• Journal of Periodontal and Implant Science
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• v.31 no.4
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• pp.811-822
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• 2001

최근 임플란트를 원하고, 필요로 하는 환자가 증가하면서 술전의 정확한 진단이 보다 중요해졌고 다양한 진단방법이 소개되고 이용되어져 왔다. 그 중 보편적으로 가장 널리 사용되어지는 방법이 방사선 촬영법이고 그 중에서도 파노라마방사선사진이다. 하지만 파노라마방사선사진의 용이함과 간편성에도 불구하고 그 방법 자체가 가지고 있는 한계점 때문에 CT/MPR(Computer Tomography/Multiplanar Reformatting)이 일부 환자에서는 반드시 필요하다는 주장이 대다수이다. 본 연구의 목적은 하악 구치부에 임플란트 시술을 받은 환자를 대상으로 파노라마방사선사진의 확대율을 알아보고 파노라마방사선사진과 CT/MPR에서 치조정-하악관간 거리가 실제 어느 정도 차이를 보이는지, 그리고 CT/MPR에 대한 파노라마방사선사진의 확대율에 환자의 하악골의 경사도와 하악관의 해부학적 위치가 어떤 영향을 미치는지를 알아보는 것이다. 본 연구는 서울대학 치과병원 치주과를 내원하여 하악구치부에 Dental Implant 시술을 받은 15명의 환자, 32개 부위를 대상으로, 임플란트 시술을 위한 술전 파노라마방사선사진과 CT/MPR, 술후의 파노라마방사선사진, CT/MPR상을 자료로, 임플란트가 식립될 위치에서 치조정에서 하악관의 길이, 하악골의 협설폭경, 하악골의 설측면에서 하악관의 수평길이, 임플란트 매식체의 설측에서 하악관까지의 수평거리를 계측하였고 이 해부학적 계측치들이 CT/MPR에 대한 파노라마방사선사진의 확대율과 어떤 상관관계에 있는지 Pearson's correlation coefficient test를 이용해 살펴보았다. 1. CT/MPR에 대한 파노라마방사선사진의 확대율은 CT/MPR상에서 하악골 단면의 협설폭경(Pearson test에서의 상관관계 분석시, 상관계수 r=-0.604), 임플란트 매식체의 설측에서 하악관까지의 수평거리(r=-0.515), 하악골의 설측면에서 하악관까지의 수평거리(r=-0.640)와 뚜렷한 음적 선형관계가 있었다. 2. CT/MPR에 대한 파노라마방사선사진의 확대율은 CT/MPR상에서 하악골의 장축의 각도와는 뚜렷한 양적 선형관계(Pearson test에서의 상관관계 분석시, 상관계수 r=-0.446)가 있었다. 3. 여러 요소중 CT/MPR에 대한 파노라마방사선사진의 확대율과 가장 유의성있는 연관성을 보이는 것은 CT/MPR상에서 하악골의 설측면에서 하악관까지의 수평거리였다(r=-0.640) 4. CT/MPR에 대한 파노라마방사선사진의 확대율은 일반적으로 생각되어지는 파노라마방사선사진의 확대율 125%보다 큰, 약 135%로 나왔다. 이상의 결과로 볼 때, 하악골의 설측면에서 하악관까지의 수평거리가 CT/MPR에 대한 파노라마방사선사진의 확대율에 가장 영향을 미치는 요소로 추정되며 확대율은 125%보다 높은 것으로 나타났다.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.509-516
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• 2016

A dental panoramic radiography which usually uses low level X-rays is subject to the Nuclear Safety Act when it is installed for the purpose of education. This paper measures radiation dose and spatial dose rate by usage and thereby aims to verify the effectiveness of radiation safety equipment and provide basic information for radiation safety of radiation workers and students. After glass dosimeter (GD-352M) is attached to direct exposure area, the teeth, and indirect exposure area, the eye lens and the thyroid, on the dental radiography head phantom, these exposure areas are measured. Then, after dividing the horizontal into a $45^{\circ}$, it is separated into seven directions which all includes 30, 60, 90, 120 cm distance. The paper shows that the spatial dose rate is the highest at 30 cm and declines as the distance increases. At 30 cm, the spatial dose rate around the starting area of rotation is $3,840{\mu}Sv/h$, which is four times higher than the lowest level $778{\mu}Sv/h$. Furthermore, the spatial dose rate was $408{\mu}Sv/h$ on average at the distance of 60 cm where radiation workers can be located. From a conservative point of view, It is possible to avoid needless exposure to radiation for the purpose of education. However, in case that an unintended exposure to radiation happens within a radiation controlled area, it is still necessary to educate radiation safety. But according to the current Medical Service Act, in medical institutions, even if they are not installed, the equipment such as interlock are obliged by the Nuclear Safety Law, considering that the spatial dose rate of the educational dental panoramic radiography room is low. It seems to be excessive regulation.

