• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권12호
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• pp.6054-6068
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• 2017

In this paper, we defined the relative cross-sectional area of forearm cortical bone and investigated its correlation with hip bone mineral density values of total femur, femoral neck, femoral trochanter, femoral inter-trochanter and femoral ward's triangle, respectively. Based on the correlations, we established a linear transformation between the relative cross-sectional area of forearm cortical bone and each hip bone BMD. We obtained forearm images using CBCT and hip bone BMDs using dual-energy X-ray absorptiometry (DXA) for 28 subjects. We also investigated the optimal forearm region to provide the strongest correlation coefficient. We used the optimized forearm region to establish each linear transformation to estimate BMD values for total femur, femoral neck, femoral trochanter, femoral inter-trochanter and femoral ward's triangle from the relative cross-sectional area of forearm cortical bone, respectively. We observed the strong correlations with total femur (r=0.889), femoral neck (r=0.924), femoral trochanter (r=0.821), femoral inter-trochanter (r=0.867) and femoral ward's triangle (r=0.895), respectively. The strongest correlation was observed in the forearm mid-shaft regions. Our results suggest that the hip bone BMD values can be simply estimated from forearm CBCT images in a convenient sitting position without X-ray exposure on a hip including genital organs, and may be useful for screening osteoporosis.

• 핵의학기술
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• 제15권2호
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• pp.30-35
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• 2011

현재 분해능 향상을 위한 프로그램인 Wide beam reconstruction (WBR: UltraSPECT, Israel) 을 사용하고 있다. WBR에 속해있는 Xact-Bone은 Planar영상과 Single photon emission computed tomography (SPECT) 영상의 분해능과 대조도를 향상시켜 상당한 영상의 질 향상에 도움을 준다고 보고 되어있다. 본 연구는 Xact-Bone의 임상적용에 대한 유용성을 알아보고자 한다. Xact-Bone에서의 유용성 평가는 분해능 평가와 Contrast Ratio를 비교분석하였다. Planar영상에서의 분해능 평가는 capillary tube를 이용하여 Full width at half maximum (FWHM)을 구하였고, Contrast Ratio분석은 2010년 1월부터 2010년 10월까지 bone scan 검사를 위해 본원에 내원한 50명의 환자 Xact-Bone의 사용 전 후 영상에서 Bone and Soft tissue (B/S) ratio 값을 비교 평가하였다. SPECT영상에서의 분해능 평가는 Triple Line Source Phantom을 이용하여 FWHM을 구하였고, Contrast Ratio 비교 분석은 NEMA IEC Body Phantom과 Standard Jaszczak Phantom을 이용하여 획득한 영상을 각각 Filtered backprojection (FBP), Orderd subset expectation maximization (OSEM), Xact-Bone으로 재구성하여 비교하였다. Planar영상에서의 유용성 평가는 capillary tube를 이용한 실험결과, FWHM은 기존의 Planar영상보다 WBR의 Xact-Bone 프로그램을 이용한 재구성 영상에서 약 20% 향상되었으며, B/S ratio값도 약 15% 향상되었다. SPECT영상의 유용성 평가는 Triple line Source Phantom을 이용한 실험결과, FWHM은 Xact-Bone이 FBP, OSEM 기법보다 각각 20%, 10% 향상되었다. 또한 NEMA IEC body Phantom을 이용한 Contrast Ratio 비교분석결과 각각 20%, 10% 향상되었고, Standard Jaszczak Phantom을 이용한 Contrast Ratio 비교분석 결과는 각각 90%, 50% 향상되었다. WBR의 Xact-bone 프로그램을 이용한 Planar 영상에서는 사용하지 않은 경우와 비교하였을 경우 상당한 영상의 분해능과 Contrast Ratio가 향상됨을 알 수 있었고, SPECT영상에서 기존의 FBP, OSEM 영상재구성 방법보다 분해능, Contrast Ratio가 향상됨을 알 수 있었다. 이에 WBR의 Xact-Bone을 이용함으로써 영상의 질적 향상이 기대되는 바이다. 하지만, 새로운 소프트웨어 도입시 병원의 특성에 맞는 protocol 과 임상적용이 필요하다고 사료된다.

