• Imaging Science in Dentistry
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• 제37권3호
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• pp.165-170
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• 2007

Purpose: To estimate the shape of root and pulp canal using a dental cone beam computed tomography (CBCT) and to evaluate the accuracy of imaging reformation. Materials and Methods: CBCT images were obtained with incisors, premolars, and molars as the destination by using PSR $9000N^{TM}$ Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) and i-CAT (Imaging Sciences International, Inc, USA) cone beam CT unit that have different kind of detector and field of view, and compared these with the shape and the size of actual root and root canal. Results: When the measuring value of cone beam computed tomography concerning to each root's bucco-lingual diameter and mesio-distal diameter was compared with the value of the actual root, it reveals an error range $-0.49{\sim}+0.63$ mm at PSR900N and $-0.97{\sim}+1.14$ mm at i-CAT (P>0.05). It was possible to identify and measure PSR$9000N^{TM}$ Dental CT system to the limit $0.48{\pm}0.06mm$ (P>0.05) and i-CAT CBCT to the limit $0.86{\pm}0.09mm$ (P<0.05) on estimating the size and the shape of root canal. Two kinds of CBCT images revealed the useful reproducibility to estimate the shape of root, but there was the difference to estimate the shape of root according to apparatus. The reproducibility of root shape in the image of three-dimensions at PSR 900N is low such as 0.65 mm in a case of minute root canal. Conclusions: CBCT images revealed higher accuracy of the imaging reformation for root and pulp and clinically CBCT is a useful diagnostic tool for the assessment of root and canal. However, there are different qualities of imaging reformation according to CBCT apparatus and limitation of reproducibility for minute root canals.

• Imaging Science in Dentistry
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• 제45권4호
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• pp.205-211
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• 2015

Purpose: This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Materials and Methods: Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. Results: The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Conclusion: Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

• 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.

• Imaging Science in Dentistry
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• 제51권4호
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• pp.351-361
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• 2021

Purpose: The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods: Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks^® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results: Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion: Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

• 대한치과의사협회지
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• 제52권3호
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• pp.132-138
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• 2014

The emergence of Cone Beam Computed Tomography(CBCT) in the late 1990s represented an innovative advancement in the field of dental and maxillofacial radiology because it greatly reduced the radiation exposure to patients and offered 3D images easily. The 3D information generated by this technique brings the potential of improved diagnosis and treatment planning for a wide range of clinical applications in dentistry. The use of CBCT includes diagnosis and surgical assessment of the orofacial hard tissue lesions, dental implant treatment planning and postoperative evaluation, TMJ assessment, diagnosis of craniofacial fracture, orthodontics, endodontics, and so on. All CBCT examinations should be justified on an individualized needs. The clinical benefits to the patient for each CBCT scan must outweigh the potential risks associated with exposure to ionizing radiation. CBCT scans should be taken with initially obtained medical and dental histories of patients and a close clinical examination. CBCT should be considered as an imaging alternative of other conventional radiography in cases where the anatomical structures of interest may not be seen. The smallest possible field of view(FOV) and the lowest setting of tube current and scan time should be chosen, and the entire images scanned should be interpreted by a qualified expert.

• Imaging Science in Dentistry
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• 제38권1호
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• pp.49-56
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• 2008

Purpose: Diagnostic estimation of destruction and formation of bone has the typical limit according to capacity of x-ray generator and image detector. So the aim of this study was to find out how much it can reproduce the shape and the density of bone in the case of using recently developed dental type of cone beam computed tomography, and which image is applied by new detector and mathematic calculation. Materials and Methods: Cone beam computed tomography (PSR 9000N, Asahi Roentgen Ind. Co., Ltd., Japan) and soft x-ray radiography were executed on dry mandible that was already decalcified during 5 hours, 10 hours, 15 hours, 20 hours, and 25 hours. Estimating and comparing of those came to the following results. Results: The change of inferior border of mandible and anterior border of ramus in the region of cortical bone was observed between first 5 and 10 hours of decalcification. The reproduction of shape and density in the region of cortical bone and cancellous bone can be hardly observed at cone beam computed tomography compared with soft x-ray radiography. The difference of decrease of bone density according to hours of decalcification increase wasn't reproduced at cone beam computed tomography compared with soft x-ray radiography. Conclusion: CBCT images revealed higher spatial resolution. However, contrast resolution in region of low contrast sensitivity is the inferiority of images' property.

