• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.159-165
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• 2013

Purpose: Abdominal compressor is used to control breathing in stereotactic body radiotherapy for lung tumors frequently. We evaluated the dynamic variation aspect of internal tumor volume by breathing. Materials and Methods: We reviewed 20 lung cancer patients (7 upper lung patients, 4 middle lung patients, 9 lower lung patients) who received stereotactic body radiotherapy using abdominal compressor between April 2012 to April 2013. Coordinate shift values were obtained by using four-dimensional cone-beam CT (4D-CBCT) to investigate treatment set-up error and moving tumor position error. To investigate how much difference of each part, we compared 95% confidence interval, maximum values and minimum values of three-dimensional vector value and analyzed conformity degree through the Pearson square correlation coefficient. Results: 95% confidence interval of three-dimensional vector value of each part is 1.8~2.9 mm in upper lobe, 2.3~5.4 mm in middle lobe and 2.2~4.0 mm in lower lobe. Conformity degree was the result that respectively is LR direction 0.75, SI direction 0.68 and AP direction 0.63 in upper lobe, LR direction 0.82, SI direction 0.51 and AP direction 0.92 in middle lobe and LR direction 0.63, SI direction 0.50 and AP direction 0.34 in lower lobe. Conclusion: We showed difference by each site in lung tumor due to respiration by using abdominal compressor. Therefore, we must correct treatment set-up error as well as moving tumor position error by breathing. It is also considered to be useful that it is the use of 4D-CBCT when correcting the error due to various dynamic variation.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.51-57
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• 2014

Purpose : In the case of treating pancreatic cancer, the importance is put on the spread of dose. Changes take place in duodenum in accordance with respiration. Thus, in this paper, I am going to trace the positioning of duodenum and the changes in bulks of body per dose by scanning the patients' Kilovoltage Cone-Beam CT using the hospital equipped CT-on rail System. Materials and Methods : Seeing three patients, I have acquired KVCBCT by using CT-on rail System and spotted the change in positioning at duodenum after comparing with the preliminary image of treatment plan by using SYNGO Software. Then, I followed the change in the bulk of duodenum and analyzed the changes in bulks of body on the same dose by transmitting the acquired KVCBCT into Pinnacle, a treatment plan system. Results : The changes in the positioning shall be as set forth like this: 1.2cm, 1.0cm in Left-Right Direction, 0cm, 0.8cm in Craniocaudal Direction, 0.1cm, and 1.0cm in Anterior-Posterior Direction. Patient number one showed that his bulks in body had increased by maximum 460%, minimum 120%, the bulks in patient number two had increased bymaximum 490%, minimum 160%, and the bulks of patient number three had increased by maximum 150%. But Minimum volume decreased 30%. Patient number one showed only a little bit of change at first when compared with the preliminary treatment plan. However, the dose increased the bulks in the patient's body: $V_{10}$ 118%, $V_{20}$ 117%, $V_{30}$ 400%, and $V_{40}$ 480% Conclusion : In treating patients with radiation therapy using 3D-CRT, the dose amount penetrated into duodenum needs to be minimized by planning appropriate treatment beforehand. In order to establish an appropriate treatment plan it is required to comprehend the changes at positioning of the duodenum by respiration and predict the changes in the bulks of duodenum by setting precise Planning Target Volume.

• The korean journal of orthodontics
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• v.41 no.3
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• pp.200-210
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• 2011

Objective: This study aimed at evaluating the changes in mandibular arch widths and buccolingual inclinations of mandibular posterior teeth after rapid maxillary expansion (RME). Methods: Baseline and post-expansion cone-beam computed tomographic (CBCT) images of patients who initially had bilateral posterior cross-bite and underwent RME with a banded-type expander were assessed in this study. The patients included 9 boys (mean age: $13.97{\pm}1.17$ years) and 11 girls (mean age: $13.53{\pm}2.12$ years). Images obtained 6 months after retention were available for 10 of these patients. Eighteen angular and 43 linear measurements were performed for the maxilla and mandible. The measurements were performed on frontally clipped images at the following time points; before expansion (T1), after expansion (T2), and after retention (T3). Statistical significance was assessed with paired sample $t$-test at $p$ < 0.05. Results: T1-T2 comparisons showed statistically significant post-RME increases for all measurements; similarly, T2-T1 and T3-T1 comparisons showed statistically significant changes. The maxillary linear and angular measurements showed decreases after expansion, and mandibular linear and angular measurements increased after retention. Conclusion: All mandibular arch widths increased and mandibular posterior teeth were uprighted after RME procedure.

• Imaging Science in Dentistry
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• v.40 no.1
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• pp.1-7
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• 2010

Purpose : The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. Materials and Methods : Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant $2.0^{TM}$, and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. Results : The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. Conclusion : Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.

