• The korean journal of orthodontics
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• v.46 no.6
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• pp.345-355
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• 2016

Objective: The purpose of this study was to determine whether predicting maturation of the midpalatal suture is possible by classifying its morphology on cone-beam computed tomography (CBCT) images and to investigate relationships with other developmental age indices. Methods: The morphology of the midpalatal suture was assessed by using CBCT images of 99 patients. Axial plane images of the midpalatal suture were classified into five stages according to the classification scheme. To make the assessment more accurate, the morphology and fusion of the midpalatal suture were additionally investigated on coronal cross-sectional planar images and volume-rendered images. Bone age was evaluated using the hand and wrist method (HWM) and cervical vertebrae method (CVM); dental age (Hellman's index), sex, and chronological age were also assessed. To evaluate relationships among variables, Spearman's rho rank test was performed along with crosstabs using contingency coefficients. Results: The HWM and CVM showed strong correlations with the maturation stage of the midpalatal suture, while other indices showed relatively weak correlations (p < 0.01). Through crosstabs, the HWM and CVM showed high association values with CBCT stage; the HWM demonstrated slightly higher values (p < 0.0001). Based on the HWM, the midpalatal suture was not fused until stage 6 in both sexes. Conclusions: Among developmental age indices, the HWM and CVM showed strong correlations and high associations, suggesting that they can be useful in assessing maturation of the midpalatal suture.

• The korean journal of orthodontics
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• v.47 no.2
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• pp.77-86
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• 2017

Objective: The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT). Methods: This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data. Results: The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of $1.1^{\circ}-2.9^{\circ}$. Conclusions: Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

• Imaging Science in Dentistry
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• v.42 no.1
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• pp.19-24
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• 2012

Purpose : Field of view and voxel resolution of cone beam computed tomography (CBCT) might affect the diagnostic capability. This study was performed to compare between the standard and HiRes zoom modes in the diagnosis of external root resorption (ERR) using CBCT. Materials and Methods : Sixty three small cavities (0.25 mm depth and 0.5 mm diameter) were simulated on the buccal, lingual, and proximal surfaces at three different levels of 16 roots of teeth. After covering the root with nail varnish, the roots were inserted in the sockets and the model was placed in a water-containing lacuna. CBCT scans were taken in both standard and HiRes zoom modes using NewTom VG (QR srl Company, Verona, Italy). Then, an observer assessed the images to determine the presence or absence of the cavities. This process was repeated by increasing the size and depth of cavities to 0.5 mm depth and 1 mm diameter. Data were analyzed by McNemar test. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio in evaluation of the simulated cavities were calculated. Results : There was a significant difference between the two imaging modes in diagnosing the shallow cavities (p=0.02).The sensitivity of the standard zoom in detecting the shallow cavities was lower than that of the HiRes zoom. The likelihood ratio of the HiRes zoom was higher in the diagnosis of both cavity types. Conclusion : This study suggested that a smaller voxel size in the HiRes zoom mode of CBCT is preferred for diagnosis of ERR.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.241-246
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• 2017

Purpose: The aim of this study was to compare the root surface areas of the maxillary permanent teeth in Thai patients exhibiting anterior normal overbite and in those exhibiting anterior open bite, using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of maxillary permanent teeth from 15 patients with anterior normal overbite and 18 patients with anterior open bite were selected. Three-dimensional tooth models were constructed using Mimics Research version 17.0. The cementoenamel junction was marked manually. The root surface area was calculated automatically by 3-Matic Research version 9.0. The root surface areas of each tooth type from both types of bite were compared using the independent t-test (P<.05). The intraclass correlation coefficient was used to assess intraobserver reliability. Results: The mean root surface areas of the maxillary central and lateral incisors in individuals with anterior open bite were significantly less than those in those with normal bite. The mean root surface area of the maxillary second premolar in individuals with anterior open bite was significantly greater than in those with normal bite. Conclusion: Anterior open-bite malocclusion might affect the root surface area, so orthodontic force magnitudes should be carefully determined.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.261-267
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• 2017

Purpose: Analyzing different patterns of maxillary sinus septa in cone-beam computed tomography (CBCT) images and predicting maxillary sinus membrane perforations. Materials and Methods: In this cross-sectional study, CBCT images of 222 patients ranging from 20 to 81 years old were evaluated. One hundred fifty-two patients (93 females and 59 males) who had maxillary sinus septa in axial views were included in this study. Cross-sectional images were used to determine classifications of sinus septa and the risk of membrane perforation using a method modified from Al-Faraje et al. Variables of sex, age, and dental status were considered. Chi-squared and Kruskal-Wallis tests were used for data analysis(P<.05). Results: In this study, 265 maxillary sinus septal patterns were found. The mean age of the patients was $44.1{\pm}14.7$ years old. The Class I and VII-div II patterns had the greatest and least prevalence, respectively. Furthermore, there was a significant relationship between the location of septa and the frequency of membrane perforation risk (P<.05). In this study, the relationship of different patterns of septa with dental status did not differ significantly (P>0.05). Conclusion: A higher prevalence of moderate risk of membrane perforation in the molar region relative to the premolar region was observed. Furthermore, maxillary sinus septa occur most frequently in the molar region, demonstrating the importance of paying attention to this region during sinus lift surgery. This study did not show any relationship between tooth loss and the presence of septa.

