1
|
Afkhami F, Wright PP, Chien PYH, Xu C, Walsh LJ, Peters OA. Exploring approaches to pulp vitality assessment: A scoping review of nontraditional methods. Int Endod J 2024. [PMID: 38661046 DOI: 10.1111/iej.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Diagnostic procedures for pulp vitality assessment are a crucial aspect of routine dental practice. This review aims to provide a comprehensive overview of nontraditional techniques and methodologies for assessing pulp vitality, specifically exploring promising approaches that are currently not used in dental practice. METHODS The study protocol was registered a priori (https://osf.io/3m97z/). An extensive electronic search was conducted across multiple databases, including MEDLINE via PubMed, Scopus, Web of Science, and Embase. Inclusion criteria were guided by the research question based on the PCC model as follows: "What are the potential nontraditional techniques (Concept) for assessing pulp vitality (Population) in the field of endodontics or clinical practice (Context)?" Studies were included that explored possible approaches to pulp vitality assessment, utilizing a range of techniques, whilst any studies using traditional pulp tests (cold, heat, and electric stimulation) or well-known methods (pulse oximetry and laser Doppler flowmetry) were excluded. Reviewers independently screened articles and extracted data. A patent search was also performed. RESULTS Of 3062 studies, 65 were included that described nontraditional approaches for assessing pulp vitality. These included a range of optical diagnostic methods, ultrasound Doppler flowmetry (UDF), magnetic resonance imaging (MRI), terahertz imaging, tooth temperature measurements, as well as invasive methodologies, including 133xenon washout, radioisotope-labelled tracers, hydrogen gas desaturation, intravital microscopy and fluorescent microspheres isotope clearance. The patent search included artificial intelligence and biomarkers methods. CONCLUSIONS This review provides details for potential innovative tests that may directly describe pulp vitality. Importantly, these methods range from clinically impractical through to promising methods that may transform clinical practice. Several nontraditional techniques have the potential to enhance diagnostic accuracy and could provide valuable insights into the assessment of pulp vitality in challenging clinical scenarios.
Collapse
Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | | | - Philip Yuan-Ho Chien
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Chun Xu
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Laurence James Walsh
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| |
Collapse
|
2
|
Parize H, Sadilina S, Caldas RA, Cordeiro JVC, Kleinheinz J, Laganá DC, Sesma N, Bohner L. Magnetic resonance imaging for jawbone assessment: a systematic review. Head Face Med 2024; 20:25. [PMID: 38641613 PMCID: PMC11027384 DOI: 10.1186/s13005-024-00424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024] Open
Abstract
PURPOSE To evaluate the accuracy of magnetic resonance imaging (MRI) for jawbone assessment compared to reference-standard measurements in the literature. MATERIALS AND METHODS An electronic database search was conducted in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library in June 2022, and updated in August 2023. Studies evaluating the accuracy of MRI for jawbone assessment compared with reference-standard measurements (histology, physical measurements, or computed tomography) were included. The outcome measures included bone histomorphometry and linear measurements. The risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The review was registered in the PROSPERO database (CRD42022342697). RESULTS From 63 studies selected for full-text analysis, nine manuscripts were considered eligible for this review. The studies included assessments of 54 participants, 35 cadavers, and one phantom. A linear measurement error ranging from 0.03 to 3.11 mm was shown. The accuracy of bone histomorphometry varies among studies. Limitations of the evidence included heterogeneity of MRI protocols and the methodology of the included studies. CONCLUSION Few studies have suggested the feasibility of MRI for jawbone assessment, as MRI provides comparable results to those of standard reference tests. However, further advancements and optimizations are needed to increase the applicability, validate the efficacy, and establish clinical utility of these methods.
Collapse
Affiliation(s)
- Hian Parize
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Sofya Sadilina
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ricardo Armini Caldas
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil.
| | - João Victor Cunha Cordeiro
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
| | - Dalva Cruz Laganá
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Newton Sesma
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
| |
Collapse
|
3
|
Candemil AP, Alves Dos Santos GN, Oliveira ML, Gatti F, Silva-Sousa YTC, Silva-Sousa AC, Mazzi-Chaves JF, Sousa-Neto MD. Accuracy of Magnetic Resonance Imaging in Clinical Endodontic Applications: A Systematic Review. J Endod 2024; 50:434-449. [PMID: 38290691 DOI: 10.1016/j.joen.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The development of dedicated coils and new magnetic resonance imaging (MRI) sequences has led to an increase in image resolution and a reduction in artifacts. Consequently, numerous studies have demonstrated the utility of MRI as a nonionizing alternative to cone-beam computed tomographic imaging. The aim of this systematic review was to evaluate the accuracy of MRI in clinical applications in endodontics. METHODS A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. The inclusion criteria encompassed studies evaluating MRI applications in endodontics, covering tooth and root canal anatomy, root canal working length, pulp vitality and regeneration, the effect of caries on dental pulp, guided endodontics, periapical lesions, and root cracks/fractures. The selected studies examined both ex vivo and in vivo human teeth using clinical MRI units. Two researchers independently screened the studies, applied the eligibility criteria, and assessed the potential risk of bias using the revised QUADAS-2 tool (Bristol Medical School, University of Bristol, UK). RESULTS A total of 18 studies were included in this systematic review, demonstrating that the use of MRI has a high diagnostic value in endodontics. In the evaluation of tooth and root canal anatomy, pulp vitality and regeneration, the effect of caries on dental pulp, periapical lesions, and root cracks/fractures, MRI's accuracy is comparable to or even higher than reference standards such as cone-beam computed tomographic imaging, micro-computed tomographic imaging, and histology. CONCLUSIONS MRI has high potential accuracy for diagnosing various clinical endodontic tasks, except for root canal length, size of caries, and periapical lesion dimensions, which are overestimated in MRI.
Collapse
Affiliation(s)
- Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil; CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France.
| | | | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Filippo Gatti
- CentraleSupélec, Ecole Normale Supérieure Paris-Saclay, Centre national de la recherche scientifique, Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Gif-sur-Yvette, France
| | | | - Alice C Silva-Sousa
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
4
|
Al-Haj Husain A, Zollinger M, Stadlinger B, Özcan M, Winklhofer S, Al-Haj Husain N, Schönegg D, Piccirelli M, Valdec S. Magnetic resonance imaging in dental implant surgery: a systematic review. Int J Implant Dent 2024; 10:14. [PMID: 38507139 PMCID: PMC10954599 DOI: 10.1186/s40729-024-00532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE To comprehensively assess the existing literature regarding the rapidly evolving in vivo application of magnetic resonance imaging (MRI) for potential applications, benefits, and challenges in dental implant surgery. METHODS Electronic and manual searches were conducted in PubMed MEDLINE, EMBASE, Biosis, and Cochrane databases by two reviewers following the PICOS search strategy. This involved using medical subject headings (MeSH) terms, keywords, and their combinations. RESULTS Sixteen studies were included in this systematic review. Of the 16, nine studies focused on preoperative planning and follow-up phases, four evaluated image-guided implant surgery, while three examined artifact reduction techniques. The current literature highlights several MRI protocols that have recently investigated and evaluated the in vivo feasibility and accuracy, focusing on its potential to provide surgically relevant quantitative and qualitative parameters in the assessment of osseointegration, peri-implant soft tissues, surrounding anatomical structures, reduction of artifacts caused by dental implants, and geometric accuracy relevant to implant placement. Black Bone and MSVAT-SPACE MRI, acquired within a short time, demonstrate improved hard and soft tissue resolution and offer high sensitivity in detecting pathological changes, making them a valuable alternative in targeted cases where CBCT is insufficient. Given the data heterogeneity, a meta-analysis was not possible. CONCLUSIONS The results of this systematic review highlight the potential of dental MRI, within its indications and limitations, to provide perioperative surgically relevant parameters for accurate placement of dental implants.
Collapse
Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marina Zollinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Mutlu Özcan
- Clinic of Chewing Function Disturbances and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Nadin Al-Haj Husain
- Clinic of Chewing Function Disturbances and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Departement of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daphne Schönegg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| |
Collapse
|
5
|
Flick K, Smeets R, Gosau M, Meyer L, Hanning U, Kyselyova AA, Scheifele C, Höhmann B, Henningsen A. Assessment of the intrasinusidal volume before and after maxillary sinus augmentation using mri - a pilot study of eight patients. BMC Oral Health 2024; 24:142. [PMID: 38287339 PMCID: PMC10823631 DOI: 10.1186/s12903-024-03858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. METHODS A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. RESULTS In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm3, corresponding with the decrease of the intrasinusidal volumes. In general, interexaminer discrepancies were low and without statistical significance. CONCLUSION In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation.
Collapse
Affiliation(s)
- K Flick
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
- Division of "Regenerative Orofacial Medicine", Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - R Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
- Division of "Regenerative Orofacial Medicine", Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - L Meyer
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - U Hanning
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A A Kyselyova
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Scheifele
- Dental Radiology Unit, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Höhmann
- Department of Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
- Division of "Regenerative Orofacial Medicine", Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
6
|
Al-Haj Husain A, Oechslin DA, Stadlinger B, Winklhofer S, Özcan M, Schönegg D, Al-Haj Husain N, Sommer S, Piccirelli M, Valdec S. Preoperative imaging in third molar surgery - A prospective comparison of X-ray-based and radiation-free magnetic resonance orthopantomography. J Craniomaxillofac Surg 2024; 52:117-126. [PMID: 37891089 DOI: 10.1016/j.jcms.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/31/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to compare preoperative data relevant to third molar surgery based on radiographic orthopantomography (OPG) and orthopantomogram-like MR images (MR-OPG), using five different MR protocols. X-ray-based OPG and OPG-like MRI reconstructions from DESS, SPACE-STIR, SPACE-SPAIR, T1-VIBE-Dixon, and UTE sequences were acquired in 11 patients undergoing third molar surgery, using a 15-channel mandibular coil. Qualitative (image quality, susceptibility to artifacts, positional relationship, contact/non-contact of the inferior alveolar nerve (IAN), relationship to maxillary sinus, IAN continuity, root morphology) and quantitative (tooth length, retromolar distance, distance to the IAN, and distance to the mandible margin) parameters of the maxillary and mandibular third molars were assessed regarding inter-reader agreement and quantitative discrepancies by three calibrated readers. Radiation-free MR-OPGs generated within clinically tolerable acquisition times, which exhibited high image quality and low susceptibility to artifacts, showed no significant differences compared with X-ray-based OPGs regarding the assessment of quantitative parameters. UTE MR-OPGs provided radiographic-like images and were best suited for assessing qualitative preoperative data (positional relationship, nerve contact/non-contact, and dental root morphology) relevant to third molar surgery. For continuous and focal nerve imaging, DESS MR-OPG was superior. MR-OPGs could represent a shift towards indication-specific and modality-oriented perioperative imaging in high-risk oral and maxillofacial surgery.
