• The korean journal of orthodontics
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• v.50 no.3
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• pp.216-226
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• 2020

Root resorption can be caused by several factors, including contact with the cortical bone. Here we report a case involving a 21-year-old female with Angle Class II, division 1 malocclusion who exhibited significant root resorption in the maxillary right central incisor after orthodontic treatment. The patient presented with significant left-sided deviation of the maxillary incisors due to lingual dislocation of the left lateral incisor and a Class II molar relationship. Cephalometric analysis demonstrated a Class I skeletal relationship (A point-nasion-B point, 2.5°) and proclined maxillary anterior teeth (upper incisor to sella-nasion plane angle, 113.4°). The primary treatment objectives were the achievement of stable occlusion with midline agreement between the maxillary and mandibular dentitions and appropriate maxillary anterior tooth axes and molar relationship. A panoramic radiograph obtained after active treatment showed significant root resorption in the maxillary right central incisor; therefore, we performed cone-beam computed tomography, which confirmed root resorption along the cortical bone around the incisive canal. The findings from this case, where different degrees of root resorption were observed despite comparable degrees of orthodontic movement in the bilateral maxillary central incisors, suggest that the incisive canal could be an inducing factor for root resorption. However, further investigation is necessary to confirm this assumption.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.160-167
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• 2013

Purpose: This study examined the factors that can be associated with the appearance of the interproximal papilla. Methods: One hundred and forty-seven healthy interproximal papillae between the maxillary central incisors were examined. For each subject, a digital photograph and periapical radiograph of the interdental embrasure were taken using a 1-mm grid metal piece. The following parameters were recorded: the amount of recession of the interproximal papilla, contact point-bone crest distance, contact point-cemento-enamel junction (CEJ) distance, CEJ-bone crest distance, inter-radicular distance, tooth shape, embrasure space size, interproximal contact area, gingival biotype, papilla height, and papilla tip form. Results: The amount of recession of the interproximal papilla was associated with the following: 1) increase in contact point-bone crest, contact point-CEJ, and CEJ-bone crest distance; 2) increase in the inter-radicular distance; 3) triangular tooth shape; 4) decrease in the interproximal contact area length; 5) increase in the embrasure space size; and 6) flat papilla tip form. On the other hand, the amount of gingival recession was not associated with the gingival biotype or papilla height. In the triangular tooth shape, the contact point-bone crest distance and inter-radicular distance were longer, the interproximal contact area length was shorter, and the embrasure space size was larger. The papilla tip form became flatter with increasing inter-radicular distance and CEJ-bone crest distance. Conclusions: The relative position of the interproximal papilla in healthy subjects was associated with the multiple factors and each factor was related to the others. A triangular tooth shape carries a higher risk of recession of the interproximal papilla because the proximal contact point is positioned more incisally and the bone crest is positioned more apically. This results in an increase in recession of the interproximal papilla and flat papilla tip form.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.21-32
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• 2021

Purpose: The purpose of the present study was to investigate the correlation between age and 34 radiomorphometric parameters on panoramic radiographs, and to provide generalized linear models (GLMs) as a non-invasive, inexpensive, and accurate method to the forensic judgement of living individual's age. Methods: The study included 417 digital panoramic radiographs of Korean individuals (178 males and 239 females, mean age: 32.57±17.81 years). Considering the skeletal differences between the sexes, GLMs were obtained separately according to sex, as well as across the total sample. For statistical analysis and to predict the accuracy of the new GLMs, root mean squared error (RMSE) and adjusted R-squared (R²) were calculated. Results: The adjusted R²-values of the developed GLMs in the total sample, and male and female groups were 0.623, 0.637, and 0.660, respectively (p<0.001), while the allowable RMSE values were 8.80, 8.42, and 8.53 years, respectively. In the GLM of the total sample, the most influential predictor of greater age was decreased pulp area in the #36 first molar (beta=-26.52; p<0.01), followed by the presence of periodontitis (beta=10.24; p<0.01). In males, the most influential factor was the presence of periodontitis (beta=9.20; p<0.05), followed by the number of full veneer crowns (beta=2.19; p<0.001). In females, the most influential predictor was the presence of periodontitis (beta=18.10; p<0.001), followed by the tooth area of the #16 first molar (beta=-11.57; p<0.001). Conclusions: We established acceptable GLM for each sex and found out the predictors necessary to age estimation which can be easily found in panoramic radiographs. Our study provides reference that parameters such as the area of tooth and pulp, the number of teeth treated, and the presence of periodontitis should be considered in estimating age.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.93-101
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• 2022

