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OBJECTIVE: The goal of this retrospective study is to examine the changes of maxillary sinus volume, sinus membrane thickness (SMT) and the distance between the floor of maxillary sinus and ostium after Le Fort I osteotomy. METHODS: A total of 30 patients who underwent Le Fort I osteotomy were evaluated just before and 1 year after the surgical operation. Linear and volumetric measurements were done via 3D-DOCTOR software on sectional and 3D images. RESULTS: Decrease in maxillary sinus volume, increase in SMT and no change in distance between the floor of the maxillary sinus and ostium were detected after surgery. After surgery, SMT was found higher in advancementâ+âimpaction group. CONCLUSION: This paper clarified that Le Fort I osteotomy affects the volume and thickness of the maxillary sinuses that may lead to deterioration of the ciliary activity and failure in the drainage which are predisposing factors for sinus pathologies. In maxillary osteotomies of later ages, maxillary sinus examination and follow-up should be performed regularly in order to maintain sinus health.
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Seio Maxilar/diagnóstico por imagem , Osteotomia de Le Fort , Adolescente , Adulto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Seio Maxilar/cirurgia , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: The aim of the present study was to evaluate the incidence of physiologic intracranial calcifications detected in cone beam computed tomography (CBCT) images of a Turkish subpopulation. METHODS: The CBCT image of the full head of 573 patients taken between 2015 and 2018 was evaluated retrospectively. The prevalence of habenular calcification, petroclinoid ligament, coroid plexus, interclinoid ligament (ICL), and carotico-clinoid ligament (CCL) calcifications was investigated. The age and gender of the patients were recorded. RESULTS: Intracranial calcification was found in 190 (33.1%) of 573 cases. The frequency of physiological calcifications is respectively; 19.2% were found as habenular, 4.88% as ICL, 3.83% as CCL, 2.7% as petroclinoid ligament, and 2.4% as choroid plexus. 38.2% of the women and 29.3% of the men had intracranial calcification. In 4 patients, both ICL and CCL ossification were detected. No statistically significant relationship was found between age, gender, and calcifications. CONCLUSION: Cone beam computed tomography is a widely used imaging technique for dental diagnosis and treatment. Intracranial physiological calcifications may be a common incidental finding of CBCT scans.
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Encefalopatias/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Adolescente , Adulto , Idoso , Encefalopatias/epidemiologia , Calcinose/epidemiologia , Feminino , Humanos , Incidência , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Turquia/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: The goal of this retrospective study is to evaluate the radiologic anatomy of sphenoidal emissary foramen (SEF) by using cone-beam computed tomography (CBCT) scans. METHODS: Three hundred seventeen (189 female and 128 male) full-head CBCT images were evaluated in this study. Incidence, diameter, shape, confluence to foramen ovale, and distance to anatomic structures of SEF were noted. RESULTS: In the 317 analyzed images, the SEF was identified in 89 (28.1%) images. Of these, 67 (21.1%) were unilateral, 22 were (6.9%) bilateral. The maximum mean diameter of SEF was measured 2.66âmm on the right side and 2.82âmm on the left side (Pâ=â0.16). The most observed SEF shape was oval with the incidence of 68.5% (P ≤ 0.05). Confluence was observed in 23.4% of SEF whereof 84.6% were in the left side (P ≤ 0.05). CONCLUSION: Observations in this study tender new anatomic parameters regarding SEF incidence, characteristics, and distances to proximate anatomic structures. Knowledge related to SEF variations will be helpful for neurosurgeons and radiologist.