Collapse
Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik A Oechslin
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders, Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daphne Schönegg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders, Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Stefan Sommer
- Siemens Healthineers International AG, Zurich, Switzerland; Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland; Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
7
|
Öçbe M, Borahan MO. Identifying the Anatomical Variations of the Inferior Alveolar Nerve with Magnetic Resonance Imaging. Niger J Clin Pract 2024; 27:136-142. [PMID: 38317047 DOI: 10.4103/njcp.njcp_641_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/03/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The inferior alveolar nerve (IAN) is located in the mandibular canal (MC). It is critical to evaluate the position of the MC during treatment planning to prevent intra or postoperative complications. AIMS This retrospective study aimed to identify the anatomy and anatomical variations of the IAN using soft tissue imaging (pulse sequence magnetic resonance imaging [MRI]). MATERIALS AND METHODS This study was designed as a retrospective Consolidated Standards of Reporting Trials (CONSORT) study. In total, 220 MR images were obtained. Nutrient canals (NCs) were classified as intraosseous and dental NCs, while bifid MCs (BMCs) were classified as forward, retromolar, and buccolingual canals. IBM SPSS Statistics 22 was used. Kolmogorov-Smirnov and Shapiro-Wilk tests, descriptive statistical methods (means, standard deviations, and frequencies), and the Chi-square test were used. Statistical significance was set at P < 0.05. RESULTS In total, 220 patients (172 females and 48 males) were evaluated. NCs were present in 92.3% of all MCs and were significantly higher in patients aged <25 years. BMCs were observed in 106 patients (24.1%). The most common BMC of MC/IAN was in the forward canal (14.4%), followed by the retromolar canal (7.5%). CONCLUSION Although previously, the dental canal was considered as an anatomical variation, this study revisited the classification and suggested that dental canals are anatomical structures.
Collapse
Affiliation(s)
- M Öçbe
- Department of Oral and Maxillofacial Radiology, Institute of Health Sciences, Marmara University, Istanbul, Turkiye
| | - M O Borahan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye
| |
Collapse
|
8
|
Schwarz L, Unger E, Gahleitner A, Rausch-Fan X, Jonke E. A novel approach for gingiva thickness measurements around lower anterior teeth by means of dental magnetic resonance imaging. Clin Oral Investig 2023; 28:18. [PMID: 38135801 PMCID: PMC10746778 DOI: 10.1007/s00784-023-05459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This diagnostic accuracy study aims to present the first measurements of gingiva thickness around lower anterior teeth using dental magnetic resonance imaging (MRI) and to compare these measurements with two established methods: (1) gingival phenotype assessment via periodontal probing, and (2) the superimposition of cone-beam computed tomography (CBCT) scans with intraoral scans of teeth and gums. MATERIALS AND METHODS Ten patients with substantial orthodontic treatment need and anterior mandibular crowding were consecutively included in this clinical case series. After periodontal probing, each patient underwent a CBCT scan, an intraoral scan of the mandible, and an MRI investigation using a novel mandibula 15-channel dental coil. RESULTS The mean gingiva thickness was 0.72 mm measured on MRI and 0.97 mm measured on CBCT, with a mean difference between the measurement methods of 0.17 ± 0.27 mm (p < 0.001). Measurement agreement between the index tests (MRI and CBCT) and the clinical reference standard (probing) yielded an overall percent agreement of 64.94% and 47.02% for MRI and CBCT, respectively. Teeth with thin phenotypes were associated with lower soft tissue dimensions in both free (MRI: 0.56 mm vs. CBCT: 0.79 mm) and supracrestal gingiva (MRI: 0.75 mm vs. CBCT: 1.03 mm) when compared to those with thick phenotypes. However, only the measurements obtained from MRI scans showed statistically significant differences between the two phenotypes. CONCLUSION Dental MRI successfully visualizes delicate structures like the gingiva in the anterior mandible and achieves a high correlation with superimposed CBCT scans, with clinically acceptable deviations. CLINICAL RELEVANCE The present study helps to establish dental MRI as a radiation-free alternative to conventional radiographic methods.
Collapse
Affiliation(s)
- Linda Schwarz
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - André Gahleitner
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Erwin Jonke
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| |
Collapse
|
9
|
Grandoch A, Oeser J, Zöller JE, Große Hokamp N, Lichtenstein T, Neugebauer J. Morphological Studies to Identify the Nasopalatine and Inferior Alveolar Nerve Using a Special Head and Neck MRI Coil. J Craniofac Surg 2023; 34:1351-1356. [PMID: 36879392 DOI: 10.1097/scs.0000000000009219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 10/18/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Procedures in oral and maxillofacial surgery bear a high risk of nerve damage. Three-dimensional imaging techniques can optimize surgical planning and help to spare nerves. The aim of this study was to investigate the diagnostic value of a 1.5 T magnetic resonance imaging (MRI) scanner with a dedicated dental signal amplification coil for the assessment of nerves in the oral cavity as compared with cone beam computed tomography (CBCT). METHODS Based on 6 predefined criteria, the assessability of the inferior alveolar and nasopalatine nerves in CBCT and MRI with a dedicated 4-channel dental coil were compared in 24 patients. RESULTS Compared with CBCT, MRI with the dental coil showed significantly better evaluability of the inferior alveolar nerve in the sagittal and axial plane and the nasopalatine nerve in the axial plane. In the sagittal plane; however, the assessability of the nasopalatine nerve was significantly better in CBCT as compared with MRI. Yet, pertaining to overall assessability, no significant differences between modalities were found. CONCLUSIONS In this pilot study, it can be reported that 1.5- T MRI with a dedicated dental coil is at least equivalent, if not superior, to CBCT in imaging nerve structures of the stomatognathic system. CLINICAL RELEVANCE Preoperative, 3-dimensional images are known to simplify and refine the planning and execution of operations in maxillofacial surgery. In contrast to computed tomography and CBCT, MRI does not cause radiation exposure while enabling visualization of all relevant hard and soft tissues and, therefore, holds an advantage over well-established techniques.
Collapse
Affiliation(s)
- Andrea Grandoch
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Julia Oeser
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Joachim E Zöller
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Thorsten Lichtenstein
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Jörg Neugebauer
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
- Dr Bayer and Colleagues Group office for dentistry, Landsberg am Lech, Germany
| |
Collapse
|
10
|
Juerchott A, Roser CJ, Saleem MA, Nittka M, Lux CJ, Heiland S, Bendszus M, Hilgenfeld T. Diagnostic compatibility of various fixed orthodontic retainers for head/neck MRI and dental MRI. Clin Oral Investig 2023; 27:2375-2384. [PMID: 36640179 PMCID: PMC10160193 DOI: 10.1007/s00784-023-04861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the diagnostic MRI compatibility of different fixed orthodontic retainers using a high-resolution 3D-sequence optimized for artifact reduction. MATERIALS AND METHODS Maxillary and mandibular retainers made of five different materials were scanned in vitro and in vivo at 3 T MRI using an MSVAT-SPACE sequence. In vitro, artifact volumes were determined for all maxillary and mandibular retainers (AVmax; AVmand). In vivo, two independent observers quantified the extent of artifacts based on the visibility of 124 dental and non-dental landmarks using a five-point rating scale (1 = excellent, 2 = good, 3 = acceptable, 4 = poor, 5 = not visible). RESULTS Rectangular-steel retainers caused the largest artifacts (AVmax/AVmand: 18,060/15,879 mm3) and considerable diagnostic impairment in vivo (mean landmark visibility score ± SD inside/outside the retainer areas: 4.8 ± 0.8/2.9 ± 1.6). Smaller, but diagnostically relevant artifacts were observed for twistflex steel retainers (437/6317 mm3, 3.1 ± 1.7/1.3 ± 0.7). All retainers made of precious-alloy materials produced only very small artifact volumes (titanium grade 1: 70/46 mm3, titanium grade 5: 47/35 mm3, gold: 23/21 mm3) without any impact on image quality in vivo (each retainer: visibility scores of 1.0 ± 0.0 for all landmarks inside and outside the retainer areas). CONCLUSIONS In contrast to steel retainers, titanium and gold retainers are fully compatible for both head/neck and dental MRI when using MSVAT-SPACE. CLINICAL RELEVANCE This study demonstrates that titanium and gold retainers do not impair the diagnostic quality of head/neck and dental MRI when applying an appropriate artifact-reduction technique. Steel retainers, however, are not suitable for dental MRI and can severely impair image quality in head/neck MRI of the oral cavity.
Collapse
Affiliation(s)
- Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Christoph J Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Muhammad Abdullah Saleem
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
11
|
Johannsen KM, de Carvalho E Silva Fuglsig JM, Hansen B, Wenzel A, Spin-Neto R. Magnetic resonance imaging artefacts caused by orthodontic appliances and/or implant-supported prosthesis: a systematic review. Oral Radiol 2023; 39:394-407. [PMID: 36178613 DOI: 10.1007/s11282-022-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Dental materials, including orthodontic appliances and implants, are commonly mentioned as a possible source of artefacts in magnetic resonance imaging (MRI). The aim of the present study was to undertake a systematic review of the relevant literature on MR image artefacts due to dental materials, limited to orthodontic appliances and implant-supported dental prosthesis, on both technical and diagnostic levels. METHODS The MEDLINE (PubMed) bibliographic database was searched up to September 2020. The search was limited to studies published in English, using the search string: (MRI or magnetic resonance) and (artefact or artifact) and (dental or ortho or implant or restoration or restorative). The studies were assessed independently by three reviewers, focusing on the following parameters: MRI sequences, tested materials, assessed parameters, efficacy level and outcome. RESULTS The search strategy yielded 31 studies, which were included in this systematic review. These studies showed that metallic dental materials, commonly present in orthodontic appliances and implant-supported dental prosthesis led to diverse types/severities of artefacts in MR images. Fifteen studies were in vivo, based on human subjects. The studies differed substantially in terms of tested materials, assessed parameters, and outcome measurements. CONCLUSIONS Metallic dental materials cause artefacts of diverse types and severities in MR images of the head and neck region. However, the diagnostic relevance of the investigated artefacts for the diverse MRI applications is yet to be studied.