Purpose: This study compared the effectiveness of complementary metal-oxide semiconductors (CMOS) and photostimulable phosphor (PSP) plates as intraoral imaging systems in terms of time efficacy, patient comfort, and subjective image quality assessment in real clinical settings. Materials and Methods: Fifty-eight patients (25 women and 33 men) were included. Patients were referred for a full-mouth radiological examination including 1 bitewing radiograph (left and right) and 8 periapical radiographs for each side (left maxilla/mandible and right maxilla/mandible). For each patient, 1 side of the dental arch was radiographed using a CMOS detector, whereas the other side was radiographed using a PSP detector, ensuring an equal number of left and right arches imaged by each detector. Clinical application time, comfort/pain, and subjective image quality were assessed for each detector. Continuous variables were summarized as mean±standard deviation. Differences between detectors were evaluated using repeated-measures analysis of variance. P<0.05 was accepted as significant. Results: The mean total time required for all imaging procedures with the CMOS detector was significantly lower than the mean total time required for imaging procedures with PSP (P<0.05). The overall mean patient comfort scores for the CMOS and PSP detectors were 4.57 and 4.48, respectively, without a statistically significant difference (P>0.05). The performance of both observers in subjectively assessing structures was significantly higher when using CMOS images than when using PSP images for all regions (P<0.05). Conclusion: The CMOS detector was found to be superior to the PSP detector in terms of clinical time efficacy and subjective image quality.

• Imaging Science in Dentistry
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• v.52 no.4
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• pp.383-391
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• 2022

Purpose: Periodontitis, the most prevalent chronic inflammatory condition affecting teeth-supporting tissues, is diagnosed and classified through clinical and radiographic examinations. The staging of periodontitis using panoramic radiographs provides information for designing computer-assisted diagnostic systems. Performing image segmentation in periodontitis is required for image processing in diagnostic applications. This study evaluated image segmentation for periodontitis staging based on deep learning approaches. Materials and Methods: Multi-Label U-Net and Mask R-CNN models were compared for image segmentation to detect periodontitis using 100 digital panoramic radiographs. Normal conditions and 4 stages of periodontitis were annotated on these panoramic radiographs. A total of 1100 original and augmented images were then randomly divided into a training (75%) dataset to produce segmentation models and a testing (25%) dataset to determine the evaluation metrics of the segmentation models. Results: The performance of the segmentation models against the radiographic diagnosis of periodontitis conducted by a dentist was described by evaluation metrics(i.e., dice coefficient and intersection-over-union [IoU] score). MultiLabel U-Net achieved a dice coefficient of 0.96 and an IoU score of 0.97. Meanwhile, Mask R-CNN attained a dice coefficient of 0.87 and an IoU score of 0.74. U-Net showed the characteristic of semantic segmentation, and Mask R-CNN performed instance segmentation with accuracy, precision, recall, and F1-score values of 95%, 85.6%, 88.2%, and 86.6%, respectively. Conclusion: Multi-Label U-Net produced superior image segmentation to that of Mask R-CNN. The authors recommend integrating it with other techniques to develop hybrid models for automatic periodontitis detection.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.179-186
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• 2017

