• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.78-86
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• 2010

Introduction: Cone beam computed tomography (CBCT) has various advantages and is used favorably in many fields in dentistry. Especially, CBCT is being used as basic diagnostic tool for 3-dimensional analysis in orthognathic patient. Two-dimensional cephalograms can be synthesized from CBCT digital imaging and communications in medicine (DICOM) data. In this study, conventional cephalograms and CBCT were taken simultaneously, and representative landmarks were located and analyzed in its accuracy and reproducibility. Materials and Methods: Ten patients who had orthognathic surgery in Wonkwang University Daejeon Dental Hospital participated in this study. For each patient, CBCT and conventional cephalogram was taken. By using Ondemand (Cybermad, Korea), 2-dimensional cephalograms was established on CBCT. In addition, 19 landmarks were designated and measured by 3 orthodontists twice a week. After these landmarks were transferred to a coordinate, distance of landmark and axis, standard error, distribution degree were measured, compared and analyzed. Results: Comparing the CT ceph group and conventional cephalogram group, CT ceph group had shown shorter distance of landmark and axis in S, Hinge axis, Bpt, Ba, Or, Corpus left. Standard error of the mean shows that CT ceph group has better reproducibility in Or, Corpus left, Hinge axis at X axis and Na, U1R, U1T, Bpt, PNS, Ba Corpus left, Hinge axis at Y axis. In both groups, mean error was less than 1.00 mm, no significant difference were found between CT ceph group and conventional cephalogram group in all measurements. Furthermore, comparing two groups, each 17 landmarks out of 19 had its characteristic in distribution degree. Conclusion: No significant difference were found between CBCT composed cephalographic radiograph and conventional cephalograghic radiograph, clinical application may be possible if improved.

• 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.

• Imaging Science in Dentistry
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• 제41권3호
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• pp.101-106
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• 2011

Purpose : This study evaluated the potential use of the computed tomography indices (CTI) on cone beam CT (CBCT) images for an assessment of the bone mineral density (BMD) in postmenopausal osteoporotic women. Materials and Methods : Twenty-one postmenopausal osteoporotic women and 21 postmenopausal healthy women were enrolled as the subjects. The BMD of the lumbar vertebrae and femur were calculated by dual energy X-ray absorptiometry (DXA) using a DXA scanner. The CBCT images were obtained from the unilateral mental foramen region using a PSR-$9000N^{TM}$ Dental CT system. The axial, sagittal, and coronal images were reconstructed from the block images using $OnDemend3D^{TM}$. The new term "CTI" on CBCT images was proposed. The relationship between the CT measurements and BMDs were assessed and the intra-observer agreement was determined. Results : There were significant differences between the normal and osteoporotic groups in the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography cortical index (CTCI). On the other hand, there was no difference between the groups in the computed tomography mental index (CTMI: inferior cortical width). Conclusion : CTI(S), CTI(I), and CTCI on the CBCT images can be used to assess the osteoporotic women.

• Imaging Science in Dentistry
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• 제42권1호
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• pp.25-33
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• 2012

Purpose : This study was performed to determine the accuracy of linear measurements on three-dimensional (3D) images using multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). Materials and Methods : MDCT and CBCT were performed using 24 dry skulls. Twenty-one measurements were taken on the dry skulls using digital caliper. Both types of CT data were imported into OnDemand software and identification of landmarks on the 3D surface rendering images and calculation of linear measurements were performed. Reproducibility of the measurements was assessed using repeated measures ANOVA and ICC, and the measurements were statistically compared using a Student t-test. Results : All assessments under the direct measurement and image-based measurements on the 3D CT surface rendering images using MDCT and CBCT showed no statistically difference under the ICC examination. The measurements showed no differences between the direct measurements of dry skull and the image-based measurements on the 3D CT surface rendering images (P>.05). Conclusion : Three-dimensional reconstructed surface rendering images using MDCT and CBCT would be appropriate for 3D measurements.

• 대한치과의사협회지
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• 제48권10호
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• pp.724-728
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• 2010

Accurate analysis of facial asymmetry prior to any orthognathic or orthodontic treatment plan is essential in ensuring good treatment result. Dental CBCT (Cone-beam Computed Tomography) provides as actual three-dimensional measurements of distance and angle without any radiographic magnification as medical CT provides, while its field of view is limited to the oral and maxillofacial area. CBCT is a useful tool for the diagnosis of facial asymmetry. The coordinates of facial landmarks are obtained from the 3D reconstruction software which enables the establishment of perpendicular planes and the identification of the landmarks. Then, the bilateral discrepancies of the landmarks are obtained as spherical polar coordinates which can show the amount of asymmetry and its direction. A method of 3D analysis of facial asymmetry using CBCT is introduced in this report.

• 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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• 제40권4호
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• pp.171-178
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• 2010

Purpose : The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Materials and Methods : Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Results : Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. Conclusion : The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.

• 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.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.291-298
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• 2020

Purpose: The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods: In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results: CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion: Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.

• 구강회복응용과학지
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• 제25권3호
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• pp.211-224
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• 2009

본 연구의 목적은 연령과 성별 및 CT 촬영 목적에 따른 하악 과두의 골 이상에 대한 양상과 발병률 그리고 호발 부위를 살펴보고, 촬영 목적에 있어서 TMD 진단을 위한 그룹과 그 외의 그룹간의 발병 양상을 비교해 보기 위함이다. 원광대학교 산본 치과 병원으로부터 $i-CAT^{TM}$ Cone Beam Computed Tomography를 이용하여 촬영된 199명의 3차원 CT 영상을 수집하고, 촬영된 MPR 이미지는 하악 과두의 연속된 시상 이미지와 관상 이미지를 얻기 위하여 TMJ 모드로 전환되었다. 3명의 관찰자는 이를 토대로 골 이상의 양상 및 발병률, 호발 부위, 그리고 하악 과두의 전반적인 외형에 대해 각기 독립적으로 판독한 결과 type F가 type N보다도 훨씬 흔하게 관찰 되었다. 시상 이미지에서의 호발 부위는 type D-C를 제외하고는 하악 과두의 전상방 및 상방 부위였으며, type D-C에서는 후상방 부위가 가장 흔하였다. 관상 이미지에서는 type E를 제외하고는 외상방 및 상방 부위에 호발하였으나, type E에서는 내상방 및 상방 부위에서 빈발 하였다. 하악 과두의 골 이상 소견은 type D-C를 제외하고는 TMD 진단을 위한 그룹에서 보다 높게 나타났으며, 그 외의 그룹에서는 type N 및 type D-C가 보다 높게 나타났다. 본 연구에서는, 하악 과두의 골 이상 소견을 6가지 분류해 보았으며, 이러한 골 이상 소견은 각기 빈발하는 부위가 있는 것으로 나타났다. 그리고 TMD 진단 그룹이 type D-C를 제외하고는 골 이상 소견이 더 높게 나타나는 경향을 보였다.