Reliability and accuracy of cone-beam computed tomography voxel density and linear distance measurement at different voxel sizes: A study on sheep head cadaver.

BACKGROUND/PURPOSE: The reliability and accuracy of linear distance and voxel density (VD) measurements are very important in dentistry. The purpose of this study was to assess the accuracy and reliability of linear distances and VD measurements of cone-beam computed tomography (CBCT) at different voxel sizes. MATERIALS AND METHODS: Eighteen-millimeter linears of size 40 gutta-percha were prepared in fresh sheep head. The head was scanned using CBCT with 0.25, 0.3, and 0.40 voxel sizes. Standard linear distances of gutta-percha were measured in panoramic CBCT images at 0.25, 0.3, and 0.4 voxel sizes. VD measurements were made separately on spongeous bone of palatal surfaces of the roots of teeth 4, 5, and 6 of maxilla and on cortical bone of teeth 4, 5, and 6 regions of the left and right hemimandibles through cross-sectional imaging. RESULTS: We found that linear distance measurements on panoramic image of CBCT were slightly lower than physical measurements. A significant difference was not found for the gutta-percha linear distances and cortical VD measurements at different voxel sizes (P ≥ 0.05). The correlation between measurements of VD at different voxels in cortical bone was greater than 0.85 (P = 0.000). CONCLUSION: Linear distance measurements on the sheep head cadaver of 0.25, 0.3, and 0.4 voxel sizes were similar and reliable when compared with physical measurements. In minimizing radiation exposure, VD measurement of cortical bone at 0.4 voxel-based CBCT could be used to estimate cortical bone density. However, studies should be performed on the human head cadaver.

Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry.

The aim of this study was to evaluate changes in jaw bones due to osteoporosis using cone beam computed tomography (CBCT) images. Subjects that had undergone CBCT for various oral conditions and demonstrating clinical findings of osteoporosis were invited to participate in the study. Dual X-ray absorptiometry (DXA) was performed on 90 patients aged over 30 years who underwent CBCT. The study groups were based on DXA results, and included 26 osteoporosis patients (mean age ± standard deviation; 58.52 ± 5.91), 33 osteopenia patients (52.67 ± 8.61) and 31 healthy controls (49.81 ± 10.47). CBCT images of jaw bones were evaluated using radiomorphometric indexes, CT values, histogram analysis (HA) and fractal dimension (FD) analysis. Right and left mandibular radiomorphometric indexes, CT values and HA measurements in osteoporosis patients were significantly lower than measurements in osteopenia patients and control subjects (P ≤ 0.05). Positive correlations were observed between measurements of spine bone mineral density (BMD) and right and left mandibular CT values (P ≤ 0.01) and HA (P ≤ 0.01) measurements. Left maxilla FD measurements in osteoporosis patients were significantly lower than in the control (P ≤ 0.05) and osteopenia (P ≤ 0.05) groups. Osteoporosis caused significant changes in radiomorphometric indexes, CT values, and HA and FD measurements in the jaw bones. (J Oral Sci 58, 185-194, 2016).

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT

Objective This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. Material and Methods The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. Results The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. Conclusions The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics. .

A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population.

OBJECTIVE: The aim of this study was to determine the root and canal morphology of the maxillary and mandibular anterior teeth in a Turkish population by analyzing cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT images of 417 females and 410 males with a mean age of ranging from 14 to 70 years were examined in this study. A total of 1453 maxillary central incisors, 1504 maxillary lateral incisors, 1523 maxillary canines, 1582 mandibular central incisors, 1603 mandibular lateral incisors, and 1604 mandibular canines were analyzed. The number of root canals and the canal configurations were investigated and then were classified according to Vertucci's classification. The data were analyzed with the Pearson Chi-square test. RESULTS: The Type 1 canal configuration was most prevalent in the maxillary anterior teeth (96.8-99.7%). The Types 2, 3, 4, and 5 canal configurations were observed within the range of 0-1.3%, 0-0.8%, 0-0.7%, and 0-1.8%, respectively. In the mandibular anterior teeth, the Type 1 canal configuration was most prevalent (77-95%). The Types 2, 3, 4, and 5 canal configurations were observed within a range of 0.2-2.7%, 0.2-1.6%, 0.9-5.9%, and 1.8-14.4%, respectively. The prevalence of two canals was higher in males than in females both in the maxillary and mandibular anterior teeth (P < 0.05). CONCLUSIONS: Type 1 was the most prevalent canal configuration of maxillary and mandibular anterior teeth in the Turkish population. Type 5 was the most frequently observed canal configuration of the two canalled teeth. The incidence of root canal numbers and configurations differed with sex.

Evaluation of the root and canal morphology of mandibular permanent molars in a south-eastern Turkish population using cone-beam computed tomography.

