• Imaging Science in Dentistry
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• v.51 no.1
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• pp.41-47
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• 2021

Purpose: This study aimed to compare the accuracy of 3-dimensional(3D) printed models derived from multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) systems with different fields of view (FOVs). Materials and Methods: Five human dry mandibles were used to assess the accuracy of reconstructions of anatomical landmarks, bone defects, and intra-socket dimensions by 3D printers. The measurements were made on dry mandibles using a digital caliper (gold standard). The mandibles then underwent MDCT imaging. In addition, CBCT images were obtained using Cranex 3D and NewTom 3G scanners with 2 different FOVs. The images were transferred to two 3D printers, and the digital light processing (DLP) and fused deposition modeling (FDM) techniques were used to fabricate the 3D models, respectively. The same measurements were also made on the fabricated prototypes. The values measured on the 3D models were compared with the actual values, and the differences were analyzed using the paired t-test. Results: The landmarks measured on prototypes fabricated using the FDM and DLP techniques based on all 4 imaging systems showed differences from the gold standard. No significant differences were noted between the FDM and DLP techniques. Conclusion: The 3D printers were reliable systems for maxillofacial reconstruction. In this study, scanners with smaller voxels had the highest precision, and the DLP printer showed higher accuracy in reconstructing the maxillofacial landmarks. It seemed that 3D reconstructions of the anterior region were overestimated, while the reconstructions of intra-socket dimensions and implant holes were slightly underestimated.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.1
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• pp.34-39
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• 2021

Objectives: The purpose of the study was to assess the occurrence, location, and dimensions of the intraosseous vascular canal in the lateral wall of the maxillary antrum using cone-beam computed tomography (CBCT). Materials and Methods: In this retrospective study, we examined 400 CBCT scans from our archive of patients who had earlier reported to a dental teaching hospital in the United Arab Emirates. The prevalence, location, and dimensions of the lateral antral intraosseous canal (LAIC) in the maxillary antrum were evaluated by 2 examiners using standardised methods. A third examiner was consulted in cases of disagreement. Results: The prevalence of LAIC was 62.3% (249 maxillary antra) among the study population. The mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC in the posterior maxillary region was 19.83±3.12 mm. There was a significant difference (P=0.05) between the maxillary molar and premolar regions in mean distance from the most inferior point of the alveolar bone and the inferior border of the LAIC. There was no statistically significant difference in mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC between dentulous and edentulous areas (P=0.1). The G3-intrasinusal type canal less than 1mm in diameter was the most common type of LAIC. Conclusion: This study established the approximate location of the LAIC in a United Arab Emirates cohort, which will assist the oral surgeon in selecting the appropriate site for sinus lift procedures with reduced risk of surgical hemorrhage.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.27-34
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• 2021

Purpose: This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. Materials and Methods: Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). Results: The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat(P<0.05). Conclusion: Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.49-54
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• 2021

Purpose: This study was conducted to establish age- and sex-specific reference standards for pterygoid hamulus(PH) dimensions using cone-beam computed tomography (CBCT). Materials and Methods: CBCT scans of 1,000 patients(493 males and 507 females) were retrospectively assessed in coronal sections for length and width measurements of the PH by 3 investigators. The study data were divided into 3 age groups(group 1: <20 years, group 2: 20-50 years, group 3: >50 years). Length and width were compared using one-way analysis of variance and the t-test for age and sex, respectively. Results: The length of the PH on the right side significantly increased from group 1 (6.11±1.47mm), through group 2 (6.65±1.67 mm) to group 3 (6.99±1.79 mm) and on the left side from group 2 (6.58±1.63) to group 3 (6.98±1.70). The width of the PH significantly decreased from group 1 (1.81±0.39 mm) to group 2 (1.61±0.39 mm) on the right side, and similarly from 1.87±0.36mm to 1.67±0.37mm on the left side. PH length (7.18±1.81mm on the right side and 7.10±1.72 mm on the left side) and width (1.68±0.38 mm on the right side and 1.74±0.36 mm on the left side) were significantly greater in males than in females. Conclusion: The length of the PH increased with age, whereas width first decreased and then increased. Length and width measurements were significantly higher in males than in females. These findings will aid in the diagnosis of untraceable pain in the oropharyngeal region related to altered PH morphology.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.35-40
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• 2021

Purpose: This study was conducted to evaluate the accuracy of cone-beam computed tomography (CBCT) in detecting the posterior superior alveolar(PSA) artery canal in a sample of the Egyptian population. Materials and Methods: CBCT images of 600 maxillary sinuses of patients were examined for the presence or absence of the PSA artery along the lateral wall of the maxillary sinus, and for the diameter and type of the canal in relation to age and sex. The distances from the canal to the alveolar crest and sinus floor were also measured. Each canal was assessed to determine whether it was bifid. Results: The PSA artery canal could be detected in 92.0% of the sinuses. The mean distance from the inferior border of the PSA artery canal to the sinus floor was 8.2±2.2 mm (range, 3.2-13.6 mm) in males and 7.3±2.1 mm (range, 3.0-13.1 mm) in females. The mean distance from the inferior border of the PSA artery canal to the alveolar crest was 18.2±2.7 mm (range, 11.0-23.9 mm) in males and 17.4±2.3 mm (range, 10.8-23.5 mm) in females. The mean diameter of the PSA artery canal was larger in male subjects. The PSA artery canal was bifid in 8.7% of cases. The most frequently observed location of the PSA artery canal was intraosseous(82.2%). Conclusion: CBCT was confirmed to be a valuable tool for evaluation and localization of the PSA artery before maxillary sinus lift surgery to avoid intraoperative bleeding.

