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Wang SH, Fuh LJ, Chen MYC, Tsai MT, Huang HL, Peng SL, Hsu JT. Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods. Head Face Med 2024; 20:33. [PMID: 38760840 PMCID: PMC11100211 DOI: 10.1186/s13005-024-00434-0] [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: 12/07/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Michael Y C Chen
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
| | - Heng-Li Huang
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
| | - Jui-Ting Hsu
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
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Luo S, Fan F, Zhang XT, Liu AJ, Lin YS, Cheng ZQ, Song CX, Wang JJ, Deng ZH, Zhan MJ. Forensic age estimation in adults by pubic bone mineral density using multidetector computed tomography. Int J Legal Med 2023; 137:1527-1533. [PMID: 37493764 DOI: 10.1007/s00414-023-03067-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
Radiology plays a crucial role in forensic anthropology for age estimation. However, most studies rely on morphological methods. This study aims to investigate the feasibility of using pubic bone mineral density (BMD) as a new age estimation method in the Chinese population. 468 pubic bone CT scans from living individuals in a Chinese hospital aged 18 to 87 years old were used to measure pubic BMD. The BMD of the bilateral pubic bone was measured using the Mimics software on cross-sectional CT images and the mean BMD of the bilateral pubic bone was also calculated. Regression analysis was performed to assess the correlation between pubic BMD and chronological age and to develop mathematical models for age estimation. We evaluated the accuracy of the best regression model using an independent validation sample by calculating the mean absolute error (MAE). Among all established models, the cubic regression model had the highest R2 value in both genders, with R2 = 0.550 for males and R2 = 0.634 for females. The results of the best model test showed that the MAE for predicting age using pubic BMD was 8.66 years in males and 7.69 years in females. This study highlights the potential of pubic BMD as a useful objective indicator for adult age estimation and could be used as an alternative in forensic practice when other better indicators are lacking.
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Affiliation(s)
- Shuai Luo
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Fei Fan
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xing-Tao Zhang
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - An-Jie Liu
- University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China
| | - Yu-Shan Lin
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Zi-Qi Cheng
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | | | - Jun-Jing Wang
- Beidaihe Hospital, Hebei, 066100, Qinhuangdao, China
| | - Zhen-Hua Deng
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Meng-Jun Zhan
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
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Jusufbegović M, Pandžić A, Busuladžić M, Čiva LM, Gazibegović-Busuladžić A, Šehić A, Vegar-Zubović S, Jašić R, Beganović A. Utilisation of 3D Printing in the Manufacturing of an Anthropomorphic Paediatric Head Phantom for the Optimisation of Scanning Parameters in CT. Diagnostics (Basel) 2023; 13:328. [PMID: 36673137 PMCID: PMC9858362 DOI: 10.3390/diagnostics13020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
Computed tomography (CT) is a diagnostic imaging process that uses ionising radiation to obtain information about the interior anatomic structure of the human body. Considering that the medical use of ionising radiation implies exposing patients to radiation that may lead to unwanted stochastic effects and that those effects are less probable at lower doses, optimising imaging protocols is of great importance. In this paper, we used an assembled 3D-printed infant head phantom and matched its image quality parameters with those obtained for a commercially available adult head phantom using the imaging protocol dedicated for adult patients. In accordance with the results, an optimised scanning protocol was designed which resulted in dose reductions for paediatric patients while keeping image quality at an adequate level.
