• 대한치과교정학회지
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• 제46권1호
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• pp.13-19
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• 2016

Objective: The aim of this study was to compare the accuracy of Bolton analysis obtained from digital models scanned with the Ortho Insight three-dimensional (3D) laser scanner system to those obtained from cone-beam computed tomography (CBCT) images and traditional plaster models. Methods: CBCT scans and plaster models were obtained from 50 patients. Plaster models were scanned using the Ortho Insight 3D laser scanner; Bolton ratios were calculated with its software. CBCT scans were imported and analyzed using AVIZO software. Plaster models were measured with a digital caliper. Data were analyzed with descriptive statistics and the intraclass correlation coefficient (ICC). Results: Anterior and overall Bolton ratios obtained by the three different modalities exhibited excellent agreement (> 0.970). The mean differences between the scanned digital models and physical models and between the CBCT images and scanned digital models for overall Bolton ratios were $0.41{\pm}0.305%$ and $0.45{\pm}0.456%$, respectively; for anterior Bolton ratios, $0.59{\pm}0.520%$ and $1.01{\pm}0.780%$, respectively. ICC results showed that intraexaminer error reliability was generally excellent (> 0.858 for all three diagnostic modalities), with < 1.45% discrepancy in the Bolton analysis. Conclusions: Laser scanned digital models are highly accurate compared to physical models and CBCT scans for assessing the spatial relationships of dental arches for orthodontic diagnosis.

• Imaging Science in Dentistry
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• 제51권1호
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• pp.55-62
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• 2021

Purpose: This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods: Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results: The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45-0.72), sensitivity (0.6-0.67), and specificity (0.23-0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68-0.77, 0.67-083, and 0.53-087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion: The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.93-101
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• 2016

Purpose: The objective of this study was to investigate the effect of varying resolutions of cone-beam computed tomography images on the accuracy of linear measurements of edentulous areas in human cadaver heads. Intact cadaver heads were used to simulate a clinical situation. Materials and Methods: Fiduciary markers were placed in the edentulous areas of 4 intact embalmed cadaver heads. The heads were scanned with two different CBCT units using a large field of view ($13cm{\times}16cm$) and small field of view ($5cm{\times}8cm$) at varying voxel sizes (0.3 mm, 0.2 mm, and 0.16 mm). The ground truth was established with digital caliper measurements. The imaging measurements were then compared with caliper measurements to determine accuracy. Results: The Wilcoxon signed rank test revealed no statistically significant difference between the medians of the physical measurements obtained with calipers and the medians of the CBCT measurements. A comparison of accuracy among the different imaging protocols revealed no significant differences as determined by the Friedman test. The intraclass correlation coefficient was 0.961, indicating excellent reproducibility. Inter-observer variability was determined graphically with a Bland-Altman plot and by calculating the intraclass correlation coefficient. The Bland-Altman plot indicated very good reproducibility for smaller measurements but larger discrepancies with larger measurements. Conclusion: The CBCT-based linear measurements in the edentulous sites using different voxel sizes and FOVs are accurate compared with the direct caliper measurements of these sites. Higher resolution CBCT images with smaller voxel size did not result in greater accuracy of the linear measurements.

• The Journal of Advanced Prosthodontics
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• 제8권5호
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• pp.380-387
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• 2016

PURPOSE. The storage conditions of impressions affect the dimensional accuracy of the impression materials. The aim of the study was to assess the effects of storage time on dimensional accuracy of five different impression materials by cone beam computed tomography (CBCT). MATERIALS AND METHODS. Polyether (Impregum), hydrocolloid (Hydrogum and Alginoplast), and silicone (Zetaflow and Honigum) impression materials were used for impressions taken from an acrylic master model. The impressions were poured and subjected to four different storage times: immediate use, and 1, 3, and 5 days of storage. Line 1 (between right and left first molar mesiobuccal cusp tips) and Line 2 (between right and left canine tips) were measured on a CBCT scanned model, and time dependent mean differences were analyzed by two-way univariate and Duncan's test (${\alpha}=.05$). RESULTS. For Line 1, the total mean difference of Impregum and Hydrogum were statistically different from Alginoplast (P<.05), while Zetaflow and Honigum had smaller discrepancies. Alginoplast resulted in more difference than the other impressions (P<.05). For Line 2, the total mean difference of Impregum was statistically different from the other impressions. Significant differences were observed in Line 1 and Line 2 for the different storage periods (P<.05). CONCLUSION. The dimensional accuracy of impression material is clinically acceptable if the impression material is stored in suitable conditions.

• Imaging Science in Dentistry
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• 제53권4호
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• pp.325-333
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• 2023

Purpose: The objective of this study was to evaluate and compare the accuracy and image quality of root surface area (RSA) measurements obtained with various cone-beam computed tomography (CBCT) protocols, relative to the gold standard of micro-computed tomography (CT), in an in vitro setting. Materials and Methods: Four dry human skulls were scanned using 8 different protocols, with voxel sizes of 0.15 mm, 0.3 mm, and 0.4 mm. Three-dimensional models of the selected teeth were constructed using CBCT and microCT protocols, and the RSA was automatically measured by the image-processing software. The absolute difference in the percentage of the RSA(%ΔRSA) was calculated and compared across the 8 CBCT protocols using repeatedmeasures analysis of variance. Finally, image quality scores of the RSA measurements were computed and reported in terms of percent distribution. Results: No significant differences were observed in the %ΔRSA across the 8 protocols (P>0.05). The deviation in %ΔRSA ranged from 1.51% to 4.30%, with an increase corresponding to voxel size. As the voxel size increased, the image quality deteriorated. This decline in quality was particularly noticeable at the apical level of the root, where the distribution of poorer scores was most concentrated. Conclusion: Relative to CBCT protocols with voxel sizes of 0.15mm and 0.3mm, the protocols with a voxel size of 0.4 mm demonstrated inferior image quality at the apical levels. In spite of this, no significant discrepancies were observed in RSA measurements across the different CBCT protocols.