OBJECTIVE: The aim of this retrospective study was to determine the root and canal morphology of the mandibular first and second permanent molars in a Turkish population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of mandibular first (n = 966) and second molar (n = 1165) teeth from 850 Turkish patients were evaluated. The root canal configurations were classified according to the method of Vertucci. The data were analyzed by Pearson's Chi-square test. RESULTS: The majority of mandibular molars were two rooted with three canals; however, three roots were identified in 0.05% of the first molars and 0.01% of the second molars, and 100% of the additional root canals were of type I configuration. Mesial roots had more complex canal systems with more than one canal, whereas most distal roots had a type I configuration. CONCLUSIONS: Within the limitations of this study, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a Turkish population. This study may help clinicians in the root canal treatment of mandibular molars.

Evaluation of the relationship between the maxillary posterior teeth and the sinus floor using cone-beam computed tomography.

AIM: The aim of this study was to evaluate the relationship between each root of maxillary premolars and molars and the maxillary sinus floor according to sex, sinus position, and age by decade in a Turkish population by using cone-beam computed tomography (CBCT) scanning. METHODOLOGY: We evaluated a database of 5,166 (2,680 maxillary premolars and 2,486 maxillary molars) CBCT scans obtained from 849 patients. The vertical relationship between each root of the molar and premolar teeth to the sinus floor was classified into three types: type 1, the roots penetrated into the sinus floor; type 2, the roots contacted the sinus floor; and type 3, the roots extended below the sinus floor. RESULTS: The results of the classification of each root in relationship to the sinus floor were as follows: type 3 occurred most frequently in the first (92.4 %) and second (71.6 %) premolar teeth, type 1 (34.2 %) occurred most frequently in the palatinal roots of the first molar teeth, type 3 occurred most frequently in the mesiobuccal (39.9 %) and distobuccal (39.7 %) roots of the first molar teeth, and type 2 (36.7 %) occurred most frequently in the mesiobuccal roots of the second molar teeth. No significant differences were found between the left and right sides, but several differences were found between males and females. The relationship between the posterior teeth and the sinus floor differed according to the age decade interval (p < 0.05). CONCLUSIONS: The maxillary first premolars have no relationship with the maxillary sinus floor, but the maxillary second molars are closer to the sinus floor. Also the second decade and males were most susceptible to undesirable results.

A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population.

AIM: The aim of this study was to evaluate the root canal number and configuration of maxillary and mandibular premolar teeth by gender, intervals for decades, tooth position and unilateral or bilateral occurrence in a Turkish population using Cone Beam Computed Tomography(CBCT) scanning. METHODOLOGY: CBCT images of 5496 maxillary and mandibular premolars from 849 patients were evaluated. The following was evaluated in all the images: numbers of roots and root canals, the morphology of the root canal configuration according to the Vertucci classification, male-female differences in the tooth position and male-female differences in unilateral or bilateral occurrence. The reliability data were analyzed with a chi-square test. RESULTS: The most prevalent root canal frequency was the two canals (86.2%) and type IV (76.9%) configuration for maxillary first premolar, one canal (59.7%) and type I (54.5%) canal configuration for second premolar. The incidence of one canal was higher in females and the occurrence of two or three canals was more common in males. The incidence of one canal was higher on the left side of maxillary premolars and the incidence of two canals was higher on the right side. Most mandibular first (93.5%) and second (98.5%) premolars had one canal. In general, females had one root canal of the mandibular premolar, whereas males had two or three canals. The type I configuration was most common and the incidence was higher on the right side. There were some differences found in the frequency distribution of the number of root canals and configuration of maxillary and mandibular premolar teeth according to intervals for decades. CONCLUSION: CBCT scanning provides comprehensive information about the root canal morphology of maxillary and mandibular premolar teeth. These data may help clinicians in root canal treatment of premolar teeth.

Evaluation of technical quality and periapical health of root-filled teeth by using cone-beam CT.

OBJECTIVE: This study aimed to assess the quality of root fillings, coronal restorations, complications of all root-filled teeth and their association with apical periodontitis (AP) detected by cone-beam computed tomography (CBCT) images from an adult Turkish subpopulation. MATERIAL AND METHODS: The sample for this study consisted of 242 patients (aging from 15 to 72 years) with 522 endodontically treated teeth that were assessed for technical quality of the root canal filling and periapical status of the teeth. Additionally, the apical status of each root-filled tooth was assessed according to the gender, dental arch, tooth type and age classification, undetected canals, instrument fracture, root fracture, apical resorption, apical lesion, furcation lesion and type and quality of the coronal structure. Statistical analysis was performed using percentages and chi-square test. RESULTS: The success rate of the root canal treatment was of 54.4%. The success rates of adequate and inadequate root canal treatment were not significantly different (p>0.05). Apical periodontitis was found in 228 (45.6%) teeth treated for root canals. Higher prevalence of AP was found in patients aging from 20 to 29 years [64 (27%) teeth] and in anterior (canines and incisors) teeth [97 (41%) teeth]. CONCLUSIONS: The technical quality of root canal filling performed by dental practitioners in a Turkish subpopulation was consistent with a high prevalence of AP. The probable reasons for this failure are multifactorial, and there may be a need for improved undergraduate education and postgraduate courses to improve the clinical skills of dental practitioners in endodontics.