• The korean journal of orthodontics
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• v.38 no.4
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• pp.265-274
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• 2008

Objective: The aim of this study was to evaluate the potency of panoramic radiography for the detection of maxillary impacted canines. Methods: Twenty-five patients were selected, comprised of 7 males (mean age: 10.9 years, range: 8.5 - 14.5 years) and 18 females (mean age: 10.9 years, range: 8.2 - 15.7 years). In total, thirty-five maxillary impacted canines were estimated. The position of the canine and root resorption of adjacent teeth were evaluated on panoramic radiography and 3D CT. Results: Except for angulation to the occlusal plane, the other parameters, such as tooth length, crown width, vertical distance and lateral shift showed larger values on panoramic radiography compared to 3D CT. In palatally impacted cases, the angulation of canine was smaller, and the vertical distance to the occlusal place was larger on panoramic radiography than 3D CT. For labially impacted canines, tooth length, crown width, and angulation to the occlusal plane were similar for the two methods. The sensitivity for detecting root resorption on panoramic radiography was calculated as being 33.3% of 3D CT. Conclusions: The position of labially impacted canines can be effectively estimated using panoramic radiography, but palatally impacted canines need further investigation such as 3D CT for proper diagnosis.

• 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.

• Journal of the Korean Society of Radiology
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• v.7 no.2
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• pp.131-136
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• 2013

Panorama of dental radiation generators can observe the wide anatomical structures of oral and maxillofacial areas but there can be distortion of lengths, angles, or shapes. CBCT can diagnose 3D images and get the ones whose errors by superposition and interference are remarkably smaller between anatomical structures. But the quality of the images by movement of subjects can be lowered as it takes long to diagnose them. And if there are impermeable radiation objects like metal in mouths, impermeable radiation lines can radially appear with the objects as center. This study tries to analyze accuracy of panorama and CBCT and get useful anatomical information in dental treatment by comparing the length of wisdom teeth which were measured by Panorama and CBCT with the teeth which were actually extracted and analyzing distortion of the teeth. The test result could be found that Panorama is expanded by average 7.3% as the errors of Panorama and Digital Vernier Caliper range from 110.7% to 103.9%. The length of wisdom teeth which were measured in CBCT and Digital Vernier Caliper could be found that the error range is 1.3%. And the length of wisdom teeth which were measured in Panorama and Digital Vernier Caliper has found that the error range shows 7.3%. So it could be found that the images of CBCT is about 6% more exact than those of Panorama. It could be found that CBCT shows the more exact images than those of Panorama. But because the examination expenses of CBCT are higher than those of Panorama and exposure dose of CBCT is much more than that of Panorama, it is thought to find proper ways in examination.

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.195-204
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• 2008

Osteoarthritis is caused by joint degeneration, a process that includes progressive loss of articular cartilage accompanied by attempted repair of articular cartilage, remodeling and sclerosis of subchondral bone, and osteophyte formation. The most common causative factor that either causes or contributes to osteoarthritis is overloading of the articular structures of the joint. The diagnosis of temporomandibular joint(TMJ) osteoarthritis is based on the patient's history and clinical findings such as limited mandibular opening, crepitation and tenderness to palpation on TMJ. The diagnosis is usually confirmed by TMJ radiographs, which will reveal evidence of structural changes in the subarticular bone of the condyle or fossa. Plain radiography techniques such as panoramic, transcranial, transpharyngeal views can be used in most dental offices for evaluation of the TMJs. However, plain radiographs are often limited due to overlapping and distortion of anatomical structures. The aim of this study was to compare the clinical examination and panoramic view with computed tomography for diagnosis of temporomandibular degenerative joint disease, and to compare the findings of condylar bony changes through panoramic radiography with that of computed tomography, hence, to confirm the limitations of clinical and panoramic radiography, and the validity of the computed tomography for diagnosis of temporomandibular degenerative joint disease. The pathophysiology of the TMJ osteoarthritis remains poorly understood, and current treatments are based more on speculation than science, and symptomatic treatments often fail to provide satisfactory pain relief. For diagnosis of TMJ osteoarthritis, clinical examination and radiographic examination for confirmation of the bony changes are essential, and computed tomography are clearly superior to plain radiographs for their limitations.

