• Imaging Science in Dentistry
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• v.46 no.1
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• pp.1-7
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• 2016

Purpose: This study assessed the accuracy of age estimates produced by a regression equation derived from lower third molar development in a Thai population. Materials and Methods: The first part of this study relied on measurements taken from panoramic radiographs of 614 Thai patients aged from 9 to 20. The stage of lower left and right third molar development was observed in each radiograph and a modified Gat score was assigned. Linear regression on this data produced the following equation: Y=9.309+1.673 mG+0.303S (Y=age; mG=modified Gat score; S=sex). In the second part of this study, the predictive accuracy of this equation was evaluated using data from a second set of panoramic radiographs (539 Thai subjects, 9 to 24 years old). Each subject's age was estimated using the above equation and compared against age calculated from a provided date of birth. Estimated and known age data were analyzed using the Pearson correlation coefficient and descriptive statistics. Results: Ages estimated from lower left and lower right third molar development stage were significantly correlated with the known ages (r=0.818, 0.808, respectively, $P{\leq}0.01$). 50% of age estimates in the second part of the study fell within a range of error of ${\pm}1year$, while 75% fell within a range of error of ${\pm}2years$. The study found that the equation tends to estimate age accurately when individuals are 9 to 20 years of age. Conclusion: The equation can be used for age estimation for Thai populations when the individuals are 9 to 20 years of age.

• Journal of Oral Medicine and Pain
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• v.46 no.4
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• pp.125-130
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• 2021

Purpose: The dental age estimation of children is performed using dental maturity. Postmortem missing of the anterior teeth or the distortion of image of the anterior teeth in panoramic radiographs can make it difficult to analyze the development of the anterior teeth. This pilot study was conducted to derive a new age estimation method based only on the developmental stage of mandibular posterior teeth. Methods: This study was conducted using panoramic radiographs of 650 subjects aged 3 to 15 years old. The dental developmental stages of the lower left first premolar, second premolar, first molar and second molar were evaluated according to the Demirjian's criteria. The intra-/inter-observer reliability was evaluated, and multiple linear regression analyses were performed including the developmental stage of each tooth as an independent variable. Results: The intra-/inter-observer reliability was 0.9626 and 0.8877, respectively, and showed very high reproducibility. Multiple linear regression analyses were performed for males and females, and the age calculation table was derived by obtaining the intercept and the coefficient according to the development stage of each tooth. The coefficient of determination (r²) of the age calculation method was 0.9634 for male and 0.9570 for female subjects, and the mean difference between chronological age and estimated dental age was -0.42 and -0.21, respectively. Conclusions: This pilot study evaluated the developmental stages of four lower posterior teeth in the Korean group according to Demirjian's criteria, and derived age estimation method. The accuracy was lower than when more teeth were used, but it will be useful to estimate age of children when the anterior teeth are difficult to accurately analyze.

• Imaging Science in Dentistry
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• v.53 no.3
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• pp.199-207
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• 2023

Purpose: The objective of this study was to evaluate the accuracy and effectiveness of an artificial intelligence (AI) program in identifying dental conditions using panoramic radiographs(PRs), as well as to assess the appropriateness of its treatment recommendations. Materials and Methods: PRs from 100 patients(representing 4497 teeth) with known clinical examination findings were randomly selected from a university database. Three dentomaxillofacial radiologists and the Diagnocat AI software evaluated these PRs. The evaluations were focused on various dental conditions and treatments, including canal filling, caries, cast post and core, dental calculus, fillings, furcation lesions, implants, lack of interproximal tooth contact, open margins, overhangs, periapical lesions, periodontal bone loss, short fillings, voids in root fillings, overfillings, pontics, root fragments, impacted teeth, artificial crowns, missing teeth, and healthy teeth. Results: The AI demonstrated almost perfect agreement (exceeding 0.81) in most of the assessments when compared to the ground truth. The sensitivity was very high (above 0.8) for the evaluation of healthy teeth, artificial crowns, dental calculus, missing teeth, fillings, lack of interproximal contact, periodontal bone loss, and implants. However, the sensitivity was low for the assessment of caries, periapical lesions, pontic voids in the root canal, and overhangs. Conclusion: Despite the limitations of this study, the synthesized data suggest that AI-based decision support systems can serve as a valuable tool in detecting dental conditions, when used with PR for clinical dental applications.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.343-350
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• 2023