• Journal of Korean Dental Science
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• v.14 no.2
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• pp.110-117
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• 2021

Purpose: The purpose of this article is to study the relationship of unintentionally extended split in the distal segment during the bilateral sagittal split ramus osteotomy (BSSRO) and skeletal relapse. Materials and Methods: Twenty patients with mandibular prognathism were divided into two groups according to whether or not unintentionally extended split had occurred. Cone-beam computed tomography images were taken before surgery (T0), immediately after surgery (T1), and postoperatively at 6 months (T2). The stability was evaluated by measuring the change of Nasion perpendicular-Pogonion (N-Pog) distance. Result: Both groups showed mild advancement of Pog during follow-up. In both groups, the condyle head rotated inward and moved posterioinferiorly after surgery, but tended to return to their original position during follow-up. Conclusion: There was no statistically significant difference between the two groups in mandible position. Moreover, the condylar position was stable. If it is difficult to proceed reduction of the unintentionally extended split, careful inspection should be performed to prevent subsequent complications during follow-up.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.181-186
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• 2022

Purpose: This study aimed to investigate inter-observer reliability among observers with different levels of proficiency and the diagnostic imaging reliability of cone-beam computed tomography (CBCT) images of the retromolar canal. Materials and Methods: CBCT images of 307 patients were assessed for the presence of retromolar canals(RMCs) by 3 observers independently. Diagnoses were made twice by each observer at intervals of more than 3 weeks. Interobserver reliability was assessed using the kappa coefficient. One observer had no experience in diagnosis using CBCT images. Therefore, a specialist in diagnostic imaging explained the CBCT images for interpretation and practiced diagnostic imaging together with this observer, while the other observer interpreted the images independently. Thereafter, the observers re-evaluated the images. Results: The interobserver kappa coefficients (including bilateral RMCs) calculated at the first reading were low, ranging from 0.21 to 0.61. Their values ranged from 0.95 (right side) to 1.00 (left side) after one-on-one practice with a diagnostic imaging specialist, while the values ranged from 0.65 (right side) to 0.66 (left side) without one-on-one practice. Conclusion: Diagnostic accuracy was improved through diagnostic imaging practice. To improve the anatomical interpretation of images, it is important to practice diagnostic imaging with a specialist in diagnostic imaging. One-on-one instruction about diagnostic imaging was an effective method of training.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.133-140
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• 2022

Purpose: The aim of this review was to systematically analyze the available literature on the correlation between the gray values (GVs) of cone-beam computed tomography (CBCT) and the Hounsfield units (HUs) of computed tomography (CT) for assessing bone mineral density. Materials and Methods: A literature search was carried out in PubMed, Cochrane Library, Google Scholar, Scopus, and LILACS for studies published through September 2021. In vitro, in vivo, and animal studies that analyzed the correlations GVs of CBCT and HUs of CT were included in this review. The review was prepared according to the PRISMA checklist for systematic reviews, and the risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A quantitative analysis was performed using a fixed-effects model. Results: The literature search identified a total of 5,955 studies, of which 14 studies were included for the qualitative analysis and 2 studies for the quantitative analysis. A positive correlation was observed between the GVs of CBCT and HUs of CT. Out of the 14 studies, 100% had low risks of bias for the domains of patient selection, index test, and reference standards, while 95% of studies had a low risk of bias for the domain of flow and timing. The fixed-effects meta-analysis performed for Pearson correlation coefficients between CBCT and CT showed a moderate positive correlation (r=0.669; 95% CI, 0.388 to 0.836; P<0.05). Conclusion: The available evidence showed a positive correlation between the GVs of CBCT and HUs of CT.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.429-438
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• 2021

Purpose: This study investigated the accuracy of laser-scanned models and 3-dimensional(3D) rendered cone-beam computed tomography (CBCT) compared to the gold standard (plaster casts) for linear measurements on dental arches. Materials and Methods: CBCT scans and plaster models from 30 patients were retrieved. Plaster models were scanned by an Emerald laser scanner (Planmeca, Helsinki, Finland). Sixteen different measurements, encompassing the mesiodistal width of teeth and both arches' length and width, were calculated using various landmarks. Linear measurements were made on laser-scanned models using Autodesk Meshmixer software v. 3.0 (Autodesk, Mill Valley, CA, USA), on 3D-rendered CBCT models using OnDemand 3D v. 1.0 (Cybermed, Seoul, Korea) and on plaster casts by a digital caliper. Descriptive statistics, the paired t-test, and intra- and inter-class correlation coefficients were used to analyze the data. Results: There were statistically significant differences between some measurements on plaster casts and laser-scanned or 3D-rendered CBCT models (P<0.05). Molar mesiodistal width and mandibular anterior arch width deviated significantly different from the gold standard in both methods. The largest mean differences of laser-scanned and 3D-rendered CBCT models compared to the gold standard were 0.12±0.23 mm and 0.42±0.53 mm, respectively. Most of the mean differences were not clinically significant. The intra- and inter-class correlation results were acceptable for all measurements(>0.830) and between observers(>0.801). Conclusion: The 3D-rendered CBCT images and laser-scanned models were useful and accurate alternatives to conventional plaster models. They could be used for clinical purposes in orthodontics and prostheses.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.85-93
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• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.