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Soltani P, Devlin H, Aydin U, Tafti KT, Baghaei K. Soft tissue simulant materials in X-ray-based imaging in dentomaxillofacial radiology: a scoping review. Oral Radiol 2024; 40:109-123. [PMID: 38129699 DOI: 10.1007/s11282-023-00721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION In in-vitro dental radiographic research, simulation of soft tissue is required to replicate the clinical condition as close as possible. This study aimed to find out which soft tissue simulation material have been studied to use in dentomaxillofacial radiology and showed similarity in radiodensity to the soft tissues of the maxillofacial region. METHODS In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool). RESULTS Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant. CONCLUSION Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.
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Affiliation(s)
- Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Hugh Devlin
- Division of Dentistry, The University of Manchester, Manchester, UK
- Department of Restorative Dentistry, School of Dentistry, Jordan University, Amman, Jordan
| | - Ulkem Aydin
- Department of Dentomaxillofacial Radiology, School of Dental Sciences, Cyprus Health and Social Sciences University, Morphou, North Cyprus
| | - Kioumars Tavakoli Tafti
- Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimia Baghaei
- Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
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Oliveira ML, Bornstein MM, Dagassan-Berndt D. Feasibility of frozen soft tissues to simulate fresh soft tissue conditions in cone beam CT scans. Dentomaxillofac Radiol 2024; 53:196-202. [PMID: 38290763 PMCID: PMC11003664 DOI: 10.1093/dmfr/twae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES To evaluate the feasibility of frozen soft tissues in simulating fresh soft tissues of pig mandibles using cone beam CT (CBCT). METHODS Two fresh pig mandibles with soft tissues containing 2 tubes filled with a radiopaque homogeneous solution were scanned using 4 CBCT units and 2 field-of-view (FOV) sizes each. The pig mandibles were deep-frozen and scanned again. Three cross-sections were exported from each CBCT volume and grouped into pairs, with one cross-section representing a fresh and one a frozen mandible. Three radiologists compared the pairs and attributed a score to assess the relative image quality using a 5-point scale. Mean grey values and standard deviation were obtained from homogeneous areas in the tubes, compared using the Wilcoxon matched-pair signed-rank test and subjected to Pearson correlation analysis between fresh and frozen physical states (α = .05). RESULTS Subjective evaluation revealed similarity of the CBCT image quality between fresh and frozen states. The distribution of mean grey values was similar between fresh and frozen states. Mean grey values of the frozen state in the small FOV were significantly greater than those of the fresh state (P = .037), and noise values of the frozen state in the large FOV were significantly greater than those of the fresh state (P = 0.007). Both mean grey values and noise exhibited significant and positive correlations between fresh and frozen states (P < 0.01). CONCLUSIONS The freezing of pig mandibles with soft tissues may serve as a method to prolong their usability and working time when CBCT imaging is planned.
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Affiliation(s)
- Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
| | - Dorothea Dagassan-Berndt
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
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de Oliveira Reis L, Santos-Corvini JPA, Gaêta-Araujo H, Sampaio-Oliveira M, Oliveira ML, Freitas DQ. Do voxel size and filter application on CBCT images improve the diagnosis of condylar morphological alterations? An ex vivo study. J Oral Rehabil 2024; 51:517-525. [PMID: 37941125 DOI: 10.1111/joor.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 07/11/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There is no established protocol for the low doses of cone-beam computed tomography (CBCT) acquisition and filter application on the diagnosis of condylar morphological alterations. OBJECTIVES The objective of the study was to evaluate the influence of voxel size and filter application on the diagnosis of condylar morphological alterations in CBCT using an ex vivo model. METHODS CBCT scans of 36 temporomandibular joints were acquired using OP300 Maxio with voxel sizes of 0.085, 0.125 and 0.280 mm. Three radiologists evaluated the condyles in the CBCT volumes under three filter modes: no filter, '1x' sharpen filter and '2x' sharpen filter. The area under the ROC curve, sensitivity and specificity were calculated by comparing the evaluators' responses with the reference standard and compared among experimental groups using analysis of variance (ANOVA) (α = 5%). RESULTS The area under the ROC curve, sensitivity and specificity were not affected by voxel size and filter application (p > .05). For osteophyte and flattening, there were more true-positive responses in smaller voxel size. For erosion, the increase of true- and false-positive responses occurred with a larger voxel size. Overall, there was a tendency to decrease true positives for osteophyte and erosion and increase false positives for flattening with the '2x' sharpen filter. CONCLUSIONS The diagnosis of condylar morphological alterations assessed in this ex vivo analysis is not influenced by the voxel size and the application of the filters. However, attention is needed with the occurrence of false-positive diagnosis with a larger voxel size for erosion and '2x' sharpen filter for flattening.
