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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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Mutalik S, Tadinada A, Molina MR, Sinisterra A, Lurie A. Effective doses of dental cone beam computed tomography: effect of 360-degree versus 180-degree rotation angles. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:433-446. [PMID: 32616450 DOI: 10.1016/j.oooo.2020.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aims of this study were to compare radiation absorbed dose (AD) and effective dose (ED) to tissues from cone beam computed tomography (CBCT) scans with 360-degree versus 180-degree rotations with use of different fields of view (FOV), to compare EDs calculated from measured ADs versus dose area product (DAP) values, and to compare doses to the lens of the eye (LOE) from different scan parameters. STUDY DESIGN ADs for each protocol were measured in tissues, including the LOE, by using an anthropometric phantom. EDs were calculated on the basis of dosimetry (EDm) and DAP values (EDd). Dose differences were determined with analysis of variance (ANOVA). RESULTS ADs and EDs were substantially lower for 180-degree rotation scans compared with 360-degree rotation scans (P < .01). Remainder tissues had the greatest effect on effective dose for most FOVs. Doses were generally lower with small FOVs compared with large FOVs. Most EDm values were lower than EDd values in large FOVs but higher in small FOVs. Differences in EDm and EDd were variable and unpredictable. LOE doses were smaller with the 180-degree scans and smaller FOVs. CONCLUSIONS Radiation doses were generally lower with 180-degree rotation scans and smaller FOVs. These parameters should be used for CBCT acquisitions, whenever possible, and should be made available in all units.
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Affiliation(s)
- Sunil Mutalik
- Sessional Faculty, University of Manitoba, Gerald Niznick College of Dentistry, Winnipeg, MB, Canada
| | - Aditya Tadinada
- Section of Oral & Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Marco R Molina
- Department of Diagnostic Imaging, University of Connecticut School of Medicine, Farmigton, Connecticut, USA
| | - Andrés Sinisterra
- Section of Oral and Maxillofacial Radiology, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
| | - Alan Lurie
- Section of Oral & Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA.
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Patel S, Brown J, Semper M, Abella F, Mannocci F. European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by. Int Endod J 2019; 52:1675-1678. [PMID: 31301231 DOI: 10.1111/iej.13187] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/08/2019] [Indexed: 01/04/2023]
Abstract
This Position Statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the use of Cone Beam Computed Tomography (CBCT) in Endodontics. This paper is an update of the ESE CBCT position statement which was published in 2014 (European Society of Endodontology 2014, https://doi.org/10.1111/iej.12267). Recent review articles provide more detailed background information and the basis for this position statement. It is intended that this position statement will be updated at least every 4-5 years to keep abreast of relevant research. The aim of this paper is to provide clinicians with evidence-based guidance on the application of CBCT in Endodontics. Since 2014, there has been an increase in the number of clinical studies confirming the positive impact of CBCT on treatment planning, decision-making when reviewing cases and reduced practitioner stress levels.
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Affiliation(s)
- S Patel
- Endodontic Postgraduate Unit, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - J Brown
- Endodontic Postgraduate Unit, King's College London Dental Institute, London, UK
| | - M Semper
- Private Practice, Bremen, Germany
| | - F Abella
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - F Mannocci
- Endodontic Postgraduate Unit, King's College London Dental Institute, London, UK
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Etiology and Measurement of Peri-Implant Crestal Bone Loss (CBL). J Clin Med 2019; 8:jcm8020166. [PMID: 30717189 PMCID: PMC6406263 DOI: 10.3390/jcm8020166] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/15/2022] Open
Abstract
The etiology of peri-implant crestal bone loss is today better understood and certain factors proposed in the past have turned out to not be of concern. Regardless, the incidence of crestal bone loss remains higher than necessary and this paper reviews current theory on the etiology with a special emphasis on traditional and innovative methods to assess the level of crestal bone around dental implants that will enable greater sensitivity and specificity and significantly reduce variability in bone loss measurement.
