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Burian E, Lenhart N, Greve T, Bodden J, Burian G, Palla B, Probst F, Probst M, Beer M, Folwaczny M, Schwarting J. Detection of caries lesions using a water-sensitive STIR sequence in dental MRI. Sci Rep 2024; 14:663. [PMID: 38182726 PMCID: PMC10770403 DOI: 10.1038/s41598-024-51151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Neuroradiology, Kantonsspital Frauenfeld, Thurgau AG, Frauenfeld, Switzerland.
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, Chicago, USA
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, 80337, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Burian E, Feuerriegel G, Sollmann N, Burian G, Palla B, Griesbauer M, Bumm C, Probst M, Beer M, Folwaczny M. Visualization of clinically silent, odontogenic maxillary sinus mucositis originating from periapical inflammation using MRI: a feasibility study. Clin Oral Investig 2023:10.1007/s00784-023-04986-4. [PMID: 37039958 DOI: 10.1007/s00784-023-04986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the following clinical question: among patients with periapical inflammatory processes in the maxilla, does the use of magnetic resonance imaging (MRI), as compared to conventional periapical (AP) and panoramic radiography (OPT), improve diagnostic accuracy? METHODS Forty-two subjects with generalized periodontitis were scanned on a 3 T MRI. Sixteen asymptomatic subjects with mucosal swelling of the maxillary sinus were enrolled in the study. Periapical edema was assessed using short tau inversion recovery (STIR) sequence. Apical osteolysis and mucosal swelling were assessed by MRI, AP, and OPT imaging using the periapical index score (PAI). Comparisons between groups were performed with chi-squared tests with Yates' correction. Significance was set at p < 0.05. RESULTS Periapical lesions of maxillary premolars and molars were identified in 16 subjects, 21 sinuses, and 58 teeth. Bone edema and PAI scores were significantly higher using MRI as compared to OPT and AP (p < 0.05). Using the STIR sequence, a significant association of PAI score > 1 and the presence of mucosal swelling in the maxillary sinus was detected (p = 0.03). CONCLUSION Periapical inflammation and maxillary mucositis could be visualized using STIR imaging. The use of MRI may help detect early, subtle inflammatory changes in the periapical tissues surrounding maxillary dentition. Early detection could guide diagnostic criteria, as well as treatment and prevention.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, IL, USA
| | - Magdalena Griesbauer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caspar Bumm
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
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Reliability and accuracy of dental MRI for measuring root canal length of incisors and canines: a clinical pilot study. Sci Rep 2022; 12:14068. [PMID: 35982139 PMCID: PMC9388478 DOI: 10.1038/s41598-022-17889-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
To evaluate whether high-resolution, non-contrast-enhanced dental MRI (dMRI) can reliably and accurately measure the canal length of incisors and canines compared with cone-beam computed tomography (CBCT). Three-Tesla dMRI was performed in 31 participants (mean age: 50.1 ± 14.2 years) with CBCT data. In total, 67 teeth were included (28 from the upper jaw and 39 from the lower jaw; 25 central incisors, 22 lateral incisors, and 20 canines). CBCT and dMRI datasets were reconstructed to visualize the root canal pathway in a single slice in the vestibulo-oral (V-O) and mesio-distal (M-D) direction. Root canal length was measured twice by two radiologists using dMRI and CBCT. Data were statistically analyzed by calculating intraclass correlation coefficients (ICCs) and performing Bland–Altman analysis. The reliability of dMRI measurements was excellent and comparable to that of CBCT measurements (intra-rater I/intra-rater II/inter-rater was 0.990/0.965/0.951 for dMRI vs. 0.990/0.994/0.992 for CBCT in the M-D direction and 0.991/0.956/0.967 for dMRI vs. 0.998/0.994/0.996 for CBCT in the V-O direction). According to Bland–Altman analysis, the mean (95% confidence interval) underestimation of root canal lengths was 0.67 mm (− 1.22 to 2.57) for dMRI and 0.87 mm (− 0.29 to 2.04) for CBCT in the M-D direction/V-O direction. In 92.5% of cases, dMRI measurements of canal length had an accuracy within 0–2 mm. Visualization and measurement of canal length in vivo using dMRI is feasible. The reliability of dMRI measurements was high and comparable to that of CBCT measurements. However, the spatial and temporal resolution of dMRI is lower than that of CBCT, which means dMRI measurements are less accurate than CBCT measurements. This means dMRI is currently unsuitable for measuring canal length in clinical practice.
