Dental Radiographs Research Articles

In Vivo Bone Regeneration Capacity of Multiscale Porous Polycaprolactone-Based High Internal Phase Emulsion (PolyHIPE) Scaffolds in a Rat Calvarial Defect Model.

Globally, one of the most common tissue transplantation procedures is bone grafting. Lately, we have reported the development of polymerized high internal phase emulsions (PolyHIPEs) made of photocurable polycaprolactone (4PCLMA) and shown their potential to be used as bone tissue engineering scaffolds in vitro. However, it is essential to evaluate the in vivo performance of these scaffolds to investigate their potential in a clinically more relevant manner. Therefore, in this study, we aimed to compare in vivo performances of macroporous (fabricated using stereolithography), microporous (fabricated using emulsion templating), and multiscale porous (fabricated using emulsion templating and perforation) scaffolds made of 4PCLMA. Also, 3D-printed macroporous scaffolds (fabricated using fused deposition modeling) made of thermoplastic polycaprolactone were used as a control. Scaffolds were implanted into a critical-sized calvarial defect, animals were sacrificed 4 or 8 weeks after implantation, and the new bone formation was assessed by micro-computed tomography, dental radiography, and histology. Multiscale porous scaffolds that include both micro- and macropores resulted in higher bone regeneration in the defect area compared to only macroporous or only microporous scaffolds. When one-grade porous scaffolds were compared, microporous scaffolds showed better performance than macroporous scaffolds in terms of mineralized bone volume and tissue regeneration. Micro-CT results revealed that while bone volume/tissue volume (Bv/Tv) values were 8 and 17% at weeks 4 and 8 for macroporous scaffolds, they were significantly higher for microporous scaffolds, with values of 26 and 33%, respectively. Taken together, the results reported in this study showed the potential application of multiscale PolyHIPE scaffolds, in particular, as a promising material for bone regeneration.

Application of Kvaal’s Age Estimation Method in Maxillary Central Incisor: A CBCT Study

Background: Radiographic dental age estimation methods are viable both for living and deceased people. One such method is the indirect assessment of quantified secondary dentinal deposition through measurements of tooth and pulp. Kvaal, et al., developed a method for chronological age estimation based on pulp size using periapical dental radiographs. There is a need to test this method of age estimation in the Indian population on living individuals not requiring tooth extraction. The current study aimed to assess the applicability of Kvaal’s method in maxillary permanent central incisor using CBCT. Materials and Methods: The study included 185 CBCT images of the individuals, ranging in age from 14 to 64 years. CBCT images were evaluated for the maxillary central incisor and metric measurements were taken from which ratios were derived. Using the ratios, a linear regression equation was derived, from which the age of an individual was predicted. Result and Conclusion: The correlation between the individual ratio and the chronological age was calculated using the Pearson correlation coefficient. The age of the individual was predicted using a linear regression equation with a SEE ranging from 10.05 to 12.78 years. When the samples were divided into various age groups, the Standard Error of Estimate has drastically reduced. The radiographic pulpal morphometric analysis used in present study can be recommended to assess the age of an adult for forensic purposes.

Parents' perspective towards dental radiography for children

Background/purposeRadiographs provide critical information on developmental and eruption problems, detection of interface caries, pulpal and periapical pathologies in clinical examination. This study aimed to evaluate parents' knowledge, attitudes and behaviors towards dental radiographs. Materials and methodsA cross-sectional study was conducted on the parents of 396 children who visited to the Pediatric Dentistry clinics. All participants were asked to answer a total of 26 questions. A questionnaire was developed to assess participants' attitudue, behavior and knowledge toward pediatric dental radiographies and provided information on their demographic characteristics. The number of positive attitudes and correct answers was scored based on items asked to the participants. In order to analyze the effect of demographic data on the obtained scores, a multivariate linear regression model was created. The significance level was accepted as 0.05 in all analyzes. ResultsChildren's dental radiography experience affects parents' attitude score towards dental radiographs (t = 4.375, P < 0.001). Parents' level of knowledge about dental radiography has a positive effect on their attitudes (t = 5.510, P = 0.005). The education level of the parents and the frequency of visits to the dentist have a significant effect on the knowledge level of the parents about dental radiography (P < 0.05). When the correlation between knowledge and attitude scores is analyzed, it is observed that there is a statistically significant, weak and positive correlation between the two variables (r = 0.34, P < 0.001). ConclusionIn conclusion, parents who did not had dental radiographs before have a more negative attitude towards dental radiographs than those who have had dental radiographs.