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Rottke D, Dreger J, Sawada K, Honda K, Schulze D. Comparison of manual and dose reduction modes of a MORITA R100 CBCT. Dentomaxillofac Radiol 2018; 48:20180009. [PMID: 30182744 DOI: 10.1259/dmfr.20180009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE: To compare effective dose differences when acquiring (1) dose reduction mode and (2) manual mode in a MORITA R100 CBCT. METHODS: 24 exposure protocols with different technique factors were performed in both the dose reduction mode and the manual mode in a Veraviewepocs 3D R100 cone beam CT device. 48 TLD were placed in a RANDO head phantom at 24 different sites. Effective doses were calculated according to the formalism published in the 103rd ICRP report. RESULTS: Effective doses for the dose reduction mode protocols ranged from 14 to 156 µSv [mean = 57 µSv, standard deviation (SD) = 37 µSv], whereas effective doses for the manual mode protocols ranged from 22 to 267 µSv (mean = 94 µSv, SD = 65 µSv). Thus, across all protocols, the dose reduction mode leads to a drop of the effective dose by 38 % (SD = 6 %). CONCLUSIONS: The estimated effective doses are significantly lower if dose reduction protocols are acquired.
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Affiliation(s)
- Dennis Rottke
- 1 Digital Diagnostic Center , Freiburg im Breisgau , Germany.,2 Department of Odontology, Oral and Maxillofacial Radiology, Faculty of Medicine, Umeå University , Umeå , Sweden
| | - Julia Dreger
- 1 Digital Diagnostic Center , Freiburg im Breisgau , Germany
| | - Kunihiko Sawada
- 3 Department of Radiology, Nihon University School of Dentistry , Tokyo , Japan
| | - Kazuya Honda
- 3 Department of Radiology, Nihon University School of Dentistry , Tokyo , Japan
| | - Dirk Schulze
- 1 Digital Diagnostic Center , Freiburg im Breisgau , Germany
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Clinician-centered Outcomes Assessment of Retreatment and Endodontic Microsurgery Using Cone-beam Computed Tomographic Volumetric Analysis. J Endod 2018; 44:1251-1256. [DOI: 10.1016/j.joen.2018.03.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/27/2018] [Accepted: 03/30/2018] [Indexed: 01/11/2023]
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Pelekos G, Acharya A, Tonetti MS, Bornstein MM. Diagnostic performance of cone beam computed tomography in assessing peri-implant bone loss: A systematic review. Clin Oral Implants Res 2018; 29:443-464. [PMID: 29578266 DOI: 10.1111/clr.13143] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate the diagnostic performance of cone beam computed tomography (CBCT) in the assessment of peri-implant bone loss and analyze its influencing factors. MATERIALS AND METHODS Clinical and preclinical studies reporting diagnostic outcomes of CBCT imaging of peri-implant bone loss compared to direct reference measurements were sought by searching five electronic databases, PubMed, MEDLINE, EMBASE, Web of Science, and CINAHL Plus, and OpenGrey. QUADAS-2 criteria were adapted for quality analysis of the included studies. A qualitative synthesis was performed. Two meta-analysis models (random-effects and mixed-effects) summarized the area under receiver operating characteristic (AUC) curve observations reported in the selected studies. The mixed-effects meta-analysis model evaluated three possible influencing factors, "defect type," "defect size," and "study effect." RESULTS The initial search yielded 3,716 titles, from which 18 studies (13 in vitro and 5 animal) were included. Diagnostic accuracy of CBCT was fair to excellent in detecting in vitro circumferential-intrabony and fenestration defects, but moderate to low for peri-implant dehiscences, and tended to be higher for larger defect sizes. Both, over- and underestimation of linear measurements were reported for the animal models. The meta-analyses included 37 AUC observations from eight studies. The random-effects model showed significant heterogeneity. The mixed-effects model exhibited also significant but lower heterogeneity, and "defect type" and "study effect" significantly influenced the variability of AUC observations. CONCLUSION In vitro, CBCT performs well in detecting peri-implant circumferential-intrabony or fenestration defects but less in depicting dehiscences. Influencing factors due to other site-related and technical parameters on the diagnostic outcome need to be addressed further in the future studies.