• 대한방사선치료학회지
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• 제28권2호
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• pp.123-130
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• 2016

목 적 : Computerized imaging reference systems 동적팬텀을이용한 cone-beamcomputed tomography(CBCT) 영상과 four-dimensionalcomputed tomography(4DCT) 영상의 체적을 비교분석 하고자 한다. 대상 및 방법 : 동적팬텀 내에 직경 1, 2, 3 cm 노드를 각각 삽입하고, CT simulator와 TruebeamSTx X-ray Imaging system을 이용하여 4DCT 영상과 CBCT 영상을 얻었다. 4DCT 영상은 maximum intensity projection(MIP), minimum intensity projection(MinIP), 그리고 average intensity projection(AVG)영상으로 재구성 하고 노드의 체적은 Eclipse system의 CT ranger tool로 CT number를 설정하여 측정하였다. 결 과 : CBCT를 기준으로 노드1, 2, 3 cm의 체적을 비교하였을 때 4DCT의 MIP는 0.54~2.33, 5.16~8.06, 9.03~20.11 ml, MinIP는 0.00~1.48, 0.00~8.47, 1.42~24.85 ml, AVG는 0.00~1.17, 0.00~2.19, 0.04~3.35 ml의 차이를 보였다. 결 론 : 노드의 체적을 비교한 결과 CBCT 영상은 4DCT의 AVG 영상과 유사한 것으로 확인되었다.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.377-384
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• 2020

This report presents 2 cases of sinus fungus ball and describes the characteristic radiographic features of fungus ball in the maxillary sinus. Two female patients, aged 62 and 40 years, sought consultations at a dental hospital for the treatment of dental implants and tooth pain, respectively. Panoramic radiography and small field-of-view(FOV) cone-beam computed tomography (CBCT) did not provide detailed information for the radiographic diagnosis of fungus ball due to the limited images of the maxillary sinus. Additional paranasal sinus computed tomographic images showed the characteristic features of fungus ball, such as heterogeneous opacification and intralesional calcification of the maxillary sinus. The calcified materials of the fungus balls were located in the middle and superior regions of the maxillary sinus. It is necessary to use large-FOV CBCT for the detection of calcified materials in the upper maxillary sinus to confirm the diagnosis of fungus ball.

• Imaging Science in Dentistry
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• 제45권1호
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• pp.67-72
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• 2015

Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

• Imaging Science in Dentistry
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• 제51권2호
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• pp.195-201
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• 2021

Unusual radiographic findings of intraosseous ameloblastoma have been reported and discussed. In the case discussed herein, cone-beam computed tomography (CBCT) clearly showed many radiographic features that were ambiguous on conventional radiographs, including an ill-defined periphery, extensive superficial buccal extension with minimal lingual extension, obvious bucco-crestal expansion, and multiple triangular (Codman's triangle-like) areas of periosteal reaction. Based on the above-mentioned findings, the differential diagnosis was a long-term infected benign or low-grade malignant lesion. An incisional biopsy was performed, and the histopathologic diagnosis was acanthomatous ameloblastoma. Recurrence of the lesion was clearly detected on CBCT images at 4 and 8 years after surgery. These unusual radiographic findings have never been reported to be associated with ameloblastoma, and thus may contribute to novel concepts in radiographic interpretation in the future. This report also underscores the important role played by CBCT as a comprehensive diagnostic tool and for definite confirmation of recurrence.