Panoramic Radiographs Research Articles

A cascading learning method with SegFormer for radiographic measurement of periodontal bone loss

ObjectiveMarginal alveolar bone loss is one of the key features of periodontitis and can be observed via panoramic radiographs. This study aimed to establish a cascading learning method with deep learning (DL) for precise radiographic bone loss (RBL) measurements at specific tooth positions.Materials and methodsThrough the design of two tasks for tooth position recognition and tooth semantic segmentation using the SegFormer model, specific tooth’s crown, intrabony portion, and suprabony portion of the roots were obtained. The RBL was subsequently measured by length through these three areas using the principal component analysis (PCA) principal axis.ResultsThe average intersection over union (IoU) for the tooth position recognition task was 0.8906, with an F1-score of 0.9338. The average IoU for the tooth semantic segmentation task was 0.8465, with an F1-score of 0.9138. When the two tasks were combined, the average IoU was 0.7889, with an F1-score of 0.8674. The correlation coefficient between the RBL prediction results based on the PCA principal axis and the clinicians’ measurements exceeded 0.85. Compared to those of the other two methods, the average precision of the predicted RBL was 0.7722, the average sensitivity was 0.7416, and the average F1-score was 0.7444.ConclusionsThe method for predicting RBL using DL and PCA produced promising results, offering rapid and reliable auxiliary information for future periodontal disease diagnosis.Clinical relevancePrecise RBL measurements are important for periodontal diagnosis. The proposed RBL-SF can measure RBL at specific tooth positions and assign the bone loss stage. The ability of the RBL-SF to measure RBL at specific tooth positions can guide clinicians to a certain extent in the accurate diagnosis of periodontitis.

Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study.

This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8-18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner's classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates' impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates' long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.

Performance of a commercially available Generative Pre-trained Transformer (GPT) in describing radiolucent lesions in panoramic radiographs and establishing differential diagnoses.

To evaluate the performance of a commercially available Generative Pre-trained Transformer (GPT) in describing and establishing differential diagnoses for radiolucent lesions in panoramic radiographs. Twenty-eight panoramic radiographs, each containing a single radiolucent lesion, were evaluated in consensus by three examiners and a commercially available ChatGPT-3.5 model. They provided descriptions regarding internal structure (radiodensity, loculation), periphery (margin type, cortication), shape, location (bone, side, region, teeth/structures), and effects on adjacent structures (effect, adjacent structure). Diagnostic impressions related to origin, behavior, and nature were also provided. The GPT program was additionally prompted to provide differential diagnoses. Keywords used by the GPT program were compared to those used by the examiners and scored as 0 (incorrect), 0.5 (partially correct), or 1 (correct). Mean score values and standard deviation were calculated for each description. Performance in establishing differential diagnoses was assessed using Rank-1, -2, and - 3. Descriptions of margination, affected bone, and origin received the highest scores: 0.93, 0.93, and 0.87, respectively. Shape, region, teeth/structures, effect, affected region, and nature received considerably lower scores ranging from 0.22 to 0.50. Rank-1, -2, and - 3 demonstrated accuracy in 25%, 57.14%, and 67.85% of cases, respectively. The performance of the GPT program in describing and providing differential diagnoses for radiolucent lesions in panoramic radiographs is variable and at this stage limited in its use for clinical application. Understanding the potential role of GPT systems as an auxiliary tool in image interpretation is imperative to validate their clinical applicability.

A robust deep learning model for the classification of dental implant brands

ObjectiveIn cases where the brands of implants are not known, treatment options can be significantly limited in potential complications arising from implant procedures. This research aims to explore the application of deep learning techniques for the classification of dental implant systems using panoramic radiographs. The primary objective is to assess the superiority of the proposed model in achieving accurate and efficient dental implant classification. Material and MethodsA comprehensive analysis was conducted using a diverse set of 25 convolutional neural network (CNN) models, including popular architectures such as VGG16, ResNet-50, EfficientNet, and ConvNeXt. The dataset of 1258 panoramic radiographs from patients who underwent implant treatment at faculty of dentistry was utilized for training and evaluation. Six different dental implant systems were employed as prototypes for the classification task. The precision, recall, F1 score, and support scores for each class have included in the classification accuracy report to ensure accurate and reliable results from the model. ResultsThe experimental results demonstrate that the proposed model consistently outperformed the other evaluated CNN architectures in terms of accuracy, precision, recall, and F1-score. With an impressive accuracy of 95.74 % and high precision and recall rates, the ConvNeXt model showcased its superiority in accurately classifying dental implant systems. Notably, the model's performance was achieved with a relatively smaller number of parameters, indicating its efficiency and speed during inference. ConclusionThe findings highlight the effectiveness of deep learning techniques, particularly the proposed model, in accurately classifying dental implant systems from panoramic radiographs.

