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Eren İ, Sarıyılmaz Ö, Eren H, Sarıyılmaz E, Uslu G. Can ultrasonography be used to determine working length in endodontic treatment? An in vitro study. Odontology 2024; 112:453-459. [PMID: 37819467 DOI: 10.1007/s10266-023-00858-1] [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: 04/03/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
This study was conducted to evaluate efficacy of ultrasonography (USG) in determining working length in in-vitro conditions. Twenty five access cavities of maxillary incisor teeth were opened and actual working lengths (AWL) were measured with dental operating microscope. The working length were then measured with an electronic apex locator and USG. USG and apex locator measurements were statistically analyzed using one sample t-test and compared with AWL. The mean AWL measurment was 20.68 mm. USG measured the working length slightly longer (21.09 mm) than the measurements of apex locator (20.64 mm). Statistical analysis showed that the USG method provided similar measurements to electronic apex locators and with no statistical difference with actual working length (P < .05). USG emerges as a promising method for working length measurement that allows simultaneous visualization of root tip anatomy in cases where electronic apex locators may be insufficient and there is buccal cortical bone loss.
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Affiliation(s)
- İrem Eren
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Öznur Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hakan Eren
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Çanakkale Onsekiz Mart University, Kepez Çanakkale TR, Sahilyolu Cd No:5, 17100, Çanakkale, Turkey.
| | - Evren Sarıyılmaz
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Gülşah Uslu
- Private Practice, Idadent Diş Kliniği, Çanakkale, Turkey
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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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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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Guo J, Wu Y, Chen L, Long S, Chen D, Ouyang H, Zhang C, Tang Y, Wang W. A perspective on the diagnosis of cracked tooth: imaging modalities evolve to AI-based analysis. Biomed Eng Online 2022; 21:36. [PMID: 35706023 PMCID: PMC9202175 DOI: 10.1186/s12938-022-01008-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Despite numerous clinical trials and pre-clinical developments, the diagnosis of cracked tooth, especially in the early stages, remains a challenge. Cracked tooth syndrome is often accompanied by dramatic painful responses from occlusion and temperature stimulation, which has become one of the leading causes for tooth loss in adults. Current clinical diagnostical approaches for cracked tooth have been widely investigated based on X-rays, optical light, ultrasound wave, etc. Advances in artificial intelligence (AI) development have unlocked the possibility of detecting the crack in a more intellectual and automotive way. This may lead to the possibility of further enhancement of the diagnostic accuracy for cracked tooth disease. In this review, various medical imaging technologies for diagnosing cracked tooth are overviewed. In particular, the imaging modality, effect and the advantages of each diagnostic technique are discussed. What's more, AI-based crack detection and classification methods, especially the convolutional neural network (CNN)-based algorithms, including image classification (AlexNet), object detection (YOLO, Faster-RCNN), semantic segmentation (U-Net, Segnet) are comprehensively reviewed. Finally, the future perspectives and challenges in the diagnosis of the cracked tooth are lighted.
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Affiliation(s)
- Juncheng Guo
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yuyan Wu
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Lizhi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Shangbin Long
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Daqi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Haibing Ouyang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Chunliang Zhang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yadong Tang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Wenlong Wang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China.
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Elbarbary M, Sgro A, Goldberg M, Tenenbaum H, Azarpazhooh A. Diagnostic Applications of Ultrasonography in Myofascial Trigger Points: A Scoping Review and Critical Appraisal of Literature. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2022. [DOI: 10.1177/87564793221102593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Myofascial trigger points (MTrPs) are pathognomonic of myofascial pain syndrome. The detection ability of MTrPs via ultrasonography is underreported and the characteristics of MTrPs are not sufficiently standardized. The objective was to summarize the characteristics and diagnostic abilities of ultrasonography for MTrP investigations. Materials and Methods: A multi-database, and bibliography hand-search was implemented. Studies of ≥10 patients, published after 1980, appraising ultrasonography as a diagnostic aid for myofascial pain syndrome were included. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate the diagnostic accuracy of the included studies. Results: Six cross-sectional studies met the inclusion criteria. The back and trapezius muscles were the most studied locations. The diagnostic studies were of low-medium risk of bias. The studies reported a large range of diagnostic metrics (accuracy 58%–100%, sensitivity 33%–91%, specificity 75%–100%, positive predictive value 91%–100%, negative predictive value 47%–97%, positive likelihood ratio 3.6, and negative likelihood ratio 0.12–0.67). Conclusion: This review found low-medium risk of bias evidence in support of ultrasonography for MTrP investigations. The clinical studies identified in the scoping review used gray-scale ultrasound equipment systems with a 5 to 14 MHz transducer to diagnose MTrPs and the local twitch response, and MTrPs were visualized mostly as hypoechoic nodules.