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Tomografia Computadorizada de Feixe Cônico , Osso Esfenoide/anatomia & histologia , Osso Esfenoide/diagnóstico por imagem , Adolescente , Adulto , Pontos de Referência Anatômicos , Feminino , Forame Oval/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: Nasal septum deviation (NSD) is an anomaly that disturbs normal mucus drainage in sinuses, leading to recurrent sinusitis. Sinusitis, infections, and mucosal irritations are the potential causes of Schneiderian membrane thickening (SMT). The aim of this study was to evaluate the characteristics and association between NSD and SMT along with factors such as age, gender, and tooth groups using cone-beam computed tomography (CBCT) imaging. METHODS: The maxillary sinus and nasal cavity of 249 patients (136 females and 113 males) were examined retrospectively using CBCT. The statistical analysis was performed to determine the association between SMT, NSD, gender, and age. RESULTS: No statistically significant relation was detected between NSD and SMT. The NSD was found in 50.6% of patients without gender predilection. Age was not associated with the presence of NSD. The mean thickness of the membrane was least in the third molar region and highest in the first molar region. The average SMT was found to be higher in males for all the examined tooth areas (Pâ≤â0.05). CONCLUSION: A retrospective evaluation of CBCT images emphasized the concept that NSD was not a factor that affected the thickening of maxillary sinus mucosa. The CBCT imaging could be used for evaluating the maxillary sinuses and nasal septum.
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Mucosa Nasal , Septo Nasal , Doenças Nasais , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mucosa Nasal/diagnóstico por imagem , Mucosa Nasal/patologia , Septo Nasal/diagnóstico por imagem , Septo Nasal/patologia , Doenças Nasais/diagnóstico por imagem , Doenças Nasais/epidemiologia , Doenças Nasais/patologia , Estudos RetrospectivosRESUMO
OBJECTIVE: To examine the nasopalatine canal (NPC) anatomical and volumetric measurements in anterior edentulous (AE) and anterior dentate (AD) individuals and to compare these findings according to sex, age, shape, and severity of resorption in the premaxilla. METHODS: Two hundred cone beam computed tomography images were divided into 2 groups: AE and AD. The diameter, the length of the NPC and the width, the length of the buccal bone anterior to the NPC were measured and recorded. Linear and volumetric measurement results were evaluated in terms of age, sex, dental status, shape, and severity of resorption. RESULTS: No significant differences were observed between the AE and AD groups in terms of the NPC volume (P = 0.289). In the AE group, the spindle shape had the highest volume, and in the same group, with aging, the volume significantly increased (P = 0.00). The mean NPC volume was found to be statistically significantly larger in males than females (P = 0.02). A statistically significant relation was observed between NPC volume and resorption status. CONCLUSION: Severe bone resorption due to sustained edentation complicated implant surgery because of the increase in incisive and nasal foramen diameters and decrease in buccal residual bone dimensions. The NPC volume was found fewer in edentulous patients, and by the resorption, the volume was decreased.
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Reabsorção Óssea/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Arcada Edêntula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Nariz/diagnóstico por imagem , Palato/diagnóstico por imagem , Pontos de Referência Anatômicos , Reabsorção Óssea/patologia , Feminino , Humanos , Imageamento Tridimensional , Arcada Edêntula/patologia , Masculino , Maxila/anatomia & histologia , Pessoa de Meia-Idade , Nariz/anatomia & histologia , Palato/anatomia & histologia , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate the effects of functional appliance treatment on mandibular trabecular structure using fractal dimension (FD) analysis of dental panoramic radiographs. MATERIALS AND METHODS: This study was conducted using digital panoramic radiographs of 45 patients with Class II malocclusion treated with functional appliances (treatment group, mean age: 11.39 ± 0.97 years; 23 girls, 22 boys) acquired before (T0) and after (T1) treatment and the panoramic radiographs of 45 control subjects who had undergone no orthodontic treatment (control group, mean age: 11.31 ± 0.87 years; 23 girls, 22 boys). FD values in the condylar process, mandibular corpus, and mandibular angle were analyzed from the panoramic radiographs of both groups. RESULTS: Analysis of changes in FD between T0 and T1 revealed significant increases in the FD values of the right and left condylar processes and right mandibular corpus in the treatment group (P < .001) and in the right condylar process in the control group (P < .05). Between-group comparisons demonstrated that the treatment group showed greater changes in the condylar process (right, P < .001; left, P < .05) and right mandibular corpus (P < .05) compared to controls. Correlation analysis between the cephalometric and FD changes in the treatment group showed the right condylar process changes were negatively correlated with GoGn/SN angle (P < .05) and positively correlated with Co-Go (P < .05), although these correlations were weak. CONCLUSIONS: FD analysis demonstrated significant changes in trabeculation of the condyle and mandibular corpus in the treatment group compared to the control group. Functional appliance treatment may lead to skeletal correction by altering skeletal form and trabeculation of the mandibular bone.
