• Title/Summary/Keyword: 치과방사선사진

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임상가를 위한 특집 2 - 구강악안면영역에서 양성 종양의 영상진단

  • Kim, Gyeong-A
    • The Journal of the Korean dental association
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    • v.47 no.10
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    • pp.637-646
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    • 2009
  • 양성 종양(benign tumor)을 언급하기에 앞서 과오종(hamartoma) 및 과다 형성(hyperplasia)과의 차이를 구분할 필요가 있다. 양성 종양은 기원조직과 유사한 조직이 이상 증식하는 것으로 서서히 성장하지만 일반적으로 치료하기 전까지 이상 증식을 지속하는 진성 신생물을 일컫는다. 이에 비해 과오종은 정상 조직이 무질서하게 과증식하는 것으로 일정기간 후에는 성장을 멈추기 때문에 진성 신생물로 간주하지 않는다. 그러나 일부 과오종이 양성 종양에 포함되기도 하는데, 예를 들어 치아종은 정상적인 치성 조직의 성장이 완료되는 시기와 거의 동일한 시기에 성장을 멈추지만 양성 종양으로 분류된다. 과다 형성은 조직의 세포가 정상적인 배열 양상을 보이면서 세포의 수가 증가하는 것으로 지속적인 성장 양상을 보이지만 그 성장이 제한적이므로 양성 종양과는 구별된다. 양성 종양은 일반적으로 무통성으로 서서히 성장하기 때문에 종양의 크기가 증가하여 안면 종창이나 동통 등을 유발하는 경우에 발견될 수 있으며, 방사선검사에서 우연히 발견되기도 한다. 방사선검사는 병소의 위치, 범위, 특징 및 병소와 인접 해부학적 구조와의 관계 등 많은 방사선학적 진단 정보를 제공한다. 일부 종양은 방사선사진에서 매우 특징적인 소견을 나타내기 때문에 방사선학적 소견으로 예비 진단을 할 수 있을 정도의 진단정보를 제공하기도 하는 반면 어떤 종양들은 방사선사진에서 관찰되는 소견이 매우 유사하여 진단에 어려움을 주기도 한다. 따라서 종양의 확진을 위해서는 생검이 필수적이며, 방사선검사는 반드시 생검에 앞서 진행되어야만 정확한 방사선학적 진단을 할 수 있다. 양성 종양은 각각의 특징적인 방사선학적인 소견을 나타내지만 일반적으로 관찰되는 양성 종양의 특징이 존재하므로 이러한 일반적인 특징을 관찰하여 병소가 양성인지 악성인지를 감별할 수 있다. 첫째, 양성 종양은 대개 호발하는 부위가 있으므로 종양의 발생부위는 감별 진단을 하는 데 매우 중요하다. 일반적으로 치성 병소는 치아가 형성되는 하악관 상방의 치조돌기에서, 혈관성 및 신경성 병소는 하악관 내에서, 연골성 종양은 하악과두와 같이 연골세포가 잔존되어 있는 부위에서 발생하는 경우가 많다. 둘째, 양성 종양은 대체로 명확한 경계와 피질골성 변연을 보이며, 종종 병소가 결체조직으로 둘러싸여 있어 병소 주위에 방사선투과성 띠가 관찰되기도 한다. 셋째, 양성 종양은 일반적으로 인접 주위 조직에 압력을 가하면서 서서히 성장하기 때문에 인접 치아의 변위 또는 흡수, 피질골의 비박, 팽융 등의 소견을 보이며 피질골의 천공은 드물다. 방사선학적으로 양성 종양의 병소 내부는 방사선투과상으로 관찰되거나, 방사선불투과상으로 관찰되거나, 방사선투과상과 방사선불투과상이 혼재된 상으로 관찰된다. 저자는 이 지면에서 이러한 방사선학적 특징을 기초로 하여 구강악안면영역에 발생하는 양성 종양을 분류하고 각각의 특징에 대해 살펴보고자 한다.

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Comparison of landmark position between conventional cephalometric radiography and CT scans projected to midsagittal plane (3차원 CT자료에서 선정된 계측점을 정중시상면으로 투사한 영상과 두부계측방사선사진상의 계측정의 위치 비교)

  • Park, Jae-Woo;Kim, Nam-Kug;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.38 no.6
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    • pp.427-436
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    • 2008
  • Objective: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. Methods: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of land-marks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. Results: The difference was from $-0.14{\pm}0.65$ to $-2.12{\pm}2.89\;mm$ in X axis, from $0.34{\pm}0.78$ to $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition.