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Affiliation(s)
| | - Adam Sgro
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Goldberg
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Howard Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- Mount Sinai Hospital, Toronto, ON, Canada
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The applications of ultrasound, and ultrasonography in dentistry: a scoping review of the literature. Clin Oral Investig 2022; 26:2299-2316. [PMID: 35028733 DOI: 10.1007/s00784-021-04340-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/06/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This scoping review aims to summarize the available literature on the clinical applications of ultrasonography and ultrasound in diagnostic, therapeutic, and interventional dental applications. MATERIALS AND METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Extension for Scoping Reviews checklist and conducted a protocol-driven scoping review of randomized controlled trials, cohort studies, cross-sectional studies, case-control studies, and case series that assessed ultrasonography or ultrasound use as a stand-alone diagnostic, therapeutic, and interventional tool in dentistry. We included studies published after 1980, study samples ≥ 10, with diagnostic, concordance, or therapeutic outcomes. We searched Ovid MEDLINE, Embase, and others (up to April 2021) and extracted information regarding study level, patient level, test or treatment level, and outcome level data. RESULTS Five interventional studies (related to oral medicine, temporomandibular disorders, and dental anesthesia), eight therapeutic studies (related to surgery and orthodontics), and seventy-five diagnostic studies (related to orthodontics, surgery, endodontics, oral medicine, temporomandibular disorders, restorative dentistry, and periodontology) were identified and presented in this review. CONCLUSION Ultrasonography has a well-established niche in diagnostic dentistry, while therapeutic and interventional ultrasounds have a smaller, yet present, niche in dentistry. However, further research is needed to report the precise estimates of the diagnostic, therapeutic, and interventional effects. CLINICAL SIGNIFICANCE Dentists are mostly unfamiliar with ultrasonography and ultrasound and their potential uses. This review maps the diagnostic and therapeutic applications of ultrasonography and ultrasound technology in dentistry and highlights the current challenges, gaps of knowledge, and research status of ultrasound technology in this regard.
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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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Kamburoğlu K, Çakmak EE, Eratam N, Sönmez G, Karahan S. In vitro assessment of periapical lesions created in sheep mandibles by using high resolution ultrasonography and cone beam computed tomography. Dentomaxillofac Radiol 2021; 50:20210048. [PMID: 34111365 DOI: 10.1259/dmfr.20210048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Providing ultrasound images of periapical lesions may be problematic depending on the thickness of the overlying cortical bone. Clinically, it is crucial to determine the cut-off value of overlaying bone thickness in terms of interference with ultrasound imaging in conjunction with assessment of changes in periapical jaw bone lesions. Our aim was to determine the minimum amount of overlaying buccal bone thickness of artificial periapical lesions in order to be visible by ultrasound imaging and to compare width, height, depth, surface area and volume measurements of detectable periapical lesions obtained from ultrasound and CBCT images. METHODS Periapical lesions were created in 16 molar teeth of sheep mandibles. Cavities were enlarged until the borders of lesions were visible on 14 MHz hockey probe ultrasound imaging. CBCT and ultrasound images were obtained simultaneously after drilling and enlarging each size of the cavities and replacing the teeth in their sockets. two observers separately assessed images twice within 2 weeks of interval. By using CBCT and ultrasound images, buccal bone thickness, maximum width, height, depth, surface area and volume of periapical lesions were measured. Intraclass correlation coefficient (ICC) was utilized and significance level was set at p < 0.05. RESULTS The mean buccal bone thickness ranged between 1.21 mm and 1.31 mm for both imaging techniques. For the measurement of buccal bone thickness, periapical lesion width, height, depth, surface area, and volume excellent ICC values were found in terms of intrarater (ranging between 0.907 and 1) and inter-rater (ranging between 0.864 and 1) reliability for both observers and their readings. There were no statistically significant differences for both observers and for their two readings between ultrasound and CBCT measurements of buccal bone thickness, and periapical lesion width and height (p > 0.05). CONCLUSIONS We suggested that a buccal thickness of approximately 1.28 mm might be accepted as a cut-off value for the detection of periapical lesions with 14 MHz hockey probe ultrasound. High resolution ultrasound provided accurate information for the measurement of buccal bone thickness and lesion width and height.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Dept of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Dept of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Nejlan Eratam
- Dept of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Dept of Dentomaxillofacial Radiology, Faculty of Dentistry, Adakent University, via Mersin 10, Turkey
| | - Sevilay Karahan
- Dept of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Dedeoğlu N, Duman ŞB, Altun O, Arıkan B. In vitro Comparison of Cone Beam Computed Tomography and Ultrasonography Imaging Methods in the Evaluation of Artificial Mandible Intraosseous Lesions. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:198-205. [PMID: 34514068 PMCID: PMC8417550 DOI: 10.30476/dentjods.2021.87481.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/20/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: Intraosseous lesions of jaws can be imaged by cone beam computed tomography (CBCT) and ultrasonography (USG). The knowledge of imaging features of these two methods about
intraosseous jaw lesions is important for dental radiology. Purpose: The aim of this study is to evaluate artificial mandible intraosseous lesions by using CBCT and USG. Materials and Method: In this in vitro study, intraosseous lesions containing water, milk, olive oil, and liver were evaluated in 60 artificial mandibles by using CBCT and USG.
