• The Journal of the Korean dental association
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• v.56 no.12
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• pp.695-706
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• 2018

Objectives: The purpose of this study was to investigate the ratio of 4 root canals and the incidence of Radix Entomolaris in mandibular first molars and find out anatomical difference according to number of roots by analysis of cone-beam CT images in a Korean population. Materials and Methods: Total 142 images containing mandibular first molars were selected from CBCT images taken from 2013 to 2017 at Gangneung-Wonju National University Dental Hospital. After reconstructing the image with reference to the Cemento-enamel junction, the root canals were detected at the bottom of the pulpal floor and the number of roots and root canals were analyzed. Various lengths and MLO-DLO-DBO angle were measured between each canal orifices and the external contour line of the tooth, and the distolingual canal wall thickness was measured. Student t-test was used for statistical significance. Results: Among the total 142 teeth, 4 canals were 42.2% and Radix Entomolaris was 25.3%. As the results of measuring various lengths and the angle, the distolingual canal orifice in Group 2(with Radix Entomolaris) tends to deviate to the lingual side than the mesiolingual canal orifice and to the mesial side than the distobuccal canal orifice. Besides, thickness of the distolingual canal wall in Group 2(with Radix Entomolaris) was significantly thinner than that of Group 1 at every level except pulpal floor level. Conclusion: It is necessary to consider the difference according to the presence of Radix Entomolaris in endodontic treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.71-78
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• 2021

Purpose: To evaluate the inter-fractional position and respiratory reproducibility of lung and liver tumors using pressure conserving type(P-type) abdominal compressor in volumetric modulated arc therapy(VMAT). Materials and methods: Six lung cancer patients and three liver cancer patients who underwent VMAT using a P-type abdominal compressor were included in this study. Cone-beam computed tomography(CBCT) images were acquired before each treatment and compared with planning CT images to evaluate the inter-fractional position reproducibility. The position variation was defined as the difference of position shift values between target matching and bone matching. 4-dimensional cone-beam computed tomography(4D CBCT) images were acquired weekly before treatment and compared with planning 4DCT images to evaluate the inter-fractional respiratory reproducibility. The respiratory variation was calculated by the magnitude of excursions by breathing. Results: The mean ± standard deviation(SD) of overall position variation values, 3D vector in the three translational directions were 1.1 ± 1.4 mm and 4.5 ± 2.8 mm for the lung and liver, respectively. The mean ± SD of respiratory variation values were 0.7 ± 3.4 mm (p = 0.195) in the lung and 3.6 ± 2.6 mm (p < 0.05) in the liver. Conclusion: The use of P-type compressor in lung and liver VMAT was effective for stable control of inter-fractional position and respiratory variation by reproduction of abdominal compression. Appropriate PTV margin must be considered in treatment planning, and image guidance before each treatment are required in order to obtain more stable reproducibility

• Imaging Science in Dentistry
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• v.52 no.3
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• pp.245-258
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• 2022

Purpose: This study compared the root canal anatomy between cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT) images before and after biomechanical preparation and root canal filling. Materials and Methods: Isthmus-containing mesial roots of mandibular molars(n=14) were scanned by micro-CT and 3 CBCT devices: 3D Accuitomo 170 (ACC), NewTom 5G (N5G) and NewTom VGi evo (NEVO). Two calibrated observers evaluated the images for 2-dimensional quantitative parameters, the presence of debris or root perforation, and filling quality in the root canal and isthmus. The kappa coefficient, analysis of variance, and the Tukey test were used for statistical analyses(α=5%). Results: Substantial intra-observer agreement (κ=0.63) was found between micro-CT and ACC, N5G, and NEVO. Debris detection was difficult using ACC (42.9%), N5G (40.0%), and NEVO (40%), with no agreement between micro-CT and ACC, N5G, and NEVO (0.05<κ<0.12). After biomechanical preparation, 2.4%-4.8% of CBCT images showed root perforation that was absent on micro-CT. The 2D parameters showed satisfactory reproducibility between micro-CT and ACC, N5G, and NEVO (intraclass correlation coefficient: 0.60-0.73). Partially filled isthmuses were observed in 2.9% of the ACC images, 8.8% of the N5G and NEVO images, and 26.5% of the micro-CT images, with no agreement between micro-CT and ACC, and poor agreement between micro-CT and N5G and NEVO. Excellent agreement was found for area, perimeter, and the major and minor diameters, while the roundness measures were satisfactory. Conclusion: CBCT images aided in isthmus detection and classification, but did not allow their classification after biomechanical preparation and root canal filling.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.3
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• pp.176-185
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• 2023

Facebow transfer is essential for accurately mounting a dental cast onto a semi-adjustable articulator. The precision of traditional analog facebow transfer is influenced by both the accuracy of the equipment used and the skill level of the operator. Considering that substantial positional deviations can adversely affect the quality of a fabricated dental prosthesis; it is critical to assess the positional accuracy of casts mounted using analog facebow transfer. This case report evaluates the linear and angular deviations of the occlusal plane for maxillary casts mounted through both analog facebow transfer and cone-beam computed tomography-based methods. The findings indicate that analog facebow transfer produced a linear deviation ranging from 3 to 16 mm and an angular deviation of the occlusal plane between 5 to 7 degrees. This case report confirms that, across two patients, analog facebow transfer can result in varying degrees of positional deviation, thereby potentially leading to inaccuracies in the fabrication of dental prostheses. These results suggest that, in clinical practice, the use of analog facebow transfer may yield significant deviations during the process of mounting maxillary casts.