Evaluation of Impacted Maxillary Canine Position Using Panoramic Radiographs and Cone-beam Computed Tomography (파노라마 방사선사진과 CBCT를 이용한 매복 상악 견치의 위치 평가)

  • Daeyoung, Hwang;Namki, Choi;Seonmi, Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.4
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    • pp.442-452
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    • 2022
  • The purpose of this study was to compare the mesio-distal and vertical position of impacted maxillary canines on panoramic radiographs with the labio-palatal position of impacted canines and root resorption of adjacent teeth on CBCT (Cone-Beam Computed Tomography). A total of 54 patients with 69 impacted maxillary canines were included in this study. On panoramic radiographs, the mesio-distal (Sector I - V), and vertical position, and angulation of impacted maxillary canines were evaluated. Labio-palatal position and root resorption of adjacent teeth were evaluated on CBCT. Labial impaction of canines was most frequent in panoramic sector I. Impaction within the arch was most frequent in sector I and II. Palatal impaction was most frequent in sector III, IV, and V. Mesially positioned canines on panoramic radiographs tended to be palatally impacted. Most of the root resorption of adjacent teeth occurred in sector III, IV, and V (p < 0.05). Canines with low angulation on panoramic radiographs tended to be palatally impacted and resorb the roots of adjacent teeth. The vertical position of impacted canines on panoramic radiographs was not statistically significant with respect to labio-palatal position and root resorption of adjacent teeth on CBCT. Analysis of the mesio-distal position and angulation of impacted maxillary canines on panoramic radiographs can be used to predict the labio-palatal position of impacted canines and root resorption of adjacent teeth.

A study on the correlations between facial biotype, submentovertex cephalometric measurements and surface EMG activity in patients with facial asymmetry (안면 비대칭 환자의 수직 안모 유형과 이하두정 두부방사선 규격사진 계측치 및 표면 근전도의 상관성에 대한 연구)

  • Kim, Seong-Soo;Lee, Nam-Ki;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.218-227
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    • 2006
  • Although the submentovertex radiograph and surface EMG are not often used due to the difficulty of interpretation, they are accepted as useful diagnostic and analytic aids for skeletal asymmetry. There have been reports which state that they were also useful for the evaluation of vertical skeletal relations. The purpose of this study was to evaluate the correlations between EMG data, measurements from submentovertex radiographs, facial types and facial asymmetry following examination of 60 asymmetric patients. The radiographic corpus length were greater in the nonaffected sides (p<0.001), gonion to interspinosum axis were greater in the affected sides and the mandibular condyle and gonion were located more anteriorly in the non-affected sides than in the affected sides but not significant (p=0.07). The activity of the anterior temporal muscle in rest position was higher in the affected sides than in the non-affected sides (p<0.01). The activity of the masseter muscle at maximum clenching was found to be nonsignificant but it was higher in the affected sides than in the non-affected sides (p=0.09). There was positive correlation between facial index and the intercondylar axes angle (p<0.01). There was positive correlation between masseter muscle activity in maximum occlusion and facial index in the affected and non-affected sides (p<0.05). The results demonstrate that the submentovertex radiograph and EMG can provide useful information for the evaluation of horizontal and vertical skeletal relations.

DETECTION OF PROXIMAL CARIES USING LASER FLUORESCENCE (레이저 형광법을 이용한 인접면 우식증 탐지효과)

  • Mo, Kyung-Hee;Yoon, Jung-Hoon;Kim, Su-Gwan;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.323-330
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    • 2004
  • The purpose of this study was to evaluate the diagnostic validity of early proximal caries lesions using laser fluorescence and whether the detection could be enhanced using a fluorescent dye. Direct visual examination and bitewing radiograph were used for comparison. The subjects of this study were 30 children of $3{\sim}9$ years old. Laser fluorescence and dye-enhanced laser fluorescence(mixed wavelength of 488 and 514 nm) were used and viewed through glasses(excluding wavelength<520 nm). For dye-enhanced laser fluorescence a 0.075% sodium fluorescein dye was applied before examination. Proximal caries lesion of each subject was assessed using visual examination, bitewing radiograph, laser fluorescence, and dye-enhanced laser fluorescence. The results in the three detection methods were compared to the assessment of bitewing radiograph. The results from the present study can be summarized as follows: 1. There was highly correlation(r=0.725-0.911) between the bitewing radiograph and all three detection methods(p<0.05) 2. The reproducibility(kappa value) of the visual examination, laser fluorescence and dye-enhanced laser fluorescence comparing with bitewing radiograph of proximal caries was 0.451, 0.683, 0.772, respectively. There was highest correlation between dye-enhanced laser fluorescence and bitewing radiograph for detection of proximal caries. The results from this study indicated that the dye-enhanced laser fluorescence considered to be accurate and reliable method in detecting proximal caries.

