• Restorative Dentistry and Endodontics
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• 제45권4호
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• pp.46.1-46.8
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• 2020

Objectives: This study aimed to investigate the incidence and location of the second mesiobuccal root (MB2) canal in maxillary molars with the aid of various measuring points and lines using cone-beam computed tomography (CT). Materials and Methods: A total of 205 images of patients who underwent cone-beam CT examinations between 2011 and 2015 as part of their dental diagnosis and treatment were included. There were 76 images of the maxillary first molar and 135 images of the maxillary second molar. Canal orifices were detected at -1 mm from the top of the pulpal floor on cone-beam CT images. Image assessment was performed by 2 observers in reformatted image planes using software. Assessments included measurement of the distance between the MB1 and MB2 canals, and the angles between the lines connecting the MB1-MB2 and distobuccal (DB)-palatal (P) canals. The data were analyzed using the student's t-test. Results: The prevalence of the MB2 canal was 86.8% in the first molar and 28.9% in the second molar. The angle between the lines connecting the MB1-MB2 and DB-P canals was 2.3° ± 5.7° in the first molar and -3.95° ± 7.73° in the second molar. The distance between the MB1 and MB2 canals was 2.1 ± 0.44 mm in the first molar and 1.98 ± 0.42 mm in the second molar. Conclusions: The angles between the lines connecting the MB1-MB2 and DB-P canals was almost parallel. These findings may aid in the prediction of the location of the MB2 canal orifice.

• 대한치과의사협회지
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• 제50권4호
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• pp.203-210
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• 2012

Objective: The aim of this study was to investigate the incidence of the C-shaped canal of permanent mandibular second molar (PMSM) in Korean sub-population using Cone-Beam CT (CBCT) data and analyze the types of C-shaped canal. Materials & Methods: The protocol for this study was approved by the Institutional Review Board at the Pusan National University Hospital (E-2011039). Among the CBCT images taken of patients who visited the St. Bennedict Dental Hospital (Busan, Korea) from May 2008 to April 2011 for implant surgery and surgical removal of impacted teeth, high-quality CBCTs from 705 patients (361 male and 342 female) were screened and 607 PMSMs of 383 patients were evaluated retrospectively. All PMSMs were anatomically analyzed in detail by using image viewer software (EasyDent; Vatech). PMSMs were evaluated in the axial plane to investigate the shape of root and canals. The C-shaped canals were classified into five types. The total incidence, gender ratio, bilateral and unilateral appearance. and the correlation between right-side and left-side occurrences of C-shaped PMSMs were computed and compared statistically using the chi-square test. Results: Among the 607 PMSMs of 383 CBCTs of 187 females and 196 males, 198 PMSMs(32.6%) had C-shaped root and 158 PMSMs(26.0%) had C-shaped canals. The shape of C-shaped root canals at the furcalion level did not have significant change at the level of mid root (P<0.0001). Female had more prevalence of C-shaped root canals than male (P<0.0001). The prevalence of bilateral occurrence of C-shaped root canals was higher than unilateral occurrence. Conclusions: The occurrence of C-shaped PMSMs among a Korean population was 32.6% and was higher than other countries and ethnicities. Understanding the prevalence of PMSMs with a C-shaped root and/or canal in a Korean population may be useful for successful endodontic treatments.

• Imaging Science in Dentistry
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• 제47권3호
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• pp.199-207
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• 2017

Purpose: Evaluation of alveolar bone is important in the diagnosis of dental diseases. The periodontal ligament space is difficult to clearly depict in cone-beam computed tomography images because the reconstruction filter conditions during image processing cause image blurring, resulting in decreased spatial resolution. We examined different reconstruction filters to assess their ability to improve spatial resolution and allow for a clearer visualization of the periodontal ligament space. Materials and Methods: Cone-beam computed tomography projections of 2 skull phantoms were reconstructed using 6 reconstruction conditions and then compared using the Thurstone paired comparison method. Physical evaluations, including the modulation transfer function and the Wiener spectrum, as well as an assessment of space visibility, were undertaken using experimental phantoms. Results: Image reconstruction using a modified Shepp-Logan filter resulted in better sensory, physical, and quantitative evaluations. The reconstruction conditions substantially improved the spatial resolution and visualization of the periodontal ligament space. The difference in sensitivity was obtained by altering the reconstruction filter. Conclusion: Modifying the characteristics of a reconstruction filter can generate significant improvement in assessments of the periodontal ligament space. A high-frequency enhancement filter improves the visualization of thin structures and will be useful when accurate assessment of the periodontal ligament space is necessary.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.511-517
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• 2007

Purpose: The aim of this study is to determine whether a difference in the amount of bone graft material is needed between edentulous patients and dentulous patients and to calculate the amount of augmentation for a sinus lift procedure. Methods: 19 patients(20 sinuses) were included to measure maxillary sinus volume. Facial CT scanning was performed using MX 8000 IDT CT devices(Philips, USA). And it was used for IDLvm(The IDL Virtual Machine) 6.0, CT Volume Analyzer Ver 2.3 program to measure maxillary sinus volumes Results: At edentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.56{\pm}0.13cm^3$(5mm height), $2.35{\pm}0.57cm^3$(10mm height), $4.85{\pm}1.10cm^3$(15mm height). At dentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.41{\pm}0.18cm^3$(5mm height), $1.76{\pm}0.42cm^3$(10mm height), $3.80{\pm}0.84cm^3$ (15mm height). A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume.(p=0.027, p=0.018, p=0.044) Conclusions: A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume. Detailed preoperative knowledge of sinus lift augmentation volume is helpful in determining the appropriate amount of the bone graft material.