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Capuani S, Gambarini G, Guarnieri R, Di Pietro G, Testarelli L, Di Nardo D. Nuclear Magnetic Resonance Microimaging for the Qualitative Assessment of Root Canal Treatment: An Ex Vivo Preliminary Study. Diagnostics (Basel) 2021; 11:1012. [PMID: 34205946 PMCID: PMC8228494 DOI: 10.3390/diagnostics11061012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 02/07/2023] Open
Abstract
AIM To assess the potential ability of nuclear magnetic resonance micro-imaging (mMRI) to visualize and identify soft tissue debris and unfilled spaces inside radicular canals in endodontic treated extracted teeth, for understanding the causes of treatment failure. Toward this goal, multi-parametric mMRI and cone beam computed tomography (CBCT) were compared. METHODOLOGY A non-recoverable root treated human tooth was extracted due to endodontic failure and excessive mobility. It was examined with both CBCT and mMRI: CBCT was performed with 0.125 mm voxel size (GXCB-500, Kavo-Gendex, Brea, CA, USA) and mMRI was performed with a spectrometer operating at 9.4T magnetic field (Bruker Avance-400, Bruker, Billerica, MA, USA). The mMRI images were obtained with a microimaging probe. Relaxation times (T1 and T2) and diffusion-weighted acquisition sequences were used to obtain multi-parametric maps of the extracted tooth (slice thickness of 200 µm and in plane resolution of 30 × 30 µm2). RESULTS T1 and T2 maps identified unfilled spaces around and close to Gutta-percha cones instead of CBCT images that were not able to highlight this aspect. T1, T2 and apparent diffusion coefficient (ADC) assumed different values in dentine and in voids, characterized by different dimensions. Moreover, they were able to discriminate between infiltrations of water only and deposits of biological material. Because Gutta-percha cones are constituted of hard, non-porous material, they do not provide a signal and in mMRI images appear as zones of noise. CONCLUSIONS Unlike the CBCT exam, mMRI can detect soft tissue debris and unfilled spaces inside radicular canals. Therefore, this in vitro study showed the potential of mMRI to evaluate the quality of the root canal treatment, suggesting its potential benefit in determining the causes of endodontic failure, without the use of ionizing radiation.
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Affiliation(s)
- Silvia Capuani
- CNR ISC c/o Physics Department, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (G.D.P.)
- Museo Storico Della Fisica e Centro Studi e Ricerche Enrico Fermi, 00185 Rome, Italy
| | - Gianluca Gambarini
- Department of Oral and Maxillo Facial Sciences, Sapienza Università di Roma, 00161 Rome, Italy; (G.G.); (R.G.); (D.D.N.)
| | - Renzo Guarnieri
- Department of Oral and Maxillo Facial Sciences, Sapienza Università di Roma, 00161 Rome, Italy; (G.G.); (R.G.); (D.D.N.)
| | - Giulia Di Pietro
- CNR ISC c/o Physics Department, Sapienza University of Rome, 00185 Rome, Italy; (S.C.); (G.D.P.)
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, Sapienza Università di Roma, 00161 Rome, Italy; (G.G.); (R.G.); (D.D.N.)
| | - Dario Di Nardo
- Department of Oral and Maxillo Facial Sciences, Sapienza Università di Roma, 00161 Rome, Italy; (G.G.); (R.G.); (D.D.N.)
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Yang X, Song C, Zhang L, Wang J, Yu X, Yu B, Zablotskii V, Zhang X. An upward 9.4 T static magnetic field inhibits DNA synthesis and increases ROS-P53 to suppress lung cancer growth. Transl Oncol 2021; 14:101103. [PMID: 33930848 PMCID: PMC8102172 DOI: 10.1016/j.tranon.2021.101103] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/08/2021] [Accepted: 04/12/2021] [Indexed: 12/20/2022] Open
Abstract
Upward 9.4 T SMF exposure for 88 h significantly inhibited A549 tumor growth in mice. 9.4 T SMF treatment for 88 h had no severe impairment to the mice key organs or blood cell count. Upward 9.4 T SMF treatment for 24 h caused A549 DNA synthesis inhibition. Upward 9.4 T SMF treatment for 24 h significantly increased ROS and P53 levels, and caused G2 cell cycle arrest.