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Reproducibility of Lateral Cephalometric Landmarks According to Radiographic Image Enhancement (방사선상 enhancement 정도에 따른 측모두부방사선규격사진 계측점 설정의 재현도)

  • Ryu, Hwang-Sog;Hwang, Hyeon-Shik
    • The korean journal of orthodontics
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    • v.32 no.1 s.90
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    • pp.59-69
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    • 2002
  • The purpose of this study was to evaluate the reproducibility of lateral cephalometric landmarks according to radiographic image enhancement, and to contribute to the identification of cephalometric landmarks. Lateral cephalograms of ten individuals were taken and stored into computer. The images were then enhanced up to four grades by Quick Ceph Image Pro$^{TM}$ on condition that the gray-scale equalization number was 50 and the detail enhancement number was 50. After thirty two landmarks were identified on monitor images by five observers, the deviations from the mean, the distances estimated between identified points and the mean point of five identified points, were evaluated for each landmark at each enhancement grade. Through the statistical analysis, following results were obtained. 1. In case of unenhanced radiographic images, the inter-observer reproducibility of the landmarks showed a large variation. 2. The comparison of deviation from the mean according to the degree of radiographic image enhancement for each landmark showed that the inter-observer reproducibility was significantly different at 5 landmarks. 3. The landmark of pterygomaxillary fissure showed higher reproducibility at enhancement grade 1 and 2 images than at unenhanced images. So did the landmark of posterior nasal spine at enhancement grade 1 images, and the landmark of menton at enhancement grade 2, 3 and 4 images respectively. The above results suggest that the reproducibility of some landmarks can be increased by radiographic image enhancement during the identification of the lateral cephalometric landmarks on the monitor.

The comparative study of three-dimensional cephalograms to actual models and conventional lateral cephalograms in linear and angular measurements (3차원 두부방사선규격사진의 정확성에 관한 연구 -실제 계측 및 측모 두부방사선 규격사진 계측과의 비교-)

  • BAE, Gi-Sun;Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.129-140
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    • 1997
  • Conventional cephalometrics have inherent errors because their evaluation is performed in two-dimension for threedimensional object. To compensate these errors, three-dimensional cephalograms - derivation of three-dimensional data from conventional lateral and postero-anterior cephalograms - were developed. In this study, the accuracy and precision of three dimensional cephalograms were determined by means of 10 linear and 12 angular measurements on 36 acrylic skull models and by the comparison of conventional lateral cephalograms. The results were as follows 1. Mean difference between three-dimensional cephalograms and actual models in linear measurements was $0.94{\pm}0.62mm$ and mean rate of magnification of three-dimensional cephalograms was $100.31{\pm}0.91%$. There were no statistically significant differences between three-dimensional cephalograms and actual models in linear measurements(${\alpha}=0.1$). 2. Mean difference between conventional lateral cephalograms and actual models in linear measurements was $6.44{\pm}1.48mm$ and mean rate of magnification of lateral cephalograms was $106.99{\pm}1.45%$. There were statistically significant differences between lateral cephalograms and actual models in linear measurements(P<0.005). 3. Mean difference between three-dimensional cephalograms and actual models in angular measurements was $1.22{\pm}0.82^{\circ}$ and mean rate of magnification of three-dimensional cephalograms was $105.71{\pm}12.07%$. There were no statistically significant differences between three-dimensional cephalograms and actual models in angular measurements(${\alpha}=0.1$). 4. Mean difference between conventional lateral cephalograms and actual models in angular measurements was $1.70{\pm}0.94^{\circ}$ and mean rate of magnification of lateral cephalograms was $106.35{\pm}15.70%$. There were no statistically significant differences between lateral cephalograms and actual models in angular measurements(${\alpha}=0.1$). There were similarity between three-dimensional and lateral cephalograms in angular measurements.