Background: Digital panoramic dental X-ray equipment (PDX) is frequently used by patients and dental workers for diagnosis and examination in dental institutions; however, infection control has not been properly implemented. Therefore, in this study, we aimed to systematically review the potential risk of cross-infection in the dental environment by investigating the contamination level of general aerobic bacteria and Staphylococcus aureus, which are important in hospital infections, in PDX areas that people mainly contact. Methods: This survey was conducted from March to May 2023 and covered one general hospital, three dental hospitals, and nine dental clinics equipped with PDX. Bacteria samples were collected from the left-handle, right-handle, forehead support, and head side support as the patient's contact areas, as well as the X-ray exposure switch and left-click mouse button as the dental hygienist's contact areas of the PDX. The collected bacteria were spread on Petrifilm, and colonies formed after 48 hours of culture were counted. Results: General aerobic bacteria and S. aureus were detected in all areas investigated. Significant differences in bacterial counts between different regions of the PDX were observed in both groups (p<0.001). The detection rates of general aerobic bacteria (p<0.001) and S. aureus (p<0.001) were significantly higher in the contact areas of patients than those of dental hygienists. A positive correlation was observed between the forehead and the temple region in terms of general aerobic bacteria and S. aureus detection (r=1) (p<0.01). Conclusion: Taken together, the presence of many bacteria, including S. aureus, detected in PDX indicates that PDX has a potential cross-infection risk. Our results therefore highlight the need for the development of appropriate disinfection protocols for reusable medical devices such as PDX and periodic infection prevention training for hospital-related workers, including dental hygienists.

• Imaging Science in Dentistry
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• v.54 no.1
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• pp.33-41
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• 2024

Purpose: The aims of this study were to create a deep learning model to distinguish between nasopalatine duct cysts (NDCs), radicular cysts, and no-lesions (normal) in the midline region of the anterior maxilla on panoramic radiographs and to compare its performance with that of dental residents. Materials and Methods: One hundred patients with a confirmed diagnosis of NDC (53 men, 47 women; average age, 44.6±16.5 years), 100 with radicular cysts (49 men, 51 women; average age, 47.5±16.4 years), and 100 with normal groups (56 men, 44 women; average age, 34.4±14.6 years) were enrolled in this study. Cases were randomly assigned to the training datasets (80%) and the test dataset (20%). Then, 20% of the training data were randomly assigned as validation data. A learning model was created using a customized DetectNet built in Digits version 5.0 (NVIDIA, Santa Clara, USA). The performance of the deep learning system was assessed and compared with that of two dental residents. Results: The performance of the deep learning system was superior to that of the dental residents except for the recall of radicular cysts. The areas under the curve (AUCs) for NDCs and radicular cysts in the deep learning system were significantly higher than those of the dental residents. The results for the dental residents revealed a significant difference in AUC between NDCs and normal groups. Conclusion: This study showed superior performance in detecting NDCs and radicular cysts and in distinguishing between these lesions and normal groups.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.433-438
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• 2015

To evaluate the radiation exposure level based on radiation workers' locations in dental radiography, the radiation dose rate in the radiographic room, lead glass, and operation system was measured. To that end, various devices were used, such as a Standard(Max-GLS, Shinhung), a panorama (PCH-2500, Vatech), a cephalometric radiography (PCH-2500), and a cone beam CT (PHT-30LFO, Vatech), as well as a PM1405 equipment as a radiation meter. Radiography conditions were set the same as the factors used in the clinical setting. As the result, the cone beam CT turned out the highest with 98 uSv and the standard showed the lowest level with 0.4 uSv/h. The panorama was measured to be higher than the Cephalo due to its different focus mode. On the lead glass surface and in the operation stand, the oral radiography device, panoramic, and Cephalo all were measured below the recording level. However, the cone beam CT was measured to have the leakage dose. Thus, radiation involved workers should be equipped with appropriate protection tools and reduce radiography time as much as possible. In addition, the structure of the radiation chamber should be also designed efficiently. Dental radiography has continued to grow in recent years, so it is necessary take appropriate protection measures for patients and radiation workers.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.30.1-30.7
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• 2015

Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.