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Fractais , Má Oclusão Classe II de Angle , Cefalometria , Criança , Feminino , Humanos , Masculino , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Mandíbula/diagnóstico por imagem , Radiografia PanorâmicaRESUMO
OBJECTIVE: We quantitatively compared the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in T1 weighted imaging (WI) and T2 WI sequences in 3 Tesla (T) magnetic resonance imaging (MRI) using zirconium, titanium (grades 4 and 5), and titanium-zirconium alloy implants to evaluate the effect of implant type and imaging sequence. STUDY DESIGN: MRI was acquired using a 3 T magnet with a 16-channel head coil. Implants of each type were mounted in gel and scanned in axial, coronal, and sagittal planes using fast spin echo sequences in T1 WI (TRâ¯=â¯600, TEâ¯=â¯12 milliseconds) and T2 WI (TRâ¯=â¯3000, TEâ¯=â¯80 milliseconds) sequences. Data were transferred to Synapse 3-D software, and images were measured twice by an oral and maxillofacial radiologist blinded to the type of implants. RESULTS: Zirconium implants resulted in the lowest SNR and CNR values (P < .05). No significant differences were identified between titanium (grades 4 and 5) and titanium-zirconium implants. The T2 WI sequence had a significantly higher SNR and CNR than T1 WI. There was no difference in intraobserver agreement between T1 WI and T2 WI. CONCLUSIONS: CNR and SNR at 3 T MRI are dependent on implant type and imaging sequence. Titanium (grades 4 and 5) and titanium-zirconium implants and the T2 WI sequence produced higher SNR and CNR values.
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Implantes Dentários , Titânio , Ligas , Imageamento por Ressonância Magnética , Razão Sinal-Ruído , ZircônioRESUMO
PURPOSE: In radiological views, strong beam hardening and streaking artifacts occur due to high-density structures and polyenergetic X-ray beams, and these lead to misdiagnosis. This study was performed in vitro to compare the contrast-to-noise ratio (CNR) of commonly used dental restorative materials by using Cone Beam Computed Tomography (CBCT) images with and without artifact reduction (AR) mode. MATERIALS AND METHODS: A total of 108 molar teeth were restored with nine different groups of restorative materials, with each group containing 12 teeth. Teeth were placed in a dry human mandible and scanned, one by one, via Planmeca 3D ProMax (Planmeca, Helsinki, Finland) with and without AR mode. Images were analyzed using ImageJ software (National Institutes of Health, Bethesda, MD) to calculate the CNR. RESULTS: CNR was calculated to be the highest in compomer (Glassiosite) images without AR mode (mean: 3.36) and with AR mode (mean: 3.61). CNR was calculated to be the lowest in amalgam (Tytin) images without AR mode (mean: 0.21) and with AR mode (mean: 0.23). A significant difference was found between materials in terms of CNR measurements (p ≤ 0.05). CNR measurements were increased after the AR mode application (p ≤ 0.05). CONCLUSION: AR mode was effective in reducing artifacts arising from dental materials on CBCT images, so it is necessary to use AR mode for correct diagnoses.
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OBJECTIVES: The aim of this study was to assess the effect of a metal artifact reduction (MAR) algorithm and the adaptive image noise optimizer (AINO) optimization filter in the detection of peri-implant dehiscences with cone beam computed tomography (CBCT). STUDY DESIGN: Nine implants (3 zirconium, 3 titanium, and 3 zirconium-titanium) were placed in 3 sheep heads. Dehiscences were created on the buccal and lingual/palatal surfaces. A total of 9 defects and 9 controls with no defects were evaluated by 3 observers. Each sheep head was scanned 5 times with 4 scan modes; (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO. Receiver operating characteristic analysis and weighted kappa coefficients were used to calculate diagnostic efficacy and intra- and interobserver agreements for each implant type and scan mode. RESULTS: For all implant types, dehiscences were most accurately detected when both MAR and AINO were applied (P ≤ .045). Detection of dehiscences was more accurate with titanium implants (P ≤ .040). There were no significant differences in agreement among and between the observers. CONCLUSIONS: The use of both MAR and AINO enhanced the detection accuracy of artificially created dehiscences in proximity to implants. Their combined use is recommended for detecting peri-implant dehiscences.