Lesion sizes were compared between CBCT and USG. Lesion sizes were measured on the anterior-posterior, bucco-lingual, and superior-inferior sides. Hounsfield unit (HU)
values of the lesions in CBCT images were compared between different materials. Echogenicity of the lesions were evaluated in USG images. One sample t and one-way Anova tests
were used for the statistical analysis of the study (p< 0.05). Results: In all size measurements of the lesions, mean CBCT values were statistically higher when compared with USG. In CBCT images, statistically difference was found between the
HU values of lesions containing olive oil and other lesion contents. In USG images, echogenicity of water, milk and olive oil was found to be anechoic and the
echogenicity of liver was found to be hypoechoic. Conclusion: CBCT was found to be more accurate than USG in measurement of the size of mandibular intraosseous lesions. According to the results of our study, it was thought
that only oil content could be differentiated by using CBCT HU values. It was found that lesions with liquid and non-liquid contents could be differentiated with
their echogenicity difference in USG images.
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Affiliation(s)
- Numan Dedeoğlu
- Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Şuayip Burak Duman
- Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Oğuzhan Altun
- Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Büşra Arıkan
- Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, 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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12
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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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Das S, Adhikari H. Reliability of Ultrasonography in differentially diagnosing periapical lesions of endodontic origin in comparison with Intra-oral periapical radiography and Cone-beam computed tomography: An in vivo study. J Conserv Dent 2021; 24:445-450. [PMID: 35399778 PMCID: PMC8989163 DOI: 10.4103/jcd.jcd_254_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/03/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Periapical granuloma, radicular cyst, and periapical abscess represent periapical changes of frequent occurrence. Addressing this diagnostic dilemma is a matter of great concern, as it aids in governing the treatment planning and predicting its outcome. Aim: To evaluate the comparative accuracy of ultrasonography (USG), intraoral periapical (IOPA) radiography, and cone-beam computed tomography (CBCT) in differentially diagnosing periapical lesions of endodontic origin. Methods: Thirty-five patients having periapical lesions associated with anterior teeth requiring endodontic therapy were included in the study. The lesions were analyzed using IOPA radiographs, CBCT scans, and USG with color Doppler (CD). Periapical surgery ensued and enucleated tissue samples were subjected to histopathological analysis. To evaluate the accuracy, diagnoses made by each of the three modalities were compared with the gold standard histopathological reports, and the diagnostic accuracy, sensitivity, and specificity of each were calculated. Statistical Analysis: Cohen kappa (κ) was used for interrater reliability, and Pearson's contingency coefficient (C) was used for correlating findings of USG with histopathology. Results: USG showed good concordance with histopathological findings (contingency coefficient: 0.664). It also showed a higher accuracy rate compared to IOPA radiography and CBCT in differentially diagnosing periapical lesions. Conclusion: USG with CD holds the potential to be used as a noninvasive adjunct in periapical diagnostics.
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Bayrakdar IS, Yılmaz AB, Kaplan FA, Bilgir E, Orhan K. Evaluation of the snowing-like ultrasonographic features of intraosseous jaw pathologies. J Ultrason 2020; 20:e307-e310. [PMID: 33500799 PMCID: PMC7830146 DOI: 10.15557/jou.2020.0053] [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: 06/10/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022] Open
Abstract
Aim of the study: Ultrasonographic examination of intraosseous jaw pathologies may reveal interesting incidental, mobile hyperechoic particles ("snowflakes") in anechoic areas. Purpose of this study is to explain and discuss this snowing-like ultrasonographic feature of intraosseous jaw pathologies. Material and methods: This study included 113 patients admitted to our clinic for examination: 43 (38.05%) males and 70 (61.9%) females with a mean age of 34.9 ± 17.2 years (range: 6-72 years). A total of 120 intraosseous lesions were evaluated prior to surgery using ultrasonography; these included non-neoplastic, odontogenic, and non-odontogenic lesions. Results: In total, 5 (4.1%) of the 120 lesions exhibited snowing-like feature on ultrasonography, including 2 (1.6% of total) of 3 incisive canal cysts, 2 (1.6% of total) of 7 dentigerous cysts, and 1 (0.8% of total) of 19 odontogenic keratocysts. Conclusions: Snowflakes evident on ultrasonography of intraosseous jaw lesions may be specific to certain pathologies. Future studies correlating radiologic and pathologic features of intraosseous jaw lesions should focus on ultrasonographic snowing-like appearance in different types of lesions and explore why they occur.