Retrospective evaluation of condylar morphology using panoramic radiography in a sample of Turkish population.

The temporomandibular joint is one of the most complex anatomic structures. It takes a great role in masticatory system and helps to make possible some functions such as speaking, chewing and swallowing. Clinicians should have sufficient anatomical knowledge to assess relationships of the hard and soft tissues, including the mandibular condyle, glenoid fossa, articular eminence of the temporal bone, the articular disc and its attachments. The aim of this study was to evaluate the frequency of different types of mandibular condyles and its distribution according to the age and gender. It was also evaluated whether the condyle types were bilaterally symmetrical or not. A total of 1315 digital panoramic images which obtained from the patients suffering from the dental problems were assessed. Demographic data, condylar morphology were noted. All obtained data were analysed by using descriptive statistics. Morphology of mandibular condyles were classified into four shapes as identified in other studies, namely: type I - oval shape, type II - diamond shape, type III - bird beak shape, type IV - crooked finger shape. Two independent examiners, who have 19 and 7 years of experience in oral and dentomaxillofacial radiology, made a consensus and evaluated all images. A total of 1315 digital panoramic images were assessed. Seven hundred sixty-seven [58.3%] the patients were female and 548 [41.6%] were male. The age range of patients was from 18 to 84 years. Right-left condyle types were found to be symmetrical in the range of 67% of the subpopulation examined in the study. For the consensus, 'oval' condyle was common on both the right and left, while 'crooked finger' condyle was the rarest. The temporomandibular joint is the most important structure for all jaw functions such as speech, swallowing. In order for all these functions to continue in a healthy way, the anatomical structure should be known very well down to the finest detail. Identification of anatomical structures and their variations can play an important role in implant dentistry. Clinicians commonly prefer conventional radiologic methods to evaluate dentomaxillofacial region. Although the most of the variations are asymptomatic and require no treatment,correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans.

Anatomical assessment of the trabecular structure of the alveolar bone in periodontal disease by fractal analysis method.

Early diagnosis and treatment of periodontitis, which can cause loss of bone support of the teeth, is of great importance. The use of fractal analysis method is being investigated in order to differentiate periodontal disease radiographically. Fractal analysis presents the degree of complexity in the structure of fractal objects as a numerical data, and has been used to measure changes in trabecular bone. The aim of this study was to compare the trabecular bone fractal dimension (FD) values of patients with periodontitis and gingivitis using panoramic radiographs, and to evaluate the possible relationship between age and gender with fractal dimension. Panoramic radiographs of 64 patients with gingivitis and 64 patients with periodontitis were evaluated retrospectively in the study. Using the radiographs of the patients, FD values measured from the trabecular bone were calculated with the box-counting method in the Image J programme. The FD values of both groups were compared. In addition, the relationship between age and gender parameters and FD values was evaluated within the groups. According to the results of the study, the calculated average FD value of the patients in the gingivitis group was 1.195, while the calculated average FD value of the patients in the periodontitis group was 1.196. No statistically significant difference was observed between the FD values of the gingivitis group and the periodontitis group (p > 0.05). No statistically significant correlation was observed between FD values and age and gender (p > 0.05). No statistically significant results were obtained for the calculated mean FD values of the patients in the gingivitis and periodontitis groups.

Exploring Age and Gender Identification Through Mandibular Parameters Using Orthopantomography: An Observational Study.