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Artefatos , Implantes Dentários , Algoritmos , Animais , Tomografia Computadorizada de Feixe Cônico , Ovinos , ZircônioRESUMO
OBJECTIVE: This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients. METHODS: In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs. RESULTS: The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively). CONCLUSIONS: The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.
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Fractais , Talassemia , Densidade Óssea , Humanos , Mandíbula/diagnóstico por imagem , Radiografia PanorâmicaRESUMO
OBJECTIVES: The aim of this study was to compare the panoramic radiographs of patients with early-stage and advanced-stage medication-related osteonecrosis of the jaw (MRONJ) for differences in radiographic findings and fractal dimension (FD). STUDY DESIGN: Data were collected from the medical records of 66 patients confirmed as having MRONJ. Panoramic radiographs of 66 patients (group I; without bone exposure; and group II; with bone exposure) were evaluated for the following signs; osteolysis, cortical erosion, focal and diffuse sclerosis, sequestrum, lamina dura thickening, enhancement of the inferior alveolar canal (IAC), persistent alveolar socket, pathologic fractures, and enhancement of the external oblique ridge. FD values were also compared between groups. RESULTS: The signs of focal and diffuse sclerosis, sequestrum, and enhancement of the IAC were observed significantly more often in group II than group I (P < .05). The mean FD values were 1.42 ± 0.11 in group I and 1.44 ± 0.18 in group II and were significantly different only in 1 region but not significantly different overall. CONCLUSIONS: Radiographic alterations of bone structures appeared more frequently in patients with advanced stages of MRONJ. No significant difference was detected in the FD values among the tested regions except the cancellous bone above the mandibular canal on the distal side of the mental foramen.
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Fractais , Osteonecrose , Osso Esponjoso , Humanos , Doenças Maxilomandibulares , Mandíbula , Radiografia PanorâmicaRESUMO
OBJECTIVES: To assess the contrast-to-noise ratio (CNR) of four different types of dental implant materials in CT and cone beam CT (CBCT) images with varying scan settings. METHODS: Four different types of implants: zirconium (Zr), titanium (Ti) Grade 4 and 5 and titanium-zirconium (Ti-ZrO2) alloy were placed in a 3% gelatin phantom in a cylindrical plastic container and scanned with two different CT machines (GE Medical systems and Toshiba Medical Systems) and one CBCT machine (I-CAT, Imaging Sciences International) with different voxel sizes of 0.2, 0.25, 0.3 and 0.4 mm. Images were analyzed using ImageJ software with the purpose of estimating the CNR. RESULTS: The CNR obtained from images acquired with CT was lower than the CBCT with all voxel sizes tested. 0.3 and 0.4 mm voxel sizes exhibited the highest CNR (p < 0.05) that gives the best image quality. Among the implant materials tested, titanium Grade 5 has the highest levels of CNR while Zirconium has the lowest (p < 0.05). CONCLUSIONS: The optimum protocol for radiographic follow-up in areas near implants on the I-CAT is low-resolution settings (0.3 and 0.4 mm voxel sizes) which gave the highest CNR thus image quality. In presence of Zr implants, an alternative imaging modality (i.e., MRI) may be considered to avoid low-quality images.
