• The korean journal of orthodontics
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• v.42 no.2
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• pp.56-63
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• 2012

Objective: To identify the right and left difference of the facial soft tissue landmarks three-dimensionally from the subjects of normal occlusion individuals. Materials and Methods: Cone-beam computed tomography (CT) scans were obtained in 48 normal occlusion adults (24 men, 24 women), and reconstructed into 3-dimensional (3D) models by using a 3D image soft ware. 3D position of 27 soft tissue landmarks, 9 midline and 9 pairs of bilateral landmarks, were identified in 3D coordination system, and their right and left differences were calculated and analyzed. Results: The right and left difference values derived from the study ranged from 0.6 to 4.6 mm indicating a high variability according to the landmarks. In general, the values showed a tendency to increase according to the lower and lateral positioning of the landmarks in the face. Overall differences were determined not only by transverse differences but also by sagittal and vertical differences, indicating that 3D evaluation would be essential in the facial soft tissue analysis. Conclusions: Means and standard deviations of the right and left difference of facial soft tissue landmarks derived from this study can be used as the diagnostic standard values for the evaluation of facial asymmetry.

• Imaging Science in Dentistry
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• v.38 no.1
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• pp.23-27
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• 2008

Purpose: The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). Materials and Methods: CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB $Mercuray^{TM}$ (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with $Vimplant2.0^{TM}$ (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. Results: The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p< 0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was $79.6{\pm}2.7^{\circ}\;and\;80.1{\pm}5.7^{\circ}$ respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. Conclusion: We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.1
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• pp.46-55
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• 2018

Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant - supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.905-917
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• 2022

This study was conducted to evaluate the use of the MAR function and the image quality of the image when examining with each radiation dose. A simple Periapical phantom was made to set up an implant, and images were obtained and analyzed according to the presence or absence of MAR function for each radiation dose using CBCT equipment. In this study, MEAN, SNR, and CNR values were obtained using the Image J program, and through statistical analysis, images were the most quantitative and suitable values when the Abutment of Implant was 100 kVp and 8 mA, and when the Center of Implant and Apex of Implant were 100 kVp and 9 mA. As a result, it was confirmed that if the radiation dose increased, the Pixel Value, SNR, and CNR values of the image rose up so that the quality of the image improved, and using the MAR function reduced artifacts.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.61-72
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• 2022

Purpose: Conventional CBCT(Cone-beam Computed-tomography) caused an error in the target volume due to organ movement in the area affected by respiratory movement. The purpose of this paper is to evaluate the usefulness of accuracy and time spent using the Gated CBCT function, which reduces errors when performing RGRT(respiratory gated radiation therapy), and to examine the appropriateness of phase. Materials and methods: To evaluate the usefulness of Gated CBCT, the QUASAR^TM respiratory motion phantom was used in the Truebeam STx^TM. Using lead marker inserts, Gated CBCT was scaned 5 times for every 20~80% phase, 30~70% phase, and 40~60% phase to measure the blurring length of the lead marker, and the distance the lead marker moves from the top phase to the end of the phase was measured 5 times. Using Cedar Solid Tumor Inserts, 4DCT was scanned for every phase, 20-80%, 30-70%, and 40-60%, and the target volume was contoured and the length was measured five times in the axial direction (S-I direction). Result: In Gated CBCT scaned using lead marker inserts, the axial moving distance of the lead marker on average was measured to be 4.46cm in the full phase, 3.11cm in the 20-80% phase, 1.94cm in the 30-70% phase, 0.90cm in the 40-60% phase. In Fluoroscopy, the axial moving distance of the lead marker on average was 4.38cm and the distance on average from the top phase to the beam off phase was 3.342cm in the 20-80% phase, 3.342cm in the 30-70% phase, and 0.84cm in the 40-60% phase. Comparing the results, the difference in the full phase was 0.08cm, the 20~80% phase was 0.23cm, the 30~70% phase was 0.10cm, and the 40~60% phase was 0.07cm. The axial lengths of ITV(Internal Target Volume) and PTV(Planning Target Volume) contoured by 4DCT taken using cedar solid tumor inserts were measured to be 6.40cm and 7.40cm in the full phase, 4.96cm and 5.96cm in the 20~80% phase, 4.42cm and 5.42cm in the 30~70% phase, and 2.95cm and 3.95cm in the 40~60% phase. In the Gated CBCT, the axial lengths on average was measured to be 6.35 cm in the full phase, 5.25 cm in the 20-80% phase, 4.04 cm in the 30-70% phase, and 3.08 cm in the 40-60% phase. Comparing the results, it was confirmed that the error was within ±8.5% of ITV Conclusion: Conventional CBCT had a problem that errors occurred due to organ movement in areas affected by respiratory movement, but through this study, obtained an image similar to the target volume of the setting phase using Gated CBCT and verified its usefulness. However, as the setting phase decreases, the scan time was increases. Therefore, considering the scan time and the error in setting phase, It is recommended to apply it to patients with respiratory coordinated stereotactic radiation therapy using a wide phase of 30-70% or more.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.373-375
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• 2002