Unsupervised knowledge representation of panoramic dental X-ray images using SVG image-and-object clustering

Unsupervised knowledge representation of panoramic dental X-ray images using SVG image-and-object clustering

Assessment of the Occupational Radiation Dose from a Handheld Portable X-ray Unit During Full-mouth Intraoral Dental Radiographs in the Dog and the Cat - A Pilot Study.

Occupational radiation protection is an important consideration in small animal clinics world-wide. With the increased use of portable handheld X-ray devices in veterinary dentistry, concerns related to occupational radiation protection are being raised. Annual occupational dose limits for dental workers are expressed as Total Dose Equivalent (TDE) or Effective Dose. The permitted TDE can vary depending on the anatomical region, ranging from 50 millisieverts (mSv) for the external whole body exposure dose to 500 mSv for external exposure of the skin or an extremity. Although several studies have been performed in human dentistry to establish the amount of backscatter radiation produced using portable handheld X-ray devices, no similar research has been conducted in veterinary dentistry. This study aimed to determine the TDE while acquiring a full mouth intraoral radiograph set in dogs and cats and to estimate the TDE for a handheld X-ray device's operator. For this, the backscatter radiation dose recorded by three sets of monitoring dosimeters located in strategic anatomical areas of the operator was assessed after taking one hundred intraoral radiographs in each group. The study concluded that the backscatter radiation levels were far below the permitted annual occupational doses in the three patient groups of this study. Even though the portable handheld X-ray unit was demonstrated to be a safe dental radiographic unit regarding backscattering radiation, the operator's eye, ovary, and breast regions were exposed to unnecessary radiation.

Radiološka dijagnostika sijalolitijaze

The existence of possible pathological conditions of the salivary glands requires the use of certain imaging techniques, which contributes to a better diagnosis of the disorder and proper treatment. Stones, inflammatory processes and tumors are conditions that are accompanied by unpleasant symptoms inside the oral cavity. Sialolithiasis is the presence of stones in the salivary glands and is a common pathological disorder. The aim of this paper is to present the diagnostic imaging of sialolithiasis. That includes the methods of dental radiography and different methods of sialography. Conventional imaging techniques in dental radiography have been abandoned over time. USG and sialography methods are more often used in clinical practice nowadays. Sialographic methods include the application of a contrast medium, which results in a better visualization of the excretory ducts of the salivary glands, in both conventional and digital imaging. CT and MRI sialography methods visualize smaller stones better in the salivary excretory ducts, with some limitations. The results of the recently reviewed scientific researches show that the radiographic imaging methods for sialolithiasis are complementary. Sialography and USG are the initial methods in diagnosing sialolithiasis, but the use of CT and MR can provide valuable additional diagnostic information.

Prevalence of soft tissue calcifications in the maxillofacial region

Aim: To evaluate the prevalence of soft tissue calcifications in orofacial region and their panoramic radiographic characteristics using digital panoramic radiographs among patients reporting to a tertiary dental hospital. Methods: 1,578 digital panoramic radiographs were retrieved from the archives and scrutinized for the presence of calcifications. Soft tissue calcifications were recorded according to age, gender, site (left or right). Data were analysed using Chi-square and Fisher’s exact test using SPSS software and a p &lt; 0.05 was considered statistically significant. Results: Among the total number of radiographs, calcified carotid artery (34.3%), calcified stylohyoid ligament (21%), tonsillolith (10.3%), phlebolith (17.6%), antrolith (6.3%), sialolith (5.9%), rhinolith (2.5%) and calcified lymph nodes (1.9%) were identified. The most commonly observed calcifications were calcification of carotid artery and stylohyoid ligament and the least commonly observed calcifications were rhinolith and calcified lymph node. A statistically significant association of the presence of calcifications of carotid artery and stylohyoid ligament on the left and right side was observed in females and tonsillolith on the right side in males (p-value &lt; 0.05). Considering the gender and age group, the occurrence of antrolith among males and rhinolith among females of young-adult population, tonsillolith among the males, calcified carotid artery and stylohyoid ligament among the females of middle-aged population was found to be significant. Conclusion: Soft tissue calcifications are often encountered in dental panoramic radiographs. Our study revealed that the soft tissue calcifications in orofacial region were more common in women and were found to be increased above 40 years of age.