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Implantes Dentários , Tomografia Computadorizada de Feixe Cônico Espiral , Zircônio , Tomografia Computadorizada de Feixe Cônico , Humanos , Imagens de FantasmasRESUMO
OBJECTIVE: This study was performed to evaluate the trabecular pattern of patients with cancer taking bisphosphonates on panoramic images using fractal dimension (FD) analysis by comparison with healthy subjects and to assess whether any difference exists between regions. METHODS: FD analysis was conducted using ImageJ 1.3 software (National Institutes of Health, Bethesda, MD, USA) with the box-counting method on panoramic radiographs of 33 patients taking bisphosphonates (13 males and 20 females) and 33 healthy sex- and age-matched individuals. RESULTS: FD values were higher (1.39 ± 0.14) in the study group than control group (1.38 ± 0.07) (p ≤ 0.05). No difference was detected in the FD values among the tested regions. The mean FD values in the control and study groups were as follows: region 1, 1.49 and 1.41 (p = 0.54); region 2, 1.36 and 1.37 (p = 0.84); region 3, 1.35 and 1.42 (p = 0.11); and region 4, 1.39 and 1.39 (p = 0.90), respectively. Female patients showed significantly lower values above the mandibular canal on the distal side of the second premolar and anterior to the mental foramen than did male patients (p ≤ 0.05). Age was unrelated to the FD in the study group (p ≥ 0.05). CONCLUSIONS: The FD values of the patients with cancer taking bisphosphonates were higher than those of the controls. FD analysis showed the potential for examining bone structure in panoramic radiographs. Studies with a larger sample size are necessary to confirm these results.
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Fractais , Dente Pré-Molar , Difosfonatos , Feminino , Humanos , Masculino , Mandíbula , Radiografia Panorâmica , Estados UnidosRESUMO
OBJECTIVES: This study compared the fractal dimension (FD) and radiomorphometric indices in the assessment of mandibular bone of patients with type 1 (T1 DM) and type 2 diabetes mellitus (T2 DM). STUDY DESIGN: Panoramic radiographs of 104 patients were evaluated to calculate FD, mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) in the mandible. RESULTS: No statistically significant differences were found in FD when T1 DM and T2 DM groups were compared with controls (P ≥ .168). Patients with T1 DM had significantly lower MCW (P < .001) and PMI (P = .030) compared with controls. Patients with T2 DM had no significant differences in MCW (P = .228) or PMI (P = .137) compared with controls. No significant differences were observed between patients with T1 DM and those with T2 DM for FD, MCW, and PMI (P > .05). In the T1 DM and T2 DM groups, there was a significant correlation between MCW and FD (P ≤ .011). No correlation was observed between FD and PMI in either the T1 DM group or the T2 DM group (P ≥ .142). No significant differences in MCI were observed between the DM groups and controls (P = .740) or between the T1 DM and T2 DM groups (P = 1.000). CONCLUSIONS: The cortical and trabecular bone architectures of patients with T1 DM and T2 DM were not different. Patients with T1 DM had lower cortical measurements compared with controls.
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Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/patologia , Fractais , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Radiografia Panorâmica , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
AIM: The aim of this study was to compare the diagnostic accuracy of intra-oral and extra-oral ultrasonographic (US) examinations performed with linear and convex probes in the detection of opaque and non-opaque foreign bodies (FBs) located in the maxillofacial area. MATERIALS AND METHODS: Thirteen different type of FBs were inserted into a sheep's head: a) on the external bone surface of mandible (between the mandibular corpus and masseter muscle), b) in the intrinsic muscular tissue (in the dorsum of the tongue) and c) in the hollow structures (into the maxillary sinus of the sheep's head). The FBs in muscle tissue were scanned intra-orally whereas FBs in bone external bone surface of mandible and in maxillary sinus were scanned both intra-orally and extra-orally. The sensitivity of cone beam computed tomography (CBCT) and US imaging methods in detection of FBs were compared for FBs on the bone surface and in the muscular tissue. RESULTS: The intra-observer kappa coefficients provided identical values of 0.236 for the extra-oral convex probe, 0.461 for the intra-oral linear probe for overall FBs detection, which indicated notably poor to fair intra-observer agreement. The inter-observer agreement showed a poor agreement for the extra-oral use of linear probe (0.341 and 0.393) and extra-oral use of convex probe (0.319 and 0.335), However, a fair agreement was determined for use of probe intra-orally (0.530 and 0.534). Overall, the diagnostic accuracy of the CBCT was higher than the US regarding the visualization of FBs in the bone tissue. CONCLUSION: US with a linear probe should be the first choice for the detection of the low-radiodensity FBs, which are entrapped in the soft tissue. However, CBCT is a more sensitive technique for the visualization of FBs in air and bone tissue compared to the US, particularly for the diagnosis of high-radiodensity FBs.