Studies have shown that 9.4 Tesla (9.4 T) high-field magnetic resonance imaging (MRI) has obvious advantages in improving image resolution and capacity, but their safety issues need to be further validated before their clinical approval. Meanwhile, emerging experimental evidences show that moderate to high intensity Static Magnetic Fields (SMFs) have some anti-cancer effects. We examined the effects of two opposite SMF directions on lung cancer bearing mice and found when the lung cancer cell-bearing mice were treated with 9.4 T SMFs for 88 h in total, the upward 9.4 T SMF significantly inhibited A549 tumor growth (tumor growth inhibition=41%), but not the downward 9.4 T SMF. In vitro cellular analysis shows that 9.4 T upward SMF treatment for 24 h not only inhibited A549 DNA synthesis, but also significantly increased ROS and P53 levels, and arrested G2 cell cycle. Moreover, the 9.4 T SMF-treatments for 88 h had no severe impairment to the key organs or blood cell count of the mice. Our findings demonstrated the safety of 9.4 T SMF long-term exposure for their future applications in MRI, and revealed the anti-cancer potential of the upward direction 9.4 T SMF.
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Affiliation(s)
- Xingxing Yang
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Chao Song
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Lei Zhang
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - Junjun Wang
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Institutes of Physical Science and Information Technology, Anhui University, Hefei 230601, China
| | - Xin Yu
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Biao Yu
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Vitalii Zablotskii
- Institute of Physics of the Czech Academy of Sciences, Prague 18221, Czechia; International Magnetobiology Frontier Research Center (iMFRC), Science Island, 230031, China
| | - Xin Zhang
- CAS Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui 230031, China; Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, Anhui 230026, China; Institutes of Physical Science and Information Technology, Anhui University, Hefei 230601, China; International Magnetobiology Frontier Research Center (iMFRC), Science Island, 230031, China.
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Leontiev W, Bieri O, Madörin P, Dagassan-Berndt D, Kühl S, Krastl G, Krug R, Weiger R, Connert T. Suitability of Magnetic Resonance Imaging for Guided Endodontics: Proof of Principle. J Endod 2021; 47:954-960. [PMID: 33774047 DOI: 10.1016/j.joen.2021.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This proof-of-principle study aimed to demonstrate that magnetic resonance imaging (MRI) is sufficiently accurate for the detection of root canals using guided endodontics. METHODS One hundred extracted human teeth (anterior and premolar) were mounted onto 5 mandibular and 5 maxillary models, fitted with splints designed to accommodate a thin layer of aqueous gel for indirect imaging, and scanned by MRI. After MRI and intraoral scans were aligned using planning software, access cavities were planned virtually, and templates were manufactured with computer-aided design/computer-aided manufacturing, the access cavities were prepared. Cone-beam computed tomographic scans were performed and matched with the virtual preoperative planning data to determine the accuracy of access cavity preparation in terms of deviation between planned and prepared cavities in the mesiodistal and buccolingual dimensions and angle. Descriptive statistical analysis was performed, and the mean values were compared using the t test. RESULTS Ninety-one of 100 root canals were successfully scouted after MRI-guided access cavity preparation. The mean angle deviation was 1.82°. The mean deviation ranged from 0.21-0.31 mm at the base of the bur and from 0.28-0.44 mm at the tip of the bur. Preparation in the buccolingual dimension was significantly more precise in mandibular compared with maxillary teeth, and accuracy in the mesiodistal dimension was more precise in anterior teeth compared with premolars. CONCLUSIONS This in vitro study demonstrated the suitability of MRI for guided endodontic access cavity preparation.
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Affiliation(s)
- Wadim Leontiev
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
| | - Philipp Madörin
- Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Ralf Krug
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
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