Aim This study aimsto examine five mandibular parameters: coronoid ramus height, condylar ramus height, projective ramus height, minimum ramus breadth, and gonial angle, using orthopantomography (OPG). Introduction The mandible, a crucial part of the human skull, demonstrates sexual dimorphism, which makes it an important tool for determining sex in forensic and anthropological investigations.Its form and structure are relatively resistant to significant changes after death. Among all skeletal components, the mandible stands out as a primary indicator of sexual differences. In forensic investigations, establishing the age and sex of an individual is considered a crucial initial step. This process can be particularly challenging in scenarios involving mass casualties, natural calamities, or extensively fragmented remains. Due to its responsiveness to growth patterns, the mandible is adept at accurately determining both age and sex. Materials and methods This study employed a sample size of 500 individuals, split equally between males and females, with 250 participants each. The age bracket chosen for this cohort ranged from 20 to 30 years, considering that bone growth characteristics within this range can assist in sex determination. The height of the mandibular ramus was assessed using Planmeca software, and subsequent data analysis was conducted using SPSS. Results When estimating age, the condylar ramus height exhibited the smallest standard error (0.010), whereas the maximum standard error for the gonial angle was 0.028. Positive t values were observed for the gonial angle (1.182), minimum ramus breadth (0.114), and coronoid ramus height (0.733). In terms of determining sex, the gonial angle, coronoid ramus height, and projective ramus height demonstrated positive coefficient functions, specifically 0.676, 0.090, and 0.286, respectively. Conversely, both the minimum ramus breadth and the condylar ramus height displayed negative values of -0.385 and -0.126, respectively. Conclusion Among the parameters evaluated, condylar ramus height emerges as the most suitable choice for estimating age, while gonial angle, coronoid ramus height, and projective ramus height are preferable for determining sex.

Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America

Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (β=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (β=0.97, P=0.001) and the probability of transmigration increased (β=1.05, P<0.001). One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.

MAXILLOFACIAL RADIOLOGY Double type III dens invaginatus

A 27-year-old male patient presented with a six-month history of swelling involving the left posterior mandible. The patient’s medical history revealed no co-morbidities and the dental history was non-contributory. Extra-orally, there was a localised hard bony swelling involving the left posterior mandible. Intra-oral examination revealed a full complement of teeth with the left maxillary lateral incisor crown appearing malformed and a retained left maxillary deciduous canine. A panoramic radiograph revealed a well-defined, multilocular radiolucency with scalloped inferior borders in the left posterior mandible associated with the fi rst to third molars (Figure 1). On further examination, a periapical was taken and revealed that the left maxillary lateral incisor appeared malformed with a periapical radiolucency (Figure 2). The periapical radiograph confi rmed the presence of a double dens invaginatus on the mesial and distal aspects. The patient was referred for an incisional biopsy of the lesion in the left posterior mandible, which was subsequently diagnosed as an inflamed odontogenic keratocyst and managed accordingly.

Gender Determination by Measuring the Mandibular Ramus and Body of the Mandible: A Retrospective Radiographic Study

Aims:1) To measure the height and width of the mandibular ramus and height of the body of the mandible on digital orthopantomograms. 2) To compare the measurements on the mandibular ramus &amp; body of the mandible and use them in gender determination. Setting and Design: Retrospective study on 120 retrieved digital ortho pantomograms of individuals of Indian origin. Materials and Methods: A study was conducted on 120 retrieved digital orthopantomograms which were categorized into three age groups of age between 21-50 years. 40 digital orthopantomograms were selected under each age group which included 20 male and 20 female radiographs. The Digital OPG images that were obtained using the PLANMECA PROLINE XC machine were measured using PLANMECA ROMEXIS 2.3.1.R software.

Assessment of the Anterior Loop and Pattern of Entry of Mental Nerve Into the Mental Foramen: A Radiographic Study of Panoramic Images.

The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction. In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve. The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test. The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible.

Evaluation of the effect of extraction in comparison to distalization on the maxillary third molars in class II malocclusion: a retrospective study

ObjectiveTo compare the effects of first premolar extraction versus distalization on the vertical position and mesiodistal angulation of maxillary third molars (MxM3) in adolescent class II patients.MethodsThe panoramic x-rays (OPGs) of 200 adolescent class II patients with developing MxM3s were screened. The chosen sample consisted of 2 groups: Group 1 (Distalization) comprising 48 MxM3s, and Group 2 (Extraction) comprising 50 MxM3s. The pre- and post-treatment OPGs were traced to detect the mesiodistal angulation changes of the second molars (MxM2) and MxM3s.ResultsThe angulation and vertical position of the MxM3s at T0 & T1 were also evaluated using Archer’s classification. The distalization group presented a non-significant decrease in the mean angulation of MxM2 and MxM3 (-2.4o & -4.5o uprighting respectively). In the extraction group, both MxM2 and MxM3 presented a highly significant decrease in the mean angulation (-10.5o & -11o uprighting respectively). The angulation and vertical position change of MxM3 significantly improved in the extraction group when compared to the distalization group (P < .001).ConclusionSignificant uprighting and occlusal positioning of the maxillary third molars occurred in the premolar extraction treatment group when compared to the distalization treatment group. The results of the current study highlight the importance of recognizing maxillary third molars during orthodontic treatment planning of Class II malocclusion cases.