• Journal of Oral Medicine and Pain
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• v.37 no.2
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• pp.125-133
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• 2012

TMJ Osteoarthritis is a degenerative disease caused by overload on joint tissue, and often accompany with local tenderness on the joint, crepitus by mandibular movement, restriction of mandibular movement, and anterior openbite. In general, panoramic radiography, TMJ panoramic radiography, and transcranial radiography are conducted to diagnose osteoarthritis after clinical examination, however, these radiographic evaluations are limited in detecting minute bony changes of early pathologic lesion. The aim of this pilot study was to evaluate the limitation and usefulness of several TMJ imaging techniques, so we compare the findings from clinical examination, plain film radiographs, tomograph, and bone scan from 81 patients with temporomandibular joint disorder. The proportion of patients showing same findings in plain film radiographs, TMJ tomograph, and bone scan was high, however, it is desirable that clinician should conduct phased imaging examinations according to the clinical findings due to the possibilities of false negative findings in diagnosis of osteoarthritis.

• Imaging Science in Dentistry
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• v.46 no.2
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• pp.103-108
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• 2016

Purpose: The current study investigates the feasibility of a platform for a nationwide dose monitoring system for dental radiography. The essential elements for an unerring system are also assessed. Materials and Methods: An intraoral radiographic machine with 14 X-ray generators and five sensors, 45 panoramic radiographic machines, and 23 cone-beam computed tomography (CBCT) models used in Korean dental clinics were surveyed to investigate the type of dose report. A main server for storing the dose data from each radiographic machine was prepared. The dose report transfer pathways from the radiographic machine to the main sever were constructed. An effective dose calculation method was created based on the machine specifications and the exposure parameters of three intraoral radiographic machines, five panoramic radiographic machines, and four CBCTs. A viewing system was developed for both dentists and patients to view the calculated effective dose. Each procedure and the main server were integrated into one system. Results: The dose data from each type of radiographic machine was successfully transferred to the main server and converted into an effective dose. The effective dose stored in the main server is automatically connected to a viewing program for dentist and patient access. Conclusion: A patient radiation dose monitoring system is feasible for dental clinics. Future research in cooperation with clinicians, industry, and radiologists is needed to ensure format convertibility for an efficient dose monitoring system to monitor unexpected radiation dose.

• Journal of radiological science and technology
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• v.34 no.1
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• pp.27-33
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• 2011

Along with the developments of science technology, up-to-date medical radiation equipments are introduced. Those equipments has brought many progresses in diagnosing patients not only in the quantitative aspects but in the qualitative ones. Especially, in the case of dental radiography, patients can be exposed more than CT, cone beam computed tomography (CBCT). In this study, we used human phantom and TLD-100H to measure the organ dose in each dental radiography and computed the effective dose according to ICRP (International Committee for Radioactivity Prevention) 60, 103. We measured the effective dose to be 5.1 and $29.5{\mu}Sv$ in the panoramic radiography and 11.2 and $14.4{\mu}Sv$ in the cephalometric radiography respectively. We also executed the CBCT and CT test on the maxillaries and the mandibles and found the amounts of effective dose were 53.7, 209.6, 129, and $391.5{\mu}Sv$ respectively in the CBCT and $93.3{\mu}$, 139.5, 282.7 and $489.7{\mu}Sv$ in the CT test. Consequently, it was shown that the effective dose in the CBCT test was lower than one in the CT test, but was higher in both panoramic and cephalometric radiography.