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Affiliation(s)
- Ibrahim Sevki Bayrakdar
- Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir-Turkey
| | - Ahmet Berhan Yılmaz
- Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum-Turkey
| | - Fatma Akkoca Kaplan
- Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir-Turkey
| | - Elif Bilgir
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir-Turkey
| | - Kaan Orhan
- Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara-Turkey
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15
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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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16
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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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17
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Tsou PY, Ma YK, Wang YH, Gillon JT, Rafael J, Deanehan JK. Diagnostic accuracy of ultrasound for upper extremity fractures in children: A systematic review and meta-analysis. Am J Emerg Med 2020; 44:383-394. [PMID: 32507477 DOI: 10.1016/j.ajem.2020.04.071] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Ultrasound has an excellent diagnostic accuracy for fractures that is reportedly comparable to plain radiographs. We aim to summarize the diagnostic accuracy of ultrasound for upper extremity fractures in children. METHODS Databases were searched from inception through November 2019 using pre-defined index terms, including "ultrasound," "fractures of upper extremities" and "children". The study is reported using Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). Meta-analysis of the diagnostic accuracy of ultrasound for fractures was conducted using the random-effects bivariate model. Subgroup analysis of fracture site (elbow vs non-elbow fractures) was also performed. Meta-regression was performed to determine if the site of fracture affected the diagnostic accuracy. RESULTS Thirty-two studies were identified in the meta-analysis. Ultrasound for fractures of the upper extremities has a sensitivity: 0.95 (95% CI: 0.93-0.97), specificity: 0.95 (95% CI: 0.91-0.98), positive likelihood ratio: 21.1 (95% CI: 10.8-41.5) and negative likelihood ratio: 0.05 (95% CI: 0.03-0.07), with an area under ROC (AUROC) curve of 0.98 (95% CI: 0.97-0.99). Subgroup analysis for elbow fracture showed ultrasound has a sensitivity: 0.95 (95% CI: 0.86-0.98), specificity: 0.87 (95% CI: 0.76-0.94), positive likelihood ratio: 7.3 (95% CI: 3.7-14.4) and negative likelihood ratio: 0.06 (95% CI: 0.02-0.16), with an AUROC of 0.96 (95% CI: 0.94-0.97). Meta-regression suggested the fracture sites would affect diagnostic accuracy of ultrasound (elbow vs non-elbow, p < 0.01). CONCLUSIONS Current evidence suggests ultrasound has excellent diagnostic accuracy for non-elbow upper extremity fractures in children, serving as an alternative diagnostic modality to plain radiographs.
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Affiliation(s)
- Po-Yang Tsou
- Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yu-Kun Ma
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hsun Wang
- Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jason T Gillon
- Department of Pediatric Emergency Medicine, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - John Rafael
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Julia K Deanehan
- Department of Pediatric Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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18
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Sönmez G, Kamburoğlu K, Yılmaz F, Koç C, Barış E, Tüzüner A. Versatility of high resolution ultrasonography in the assessment of granulomas and radicular cysts: a comparative in vivo study. Dentomaxillofac Radiol 2019; 48:20190082. [PMID: 31188679 DOI: 10.1259/dmfr.20190082] [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] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To evaluate and compare the diagnostic potential of high resolution ultrasound with periapical radiographs (PR) and CBCT in assessing granulomas and radicular cysts. METHODS This study included a total of 33 teeth from 33 patients with periapical lesions. Subjects were distributed among three groups. A consisted of teeth that were extracted. B consisted of teeth treated with root-canal treatment followed by apical surgery. C consisted of teeth treated with root-canal treatment only. Pre-treatment PR, ultrasound and CBCT images were obtained for Groups A, B and C and 6 month post-treatment PR and ultrasound images were obtained for Groups B and C. In addition, histopathological analysis was performed on lesions in Groups A and B. Lesions were classified as either cystic lesions or granulomas. Width, height, depth, surface area and volume of lesions were measured using the built-in softwares of the appropriate imaging modalities. Measurements were compared by Wilcoxon and paired sample t tests. Ultrasound and histopathological findings were compared with κ and Mc Nemar. Statistical significance was set at p < 0.05. RESULTS κ coefficient (0.667; p = 0.002) suggested good agreement between ultrasound and histopathology. No statistically significant differences were found among periapical radiography, CBCT and ultrasound in the pre-treatment measurements of lesion width ( p = 0.308) or between CBCT and periapical radiography in the pre-treatment measurements of lesion height ( p = 0.863). In all cases, mean measurement values for all variables were lower for ultrasound than for CBCT. CONCLUSION Ultrasound provided useful information for the diagnosis and assessment of granulomas and radicular cysts.
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Affiliation(s)
- Gül Sönmez
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Funda Yılmaz
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Cemre Koç
- Department of Endodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Emre Barış
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Ayşegül Tüzüner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Tian FC, Bergeron BE, Kalathingal S, Morris M, Wang XY, Niu LN, Tay FR. Management of Large Radicular Lesions Using Decompression: A Case Series and Review of the Literature. J Endod 2019; 45:651-659. [DOI: 10.1016/j.joen.2018.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/10/2018] [Accepted: 12/15/2018] [Indexed: 01/08/2023]
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20
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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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21
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Zainedeen O, Al Haffar I, Kochaji N, Wassouf G. The efficacy of ultrasonography in monitoring the healing of jaw lesions. Imaging Sci Dent 2018; 48:153-160. [PMID: 30276151 PMCID: PMC6148038 DOI: 10.5624/isd.2018.48.3.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to assess the reliability of ultrasonography (US) in comparison with cone-beam computed tomography (CBCT) as a tool for monitoring the healing of jaw lesions. Materials and Methods Twenty-one radiolucent lesions in jaws referred to the Oral Surgery Department at our institution were selected for this study. All lesions underwent CBCT and US examinations. The anteroposterior, superoinferior, and mesiodistal dimensions of the lesions were measured on CBCT and US images before surgery and at 6 months after surgery. The dimensions were compared between the US and CBCT images. Blood-flow velocity around the lesions was measured by color Doppler before surgery and at 1 week and 6 months after surgery to assess the capability of US to show changes in blood-flow velocity around the lesion. Results Before surgery, there were no significant differences between US and CBCT in the mesiodistal and anteroposterior dimensions, although a significant difference was found in the superoinferior dimension (P<.05). However, at 6 months after surgery, significant differences were found between US and CBCT in all dimensions, and it is likely that the US measurements more accurately reflected the extent of healing. The average blood-flow velocity increased at 1 week after surgery (5.84 cm/s) compared with the velocity before surgery (4 cm/s) (P<.05). Then, at 6 months after surgery, the blood-flow velocity significantly decreased (3.53 cm/s) compared to the velocity measured at 1 week after surgery (P<.05). Conclusion US with color Doppler was confirmed to be a more efficient tool than CBCT for monitoring bone healing.