Purpose of this study is present the normal range of cardiac size and cardiothoracic ratio according to patient position(chest PA and AP) and age of Korean adult male on digital chest X - ray, And to propose a mutually compatible conversion rate. 1,024 males were eligible for this study, among 1,300 normal chest patients who underwent chest PA and low-dose CT examinations on the same day at the 'S' Hospital Health Examination Center in Seoul From January to December 2014. CS and CTR were measured by Danzer (1919). The mean difference between CS and CTR was statistically significant (p<0.01) in Chest PA (CS 135.48 mm, CTR 43.99%) and Chest AP image (CS 155.96 mm, CTR 51.75%). There was no statistically significant difference between left and right heart in chest PA and AP images (p>0.05). CS showed statistically significant difference between Chest PA (p>0. 05) and Chest AP (p<0.05). The thorax size and CTR were statistically significant (p<0.01) in both age and chest PA and AP. Result of this study, On Chest AP image CS was magnified 15%, CTR was magnified 17% compare with Chest PA image. CS and CTR were about 10% difference by changing posture at all ages.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.6.1-6.10
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• 2019

Background: Osteomyelitis is an intraosseous inflammatory disease characterized by progressive inflammatory osteoclasia and ossification. The use of quantitative analysis to assist interpretation of osteomyelitis is increasingly being considered. The objective of this study was to perform early diagnosis of osteomyelitis on digital panoramic radiographs using basic functions provided by picture archiving and communication system (PACS), a program used to show radiographic images. Methods: This study targeted a total of 95 patients whose symptoms were confirmed as osteomyelitis under clinical, radiologic, pathological diagnosis over 11 years from 2008 to 2017. Five categorized patients were osteoradionecrosis, bisphosphonate-related osteonecrosis of jaw (BRONJ, suppurative and sclerosing type), and bacterial osteomyelitis (suppurative and sclerosing type), and the control group was 117 randomly sampled. The photographic density in a certain area of the digital panoramic radiograph was determined and compared using the "measure area rectangle," one of the basic PACS functions in INFINITT PACS^® (INFINITT Healthcare, Seoul, South Korea). A conditional inference tree, one type of decision making tree, was generated with the program R for statistical analysis with SPSS^®. Results: In the conditional inference tree generated from the obtained data, cases where the difference in average value exceeded 54.49 and the difference in minimum value was less than 54.49 and greater than 12.81 and the difference in minimum value exceeded 39 were considered suspicious of osteomyelitis. From these results, the disease could be correctly classified with a probability of 88.1%. There was no difference in photographic density value of BRONJ and bacterial osteomyelitis; therefore, it was not possible to classify BRONJ and bacterial osteomyelitis by quantitative analysis of panoramic radiographs based on existing research. Conclusions: This study demonstrates that it is feasible to measure photographic density using a basic function in PACS and apply the data to assist in the diagnosis of osteomyelitis.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.1
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• pp.37-45
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• 2016

The purpose of this study was to assess the intra-rater, inter-rater and test-retest reliability and validity of frontal plane lower extremity alignment estimated from a rasterstereographic method using ABW-Mapper. Eighteen subjects participated in this study. The S angle (stereographic angle-frontal plane lower extremity alignment estimated from a rasterstereographic method) in standing was measured throughout the two sessions with one week interval by two different readers. In the first session, a reader measured S angle twice per subject with a short break in-between. The Q-angle (quadriceps angle) was measured using a standard goniometer from a photography taken through digital camera with the participant standing in the same position as in the S angle measurement. The HKA(hip-knee-ankle) angle was measured from a computer based digital radiograph with the computerized measurement software. Reliability was tested using intraclass correlation coefficients(ICC). Validity was tested using a Pearson's correlation coefficient. Excellent intra-rater(ICC=0.956~0.974), inter-rater(ICC=0.962), test-retest reliability (ICC=0.945) were demonstrated. There were strong negative correlations between S angle and Q-angle (r=-0.739), and between S angle and HKA angle (r=-0.702). Therefore, the S angle measured using a rasterstereographic mapper may be used to as a preliminary or supplementary tool to evaluate and study LE alignment in the frontal plane in relation to HKA angle or Q-angle.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.203-220
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• 1991

