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Burian E, Lenhart N, Greve T, Bodden J, Burian G, Palla B, Probst F, Probst M, Beer M, Folwaczny M, Schwarting J. Detection of caries lesions using a water-sensitive STIR sequence in dental MRI. Sci Rep 2024; 14:663. [PMID: 38182726 PMCID: PMC10770403 DOI: 10.1038/s41598-024-51151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Neuroradiology, Kantonsspital Frauenfeld, Thurgau AG, Frauenfeld, Switzerland.
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, Chicago, USA
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, 80337, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Golež A, Ovsenik M, Romarić K, Cankar K. The Use of Magnetic Resonance Imaging in Diagnostics of Radix Paramolaris: A Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
This case report aims to present a rare morphological variation of Radix Paramolaris (RP) diagnosed using Magnetic Resonance Imaging (MRI) to discuss its morphological associations and possible implications on dental treatment. Radix paramolaris is a buccally located supernumerary root of the permanent mandibular molars. It is very rare in the European population, with a prevalence below 4%.
Case Presentation:
A 7-year-old boy with severe Class II malocclusion is presented. The first phase of orthodontic treatment consisted of therapy with a removable activator appliance. Before the second phase of treatment, unilateral radix paramolaris on the second right permanent mandibular molar was discovered.
Results:
Supernumerary root was diagnosed using a 3T whole-body MRI system. This case confirmed the association between supernumerary roots and increased buccal crown cusps in a mandibular molar. Furthermore, it demonstrated the effectiveness of non-invasive MRI as a complementary diagnostic tool, offering clear advantages in diagnosing rare morphological variations such as supernumerary roots. Unlike conventional radiography, MRI is able to distinguish the soft tissues, including the dental pulp, and does not emit ionizing radiation.
Conclusion:
To diagnose a supernumerary root and the state of its pulpal tissue, a precise radiographic and clinical examination is required since awareness of exact root morphology can be of paramount importance in clinical decision-making for several dental procedures.
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Cankar K, Vidmar J, Nemeth L, Serša I. T2 Mapping as a Tool for Assessment of Dental Pulp Response to Caries Progression: An in vivo MRI Study. Caries Res 2019; 54:24-35. [PMID: 31509847 DOI: 10.1159/000501901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/03/2019] [Indexed: 11/19/2022] Open
Abstract
Among radiological methods, magnetic resonance imaging (MRI) excels in its ability to image soft tissue at great contrast and without the need of harmful radiation. This study tested whether in vivo MRI based on standard MRI sequences run on a standard clinical MRI system can be used to quantify dental pulp response to caries progression using the T2 mapping method. In the study, 74 teeth were scanned on a 3-T MRI system, and caries was assessed according to the International Caries Detection and Assessment System (ICDAS). The T2 maps were processed to obtain T2 profiles along selected root canals (from crown to apex), and the profiles were sorted according to both tooth type (single-rooted vs. molar) and ICDAS score. In all the examined dental pulps, it was found that T2 values decrease with an increase in the ICDAS score. In the coronal part of dental pulps, average T2 values of 166, 153, and 115 ms were found in ICDAS groups 0, 1-3, and 4-6, respectively. In single-rooted teeth, T2 values were found approximately constant as a function of dental pulp depth, while in multi-rooted teeth, they were found increasing in the coronal part and decreasing towards the root apex. The study confirmed that T2 mapping of dental pulp can be used to reliably quantify its response to caries progression and that it has a potential to become a complementary diagnostic tool to standard radiographic methods in the assessment of dental pulp response to caries.
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Affiliation(s)
- Ksenija Cankar
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia,
| | - Jernej Vidmar
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Institute of Radiology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Jožef Stefan Institute, Ljubljana, Slovenia
| | - Lidija Nemeth
- Department of Dental Diseases and Normal Dental Morphology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Igor Serša
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Jožef Stefan Institute, Ljubljana, Slovenia
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Ariji Y, Ariji E, Nakashima M, Iohara K. Magnetic resonance imaging in endodontics: a literature review. Oral Radiol 2018; 34:10-16. [PMID: 30484095 DOI: 10.1007/s11282-017-0301-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/20/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) has recently been used for the evaluation of dental pulp anatomy, vitality, and regeneration. This study reviewed the recent use of MRI in the endodontic field. METHODS Literature published from January 2000 to March 2017 was searched in PubMed using the following Medical Subject Heading (MeSH) terms: (1) MRI and (dental pulp anatomy or endodontic pulp); (2) MRI and dental pulp regeneration. Studies were narrowed down based on specific inclusion criteria and categorized as in vitro, in vivo, or dental pulp regeneration studies. The MRI sequences and imaging findings were summarized. RESULTS In the in vitro studies on dental pulp anatomy, T1-weighted imaging with high resolution was frequently used to evaluate dental pulp morphology, demineralization depth, and tooth abnormalities. Other sequences such as apparent diffusion coefficient mapping and sweep imaging with Fourier transformation were used to evaluate pulpal fluid and decayed teeth, and short-T2 tissues (dentin and enamel), respectively. In the in vivo studies, pulp vitality and reperfusion were visible with fat-saturated T2-weighted imaging or contrast-enhanced T1-weighted imaging. In both the in vitro and in vivo studies, MRI could reveal pulp regeneration after stem cell therapy. Stem cells labeled with superparamagnetic iron oxide particles were also visible on MRI. Angiogenesis induced by stem cells could be confirmed on enhanced T1-weighted imaging. CONCLUSION MRI can be successfully used to visualize pulp morphology as well as pulp vitality and regeneration. The use of MRI in the endodontic field is likely to increase in the future.
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Affiliation(s)
- Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan.
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Misako Nakashima
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, 7-430 Morioka-cho, Obu, 474-8511, Japan
| | - Koichiro Iohara
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Research Institute, 7-430 Morioka-cho, Obu, 474-8511, Japan
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