• Progress in Medical Physics
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• v.19 no.3
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• pp.186-190
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• 2008

In this study, we describe the preliminary application for the delineation of a metal object using cone-beam reconstruction (CBR) based on limited electronic portal imaging device (EPID) projections. A typical Feldkamp, Davis and Kress (FDK) reconstruction algorithm accompanying the edge preserving smoothing filter was used as only a few projections are acquired for reconstruction. In a correlation study of the projection numbers, we found that the size of the seeds and their location depicted by these CBR images were almost identical. Limited views were used for CBR, and our method is inexpensive and competitive for use in clinical applications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.346-351
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• 2011

Purpose: The purpose of this study was to measure the angular differences between the horizontal reference planes on the CBCT generated PA cephalogram and the modified interpupillary plane, which was usually used in the clinical examination, and to evaluate the validity of the horizontal reference planes. Methods: The CBCT generated PA cephalogram was used to measure the angles between the FH, Lo and IP planes. The subjects consisted of 42 patients with facial asymmetry (males: 21, females: 21, mean-age: 21.6 years). The control groups were also assessed (males: 10, females: 10, mean-age: 23.8 years). The distance of the interpupil was measured on the soft-tissue volume rendered image. The angular differences were statistically analyzed using the $Mann-Whitney$ $U$ $test$ for inter-group comparisons and the $Friedman$ $test$ for intra-group comparisions. Results: The angle between the FH plane and IP plane (the angle of the FH-IP line) showed a statistically significant difference between the two groups ($p$ <0.05). There was no statistical differences between each angle (angle of the FH-IP line, angle of the FH-Lo line, angle of the Lo-IP line) on the intra-group comparision ($p$ >0.05). Conclusion: The angle between the Lo line and IP line (angle of the Lo-IP line) showed no statistically significant difference in both the control and asymmetry groups. Therefore, the Lo line could be used as a horizontal reference plane in CBCT generated PA cephalograms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.229-235
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• 2010

Purpose: This study examined the significance of increased bone density according to time after implantation on maxilla using demographic data with CBCT and compared the bone density between before vs. after implantation using the Hounsfield index. Materials and Methods: Twenty-five implant site on maxilla were selected. Cone-beam computerized tomography (CBCT) scans were used for the analysis. The implant sites were evaluated digitally using the Hounsfield scale with EzImplant TM and the results were compared over time. Statistical data over time was carried out to determine the correlation between the recorded Hounsfield unit (HU) over time and gender difference using repeated ANOVA. Results: The bone density of implantation site over time showed an increase in the HU mean values. Immediately after implantation, bone density was significantly increased than bone density before implantation. Until 6 month follow-up, bone density showed stable increasement. There is no significant difference on gender. Conclusions: Using CBCT, bone density increased over time after implantation on maxilla. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density and stability of implant.

• The korean journal of orthodontics
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• v.45 no.4
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• pp.180-189
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• 2015

Objective: To compare the positions of the mandibular premolars in Angle Class I subjects according to vertical facial type. The results will provide a theoretical basis for predicting effective tooth movement in orthodontic treatment. Methods: Cephalometric parameters were determined using cone-beam computed tomography in 120 Angle Class I subjects. Subjects were categorized as short, normal, and long face types according to the Frankfort mandibular angle. Parameters indicating the position of the mandibular right premolars and the mandible were also measured. Results: The angle between the mandibular first premolar axis and buccal cortex, the distance between the root apex and buccal cortex, angle of vestibularization, arc of vestibularization, and root apex maximum movable distance were significantly greater in the short face type than in the long and norm face types. The angle between the mandibular second premolar axis and buccal cortex, the distance from root apex to buccal cortex, and the arc of vestibularization were significantly greater in the short face type than in the normal face type. Conclusions: There are significant differences in the mandibular premolar positions in Class I subjects according to vertical facial type.

• The korean journal of orthodontics
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• v.45 no.4
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• pp.153-163
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• 2015

Objective: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of $35^{\circ}$. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.