The purpose of this study was to investigate the changes of morphology and structure of bone tissue, caused by administration of high-dose hydrocortisone, elcatonin and cyclophosphamide. In order to carry out experiment, 60 four-week old Sprague-Dawley strain rats weighing about 107 gms were selected and divided into experimental group and control group. The experimental group was subdivided into three groups, assigned fifteen rats for each group, by the different drugs administered. Each experimental group was then categorized as follows: hydrocortisone 30㎎/㎏ b.w. with daily subcutaneous injection, elcatonin 20U/㎏ b.w. with daily subcutaneous injection, and cyclophosphamide 100㎎/㎏ b.w. with a single intraperitoneal injection. Fifteen rats were injected daily with 5㎖/㎏ b.w. of normal saline solution subcutaneously in control group. Rats in control group and experimental group were serially sacrificed on the 6th, the 15th and the 22nd day after injection of normal saline, hydrocortisone, elcatonin and cyclophosphamide, respectively. Being sacrificed, both sides of mandibular condyles were removed and fixed with 10% neutral formaline. The one side of mandibular condyles was radiographed with soft X-ray apparatus. Thereafter, the obtained radiographs were observed, and the bone density of condylar head and condylar neck regions was measured by use of transferring video-based digital radiograph. The other side was further decalcified and embedded in paraffin as usual manner, then sectioned and stained with hematoxylin and eosin, observed by light microscope. The obtained results were as follows: 1. Sclerotic changes with regularly increased trabecular pattern were seen throughout experimental periods in hydrocortisone group. Increased the number of trabecular pattern with irregularity and periodic striation on the periphery of condylar head region were appeared with lapse of time in elcatonin group. In cyclophosphamide group, irregular trabecular pattern and stippled radiopacities on mandibular condyle were observed with lapse of time. 2. The bone density of condylar head region was increased in hydrocortisone group, decreased in elcatonin group, and tended to be decreased in cyclophosphamide group, compared with that of control group according to the experimental periods. 3. The bone density of condylar neck region tended to be rather increased in hydrocortisone group, elcatonin group and cyclophosphamide group, depending on the experimental periods. 4. In microscopic studies, there were irregular trabecular bonds and osteoblastic activity in hydrocortisone group and elcatonin group throughout experimental periods, degenerative cartilage and trabecular bones in the 6th day and densely calcified trabecular bones in the 22nd day in cyclophosphamide group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.389-395
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• 2010

Purpose: Although it is generally accepted that patients with controlled diabetes have similar rates of success for dental implants as healthy individuals, the use of dental implants in diabetic patients is controversial. In addition, the impact of diabetes on the healing of bone associated with immediately place dental implants is not completely understood. The purpose of this study was to measure bone response to implants radiologically in uncontrolled and insulin-controlled diabetic rats. Materials and Methods: Twenty rats were divided into control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. Two titanium implants ($1.2{\times}3$ mm) were placed in the extraction socket of the maxillary first molars of the animals and were harvested at 3 days, 1, 2 and 4 weeks. The bone density was measured by digital radiography using gray-level analysis (histogram) in the regions of interest (ROI) at four points: two mesial and two distal to both sides of the implant. Results: The results showed that the osseointegration of the implants was impaired in the diabetic rats compared to the control and the insulin-treated rats. The radiographic evidence demonstrated marked destruction of bone around the implants in the diabetic group. Both the control and the insulin-treated groups had a significantly higher bone density on radiograph than the diabetic group from the 1 week of the experiment (P<0.05 for each comparison). Conclusion: The present study revealed that the immediate placement of titanium implants in the maxilla of diabetic rat lead to delay in the maturation of bone adjacent to implants. It is expected that the reduced predictability of success of immediate implantation in patient with the uncontrolled diabetes.