• Imaging Science in Dentistry
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• 제51권1호
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• pp.87-90
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• 2021

The increased use of cone-beam computed tomographic (CBCT) scans has made it increasingly necessary to evaluate incidental findings on CBCT scans. This report describes the case of a 66-year-old female patient who presented to the Department of Oral and Maxillofacial Pathology, Radiology and Medicine at the College of Dentistry of the author's institution and underwent a CBCT scan for maxillary alveolar process implant planning. Upon evaluation of the CBCT scan, a radiopaque (soft tissue attenuation) mass in the left superior aspect of the nasal cavity and left locule of the sphenoid sinus with opacification of the left locule of the sphenoid sinus was incidentally noted. These radiographic findings were suggestive of a space-occupying mass with a high possibility of malignancy. A further medical evaluation confirmed renal cell cancer metastasis to the sphenoid sinus. This study shows the significance of reviewing the entire CBCT scan for incidental findings.

• Imaging Science in Dentistry
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• 제45권4호
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• pp.205-211
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• 2015

Purpose: This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Materials and Methods: Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. Results: The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Conclusion: Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

• Imaging Science in Dentistry
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• 제53권3호
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• pp.247-256
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• 2023

The aim of this report is to present a case of chondroblastic osteosarcoma located in the right maxillary premolar region of a 17-year-old female patient. The initial clinical presentation and 2-dimensional (2D) radiographic methods proved inadequate for a definitive diagnosis. However, a cone-beam computed tomography scan revealed a hyperdense, heterogeneous lesion in the right maxillary premolar region, exhibiting a characteristic "sun-ray" appearance. To assess soft tissue involvement, a medical computed tomography scan was subsequently conducted. A positron emission tomography scan detected no metastasis or indications of secondary tumors. T1- and T2-weighted magnetic resonance imaging showed signal heterogeneity within the lesion, including areas of low signal intensity at the periphery. Histological examination conducted after an incisional biopsy confirmed the diagnosis of highgrade chondroblastic osteosarcoma. The patient was then referred to an oncology department for chemotherapy before surgery. In conclusion, these findings suggest that early diagnosis using 3-dimensional imaging can detect chondroblastic osteosarcoma in its early stages, such as before metastasis occurs, thereby improving the patient's prognosis.

• Imaging Science in Dentistry
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• 제51권2호
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• pp.93-106
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• 2021

Purpose: This study was conducted to review the literature regarding the types of cone-beam computed tomography (CBCT) artifacts around dental implants and the factors that influence their formation. Materials and Methods: A search strategy was carried out in the PubMed, Embase, and Scopus databases to identify published between 2010 and 2020, and 9 studies were selected. The implants included 306 titanium, titanium-zirconium, and zirconia implants, as well as 5 titanium cylinders. Results: The artifacts around the implants were the beam-hardening artifact, the streaking artifact, and band-like radiolucent areas. Some factors that influenced the formation of artifacts were the implant material, bone type, evaluated regions, distance, type of CBCT, field of view (FOV) size, milliamperage, peak kilovoltage (kVp), and voxel size. The beam-hardening artifact was the most widely reported, and it was minimized in protocols with a smaller FOV, larger voxels, and higher kVp. Conclusion: The risk and benefit of these protocols in individuals with dental implants must be considered, and clinical examinations and complementary radiographs play an essential role in implantology.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.69-75
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• 2023

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

• Imaging Science in Dentistry
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• 제37권3호
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• pp.139-147
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• 2007

Purpose: To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) patients. Materials and Methods: 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra- and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Results: Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78-0.84), but interobserver agreement was fair (k=0.45). Conclusion: CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

• Imaging Science in Dentistry
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• 제38권3호
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• pp.153-161
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• 2008

Purpose : To compare and evaluate the diagnostic ability of cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Materials and Methods : CBCT and MRI of 46 TMJs of 23 patients with TMJ disorders were evaluated. They were divided into 3 groups according to the position of the articular disc of the TMJ at closed mouth position and the reduction of the disc during open mouth position on MRI: no disc displacement group (NDD), disc displacement with reduction group (DDR), and disc displacement without reduction group (DDWR). With PACS viewing soft-wares, position of mandibular condyle in the articular fossa, osseous change of mandibular condyle, shape of articular fossa, and mediolateral and anteroposterior dimensions of mandibular condyle were evaluated on CBCT and MRI. Each value was tested statistically. Results : The position of mandibular condyle in the articular fossa were concentric in the NDD, DDR, and DDWR of CBCT and NDD of MRI. However, condyle was positioned posteriorly in DDR and DDWR of MRI. Flattening, sclerosis and osteophyte of the mandibular condyle were much more apparent on DDR of CBCT than MRI. And the erosion of the condyle was much more apparent on DDWR of MRI than CBCT. Box and Sigmoid types of articular fossa were found most frequently in DDR of MRI. Flattened type was found most frequently in DDR of CBCT and deformed type was found most frequently in DDWR of CBCT. No significant difference in mediolateral and anteroposterior dimensions were shown on CBCT and MRI. Conclusion : Since MRI and CBCT has unique diagnostic imaging ability, both modalities should be used together to supplement each other to evaluate TMJ.

