusitis and odontogenic maxillary sinusitis. In the last few years, new progress has been made in the diagnosis, pathophysiology, and treatment of odontogenic maxillary sinusitis. Periodontitis, polyposis, and iatrogenesis are regarded as causes of odontogenic maxillary sinusitis. Dental implant dislocation into the maxillary sinus and augmentation are the main cause of iatrogenesis compared to root canal full material. The symptoms are too similar to distinguish odontogenic maxillary sinusitis from chronic rhinosinusitis. Computed tomography is the gold standard for diagnosis, while it is difficult to rule out odontogenic maxillary sinusitis by conventional panoramic radiographs. Cone-beam computed tomography (CBCT) is currently the most broadly used to make diagnosis and differential diagnosis for maxillary sinus disease. The imaging diagnosis, clinical diagnosis, and pathological diagnosis are often not completely in accordance. Most researchers believe that odontogenic maxillary sinus infection results from the spread of apical pathogenic microbial infections: either through the local vascular system, lymphatic system, or the Haval system of the alveolar bone itself. DNA and RNA sequencing of mucosal tissues of maxillary sinus disease confirmed that the mechanisms of odontogenic maxillary sinusitis and nonodontogenic maxillary sinusitis are different. Microbial RNA sequencing of the maxillary sinus also verifies this conclusion. Clinical serum testing of chemical factors has not been widely exploited. It is unknown whether the thickening of the maxillary sinus membrane is the result of pathogen infection or inflammatory mediators. Many doctors have recommended a consensus on multidisciplinary cooperation management, but a global consensus has not yet been reached. Diagnosis methods for odontogenic maxillary sinus disease are diversified. Tissue DNA and RNA sequencing, chemical factor determination, and microbiological DNA and RNA sequencing have appeared, and the misdiagnosis rate has gradually decreased. The pathophysiology of odontogenic maxillary sinusitis and chronic rhinosinusitis is different. The molecular mechanism of the thickening of the Schneider membrane in odontogenic sinus is unknown.

Comparison of two established 2D staging techniques to their appliance in 3D cone beam computer-tomography for dental age estimation

For medicolegal purposes, orthodontic or orthognathic treatment various stomatological staging technique for age estimation with appliance of conventional radiographic images have been published. It remains uninvestigated if cone beam computer-tomography delivers comparable staging results to the conventional radiographic stages of third molar analysis. We conducted a retrospective cross-sectional study of 312 patients aged 13–21 years. Dental age estimation staging technique, introduced by Nolla and Demirjian, were applied on the left lower third molar imaged by conventional panoramic radiographs and cone beam computer-tomography. It was investigated if 2D and 3D imaging presented different staging results for dental age estimation. In 21% the Demirjian’s staging differed by a single stage between 2 and 3D images. The greatest congruence (87%) between 2 and 3D images was revealed for stage 7 (G). In contrary, stage 5 (E) presented the lowest level of congruence with 47.4%. The categorization of Nolla revealed divergences in staging for than two categorical variables in Nolla’s stages 3, 4, 5 and 6. In general, the analysis of the data displayed the divergence for Nolla’s stages 4–8. The staging results for 2D and 3D imaging in accordance to the rules of Nolla and Demirjian showed significant differences. Individuals of 18 years may present immature third molars, thus merely an immature third molar cannot reject legal majority. Nolla’s and Demirjian’s 2D and 3D imaging present significantly different staging results.

Evaluation of morphological variation of mandibular condyle using panoramic radiography

Background: The current study was done to evaluate variations of TMJ condylar morphology using conventional panoramic radiograph. Methods: This study comprised radiographic evaluation of 120 condylar heads of 60 patients. Then evaluate the mandibular condylar shape in 2D dimensional view (OPG). Results: In this study, 60 pairs of condylar heads were evaluated. Out of them 55% were oval in shape, followed by bird beak (30%), diamond (12%) and least being crooked finger (3%).Conclusion: Oval shape followed by bird beak type was found to be the most common in both genders with the condyle shape being symmetrical in about three quarters of the studied sample.

Perbedaan jumlah mikronukleus mukosa gingiva dan mukosa bukal akibat radiasi radiografi panoramik

Objectives: Panoramic radiography exposure causes DNA damage and micronucleus formation. The gingival mucosa and buccal mucosa were used to identify the number of micronucleus due to radiation exposure because they have a high prevalence of oral cancer in Southeast Asia. This research is aimed to determine the difference between micronucleus formation at the buccal mucosa and the gingival mucosa after exposed by conventional panoramic radiography in the Dentomaxillofacial Radiology Installation of Prof. Soedomo dental hospital, Universitas Gadjah Mada. &#x0D; Material and Methods: Samples were obtained by rolling the cervical brush against the buccal and gingival mucosa at 10 days after radiation exposure. Samples were stained using the Feulgen-Rossenbeck method and analyzed under binuclear light microscope with a 400x magnification.&#x0D; Results: Analysis of independent T tests showed that there was a significant difference (p&lt;0,05) in the increasing of micronucleus formation between the buccal mucosa and the gingival mucosa. The average difference in the number of micronucleus were 5,5/1000 cells. &#x0D; Conclusion: There were differences in the increasing of micronucleus between the buccal mucosa and the gingival mucosa due to exposure of conventional panoramic radiography. The buccal mucosa had higher increase than the gingival mucosa. &#x0D;

Reliability of Cone Beam Computed Tomography in Comparison with Panoramic Radiography to Predict the Anatomical Relationship of Inferior Alveolar Nerve with Mandibular Third Molar: A Radiological and Clinical Study.