Collapse
Affiliation(s)
- Katrine Mølgaard Johannsen
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark.
| | | | - Brian Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark
| |
Collapse
|
12
|
Flügge T, Gross C, Ludwig U, Schmitz J, Nahles S, Heiland M, Nelson K. Dental MRI-only a future vision or standard of care? A literature review on current indications and applications of MRI in dentistry. Dentomaxillofac Radiol 2023; 52:20220333. [PMID: 36988090 PMCID: PMC10170172 DOI: 10.1259/dmfr.20220333] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/30/2023] Open
Abstract
MRI is increasingly used as a diagnostic tool for visualising the dentoalveolar complex. A comprehensive review of the current indications and applications of MRI in the dental specialities of orthodontics (I), endodontics (II), prosthodontics (III), periodontics (IV), and oral surgery (V), pediatric dentistry (VI), operative dentistry is still missing and is therefore provided by the present work.The current literature on dental MRI shows that it is used for cephalometry in orthodontics and dentofacial orthopaedics, detection of dental pulp inflammation, characterisation of periapical and marginal periodontal pathologies of teeth, caries detection, and identification of the inferior alveolar nerve, impacted teeth and dentofacial anatomy for dental implant planning, respectively. Specific protocols regarding the miniature anatomy of the dentofacial complex, the presence of hard tissues, and foreign body restorations are used along with dedicated coils for the improved image quality of the facial skull.Dental MRI poses a clinically useful radiation-free imaging tool for visualising the dentoalveolar complex across dental specialities when respecting the indications and limitations.
Collapse
Affiliation(s)
- Tabea Flügge
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Christian Gross
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ute Ludwig
- Medical Physics, Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johanna Schmitz
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Susanne Nahles
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Max Heiland
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Oral and Maxillofacial Surgery, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
13
|
Hilgenfeld T, Saleem MA, Schwindling FS, Ludwig U, Hövener JB, Bock M, Flügge T, Eisenbeiss AK, Nittka M, Mente J, Jende JME, Heiland S, Bendszus M, Juerchott A. High-Resolution Single Tooth MRI With an Inductively Coupled Intraoral Coil-Can MRI Compete With CBCT? Invest Radiol 2022; 57:720-727. [PMID: 35640007 DOI: 10.1097/rli.0000000000000890] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of this study were to quantify T1/T2-relaxation times of the dental pulp, develop a realistic tooth model, and compare image quality between cone-beam computed tomography (CBCT) and high-resolution magnetic resonance imaging (MRI) of single teeth using a wireless inductively coupled intraoral coil. METHODS T1/T2-relaxometry was performed at 3 T in 10 healthy volunteers (283 teeth) to determine relaxation times of healthy dental pulp and develop a realistic tooth model using extracted human teeth. Eight MRI sequences (DESS, CISS, TrueFISP, FLASH, SPACE, TSE, MSVAT-SPACE, and UTE) were optimized for clinically applicable high-resolution imaging of the dental pulp. In model, image quality of all sequences was assessed quantitatively (contrast-to-noise ratio) and qualitatively (visibility of anatomical structures and extent of susceptibility artifacts using a 5-point scoring scale). Cone-beam computed tomography served as the reference modality for qualitative assessment. Statistical analysis was performed using 2-way analysis of variance, Fisher exact test, and Cohen κ. RESULTS In vivo, relaxometry of dental pulps revealed T1/T2 relaxation times at 3 T of 738 ± 100/171 ± 36 milliseconds. For all sequences, an isotropic resolution of (0.21 mm) 3 was achieved, with acquisition times ranging from 6:19 to 8:02 minutes. In model, the highest contrast-to-noise ratio values were observed for UTE, followed by TSE and CISS. The best image/artifact quality, however, was found for DESS (mean ± SD: 1.3 ± 0.3/2.2 ± 0.0), FLASH (1.5 ± 0.3/2.4 ± 0.1), and CISS (1.5 ± 0.4/2.5 ± 0.1), at a level comparable to CBCT (1.2 ± 0.3/2.1 ± 0.1). CONCLUSIONS Optimized MRI protocols using an intraoral coil at 3 T can achieve an image quality comparable to reference modality CBCT within clinically applicable acquisition times. Overall, DESS revealed the best results, followed by FLASH and CISS.
Collapse
Affiliation(s)
| | | | | | - Ute Ludwig
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, Kiel
| | - Michael Bock
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Anne-Katrin Eisenbeiss
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel
| | | | - Johannes Mente
- Division of Endodontics and Dental Traumatology, Department of Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | | | | | | | | |
Collapse
|
14
|
Bohner L, Hanisch M, Sesma N, Blanck-Lubarsch M, Kleinheinz J. Artifacts in magnetic resonance imaging caused by dental materials: a systematic review. Dentomaxillofac Radiol 2022; 51:20210450. [PMID: 35348371 PMCID: PMC10043623 DOI: 10.1259/dmfr.20210450] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this systematic review was to search in literature in which severity unintended effects are caused by dental materials in magnetic resonance imaging (MRI), such as to evaluate whether these artifacts hamper the diagnosis in the head and neck region. MATERIALS AND METHODS Clinical studies showing the severity of artifacts which dental materials are capable of causing in MRI of head and neck, such as their influence on diagnostic accuracy, were included in this review. The searches were conducted in four electronic databases (PubMed/Medline, Embase, Scopus and Web of Science), and a manual search was made in the reference lists of papers screened for full-text reading. Risk of bias was assessed using "Quality Assessment Tool for Diagnostic Accuracy Studies-2" (QUADAS-2). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence. RESULTS From 151 studies selected for full-reading, 19 were considered eligible for this review. Artifacts caused by orthodontic appliances were well-documented, and stainless steel brackets were the materials most likely to cause artifacts in MR imaging of head and neck. The literature was scarce for dental implants and restorations. Diagnoses within the oral cavity, but also those of the brain and craniofacial structures, were affected. CONCLUSION Artifacts caused by orthodontic appliances may affect the diagnosis in oral cavity and craniofacial structures. Data regarding dental implants and prosthodontics restorations were inconclusive. The severity of artifacts in MRI and their influence on diagnosis is dependent on dental material features, location in the oral cavity, and magnetic resonance parameters.
Collapse
Affiliation(s)
- Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Muenster, Germany
| | - Marcel Hanisch
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Muenster, Germany
| | - Newton Sesma
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Muenster, Germany
| |
Collapse
|
15
|
Tesfai AS, Vollmer A, Özen AC, Braig M, Semper-Hogg W, Altenburger MJ, Ludwig U, Bock M. Inductively Coupled Intraoral Flexible Coil for Increased Visibility of Dental Root Canals in Magnetic Resonance Imaging. Invest Radiol 2022; 57:163-170. [PMID: 34510099 DOI: 10.1097/rli.0000000000000826] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Accurate visualization of dental root canals is vital for the correct diagnosis and subsequent treatment. This work assesses the improvement of a dedicated new coil for dental magnetic resonance imaging (MRI) in comparison to conventional ones in terms of signal-to-noise ratio (SNR) and visibility. MATERIALS AND METHODS A newly developed intraoral flexible coil was used to display dental roots with MRI, and it provides improved sensitivity with a loop design and size adjusted to a single tooth anatomy. Ex vivo and in vivo measurements were performed on a 3 T clinical MR system, and results were compared with conventional head and surface coil images. Additional comparison was performed with a modified fast spin echo sequence and a constructive interference in steady-state sequence. RESULTS Ex vivo, an SNR gain of 6.3 could be achieved with the intraoral flexible coil setup, and higher visibility down to 200 μm was possible, whereas the external loop coil is limited to 400 μm. In vivo measurements in a volunteer resulted in an SNR gain of up to 4.5 with an improved delineation of the root canals, especially for the branch tissue splitting of the mesial root canal into mesial-buccal and mesial-lingual. CONCLUSIONS In summary, we showed the feasibility of implementing a wireless coil approach with readily available dental practice materials for sealing and placement. Highly improved MRI scans can be acquired within clinically feasible scan times, and this might provide additional medical findings to supplement available x-ray images.
Collapse
Affiliation(s)
| | - Andreas Vollmer
- Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | | | | | - Wiebke Semper-Hogg
- Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Markus Jörg Altenburger
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ute Ludwig
- From the Department of Radiology, Medical Physics
| | - Michael Bock
- From the Department of Radiology, Medical Physics
| |
Collapse
|
16
|
Probst FA, Burian E, Malenova Y, Lyutskanova P, Stumbaum MJ, Ritschl LM, Kronthaler S, Karampinos D, Probst M. Geometric accuracy of magnetic resonance imaging-derived virtual 3-dimensional bone surface models of the mandible in comparison to computed tomography and cone beam computed tomography: A porcine cadaver study. Clin Implant Dent Relat Res 2021; 23:779-788. [PMID: 34318580 DOI: 10.1111/cid.13033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Providing accurate 3-dimensional virtual bone surface models is a prerequisite for virtual surgical planning and additive manufacturing in craniomaxillofacial surgery. For this purpose, magnetic resonance imaging (MRI) may be a radiation-free alternative to computed tomography (CT) and cone beam computed tomography (CBCT). PURPOSE The aim of this study was to assess the geometric accuracy of 3-dimensional T1-weighted MRI-derived virtual bone surface models of the mandible in comparison to CT and CBCT. MATERIALS AND METHODS Specimens of the mandible from porcine cadavers were scanned with (1) a 3-dimensional T1-weighted MRI sequence (0.6 mm isotropic voxel) optimized for bone imaging, (2) CT, and (3) CBCT. Cortical mandibular structures (n = 10) were segmented using semiautomated and manual techniques. Imaging-based virtual 3-dimensional models were aligned with a high-resolution optical 3-dimensional surface scan of the dissected bone (=ground truth) and global geometric deviations were calculated (mean surface distance [MSD]/root-mean-square distance [RMSD]). Agreement between the imaging modalities was assessed by equivalence testing and Bland-Altman analysis. RESULTS Intra- and inter-rater agreement was on a high level for all modalities. Global geometric deviations (MSD/RMSD) between optical scans and imaging modalities were 0.225 ± 0.020 mm/0.345 ± 0.074 mm for CT, 0.280 ± 0.067 mm/0.371 ± 0.074 mm for MRI, and 0.352 ± 0.076 mm/0.454 ± 0.071 mm for CBCT. All imaging modalities were statistically equivalent within an equivalence margin of ±0.3 mm, and Bland-Altman analysis indicated high agreement as well. CONCLUSIONS The results of this study indicate that the accuracy and reliability of MRI-derived virtual 3-dimensional bone surface models is equal to CT and CBCT. MRI may be considered as a reliable alternative to CT and CBCT in computer-assisted craniomaxillofacial surgery.
