Automatic measurement of mandibular cortical bone width on cone-beam computed tomography images.

OBJECTIVE: The computed tomography cortical index (CTCI), computed tomography mandibular index (CTMI), and computed tomography index (inferior) [CTI(I)] are indexes obtained from cone-beam computed tomography images for the assessment of the mandibular cortex quality for implant planning or osteoporosis. However, cross-sectional image reconstruction for the measurements is labor-intensive. This study aimed to develop and evaluate a method to automatically reconstruct cross-sectional images and measure the cortex width in all areas inferior to the mental foramen (MF). METHODS: Seventy-one women (mean age: 52.4 years; range: 20-78 years) were enrolled. They were divided into four age and CTCI groups, including females younger (FY) and females older (FO) than 50 years (C1: normal, C2: mild/moderate erosion, and C3: severe porosity). Automatic and manual measurements of CTMI and CTI(I) were compared, and the inter- and intraobserver agreements were assessed using the intraclass correlation coefficient (ICC). The relationships between CTMI or CTI(I) and CTCI were also assessed. RESULTS: The mean processing times for reconstruction and measurements were 31.9 s and 1.22 s, respectively. ICCs for the comparison of automatic and manual measurements were 0.932 and 0.993 in the C1 and C2/C3 groups, respectively. Significant differences in CTMI and CTI(I) were observed between the FY or the FO-C1 and FO-C3 groups (p < 0.05). CONCLUSION: The automatic and manual measurements showed a strong agreement. The new method could drastically reduce routine clinical workload. Additionally, our method enables the measurement of the cortex width in all the mandibular bones inferior to the MF.

Evaluation of root morphology of maxillary and mandibular second molars lost due to periodontitis.

BACKGROUND AND OBJECTIVE: Little is known about the anatomical characteristics of root morphology in molars lost due to periodontal reason. The aim of this study was to study root morphology in maxillary and mandibular molars lost due to periodontitis by investigating the frequency of root fusion, classifying fusion types, and measuring radicular groove depth by micro-computed tomography. MATERIAL AND METHODS: Ninety-eight posterior teeth were collected from 87 Japanese patients during the study period. Of these, maxillary (N = 36) and mandibular (N = 22) second molars lost most frequently were assessed for root fusion and morphology. RESULTS: The 36 maxillary second molars included nine (25%) teeth with a single root, 14 (39%) with two roots, and 13 (36%) with three roots. Of the 23 maxillary second molars with fused (1 and 2) roots, there were 11 (48%), 2 (9%), 1 (4%), 1 (4%), 3 (13%), and 5 (22%) teeth with root types 1-6, respectively. The 22 mandibular second molars comprised 14 (64%) teeth with a single root, 7 (32%) with two roots, and one (4%) with three roots. Of the 14 mandibular second molars with a fused (1) root, 12 (86%) had a C-shaped root and two (14%) had a non-C-shaped root. CONCLUSION: We observed a higher frequency of root fusion in the present study compared with that reported by previous studies using randomly selected second molars.

Quantification of voxel values in micro computed tomography using multiple porosity hydroxyapatite blocks.

Microfocus X-ray computed tomography (micro-CT) has been applied as a method for the nondestructive and detailed assessment of trabecular bone patterns and tooth structure. Voxel values obtained from micro-CT are not absolute values. Therefore, voxel values were assessed using hydroxyapatite (HA) blocks with a different vesicle rate to quantify voxel values of micro-CT images in the present investigation.HA blocks with 4 levels of porosity and a block with a soft tissue-equivalent density were used, and the voxel values of each block were measured. Correlations between voxel values of micro-CT and HA densities were analyzed. Also, black and white binary images were produced, and the ratios of white pixels to pixels in regions of interest (ROIs) were calculated. The relationship between voxel values of micro-CT and HA densities could be regressed using a linear equation, and the correlation coefficient was high. Also, there were no significant differences in the regression equations between the first and second times. Voxel values of micro-CT might be convertible to HA densities using a regression equation.

Optimizing the reconstruction filter in cone-beam CT to improve periodontal ligament space visualization: An in vitro study.