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Affiliation(s)
- Obai Zainedeen
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Nabil Kochaji
- Department of Oral Pathology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - George Wassouf
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
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Lizio G, Salizzoni E, Coe M, Gatto MR, Asioli S, Balbi T, Pelliccioni GA. Differential diagnosis between a granuloma and radicular cyst: effectiveness of magnetic resonance imaging. Int Endod J 2018; 51:1077-1087. [PMID: 29618163 DOI: 10.1111/iej.12933] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/30/2018] [Indexed: 11/30/2022]
Abstract
AIM To investigate the diagnostic reliability and accuracy of magnetic resonance imaging (MRI) to differentiate periapical lesions of endodontic origin and to compare the results with histopathological information. METHODOLOGY The radiolucent periapical jaw lesions of 34 patients, which were surgically enucleated, were investigated by two radiologists using MRI, based on the same six criteria, to categorize the lesions as granulomas, radicular cysts or others. After apicoectomies, two oral pathologists (blinded to the radiologist's diagnoses) analysed all specimens by referring to seven specific parameters and diagnosed the specimens as granulomas, radicular cysts or other conditions. The inter-rater agreements between the radiologists and pathologists in terms of MRI and histological diagnoses, respectively, along with the discriminant power of the adopted criteria and the accuracy of the MRI assessments compared with the histopathological results, were calculated. Cohen's kappa test was adopted to examine inter-rater agreement between the two radiologists and two pathologists. Guttman's lambda coefficient (λ6 ) was used to evaluate the internal consistency of the items used for the differential diagnosis by radiologists. The accuracy resulted from a receiver operator characteristic (ROC) analysis. RESULTS A strong inter-rater reliability was observed between the two radiologists (k-statistic = 0.86, P = 0.0001) and the two pathologists (k-statistic = 0.88, P = 0.0001). The internal consistency of the diagnostic items was 0.605 for cysts and 0.771 for granulomas. The accuracy (true positives plus true negatives) of the radiologists was greater than that of the pathologists based on analysis (area under the curve = 0.87 and 0.91, respectively). CONCLUSIONS The reliability and accuracy of MRI were high and comparable to histopathological reliability, highlighting the usefulness of this noninvasive technique as a pre-treatment diagnostic method for periapical endodontic lesions.
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Affiliation(s)
- G Lizio
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Dental Clinic, Bologna, Italy
| | - E Salizzoni
- Department of Experimental, Diagnostic and Specialty Medicine, Unit of Radiology, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - M Coe
- Department of Experimental, Diagnostic and Specialty Medicine, Unit of Radiology, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - M R Gatto
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Dental Clinic, Bologna, Italy
| | - S Asioli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Unit of Surgical Pathology, Bellaria Hospital, Bologna, Italy
| | - T Balbi
- Department of Experimental, Diagnostic and Specialty Medicine, Unit of Pathology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G A Pelliccioni
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Dental Clinic, Bologna, Italy
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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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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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Trends in maxillofacial imaging. Clin Radiol 2017; 73:4-18. [PMID: 28341434 DOI: 10.1016/j.crad.2017.02.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 01/23/2017] [Accepted: 02/09/2017] [Indexed: 11/20/2022]
Abstract
Maxillofacial imaging encompasses radiology of the teeth and jaws, including the temporomandibular joints. Modalities used include intra-oral radiographs, panoramic tomography, cephalograms, cone-beam computed tomography, computed tomography, magnetic resonance imaging, ultrasound, and radionuclide imaging. Common indications for imaging are impacted and supernumerary teeth, dental implants, inflammatory dental disease, and fibro-osseous lesions, cysts, and masses of the jaws. Osteonecrosis of the jaws may follow radiotherapy or the use of bisphosphonates and other drugs. Imaging of the temporomandibular joints and the potential role of imaging in obstructive sleep apnoea are also discussed.