Collapse
Affiliation(s)
- Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Yoana Malenova
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | - Plamena Lyutskanova
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | | | - Lucas Maximilian Ritschl
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
17
|
Patil S, Alkahtani A, Bhandi S, Mashyakhy M, Alvarez M, Alroomy R, Hendi A, Varadarajan S, Reda R, Raj AT, Testarelli L. Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review. Diagnostics (Basel) 2021; 11:1208. [PMID: 34359291 PMCID: PMC8303698 DOI: 10.3390/diagnostics11071208] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of treatment. This review aimed to examine the accuracy of ultrasound and compare it to radiographs in distinguishing these lesions in vivo. METHODS This review process followed the PRISMA guidelines. A literature search of databases (PubMed, Scopus, Embase, and Web of Science) was conducted without any restrictions on time. Articles available in English were included. The selection was done according to the inclusion and exclusion criteria. The QUADAS-2 tool was used to assess the quality of the studies. RESULTS The search provided a total of 87 articles, out of which, five were selected for the final review. In all the studies, ultrasound had higher accuracy in distinguishing periapical lesions. All the studies indicated a risk of bias, especially in patient selection. CONCLUSION Within limitations, the study indicates that ultrasound is a better diagnostic tool to distinguish periapical lesions compared to radiographs but further studies with well-designed, rigorous protocols and low risk of bias are needed to provide stronger evidence.
Collapse
Affiliation(s)
- Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ahmed Alkahtani
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.B.); (M.M.)
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (S.B.); (M.M.)
| | - Mario Alvarez
- Division of Endodontics and Orthodontics, University of Southern California, Los Angeles, CA 90007, USA;
| | - Riyadh Alroomy
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, AlMajmaah 11952, Saudi Arabia;
| | - Ali Hendi
- Department of Radiology, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Saranya Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00161 Rome, Italy;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India; (S.V.); (A.T.R.)
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00161 Rome, Italy;
| |
Collapse
|
18
|
The Chairside Periodontal Diagnostic Toolkit: Past, Present, and Future. Diagnostics (Basel) 2021; 11:diagnostics11060932. [PMID: 34067332 PMCID: PMC8224643 DOI: 10.3390/diagnostics11060932] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Periodontal diseases comprise a group of globally prevalent, chronic oral inflammatory conditions caused by microbial dysbiosis and the host immune response. These diseases specifically affect the tooth-supporting tissues (i.e., the periodontium) but are also known to contribute to systemic inflammation. If left untreated, periodontal diseases can ultimately progress to tooth loss, lead to compromised oral function, and negatively impact the overall quality of life. Therefore, it is important for the clinician to accurately diagnose these diseases both early and accurately chairside. Currently, the staging and grading of periodontal diseases are based on recording medical and dental histories, thorough oral examination, and multiple clinical and radiographic analyses of the periodontium. There have been numerous attempts to improve, automate, and digitize the collection of this information with varied success. Recent studies focused on the subgingival microbiome and the host immune response suggest there is an untapped potential for non-invasive oral sampling to assist clinicians in the chairside diagnosis and, potentially, prognosis. Here, we review the available toolkit available for diagnosing periodontal diseases, discuss commercially available options, and highlight the need for collaborative research initiatives and state-of-the-art technology development across disciplines to overcome the challenges of rapid periodontal disease diagnosis.
Collapse
|
19
|
Is MRI a viable alternative to CT/CBCT to identify the course of the inferior alveolar nerve in relation to the roots of the third molars? Clin Oral Investig 2020; 25:3861-3871. [PMID: 33289048 PMCID: PMC8137481 DOI: 10.1007/s00784-020-03716-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/25/2020] [Indexed: 12/23/2022]
Abstract
Objectives To assess the reliability of judging the spatial relation between the inferior alveolar nerve (IAN) and mandibular third molar (MTM) based on MRI or CT/CBCT images. Methods Altogether, CT/CBCT and MRI images of 87 MTMs were examined twice by 3 examiners with different degrees of experience. The course of the IAN in relation to the MTM, the presence/absence of a direct contact between IAN and MTM, and the presence of accessory IAN were determined. Results The IAN was in > 40% of the cases judged as inferior, while an interradicular position was diagnosed in < 5% of the cases. The overall agreement was good (κ = 0.72) and any disagreement between the imaging modalities was primarily among the adjacent regions, i.e., buccal/lingual/interradicular vs. inferior. CT/CBCT judgements presented a very good agreement for the inter- and intrarater comparison (κ > 0.80), while MRI judgements showed a slightly lower, but good agreement (κ = 0.74). A direct contact between IAN and MTM was diagnosed in about 65%, but in almost 20% a disagreement between the judgements based on MRI and CT/CBCT was present resulting in a moderate overall agreement (κ = 0.60). The agreement between the judgements based on MRI and CT/CBCT appeared independent of the examiner’s experience and accessory IAN were described in 10 cases in MRI compared to 3 cases in CT/CBCT images. Conclusions A good inter- and intrarater agreement has been observed for the assessment of the spatial relation between the IAN and MTM based on MRI images. Further, MRI images might provide advantages in the detection of accessory IAN compared to CT/CBCT. Clinical relevance MRI appears as viable alternative to CT/CBCT for preoperative assessment of the IAN in relation to the MTM. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-020-03716-4.
Collapse
|
20
|
Probst FA, Schweiger J, Stumbaum MJ, Karampinos D, Burian E, Probst M. Magnetic resonance imaging based
computer‐guided
dental implant surgery—A clinical pilot study. Clin Implant Dent Relat Res 2020; 22:612-621. [DOI: 10.1111/cid.12939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/23/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery University Hospital, LMU Munich Munich Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry University Hospital, LMU Munich Munich Germany
| | | | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar Technical University Munich Munich Germany
| |
Collapse
|
21
|
Roser C, Hilgenfeld T, Sen S, Badrow T, Zingler S, Heiland S, Bendszus M, Lux CJ, Juerchott A. Evaluation of magnetic resonance imaging artifacts caused by fixed orthodontic CAD/CAM retainers-an in vitro study. Clin Oral Investig 2020; 25:1423-1431. [PMID: 32785849 PMCID: PMC7878219 DOI: 10.1007/s00784-020-03450-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/07/2020] [Indexed: 12/27/2022]
Abstract
Objectives Magnetic resonance imaging (MRI) image quality can be severely impaired by artifacts caused by fixed orthodontic retainers. In clinical practice, there is a trend towards using computer-aided design/computer-aided manufacturing (CAD/CAM) retainers. This study aimed to quantify MRI artifacts produced by these novel CAD/CAM retainers. Material and methods Three CAD/CAM retainers and a stainless-steel retainer (“Twistflex”; clinical reference standard) were scanned in vitro at 3-T MRI using a high-resolution 3D sequence. The artifact diameters and three-dimensional artifact volumes (AV) were determined for all mandibular (AVmand) and maxillary (AVmax) retainers. Moreover, the corresponding ratio of artifact volume to retainer volume (AV/RVmand, AV/RVmax) was calculated. Results Twistflex caused large artifact volumes (AVmand: 13530 mm3; AVmax: 15642 mm3; AV/RVmand: 2602; AV/RVmax: 2235). By contrast, artifact volumes for CAD/CAM retainers were substantially smaller: whereas artifact volumes for cobalt–chromium retainers were moderate (381 mm3; 394 mm3; 39; 31), grade-5 titanium (110 mm3; 126 mm3; 12; 12) and nickel–titanium (54 mm3; 78 mm3; 12; 14) both produced very small artifact volumes. Conclusion All CAD/CAM retainers caused substantially smaller volumes of MRI artifacts compared to Twistflex. Grade-5 titanium and nickel–titanium CAD/CAM retainers showed the smallest artifact volumes. Clinical relevance CAD/CAM retainers made from titanium or nickel–titanium may not relevantly impair image quality in head/neck and dental MRI. Artifacts caused by cobalt–chromium CAD/CAM retainers may mask nearby dental/periodontal structures. In contrast, the large artifacts caused by Twistflex are likely to severely impair diagnosis of oral and adjacent pathologies.
Collapse
Affiliation(s)
- Christoph Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Badrow
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
22
|
Karamifar K, Tondari A, Saghiri MA. Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities. Eur Endod J 2020; 5:54-67. [PMID: 32766513 PMCID: PMC7398993 DOI: 10.14744/eej.2020.42714] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.
Collapse
Affiliation(s)
- Kasra Karamifar
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
| | - Afsoon Tondari
- Department of Restorative Dentistry, Dental Branch, Shiraz Azad University, Shiraz, Iran
| | - Mohammad Ali Saghiri
- From the Department of Restorative Dentistry, Rutgers School of Dental Medicine, New Jersey, USA
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
| |
Collapse
|
23
|
Röttiger C, Hellige M, Ohnesorge B, Bienert-Zeit A. Magnetic resonance imaging and computed tomography of equine cheek teeth and adjacent structures: comparative study of image quality in horses in vivo, post-mortem and frozen-thawed. Acta Vet Scand 2019; 61:62. [PMID: 31823831 PMCID: PMC6905104 DOI: 10.1186/s13028-019-0495-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of cadavers for radiology research methodologies involving subjective image quality evaluation of anatomical criteria is well-documented. The purpose of this method comparison study was to evaluate the image quality of dental and adjacent structures in computed tomography (CT) and high-field (3 T) magnetic resonance (MR) images in cadaveric heads, based on an objective four-point rating scale. Whilst CT is a well-established technique, MR imaging (MRI) is rarely used for equine dental diagnostics. The use of a grading system in this study allowed an objective assessment of CT and MRI advantages in portraying equine cheek teeth. As imaging is commonly performed with cadaveric or frozen and thawed heads for dental research investigations, the second objective was to quantify the impact of the specimens' conditions (in vivo, post-mortem, frozen-thawed) on the image quality in CT and MRI. RESULTS The CT and MR images of nine horses, focused on the maxillary premolar 08s and molar 09s, were acquired post-mortem (Group A). Three observers scored the dental and adjacent tissues. Results showed that MR sequences gave an excellent depiction of endo- and periodontal structures, whereas CT produced high-quality images of the hard tooth and bony tissues. Additional CT and MRI was performed in vivo (Group B) and frozen-thawed (Group C) in three of these nine horses to specify the condition of the best specimens for further research. Assessing the impact of the specimens' conditions on image quality, specific soft tissues of the maxillary 08s and 09s including adjacent structures (pulps, mucosa of the maxillary sinuses, periodontal ligament, soft tissue inside the infraorbital canal) were graded in group B and C and analysed for significant differences within CT and MR modalities in comparison to group A. Results showed that MRI scores in vivo were superior to the post-mortem and frozen-thawed condition. CONCLUSIONS On comparing the imaging performance of CT and MRI, both techniques show a huge potential for application in equine dentistry. Further studies are needed to assess the clinical suitability of MRI. For further research investigations it must be considered, that the best MR image quality is provided in live horses.