PURPOSE: Evaluation of alveolar bone is important in the diagnosis of dental diseases. The periodontal ligament space is difficult to clearly depict in cone-beam computed tomography images because the reconstruction filter conditions during image processing cause image blurring, resulting in decreased spatial resolution. We examined different reconstruction filters to assess their ability to improve spatial resolution and allow for a clearer visualization of the periodontal ligament space. MATERIALS AND METHODS: Cone-beam computed tomography projections of 2 skull phantoms were reconstructed using 6 reconstruction conditions and then compared using the Thurstone paired comparison method. Physical evaluations, including the modulation transfer function and the Wiener spectrum, as well as an assessment of space visibility, were undertaken using experimental phantoms. RESULTS: Image reconstruction using a modified Shepp-Logan filter resulted in better sensory, physical, and quantitative evaluations. The reconstruction conditions substantially improved the spatial resolution and visualization of the periodontal ligament space. The difference in sensitivity was obtained by altering the reconstruction filter. CONCLUSION: Modifying the characteristics of a reconstruction filter can generate significant improvement in assessments of the periodontal ligament space. A high-frequency enhancement filter improves the visualization of thin structures and will be useful when accurate assessment of the periodontal ligament space is necessary.

Increased expression of interleukin (IL)-35 and IL-17, but not IL-27, in gingival tissues with chronic periodontitis.

BACKGROUND: Interleukin (IL)-35 plays an important role in immune regulation through the suppression of effector T-cell populations, including T-helper 17 (Th17) cells. Although Th17 cells and IL-17 are involved in the pathogenesis of periodontitis, the level of IL-35 in inflamed periodontal tissues is unclear. Here, IL-35, IL-17, and IL-27 production/expression in gingival crevicular fluid (GCF) and human gingival tissue were investigated. METHODS: GCF samples were collected from buccal (mesial, center, and distal) sites of teeth from patients with chronic periodontitis (CP) and healthy controls and were analyzed by enzyme-linked immunosorbent assay for IL-35 (periodontitis, n = 36; healthy, n = 30) and IL-17 (periodontitis, n = 16; healthy, n = 13). Gingival tissue, including sulcus/pocket epithelium and underlying connective tissue, was collected from an additional 10 healthy participants and 10 patients with CP and were analyzed by quantitative polymerase chain reaction (qPCR) for Epstein Barr virus-induced gene 3 (EBI3), IL12A, and IL17A. IL27p28 was also tested by qPCR. RESULTS: IL-35 and IL-17 were significantly higher in GCF from patients with periodontitis than healthy participants (P <0.01, P <0.05, respectively). In both healthy participants and those with periodontitis, positive correlations were found among IL-35 and probing depth and clinical attachment level (CAL) as well as between IL-17 and CAL. EBI3, IL12A (components of IL-35), and IL17A messenger RNA expression levels were significantly higher in inflamed gingival tissue than in healthy control tissues (P <0.05). IL27p28 was not detected in any sample, suggesting that IL-27 is not produced in large quantities in periodontal tissue. CONCLUSION: IL-35 and IL-17, but not IL-27, may play important roles in the pathogenesis of periodontitis.

Aggregatibacter actinomycetemcomitans lipopolysaccharide stimulated epithelial cells produce interleukin-15 that regulates T cell activation.

OBJECTIVE: Oral epithelial cells act not only as mechanical barriers but also as immunological barriers by producing various mediators such as cytokines. Since, in periodontal disease, limited information is available regarding the role of oral epithelial cell-derived cytokines on T cell activation, we investigated the responses of human T cells (Jurkat cell) to cytokines in KB cells (an oral epithelial cell line) that had been stimulated with Aggregatibacter actinomycetemcomitans lipopolysaccharide (LPS). DESIGN: To evaluate T cell activation in response to the culture supernatant of KB cells, we examined cell proliferation and interferon gamma (IFN-γ) production, which is closely related to periodontal disease, in Jurkat cells. Culture supernatant of LPS-stimulated KB cells enhanced cell proliferation and IFN-γ production in Jurkat cells. To determine the active component within the culture supernatant, the production of epithelial cell-derived cytokines, interleukin-12 (IL-12), IL-15 and IL-18, in LPS-stimulated KB cells was analysed. RESULTS: IL-15, but not IL-18, was significantly increased in the culture supernatant of LPS-stimulated KB cells. Moreover, additional anti-IL-15 neutralizing antibody abolished culture supernatant-induced IFN-γ expression in Jurkat cells. CONCLUSION: These results suggest that periodontal pathogens induce the production of IL-15 from epithelial cells, and leading the activation of T cells in periodontal lesions.