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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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Mehdizadeh M, Maarefat N, Bagherieh S. Comparison of Accuracy of determining the Distance between Alveolar Crest and Cementoenamel Junction in Digital Radiography with Scanora and DentalEye Software Programs. J Contemp Dent Pract 2016; 17:815-819. [PMID: 27794151 DOI: 10.5005/jp-journals-10024-1936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To compare the accuracy of determining the distance between alveolar crest and cementoenamel junction (CEJ) in digital radiography with two image processing software programs. MATERIALS AND METHODS In this in vitro study, 63 sites in a dried human mandible underwent digital periapical radiography. The distance from the alveolar crest to the CEJ was calculated using DentalEye and Scanora software programs and compared with the standard mode (measured on the skull). Statistical analysis was performed with analysis of variance (ANOVA) and paired t-test using Statistical Package for the Social Sciences (SPSS) 23 at α = 0.05. RESULTS There were significant differences in the distances between CEJ and the alveolar crest at the mesial surfaces as measured by the three techniques in standard mode, using DentalEye and Scanora (p-value ≤ 0.03) softwares; however, there were no significant differences between the results on distal surfaces (p-value = 0.248). CONCLUSION Under the limitations of the present study, the measurements made to determine the distance from the CEJ to the alveolar crest with DentalEye and Scanora, relative to each other, and relative to the standard mode, were accurate only on distal surfaces of teeth. CLINICAL SIGNIFICANCE Digital dental software programs are useful assets that can enhance the diagnosing ability and reduce the need of taking extra images.
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Affiliation(s)
- Mojdeh Mehdizadeh
- Department of Radiology, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran
| | - Negar Maarefat
- Student Research Committee, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran
| | - Shervin Bagherieh
- Student Research Committee, Faculty of Dentistry, Isfahan University of Medical Science, Isfahan, Islamic Republic of Iran, Phone: +00989132881338, e-mail:
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Laher AE, Wells M. Ultrasonographically locating the mental foramen and its soft tissue relations. Dentomaxillofac Radiol 2016; 45:20160236. [PMID: 27506296 PMCID: PMC5595029 DOI: 10.1259/dmfr.20160236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/30/2016] [Accepted: 08/09/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES This ultrasound-based cross-sectional study aimed to visualize, locate and compare the position of the mental foramen with regard to its relationship to various soft tissue landmarks. METHODS 100 Black and Caucasian subjects were included. An ultrasound transducer was used to locate the mental foramina. Distances to various landmarks were measured and compared. RESULTS All mental foramina were visualized. The mean soft tissue distance of the entire group from the mental foramen on the right and left sides, respectively, were as follows: (a) 3.4 mm [standard deviation (SD) 1.7 mm] and 3.4 mm (SD 1.5 mm) lateral to a vertical line passing through the chelion; (b) 20.1 mm (SD 2.6 mm) and 20.1 mm (SD 2.6 mm) distal to a horizontal line bisecting the chelions; (c) 15.1 mm (SD 2.4 mm) and 15.0 mm (SD 2.4 mm) proximal to the inferior border of the mandible. We found no statistically significant differences between race groups, between gender group and between age categories with regard to the horizontal soft tissue distance from a vertical line passing through the chelion to the mental foramen on the right or left sides. There were statistically significant (but not clinically significant) differences between race groups and between gender groups but not between age groups with regard to the vertical soft tissue distance from a horizontal line bisecting the chelions to the mental foramen as well as from the inferior border of the mandible to the mental foramen on both the right and left sides. CONCLUSIONS This study suggests that ultrasound is a feasible imaging modality that can be utilized to locate the mental foramen. Differences in the position of the mental foramen with regard to various soft tissue landmarks are minor and clinically insignificant.
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Affiliation(s)
- Abdullah E Laher
- Department of Emergency Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Department of Emergency Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
| | - Mike Wells
- Department of Emergency Medicine, Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South Africa
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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: 40] [Impact Index Per Article: 5.0] [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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Evirgen Ş, Kamburoğlu K. Review on the applications of ultrasonography in dentomaxillofacial region. World J Radiol 2016; 8:50-58. [PMID: 26834943 PMCID: PMC4731348 DOI: 10.4329/wjr.v8.i1.50] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/06/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
Use of ultrasonography (US) in dentomaxillofacial region became popular in recent years owing to increasing radiation dose concerns and economic limitations. It helps to visualize fine detail of the surface structure of the oral and maxillofacial tissues without ionizing radiation. In diagnostic ultrasound, high frequency sound waves are transmitted into the body by a transducer and echoes from tissue interface are detected and displayed on a screen. Sound waves are emitted via piezoelectric crystals from the ultrasound transducer. US technique can be used in dentomaxillofacial region for the examination of bone and superficial soft tissue, detection of major salivary gland lesions, temporomandibular joint imaging, assessment of fractures and vascular lesions, lymph node examination, measurement of the thickness of muscles and visualization of vessels of the neck. It has the potential to be used in the evaluation of periapical lesions and follow up of periapical bone healing. Also, it may be used for the evaluation of periodontal pocket depth and for the determination of gingival thickness before dental implantology.
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Abstract
This article provides the reader with the knowledge and skills of identification and diagnostic interpretative skills using planar images, tomographic images, CBCT, MDCT, pertinent MR images, as well as bone scans and PET images. The goal is to provide sufficient in-depth knowledge of the technique, anatomy, and radiographic identifiers for the diagnosis of local and systemic pathoses. The information will train the reader to be an advocate of selection criteria as well as a follower of the "Image Gently" campaign and philosophy supported by the organized dentistry in the United States, especially in Diagnostic Radiology.