Collapse
|
24
|
Evaluation of magnetic resonance imaging for diagnostic purposes in operative dentistry—a systematic review. Clin Oral Investig 2019; 24:547-557. [DOI: 10.1007/s00784-019-03103-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
|
25
|
In vivo comparison of MRI- and CBCT-based 3D cephalometric analysis: beginning of a non-ionizing diagnostic era in craniomaxillofacial imaging? Eur Radiol 2019; 30:1488-1497. [PMID: 31802215 DOI: 10.1007/s00330-019-06540-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate whether magnetic resonance imaging (MRI) can serve as an alternative diagnostic tool to the "gold standard" cone-beam computed tomography (CBCT) in 3D cephalometric analysis. METHODS In this prospective feasibility study, 12 patients (8 males, 4 females; mean age ± SD, 26.1 years ± 6.6) underwent 3D MRI and CBCT before orthognathic surgery. 3D cephalometric analysis was performed twice by two independent observers on both modalities. For each dataset, 27 cephalometric landmarks were defined from which 35 measurements (17 angles, 18 distances) were calculated. Statistical analyses included the calculation of Euclidean distances, intraclass correlation coefficients (ICCs), Bland-Altman analysis, and equivalence testing (linear mixed effects model) with a predefined equivalence margin of ± 1°/1 mm. RESULTS Analysis of reliability for CBCT vs. MRI (intra-rater I/intra-rater II/inter-rater) revealed Euclidean distances of 0.86/0.86/0.98 mm vs. 0.93/0.99/1.10 mm for landmarks, ICCs of 0.990/0.980/0.986 vs. 0.982/0.978/0.980 for angles, and ICCs of 0.992/0.988/0.989 vs. 0.991/0.985/0.988 for distances. Bland-Altman analysis showed high levels of agreement between CBCT and MRI with bias values (95% levels of agreement) of 0.03° (- 1.49; 1.54) for angles and 0.02 mm (- 1.44; 1.47) for distances. In the linear mixed effects model, the mean values of CBCT and MRI measurements were equivalent. CONCLUSION This feasibility study indicates that MRI enables reliable 3D cephalometric analysis with excellent agreement to corresponding measurements on CBCT. Thus, MRI could serve as a non-ionizing alternative to CBCT for treatment planning and monitoring in orthodontics as well as oral and maxillofacial surgery. KEY POINTS • Clinically established 3D cephalometric measurements performed on MRI are highly reliable and show an excellent agreement with CBCT (gold standard). • The MRI technique applied in this study could be used as a non-ionizing diagnostic tool in orthodontics as well as oral and maxillofacial surgery. • Since most patients benefiting from 3D cephalometry are young in age, the use of MRI could substantially contribute to radiation protection and open up new possibilities for treatment monitoring.
Collapse
|
26
|
Burian E, Probst FA, Weidlich D, Cornelius CP, Maier L, Robl T, Zimmer C, Karampinos DC, Ritschl LM, Probst M. MRI of the inferior alveolar nerve and lingual nerve-anatomical variation and morphometric benchmark values of nerve diameters in healthy subjects. Clin Oral Investig 2019; 24:2625-2634. [PMID: 31705309 DOI: 10.1007/s00784-019-03120-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/01/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Since MRI using dedicated imaging sequences has recently shown promising results in direct visualization of the inferior alveolar nerve (IAN) and the lingual nerve (LN) with high spatial resolution, the aim of this study was to generate suitable standard specifications to reliably depict the IAN and LN in MRI and to delineate the anatomy and its variants of these nerves in healthy subjects. METHODS Thirty healthy volunteers were examined on a 3-T scanner (Elition, Philips Healthcare, Best, the Netherlands). The sequence protocol consisted of 3D STIR, 3D DESS, and 3D T1 FFE "black bone" sequences. RESULTS The study reconfirmed a good feasibility of direct visualization of proximal and peripheral portions of the IAN and of the proximal course of the LN. The STIR sequence showed the highest apparent signal to noise ratio (aSNR) and best apparent nerve-muscle contrast to noise ratio (aNMCNR) for IAN and for the LN. The applied MRI sequences allowed to differentiate the tissue composition of the neurovascular bundle inside the mandibular canal. CONCLUSION Dedicated MRI sequence protocols proved effectively to detect the IAN and LN and their course in healthy volunteers. The tissue composition of the mandibular neurovascular bundle was conclusively distinguishable as was the varying topography inside multiple bony channels. CLINICAL RELEVANCE The presented data on the precise and valid visualization of the IAN and LN have clinical implications in respect to local anesthesia prior to dental treatments in the mandible but also regarding surgical procedures and implant insertion in the molar region.
Collapse
Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany.
| | - Florian A Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Carl-Peter Cornelius
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Maier
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany
| | - Teresa Robl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany
| |
Collapse
|
27
|
Maspero C, Abate A, Bellincioni F, Cavagnetto D, Lanteri V, Costa A, Farronato M. Comparison of a tridimensional cephalometric analysis performed on 3T-MRI compared with CBCT: a pilot study in adults. Prog Orthod 2019; 20:40. [PMID: 31631241 PMCID: PMC6801285 DOI: 10.1186/s40510-019-0293-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/21/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Since the introduction of cone-beam computed tomography (CBCT) in dentistry, this technology has enabled distortion-free three-dimensional cephalometric analysis for orthodontic and orthognathic surgery diagnosis. However, CBCT is associated with significantly higher radiation exposure than traditional routine bidimensional examinations for orthodontic diagnosis, although low-dose protocols have markedly reduced radiation exposure over time. The objective of this preliminary feasibility study is to compare the accuracy and diagnostic capabilities of an already-validated three-dimensional cephalometric analysis on CBCT to those of an analysis on 3-T magnetic resonance imaging (3T-MRI) to assess whether the latter can deliver a comparable quality of information while avoiding radiation exposure. MATERIALS AND METHODS In order to test the feasibility of three-dimensional cephalometry on 3T-MRI, 18 subjects (4 male; 14 female) with mean age 37.8 ± SD 10.2, who had undergone both maxillofacial CBCT and maxillofacial 3T-MRI for various purposes within 1 month, were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione Ospedale Policlinico Maggiore, IRCCS, Milano, Italy. A three-dimensional cephalometric analysis composed of ten midsagittal and four bilateral landmarks and 24 measurements (11 angular, 13 linear) was performed on both scans using Mimics Research® v. 17.0 (NV, Technologielaan 15, 3001 Leuven, Belgium). Cephalometric analysis was performed twice by two independent orthodontists for each scan, and each orthodontist repeated the measurements 3 weeks later. Statistical analysis was performed with SPSS® 20.00 for Windows (IBM® Corporation, Sommers, NY, USA). A Bland-Altman test for each cephalometric value was performed to assess the agreement between the procedures. The intraclass correlation coefficient (ICC) was used to assess interobserver and intraobserver reliability. The coefficient of variation was used to evaluate precision. RESULTS Both procedures showed good reliability, with mean intraobserver ICCs of 0.977/0.971 for CBCT and 0.881/0.912 for MRI. The average interobserver ICCs were 0.965 for CBCT and 0.833 for MRI. A Bland-Altman analysis for the cephalometric tracing revealed a similar range of agreement between the two modalities; the bias range (mean ± SD) was - 0.25-0.66 mm (0.174 ± 0.31) for distances and - 0.41-0.54° (0.12 ± 0.33) for angles. CONCLUSIONS Within the main limitation of this pilot study, that is, the small sample, it is possible to state that cephalometric measurements on 3T-MRI seem to possess adequate reliability and repeatability and that they show satisfying agreement with values measured on CBCTs. An MRI examination does not expose patients to ionizing radiation and could provide an alternative to CBCT for three-dimensional cephalometrics in the future.
Collapse
Affiliation(s)
- Cinzia Maspero
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy. .,University of Milan, Milan, Italy.
| | - Andrea Abate
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.,University of Milan, Milan, Italy
| | - Francesca Bellincioni
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.,University of Milan, Milan, Italy
| | - Davide Cavagnetto
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.,University of Milan, Milan, Italy
| | - Valentina Lanteri
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.,University of Milan, Milan, Italy
| | - Antonella Costa
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Marco Farronato
- Department of Orthodontics, UOC Maxillofacial and Dental Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20142, Milan, Italy.,University of Milan, Milan, Italy
| |
Collapse
|
28
|
Demirturk Kocasarac H, Kursun-Cakmak ES, Ustaoglu G, Bayrak S, Orhan K, Noujeim M. Assessment of signal-to-noise ratio and contrast-to-noise ratio in 3 T magnetic resonance imaging in the presence of zirconium, titanium, and titanium-zirconium alloy implants. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:80-86. [PMID: 31628073 DOI: 10.1016/j.oooo.2019.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/09/2019] [Accepted: 08/31/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We quantitatively compared the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in T1 weighted imaging (WI) and T2 WI sequences in 3 Tesla (T) magnetic resonance imaging (MRI) using zirconium, titanium (grades 4 and 5), and titanium-zirconium alloy implants to evaluate the effect of implant type and imaging sequence. STUDY DESIGN MRI was acquired using a 3 T magnet with a 16-channel head coil. Implants of each type were mounted in gel and scanned in axial, coronal, and sagittal planes using fast spin echo sequences in T1 WI (TR = 600, TE = 12 milliseconds) and T2 WI (TR = 3000, TE = 80 milliseconds) sequences. Data were transferred to Synapse 3-D software, and images were measured twice by an oral and maxillofacial radiologist blinded to the type of implants. RESULTS Zirconium implants resulted in the lowest SNR and CNR values (P < .05). No significant differences were identified between titanium (grades 4 and 5) and titanium-zirconium implants. The T2 WI sequence had a significantly higher SNR and CNR than T1 WI. There was no difference in intraobserver agreement between T1 WI and T2 WI. CONCLUSIONS CNR and SNR at 3 T MRI are dependent on implant type and imaging sequence. Titanium (grades 4 and 5) and titanium-zirconium implants and the T2 WI sequence produced higher SNR and CNR values.