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Affiliation(s)
- Merim Jusufbegović
- Radiology Clinic, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
- Department of Radiological Technologies, Faculty of Health Studies, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Adi Pandžić
- Department of Mechanical Production Engineering, Faculty of Mechanical Engineering Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Mustafa Busuladžić
- Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Lejla M. Čiva
- Sarajevo Medical School, University Sarajevo School of Science and Technology, 71210 Ilidža, Bosnia and Herzegovina
| | | | - Adnan Šehić
- Department of Radiological Technologies, Faculty of Health Studies, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Sandra Vegar-Zubović
- Radiology Clinic, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
- Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Rahima Jašić
- Department of Radiation Protection and Medical Physics, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
| | - Adnan Beganović
- Faculty of Science, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
- Department of Radiation Protection and Medical Physics, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
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Association between forearm cortical bone properties and handgrip strength in women with distal radius fractures: A cross-sectional study. PLoS One 2020; 15:e0243294. [PMID: 33270744 PMCID: PMC7714147 DOI: 10.1371/journal.pone.0243294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/19/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Mechanical and biochemical bone properties are influenced by muscles. However, the muscle-bone interaction has not been fully elucidated regarding the upper extremities. The objective of the present study was to evaluate the mechanical muscle-bone interaction at the forearm by evaluating the relationship between the properties of three-dimensional (3D) forearm cortical bone models derived from conventional computed tomography (CT) images and handgrip strength (HGS). METHODS A total of 108 women (mean age, 75.2 ± 9.4 years; range, 62-101 years) with a distal radius fracture who took conventional CT scans for the assessment of the fracture were included in this study. Distal radius 3D models were reconstructed and the average cortical bone density (Cd) and thickness (Ct) of the region of interest (ROI), which might be affected by the forearm flexor muscles, were calculated using a 3D modeling software. Clinical parameters including HGS, lumbar and hip bone mineral densities (BMDs), and other demographic factors were also obtained. A multivariate linear regression analysis was performed to identify relevant factors associated with HGS. RESULTS HGS was found to be independently associated with height and Cd, but no significant difference was found between HGS and Ct, age, weight, as well as lumber and hip BMDs. CONCLUSIONS Cortical bone density might be associated with HGS, which is generated by the forearm flexor muscles. Hence, the mechanical muscle-bone interaction in the upper extremities could be supported by the present study.
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Bioactive glass granules S53P4 in osteotomy Le Fort I. Sci Rep 2020; 10:12690. [PMID: 32728040 PMCID: PMC7391678 DOI: 10.1038/s41598-020-68932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 06/30/2020] [Indexed: 11/08/2022] Open
Abstract
We evaluated bioactive glass graft (S53P4) in patients undergoing Le Fort I osteotomy, with non-grafted patients as controls. Computed tomography facial scans of the 25 patients submitted for Le Fort I were divided into two groups: Group 1-S53P4 group and Group 2-without grafting. CT scans were analyzed in the immediate postoperative period (T1) and 6 months later (T2), for linear bone gap measurements, tomographic radiodensity and behavior of the maxillary sinus. A Kruskal-Wallis test on bone gap data adopted α significance levels (p ≤ 0.05). The Friedman test (p ≤ 0.05) was used to evaluate sinus reaction cores. For gap measurements, we observed a decrease in median data between T1 and T2 in both groups, with statistical significances observed between groups in T0; G1 presented statistical difference in its two studied times (p ≤ 0.0001). For bone density, the studied data behaved inversely. G1's bone density decreased from T1 to T2, whereas in G2 there was an increase from T1 to T2. S53P4 did not elicit increased reactions and/or sinus infections in the G1 group (p ≥ 1.00). S53P4 did not impact on Le Fort I osteotomies as a coadjuvant and a favorable factor in bone formation, and appeared innocuous in the maxillary sinus.