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TRAUMATIC BONE CYST : A CASE REPORT (외상성 골낭의 치험례)

  • Oh, Min-Hyung;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.18-25
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    • 2005
  • Traumatic bone cyst is a nonodontogenic cyst without epithelial-linig which contains fluid in it's cavity, and it is limited by bone walls with no evidence of infection. Traumatic bone cyst is asymptomatic and appears more frequently in the second decade. Gender distribution is approximately equal, although males are affected slightly often than females. Radiographically the lesion shows a well demarcated radiolucent lesion of variable size and the lesion may have scalloped margins. The adjacent teeth to traumatic bone cyst remains vital. Traumatic bone cyst is usually treated by surgical exploration and currettage of the lesion. In the first case of this case report, the patient was refered from the local dental clinic for the radiolucent area under the left mandibular first molar. From the panorama radiograph at the first visit, the radiolucent area of the left mandible showed a well defined scalloped margin and identified as traumatic bone cyst. In the second case, the patient have visited for the chief complaint of swelling and abcess of right maxillary second premolar. In the radiographic check up with panorama radiograph, the radiolucent lesion with well demarcated scalloped margin was found in the right mandible body, and identified as traumatic bone cyst. In the first case, overinstrumentation was done through the mesial root canal to irrigate the lesion. In the second case, not any treatment was done, and watched the progression of the lesion. And in both cases, after two month, the radiolucency and the size of the lesion has decreased to show healing in progress.

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THE MEDIAL SIGMOID DEPRESSION: Its Anatomic and Radiographic Considerations (하악골과 방사선사진상에서의 하악절흔 내측 함요)

  • Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.7-13
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    • 1991
  • An anatomic radiolucency called medial sigmoid depression can be observed on a number of panoramic and mandibular oblique lateral views in the ramus just below and anterior to the mandibular sigmoid notch. The radiolucency may be unilateral or bilateral. Seventy-eight mandibles of dry skulls were visually examined and radiographed by panoramic machine. The observable incidence, the location center, and the mean size of the medial sigmoid depression were studied. Additionally, the radiographic incidence of the depression was determined using 500 panoramic radiographs. Normal anatomic radiolucent areas in the jaws are encountered often in the radiographs taken for the usual dental practice purpose. Some of these radiolucencies can be misdiagnosed as pathologic entities. But in most cases, the size, location, and appearance of the radiolucent area, and the presence or absence of symptoms can lead one to the correct diagnosis before surgery is undertaken. And this can be secured if diagnosticians are aware of the common and varied appearances of the normal anatomic radiolucencies A depression in the ramus just below and slightly anterior to the most inferior aspect of mandibular sigmoid notch shows occasionally foramen-like or notch-like radiolucency on some panoramic and oblique lateral views. This radiolucency was named medial sigmoid depression by Langlais et a1. in 1983. Since there're no reports about this medial sigmoid depression after that, (The author retrieved the Mediline from 1983 to 1990: Cambridge scientific abstracts, (7200 Wisconsin Ave Bethesda MD 20814 U.S.A.) National Library of Medicine) the author studied the size and the location of the depression of the mandible specimens, and determined the relationship between the observable anatomic incidence and its reproducibility on the radiographs.

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Evaluation of Skeletal and Dental Maturity in Relation to Vertical Facial Types and the Sex of Growing Children (성장기 아동의 수직적 안모 형태와 성별에 따른 골격적 성숙도와 치아 성숙도 평가)

  • Jo, Seon-Gyeong;Kim, Byounghwa;Lee, Jewoo;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.4
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    • pp.414-424
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    • 2021
  • The purpose of this retrospective study was to evaluate the skeletal and dental maturity according to the vertical facial type and sex in Korean children in the developmental stage. In total, 184 participants aged 8 - 14 years were selected and divided into three groups based on the mandibular plane angle. For the comparison between the sexes, the three groups were each divided into male and female subgroups. The skeletal and dental maturity were assessed using lateral cephalograms, hand-wrist radiographs and panoramic radiographs. The vertical growth group showed significantly greater cervical vertebral and hand-wrist maturity than that in the horizontal growth group. Dental maturity was the highest in the vertical growth group. Girls showed greater skeletal maturity than boys, and no distinct difference was observed between the dental maturity of the sexes. Analysis of the vertical facial type in children can provide ancillary indicators that may help determine the optimal timing for orthodontic treatment initiation. Earlier initiation of orthodontic treatment may be considered for patients with vertical facial growth patterns.