• The korean journal of orthodontics
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• v.54 no.3
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• pp.171-184
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• 2024

Objective: This study aimed to determine the maxillary and mandibular basal bone regions and explore the three-dimensional positional relationship between the dentition and basal bone regions in patients with skeletal Class I and Class II malocclusions with mandibular retrusion. Methods: Eighty patients (40 each with Class I and Class II malocclusion) were enrolled. Maxillary and mandibular basal bone regions were determined using cone-beam computed tomography images. To measure the relationship between the dentition and basal bone region, the root position and root inclination were calculated using the coordinates of specific fixed points by a computer program written in Python. Results: In the Class II group, the mandibular anterior teeth inclined more labially (P < 0.05), with their apices positioned closer to the external boundary. The apex of the maxillary anterior root was positioned closer to the external boundary in both groups. Considering the molar region, the maxillary first molars tended to be more lingually inclined in females (P = 0.037), whereas the mandibular first molars were significantly more labially inclined in the Class II group (P < 0.05). Conclusions: Mandibular anterior teeth in Class II malocclusion exhibit a compensatory labial inclination trend with the crown and apex relative to the basal bone region when mandibular retrusion occurs. Moreover, as the root apices of the maxillary anterior teeth are much closer to the labial side in Class I and Class II malocclusion, the range of movement at the root apex should be limited to avoid extensive labial movement.

• The Transactions of the Korea Information Processing Society
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• v.13 no.7
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• pp.326-334
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• 2024

Extra-oral imaging techniques such as Panoramic X-rays (PXs) and Cone Beam Computed Tomography (CBCT) are the most preferred imaging modalities in dental clinics owing to its patient convenience during imaging as well as their ability to visualize entire teeth information. PXs are preferred for routine clinical treatments and CBCTs for complex surgeries and implant treatments. However, PXs are limited by the lack of third dimensional spatial information whereas CBCTs inflict high radiation exposure to patient. When a PX is already available, it is beneficial to reconstruct the 3D oral structure from the PX to avoid further expenses and radiation dose. In this paper, we propose 3DentAI - an U-Net based deep learning framework for 3D reconstruction of oral structure from a PX image. Our framework consists of three module - a reconstruction module based on attention U-Net for estimating depth from a PX image, a realignment module for aligning the predicted flattened volume to the shape of jaw using a predefined focal trough and ray data, and lastly a refinement module based on 3D U-Net for interpolating the missing information to obtain a smooth representation of oral cavity. Synthetic PXs obtained from CBCT by ray tracing and rendering were used to train the networks without the need of paired PX and CBCT datasets. Our method, trained and tested on a diverse datasets of 600 patients, achieved superior performance to GAN-based models even with low computational complexity.

• The Journal of Advanced Prosthodontics
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• v.16 no.4
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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.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.285-289
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• 1995

Purpose : We compared the calcualted percent depth dose curves of 6 MeV electron beam to that of measured to evaluate the usefulness of Monte-carlo simulation method in radiation physics. Materials and Methods : The radiation dose values of 6 MeV electron beam using EGS4 code with one million histories in water were compared values that were measured from the depth dose curve of electron beam irradiated by medical accelerator ML6M. The central axis dose values were calculated according to the changing field size. such as $5{\times}5,\;10{\times}10,\;15{\times}15,\;20{\times}20cm^2$. Results : The value calculated showed a very similar shape to depth dose curve. The calculated and measured value of $D_max$ at $10{\times}10cm^2$ cone is 15mm and 14mm respectively. The calculated value of the surface radiation dose rate is $65.52\%$ and measured one is $76.94\%$. The surface radiation dose rate has varied from $64.43\%$ to $66.99\%$. The calculated values of $D_max$ are in the range between 15mm and 18mm. The calculated value was fitted well with measured value around the $D_max$ area, excluding build up range and below the $90\%$ depth dose area. Conclusion : This result suggested that the calculation of dose value can be replace the direct measurement of the dose for radiation therapy. Also, EGS4 may be a very convenient program to assess the effect of radiation dose using by personal computers.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.1
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• pp.77-86
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• 2016

Purpose : When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) Materials and Methods : VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every $5^{\circ}$ gantry angle in a different filed size($3{\times}3cm^2$, $10{\times}10cm^2$) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the $127^{\circ}$ in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was $0.9g/cm^3$, and in the case of Spine Down Bar, it was $0.7g/cm^3$. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the $170^{\circ}beam$ crossing the Spine Down Bar. Conclusion : To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.