Collapse
Affiliation(s)
| | | | - Gulbahar Ustaoglu
- Department of Periodontology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Seval Bayrak
- Department of Oral and Maxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Kaan Orhan
- Professor, Department of Oral and Maxillofacial Radiology, Ankara University, Ankara, Turkey; OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marcel Noujeim
- Professor, Oral and Maxillofacial Radiology, Private practice, San Antonio, Texas, USA
| |
Collapse
|
29
|
Ariji Y, Ariji E, Nakashima M, Iohara K. Magnetic resonance imaging in endodontics: a literature review. Oral Radiol 2018; 34:10-16. [PMID: 30484095 DOI: 10.1007/s11282-017-0301-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/20/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) has recently been used for the evaluation of dental pulp anatomy, vitality, and regeneration. This study reviewed the recent use of MRI in the endodontic field. METHODS Literature published from January 2000 to March 2017 was searched in PubMed using the following Medical Subject Heading (MeSH) terms: (1) MRI and (dental pulp anatomy or endodontic pulp); (2) MRI and dental pulp regeneration. Studies were narrowed down based on specific inclusion criteria and categorized as in vitro, in vivo, or dental pulp regeneration studies. The MRI sequences and imaging findings were summarized. RESULTS In the in vitro studies on dental pulp anatomy, T1-weighted imaging with high resolution was frequently used to evaluate dental pulp morphology, demineralization depth, and tooth abnormalities. Other sequences such as apparent diffusion coefficient mapping and sweep imaging with Fourier transformation were used to evaluate pulpal fluid and decayed teeth, and short-T2 tissues (dentin and enamel), respectively. In the in vivo studies, pulp vitality and reperfusion were visible with fat-saturated T2-weighted imaging or contrast-enhanced T1-weighted imaging. In both the in vitro and in vivo studies, MRI could reveal pulp regeneration after stem cell therapy. Stem cells labeled with superparamagnetic iron oxide particles were also visible on MRI. Angiogenesis induced by stem cells could be confirmed on enhanced T1-weighted imaging. CONCLUSION MRI can be successfully used to visualize pulp morphology as well as pulp vitality and regeneration. The use of MRI in the endodontic field is likely to increase in the future.
Collapse
Affiliation(s)
- Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan.
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Misako Nakashima
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, 7-430 Morioka-cho, Obu, 474-8511, Japan
| | - Koichiro Iohara
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, 7-430 Morioka-cho, Obu, 474-8511, Japan
| |
Collapse
|
30
|
3D cephalometric analysis using Magnetic Resonance Imaging: validation of accuracy and reproducibility. Sci Rep 2018; 8:13029. [PMID: 30158656 PMCID: PMC6115428 DOI: 10.1038/s41598-018-31384-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/19/2018] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to validate geometric accuracy and in vivo reproducibility of landmark-based cephalometric measurements using high-resolution 3D Magnetic Resonance Imaging (MRI) at 3 Tesla. For accuracy validation, 96 angular and 96 linear measurements were taken on a phantom in 3 different positions. In vivo MRI scans were performed on 3 volunteers in five head positions. For each in vivo scan, 27 landmarks were determined from which 19 angles and 26 distances were calculated. Statistical analysis was performed using Bland-Altman analysis, the two one-sided tests procedure and repeated measures one-way analysis of variance. In comparison to ground truth, all MRI-based phantom measurements showed statistical equivalence (p < 0.001) and an excellent agreement in Bland-Altman analysis (bias ranges: -0.090-0.044°, -0.220-0.241 mm). In vivo cephalometric analysis was highly reproducible among the five different head positions in all study participants, without statistical differences for all angles and distances (p > 0.05). Ranges between maximum and minimum in vivo values were consistently smaller than 2° and 2 mm, respectively (average ranges: 0.88°/0.87 mm). In conclusion, this study demonstrates that accurate and reproducible 3D cephalometric analysis can be performed without exposure to ionizing radiation using MRI.
Collapse
|
31
|
Di Nardo D, Gambarini G, Capuani S, Testarelli L. Nuclear Magnetic Resonance Imaging in Endodontics: A Review. J Endod 2018; 44:536-542. [DOI: 10.1016/j.joen.2018.01.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/30/2017] [Accepted: 01/01/2018] [Indexed: 01/31/2023]
|
32
|
Wanner L, Ludwig U, Hövener JB, Nelson K, Flügge T. Magnetic resonance imaging-a diagnostic tool for postoperative evaluation of dental implants: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:e103-e107. [PMID: 29501353 DOI: 10.1016/j.oooo.2018.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Compared with cone beam computed tomography (CBCT), magnetic resonance imaging (MRI) might be superior for the diagnosis of nerve lesions associated with implant placement. STUDY DESIGN A patient presented with unilateral pain associated with dysesthesia in the region of the right lower lip and chin after implant placement. Conventional orthopantomography could not identify an association between the position of the inferior alveolar nerve and the implant. For 3-dimensional display of the implant in relation to the surrounding anatomy, CBCT was compared with MRI. RESULTS MRI enabled the precise depiction of the implant position and its spatial relation to the inferior alveolar nerve, whereas the nerve position and its exact course within the mandible could not be directly displayed in CBCT. CONCLUSION MRI may be a valuable, radiation-free diagnostic tool for the visualization of intraoral hard and soft tissues, offering an objective assessment of nerve injuries by a direct visualization of the inferior alveolar neurovascular bundle.
Collapse
Affiliation(s)
- Laura Wanner
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Ute Ludwig
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Jan-Bernd Hövener
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
33
|
Heil A, Schwindling FS, Jelinek C, Fischer M, Prager M, Lazo Gonzalez E, Bendszus M, Heiland S, Hilgenfeld T. Determination of the palatal masticatory mucosa thickness by dental MRI: a prospective study analysing age and gender effects. Dentomaxillofac Radiol 2017; 47:20170282. [PMID: 28959890 DOI: 10.1259/dmfr.20170282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this prospective study was to evaluate age and gender effects on the palatal masticatory mucosa thickness by using non-invasive and non-ionizing MRI. METHODS 40 periodontally healthy participants of five gender-balanced age groups (20-29, 30-39, 40-49, 50-59 and 60-69 years, respectively) underwent dental MRI at 3 Tesla using a contrast-enhanced, high-resolution 3D-sequence. The palatal masticatory mucosa was measured at 40 standard measurement points by two independent observers. Statistical analysis was performed by using intraclass correlation coefficient (ICC), Shapiro-Wilk test, two-way analysis of variance and post-hoc Tukey HSD test. RESULTS Measurements of the palatal masticatory mucosa thickness were highly reliable with a mean intraobserver ICC of 0.989 and a mean interobserver ICC of 0.987. Mean palatal masticatory mucosa thickness increased with the distance from the gingival margin in all tooth regions. Molars showed a considerably lower average palatal masticatory mucosa thickness at intermediate heights in comparison to canines and premolars. Average palatal masticatory mucosa thickness continuously increased with age and significantly differed between age groups (p < 0.01). A significant increase was observed between the age groups of 30-39 years and 40-49 years (p = 0.04). Gender had no significant effect on average palatal mucosa thickness (p = 0.19). However, there was a tendency towards thicker mucosa in males (mean ± SD, 3.36 mm ± 0.47) compared to females (3.23 mm ± 0.44). CONCLUSIONS In the present study, dental MRI allowed for a highly reliable determination of the palatal masticatory mucosa thickness. Considerable intra- and interindividual variations in palatal masticatory mucosa thickness were observed. Average palatal masticatory mucosa thickness was dependent on age but not on gender.
Collapse
Affiliation(s)
- Alexander Heil
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Constanze Jelinek
- 3 Department of Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Manuel Fischer
- 4 Section of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Marcel Prager
- 4 Section of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Martin Bendszus
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- 4 Section of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- 1 Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
34
|
Schoppe C, Hellige M, Rohn K, Ohnesorge B, Bienert-Zeit A. Comparison of computed tomography and high-field (3.0 T) magnetic resonance imaging of age-related variances in selected equine maxillary cheek teeth and adjacent tissues. BMC Vet Res 2017; 13:280. [PMID: 28874149 PMCID: PMC5585999 DOI: 10.1186/s12917-017-1200-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 08/24/2017] [Indexed: 11/22/2022] Open
Abstract
Background Modern imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) have the advantage of producing images without superimposition. Whilst CT is a well-established technique for dental diagnostics, MRI examinations are rarely used for the evaluation of dental diseases in horses. Regarding equine endodontic therapies which are increasingly implemented, MRI could help to portray changes of the periodontal ligament and display gross pulpar anatomy. Knowledge of age-related changes is essential for diagnosis, as cheek teeth and surrounding structures alter with increasing age. The aim of the present study was to highlight the advantages of CT and MRI regarding age-related changes in selected equine cheek teeth and their adjacent structures. Results The CT and MRI appearances of the maxillary 08 s and 09 s and adjacent structures were described by evaluation of post-mortem examinations of nine horses of different ages (Group A: <6 years, B: 6–15 years, C: ≥16 years). Most of the tissues selected were imaged accurately with MRI and CT. Magnetic resonance imaging gives an excellent depiction of soft endo- and periodontal units, and CT of hard dental and bony tissues. Negative correlation between dental age and pulpar sizes was found: 71.3% of the changes in pulp dimensions can be explained by teeth aging. Pulpar sizes ranged from 14.3 to 1.3 mm and were significantly smaller in older horses (p < 0.05). A common pulp chamber was present in 33% of the teeth with a mean dental age of 2.25 years. Ninety-four percent of the 08 and 09 alveoli of all groups were in direct contact with the maxillary sinus. An age-related regression was found (R2 = 0.88) for the distance between alveoli and the infraorbital canal. Conclusions The present study provides information about the dental and periodontal age-related morphology and its visibility using different imaging techniques. These results aid in evaluating diagnostic images and in deciding which is the superior imaging modality for clinical cases.
Collapse
Affiliation(s)
- Christin Schoppe
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany.
| | - Maren Hellige
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| | - Karl Rohn
- Institute for Veterinary Biometry and Epidemiology, University of Veterinary Medicine Hannover, Foundation, Buenteweg 2, 30559, Hannover, Germany
| | - Bernhard Ohnesorge
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| | - Astrid Bienert-Zeit
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
| |
Collapse
|
35
|
Probst M, Richter V, Weitz J, Kirschke JS, Ganter C, Troeltzsch M, Nittka M, Cornelius CP, Zimmer C, Probst FA. Magnetic resonance imaging of the inferior alveolar nerve with special regard to metal artifact reduction. J Craniomaxillofac Surg 2017; 45:558-569. [DOI: 10.1016/j.jcms.2017.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/08/2016] [Accepted: 01/09/2017] [Indexed: 11/30/2022] Open
|
36
|
Nakashima M, Iohara K, Murakami M, Nakamura H, Sato Y, Ariji Y, Matsushita K. Pulp regeneration by transplantation of dental pulp stem cells in pulpitis: a pilot clinical study. Stem Cell Res Ther 2017; 8:61. [PMID: 28279187 PMCID: PMC5345141 DOI: 10.1186/s13287-017-0506-5] [Citation(s) in RCA: 218] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/05/2017] [Accepted: 02/10/2017] [Indexed: 02/06/2023] Open
Abstract
Background Experiments have previously demonstrated the therapeutic potential of mobilized dental pulp stem cells (MDPSCs) for complete pulp regeneration. The aim of the present pilot clinical study is to assess the safety, potential efficacy, and feasibility of autologous transplantation of MDPSCs in pulpectomized teeth. Methods Five patients with irreversible pulpitis were enrolled and monitored for up to 24 weeks following MDPSC transplantation. The MDPSCs were isolated from discarded teeth and expanded based on good manufacturing practice (GMP). The quality of the MDPSCs at passages 9 or 10 was ascertained by karyotype analyses. The MDPSCs were transplanted with granulocyte colony-stimulating factor (G-CSF) in atelocollagen into pulpectomized teeth. Results The clinical and laboratory evaluations demonstrated no adverse events or toxicity. The electric pulp test (EPT) of the pulp at 4 weeks demonstrated a robust positive response. The signal intensity of magnetic resonance imaging (MRI) of the regenerated tissue in the root canal after 24 weeks was similar to that of normal dental pulp in the untreated control. Finally, cone beam computed tomography demonstrated functional dentin formation in three of the five patients. Conclusions Human MDPSCs are safe and efficacious for complete pulp regeneration in humans in this pilot clinical study.
Collapse
Affiliation(s)
- Misako Nakashima
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Koichiro Iohara
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masashi Murakami
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroshi Nakamura
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Yayoi Sato
- Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Kenji Matsushita
- Department of Dental and Oral Infrastructure Development, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
37
|
Smeets R, Schöllchen M, Gauer T, Aarabi G, Assaf AT, Rendenbach C, Beck-Broichsitter B, Semmusch J, Sedlacik J, Heiland M, Fiehler J, Siemonsen S. Artefacts in multimodal imaging of titanium, zirconium and binary titanium-zirconium alloy dental implants: an in vitro study. Dentomaxillofac Radiol 2016; 46:20160267. [PMID: 27910719 DOI: 10.1259/dmfr.20160267] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To analyze and evaluate imaging artefacts induced by zirconium, titanium and titanium-zirconium alloy dental implants. METHODS Zirconium, titanium and titanium-zirconium alloy implants were embedded in gelatin and MRI, CT and CBCT were performed. Standard protocols were used for each modality. For MRI, line-distance profiles were plotted to quantify the accuracy of size determination. For CT and CBCT, six shells surrounding the implant were defined every 0.5 cm from the implant surface and histogram parameters were determined for each shell. RESULTS While titanium and titanium-zirconium alloy induced extensive signal voids in MRI owing to strong susceptibility, zirconium implants were clearly definable with only minor distortion artefacts. For titanium and titanium-zirconium alloy, the MR signal was attenuated up to 14.1 mm from the implant. In CT, titanium and titanium-zirconium alloy resulted in less streak artefacts in comparison with zirconium. In CBCT, titanium-zirconium alloy induced more severe artefacts than zirconium and titanium. CONCLUSIONS MRI allows for an excellent image contrast and limited artefacts in patients with zirconium implants. CT and CBCT examinations are less affected by artefacts from titanium and titanium-zirconium alloy implants compared with MRI. The knowledge about differences of artefacts through different implant materials and image modalities might help support clinical decisions for the choice of implant material or imaging device in the clinical setting.
Collapse
Affiliation(s)
- Ralf Smeets
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schöllchen
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Gauer
- 2 Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- 3 Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandre T Assaf
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Rendenbach
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedicta Beck-Broichsitter
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Semmusch
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Sedlacik
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Siemonsen
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
38
|
Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig 2016; 21:2213-2220. [PMID: 27878463 DOI: 10.1007/s00784-016-2014-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/16/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of the study is to assess the correlation between the mandibular canal tracing done on cone beam CT (CBCT) data, with the size, shape, and position of the neurovascular bundle (NB) obtained by magnetic resonance imaging (MRI). MATERIAL AND METHODS Six human cadaver mandibles were scanned with a CBCT Promax® scanner (Planmeca, Helsinki, Finland) and with an Ingenia® 3.0 T MR system (Philips, Amsterdam, The Netherlands). The NB was segmented from the MRI dataset, while the mandibular canal (MC) tracing was done on the CBCT images. Quantitative 3D analysis was made for the full-segmented nerves and for three defined regions of specific clinical interest, namely angle, body, and mental region. RESULTS From the 3D MRI analysis, the nerve thickness (for the angle, body, and mental region) ranges from 0.8 to 5.2 mm, while the thickness of the mandibular canal tracing is approximately 2.00 mm on both sides as chosen in the tracing software. The mean volume of the NB on the left is 828.49 ± 215.54 mm3 and on the right 792.98 ± 264.57 mm3. For the nerve tracing, the mean value is 351.92 ± 16.42 and 339.69 ± 16.12 mm3 on the left and right sides, respectively. Wilcoxon signed-rank test showed significant differences between NB and MC volume measurements (p = 0.0005). The Bland-Altman plots show an increasing slope for thickness and volume, indicating that the absolute differences between neurovascular bundle, estimated by MRI, and the mandibular canal, drawn on the CBCT images, increase with larger mean values. CONCLUSIONS Surgeons should be aware of the shortcomings of nerve tracing in the different regions of the mandible. CLINICAL RELEVANCE Tracing of the inferior alveolar nerve (IAN) underestimates shape and volume. Whenever nerve tracing instead of well-recognizable anatomical bony landmarks is used for surgical planning that need precision, a wider safe margin is recommended.
Collapse
Affiliation(s)
- Jimoh O Agbaje
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Elke Van de Casteele
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Ahmed S Salem
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Dickson Anumendem
- Centre for Educational Effectiveness and Evaluation of the Catholic University of Leuven, Leuven, Belgium
| | - Ivo Lambrichts
- Faculty of Medicine, Hasselt University, Diepenbeek, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Faculty of Medicine, Hasselt University, Diepenbeek, Belgium
| |
Collapse
|
39
|
Poorsattar-Bejeh Mir A, Rahmati-Kamel M. Should the orthodontic brackets always be removed prior to magnetic resonance imaging (MRI)? J Oral Biol Craniofac Res 2016; 6:142-52. [PMID: 27195213 PMCID: PMC4862114 DOI: 10.1016/j.jobcr.2015.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 01/31/2023] Open
Abstract
Request for temporary removal of orthodontic appliances due to medical conditions that require magnetic resonance (MR) imaging is not uncommon in daily practice in the field of orthodontics. This may be at the expense of time and cost. Metal Orthodontic appliances cause more signal loss and image distortion as compared to ceramic and titanium ones. Stainless steel and large brackets in addition to the oriented miniscrews in relation to the axis of magnetic field may cause severe signal loss and image distortion. Moreover, gradient echo and frequency-selective fat saturation MR protocols are more susceptible to metal artifacts. The spin echo and fat-suppression protocols, low magnetic field strength (e.g., 1.5 Tesla vs. 3 Tesla), small field of view, high-resolution matrix, thin slice, increased echo train length and increased receiver band width could be applied to lessen the metal artifacts in MR images. The larger the distance between an appliance and desired location to be imaged, the lower the distortion and signal loss. Decision to remove brackets should be made based on its composition and desired anatomic location. In this review, first the principles of MR imaging are introduced (Part-I) and then the interactions of orthodontic appliances and magnetic field are farther discussed (Part-II).
Collapse
Affiliation(s)
- Arash Poorsattar-Bejeh Mir
- Researcher, Dental Materials Research Center, Dentistry School, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
- Fusion Dental Research Center, Dallas, TX, USA
| | - Manouchehr Rahmati-Kamel
- Head, Department of Orthodontics, Dentistry School, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
| |
Collapse
|
40
|
Gradl J, Höreth M, Pfefferle T, Prager M, Hilgenfeld T, Gareis D, Bäumer P, Heiland S, Bendszus M, Hähnel S. Application of a Dedicated Surface Coil in Dental MRI Provides Superior Image Quality in Comparison with a Standard Coil. Clin Neuroradiol 2016; 27:371-378. [PMID: 26869445 DOI: 10.1007/s00062-016-0500-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/15/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE Purpose of our research was the evaluation of a dedicated dental surface coil in comparison with a standard head and neck coil for the improvement of dental magnetic resonance imaging (MRI). MATERIALS AND METHODS Axial T1-weighted spin echo MRI was performed by using a newly developed dental coil for MRI and a standard head and neck coil on five volunteers. In addition, MRI was implemented with dental coil on five patients. Using the Wilcoxon test, we compared the volunteers' signal-to-noise ratio (SNR) of a variety of anatomical structures (e.g., hard tooth tissue, pulp tissue, bone, muscle tissue). Also subjective evaluation of image quality was performed on both volunteers and patients. RESULTS Compared with the head and neck coil, the mean SNR was 3.5-fold higher on an average with the dental coil (range: from 2.7 [masseter muscle] to 4.6 [pulp tissue]). That difference was statistically significant for all evaluated structures. The higher SNR also resulted in a superior image quality as determined by subjective evaluation. CONCLUSION Dental MRI benefits profoundly from using a dedicated dental coil.