• Imaging Science in Dentistry
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• 제44권4호
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• pp.263-271
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• 2014

Purpose: This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Materials and Methods: Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: $13cm{\times}15cm;$ voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. Results: RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Conclusion: Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

• 대한치과교정학회지
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• 제46권5호
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• pp.331-342
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• 2016

Objective: To evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies. Methods: An electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2. Results: Nine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies. Conclusions: Current evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority.

• Restorative Dentistry and Endodontics
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• 제49권1호
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• pp.1.1-1.18
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• 2024

The implementation of imaging methods that enable sensitive and specific observation of anatomical structures has been a constant in the evolution of endodontic therapy. Cone-beam computed tomography (CBCT) enables 3-dimensional (3D) spatial anatomical navigation in the 3 volumetric planes (sagittal, coronal and axial) which translates into great accuracy for the identification of endodontic pathologies/conditions. CBCT interpretation consists of 2 main components: (i) the generation of specific tasks of the image and (ii) the subsequent interpretation report. A systematic and reproducible method to review CBCT scans can improve the accuracy of the interpretation process, translating into greater precision in terms of diagnosis and planning of endodontic clinical procedures. MEDLINE (PubMed), Web of Science, Google Scholar, Embase and Scopus were searched from inception to March 2023. This narrative review addresses the theoretical concepts, elements of interpretation and applications of the CBCT scan in endodontics. In addition, the contents and rationale for reporting 3D endodontic imaging are discussed.

• Imaging Science in Dentistry
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• 제52권3호
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• pp.289-294
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• 2022

Purpose: This study aimed to evaluate the diagnostic performance of panoramic images compared to cone-beam computed tomography (CBCT) imaging for maxillary third molar (M3)-associated external root resorption (ERR), and to identify the risk factors of ERR on panoramic images. Materials and Methods: The study population was composed of all patients who underwent panoramic imaging at Dankook University Dental Hospital from May to October 2019. In total, 397 cases of maxillary M3s in 247 patients(147 men and 100 women) were included. The diagnostic accuracy of ERR in panoramic images compared to CBCT images was evaluated using the chi-square test. To identify risk factors for ERR, dental records and panoramic findings were evaluated by logistic regression analysis. Results: The diagnostic accuracy of ERR on panoramic images was 0.79 compared to CBCT images (P<0.05). Superimposition of M3s onto second molars (M2) was associated with an approximately 33 times higher risk of ERR than separated M3s(P<0.05). Impacted M3s showed a 5 times higher risk of ERR than erupted M3s(P<0.05). Conclusion: ERR related to M3s is a common clinical condition, and superimposition of M3 onto M2 on panoramic images was the most important risk factor for ERR. It seemed that CBCT examinations for maxillary M3s might be indicated for ERR diagnosis especially if panoramic radiographs show superimposition of M3 onto M2. Impaction itself was also a risk factor, and it should be carefully examined.

• 대한치과교정학회지
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• 제48권5호
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• pp.292-303
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• 2018

Objective: Biplanar imaging systems allow for simultaneous acquisition of lateral and frontal cephalograms. The purpose of this study was to compare measurements recorded on three-dimensional (3D) cephalograms constructed from two-dimensional conventional radiographs and biplanar radiographs generated using a new biplanar imaging system with those recorded on cone-beam computed tomography (CBCT)-generated cephalograms in order to evaluate the accuracy of the 3D cephalograms generated using the biplanar imaging system. Methods: Three sets of lateral and frontal radiographs of 15 human dry skulls with prominent facial asymmetry were obtained using conventional radiography, the biplanar imaging system, and CBCT. To minimize errors in the construction of 3D cephalograms, fiducial markers were attached to anatomical landmarks prior to the acquisition of radiographs. Using the 3D $Ceph^{TM}$ program, 3D cephalograms were constructed from the images obtained using the biplanar imaging system (3D $ceph_{biplanar}$), conventional radiography (3D $ceph_{conv}$), and CBCT (3D $ceph_{cbct}$). A total of 34 measurements were obtained compared among the three image sets using paired t-tests and Bland-Altman plotting. Results: There were no statistically significant differences between the 3D $ceph_{biplanar}$ and 3D $ceph_{cbct}$ measurements. In addition, with the exception of one measurement, there were no significant differences between the 3D $ceph_{cbct}$ and 3D $ceph_{conv}$ measurements. However, the values obtained from 3D $ceph_{conv}$ showed larger deviations than those obtained from 3D $ceph_{biplanar}$. Conclusions: The results of this study suggest that the new biplanar imaging system enables the construction of accurate 3D cephalograms and could be a useful alternative to conventional radiography.