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Affiliation(s)
- Larissa de Oliveira Reis
- Department of Dentistry, Federal University of Juiz de Fora Campus Governador Valadares (UFJF-GV), Governador Valadares, Minas Gerais, Brazil
| | | | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Matheus Sampaio-Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Matheus L Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Yadegari A, Safi Y, Shahbazi S, Yaghoutiazar S, Ghazizadeh Ahsaie M. Assessment of CBCT gray value in different regions-of-interest and fields-of-view compared to Hounsfield unit. Dentomaxillofac Radiol 2023; 52:20230187. [PMID: 37874074 DOI: 10.1259/dmfr.20230187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVES Different factors can affect the discrepancy between the gray value (GV) measurements obtained from CBCT and the Hounsfield unit (HU) derived from multidetector CT (MDCT), which is considered the gold-standard density scale. This study aimed to explore the impact of region of interest (ROI) location and field of view (FOV) size on the difference between these two scales as a potential source of error. METHODS Three phantoms, each consisting of a water-filled plastic bin containing a dry dentate human skull, were prepared. CBCT scans were conducted using the NewTom VGi evo system, while MDCT scans were performed using Philips system. Three different FOV sizes (8 × 8 cm, 8 × 12 cm, and 12 × 15 cm) were used, and the GVs obtained from eight distinct ROIs were compared with the HUs from the MDCT scans. The ROIs included dental and bony regions within the anterior and posterior areas of both jaws. Statistical analyses were performed using SPSS v. 26. RESULTS The GVs derived from CBCT images were significantly influenced by both ROI location and FOV size (p < 0.05 for both factors). Following the comparison between GVs and HUs, the anterior mandibular bone ROI represented the minimum error, while the posterior mandibular teeth exhibited the maximum error. Moreover, the 8 × 8 cm and 12 × 15 cm FOVs resulted in the lowest and highest degrees of GV error, respectively. CONCLUSIONS The ROI location and the FOV size can significantly affect the GVs obtained from CBCT images. It is not recommended to use the GV scale within the posterior mandibular teeth region due to the potential for error. Additionally, selecting smaller FOV sizes, such as 8 × 8 cm, can provide GVs closer to the gold-standard numbers.
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Affiliation(s)
- Atiye Yadegari
- Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Shahbazi
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Yaghoutiazar
- Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ramage A, Lopez Gutierrez B, Fischer K, Sekula M, Santaella GM, Scarfe W, Brasil DM, de Oliveira-Santos C. Filtered back projection vs. iterative reconstruction for CBCT: effects on image noise and processing time. Dentomaxillofac Radiol 2023; 52:20230109. [PMID: 37665027 DOI: 10.1259/dmfr.20230109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES To assess the effect of standard filtered back projection (FBP) and iterative reconstruction (IR) methods on CBCT image noise and processing time (PT), acquired with various acquisition parameters with and without metal artefact reduction (MAR). METHODS CBCT scans using the Midmark EIOS unit of a human mandible embedded in soft tissue equivalent material with and without the presence of an implant at mandibular first molar region were acquired at various acquisition settings (milliamperages [4mA-14mA], FOV [5 × 5, 6 × 8, 9 × 10 cm], and resolutions [low, standard, high] and reconstructed using standard FBP and IR, and with and without MAR. The processing time was recorded for each reconstruction. ImageJ was used to analyze specific axial images. Radial transaxial fiducial lines were created relative to the implant site. Standard deviations of the gray density values (image noise) were calculated at fixed distances on the fiducial lines on the buccal and lingual aspects at specific axial levels, and mean values for FBP and IR were compared using paired t-tests. Significance was defined as p < 0.05. RESULTS The overall mean for image noise (± SD) for FBP was 198.65 ± 55.58 and 99.84 ± 16.28 for IR. IR significantly decreased image noise compared to FBP at all acquisition parameters (p < 0.05). Noise reduction among different scanning protocols ranged between 29.7% (5 × 5 cm FOV) and 58.1% (5mA). IR increased processing time by an average of 35.1 s. CONCLUSIONS IR significantly reduces CBCT image noise compared to standard FBP without substantially increasing processing time.