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Hong SW, Kang JH. Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults. Sci Rep 2020; 10:3623. [PMID: 32107437 PMCID: PMC7046747 DOI: 10.1038/s41598-020-60554-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 02/10/2020] [Indexed: 02/06/2023] Open
Abstract
This study aimed to clarify how masticatory muscle atrophy induced by botulinum toxin (BTX) injection affects cortical bone quality of the mandible using 3D modeling technology. A total of 39 young (26.9 ± 6.0 years) and 38 post-menopausal (55.3 ± 6.3 years) females were included. Computed tomography (CT) images were obtained before and after 12 months of treatment. Predictor variables were application of a stabilization splint, and/or two times of BTX injection in the bilateral temporalis and masseter muscles within a six-month interval. Outcome variables were changes in average Hounsfield units (HU) and cortical thickness of region of interest (ROI). 3D mandibular models were reconstructed using CT images, and models were used to calculate average HU and cortical thickness of ROIs, including inferior half of the lateral surface of ascending ramus, coronoid process, and temporomandibular joint condyle. Cortical bone quality at muscle insertion site was influenced by decreased muscle thickness but seemed not to be affected by decreased functional loading. Reduced functional loading seemed to influence cortical bone quality of the condyles. These effects were more remarkable in post-menopausal females. Hence, decreased masticatory muscle thickness may lead to alterations of the mandibular cortical structures, especially in post-menopausal females.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea.
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Kim TW, Lee MC, Cho JH, Kim JS, Lee YS. The Ideal Location of the Lateral Hinge in Medial Closing Wedge Osteotomy of the Distal Femur: Analysis of Soft Tissue Coverage and Bone Density. Am J Sports Med 2019; 47:2945-2951. [PMID: 31465238 DOI: 10.1177/0363546519869325] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although an appropriate hinge position to prevent unstable lateral hinge fractures is well established in medial opening wedge high tibial osteotomy, the position during medial closing wedge distal femoral osteotomy has not been elucidated. PURPOSE/HYPOTHESIS The purpose was to evaluate the ideal hinge position that would prevent an unstable lateral hinge fracture during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density around the hinge area. The hypothesis was that the ideal hinge position could be clarified by analyzing soft tissue coverage and bone density around the lateral hinge area. STUDY DESIGN Controlled laboratory study. METHODS In 20 cadaveric knees (mean age, 70.3 ± 19.2 years), the femoral attachment of the gastrocnemius lateral head was quantitatively analyzed as a soft tissue stabilizer using digital photography and fluoroscopy. Then, medial closing wedge distal femoral osteotomy was performed, locating the lateral hinge either inside (group 1) or outside (group 2) the femoral attachment of the gastrocnemius lateral head, and the incidence of unstable lateral hinge fractures was compared between the 2 groups. Cortical bone density around the lateral hinge was measured using Hounsfield units on 30 computed tomography scans and reconstructed as a 3-dimensional mapping model. The transitional zone with low bone density was regarded as the safe hinge position with an increased capacity for bone deformation. RESULTS The upper and lower margins of the femoral attachment of the gastrocnemius lateral head were 9.1 ± 0.9 mm above and 8.0 ± 1.4 mm below the upper border of the lateral femoral condyle, respectively, and the femoral attachment of the gastrocnemius lateral head was widest in the anteroposterior dimension 0.4 ± 1.7 mm above the upper border of the lateral femoral condyle. The incidence of unstable lateral hinge fractures during osteotomy was significantly decreased in group 1 compared with group 2 (group 1: 0/10; group 2: 5/10; P = .01). An isolated transitional zone with low bone density was observed in all 30 knees and located 1.3 ± 0.8 mm above the upper border of the lateral femoral condyle. Bone density of the transitional zone with low bone density was significantly lower than surrounding femoral cortices (P < .001). CONCLUSION Only the upper border of the lateral femoral condyle can be recommended as an ideal hinge position to prevent unstable lateral hinge fractures during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density. CLINICAL RELEVANCE When the hinge is positioned at the upper border of the lateral femoral condyle during biplanar medial closing wedge distal femoral osteotomy, the risk of unstable hinge fractures can be minimized.
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Affiliation(s)
- Tae Woo Kim
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Myung Chul Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae Ho Cho
- Department of Orthopaedic Surgery, Hallym University Medical Center, Chuncheon, Republic of Korea
| | - Jong Seop Kim
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong Seuk Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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