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Affiliation(s)
- Mel Mupparapu
- Department of Oral Medicine, Robert Schattner Center, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Suite 214, Philadelphia, PA 19104, USA.
| | - Christine Nadeau
- Faculty of Dental Medicine, Université Laval, 2420, rue de la Terrasse, Québec, Québec G1V 0A6, Canada
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Effect of Cortical Bone Thickness on Detection of Intraosseous Lesions by Ultrasonography. Radiol Res Pract 2015; 2015:797593. [PMID: 26366296 PMCID: PMC4561116 DOI: 10.1155/2015/797593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 08/02/2015] [Accepted: 08/04/2015] [Indexed: 11/18/2022] Open
Abstract
Background. Usefulness of ultrasound (US) in detection of intrabony lesions has been showed. A cortical bone perforation or a very thin and intact cortical bone is prerequisite for this purpose. Objective. The current in vitro study was aimed at measuring the cut-off thickness of the overlying cortical bone which allows ultrasonic assessment of bony defects. Materials and Methods. 20 bovine scapula blocks were obtained. Samples were numbered from 1 to 20. In each sample, 5 artificial lesions were made. The lesions were made in order to increase the overlying bone thickness, from 0.1 mm in the first sample to 2 mm in the last one (with 0.1 mm interval). After that, the samples underwent ultrasound examinations by two practicing radiologists. Results. All five lesions in samples numbered 1 to 11 were detected as hypoechoic area. Cortical bone thickness more than 1.1 mm resulted in a failure in the detection of central lesions. Conclusion. We can conclude that neither bony perforation nor very thin cortical bones are needed to consider US to be an effective imaging technique in the evaluation of bony lesion.
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Khambete N, Kumar R. Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study. J Conserv Dent 2015; 18:39-43. [PMID: 25657525 PMCID: PMC4313477 DOI: 10.4103/0972-0707.148889] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 09/26/2014] [Accepted: 10/04/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. MATERIALS AND METHODS Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. RESULTS Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. CONCLUSION Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical.
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Affiliation(s)
- Neha Khambete
- Department of Oral Medicine, Diagnosis and Radiology, Chatrapati Shahu Maharaj Shikshan Sanstha Dental College and Hospital, Aurangabad, India
| | - Rahul Kumar
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India
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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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Saraf PA, Kamat S, Puranik RS, Puranik S, Saraf SP, Singh BP. Comparative evaluation of immunohistochemistry, histopathology and conventional radiography in differentiating periapical lesions. J Conserv Dent 2014; 17:164-8. [PMID: 24778515 PMCID: PMC4001275 DOI: 10.4103/0972-0707.128061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 12/21/2013] [Accepted: 12/29/2013] [Indexed: 11/05/2022] Open
Abstract
Background and Aim: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Aim: Periapical lesions often present differently on the radiograph resulting in a dilemma in the mind of the dentist to arrive at a final diagnosis. Although, histopathologic diagnosis has been used for confirmation of the true nature of periapical lesion, the concept of transformation of periapical granulomas containing epithelium without cystification into cyst remains controversial. The aim of this in vivo study was to evaluate the efficacy of conventional radiography and histopathology in differentiating periapical lesions in adjunct with immunohistochemical analysis. Materials and Method: Thirty patients having large periapical radiolucency that do not heal successfully with routine endodontic therapy in relation to either maxillary or mandibular anterior teeth were selected for the study. Intraoral periapical radiographs were obtained and provisional diagnosis of the apical areas were made. Endodontic surgery was performed to enable histopathogical investigation. The histopathological interpretation was done to arrive at a final diagnosis and selected questionable granulomas were subjected for cytokeratin (CK-14) stain. Results: The histopathological profile of lesions consisted of 66.66% periapical granulomas, 10% cysts, 6.67% abscess and 16.67% granulomas with cystic potential. The radiographic and histopathologic correlation was found in only 30% of these cases. Strong CK-14 expression was observed in all five cases of periapical granuloma with cystic potential. Conclusion: The radiographic diagnosis of periapical lesions remains inconclusive. Although histopathologic examination of periapical lesions gives true nature, the precise nature of subsets of periapical granulomas may be achieved with adjunct use of immunohistochemical markers.