4D CT is a dynamic volume imaging system of moving organs with an image quality comparable to conventional CT, and is realized with continuous and high-speed cone-beam CT. In order to realize 4D CT, we have developed a novel 2D detector on the basis of the present CT technology, and mounted it on the gantry frame of the state-of-the-art CT-scanner. In the present report we describe the design of the first model of 4D CT-scanner as well as the early results of performance test. The x-ray detector for the 4D CT-scanner is a discrete pixel detector in which pixel data are measured by an independent detector element. The numbers of elements are 912 (channels) ${\times}$ 256 (segments) and the element size is approximately 1mm ${\times}$ 1mm. Data sampling rate is 900views(frames)/sec, and dynamic range of A/D converter is 16bits. The rotation speed of the gantry is l.0sec/rotation. Data transfer system between rotating and stationary parts in the gantry consists of laser diode and photodiode pairs, and achieves net transfer speed of 5Gbps. Volume data of 512${\times}$512${\times}$256 voxels are reconstructed with FDK algorithm by parallel use of 128 microprocessors. Normal volunteers and several phantoms were scanned with the scanner to demonstrate high image quality.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.93-98
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• 2020

Purpose: Little is known regarding the accuracy of clinical magnetic resonance imaging (MRI) protocols with acceptable scan times in sinus graft assessment. The aim of this study was to evaluate the correlations between MRI and cone-beam computed tomographic (CBCT) measurements of maxillary sinus grafts using 2 different clinical MRI imaging protocols. Materials and Methods: A total of 15 patients who underwent unilateral sinus lift surgery with biphasic calcium phosphate were included in this study. CBCT, T1-weighted MRI, and T2-weighted MRI scans were taken 6 months after sinus lift surgery. Linear measurements of the maximum height and buccolingual width in coronal images, as well as the maximum anteroposterior depth in sagittal images, were performed by 2 trained observers using CBCT and MRI Digital Imaging and Communication in Medicine files. Micro-computed tomography (micro-CT) was also performed to confirm the presence of bone tissue in the grafted area. Correlations between MRI and CBCT measurements were assessed with the Pearson test. Results: Significant correlations between CBCT and MRI were found for sinus graft height (T1-weighted, r=0.711 and P<0.05; T2-weighted, r=0.713 and P<0.05), buccolingual width (T1-weighted, r=0.892 and P<0.05; T2-weighted, r=0.956 and P<0.05), and anteroposterior depth (T1-weighted, r=0.731 and P<0.05; T2-weighted, r=0.873 and P<0.05). The presence of bone tissue in the grafted areas was confirmed via micro-CT. Conclusion: Both MRI pulse sequences tested can be used for sinus graft measurements, as strong correlations with CBCT were found. However, correlations between T2-weighted MRI and CBCT were slightly higher than those between T1-weighted MRI and CBCT.