ABSTRACTObjectives:The purpose of the study was to assess the precision of cone beam computed tomography (CBCT) in comparison with panoramic radiography in determining the anatomical relationship of inferior alveolar nerve (IAN) with the impacted mandibular third molar.Materials and Methods:Twenty patients diagnosed with the following panoramic radiographic markers: darkening of the root, interruption of white line of mandibular canal, diversion of mandibular canal, and narrowing of the roots suggesting a close relationship of roots with the mandibular canal were selected and underwent an additional CBCT to assess the proximity of IAN to mandibular third molar roots. All patients were assessed for loss of sensation or neurosensory deficit in the chin and lower lip during postoperative period by objective and subjective methods.Results:Twenty patients with an average age of 25.4 years (21–39 years) with 21 impacted mandibular third molars were included in this sample. It was found that after the removal of impacted third molars, IAN was not visible in any of the cases and postoperative objective and subjective neurosensory tests showed no signs of neurosensory disturbances.Conclusion:The study found that CBCT had limited usefulness in neurovascular bundle exposure prediction, prior to surgical removal of impacted mandibular third molars. The accuracy of radiographic markers in conventional panoramic radiography to predict neurovascular exposure was also limited.

Diagnostic accuracy and reliability of panoramic temporomandibular joint (TMJ) radiography to detect bony lesions in patients with TMJ osteoarthritis

Background/purposeThe value of the temporomandibular joint (TMJ) projections of panoramic radiography for diagnosing TMJ osteoarthritis is not completely elucidated. This study aimed to assess the diagnostic accuracy and reliability of panoramic TMJ radiography to detect bony lesions in patients with TMJ osteoarthritis. Materials and methodsThis study included 55 TMJs of 44 subjects who were diagnosed with TMJ osteoarthritis. They underwent panoramic radiography (PanRad), lateral (LatTMJ) and frontal (FrnTMJ) projection panoramic TMJ radiography, and cone-beam computed tomography (CBCT). All images were examined by two observers for flattening, erosion, and osteophytes on the condylar head and articular eminence of the TMJ. ResultsFor detecting flattening lesions on the mandibular condyle, the sensitivities of PanRad, LatTMJ, and FrnTMJ were less than 67% and the combination of LatTMJ and FrnTMJ (ComTMJ) had the highest sensitivity for both observers (67.6% and 79.7%, respectively). For erosion lesions, the sensitivity of ComTMJ for observer 1 was the highest, at 84.3%, whereas the specificity of ComTMJ was the lowest, at 37.5%. The sensitivities of all four methods for observer 2 were less than 54% and the specificities ranged from 75.0% to 100%. The overall diagnostic accuracy was highest for ComTMJ (64.3%), followed by LatTMJ (59.5%). The intraobserver reliability was good for one observer and excellent for the other, and the interobserver reliability was fair or moderate. ConclusionPanoramic TMJ radiography demonstrated limited diagnostic accuracy and acceptable reliability in detecting bony lesions of the TMJ, although it was better than conventional panoramic radiography.

OA193] Patient dosimetry during cone beam ct in dental implant planning

Purpose Cone beam CT (CBCT) is an advanced imaging technique compared to panoramic radiography and of lower cost than a conventional CT procedure. Its advantages are the focused imaging of the maxillofacial region and a reduced radiation exposure with relatively low cost. CBCT produces three-dimensional information on the facial skeleton and teeth in a few seconds time. The purpose of the study was to measure patient radiation exposure in terms of Kerma Area Product (KAP) in implant planning dentistry, to estimate effective dose (Ef) and to compare patient radiation doses with corresponding values from CT and conventional panoramic radiography, in clinical practice. Methods The X-ray system used was a CS9300 Carestream system. Patient sample included 168 individuals undergoing 211 CBCT examinations. Data recorded included: KAP, tube voltage, tube current, exposure time, field of view (FOV), patient age and clinical indication. Five examination types were selected in order to keep protocol settings as similar as possible. Results Patient mean age was 55 years. Patients underwent either 1 (80.2%), 2 (14.7%), 3 (2.5%) or >3 (2.3%) CBCT examinations. Protocol details were: 80–90 kV, 4–5 mA, 8 s exposure time and fixed FOV of 10*10 cm2. Mean (SD) KAP was 533 (112) mGy*cm2. Median KAP value was 530 mGy*cm2. A conversion factor of 0.08 mSv/Gycm2 was used to calculate Ef. Mean (SD) Ef was found 42.7 (9.0) μSv (median 42.4 μSv). A broad comparison was done with international data from dental dosimetry studies using different modalities, showing that CBCT requires 4–10 times lower radiation exposure than corresponding CT images, depending on examination type. At the same time, CBCT patient radiation exposure is 3–6 times higher than panoramic radiography. Conclusions CBCT is an accurate and useful tool for many clinical oral-maxillofacial indications. Although CBCT doses are significantly lower than conventional CT, yet they are higher than those from conventional imaging used in dentistry. Therefore, a risk/benefit analysis must be carried out before a CBCT investigation is requested.

Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment.

Odontogenic causes of sinusitis are frequently missed; clinicians often overlook odontogenic disease whenever examining individuals with symptomatic rhinosinusitis. Conventional treatments for chronic rhinosinusitis (CRS) will often fail in odontogenic sinusitis. There have been several recent developments in the understanding of mechanisms, diagnosis, and treatment of odontogenic sinusitis, and clinicians should be aware of these advances to best treat this patient population. The majority of odontogenic disease is caused by periodontitis and iatrogenesis. Notably, dental pain or dental hypersensitivity is very commonly absent in odontogenic sinusitis, and symptoms are very similar to those seen in CRS overall. Unilaterality of nasal obstruction and foul nasal drainage are most suggestive of odontogenic sinusitis, but computed tomography is the gold standard for diagnosis. Conventional panoramic radiographs are very poorly suited to rule out odontogenic sinusitis, and cannot be relied on to identify disease. There does not appear to be an optimal sequence of treatment for odontogenic sinusitis; the dental source should be addressed and ESS is frequently also necessary to alleviate symptoms. Odontogenic sinusitis has distinct pathophysiology, diagnostic considerations, microbiology, and treatment strategies whenever compared with chronic rhinosinusitis. Clinicians who can accurately identify odontogenic sources can increase efficacy of medical and surgical treatments and improve patient outcomes.

Feasibility of Dentascan in planning of implant surgery in posterior maxilla and mandible

ObjectivesThe present evaluate the feasibility of Computed tomography (Dentascan), in assessment of the implant site in posterior maxilla & mandible. Material and Methodsdata of total 11 patients with 20 implant sites were involved in the present study. Out of the 20 implant sites selected 10 were in posterior maxilla and 10 in posterior mandible. All the patients were routinely examined by panoramic radiography and CT. All images obtained i.e., conventional panoramic radiograph, and film based Dentascan MPR- CT images were evaluated for the detectability of mandibular canal at the mental foramen, 1cm, 2cm, and 3cm posterior to mental foramen. The judgments were then compared by using the four point grading score. ResultsBoth the statistical analysis and radiographic observation showed that Dentascan MPR CT gives significantly clearer images at the mental foramen and 1cm, 2cm , 3cm posterior to it. Dentascan also provides significantly better visualization of the vital structures along with the bone density. The panoramic and Dentascan MPR CT images did not show a significant difference in visualization of the crest of alveolar ridge in both maxillary as well as the mandibular arch. ConclusionThe Dentascan MPR- CT images revealed significantly clearer images as well as better visualization of the vital structures than conventional panoramic radiography. Apart from providing clearer images Dentascan also gives the buccopalatal/buccolingual dimension at the implant site, along with the density of the available bone.

Quantification by Quadrants of the Distortion Present in Conventional Panoramic Radiograph

Quantification by Quadrants of the Distortion Present in Conventional Panoramic Radiograph

Accuracy and head positioning effects on measurements of anterior tooth length using 3-dimensional and conventional dental panoramic radiography.

The purposes of this study were to examine the accuracy and the head positioning effects on measurements of anterior tooth length using 3-dimensional (3D) and conventional dental panoramic radiography and to investigate whether 3D panoramic radiography is suitable for the evaluation of anterior tooth length. A simulated human head was radiographed at 4, 8, and 12mm displaced positions, and at 5°, 10°, and 15° tilted positions from the standard head position using 3D and conventional panoramic radiography, and also using cone-beam computed tomography. Anterior tooth lengths were measured on the panoramic and cone-beam computed tomography images. The values for the standard head position in the panoramic radiographs were defined as the standard values. Measurement error was defined as the standard value minus the cone-beam computed tomography value on each panoramic radiograph. The head position ratio of the measurement value to the standard value at each head position was calculated. Measurement errors for the 3D panoramic radiographs were significantly smaller than those for the conventional panoramic radiographs. In the 3D panoramic radiographs, the head position ratios at the 4, 8, and 12mm displaced positions and at the 5° tilted position were within ±5% of the standard value. Three-dimensional panoramic radiography is suitable for the quantitative evaluation of anterior tooth length with high accuracy.

Letters to the Editor.

Letters to the Editor.