• Imaging Science in Dentistry
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• v.38 no.1
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• pp.17-22
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• 2008

Purpose: It is important to determine the bucco-lingual inclination of implants on radiographs before the implant surgery. The purpose of this study was to compare the buccolingual inclination in alveolar bone and the tooth with dental cone beam CT and to prepare the standard for the buccolingual inclination of implant. Materials and Methods: Axial, panoramic, and buccolingually sectioned images of 80 implant cases with stent including straight marker using CB $Mercuray^{TM}$ (Hitachi, Japan) were evaluated. The comparison of the buccolingual inclination of remained alveolar bone with the tooth and the marker on butcolingually sectioned views was performed statistically. Results: The average buccolingual inclination of remained alveolar bone and tooth was $82.8{\pm}4.6^{\circ}\;and\;85.8{\pm}4.7^{\circ}$ (p<0.05, r=0.96) at the 1st molar area and $76.4{\pm}1.7^{\circ}\;and\;82.7{\pm}1.7^{\circ}$ respectively (p>0.05, r=0.12) at the 2nd premolar area in upper jaw. The average buccolingua1 inclination of remained alveolar bone and tooth was $81.3{\pm}8.3^{\circ}\;and\;87.5{\pm}6.3^{\circ}$ (p>0.05, r=0.85) at the lower 2nd premolar area and $94.3{\pm}6.6^{\circ}\;and\;93.3{\pm}7.2^{\circ}$ respectively (p>0.05, r=0.91) at the 1st molar area in lower jaw. The inclinations of markers were very different from those of remained bone at the most of areas except the upper 2nd premolar area (r=0.79). Conclusion: We recommend dental CBCT analysis for determining the buccolingual inclination of dental implant, because of significant difference, in average, between the bucco1ingual inclination of remained alveolar bone and tooth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.11-16
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• 2014

Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.2
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• pp.15-22
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• 2012

The purpose of this study was to measure the absorbed dose and calculate the effective dose for cone beam computed tomography (CBCT) and panorama units and to estimate usefulness of x-ray protective. Rando phantom and glass dosimeters were used for dosimetry. The absorbed doses were measured at 15 organs and 14 remainder from correspond to ICRP 2007 recommendations. The absorbed dose was highest in salivary glands as measured CBCT 2.420mGy, panorama 0.307mGy. Absorbed dose in another organs were high in order of thyroid, brain, skin, esophagus. The effective dose was CBCT 0.100mSv, panorama 0.011mSv and effective dose of panorama was higher than that of CBCT by 10 times. In case of wearing x-ray protective, reducing effective dose of CBCT by 0.066mSv (66%) and panorama by 0.008mSv (72%). Effective dose were reduced by radiological shielding but it needs further optimization studies, where dosimetric data are analyzed in combination with image quality with keep the patients' exposure as low as possible.

• Imaging Science in Dentistry
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• v.40 no.4
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• pp.179-185
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• 2010

Purpose : Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Materials and Methods : Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of $Ez3D2009^{TM}$ (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Results : Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Conclusion : Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.121-127
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• 2024

Purpose: Preoperative identification of the intraosseous posterior superior alveolar artery (PSAA) is critical when planning sinus surgery. This study was conducted to determine the distance between the cementoenamel junction and the PSAA, as well as to identify factors influencing the detection of the PSAA on cone-beam computed tomography (CBCT). Materials and Methods: In total, 254 CBCT scans of maxillary sinuses, acquired with 2 different scanners, were examined to identify the PSAA. The distance from the cementoenamel junction (CEJ) to the PSAA was recorded at each maxillary posterior tooth position. Binomial logistic regression and multiple linear regression were employed to evaluate the effects of scanner type, CBCT parameters, sex, and age on PSAA detection and CEJ-PSAA distance, respectively. P-values less than 0.05 were considered to indicate statistical significance. Results: The mean CEJ-PSAA distances at the second molar, first molar, second premolar, and first premolar positions were 17.0±4.0 mm, 21.8±4.1 mm, 19.5±4.7 mm, and 19.9±4.9 mm for scanner 1, respectively, and 17.3±3.5 mm, 16.9±4.3 mm, 18.5±4.1 mm, and 18.4±4.3 mm for scanner 2. No independent variable significantly influenced PSAA detection. However, tooth position (b=-0.67, P<0.05) and scanner type (b=-1.3, P<0.05) were significant predictors of CEJ-PSAA distance. Conclusion: CBCT-based estimates of CEJ-PSAA distance were comparable to those obtained in previous studies involving cadavers, CT, and CBCT. The type of CBCT scanner may slightly influence this measurement. No independent variable significantly impacted PSAA detection.

• Journal of Periodontal and Implant Science
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• v.53 no.5
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• pp.388-401
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• 2023

Purpose: This study investigated the accuracy of free-hand implant surgery performed by an experienced operator compared to static guided implant surgery performed by an inexperienced operator on an anterior maxillary dental model arch. Methods: A maxillary dental model with missing teeth (No. 11, 22, and 23) was used for this in vitro study. An intraoral scan was performed on the model, with the resulting digital impression exported as a stereolithography file. Next, a cone-beam computed tomography (CBCT) scan was performed, with the resulting image exported as a Digital Imaging and Communications in Medicine file. Both files were imported into the RealGUIDE 5.0 dental implant planning software. Active Bio implants were selected to place into the model. A single stereolithographic 3-dimensional surgical guide was printed for all cases. Ten clinicians, divided into 2 groups, placed a total of 60 implants in 20 acrylic resin maxillary models. Due to the small sample size, the Mann-Whitney test was used to analyze mean values in the 2 groups. Statistical analyses were performed using SAS version 9.4. Results: The accuracy of implant placement using a surgical guide was significantly higher than that of free-hand implantation. The mean difference between the planned and actual implant positions at the apex was 0.68 mm for the experienced group using the free-hand technique and 0.14 mm for the non-experienced group using the surgical guide technique (P=0.019). At the top of the implant, the mean difference was 1.04 mm for the experienced group using the free-hand technique and 0.52 mm for the non-experienced group using the surgical guide technique (P=0.044). Conclusions: The data from this study will provide valuable insights for future studies, since in vitro studies should be conducted extensively in advance of retrospective or prospective studies to avoid burdening patients unnecessarily.