• The korean journal of orthodontics
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• v.39 no.5
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• pp.289-299
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• 2009

Objective: The purpose of the present study was to evaluate the effectiveness of the use of Head Posture Aligner (HPA) during cone-beam computed tomography (CBCT) scan in generation of frontal cephalograms using 3D CBCT images. Methods: CBCT scans and frontal cephalograms were made in 30 adult individuals. While a couple of CBCT scan was made for one subject, one was made with conventional method, without use of HPA, the other was acquired with the use of HPA. After creation of virtual frontal cephalogram from each 3D CBCT image, it was traced and compared with the tracing of real frontal cephalogram. Results: In the comparison of the measurements, the virtual cephalograms with the use of HPA did not show statistically significant differences with the real cephalograms whereas the virtual cephalograms without the use of HPA presented significant differences with real cephalograms in many measurements. In the correlation analysis with the measurements of the real cephalograms, the virtual cephalograms with the use of HPA showed higher correlations in all measurements than the virtual cephalograms without the use of HPA. Conclusions: Measurements from CBCT-generated cephalograms become similar to those from real cephalograms with the use of HPA during CBCT scan. Thus, the use of HPA is suggested during the CBCT scan in order to construct accurate virtual frontal cephalograms using 3D CBCT images.

• Progress in Medical Physics
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• v.25 no.1
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• pp.37-45
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• 2014

The accuracy and uniformity of CT numbers are the main causes of radiation dose calculation error. Especially, for the dose calculation based on kV-Cone Beam Computed Tomography (CBCT) image, the scatter affecting the CT number is known to be quite different by the object sizes, densities, exposure conditions, and so on. In this study, the scatter impact on the CBCT based dose calculation was evaluated to provide the optimal condition minimizing the error. The CBCT images was acquired under three scatter conditions ("Under-scatter", "Over-scatter", and "Full-scatter") by adjusting amount of scatter materials around a electron density phantom (CIRS062, Tissue Simulation Technology, Norfolk, VA, USA). The CT number uniformities of CBCT images for water-equivalent materials of the phantom were assessed, and the location dependency, either "inner" or "outer" parts of the phantom, was also evaluated. The electron density correction curves were derived from CBCT images of the electron density phantom in each scatter condition. The electron density correction curves were applied to calculate the CBCT based doses, which were compared with the dose based on Fan Beam Computed Tomography (FBCT). Also, 5 prostate IMRT cases were enrolled to assess the accuracy of dose based on CBCT images using gamma index analysis and relative dose differences. As the CT number histogram of phantom CBCT images for water equivalent materials was fitted with a gaussian function, the FHWM (146 HU) for "Full-scatter" condition was the smallest among the FHWM for the three conditions (685 HU for "under scatter" and 264 HU for "over scatter"). Also, the variance of CT numbers was the smallest for the same ingredients located in the center and periphery of the phantom in the "Full-scatter" condition. The dose distributions calculated with FBCT and CBCT images compared in a gamma index evaluation of 1%/3 mm criteria and in the dose difference. With the electron density correction acquired in the same scatter condition, the CBCT based dose calculations tended to be the most accurate. In 5 prostate cases in which the mean equivalent diameter was 27.2 cm, the averaged gamma pass rate was 98% and the dose difference confirmed to be less than 2% (average 0.2%, ranged from -1.3% to 1.6%) with the electron density correction of the "Full-scatter" condition. The accuracy of CBCT based dose calculation could be confirmed that closely related to the CT number uniformity and to the similarity of the scatter conditions for the electron density correction curve and CBCT image. In pelvic cases, the most accurate dose calculation was achievable in the application of the electron density curves of the "Full-scatter" condition.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.60-69
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• 2016

Purpose: The objective of this study was to compare the accuracy of digital models from 3 dimentional (3D) optical scanner and cone beam computed tomography (CBCT). Materials and Methods: We obtained digital models from 11 pairs of stone casts using a 3D optical scanner and a CBCT, and compared the accuracy of the models. Results: The error range of average positive distance was 0.059 - 0.117 mm and negative distance was 0.066 - 0.146 mm. Statistically (P < 0.05), average positive distance was larger than $70{\mu}m$ and shorter than $100{\mu}m$, and that of negative distance was larger than $100{\mu}m$ and shorter than $120{\mu}m$. Conclusion: We concluded that the accuracy of digital models generated from CBCT is not appropriate to make final prostheses. However, it may be acceptable for provisional restorations and orthodontic diagnoses with respect to the accuracy of the digitalization.