• 치과방사선
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• 제28권1호
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• pp.225-234
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• 1998

We used five adult dog mandibles embedded in resin block and six different cross-sectional planes for each mandible were choosen. According to the angle of mandibular occulsal plane to vertical plane(mandibular angle) and gantry angle of CT machine, we classified 4 experimental groups and 1 control group. The control group images were taken at the mandibular angel 0° and gantry angle 0°. The experimental images were taken at the mandibular angle 15° and gantry angle 0°(group 1); 30° and 0°(group 2); 15° and 15°(group 3) ;30° and 30°(group 4), respectively. Using the reformatted cross-sectional images, the distance from the mandibular canal to the alveolar crest and the distance from the mandibular canal to the buccal cortex and to the lingual cortex was measured and compared. The obtained results were as follows: 1. The distance from the mandibular canal to the alveolar crest of group 1 and 2 was larger than control group, but the distance of group 3 and 4 was smaller. The distance from the mandibular canal to the buccal cortex and to the lingual cortex of all experimental groups was smaller than control group. 2. The distance from the mandibular canal to the alveolar crest showed the largest difference from control group in all experimental groups, especially in group 2 and 4(p<0.05). 3. In the distance from the mandibular canal to the alveolar crest, the number of deviation value under 1 mm was 20 in group 3 and was 11 in group 2 and 4, respectively. 4. The deviation value of the distance from the mandibular canal to the buccal cortex and to the lingual cortex was under 1 mm in most cases.

• 구강회복응용과학지
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• 제26권2호
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• pp.111-120
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• 2010

목적: 본 연구는 측두하악관절의 시상 CT 이미지에서 최대교두감합위시 양 과두의 위치와 대칭성을 평가하기 위해 기획되었다. 재료 및 방법: Cone-bem CT가 각 100명의 남/녀 그리고 증상/무증상으로 분류된 총 200명의 400개 측두하악관절을 평가하는데 사용되었다. 3명의 독립된 평가자(치과의사)가 전방위(AP), 중앙위(MP), 후방위(PP)으로 분류된 과두 위치와 양 과두의 대칭성을 결정하였다. 결과: 성별에 따른 전방위, 중앙위, 후방위의 평균 퍼센트(%)는 남성에서 48.5, 28.5, 23였고, 여성에서 34, 38, 28였다. 과두의 대칭성은 성별에 관계없이 대칭인 경우가 많았다. 증상과 무증상의 관점에서 보면 전방위, 중앙위, 후방위의 평균 퍼센트(%)는 무증상 그룹에서 44.5, 34, 21.5였고, 증상이 있는 그룹에서는 37, 33.5, 29.5였다. 과두의 대칭성은 무증상 그룹에서는 대칭성이 더 빈번했고, 증상 그룹에서는 비대칭이 더 많았다. 결론: 이 데이터는 Cone-bean CT에 의해서 얻어진 최대교두감합위에서 과두 위치의 임상 평가를 위해 유용한 기준이 될 수 있을 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제36권1호
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• pp.147-154
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• 2006

Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

• 대한치과의사협회지
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• 제54권10호
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• pp.811-819
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• 2016

범안면골 골절은 안면부 손상 그 자체로도 치료가 까다롭고 어렵지만, 동반된 다른 신체 중요 장기의 손상 등과 함께 치료 후 에도 남을 수 있는 안면의 심미적, 기능적 문제들 때문에 더욱 치료가 힘들어 질 수 있다. 뇌손상 등의 중요 장기 손상으로 인해 수술이 빠른 시일 내에 시행되지 못할 때에는 관련 의학분과와의 긴밀한 협진 하에 수술 전 처치가 이루어질 수 있도록 하여야 하며, 연조직을 포함한 골절편 등 안면 구조물들이 손상되지 않고 전체적인 형태를 유지할 수 있도록 응급 처치가 되어야 한다. 3D CT 등의 영상진단을 통해 안면골 골절을 치료하기 위한 전체적인 계획을 수립해야 한다. 이 계획에는 수술을 위한 기도확보 방법, 골절의 정복 고정 순서, 접근 방법, 안구, 코 등의 재건 방법 그리고 연조직에 손상에 대한 처치가 포함된다. 수술 시에는 환자 개개인의 상황에 맞춰 되도록 정확한 정복과 고정이 가능한 안면구조물에서 부터 시작하여 교합을 형성하고, 안면골의 유기적인 관계에 유의하여 삼차원적인 구조를 재위치 시킬 수 있도록 해야 한다. 연조직 봉합 시에는 얼굴 피부의 처짐 등을 방지하기 위해 골막, 근막 및 중요 안면 인대들을 고려하여 시행하여야 한다.

• Journal of Periodontal and Implant Science
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• 제53권5호
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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.