• Imaging Science in Dentistry
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• 제36권3호
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• pp.137-143
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• 2006

Purpose : To evaluate location, distribution, diameter, and length of the nutrient canals on mandibular anterior region using a cone beam computed tomography (CBCT). Materials and Methods : Mandibular CBCT was performed on 33 adults (18 males and 15 females) with no history of systemic disease, and any other dental surgery history Location, distribution, diameter, and length of the nutrient canals on mandibular anterior region were radiographically evaluated. A statistical comparison was done by SPSS. Results : In the location and distribution of nutrient canals, they were found in 6.8% at labial portion above root apex, in 93.28% at lingual portion above root apex in 46.2% at labial portion below root apex, and in 53.6% at lingual portion below root apex. Nutrient canals at lingual portion above root apex were most frequently observed between central and lateral incisors, and those at labial and lingual portion below root apex were most frequently observed between central incisors. The mean diameters of nutrient canals were 0.54 mm at labial portion above root apex, 0.61 mm at lingual portion above root apex, 0.66 mm at labial portion below root apex, and 0.76 mm at lingual portion below root apex. The mean lengths of nutrient canals were 2.63 mm at labial portion above root apex, 3.74 mm at lingual portion above root apex, 4.51 mm at labial portion below root apex, and 6.77 mm at lingual portion below root apex. Conclusion : CBCT is useful device to evaluate the anatomical structure of nutrient canals on mandibular anterior region.

• Imaging Science in Dentistry
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• 제37권2호
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• pp.87-92
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• 2007

Purpose: To measure the absorbed doses of cone beam computed tomography (CBCT), which is recently being more frequently used, and to compare them with those of panoramic radiography. Materials and Methods: To measure the absorbed doses of CBCT ($PSR-9000N^{TM}$, Asahi Roentgen Ind. Co., Japan), we placed TLD chips on the skin regions above the parotid and thyroid glands, and on the dorsum of tongue in a dental head phantom. We used two image acquisition modes of the Dental and Panoramic modes of CBCT, which differed in the field of view. Also, panoramic radiographs (Auto IIIN, Asahi Roentgen Ind. Co., Japan) were taken to compare with the absorbed doses of CBCT. Result: In the Dental mode of CBCT, the absorbed doses of the parotid gland, dorsum of tongue, and thyroid gland were 3.53, 3.13, and 0.36 mGy, respectively. In the Panoramic mode of CBCT, they were 9.57, 9.15, and 0.85 mGy, respectively. The panoramic mode showed higher absorbed doses than those of the Dental mode. In the panoramic radiography, the absorbed doses of the parotid gland, dorsum of tongue, and thyroid gland were 1.21, 1.19, and 0.16 mGy, respectively. And they were about 1/3 of the Dental mode and 1/9 of the Panoramic mode of CBCT. Conclusion: Absorbed doses of CBCT are higher than those of panoramic radiography, and dependent upon the field of view.

• Imaging Science in Dentistry
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• 제37권2호
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• pp.103-110
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• 2007

Purpose: To examine the danger zone of mesial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. Materials and Methods: 20 mandibular first molars without caries and restorations were collected, CT images were obtained by CBCT ($PSR9000N^{TM}$, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea), Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal orifice, distal wall thickness of mesiobuccal canal (MB-D), distal wall thickness of mesiolingual canal (ML-D), distal wall thickness of central part (C-D), mesial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolingual canal (ML-M) were measured, Results: The mean distance between the canal orifice and the furcation of the roots is 2.40 mm, Distal wall is found to be thinner than mesial wall. Mean dentinal wall thickness of distal wall is about 1 mm, The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences are not noted between 4 mm and 5 mm in MB-D and C-D, MB-D is thinner than ML-D although the differences is not significant. Conclusion: The present study confirmed the anatomical weakness of distal surface of the coronal part of the mesial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment.