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Karkle A, Slaidina A, Zolovs M, Vaskevica A, Meistere D, Bokvalde Z, Neimane L. Comparative Analysis of Examination Methods for Periapical Lesion Diagnostics: Assessing Cone-Beam Computer Tomography, Ultrasound, and Periapical Radiography. Diagnostics (Basel) 2024; 14:766. [PMID: 38611679 PMCID: PMC11011571 DOI: 10.3390/diagnostics14070766] [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: 03/04/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
INTRODUCTION Periapical lesions of teeth are typically evaluated using periapical X-rays (PA) or cone-beam computer tomography (CBCT); however, ultrasound imaging (US) can also be used to detect bone defects. A comparative analysis is necessary to establish the diagnostic accuracy of US for the detection of periapical lesions in comparison with PA and CBCT. OBJECTIVES This study aimed to evaluate and compare the measurement precision of US against PA and CBCT in detecting periapical lesions. METHODS This study included 43 maxillary and mandibular teeth with periapical lesions. All teeth were examined clinically, radiographically, and ultrasonographically. Observers evaluated and measured the periapical lesions on CBCT, PA, and US images. RESULTS The comparison of lesion size showed that it differs significantly between the different methods of examination. A statistically significant difference was found between CBCT and US (mean difference = 0.99 mm, 95% CI [0.43-1.55]), as well as between CBCT and PA (mean difference = 0.61 mm, 95% CI [0.17-1.05]). No difference was found between the US and PA methods (p = 0.193). CONCLUSION US cannot replace PA radiography in detecting pathologies but it can accurately measure and characterize periapical lesions with minimal radiation exposure. CBCT is the most precise and radiation-intensive method so it should only be used for complex cases.
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Affiliation(s)
- Aleksandra Karkle
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Anda Slaidina
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
- Department of Prosthetic Dentistry, Riga Stradins University, LV-1007 Riga, Latvia
| | - Maksims Zolovs
- Statistics Unit, Riga Stradins University, LV-1007 Riga, Latvia;
- Institute of Life Sciences and Technology, Daugavpils University, LV-5401 Daugavpils, Latvia
| | - Anete Vaskevica
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Dita Meistere
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
| | - Zanda Bokvalde
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Laura Neimane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
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Jia W, Jing H, Xia G, Angang D, Wei Z, Pengfei Z, Shujun R, Mengying M, Zhengwei H, Shensheng G. Utility of Ultrasonography for Diagnosing and Differentiating Periapical Granuloma from Radicular Cyst. Acad Radiol 2023; 30:2329-2339. [PMID: 37394410 DOI: 10.1016/j.acra.2023.05.039] [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: 02/17/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular cysts from granulomas. MATERIALS AND METHODS This study included 109 teeth with periapical lesions of endodontic origin from 109 patients scheduled for apical microsurgery. Ultrasonic outcomes were analyzed and categorized after thorough clinical and radiographic examinations using US. B-mode US images reflected the echotexture, echogenicity, and lesion margin, while color Doppler US assessed the presence and features of blood flow of interested areas. Pathological tissue samples were obtained during apical microsurgery and subjected to histopathological examination. Fleiss' κ was used to measure interobserver reliability. Statistical analyses were performed to assess the diagnostic validity and the overall agreement between US and histological findings. The reliability of US compared to histopathological examinations was assessed based on Cohen's κ. RESULTS The percent accuracy of US for diagnosing cysts, granulomas, and cysts with infection based on histopathological findings was 89.9%, 89.0%, and 97.2%, respectively. The sensitivity of US diagnoses was 95.1% for cysts, 84.1% for granulomas, and 80.0% for cysts with infection. The specificity of US diagnoses was 86.8% for cysts, 95.7% for granulomas, and 98.1% for cysts with infection. The reliability for US compared to histopathological examinations was good (κ = 0.779). CONCLUSION The echotexture characteristics of lesions in US images correlated with their histopathological features. US can provide accurate information on the nature of periapical lesions based on the echotexture of their contents and the presence of vascularity. It can help improve clinical diagnosis and avoid overtreatment of patients with apical periodontitis.
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Affiliation(s)
- Wang Jia
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Jing
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gong Xia
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Ding Angang
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Zhou Wei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Zhang Pengfei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Ran Shujun
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Mao Mengying
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Zhengwei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gu Shensheng
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
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Gliga A, Imre M, Grandini S, Marruganti C, Gaeta C, Bodnar D, Dimitriu BA, Foschi F. The Limitations of Periapical X-ray Assessment in Endodontic Diagnosis-A Systematic Review. J Clin Med 2023; 12:4647. [PMID: 37510762 PMCID: PMC10380197 DOI: 10.3390/jcm12144647] [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: 06/07/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Diagnosis is a key aspect in endodontic treatment, in a decade where invasive interventions are misapprehended as social tendency instead of medical necessity. All diagnostic facets should be considered before intending the operative phase. Intraoral endodontic radiology-based diagnosis has been shown to be limited. Periapical X-ray is the most used endodontic imaging, yet it does not provide high accuracy. Traditionally, dentists have been trained to diagnose a cyst by certain aspects (size, shape and appearance); hence, an assumption that teeth are affected by "periapical cyst" were subjected to unnecessary extraction or apicoectomy. The aim of this systematic review is to critically appraise the publications that relate the histological diagnosis of a periapical lesion (considered the gold standard) to intraoral X-ray investigation. Ovid Medline, PubMed, ScienceDirect, Mendeley and Scopus were searched for English-language studies comparing periapical diagnosis obtained by using two techniques (histopathology and X-ray). Sixteen articles were included for the final analysis (qualitative and quantitative evaluation) out of which only two supported the statement that periapical diagnosis can be coherently assessed through periapical imaging. Although there is not enough evidence to deliver a definitive conclusion, there are many publications that refute the diagnosis of a cyst via periapical X-ray.
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Affiliation(s)
- Alexandru Gliga
- Department of Operative Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Marina Imre
- Department of Complete Denture, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Simone Grandini
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Carlo Gaeta
- Unit of Endodontics, Department of Medical Biotechnologies, Periodontology, Restorative and Paediatric Dentistry, University of Siena, 53100 Siena, Italy
| | - Dana Bodnar
- Department of Operative Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Alexandru Dimitriu
- Department of Endodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Federico Foschi
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London SE19RT, UK
- Peninsula Dental School, University of Plymouth, Plymouth PL6 8BT, UK
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Kasperek D, Ali R, Jarad F. Suspected Endodontic Failure in a Patient with Cleidocranial Dysplasia: A Case Report. J Endod 2023; 49:445-449. [PMID: 36736769 DOI: 10.1016/j.joen.2023.01.008] [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: 10/30/2022] [Revised: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Abstract
A patient's medical history and related dental manifestations can significantly contribute to confounding signs and symptoms leading to a diagnostic challenge. An 18-year-old female patient presented with persistent radiographic radiolucency associated with the apex of a previously treated tooth (tooth 9); asymptomatic apical periodontitis and endodontic failure were suspected. This report presents how a patient's condition of cleidocranial dysplasia had a profound effect on her dental history, which included the presence of multiple supernumerary teeth. Extensive surgical intervention during the patient's childhood was required to remove the supernumerary teeth, which resulted in an endodontic misdiagnosis in her adult life. After clinical and radiographic examination, the patient was diagnosed with a periapical scar. Periapical fibrous scars have a prevalence of between 2.5% and 12% and are a rare healing process with fibrous tissue after surgical and nonsurgical interventions. This report describes the diagnosis and pathophysiology of fibrous scars, including their risk factors and long-term monitoring approaches.
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Affiliation(s)
- Dariusz Kasperek
- Department of Restorative Dentistry, University of Liverpool, Liverpool, United Kingdom.
| | - Rahat Ali
- Department of Restorative Dentistry, University of Liverpool, Liverpool, United Kingdom
| | - Fadi Jarad
- Department of Restorative Dentistry, University of Liverpool, Liverpool, United Kingdom.
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5
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Jaswal S, Patil N, Singh MP, Dadarwal A, Sharma V, Sharma AK. A Comparative Evaluation of Digital Radiography and Ultrasound Imaging to Detect Periapical Lesions in the Oral Cavity. Cureus 2022; 14:e30070. [DOI: 10.7759/cureus.30070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
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Cotti E, Schirru E. Present status and future directions: Imaging techniques for the detection of periapical lesions. Int Endod J 2022; 55 Suppl 4:1085-1099. [PMID: 36059089 DOI: 10.1111/iej.13828] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Diagnosing and treating apical periodontitis (AP) in an attempt to preserve the natural dentition, and to prevent the direct and indirect systemic effects of this condition, is the major goal in endodontics. Considering that AP is frequently asymptomatic, and is most often associated with a lesion in the periapex of the affected tooth, within the maxillary bones, imaging becomes of paramount importance for the diagnosis of the disease. The aim of this narrative review was to investigate the most relevant classic and current literature to describe which are, to date, the diagnostic imaging systems most reliable and advanced to achieve the early and predictable detection of AP, the best measures of the lesions and the disclosure of the different features of the disease. Dental panoramic tomography (DPT) is a classic exam, considered still useful to provide the basic diagnosis of AP in certain districts of the maxillary bones. Periapical radiographs (PRs) represent a valid routine examination, with few, known limitations. Cone-beam computed tomography (CBCT) is the only system that ensures the early and predictable detection of all periapical lesions in the jaws, with the minor risk of false positives. These techniques can be successfully implemented, with ultrasounds (USI) or magnetic resonance (MRI) imaging, exams that do not use ionising radiations. MRI and USI provide information on specific features of the lesions, like the presence and amount of vascular supply, their content and their relationship with the surrounding soft tissues, leading to differential diagnoses. Further, all the three-dimensional systems (CBCT, USI and MRI) allow the volumetric assessment of AP. Pioneering research on artificial intelligence is slowly progressing in the detection of periapical radiolucencies on DPTs, PRs and CBCTs, however, with promising results. Finally, it is established that all imaging techniques have to be associated with a thorough clinical examination and a good degree of calibration of the operator.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Elia Schirru
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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7
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Avcı F, Etöz M, Üstün Y, Arslan T. Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study. Imaging Sci Dent 2022; 52:209-217. [PMID: 35799971 PMCID: PMC9226231 DOI: 10.5624/isd.20210239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/08/2021] [Accepted: 12/27/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs. Materials and Methods In the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared. Results In the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible. Conclusion The ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.
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Affiliation(s)
- Fatma Avcı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Meryem Etöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
| | - Tuğrul Arslan
- Department of Endodontics, Faculty of Dentistry, University of Erciyes, Melikgazi, Turkey
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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.
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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;
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Management of the Sequelae of a Sport-Related Traumatic Dental Injury Using Ultrasound Examination in the Diagnosis and Follow-Up. Dent J (Basel) 2021; 9:dj9030027. [PMID: 33801327 PMCID: PMC8000130 DOI: 10.3390/dj9030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/23/2022] Open
Abstract
About a quarter of all oral pathologies involving the oral cavity and dental apparatus are traumatic injuries, and a substantial number of these cases are the result of sports injuries affecting adolescents and young adults. Here, we report the case of a 25-year-old healthy female referred to the department of Endodontics for the evaluation and management of teeth 1.2 and 1.1 because of a chronic apical abscess in an area involved in a sport-related dental trauma in the past. A multi-modular diagnostic assessment, comprising conventional periapical radiographs, CBCT imaging, ultrasound, and histopathologic examination, led to a final diagnosis of an apical granulomatous lesion connected to both teeth, and an associated sinus tract. During the follow-up period of three years, the patient was reviewed twice a year and showed progressive healing of the bone and absence of the sinus tract. The present report shows the challenges of diagnosing complications arising from past dental trauma. Furthermore, it is the first documented traumatic case where ultrasound examination was fruitfully used. Emphasis should be put on introducing diagnostic ultrasound for the management of both apical periodontitis and the related sinus tract.
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Natanasabapathy V, Arul B, Mishra A, Varghese A, Padmanaban S, Elango S, Arockiam S. Ultrasound imaging for the differential diagnosis of periapical lesions of endodontic origin in comparison with histopathology - a systematic review and meta-analysis. Int Endod J 2021; 54:693-711. [PMID: 33368404 DOI: 10.1111/iej.13465] [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: 08/17/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Differentiating periapical lesions is important for treatment planning and subsequent treatment outcome. OBJECTIVE To assess the diagnostic accuracy of ultrasound imaging for the differentiation of periapical lesions in comparison with histopathology. METHODS PubMed, Scopus, Embase, Web of Science and ProQuest databases were searched for clinical studies published until June 2020 that evaluated the use of ultrasound (US) imaging for differential diagnosis of periapical lesions and used histopathology as the reference standard. Animal studies, laboratory-based studies, reviews and clinical studies not using a reference standard were excluded. Risk of bias (RoB) assessment was performed using a modified Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The random effects model was used for quantitative analysis of the data, and the Deeks test was used for calculating publication bias. Quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twelve articles were included in the systematic review, out of which ten articles were quantitatively assessed. All the articles had a high RoB and concerns regarding applicability in the patient selection domain. For the index test domain, seven articles had low and the remaining five had unclear RoB and concerns regarding applicability. In the reference standard domain, low RoB and concerns regarding applicability were observed for all the articles. The RoB was low in flow and timing domains in all the articles except for one, where it was high. Summary estimates of sensitivity and specificity of US to diagnose periapical granulomas were 0.94 and 0.98, whereas for periapical cysts it was 0.98 and 0.99, respectively. Area under the curve for diagnosis of both periapical granulomas and periapical cysts was 0.99. All the included articles had inherent publication bias. Quality of evidence using GRADE, for sensitivity, was moderate for periapical granulomas and high for periapical cysts, whereas for specificity, it was high for periapical granulomas and low for periapical cysts. DISCUSSION The available evidence is considered to be of low quality due to the observational nature of the studies and inherent publication bias. CONCLUSION Although the sensitivity and specificity for differentiating periapical cysts and periapical granulomas using US were high, taking the quality of evidence into consideration, it can serve as an additional tool in differential diagnosis of periapical lesions.
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Affiliation(s)
- V Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - B Arul
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - A Mishra
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - A Varghese
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - S Padmanaban
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - S Elango
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - S Arockiam
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meeankshi Ammal Dental College, Chennai, India
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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.
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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
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Musu D, Cadeddu Dessalvi C, Shemesh H, Frenda MG, Mercuro G, Cotti E. Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo study. Int Endod J 2020; 53:1289-1298. [PMID: 32531801 DOI: 10.1111/iej.13346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves. METHODOLOGY Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra-bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2 mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2 mm) and large (5 mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2 mm) and large (5 mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver-operating characteristics (ROC) were analysed. The significance of the findings (P < 0.05) was appraised using the chi-square statistics with the Yates correction, whilst the intra- and inter-examiner agreements were evaluated through Kappa statistics. RESULTS USE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k-values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter-observer agreement. The intra-observer agreement was also high (k-value = 0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P < 0.0001). CONCLUSIONS USE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate.
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Affiliation(s)
- D Musu
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - C Cadeddu Dessalvi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - H Shemesh
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - M G Frenda
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - G Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - E Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
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Arslan ZB, Demir H, Berker Yıldız D, Yaşar F. Diagnostic accuracy of panoramic radiography and ultrasonography in detecting periapical lesions using periapical radiography as a gold standard. Dentomaxillofac Radiol 2020; 49:20190290. [PMID: 32453610 DOI: 10.1259/dmfr.20190290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to compare the accuracy of imaging techniques in diagnosing periapical lesions. METHODS Imaging records of 80 patients (51 females, 29 males, aged between 14 and 75 years) including periapical and panoramic radiographs and ultrasonographic images were selected from databases of Selcuk University Dentistry Faculty. Periapical radiographs were accepted as gold-standard and 160 anterior maxillary and mandibular teeth with or without periapical lesion were included to the study. Three specialist observers (dental radiologists) evaluated the presence and appearance of periapical lesions on panoramic radiograph and ultrasonographic images.Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic value of panoramic radiographs and ultrasonography were determined. RESULTS Sensitivity was 0.80 and 0.77 for ultrasonographic images and panoramic radiographs, respectively which shows that periapical lesion was correctly detected in 80% of the cases with ultrasound and in 77% of the cases with panoramic radiography. Specificity values were determined as 0.97 for ultrasound and 0.95 for panoramic radiography. Overall diagnostic accuracy was 0.86 and 0.84 for ultrasound and panoramic radiography, respectively. CONCLUSIONS Periapical and panoramic radiographs are commonly used to visualize periapical lesions. Besides, ultrasonography is an alternative method to digital radiographic techniques in the diagnosis of anterior teeth with periapical lesions.
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Affiliation(s)
- Zeynep Betül Arslan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hilal Demir
- Konya Oral and Dental Health Center, Konya, Turkey
| | | | - Füsun Yaşar
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Davide M, Hagay S, Michela B, Claudia D, Elisabetta C. The effectiveness of ultrasound examination to assess the healing process of bone lesions of the jaws: a systematic review. Clin Oral Investig 2020; 24:3739-3747. [PMID: 32418014 DOI: 10.1007/s00784-020-03339-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the potential of ultrasound examination (USE) as an adjunctive method to conventional radiology to evaluate the healing processes occurring after the treatment of bone lesions of the jaws. The research question was: what is the effectiveness of USE to evaluate the healing of intra-osseous bone lesions when compared to radiological or clinical examination? MATERIALS AND METHODS Six databases (PubMed, the Web of Science, Scopus, Embase, the Cochrane Library, and Best Evidence) were searched from their inception (PROSPERO CRD42019134482). A quality assessment was performed combining the Downs and Black tool and the Newcastle-Ottawa scale. The risk of bias was calculated using the Cochrane collaboration tool to assess the risk of bias. RESULTS A total of 4404 records were screened, and 7 studies meeting the inclusion criteria were included in the systematic review. USE allowed to evaluate the healing of jaw bone lesions by assessing their reduction in size, the increase in echogenicity of the affected area, and the progressive decrease\disappearance of the vascular flow signal within the lesions. CONCLUSIONS USE implemented with color power Doppler is an advanced imaging technique feasible to monitor the early and long-term response of the intra-osseous lesions of the jaws to both surgical and nonsurgical treatment. CLINICAL RELEVANCE This systematic review brought evidence that USE can constitute a safe alternative imaging technique in the dental clinical practice for the management of central lesions of the maxillary bones.
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Affiliation(s)
- Musu Davide
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy.
| | - Shemesh Hagay
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Boccuzzi Michela
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
| | - Dettori Claudia
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
| | - Cotti Elisabetta
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Sardegna, Italy
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Cotti E, Musu D, Goddi A, Dettori C, Campisi G, Shemesh H. Ultrasound Examination to Visualize and Trace Sinus Tracts of Endodontic Origin. J Endod 2019; 45:1184-1191. [DOI: 10.1016/j.joen.2019.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/22/2019] [Accepted: 07/14/2019] [Indexed: 12/29/2022]
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Marotti J, Broeckmann J, Chuembou Pekam F, Praça L, Radermacher K, Wolfart S. Impression of Subgingival Dental Preparation Can Be Taken with Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:558-567. [PMID: 30454854 DOI: 10.1016/j.ultrasmedbio.2018.09.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 06/09/2023]
Abstract
Because of its ability to capture hard structures behind soft tissue, ultrasound-based micro-scanning may be a promising alternative for taking digital impressions of teeth, especially in the case of subgingival margin preparations. The aim of this study was to assess the accuracy of ultrasound impressions taken of subgingivally prepared teeth compared with digital optical impressions. Ten extracted human teeth (7 pre-molars, 3 molars) were prepared for crowns with chamfer finish line and then digitized using two different intra-oral scanners (Cara Trios, 3 Shape, Heraeus Kulzer, Hanau, Germany; and Lava COS; 3M ESPE, Seefeld, Germany) and one extra-oral scanner (Cares CS2, Straumann, Basel, Switzerland). Afterward, the preparation margin was covered with porcine gingiva (thickness ranged between 0.3 and 0.9 mm), and every sample was scanned with a high-frequency ultrasound scanner under experimental subgingival conditions. Optical scanning processes were performed without gingiva. The data sets were superimposed on each other for pairwise comparisons, and deviations between different scans were determined using a 3-D evaluation software (CloudCompare). Kruskal-Wallis and post hoc tests (Dunn-Bonferroni) were applied to detect significant differences at p ≤ 0.05. The ultrasound scanner was able to detect subgingival preparation margins. Mean deviations for all comparisons ranged from 12.34 to 46.38 µm. There were no statistically significant differences between superimpositions of intra-oral and extra-oral scans (Trios-Lava, Lava-CS2, Trios-CS2), whereas in comparisons between intra-/extra-oral scans and ultrasound scans, mean deviations were statistically significantly higher. There were no significant differences with respect to type of tooth (pre-molar and molar). However, gingiva thickness was significantly correlated with the quality of the ultrasound scan; thin layers had better image quality than thicker layers. Ultrasound was able to scan tooth preparation margins covered with gingiva, although with less accuracy than achieved by conventional optical scanners (non-covered margins). Gingiva thickness may play an important role in ultrasound scan accuracy.
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Affiliation(s)
- Juliana Marotti
- Centre for Implantology, Department of Prosthodontics and Biomaterials, Medical School RWTH Aachen University, Aachen, Germany.
| | - Judith Broeckmann
- Centre for Implantology, Department of Prosthodontics and Biomaterials, Medical School RWTH Aachen University, Aachen, Germany
| | | | - Luciano Praça
- Centre for Implantology, Department of Prosthodontics and Biomaterials, Medical School RWTH Aachen University, Aachen, Germany
| | - Klaus Radermacher
- Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Stefan Wolfart
- Centre for Implantology, Department of Prosthodontics and Biomaterials, Medical School RWTH Aachen University, Aachen, Germany
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Puri N, Ahuja US, Dhillon M, Rathore A. Ultrasonography as a Diagnostic Aid in Evaluating Cystic Lesions, Benign Tumors and Malignancies of Maxillofacial Region: A Clinical Study. Open Dent J 2018. [DOI: 10.2174/1874210601811131050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
To evaluate the accuracy of Ultrasonography as a diagnostic aid in cysts, benign tumors and malignancies of maxillofacial region.
Objectives:
This study was conducted to evaluate the accuracy of ultrasonography in the diagnosis of the osseous lesions of the jaws including cysts, benign tumors and malignant tumors. All the findings obtained by ultrasonography were compared and correlated with the clinical diagnosis, radiographic diagnosis and histopathological findings.
Materials and Methods:
The study was conducted on 42 patients with osseous maxillofacial swellings. The clinical and radiographic examination was carried out for all the patients who were afterward subjected to ultrasonography with color Doppler followed by histopathology. All the findings obtained were then statistically analyzed.
Results:
The utility of ultrasonography was evaluated considering histopathology as a gold standard. The diagnostic accuracy of ultrasound was found to be 100% in cystic lesions, 80% in benign tumors, and 85.71% in malignant tumors.
Conclusion:
Ultrasonography provides an accurate imaging of the head and neck region and does provide information about the nature of the lesion, its extent, and relationship with the surrounding structures. We propose the use of ultrasonography as an adjunctive examination for osseous lesions of the jaws before any invasive treatment.
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Nguyen KCT, Pachêco-Pereira C, Kaipatur NR, Cheung J, Major PW, Le LH. Comparison of ultrasound imaging and cone-beam computed tomography for examination of the alveolar bone level: A systematic review. PLoS One 2018; 13:e0200596. [PMID: 30281591 PMCID: PMC6169851 DOI: 10.1371/journal.pone.0200596] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 06/30/2018] [Indexed: 02/01/2023] Open
Abstract
Background and objective The current methods to image alveolar bone in humans include intraoral 2D radiography and cone-beam computed tomography (CBCT). However, these methods expose the subject to ionizing radiation. Therefore, ultrasound imaging has been investigated as an alternative technique, as it is both non-invasive and free from ionizing radiation. In order to assess the validity and reliability of ultrasonography in visualizing alveolar bone, a systematic review was conducted comparing ultrasound imaging to CBCT for examination of the alveolar bone level. Study design Seven databases were searched. Studies addressing examination of alveolar bone level via CBCT and ultrasound were selected. Risk of bias under Cochrane guidelines was used as a methodological quality assessment tool. Results All the four included studies were ex vivo studies that used porcine or human cadaver samples. The alveolar bone level was measured by the distance from the alveolar bone crest to certain landmarks such as cemento-enamel junction or gingival margin. The risk of bias was found as low. The mean difference between ultrasound and CBCT measurements ranged from 0.07 mm to 0.68 mm, equivalent to 1.6% - 8.8%. Conclusions There is currently preliminary evidence to support the use of ultrasonography as compared to CBCT for the examination of alveolar bone level. Further studies comparing ultrasound to gold standard methods would be necessary to help validate the accuracy of ultrasonography as a diagnostic technique in periodontal imaging.
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Affiliation(s)
- Kim-Cuong T. Nguyen
- Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Camila Pachêco-Pereira
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Comprehensive Dentistry, UT Health San Antonio, San Antonio, Texas, United States of America
| | - Neelambar R. Kaipatur
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
- * E-mail: (LHL); (NRK)
| | - June Cheung
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W. Major
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Lawrence H. Le
- Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
- * E-mail: (LHL); (NRK)
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Park KM, Choi E, Kwak EJ, Kim S, Park W, Jeong JS, Kim KD. The relationship between masseter muscle thickness measured by ultrasonography and facial profile in young Korean adults. Imaging Sci Dent 2018; 48:213-221. [PMID: 30276158 PMCID: PMC6148042 DOI: 10.5624/isd.2018.48.3.213] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 06/12/2018] [Accepted: 06/18/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the relationship between masseter muscle thickness, facial morphology, and mandibular morphology in Korean adults using ultrasonography. Materials and Methods Ultrasonography was used to measure the masseter muscle thickness bilaterally of 40 adults (20 males, 20 females) and was performed in the relaxed and contracted states. Facial photos and panoramic radiography were used for morphological analyses and evaluated for correlations with masseter muscle thickness. We also evaluated the correlations of age, body weight, stature, and body constitution with masseter muscle thickness. Results In the relaxing, the masseter was 9.8±1.3 mm in females and 11.3±1.2 mm in males. In the contracted state, it was 12.4±1.4 mm in females and 14.7±1.4 mm in males. Facial photography showed that bizygomatic facial width over facial height was correlated with masseter muscle thickness in both sexes in the relaxed state, and was statistically significantly correlated with masseter muscle thickness in males in the contracted state. In panoramic radiography, correlations were found between anterior angle length and posterior angle length and masseter muscle thickness in females, and between body length and posterior angle length, between anterior angle length and body length, between ramal length and body length, and between body length and condyle length in males. Conclusion Masseter muscle thickness was associated with facial and mandibular morphology in both sexes, and with age in males. Ultrasonography can be used effectively to measure masseter muscle thickness.
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Affiliation(s)
- Kyeong-Mee Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Eunhye Choi
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Eun-Jung Kwak
- Seoul Dental Hospital for the Disabled, Seoul, Korea
| | - Seoyul Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jin-Sun Jeong
- School of Stomatology, Shandong University, Jinan Shi, Shandong Province, China
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
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SAYED AHMEDM, LAMARCK RACHEL, CRUZ ELISA, CHAVES EROS, MUKDADI OSAMAM. QUANTITATIVE ASSESSMENT OF GINGIVAL INFLAMMATION USING HIGH-RESOLUTION ULTRASOUND EX-VIVO. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519418500124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigates the feasibility of using high-resolution ultrasound imaging echogenicity to quantitatively diagnose gingival inflammation. Gingival samples were extracted from the study participants during gingivectomy procedures. Ultrasound mechanical scanning of the samples was immediately conducted ex-vivo to render cross-sectional images of high resolution, at different locations. Samples’ histological preparation and analysis was followed after performing ultrasound imaging. Histological sections were then matched with ultrasound images at different sections for each gingival sample. The matched image pairs were used to estimate two quantitative measures; relative inflammation area and ultrasound image echogenicity. These parameters were employed to judge the diagnostic potential of gingival ultrasound imaging. The results show that ultrasound images exhibited low intensity levels at the inflamed gingival regions, while healthy layers showed higher intensity levels. The relative area parameter implied a strong relationship between ultrasound and histological images. Ultrasound echogenicity was found to be statistically significant in differentiating between some inflammation degrees in the studied gingival samples. In summary, ultrasound imaging has the potential to be a noninvasive adjunct diagnostic tool for gingival inflammation, and may help assess the stage of the disease and ultimately limit periodontal disease occurrence; taking into consideration the limits of this study.
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Affiliation(s)
- AHMED M. SAYED
- Biomedical Engineering Department, Helwan University, Helwan, Cairo, Egypt
| | - RACHEL LAMARCK
- Piracicaba Dentistry College, University of Campina, Piracicaba, Brazil
| | - ELISA CRUZ
- Paulista Association for Medicine Development, Sao Paulo, Brazil
| | - EROS CHAVES
- College of Dentistry, University of Oklahoma, Oklahoma, USA
| | - OSAMA M. MUKDADI
- Mechanical and Aerospace Engineering Department, West Virginia University, Morgantown, West Virginia, USA
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21
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Gad K, Ellabban M, Sciubba J. Utility of Transfacial Dental Ultrasonography in Evaluation of Cystic Jaw Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:635-644. [PMID: 28877358 DOI: 10.1002/jum.14374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Plain radiography has been widely used in dentistry. Because of the variability of the quality of equipment, radiographic technique, accuracy of interpretation, and radiation risk to the patients, the field is ripe for the introduction of other newer diagnostic modalities. In this report, we demonstrate the utility of ultrasonography in the diagnostic workup of cystic or cystlike lesions of the jaw. METHODS We used a transfacial ultrasonographic scanning approach to examine 32 patients with clinical or radiographic presentation of a jaw cyst. Computed tomography and histopathologic analysis were used as the reference standards to confirm the findings. RESULTS Ultrasonography could establish the presence or absence of a lesion, erosion of the buccal cortical plate, and identification of associated soft tissue involvement in all cases (sensitivity and specificity, 100% and 100%, respectively; area under the receiver operating characteristic curve, 1.0; P < .001). CONCLUSIONS Our observations revealed the usefulness of ultrasonography and demonstrated its potential value when introduced as a routine office-based imaging method for dentistry.
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Affiliation(s)
- Khaled Gad
- Department of Radiology, Suez Canal University School of Medicine, Ismailia, Egypt
| | - Mohamed Ellabban
- Division of Plastic and Reconstructive Surgery, Suez Canal University School of Medicine, Ismailia, Egypt
| | - James Sciubba
- Department of Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Milton J. Dance Head and Neck Center Greater Baltimore Medical Center, Baltimore, Maryland, USA
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22
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Kondrashova T, De Wan D, Briones MU, Kondrashov P. Integration of ultrasound imaging into pre-clinical dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:228-234. [PMID: 27041147 DOI: 10.1111/eje.12205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Patients have complex healthcare needs and typically require more than one healthcare discipline to address issues regarding their health. Interprofessional teams of healthcare professionals may be able to address these complex needs and improve patient outcomes by combining resources. To evaluate the feasibility of integrating ultrasound into a dental school curriculum to teach anatomy as part of an interprofessional education experience, the current study surveyed first-year dental students to determine their perceptions of the integration of ultrasound techniques into the curriculum. MATERIALS AND METHODS Ultrasound laboratory exercises were developed for first-year dental students as part of their anatomy course. The exercises were focused on head, neck and abdominal anatomy. To assess student perception of the integration of ultrasound into the dental curriculum, a survey was created specifically for the current study. RESULTS Between 2013 and 2015, two classes of first-year dental students participated in the ultrasound laboratory exercise and completed the survey (n = 83). Student survey responses suggested ultrasound was a valuable teaching tool because it allowed them to visualise anatomical structures using live imaging. They also agreed that the ultrasound laboratory exercises were an efficient learning tool, but the majority did not believe that they would use ultrasound regularly in their future practice. CONCLUSIONS Results of the current study suggested first-year dental students were satisfied with the integration of ultrasound techniques into the dental curriculum. Survey results indicated that the students enjoyed the ultrasound laboratory exercise and felt ultrasound was an effective learning tool.
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Affiliation(s)
- T Kondrashova
- Department of Family Medicine, Preventive Medicine and Community Health, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
| | - D De Wan
- Missouri School of Dentistry & Oral Health, A.T. Still University, Kirksville, MO, USA
| | - M U Briones
- Academic Affairs, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
| | - P Kondrashov
- Anatomy Department, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
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Cone beam computed tomography and ultrasonography imaging of benign intraosseous jaw lesion: a prospective radiopathological study. Clin Oral Investig 2017; 22:1531-1539. [PMID: 29046963 DOI: 10.1007/s00784-017-2257-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We assessed whether ultrasonography (US) can be used in combination with cone beam computed tomography (CBCT) to image intraosseous jaw lesions. MATERIAL AND METHODS Using CBCT and US, we evaluated 123 lytic intraosseous jaw lesions diagnosed in 121 patients with guidance from the CBCT findings. The lesions were classified into two groups based on histopathological evaluation: (1) cysts and (2) tumors and tumor-like lesions. US and histopathological findings on the lesions of the two groups and their relationships with each other were also assessed. Results are reported as means ± standard errors, and p < 0.001 was accepted as indicating statistical significance. RESULT In total, 123 lesions were evaluated; 74 (60.2%) were cysts and 49 (39.8%) were tumors or tumor-like lesions. The CBCT and US findings were compatible as far as dimensional measurements of the lesions in the three planes (p < 0.001). The US and histopathological findings on the content of the lesions correlated (p < 0.001). CONCLUSION CBCT provides useful information for diagnosing intraosseous jaw lesions. Because it offers no valid Hounsfield unit (HU) value, it does not differentiate between solid and cystic masses. Thus, US can be used with CBCT to image intraosseous jaw lesions caused by buccal cortical thinning or perforation. CLINICAL RELEVANCE US provides useful information about intraosseous jaw lesions and can be used with CBCT to image such lesions caused by buccal cortical thinning or perforation. Clinicians can take this information into consideration when evaluating intraosseous jaw pathology.
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Ultrasound examination with color power Doppler to assess the early response of apical periodontitis to the endodontic treatment. Clin Oral Investig 2017; 22:131-140. [DOI: 10.1007/s00784-017-2089-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/20/2017] [Indexed: 01/05/2023]
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25
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Ultrasound evaluation of intra-osseous cavity: A preliminary study in pig mandibles. J Oral Biol Craniofac Res 2016; 6:S14-S17. [PMID: 27900244 DOI: 10.1016/j.jobcr.2016.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/05/2016] [Indexed: 11/21/2022] Open
Abstract
AIMS To assess the role of ultrasonography as a possible tool for diagnosis of intra-osseous lesions. METHODS Our sample comprised five macerated pig jaws. The regions of bony crypts of third molars were examined on both sides, totaling 10 examinations. The degrees of difficulty for both ultrasound image visualization and bone translucency were rated by two groups of evaluators (i.e. dental radiologists and physician ultrasonographers). RESULTS Our results showed that it is possible to detect images of the intra-osseous cavity at a low-degree difficulty by using both radiographic and ultrasonic techniques (46.6% and 43.3%, respectively). However, the crypts were not fully detected by both groups (16.6% and 13.3%, respectively). CONCLUSIONS We concluded that ultrasonography is a useful method for evaluation of intra-osseous lesions in jaws, provided that the cortical bone is thin enough to allow ultrasound waves to pass through.
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Tikku AP, Bharti R, Sharma N, Chandra A, Kumar A, Kumar S. Role of ultrasound and color doppler in diagnosis of periapical lesions of endodontic origin at varying bone thickness. J Conserv Dent 2016; 19:147-51. [PMID: 27099421 PMCID: PMC4815543 DOI: 10.4103/0972-0707.178694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS To access the role of ultrasound and color doppler in diagnosing periapical lesions of maxilla and mandible. SETTINGS AND DESIGN This study was conducted in the Department of Conservative Dentistry and Endodontics (Faculty of Dental Sciences), Department of Radiotherapy, and Department of Pathology. MATERIALS AND METHODS The study group comprised 30 patients with periapical lesions of endodontic origin in maxilla and mandible requiring endodontic surgery. After thorough clinical and radiographic examination patients were subjected to ultrasound and color doppler examination, where the lesions were assessed for their contents as to cystic or solid. Following which periapical surgery was done and the pathological tissue obtained was subjected to histopathological examination. The results of the ultrasound examination were correlated with histopathological features. The diagnostic validity of ultrasound was assessed by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. STATISTICAL ANALYSIS USED The statistical analysis was done using statistical package for social sciences (SPSS) version 15.0 statistical analysis software. The values were represented in number (%). RESULTS Within the limitations of the current study it can be stated that although ultrasound may not establish the definitive diagnosis, it can facilitate the differential diagnosis between cystic and solid granulomatous lesions. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone. CONCLUSION Ultrasound can routinely be recommended as a complimentary method for the diagnosis of periapical lesions of endodontic origin. However, this technique may have a limited role in detecting periapical lesions present in the region with thick overlying cortical bone.
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Affiliation(s)
- Aseem P Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neha Sharma
- Department of Conservative Dentistry and Endodontics, Government Dental College, Shimla, Himachal Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashutosh Kumar
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunil Kumar
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
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Ultrasonography in the diagnosis of bone lesions of the jaws: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e19-29. [PMID: 27260284 DOI: 10.1016/j.oooo.2016.03.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/02/2016] [Accepted: 03/28/2016] [Indexed: 11/21/2022]
Abstract
The diagnostic use of ultrasonography in dentistry and maxillofacial surgery has previously been described in the literature. Considering that ultrasonography may be useful for the diagnosis of bone lesions of the jaws, a systematic review was carried out to examine the evidence. This review determined that ultrasonography has been used effectively for the diagnosis of infective and/or inflammatory lesions, cysts, nonodontogenic tumors, odontogenic tumors, and arteriovenous malformations and for the differential diagnosis of lesions of endodontic origin, compared with the gold standard of histologic analysis. Ultrasonography may be a viable adjunct to other special tests for the diagnosis of intraosseous lesions of the jaws, as it is noninvasive and does not involve ionizing radiation exposure of the patient.
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Chan HL, Wang HL, Fowlkes JB, Giannobile WV, Kripfgans OD. Non-ionizing real-time ultrasonography in implant and oral surgery: A feasibility study. Clin Oral Implants Res 2016; 28:341-347. [PMID: 26992276 DOI: 10.1111/clr.12805] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE Ultrasound imaging has potential to complement radiographic imaging modalities in implant and oral surgery given that it is non-ionizing and provides instantaneous images of anatomical structures. For application in oral and dental imaging, its qualities are dependent on its ability to accurately capture these complex structures. Therefore, the aim of this feasibility study was to investigate ultrasound to image soft tissue, hard tissue surface topography and specific vital structures. MATERIAL AND METHODS A clinical ultrasound scanner, paired with two 14-MHz transducers of different sizes (one for extraoral and the other for intraoral scans), was used to scan the following structures on a fresh cadaver: (i) the facial bone surface and soft tissue of maxillary anterior teeth, (ii) the greater palatine foramen; (iii) the mental foramen and (iv) the lingual nerve. Multiple measurements relevant to these structures were made on the ultrasound images and compared to those on cone-beam computed tomography (CBCT) scans and/or direct measurements. RESULTS Ultrasound imaging could delineate hard tissue surfaces, including enamel, root dentin and bone as well as soft tissue with high resolution (110 μm wavelength). The greater palatine foramen, mental foramen and lingual nerve were clearly shown in ultrasound images. Merging ultrasound and CBCT images demonstrated overall spatial accuracy of ultrasound images, which was corroborated by data gathered from direct measurements. CONCLUSION For the first time, this study provides proof-of-concept evidence that ultrasound can be a real-time and non-invasive alternative for the evaluation of oral and dental anatomical structures relevant for implant and oral surgery.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Jeffery Brian Fowlkes
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
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Sandhu SS, Singh S, Arora S, Sandhu AK, Dhingra R. Comparative evaluation of advanced and conventional diagnostic AIDS for endodontic management of periapical lesions, an in vivo study. J Clin Diagn Res 2015; 9:ZC01-4. [PMID: 25738075 PMCID: PMC4347166 DOI: 10.7860/jcdr/2015/9301.5360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/31/2014] [Indexed: 11/24/2022]
Abstract
AIM To evaluate efficacy of Colour Doppler ultrasonography (CDUSG), direct digital radiography (DDR) and conventional radiography (CR) in diagnosis of periapical lesions and to clinically correlate treatment plan of periapical diseases. MATERIALS AND METHODS Thirty patients which were diagnosed with periapical lesions in anterior region by using both conventional and digital radiography were examined using colour doppler ultrasound imaging at the site of lesion. The images of each lesion were analysed by two endodontists and by an expert oral radiologist. A tentative differential diagnosis was agreed upon, based on certain principles discussed in article, then a diagnosis between cyst, granuloma and mixed lesions was made. Periapical lesions diagnosed as mixed lesions by colour doppler ultrasonography (CDUSG) were treated non-surgically whereas other periapical lesions were treated surgically. Tissues obtained during endodontic surgery were processed and examined for histopathological findings, and compared with the diagnosis made by ultrasound images. Statistical analysis was done with Chi-Square test and using one-way-Anova. RESULTS The periapical lesions which were diagnosed as granuloma by ultrasonographic findings, was confirmed by the results of histopathological examination in all 16 surgically treated cases. The lesions in rest of the 14 cases which showed vascularity and were diagnosed as mixed lesions by ultrasonography, were treated non-surgically and had a favourable prognosis. CONCLUSION CR and DDR facilitate diagnosis of the presence of periapical disease, but do not provide and information of its nature. CDUSG imaging facilitates accurate information on the pathological nature of the lesion and hence can lead to predictable treatment planning.
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Affiliation(s)
- Sukhpash Singh Sandhu
- Reader, Department of Conservative Dentistry and Endodontics, MNDAV Dental College, Solan, Himachal Pradesh, India
| | - Smita Singh
- Professor, Department of Conservative Dentistry and Endodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
| | - Saurabh Arora
- Reader, Department of Conservative Dentistry and Endodontics, Seema Dental College, Rishikesh, Uttarakhand, India
| | | | - Ravneet Dhingra
- Reader, Department of Oral Medicine, Seema Dental College, Rishikesh, Uttarakhand, India
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30
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Duarte PM, Sowa MG, Xiang X, Zhang C, Santos VR, Miranda TS, Reis AF, Liu KZ. Assessment of the hemodynamic profile in periodontal tissues of diabetic subjects with periodontitis by optical spectroscopy. J Periodontal Res 2014; 50:594-601. [PMID: 25369875 DOI: 10.1111/jre.12239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The influence of diabetes mellitus (DM) on the hemodynamics of periodontal tissues has not been assessed previously. The primary objective of this study was to validate optical spectroscopy as a periodontal diagnostic tool for subjects with type 2 DM and chronic periodontitis. MATERIAL AND METHODS Using a portable optical near-infrared spectrometer, optical spectra were obtained from healthy (n = 127), gingivitis (n = 115), and periodontitis (n = 109) sites of 65 subjects with type 2 DM and chronic periodontitis. Healthy (n = 65) sites of 15 nondiabetic subjects without periodontitis were used as controls. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering-loss function was used to determine the relative contribution of deoxygenated hemoglobin and oxygenated hemoglobin (HbO2 ) to the overall spectrum. The balance between tissue oxygen delivery and oxygen utilization in periodontal tissues was assessed. RESULTS In diabetic subjects, tissue oxygen saturation and HbO2 concentration were significantly decreased in the periodontitis sites (p < 0.01) compared with the healthy and gingivitis sites. Furthermore, tissue oxygenation in healthy sites of control subjects was significantly higher than that in sites of diabetic subjects (p < 0.01). CONCLUSION In summary, the results of this study suggest that optical spectroscopy can monitor the hemodynamic profile in diabetic subjects with chronic periodontitis. Furthermore, healthy sites of diabetic subjects presented lower tissue oxygenation than did those of nondiabetic subjects.
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Affiliation(s)
- P M Duarte
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - M G Sowa
- Medical Devices Portfolio, National Research Council of Canada, Winnipeg, Manitoba, Canada
| | - X Xiang
- Department of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - C Zhang
- The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China
| | - V R Santos
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - T S Miranda
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil
| | - A F Reis
- Dental Research Division, Department of Operative Dentistry, Guarulhos University, Guarulhos, SP, Brazil
| | - K-Z Liu
- Medical Devices Portfolio, National Research Council of Canada, Winnipeg, Manitoba, Canada.,Department of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Zhang C, Xiang X, Xu M, Fan C, Sowa MG, Liu KZ. Assessment of tissue oxygenation of periodontal inflammation in patients with coronary artery diseases using optical spectroscopy. BMC Oral Health 2014; 14:25. [PMID: 24666796 PMCID: PMC3987688 DOI: 10.1186/1472-6831-14-25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/19/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We have recently developed a non-invasive periodontal diagnostic tool that was validated in periodontitis patients without systemic disorders like coronary artery disease (CAD). The purpose of present study is to verify whether this optical instrument can also be used in periodontitis patients with CAD. METHODS A total of 62 periodontitis patients with CAD were recruited along with a control group consisting of 59 age and gender matched periodontitis volunteers without systemic disorders. Using a portable optical near-infrared spectrometer, optical spectra were obtained, processed and evaluated from the two groups. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of deoxygenated hemoglobin (Hb) and oxygenated hemoglobin (HbO2) to the overall spectrum. The balance between tissue oxygen delivery and utilization in periodontal tissues was then assessed. RESULTS Tissue oxygen saturation was significantly decreased in the periodontitis sites (p < 0.01), compared to the healthy sites in those individuals with CAD. There was a trend towards increased concentration of Hb and decreased concentration of HbO2 from healthy to diseased sites, without statistical significance (p > 0.05). No statistical differences were found in tissue oxygen saturation between the CAD and control groups either in periodontal healthy or inflammatory sites. CONCLUSION This study supports the hypothesis that optical spectroscopy can determine the periodontal inflammation in patients with certain systemic disorders like CAD. And the overall periodontal oxygenation profiles in CAD patients resemble those in non-CAD individuals either in healthy or inflammatory sites.
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Affiliation(s)
| | | | | | | | | | - Kan-Zhi Liu
- Medical Devices Portfolio, National Research Council of Canada, 435 Ellice Ave,, Winnipeg, MB R3B 1Y6, Canada.
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Marotti J, Heger S, Tinschert J, Tortamano P, Chuembou F, Radermacher K, Wolfart S. Recent advances of ultrasound imaging in dentistry--a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 115:819-32. [PMID: 23706922 DOI: 10.1016/j.oooo.2013.03.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 12/28/2012] [Accepted: 03/16/2013] [Indexed: 02/07/2023]
Abstract
Ultrasonography as an imaging modality in dentistry has been extensively explored in recent years due to several advantages that diagnostic ultrasound provides. It is a non-invasive, inexpensive, painless method and unlike X-ray, it does not cause harmful ionizing radiation. Ultrasound has a promising future as a diagnostic imaging tool in all specialties in dentistry, for both hard and soft tissue detection. The aim of this review is to provide the scientific community and clinicians with an overview of the most recent advances of ultrasound imaging in dentistry. The use of ultrasound is described and discussed in the fields of dental scanning, caries detection, dental fractures, soft tissue and periapical lesions, maxillofacial fractures, periodontal bony defects, gingival and muscle thickness, temporomandibular disorders, and implant dentistry.
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Affiliation(s)
- Juliana Marotti
- Department of Prosthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, 05508-000 São Paulo-SP.
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Abstract
Through-transmission alveolar ultrasonography (TAU) is a novel imaging modality in dental medicine. A brief introduction to through-transmission ultrasonography (TTU) is followed by a description of the first commercially available TAU device, the Cavitat CAV 4000 (Cavitat Medical Technologies, Inc., Alba, TX). Recent associations between systemic osteoporosis, oral osteoporosis, periodontal diseases, and cardiovascular diseases underline the importance of early detection and treatment of oral cancellous bone pathologies associated with low bone density (LBD), such as regional ischemic osteoporosis, chronic nonsuppurative osteomyelitis, bone marrow edema, and cavitational ischemic osteonecrosis (osteocavitation). While the impact of osteoporosis on maxillofacial bones is acknowledged, there is a lack of reliable prevalence rate, and the National Institutes of Health (NIH) recommend that more attention should be paid to skeletal health, especially in persons with conditions known to be associated with secondary osteoporosis. TAU, a safe and effective imaging modality, can be a valuable tool in research as well as for the clinical assessment of alveolar cancellous bone pathologies associated with LBD and ischemia.
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Affiliation(s)
- Jacques Imbeau
- Dental Services, Bay of Plenty Environmental Health Clinic, New Zealand.
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34
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Liu KZ, Duarte PM, Santos VR, Xiang X, Xu M, Miranda TS, Fermiano D, Gonçalves TED, Sowa MG. Assessment of tissue oxygenation of periodontal inflammation in smokers using optical spectroscopy. J Clin Periodontol 2014; 41:340-7. [DOI: 10.1111/jcpe.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Kan-Zhi Liu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Poliana Mendes Duarte
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Vanessa Renata Santos
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Xiaoming Xiang
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Minqi Xu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
| | | | - Daiane Fermiano
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | | | - Micheal G. Sowa
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
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Culjat MO, Choi M, Singh RS, White SN. Ultrasound imaging of dental implants. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:456-9. [PMID: 23365927 DOI: 10.1109/embc.2012.6345966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Accurate measurement of soft tissue thickness is needed prior to dental implant placement and prior to surgical uncovering of the implant. Ultrasonography has many potential advantages for use in dental implant surgery, but has not yet been made suitable for clinical use. A 2D ultrasound imaging system and a mechanical positioning system were used to scan dental implants embedded in a porcine jaw, covered by soft tissue, submerged in a water tank. Results indicated that ultrasound can be used to accurately detect, locate, and measure dental implant fixtures and measure the thickness of the overlying soft tissue in an ex vivo environment.
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36
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Chen YL, Chang HH, Chiang YC, Lin CP. Application and development of ultrasonics in dentistry. J Formos Med Assoc 2013; 112:659-65. [PMID: 23810702 DOI: 10.1016/j.jfma.2013.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 05/07/2013] [Accepted: 05/11/2013] [Indexed: 12/16/2022] Open
Abstract
Since the 1950s, dentistry's ultrasonic instruments have developed rapidly. Because of better visualization, operative convenience, and precise cutting ability, ultrasonic instruments are widely and efficiently applied in the dental field. This article describes the development and improvement of ultrasonic instruments in several dental fields. Although some issues still need clarification, the results of previous studies indicate that ultrasonic instruments have a high potential to become convenient and efficient dental tools and deserve further development.
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Affiliation(s)
- Yen-Liang Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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37
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Choi M, Culjat MO, Singh RS, White SN. Ultrasound imagery for dental implant diagnosis and treatment planning in a porcine model. J Prosthet Dent 2012; 108:344-53. [PMID: 23217466 DOI: 10.1016/s0022-3913(12)60190-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Prince CN, Annapurna CS, Sivaraj S, Ali IM. Ultrasound imaging in the diagnosis of periapical lesions. J Pharm Bioallied Sci 2012; 4:S369-72. [PMID: 23066292 PMCID: PMC3467915 DOI: 10.4103/0975-7406.100275] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/09/2022] Open
Abstract
Background and Objectives: To assess the diagnostic capability of real-time ultrasound imaging, together with the application of color power Doppler in the identification and differential diagnosis of the periapical lesions. Materials and Methods: Fifteen patients with periapical lesions of pulpal origin, diagnosed with clinical and conventional radiographic examination, were examined further using ultrasonography. The results from the biopsies of the lesions were compared and statistically analyzed. Results: The differential diagnosis between periapical granulomas and cystic lesions, which were based on the ultrasonographic findings, were confirmed by the results of the histopathologic examination in 13 (86.7%) of 15 cases, one being granuloma and 14 being cystic lesion. Interpretation and Conclusion: Ultrasound real-time imaging is a technique that may help make a differential diagnosis between cysts and granulomas by revealing the nature of the content of a bony lesion. This technique may have further applications in the study of other lesions of the jaws.
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Affiliation(s)
- Christo Naveen Prince
- Department of Oral Medicine and Radiology, JKK Nattaraja Dental College and Hospital, Komarapalayam, Tamil Nadu, India
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Goel S, Nagendrareddy SG, Raju MS, Krishnojirao DRJ, Rastogi R, Mohan RPS, Gupta S. Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions. Indian J Radiol Imaging 2012; 21:279-83. [PMID: 22223940 PMCID: PMC3249943 DOI: 10.4103/0971-3026.90688] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions. Materials and Methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed. Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case. Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions.
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Affiliation(s)
- Sumit Goel
- Department of Oral Medicine and Radiology, Subharti Dental College and Hospital, Meerut, India
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Deepak BS, Subash TS, Narmatha VJ, Anamika T, Snehil TK, Nandini DB. Imaging techniques in endodontics: an overview. J Clin Imaging Sci 2012; 2:13. [PMID: 22530184 PMCID: PMC3328979 DOI: 10.4103/2156-7514.94227] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 02/17/2012] [Indexed: 02/06/2023] Open
Abstract
This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed.
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Affiliation(s)
- B S Deepak
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College, Davangere, Karnataka, India
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Petersson A, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Mejàre I, Portenier I, Sandberg H, Tranaeus S, Bergenholtz G. Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review. Int Endod J 2012; 45:783-801. [PMID: 22429152 DOI: 10.1111/j.1365-2591.2012.02034.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This systematic review evaluates the diagnostic accuracy of radiographic methods employed to indicate presence/absence and changes over time of periapical bone lesions. Also investigated were the leads radiographic images may give about the nature of the process and the condition of the pulp in nonendodontically treated teeth. Electronic literature search included the databases PubMed, Embase and CENTRAL from January 1950 to June 2011. All languages were accepted provided there was an abstract in English. The MeSH terms were 'Cone beam computed tomography (CBCT)', 'Radiography, panoramic', 'Periapical diseases', 'Dental pulp diseases', 'Sensitivity and specificity', 'receiver operating characteristics (ROC) curve', 'Cadaver', 'Endodontics' and 'Radiography dental'. Two reviewers independently assessed abstracts and full text articles. An article was read in full text if at least one of the two reviewers considered an abstract to be potentially relevant. Altogether, 181 articles were read in full text. The GRADE approach was used to assess the quality of evidence of each radiographic method based on studies of high or moderate quality. Twenty-six studies fulfilled criteria set for inclusion. None was of high quality; 11 were of moderate quality. There is insufficient evidence that the digital intraoral radiographic technique is diagnostically as accurate as the conventional film technique. The same applies to CBCT. No conclusions can be drawn regarding the accuracy of radiological examination in identifying various forms of periapical bone tissue changes or about the pulpal condition.
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Affiliation(s)
- A Petersson
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
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Measuring Bone Density in Healing Periapical Lesions by Using Cone Beam Computed Tomography: A Clinical Investigation. J Endod 2012; 38:28-31. [DOI: 10.1016/j.joen.2011.09.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/26/2011] [Accepted: 09/30/2011] [Indexed: 11/20/2022]
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Maity I, Kumari A, Shukla AK, Usha H, Naveen D. Monitoring of healing by ultrasound with color power doppler after root canal treatment of maxillary anterior teeth with periapical lesions. J Conserv Dent 2011; 14:252-7. [PMID: 22025828 PMCID: PMC3198554 DOI: 10.4103/0972-0707.85804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Revised: 03/23/2011] [Accepted: 04/05/2011] [Indexed: 11/12/2022] Open
Abstract
Aims: To assess the reliability of ultrasound imaging coupled with Color Power Doppler for monitoring the healing after nonsurgical endodontic therapy. Materials and Methods: Ten asymptomatic maxillary anterior teeth with approximately similar-sized periapical radiolucent lesions of average dimension 1.3 – 1.9 cm, as observed on an intraoral periapical radiograph, and confirmed by ultrasound was selected for the study. After confirming the diagnosis all the teeth were subjected to nonsurgical endodontic treatment. Postoperative healing was monitored using postoperative subjective feedback, a radiograph, and an ultrasound with a color power doppler, at intervals of six weeks, three months, and six months. Results: Eight among the ten cases studied showed signs of healing, with an ultrasound, as early as six weeks postoperatively, but the radiographs showed a noticeable change only at the end of three months. At the end of the follow-up period of three months and six months, the findings in terms of change in the lesion size were the same with both the radiograph and ultrasound. Ultrasonography was able to predict the healing very consistently at all recall periods from six weeks onward providing vital information such as changes in vascularity and bone formation as compared to radiographs. Conclusions: Ultrasound with Color Power Doppler is an efficient tool for monitoring bone healing as compared to the conventionally employed radiographic method.
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Affiliation(s)
- Ipsita Maity
- Department of Conservative Dentistry and Endodontics, V. S. Dental College and Hospital, Bangalore, India
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Reddy S, Sukumaran V, Bharadwaj N. Tailor-made endodontic obturator for the management of Blunderbuss canal. J Conserv Dent 2011; 14:199-202. [PMID: 21814367 PMCID: PMC3146118 DOI: 10.4103/0972-0707.82606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 11/05/2010] [Accepted: 12/15/2010] [Indexed: 11/30/2022] Open
Abstract
The complex anatomy of the blunderbuss root canal often poses a major challenge to accomplish adequate obturation for a biological seal. Moreover, the roll-cone, Gutta-percha obturation technique, which is routinely practiced, also results in a mismatch and failure to configure to the canal volume in the absence of an apical barrier. Hence, an attempt has been made to tailor-make a heat polymerized polymethyl methacrylate resin as an endodontic obturator, to match the canal volume, which has been ascertained by Spiral computed tomography and mathematical integration. A one-year follow-up examination has revealed that the tooth is asymptomatic, with the repair of the lesion evident radiographically.
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Affiliation(s)
- Smitha Reddy
- Department of Conservative Dentistry and Endodontics, Sri Sai Dental College and Hospital, Vikarabad, Ranga Reddy District, Andhra Pradesh, India
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Pallagatti S, Sheikh S, Puri N, Mittal A, Singh B. To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Eur J Radiol 2011; 81:1821-7. [PMID: 21601401 DOI: 10.1016/j.ejrad.2011.04.065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 04/22/2011] [Indexed: 12/18/2022]
Abstract
AIM To evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. MATERIAL AND METHODS The study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. RESULTS The diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). CONCLUSION Ultrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.
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Affiliation(s)
- Shambulingappa Pallagatti
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India.
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Tikku AP, Kumar S, Loomba K, Chandra A, Verma P, Aggarwal R. Use of ultrasound, color Doppler imaging and radiography to monitor periapical healing after endodontic surgery. J Oral Sci 2011; 52:411-6. [PMID: 20881334 DOI: 10.2334/josnusd.52.411] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study evaluated the effectiveness of ultrasound, color Doppler imaging and conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. Fifteen patients who underwent periapical surgery for endodontic pathology were randomly selected. In all patients, periapical lesions were evaluated preoperatively using ultrasound, color Doppler imaging and conventional radiography, to analyze characteristics such as size, shape and dimensions. On radiographic evaluation, dimensions were measured in the superoinferior and mesiodistal direction using image-analysis software. Ultrasound evaluation was used to measure the changes in shape and dimensions on the anteroposterior, superoinferior, and mesiodistal planes. Color Doppler imaging was used to detect the blood-flow velocity. Postoperative healing was monitored in all patients at 1 week and 6 months by using ultrasound and color Doppler imaging, together with conventional radiography. The findings were then analyzed to evaluate the effectiveness of the 3 imaging techniques. At 6 months, ultrasound and color Doppler imaging were significantly better than conventional radiography in detecting changes in the healing of hard tissue at the surgical site (P < 0.004). This study demonstrates that ultrasound and color Doppler imaging have the potential to supplement conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin.
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Affiliation(s)
- Aseem P Tikku
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India.
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Raghav N, Reddy SS, Giridhar AG, Murthy S, Yashodha Devi BK, Santana N, Rakesh N, Kaushik A. Comparison of the efficacy of conventional radiography, digital radiography, and ultrasound in diagnosing periapical lesions. ACTA ACUST UNITED AC 2011; 110:379-85. [PMID: 20727498 DOI: 10.1016/j.tripleo.2010.04.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 04/23/2010] [Accepted: 04/24/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of conventional radiography, digital radiography and ultrasound imaging in diagnosing periapical lesions. STUDY DESIGN Twenty-one patients aged between 15 and 45 years with well defined periapical radiolucency associated with anterior maxillary or mandibular teeth requiring endodontic surgery or extraction were selected and consented to the study. Preoperative intraoral periapical radiographs and digital images using charge-coupled device obtained by paralleling technique were assessed by 3 specialist observers who gave their diagnosis of the periapical lesions. Then ultrasound examination was performed and the images were assessed for size, contents, and vascular supply by 3 ultrasonographers. It was followed by curettage of periapical tissues to enable histopathologic investigation, which is the gold standard in diagnosis. The data were statistically analyzed using SPSS, analysis of variance, and kappa statistics. RESULTS The percentage accuracy of diagnosing periapical lesions using conventional radiography was 47.6%, digital radiography 55.6%, and ultrasound 95.2%. Ultrasound had the highest sensitivity and specificity: 0.95 and 1.00, respectively. CONCLUSION Conventional and digital radiography enable diagnosis of periapical diseases, but not their nature, whereas ultrasound provides accurate information on the pathologic nature of the lesions, which is of importance in predicting the treatment outcome. Therefore ultrasound can be used as an adjunct to conventional or digital radiography in diagnosing periapical lesions.
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Affiliation(s)
- Namita Raghav
- Department of Oral Medicine, Diagnosis and Radiology, K. D. Dental College and Hospital, Mathura, India.
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Gao Y, Haapasalo M, Shen Y, Wu H, Jiang H, Zhou X. Development of Virtual Simulation Platform for Investigation of the Radiographic Features of Periapical Bone Lesion. J Endod 2010; 36:1404-9. [DOI: 10.1016/j.joen.2010.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 04/24/2010] [Accepted: 04/29/2010] [Indexed: 11/15/2022]
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Xiang X, Sowa MG, Iacopino AM, Maev RG, Hewko MD, Man A, Liu KZ. An update on novel non-invasive approaches for periodontal diagnosis. J Periodontol 2010; 81:186-98. [PMID: 20151796 DOI: 10.1902/jop.2009.090419] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
For decades there has been an ongoing search for clinically acceptable methods for the accurate, non-invasive diagnosis and prognosis of periodontitis. There are several well-known inherent drawbacks with current clinical procedures. The purpose of this review is to summarize some of the newly emerging diagnostic approaches, namely, infrared spectroscopy, optical coherence tomography (OCT), and ultrasound. The history and attractive features of these new approaches are briefly illustrated, and the interesting and significant inventions related to dental applications are discussed. The particularly attractive aspects for the dental community are that some of these methods are totally non-invasive, do not impose any discomforts to the patients during the procedure, and require no tissue to be extracted. For instance, multiple inflammatory indices withdrawn from near infrared spectra have the potential to identify early signs of inflammation leading to tissue breakdown. Morphologically, some other non-invasive imaging modalities, such as OCT and ultrasound, could be employed to accurately measure probing depths and assess the status of periodontal attachment, the front-line of disease progression. Given that these methods reflect a completely different assessment of periodontal inflammation, if clinically validated, these methods could either replace traditional clinical examinations for the diagnosis of periodontitis or at least serve as attractive complementary diagnostic tools. However, the potential of these techniques should be interpreted more cautiously given the multifactorial character of periodontal disease. In addition to these novel tools in the field of periodontal inflammatory diseases, other alternative modalities like microbiologic and genetic approaches are only briefly mentioned in this review because they have been thoroughly discussed in other comprehensive reviews.
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Affiliation(s)
- Xiaoming Xiang
- Institute for Biodiagnostics, National Research Council of Canada, Winnipeg, MB
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