Türkiye’deki Çocuk Diş Hekimlerinin Dental Radyografi Bilgi ve Tutumlarının Değerlendirilmesi

Aim: The aim of this study is to evaluate the knowledge levels and attitudes of pediatric dentists regarding the use of dental radiography through an online survey. Materials and Method: A data collection form consisting of a total of 17 questions and 2 basic parts, which was prepared in accordance with the current guidelines of the European Academy of Pediatric Dentistry regarding the use of radiography in 2020, was used. The first part of the form was prepared to evaluate the sociodemographic characteristics of the participants and the second part of the form was for the evaluation of the participants’ level of knowledge about the use of radiography in pediatric dentistry. In the analysis of the data, descriptive statistics, mean values, frequencies and proportions were calculated. The chisquare test was used to determine the association between categorical variables. Results: 131 pediatric dentists participated in the study. In accordance with the Guideline recommendation, 40.5% of dentists stated that they preferred bite-wing radiographs as the first choice for the detection and diagnosis of dental caries and 77% stated that they preferred periapical radiographs as the first choice for dental trauma. Conclusion: Even though pediatric dentists in Türkiye usually choose the most appropriate radiographic technique for most clinical situations; knowledge levels need to be increased for more precise diagnosis and treatment planning and radiation protection.

Facial, lingual, and infraorbital artery calcification: A rare incidental radiographic finding

Identifying calcification of arteries in the head and neck region may aid in the diagnosis of advanced systemic conditions. In contrast, failure to recognize them can result in incorrect diagnoses and ineffective treatments. Radiographic analyses can be used to detect such calcifications. This report focuses on calcifications discovered in the facial, lingual, and infraorbital arteries following a routine dental care panoramic radiograph. This report is particularly notable because it is the second in the literature to highlight the calcification of all three arteries.

A retrospective comparative fractal and radiomorphometric analysis of the effect of 3 generations of anti-epileptic drugs on the mandible

The present study investigated the possible impacts of anti-epileptic drugs (AEDs) on trabecular and cortical bone in the mandible. Fractal dimension (FD) and the radiomorphometric parameters of mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) were assessed on 497 dental panoramic radiographs (DPRs) of patients in the case group and controls. AEDs were compared according to 3 generations, duration of use, and patient age and sex. FD of the angle and body of the mandible and MCW were significantly lower in the case group than in the control group (P < .001). FD values in the ramus and angle were lower in first-generation and third-generation AEDs than in second-generation drugs (P ≤ .011). FD in the mandibular body was lower in first-generation and second-generation AED users than in third-generation drugs (P=.017). Drug use for at least 1 year resulted in significantly lower values for all FDs and MCW values and more class 3 MCI assessments than short-duration use, but PMI was higher with more than 1 year of AED use (P ≤ .020). Age and sex had no significant effects. AEDs caused significant changes in bone compared with controls in some FD values, MCW, and MCI. The effect of drug generation is pronounced in trabecular bone. Anti-epileptic drug use for more than 1 year had a greater effect than short-term use.

The effect of age and gender on tooth loss in different jaw areas and fixed prosthetic dental treatments

Aim: Rehabilitation of tooth losses with fixed prosthesis applications is still a highly preferred option today. Teeth are the most important components for chewing function, proper phonation, and aesthetics. The aim of the study is to examine the relationship between tooth loss and fixed prosthetic restorations in patients of different age groups and genders. Methodology: In this study, a total of 300 patients were studied to examine the relationship between tooth deficiencies and the number of fixed restorations applied with gender and age. These patients were divided into two gender groups, male and female, and six age groups, with n = 25 in each group. Fixed prosthetic restorations in the missing teeth and mouths of the patients were recorded on dental panoramic radiographs. Statistical analysis was conducted with the one-way ANOVA test. Results: Tooth loss and the number of prosthetic applications increased statistically with age, but no statistical difference was found with gender. The Independent samples t-test analysis of variances was used in this study (p &lt; 0.05). Conclusion: Tooth loss increases in patients with age due to many factors. This problem should be prevented by popularizing preventive dental practices. Female patients with poor dental hygiene and tooth loss associated with hormonal changes in specific age ranges have increased. How to cite this article: Keçeci M, Demirel MG. The effect of age and gender on tooth loss in different jaw areas and fixed prosthetic dental treatments. Int Dent Res 2023;13(1):7-12. https://doi.org/10.5577/idr.2023.vol13.no1.2 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

The correlation of the change in vertical angulation of the beam in the bisecting technique to the length of the tooth