Position of the mandibular foramen in relation to the occlusal plane in children with skeletal class malocclusion

Frequently, practitioners use the inferior alveolar nerve block in the procedures desired on the teeth in the mandible and the surrounding tissues. This study aimed to reveal the position of the mandibular foramen (MF) according to the malocclusion types on panoramic radiographs of children aged 9-18 years living with malocclusion in Turkey. Panoramic and cephalometric radiographs of 330 patients between 9 and 18 years old were analyzed retrospectively. We grouped the skeletal malocclusion types as Class 1, 2, and Class 3 based on lateral cephalometric radiographs and evaluated the location of MF in malocclusion types according to age and gender. We observed that the distances to the occlusal plane, posterior edge, and gonion point increased with age while the distance to the anterior edge decreased. There was a significant difference according to age and gender in all malocclusion types (p&lt;0.05). We determined that the MF was positioned upward parallel to the increase in age and approached the midpoint of the ramus of the mandible from the posterior. The fact that MF is placed higher than the occlusal plane in Class 3 malocclusions compared to other types and differs by gender will guide clinicians in providing effective and safe inferior alveolar nerve block in pediatric malocclusions.

Prediction of extraction difficulty for impacted maxillary third molars with deep learning approach

ObjectiveThe aim of this study is to determine if a deep learning (DL) model can predict the surgical difficulty for impacted maxillary third molar tooth using panoramic images before surgery. Materials and MethodsThe dataset consists of 708 panoramic radiographs of the patients who applied to the Oral and Maxillofacial Surgery Clinic for various reasons. Each maxillary third molar difficulty was scored based on dept (V), angulation (H), relation with maxillary sinus (S), and relation with ramus (R) on panoramic images. The YoloV5x architecture was used to perform automatic segmentation and classification. To prevent re-testing of images, participate in the training, the data set was subdivided as: 80 % training, 10 % validation, and 10 % test group. ResultsImpacted Upper Third Molar Segmentation model showed best success on sensitivity, precision and F1 score with 0,9705, 0,9428 and 0,9565, respectively. S-model had a lesser sensitivity, precision and F1 score than the other models with 0,8974, 0,6194, 0,7329, respectively. ConclusionThe results showed that the proposed DL model could be effective for predicting the surgical difficulty of an impacted maxillary third molar tooth using panoramic radiographs and this approach might help as a decision support mechanism for the clinicians in peri-surgical period.

Third Molar Comparison in Class I and II Extraction and Non-extraction Orthodontic Treatment: A Retrospective Longitudinal Study.

This study compared third molar angulation and eruption status in Class I and II malocclusions after orthodontic treatment with and without first premolar extractions. The sample comprised 93 patients divided into four groups: Group 1, Class I malocclusion treated with first premolar extractions; Group 2, Class I malocclusion treated without extractions; Group 3, Class II malocclusion treated with first premolar extractions; and Group 4, Class II malocclusion treated without extractions. Panoramic radiographs were used to evaluate the third molar mesiodistal angulations at T1 (pretreatment), T2 (posttreatment), and T3 (long-term posttreatment). Third molar eruption status was assessed in dental casts. Intergroup angulations and eruption status comparisons were performed using one-way analysis of variance (ANOVA), followed by Tukey's test and Kruskal-Wallis test, respectively. Significantly greater mesial angulation and percentage of erupted right maxillary third molars were observed in the Class I extraction group. Significantly greater eruption status of the right mandibular third molars was observed in the Class I and Class II malocclusion extraction groups. Class I and II malocclusion extraction treatment exhibited more favorable angulations and a greater number of erupted third molars than non-extraction treatment. The non-extraction groups exhibited a greater percentage of unerupted third molars.

Risk factor analysis for perioperative complications in impacted third molar surgery - a single center experience.