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Affiliation(s)
- Prahlad A Saraf
- Departments of Conservative Dentistry and Endodontics, P M N M Dental College and Hospital, Bagalkot, Karnataka, India
| | - Sharad Kamat
- Departments of Conservative Dentistry and Endodontics, Bharathi Vidyapeeth Deemed University Dental College and Hospital, Wanlesswadi, Sangli, Maharashtra, India
| | - R S Puranik
- Departments of Oral and Maxillofacial Pathology, P M N M Dental College and Hospital, Bagalkot, Karnataka, India
| | - Surekha Puranik
- Departments of Oral Medicine Diagnosis and Radiology, P M N M Dental College and Hospital, Bagalkot, Karnataka, India
| | - Suma P Saraf
- Departments of Oral and Maxillofacial Surgery, P M N M Dental College and Hospital, Bagalkot, Karnataka, India
| | - Bhanu Pratap Singh
- Departments of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Shimla, Himachal Pradesh, India
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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: 70] [Impact Index Per Article: 7.0] [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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Bhullar Kaur R, Bhullar A, Vanaki S, Puranik R, Sudhakara M, Kamat M. A comparative histopathological & bacteriological insight into periapical lesions: An analysis of 62 lesions from north Karnataka. Indian J Dent 2013. [DOI: 10.1016/j.ijd.2012.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Szopinski KT, Regulski P. Visibility of dental pulp spaces in dental ultrasound. Dentomaxillofac Radiol 2013; 43:20130289. [PMID: 24170803 DOI: 10.1259/dmfr.20130289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study was to assess the feasibility of dental ultrasound with conventional sonographic equipment. The teeth of three adult volunteers who had cone beam CT examinations performed previously with clinical indications and one extracted tooth were examined using linear and compact (hockey stick) sonographic probes. The sonographic images were compared with cone beam CT images reconstructed accordingly. Dental pulp spaces were demonstrated in all teeth not covered with prosthetic crowns. The dentin and pulp were best visualized at the level of the neck of the teeth. The dentin was hypoechoic, and the superficial layer comprising the cementum and the pulp spaces were hyperechoic. Dental ultrasound is feasible with general purpose sonographic machines. The buccal surfaces of all teeth are accessible with a compact (hockey stick) probe. Visualization and differentiation of dental pulp spaces, dentin and the superficial layer comprising cementum is possible in the portions of teeth not covered by the alveolar bone or prosthetic crowns. The dental pulp spaces are best seen at the level of the tooth neck. Pulp and endodontic fillings can be distinguished on ultrasound.
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Affiliation(s)
- K T Szopinski
- Department of Dental and Maxillofacial Radiology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
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Park M, Kim S. A validation study on the insertion depth ranges of the five phase points by using musculoskeletal ultrasound: a pilot study. Complement Ther Med 2013; 21:641-8. [PMID: 24280473 DOI: 10.1016/j.ctim.2013.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 07/23/2013] [Accepted: 08/06/2013] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES We conducted preliminary research to validate the insertion depth ranges of the five phase points by using ultrasonography. DESIGN AND SETTING The insertion depth ranges of the five phase points were investigated by reviewing acupuncture and moxibustion literature. The following lengths were measured in centimetres in order to substitute B-cun values with centimetre values: the distance from the cubital crease to the palmar crease, from the inferior border of the medial tibia condyle to the medial malleolus, and from the popliteal crease to the prominence of the lateral malleolus. The five phase points were represented by pen marks on the skin, per the World Health Organization acupuncture point specifications. The anatomical structures of the five phase points within the insertion depth ranges were observed using colour Doppler ultrasound. RESULTS The five phase points for which the insertion depth ranges needed to be modified were LU11, HT9, PC9, LI1, LI2, SI1, SI2, TE1, ST45, BL66, GB44, SP1, SP2, LR1, and BL67. The five phase points that required careful insertion of acupuncture needles were LU8, LU9, LU10, LI5, ST36, ST41, SP3, HT4, HT7, HT8, SI3, SI8, BL40, KI2, KI3, KI10, KI27, GB34, GB38, LR3, and LR4. CONCLUSION This preliminary study provided evidence on the insertion depths in acupuncture treatment. To generate more concrete evidence regarding insertion depths, further research should be conducted in a participant group with more diverse body mass index (BMI) values by using acupoint-specific ultrasonography transducers that can measure the acupoints properly.
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Affiliation(s)
- Manyong Park
- Wonkwang University Oriental Medical Hospital, Department of Acupuncture & Moxibustion, Gwangju, South Korea
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Darshan DD, Katti G, Raviraj GA, Manikantan NS, Kumar ADM, Balakrishnan D. Sound waves for unsound entities: an electronic search study to evaluate the diagnostic efficacy of ultrasonography in cysts and tumors of maxillofacial region. J Contemp Dent Pract 2013; 14:586-9. [PMID: 24309332 DOI: 10.5005/jp-journals-10024-1368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this electronic search study was to evaluate the diagnostic efficacy of ultrasonography in cysts and tumors of maxillofacial region. MATERIALS AND METHODS An electronic search was performed for articles published from January 1989 to august 2009. RESULTS Only 30 publications were searched and 22 publications showed high level of evidence (4 review articles, 12 clinical studies, 2 case reports, 1 quantitative analysis, 2 research articles and 1 preliminary report) with total of more than 2000 patients. CONCLUSION Ultrasonography is a noninvasive, low cost procedure, and recommended as a complimentary imaging modality.
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Affiliation(s)
- D D Darshan
- Assistant Professor, Department of Oral Medicine and Radiology KVG Dental College and Hospital, Sullia, Karnataka, India, Phone: 9986220538, e-mail:
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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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Peters CI, Peters OA. Cone beam computed tomography and other imaging techniques in the determination of periapical healing. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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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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Important technical parameters are not presented in reports of intraoral digital radiography in endodontic treatment: recommendations for future studies. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:251-8.e1-6. [DOI: 10.1016/j.oooo.2012.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Revised: 01/20/2012] [Accepted: 02/22/2012] [Indexed: 01/08/2023]
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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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