Objectives: To find out the correlation between changes in vertical angle beam in periapical radiography of bisecting techniques to the length dimension of the tooth.&#x0D; Materials and Methods: This study was a study using laboratory experimental methods. The samples used in this study were incisor 1, incisor 2, canine, premolar 1, premolar 2, molar 1, and molar 2 region 1. Based on the results of the minimum number of samples at G*power, measures of effect size f (0.4512937), α err prob (0.05), power (1-β err prob) (0.8), number of groups (5), number of measurements (2), corr among rep measurements (0.6), nonpersphericity correction € ( (1). All teeth are treated in the form of a change in angle from the standard angle recommended by White and Pharoah to -10°, -5°, 0°, +5°, +10° , +10° in each tooth using the Dental X-ray unit of Veraview V080 type EX-2 70 kV. 7 mA.&#x0D; Results: Based on Saphiro-Wilk, Kruskall-Wallis, and Paired t-test tests, it is known that there is a significant relationship between the actual length of the tooth and the length of the radiograph result in the change of angle + foreshortening, and the change of angle - the elongation. However, this does not apply to molar teeth 1 and 2 at positive angle changes However, this does not apply to molar teeth 1 and 2. A change in angle -10° is a change in angle with a better degree.&#x0D; Conclusion: There is a correlation between the change in vertical angle beam in the periapical radiography of bisecting techniques to the length dimension of the tooth.

Experimental validation of computer-vision methods for the successful detection of endodontic treatment obturation and progression from noisy radiographs

Purpose(1) To evaluate the effects of denoising and data balancing on deep learning to detect endodontic treatment outcomes from radiographs. (2) To develop and train a deep-learning model and classifier to predict obturation quality from radiomics.MethodsThe study conformed to the STARD 2015 and MI-CLAIMS 2021 guidelines. 250 deidentified dental radiographs were collected and augmented to produce 2226 images. The dataset was classified according to endodontic treatment outcomes following a set of customized criteria. The dataset was denoised and balanced, and processed with YOLOv5s, YOLOv5x, and YOLOv7 models of real-time deep-learning computer vision. Diagnostic test parameters such as sensitivity (Sn), specificity (Sp), accuracy (Ac), precision, recall, mean average precision (mAP), and confidence were evaluated.ResultsOverall accuracy for all the deep-learning models was above 85%. Imbalanced datasets with noise removal led to YOLOv5x’s prediction accuracy to drop to 72%, while balancing and noise removal led to all three models performing at over 95% accuracy. mAP saw an improvement from 52 to 92% following balancing and denoising.ConclusionThe current study of computer vision applied to radiomic datasets successfully classified endodontic treatment obturation and mishaps according to a custom progressive classification system and serves as a foundation to larger research on the subject matter.

Recognition and segmentation of teeth and mandibular nerve canals in panoramic dental X-rays by Mask RCNN

This study proposes a method based on the instance segmentation algorithm Mask RCNN for recognizing and segmenting 32 teeth and 2 mandibular nerve canals in panoramic dental X-rays. Compared with Faster RCNN, Mask RCNN has an additional semantic segmentation branch, which could directly obtain the position of teeth and the information about mandibular nerve canals in this study. At the same time, Mask RCNN introduces ROI Align, making Mask segmentation more accurate. A total of 120 training sets, 40 validation sets, and 120 test sets were used in the training and testing process. Forty of the test sets were used to test the full-tooth panoramic dental X-rays, and 40 were used for the edentulous panoramic dental X-rays, with 40 for the mandibular canals. The average precision, recall, and F1-score values of the full teeth were 96.59 %, 96.4 %, and 96.5 %, respectively. The Pm value of the defined edentulous panoramic dental X-rays was 95.41 %, and the average precision, recall, and F1-score values of mandibular canals were 76.05 %, 83.70 %, and 78.10 %, respectively. The results showed that the algorithm could effectively identify each tooth, including missing teeth and mandibular nerve canals in panoramic dental X-rays, solving the problem of too many oral structures in panoramic dental X-rays, which makes it difficult to determine the overall oral state. This study will help other researchers promote the research on artificial intelligence-assisted diagnosis in the oral field.

Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents.

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm2 and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm2 and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics-reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.

Deep convolution neural network for screening carotid calcification in dental panoramic radiographs.

Ischemic stroke, a leading global cause of death and disability, is commonly caused by carotid arteries atherosclerosis. Carotid artery calcification (CAC) is a well-known marker of atherosclerosis. Such calcifications are classically detected by ultrasound screening. In recent years it was shown that these calcifications can also be inferred from routine panoramic dental radiographs. In this work, we focused on panoramic dental radiographs taken from 500 patients, manually labelling each of the patients' sides (each radiograph was treated as two sides), which were used to develop an artificial intelligence (AI)-based algorithm to automatically detect carotid calcifications. The algorithm uses deep learning convolutional neural networks (CNN), with transfer learning (TL) approach that achieved true labels for each corner, and reached a sensitivity (recall) of 0.82 and a specificity of 0.97 for individual arteries, and a recall of 0.87 and specificity of 0.97 for individual patients. Applying and integrating the algorithm in healthcare units and dental clinics has the potential of reducing stroke events and their mortality and morbidity consequences.