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Affiliation(s)
- Georgios Pelekos
- Periodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Aneesha Acharya
- Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
- Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Maurizio S Tonetti
- Periodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Hayashi T, Arai Y, Chikui T, Hayashi-Sakai S, Honda K, Indo H, Kawai T, Kobayashi K, Murakami S, Nagasawa M, Naitoh M, Nakayama E, Nikkuni Y, Nishiyama H, Shoji N, Suenaga S, Tanaka R. Clinical guidelines for dental cone-beam computed tomography. Oral Radiol 2018; 34:89-104. [PMID: 30484133 DOI: 10.1007/s11282-018-0314-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/28/2022]
Abstract
Dental cone-beam computed tomography (CBCT) received regulatory approval in Japan in 2000 and has been widely used since being approved for coverage by the National Health Insurance system in 2012. This imaging technique allows dental practitioners to observe and diagnose lesions in the dental hard tissue in three dimensions (3D). When performing routine radiography, the examination must be justified, and optimal protection should be provided according to the ALARA (as low as reasonably achievable) principles laid down by the International Commission on Radiological Protection. Dental CBCT should be performed in such a way that the radiation exposure is minimized and the benefits to the patient are maximized. There is a growing demand for widespread access to cutting-edge health care through Japan's universal health insurance system. However, at the same time, people want our limited human, material, and financial resources to be used efficiently while providing safe health care at the least possible cost to society. Japan's aging population is expected to reach a peak in 2025, when most of the baby boomer generation will be aged 75 years or older. Comprehensive health care networks are needed to overcome these challenges. Against this background, we hope that this text will contribute to the nation's oral health by encouraging efficient use of dental CBCT.
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Affiliation(s)
- Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan.
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Toru Chikui
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Sachiko Hayashi-Sakai
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Surugadai Kand Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Hiroko Indo
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Kaoru Kobayashi
- Department of Oral and Maxillofacial Radiology and Diagnosis, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masako Nagasawa
- Division of Bio-Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Munetaka Naitoh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Eiji Nakayama
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Yutaka Nikkuni
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Noriaki Shoji
- Division of Oral Diagnosis, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Shigeaki Suenaga
- Division of Oncology, Department of Maxillofacial Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China
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Tadinada A, Schneider S, Yadav S. Evaluation of the diagnostic efficacy of two cone beam computed tomography protocols in reliably detecting the location of the inferior alveolar nerve canal. Dentomaxillofac Radiol 2017; 46:20160389. [PMID: 28128638 DOI: 10.1259/dmfr.20160389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Reliable three-dimensional localization of the inferior alveolar nerve canal (IANC) is valuable for a variety of dentoalveolar procedures. Although conventional CBCT offers three-dimensional information at a reasonably low dose, it is still a significant amount of radiation. In this ex vivo study, we evaluated the ability of a 180° rotational CBCT acquisition protocol with lower number of basis projections to create a CBCT data set for reliable localization of the IANC compared with a conventional 360° rotational CBCT acquisition. METHODS 50 dry human skulls were imaged using 180° and 360° rotational CBCT protocols. Measurements of the IANC throughout its course in the mandible were carried out. Two raters evaluated the measurements and rated the scans based on their ability to visualize the IANC, and the measurements were carried out. RESULTS The IANC length measurements for the 180° and 360° protocols were identical. There was no difference between evaluations by the two raters for the two protocols. Interexaminer reliability values were >90% for the two protocols. The sensitivity values for the two protocols were >95%. The specificity for both protocols was 100%. CONCLUSIONS 180° CBCT acquisition protocol is able to accurately locate the IANC with high reliability and is comparable to a conventional 360° protocol.
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Affiliation(s)
- Aditya Tadinada
- 1 Division of Oral and Maxillofacial Radiology, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
| | - Sydney Schneider
- 2 University of Connecticut, School of Dental Medicine, Farmington, CT, USA
| | - Sumit Yadav
- 3 Division of Orthodontics, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
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