Collapse
Affiliation(s)
- J Gradl
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - M Höreth
- Heidelberg University School of Medicine, Heidelberg, Germany
| | - T Pfefferle
- Department of Oral, Dental and Maxillofacial Diseases, University of Heidelberg Medical Center, Heidelberg, Germany
| | - M Prager
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - T Hilgenfeld
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - D Gareis
- NORAS MRI Products GmbH, Leibnizstrasse 4, 97204, Höchberg, Germany
| | - P Bäumer
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - S Heiland
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - M Bendszus
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - S Hähnel
- Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
41
|
Iohara K, Fujita M, Ariji Y, Yoshikawa M, Watanabe H, Takashima A, Nakashima M. Assessment of Pulp Regeneration Induced by Stem Cell Therapy by Magnetic Resonance Imaging. J Endod 2016; 42:397-401. [PMID: 26778266 DOI: 10.1016/j.joen.2015.11.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 11/19/2015] [Accepted: 11/26/2015] [Indexed: 01/26/2023]
Abstract
INTRODUCTION This study was designed to evaluate the usefulness of magnetic resonance imaging (MRI) to assess the regeneration of pulp tissue. METHODS Mobilized dental pulp stem cells and granulocyte colony-stimulating factor with collagen were transplanted into mature pulpectomized teeth for pulp regeneration (n = 4). The controls consisted of pulpectomized teeth with or without collagen and normal teeth with intact pulp tissue (n = 4, each). The signal intensity (SI) of MRI using T2 sequences was compared after the extraction of teeth in dogs. MRI was correlated with the corresponding histologic findings. RESULTS Pulp tissue was fully regenerated 90 days after cell transplantation. On the other hand, the root canal was empty in the control collagen-transplanted teeth at 90 days. The SI of the normal teeth was significantly higher than that of nonvital pulpectomized teeth and the controls of collagen transplanted teeth at 90 days. The stem cell transplanted teeth showed a gradual decrease in the SI until 180 days at which time the SI was similar to that in the normal teeth and significantly higher than that in the teeth transplanted with collagen alone without the stem cells. CONCLUSIONS The changes in the SI of the pulplike tissue were consistent with the histologic findings, showing the potential usefulness of the noninvasive method to serially access the efficacy of pulp regenerative therapy.
Collapse
Affiliation(s)
- Koichiro Iohara
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan
| | - Masanori Fujita
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan; Department of Endodontology, School of Dentistry, Aichi-gakuin University, Nagoya, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-gakuin University, Nagoya, Japan
| | - Misato Yoshikawa
- Department of Aging Neurobiology, Center of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan
| | - Hideto Watanabe
- Institute for Molecular Science of Medicine, Aichi Medical University, Nagakute, Japan
| | - Akihiko Takashima
- Department of Aging Neurobiology, Center of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan
| | - Misako Nakashima
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan.
| |
Collapse
|
42
|
Sedlacik J, Kutzner D, Khokale A, Schulze D, Fiehler J, Celik T, Gareis D, Smeets R, Friedrich RE, Heiland M, Assaf AT. Optimized 14 + 1 receive coil array and position system for 3D high-resolution MRI of dental and maxillomandibular structures. Dentomaxillofac Radiol 2015; 45:20150177. [PMID: 26371075 DOI: 10.1259/dmfr.20150177] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The purpose of this study was to design, build and test a multielement receive coil array and position system, which is optimized for three-dimensional (3D) high-resolution dental and maxillomandibular MRI with high patient comfort. METHODS A 14 + 1 coil array and positioning system, allowing easy handling by the technologists, reproducible positioning of the patients and high patient comfort, was tested with three healthy volunteers using a 3.0-T MRI machine (Siemens Skyra; Siemens Medical Solutions, Erlangen, Germany). High-resolution 3D T1 weighted, water excitation T1 weighted and fat-saturated T2 weighted imaging sequences were scanned, and 3D image data were reformatted in different orientations and curvatures to aid diagnosis. RESULTS The high number of receiving coils and the comfortable positioning of the coil array close to the patient's face provided a high signal-to-noise ratio and allowed high quality, high resolution, 3D image data to be acquired within reasonable scan times owing to the possibility of parallel image acquisition acceleration. Reformatting the isotropic 3D image data in different views is helpful for diagnosis, e.g. panoramic reconstruction. The visibility of soft tissues such as the mandibular canal, nutritive canals and periodontal ligaments was exquisite. CONCLUSIONS The optimized MRI receive coil array and positioning system for dental and oral-maxillofacial imaging provides a valuable tool for detecting and diagnosing pathologies in dental and oral-maxillofacial structures while avoiding radiation dose. The high patient comfort, as achieved by our design, is very crucial, since image artefacts due to movement or failing to complete the examination jeopardize the diagnostic value of MRI examinations.
Collapse
Affiliation(s)
- Jan Sedlacik
- 1 Department of Diagnostics and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Daniel Kutzner
- 1 Department of Diagnostics and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Arun Khokale
- 1 Department of Diagnostics and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Dirk Schulze
- 1 Department of Diagnostics and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Jens Fiehler
- 1 Department of Diagnostics and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | | | | | - Ralf Smeets
- 3 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Reinhard E Friedrich
- 3 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Max Heiland
- 3 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| | - Alexandre T Assaf
- 3 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany
| |
Collapse
|
43
|
Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques of the inferior alveolar nerve (IAN): a narrative review. Surg Radiol Anat 2015; 38:55-63. [PMID: 26163825 PMCID: PMC4744261 DOI: 10.1007/s00276-015-1510-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 06/10/2015] [Indexed: 11/28/2022]
Abstract
Purpose The purpose of this study was to produce an overview of the present visualization techniques of the inferior alveolar nerve (IAN) in order to reduce the rates of nerve damage after third molar (M3) removal and bilateral sagittal split osteotomy (BSSO). Methods An electronic literature search was performed of the English-language scientific literature published prior to December 31, 2014 using the LIMO KU Leuven search platform. Information on the specifications of the different imaging techniques, their clinical application, advantages, disadvantages, and duration was extracted from 11 reports. Results Five methods for IAN visualization were obtained from the search results, which are cone-beam computed tomography (CBCT) and automatic extraction of the IAN canal using computed tomography (CT), magnetic resonance imaging (MRI), panoramic radiography, endoscopy, and ultrasonographic visualization. Conclusion The results of this study suggest that high-resolution MRI is the most commonly used method for direct visualization of the IAN. Six out of the eleven manuscripts use this technique. Recently, there have been some (experimental) modifications to the conventional MRI in the form of diffusion tensor tractography (DTT), phase-contrast magnetic resonance angiography (PC-MRA), and dental MRI. Future studies will focus on an intraoperative application of MRI to visualize the IAN during surgery.
Collapse
Affiliation(s)
- Annelies Weckx
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Jimoh Olubanwo Agbaje
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Yi Sun
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University Leuven, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| |
Collapse
|
44
|
Assaf AT, Zrnc TA, Remus CC, Khokale A, Habermann CR, Schulze D, Fiehler J, Heiland M, Sedlacik J, Friedrich RE. Early detection of pulp necrosis and dental vitality after traumatic dental injuries in children and adolescents by 3-Tesla magnetic resonance imaging. J Craniomaxillofac Surg 2015; 43:1088-93. [PMID: 26165761 DOI: 10.1016/j.jcms.2015.06.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/22/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES More than 50% of all children suffer a traumatic dental injury (TDI) during childhood. In many cases, dentists apply root canal treatment (RCT), which is performed on an average of 7-10 days after replantation. Our aim was to evaluate whether RCT is necessary in many cases, and whether revitalization of affected teeth is possible and measurable by visualization using 3T magnetic resonance imaging (MRI). MATERIAL AND METHODS Seven healthy children with TDI were treated by repositioning of the affected teeth and reduction of alveolar process fractures followed by splinting. Two weeks after initial treatment, splints were removed. After 6 weeks, all children received 3-Tesla (3T), three-dimensional, high-resolution MRI with a 20-channel standard head and neck coil. The mean age of the children (male/female = 5:2) was 10.8 years (range, 8-17 years). In addition, all children received conventional dental examination for tooth vitality and dental sensitivity to cold and tenderness on percussion. RESULTS 3T MRI provided excellent images that allowed fine discrimination between dental pulp and adjacent tooth. Using four in-house optimized, non-contrast-enhanced sequences, including panoramic reconstruction, the assessment and analysis of the dental pulp was sufficiently feasible. We could demonstrate reperfusion and thus vitality of the affected teeth in 11 sites. In one child, MRI was able to detect nonreperfusion after TDI of the affected tooth. MRI results were confirmed by clinical examination in all cases. As a consequence of this expectant management and proof of reperfusion and tooth vitality by 3T MRI, only one child had to be treated by RCT. CONCLUSION 3T MRI is a very promising tool for visualization and detection in the field of dental and oromaxillofacial diseases. By using new 3T MRI sequences in children with TDI, we could demonstrate that RCT are not necessary in every case, and thus could prevent unnecessary treatment of children in the future. Larger studies should follow to confirm the potential benefit in clinical practice.
Collapse
Affiliation(s)
- Alexandre T Assaf
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany.
| | - Tomislav A Zrnc
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Dr. H.F. Zeilhofer, MD, DMD, PhD), University Hospital Basel, University of Basel, Spitalstr. 21, 4056 Basel, Switzerland
| | - Chressen C Remus
- Department for Diagnostics and Interventional Radiology (Head: Prof. Dr. G. Adam, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 78, 20246 Hamburg, Germany
| | - Arun Khokale
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Christian R Habermann
- Department for Diagnostics and Interventional Radiology (Head: Dr. H. Denkhaus, MD), Marien Hospital Hamburg, Alfredstraße 9, 22087 Hamburg, Germany
| | - Dirk Schulze
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Jan Sedlacik
- Department of Diagnostics and Interventional Neuroradiology (Head: Prof. J. Fiehler, MD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland, MD, DMD, PhD), University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| |
Collapse
|
45
|
Benic GI, Elmasry M, Hämmerle CHF. Novel digital imaging techniques to assess the outcome in oral rehabilitation with dental implants: a narrative review. Clin Oral Implants Res 2015; 26 Suppl 11:86-96. [DOI: 10.1111/clr.12616] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Moustafa Elmasry
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| |
Collapse
|