• Journal of the Korean Society of Radiology
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• v.7 no.3
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• pp.175-179
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• 2013

To find out the appropriate defensive measures for protectors and radiation workers in rotating radiation generating devices such as CBCT and panorama, irradiation dose depending on the position was compared and analyzed. The devices such as panorama DP-90-P PAX-500 (Vatech, Korea) and CBCT DCT-90-P IMPLAGRAPHY Dental CT system (Vatech, Korea) were used. As irradiation dose measuring instruments, Ion chamber model 2026 and Reader 20X5-60E were used. The exposure conditions were set as the factor used in the clinical trial. The result of the experiment showed that panorama was the highest, 81${\mu}R$, at point A where the test starts first and the lowest, 53${\mu}R$, at point D where the test ends. In case of CBCT, it was the highest, 1,021${\mu}R$, at point D where the test ends and was measured as the highest, 809.67${\mu}R$, at point A where the test starts. If protectors and radiation workers are forced to examine a patient holding him, they should be positioned in the middle of the point where X ray tube starts to rotate and the point where it ends to avoid the position where radiation dose is the most. And due to the nature of equipment, it will be the safest for them to stand at the opposite side of the machine and to uphold it from the rear rather than upholding it from the side of a patient and they should wear appropriate the protection gear.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.301-307
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• 2012

50-year-old female and 50-year-old male were referred to the department of the oral and maxillofacial surgery of Kyungpook national university dental hospital with asymptomatic lesions on their posterior mandibular body areas. They were discovered incidentally on panoramic radiographs during routine dental examination. Physical examination revealed no remarkable findings. Each panoramic radiograph showed well defined radiolucent lesions without hyperostotic border on their posterior mandibular body area. At first they were diagnosed as benign tumors because they looked like multilocular pattern and one of the patient showed discontinuity of mandibular canal within the lesion. CT scans demonstrated well demarcated and irregular lingual depression filled with fat tissue and they were diagnosed as developmental salivary gland defects. One of the lesion showed no change on follow-up panoramic radiograph after 4 months. Developmental salivary gland defects resembling benign tumor are atypical cases and it is suggested that confirmatory imaging using CT or MRI should be taken.

• 대한치과교정학회:학술대회논문집
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• 2005.11a
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• pp.62-64
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• 2005

• The korean journal of orthodontics
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• v.38 no.4
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• pp.240-251
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• 2008

Objective: The purpose of this study was to evaluate the effect of head position changes on the root parallelism between adjacent teeth on panoramic radiographs. Methods: A model with normal occlusion was constructed in the SolidWorks program, then RP (rapid protyping) model was fabricated. The model was repeatedly imaged and repositioned five times at each of the following nine positions: ideal head position, $5^{\circ}$ up, $10^{\circ}$ up, $5^{\circ}$ down, $10^{\circ}$ down, $5^{\circ}$, right, $10^{\circ}$, up, and $5^{\circ}$ right rotation, $10^{\circ}$ right rotation. Panoramic radiographs were taken by Planmeca ProMax and the angle between the long axes of adjacent teeth was directly measured in the monitor. Results: Axes of adjacent teeth tended to converge toward the occlusal plane when the head tilted up and converged in the opposite direction to the occlusal plane when the head tilted down. Anterior teeth showed the most notable differences. When one side of the head tilted up $5^{\circ}$ and $10^{\circ}$ along the anteroposterior axis (Y axis), tooth axes of the same side tended to converge toward the occlusal plane and tooth axes of the opposite side tended to converge in the opposite direction to the occlusal plane. When the head rotated to one side along the vertical axis (Z axis), the canine and lateral incisor of the same side converged in the opposite direction to the occlusal plane and the canine and lateral incisor of the other side converged toward the occlusal plane. Conclusions: When assessing the root parallelism on panoramic radiographs, the occlusal plane cant (anteroposterior or lateral) or asymmetry of the dental arch should be considered because these can cause distortion of tooth axes on panoramic radiographs.