• Imaging Science in Dentistry
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• 제49권4호
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• pp.265-272
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• 2019

Purpose: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) with that of parallel(PPA) and oblique projected periapical(OPA) radiography for the detection of different types of peri-implant bone defects. Materials and Methods: Forty implants inserted into bovine rib blocks were used. Thirty had standardized bone defects(10 each of angular, fenestration, and dehiscence defects), and 10 were defect-free controls. CBCT, PPA, and OPA images of the samples were acquired. The images were evaluated twice by each of 2 blinded observers regarding the presence or absence and the type of the defects. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were determined for each radiographic technique. The 3 modalities were compared using the Fisher exact and chi-square tests, with P<0.05 considered as statistical significance. Results: High inter-examiner reliability was observed for the 3 techniques. Angular defects were detected with high sensitivity and specificity by all 3 modalities. CBCT and OPA showed similar AUC and sensitivity in the detection of fenestration defects. In the identification of dehiscence defects, CBCT showed the highest sensitivity, followed by OPA and PPA, respectively. CBCT and OPA had a significantly greater ability than PPA to detect fenestration and dehiscence defects(P<0.05). Conclusion: The application of OPA radiography in addition to routine PPA imaging as a radiographic follow-up method for dental implantation greatly enhances the visualization of fenestration and dehiscence defects. CBCT properly depicted all defect types studied, but it involves a relatively high dose of radiation and cost.

• Imaging Science in Dentistry
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• 제42권4호
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• pp.219-224
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• 2012

Purpose: This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. Materials and Methods: The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. Results: In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. Conclusion: The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate.

• Imaging Science in Dentistry
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• 제53권2호
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• pp.109-115
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• 2023

Purpose: The aim of this study was to evaluate changes in the trabecular bone through texture analysis and compare the texture analysis characteristics of different areas in patients with medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: Cone-beam computed tomographic images of 16 patients diagnosed with MRONJ were used. In sagittal images, 3 regions were chosen: active osteonecrosis(AO); intermediate tissue (IT), which presented a zone of apparently healthy tissue adjacent to the AO area; and healthy bone tissue (HT) (control area). Texture analysis was performed evaluating 7 parameters: secondary angular momentum, contrast, correlation, sum of squares, inverse moment of difference, sum of entropies, and entropy. Data were analyzed using the Kruskal-Wallis test with a significance level of 5%. Results: Comparing the areas of AO, IT, and HT, significant differences (P<0.05) were observed. The IT and AO area images showed higher values for parameters such as contrast, entropy, and secondary angular momentum than the HT area, indicating greater disorder in these tissues. Conclusion: Through texture analysis, changes in the bone pattern could be observed in areas of osteonecrosis. The texture analysis demonstrated that areas visually identified and classified as IT still had necrotic tissue, thereby increasing the accuracy of delimiting the real extension of MRONJ.

• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.339-350
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• 2017

Purpose: The purpose of this study was to determine the critical diabetes duration in a streptozotocin (STZ)-induced diabetic rat calvarial defect model for experimentation regarding bone regeneration by evaluating the association between diabetes duration and bone healing capacity through histological and radiographic analyses. Methods: Experimental diabetes was induced in 50 of 60 rats by an STZ injection. The rats were divided into 5 groups, including a control group (group 1), according to diabetes durations of 0, 2, 4, 6, and 8 weeks, respectively. Eighteen rats survived: 4 in group 1, 4 in group 2, 4 in group 3, 5 in group 4, and 1 in group 5. Calvarial defects were created at 0, 2, 4, 6, and 8 weeks after STZ injection in groups 1-5. Cone-beam computed tomography scanning was performed at baseline and at 5 and 7 weeks after surgery. The rats were sacrificed 7 weeks after surgery, followed by histological evaluation. Results: The voxel gray values (VGVs) of group 1 and group 2 increased, whereas the VGVs of group 3 and group 4 decreased starting 5 weeks after surgery, although this trend did not reach statistical significance between groups. On the reconstructed 3-dimensional images and based on an analysis of histological features, groups 1 and 2 showed apparent bone regeneration, while groups 3-5 showed very limited bone regeneration. Conclusions: The critical diabetes duration in an STZ-induced diabetic rat calvarial defect model for experimentation regarding bone regeneration was between 2 and 4 weeks. It is suggested that researchers who use STZ-induced diabetic rats wait for more than 2 weeks following diabetes induction before placing implants or conducting bone regeneration studies to allow definite disturbances in bone healing to emerge.