The surgical removal of impacted third molars is usually carried out by an oral/maxillofacial surgeon. Two specific risks of surgical removal of impacted third molars are oroantral communication (OAC) when extracting ​​upper third molars and hypesthesia of the inferior alveolar nerve (IAN) ​​when extracting lower third molars. The aim of this study is to determine the distribution of complications in deeply impacted third molar surgery, to identify specific risk factors influencing the most common perioperative (OAC, IAN hypesthesia) and to compare these results with other studies. The clinical findings, digital panoramic radiographs, intra- and postoperative data of 80 patients with a total of 232 impacted third molars that had been subjected for tooth extraction, from December 2022 and August 2023, were collected and analyzed. Perioperative complications (IAN hypesthesia, OAC, hypesthesia lingual nerve, postoperative bleeding, postoperative infection) were identified. A risk analysis for OAC and IAN hypesthesia was performed regarding perioperative data. Overall, the rate of OAC for the right upper third molar was 12.8% and for the left upper third molar 15.6%. The complication rates regarding transient hypesthesia were 8.1% for the left IAN and 7.3% for the right IAN. The distance to maxillary sinus, the depth score according to Pell and Gregory, the bone coverage score, the operation time, the tooth's angulation and the type of surgeon (oral surgeon, DMD) were identified as significant risk factors for the occurrence of OAC. The minimum distance to IAN, the bone coverage score, the total operation time and the operation by an oral surgeon (DMD) were identified as significant risk factors for hypesthesia of the IAN. Next to the risk factors from above, the present study is one of the first showing that patients who were primarily operated on by an oral surgeon (DMD) and not a maxillofacial surgeon (MD, DMD) showed higher rates of OAC and IAN hypesthesia in impacted third molar extraction. The results of this study can serve as a baseline for further studies to investigate complication patterns in impacted third molar surgery.

Attention-guided jaw bone lesion diagnosis in panoramic radiography using minimal labeling effort

Developing a deep-learning-based diagnostic model demands extensive labor for medical image labeling. Attempts to reduce the labor often lead to incomplete or inaccurate labeling, limiting the diagnostic performance of models. This paper (i) constructs an attention-guiding framework that enhances the diagnostic performance of jaw bone pathology by utilizing attention information with partially labeled data; (ii) introduces an additional loss to minimize the discrepancy between network attention and its label; (iii) introduces a trapezoid augmentation method to maximize the utility of minimally labeled data. The dataset includes 716 panoramic radiograph data for jaw bone lesions and normal cases collected and labeled by two radiologists from January 2019 to February 2021. Experiments show that guiding network attention with even 5% of attention-labeled data can enhance the diagnostic accuracy for pathology from 92.41 to 96.57%. Furthermore, ablation studies reveal that the proposed augmentation methods outperform prior preprocessing and augmentation combinations, achieving an accuracy of 99.17%. The results affirm the capability of the proposed framework in fine-grained diagnosis using minimally labeled data, offering a practical solution to the challenges of medical image analysis.

Establishment of dose monitoring system for dentistry

Along with the advancement of dental x-ray equipment, the use of diagnostic radiation has been rapidly increasing. Accordingly, concerns about radiation exposure are increasing. In particular, imaging examinations inthe dental field have a low individual radiation exposure. However, the frequency of the examinations is high.Also, due to the abundant usage of dental CBCT, concerns has been widely spread across the users and the nation. In response to this, there has been a need to establish a dose monitoring system for dental x-ray equipment.Therefore, the purpose of this study was to establish of a national dose monitoring system for imaging examinations in the dentistry. For the system establishment, the structure of intraoral, panoramic radiography and CBCT system was surveyed and the integrated data collection plan was prepared. Based on this, dose monitoring system, which can be utilized for nation-wide, was established and a pilot operation was conducted. In orderto continuously expand the system in the future, system supplements should be confirmed through gatheringexpert opinions.

National-level Dental Radiological Dose Management

There is growing public concern about patients' radiation exposure from recent medical imaging using ion-izing radiation. While medical radiation exposure has inevitable aspects, efforts to optimize doses in line with the principles of justification and optimization are necessary to maximize diagnostic value with the minimumradiation dose. Diagnostic reference levels have been proposed as a means to achieve optimization, in accordance with ICRP (International Commission on Radiological Protection) publications 60 and 73, as well as EC (European Commission) Directive 97/43/Euratom. According to Requirement 34 of the 'InternationalBasic Safety Standards' published by the IAEA in 2014, governments are recommended to establish national diagnostic reference levels. According to ICRP Publication 135, issued in 2017, national diagnostic reference levels should be revised regularly, preferably every 3-5 years, and more frequently in the case of technologicaladvancements, such as in the case of CBCT. In South Korea, diagnostic reference levels for various imagingmodalities have been established since 2007. In the field of dentistry, diagnostic reference levels for intraoral and panoramic radiography were established in 2009, and in 2018, diagnostic reference levels for dental CBCT were introduced for the first time. The purpose of this report is to discuss the current national-level patient radia-tion dose management in South Korea and explore its applications

Automatic for Generating Landmark Mandibular Panoramic Radiography Image

Automatic for Generating Landmark Mandibular Panoramic Radiography Image