Age Group Classification of Dental Radiography without Precise Age Information Using Convolutional Neural Networks.

Automatic age estimation using panoramic dental radiographic images is an important procedure for forensics and personal oral healthcare. The accuracies of the age estimation have increased recently with the advances in deep neural networks (DNN), but DNN requires large sizes of the labeled dataset which is not always available. This study examined whether a deep neural network is able to estimate tooth ages when precise age information is not given. A deep neural network model was developed and applied to age estimation using an image augmentation technique. A total of 10,023 original images were classified according to age groups (in decades, from the 10s to the 70s). The proposed model was validated using a 10-fold cross-validation technique for precise evaluation, and the accuracies of the predicted tooth ages were calculated by varying the tolerance. The accuracies were 53.846% with a tolerance of ±5 years, 95.121% with ±15 years, and 99.581% with ±25 years, which means the probability for the estimation error to be larger than one age group is 0.419%. The results indicate that artificial intelligence has potential not only in the forensic aspect but also in the clinical aspect of oral care.

A novel technique for dental radiographic image segmentation based on neutrosophic logic

Oral diseases are very prevalent worldwide and affect people of all ages. Dentists depend on x-rays to study the characteristics of oral diseases. The segmentation and analysis of dental X-ray images pose various challenges compared to other medical images. This makes dental X-ray imaging more challenging because of poor resolution, which makes the segmentation of different parts of teeth and their abnormalities unreliable. It has been shown that Dental X-ray Image Segmentation (DXIS) is a primary and critical step in obtaining relevant and important details about oral diseases. DXIS plays a crucial role in practical dentistry to help identify various periodontal diseases. The proposed methodology automatically segments the teeth regions and assists in further analysis. It works on both peri-apical and panoramic types of dental radiographic images. Neutrosophic logic is used to select the initial region of interest. The best way to improve the performance and make the system faster is to restrict the computation within the foreground regions. The input dental radiographic image is mapped into the neutrosophic domain using the patch level feature, gradient feature, entropy feature, and local binary pattern. Applying neutrosophic logic helps to localize the initial region of interest. Subsequently, a fuzzy c-means algorithm is applied to segment a more accurate region of interest. The proposed methodology has been evaluated on publicly available data sets, ‘Panoramic Dental X-rays with Segmented Mandibles’ and ‘Digital Dental X-ray Database for Caries Screening,’ with the result that the accuracy of the proposed methodology is as high as 93.20%. This performance level confirms that the proposed segmentation technique highly correlates with the manual system.

Panoramic X-ray Radiation Exposure Safety Test at ATRO Muhammadiyah Makassar

Introduction: The radiation safety protocol is an effort made to create conditions so that the dose of ionizing radiation that affects humans and the environment does not exceed the specified limit value. This study aimed to measure exposure to X-ray radiation on panoramic X-rays at ATRO Muhammadiyah Makassar.&#x0D; Methods: This research was conducted at the radiology department of ATRO Muhammadiyah Makassar in December 2022. The tools and materials that will be used in this research are dental X-ray planes, survey meters, and perspex phantom, with a thickness of 10 mm, as a substitute for organs in humans. Measurement of the radiation dose exposure in dental X-ray examinations was carried out using an exposure factor of 70 kV, 8 mA at a distance of 1 meter, 2 meters, 3 meters, and 4 meters from various directions, namely front, left side, right side, and back with time. Different exposure on each object.&#x0D; Results: The highest dose intensity value was found at 0.25 seconds with a distance of 1 meter in the forward direction with a dosing accuracy of 138.4 (µSv/h). The lowest point is at 0.17 seconds with a distance of 3 meters behind with a dosing accuracy of 0.89 (µSv/h) for an officer who is in the radiation field during irradiation.&#x0D; Conclusion: The safe distance for a radiation officer and the general public who must be in the radiation field to assist patients during an examination is 4 meters from the radiation source.

Establishment of a local diagnostic reference level for dental intraoral bitewing X-rays.

A state-based local diagnostic reference level (LDRL) for dental intraoral X-rays has been established. LDRL values of 2.0 mGy incident air kerma (IAK) and 57 mGy•cm2 air kerma-area product (KAP) for an adult posterior bitewing X-ray were determined based on 811 X-ray units surveyed. This IAK LDRL value is greater than those established in several other nations and regions around the world in similar studies. Analyses of radiographic technique and equipment usage are included to provide broad guidance as to ways that imaging could be optimised, such as in the selection of exposure factors, collimators, image receptors, and X-ray unit models.