• The Journal of Advanced Prosthodontics
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• 제16권4호
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• pp.212-220
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• 2024

PURPOSE. This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS. 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient's CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS. The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant (P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant (P < .001). The mean distance of RF-I was 15.68 ± 2.13 mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION. There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root.

• 대한치과교정학회지
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• 제50권2호
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• pp.108-119
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• 2020

Objective: The primary objective of this study was to quantitatively analyze the bone parameters (thickness and density) at four different interdental areas from the distal region of the canine to the mesial region of the second molar in the maxilla and the mandible. The secondary aim was to compare and contrast the bone parameters at these specific locations in terms of sex, growth status, and facial type. Methods: This retrospective cone-beam computed tomography (CBCT) study reviewed 290 CBCT images of patients seeking orthodontic treatment. Cortical bone thickness in millimeters (mm) and density in pixel intensity value were measured for the regions (1) between the canine and first premolar, (2) between the first and second premolars, (3) between the second premolar and first molar, and (4) between the first and second molars. At each location, the bone thickness and density were measured at distances of 2, 6, and 10 mm from the alveolar crest. Results: The sex comparison (male vs. female) in cortical bone thickness showed no significant difference (p > 0.001). The bone density in growing subjects was significantly (p < 0.001) lower than that in non-growing subjects for most locations. There was no significant difference (p > 0.001) in bone parameters in relation to facial pattern in the maxilla and mandible for most sites. Conclusions: There was no significant sex-related difference in cortical bone thickness. The buccal cortical bone density was higher in females than in males. Bone parameters were similar for subjects with hyperdivergent, hypodivergent, and normodivergent facial patterns.

• 한국방사선학회논문지
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• 제8권5호
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• pp.265-269
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• 2014

방사선을 이용한 백혈병의 전신방사선 치료는 환자의 골수에 건강한 골수세포를 이식하는 골수이식(bone marrow transplantation) 시행 전, 골수의 재구성을 위한 준비단계로 전신에 외부 방사선을 조사(external beam therapy)하여 유해한 세포를 죽이거나 면역체계의 억제를 목적으로 시행된다. 전신방사선 치료를 시행할 경우 환자의 표면선량을 증가하기 위해 사용되는 산란판(spoiler)을 사용하게 되는데 산란판을 사용할 때의 표면선량은 환자와의 거리에 따라 달라지고, 두께에 따라 달라지게 된다. 이에 본 논문에서는 산란판의 두께에 따른 표면선량의 변화를 알아보았다. 아크릴로 된 산란판을 0.5 cm부터 3.0 cm 까지 0.5 cm 간격으로 제작하여 각각 측정한 결과 2.0 cm를 기준으로 두께에 따라 약 0.5% 정도의 표면선량의 증가를 관찰 할 수 있었다. 이를 토대로 임상에 직접 적용하기에는 제한적일 수 있으나 임상실험과 치료받은 환자의 예후 등을 조사하여 임상에 적용한다면 각기 다른 표면선량을 요구하는 환자들에게 산란판의 두께변화 만으로도 적절한 표면선량을 부여하는 방법이 될 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제49권5호
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• pp.299-309
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• 2019

Purpose: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. Methods: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. Results: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between $1.0{\pm}0.4mm$ for central incisors and $1.3{\pm}0.6mm$ for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. Conclusions: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.