• 대한치과의사협회지
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• 제53권8호
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• pp.558-568
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• 2015

Objective: The objectives of this study were to measure pediatric organ and effective doses of cone-beam computed tomography (CBCT) for orthodontic analysis and to compare them to those of panoramic and lateral cephalometric radiography, the conventional radiography for orthodontic analysis. Materials and Methods: Alphard VEGA for CBCT, Planmeca Proline XC for panoramic radiography and Orthophos CD for cephalometric radiography were used for this study. Thermoluminescent dosimeter (TLD) chips were located at 24 anatomic sites of 10-year-old anthropomorphic phantom and exposed during CBCT (C-mode; $200{\times}179mm$ FOV), panoramic and lateral cephalometric radiographic procedures at the clinical exposure settings for 10-year-old patient. Pediatric organ and effective doses were measured and calculated using ICRP 2007 tissue weighting factors. Results: Effective doses of CBCT, panoramic radiography and lateral cephlometric radiography in pediatric clinical exposure settings were $292.5{\mu}Sv$, $19.3{\mu}Sv$, and $4.4{\mu}Sv$ respectively. The thyroid gland contributed most significantly to the effective dose in all the radiographic procedures. Conclusion: Effective dose of CBCT was about 12 times to conventional radiographic procedures for orthodontic analysis in pediatric patient. The use of CBCT for orthodontic analysis should be fully justified over conventional radiography and dose optimization to decrease thyroid dose is needed in pediatric patients.

• Journal of Oral Medicine and Pain
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• 제41권2호
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• pp.41-47
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• 2016

Purpose: The purpose of this study was to analyze the size and morphology of mandibular condyle and mandibular fossa between temporomandibular joint (TMJ) disc displacement (DD) patients and healthy subjects using cone-beam computed tomography (CBCT). Methods: Twenty healthy subjects and twenty TMJ DD patients participated in this study respectively. We made five measurements in mandibular condyle (medio-lateral dimension, antero-posterior dimension, condyle height, intercondylar distance and intercondylar angle) and two measurements in mandibular fossa (mandibular fossa depth and articular eminence angle) using CBCT image. Results: There was no difference between two groups in medio-lateral dimension. In case of antero-posterior dimension, average of healthy controls was larger than that of TMJ DD patients, but that was not significant statistically. There were no significant differences between two groups in condyle height. Comparing intercondylar distance and intercondylar angle between two groups, there was no significant difference between two groups. In comparison of mandibular fossa depth and articular eminence angle, there was no significant difference between two groups. Conclusions: We couldn't find any definite relationship between TMJ morphology and TMJ DD.

• Imaging Science in Dentistry
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• 제46권1호
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• pp.57-62
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• 2016

Fusion is an abnormality of tooth development defined as the union of two developing dental germs, resulting in a single large dental structure. This irregular tooth morphology is associated with a high predisposition to dental caries and periodontal diseases. As a result of recurring inflammatory periodontal processes, disorders such as periodontal pocket, pericoronitis, and paradental cysts may develop. A rare mandibular anatomic variation is the retromolar canal, which is very significant for surgical procedures. The fusion of a paramolar and mandibular third molar associated with a paradental cyst co-occurring with the presence of a retromolar canal is rare, and the aim of the present study is to describe the evaluation of this anatomical configuration using cone-beam computed tomography.

• Imaging Science in Dentistry
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• 제46권1호
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• pp.39-45
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• 2016

The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

• Imaging Science in Dentistry
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• 제48권1호
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• pp.67-72
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• 2018

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a cone-beam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

• Restorative Dentistry and Endodontics
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• 제40권3호
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• pp.241-248
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• 2015

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

• Restorative Dentistry and Endodontics
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• 제40권2호
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• pp.161-165
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• 2015

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

• Imaging Science in Dentistry
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• 제49권3호
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• pp.209-212
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• 2019

Purpose: Fossa navicularis is a bone defect in the clivus. Familiarity with this anatomical variant is important because it is close to vital anatomical structures in the base of the skull. The aim of this study was to determine the prevalence and morphometric properties of fossa navicularis within the clivus in a Turkish subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: A total of 168 CBCT scans (female: 96, male: 71) were evaluated. High-quality CBCT images of patients without a syndromic condition or a history of neurological disease or surgery were included in the study. The prevalence, depth, length, and width of the fossa navicularis were performed. Results: The prevalence of fossa navicularis was 27.5% (n=46 patients). Sex was not associated with the depth, length, or width of the fossa navicularis (P>0.05). A significant positive correlation was found between age and length of the fossa navicularis(P>0.05). Conclusion: Fossa navicularis was found to be rare (27.5%). Anatomical variants of the skull base can also be clearly identified on CBCT images. The results of this study may be useful to radiologists, anatomists, and surgeons interested in the skull base.

• Journal of Korean Dental Science
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• 제12권1호
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• pp.20-28
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• 2019

Purpose: This study was performed to evaluate the effect of voxel size on the accuracy of landmark identification in cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images were obtained from 15 dry human skulls with two different voxel sizes; 0.39 mm and 0.10 mm. Three midline landmarks and eight bilateral landmarks were identified by 5 examiners and were recorded as three-dimensional coordinates. In order to compare the accuracy of landmark identification between large and small voxel size images, the difference between best estimate (average value of 5 examiners' measurements) and each examiner's value were calculated and compared between the two images. Result: Landmark identification errors showed a high variability according to the landmarks in case of large voxel size images. The small voxel size images showed small errors in all landmarks. The landmark identification errors were smaller for all landmarks in the small voxel size images than in the large voxel size images. Conclusion: The results of the present study indicate that landmark identification errors could be reduced by using smaller voxel size scan in CBCT images.

• 대한구강악안면임플란트학회지
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• 제22권4호
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• pp.210-218
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• 2018

Purpose: The purpose of this study was to investigate the validity and reproducibility of a method based on cone-beam computed tomography (CBCT) technology for the visualization and measurement of gingival soft-tissue dimensions. Material and Methods: A total of 66 selected points in soft-tissue of the ex vivo head of an adult pig were investigated in this study. For the measurement of radiographic thickness (RT), wet soft-tissue surfaces were lightly covered with barium sulfate powder using a powder spray. CBCT was taken and DICOM files were assessed for soft-tissue thickness measurement at reference points. A periodontal probe and a rubber stop were used for the measurement of trans-gingival probing thickness (TPT). After flap elevation, actual thickness of soft-tissue (actual thickness, AT) was measured. Correlation analysis and intraclass correlation coefficients analysis (ICC) were performed for AT, TPT, and RT. Results: All variables were distributed normally. Strong significant correlations of AT with RT and TPT values were found. The two ICC values between TPT vs. AT and RT vs. AT differed significantly. Conclusion: Our results indicated that correlation of RT was stronger than that of TPT with AT. We concluded that soft tissue measurement with CBCT could be a reliable method, compared to the trans-gingival probing measurement method.