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Affiliation(s)
- Amanda Ramage
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - Kathleen Fischer
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | | | - William Scarfe
- University of Louisville School of Dentistry, Louisville, Kentucky, USA
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Dritsas K, Probst J, Ren Y, Verna C, Katsaros C, Halazonetis D, Gkantidis N. Effect of hydration on the anatomical form of human dry skulls. Sci Rep 2022; 12:22549. [PMID: 36581665 DOI: 10.1038/s41598-022-27042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
In radiology research soft tissues are often simulated on bone specimens using liquid materials such as water, or gel-like materials, such as ballistic gel. This study aimed to test the effect of hydration on the anatomical form of dry craniofacial bone specimens. Sixteen human dry skulls and 16 mandibles were scanned with an industrial scanner in dry conditions and after water embedding. Ten skulls were also embedded for different time periods (5 or 15 min). The subsequent 3D surface models were best-fit superimposed and compared by calculating mean absolute distances between them at various measurement areas. There was a significant, primarily enlargement effect of hydration on the anatomical form of dry skeletal specimens as detected after water embedding for a short time period. The effect was smaller in dry skulls (median 0.20 mm, IQR 0.17 mm) and larger in mandibles (median 0.56 mm, IQR 0.57 mm). The effect of different water embedding times was negligible. Based on the present findings, we suggest to shortly hydrate the skeletal specimens prior to reference model acquisition so that they are comparable to hydrated specimens when liquid materials are used as soft-tissue simulants for various radiologic research purposes.
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Safi Y, Ghazizadeh Ahsaie M, Jafarian Amiri M, Khalaf K. Effect of the Field of View Size on CBCT Artifacts Caused by the Presence of Metal Objects in the Exomass. Int J Dent 2022; 2022:1-10. [PMID: 36117513 PMCID: PMC9481401 DOI: 10.1155/2022/2071108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
Materials and Methods In this in vitro experimental study, titanium implants, teeth with cobalt-chromium (Co-Cr) intracanal posts, and teeth with mesio-occluso-distal (MOD) amalgam restorations were placed in an empty socket of the extracted third molar of a human mandible. These metallic materials were differently arranged in the exomass (zone outside of the FOV). A polypropylene tube containing dipotassium phosphate was placed in the empty socket of the right canine tooth in a dry human mandible. CBCT scans were taken with a NewTom VGI (Verona, Italy) scanner using a 6 × 6 cm and an 8 × 8 cm FOV. The histogram tool of OnDemand software (Cybermed, Seoul, Korea) was used to select circles with a 1.5 mm diameter as the (ROI) at the center of the homogenous solution of dipotassium phosphate tube on the axial plane. The mean gray value (GV) and its standard deviation (SD) in the region of interest (ROI) were calculated (P > 0.05). The data were analyzed by SPSS 26. Results The reduction in the size of the FOV significantly decreased the mean GV (P < 0.001). Metal objects in the exomass significantly decreased the mean GV (P < 0.001), and minimum mean GV and maximum SD were recorded for amalgam, followed by Co-Cr intracanal posts, and titanium implants. The unilateral presence of a metal object was associated with a higher mean GV and lower SD (P < 0.001). Conclusion Using a smaller FOV increases the size of the exomass, which may negatively affect the image quality. Metal objects in the exomass decrease the GV of CBCT scans and adversely affect the image quality.
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Moshfeghi M, Safi Y, Różyło-Kalinowska I, Gandomi S. Does the size of an object containing dental implant affect the expression of artifacts in cone beam computed tomography imaging? Head Face Med 2022; 18:20. [PMID: 35765076 PMCID: PMC9241278 DOI: 10.1186/s13005-022-00326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Artifacts fault image quality but handling several factors can affect it. This study was conducted to investigate the effect of object size on artifacts in cone-beam computed tomography systems. Methods Five phantoms, each containing a titanium implant in a sheep bone block, were fabricated of various sizes ranging from XS to XL: The M phantom was the same size as the device’s field of view (FOV). The L and XL phantoms were 20 and 40% larger than the FOV while the S and XS phantoms were 20 and 40% smaller than FOV, respectively. Ballistic gelatin was used to fill the phantoms. Phantoms were scanned by NewTom VGI and HDXWill Q-FACE. The mean and standard deviation (SD) of gray values in each 120 ROI was obtained by OnDemand software. The contrast to noise ratio (CNR) was also calculated. Results The gray value in S and M phantoms were more homogenous. The lowest SD value (10.20) was found in S phantom. The highest value for SD (125.16) was observed in XL phantom. The lowest (4.47) and highest (9.92) CNR were obtained in XL and S phantoms, respectively. HDXWill Q-FACE recorded a higher SD and a lower CNR than NewTom VGI (P < 0.05). Conclusion Object dimensions of the FOV size or up to 20% smaller provided better image quality. Since the dimensions of soft tissue in most patients are larger than the selective FOV, it is recommended that in CBCT artifacts studies, an object with dimensions closer to the patient’s dimensions be used to better relate the results with the clinical condition, because the sample dimensions affect the amount of artifacts.
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Affiliation(s)
- Mahkameh Moshfeghi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ingrid Różyło-Kalinowska
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Lublin, Poland
| | - Shiva Gandomi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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