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de Freitas BN, da Motta RJG, Pauwels R, Oliveira-Santos C, Tirapelli C. Influence of metal artefact reduction on the diagnosis of contact between implant and mandibular canal in cone beam computed tomography: An ex-vivo study. Clin Oral Implants Res 2023; 34:741-750. [PMID: 37246310 DOI: 10.1111/clr.14100] [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: 01/05/2023] [Revised: 04/23/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the influence of metal artefact reduction (MAR) in the diagnosis of dental implant contact with the mandibular canal (MC) using cone beam computed tomography (CBCT). METHODS Dental implants were installed with surgical guides in the posterior hemiarches of 10 dry human mandibles: 0.5 mm above to the MC cortex (G1/n = 8) and 0.5 mm inside the MC (G2/n = 10). The experimental set-up was scanned with two CBCT equipment using 85 kV and 90 kV, MAR ON or OFF, and different tube currents (4 mA, 8 mA and 10 mA). Two dentomaxillofacial radiologists (DMFRs) and two dentists (DDS) scored the relation between the dental implant and MC. Descriptive statistics were used to observe the absolute frequency of scores. Sensitivity, specificity and accuracy were calculated considering the known relation between the dental implant and the MC interior. McNemar's test (α = .05) was applied to compare the diagnostic efficacy of MAR ON versus MAR OFF. RESULTS Overall specificity was higher than sensitivity for both DDS and DMFR (97% vs. 50% and 92.0% vs. 78.0% respectively). There was a significant effect of MAR (p = .031) for DMFR in the case of contact between the dental implant with the MC interior, in which sensitivity decreased with MAR activation from 90% to 40%. DMFR observers showed a better diagnostic performance compared with the DDS observers (accuracy of 84.0% and 71.0%, respectively). CONCLUSIONS Due to the limited efficacy of MAR, it should not be used when conducting CBCT scans for the evaluation of contact between the implant and the mandibular canal.
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Affiliation(s)
- Bruna Neves de Freitas
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Raphael Jurca Gonçalves da Motta
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Lee JH, Lee HL, Park IY, On SW, Byun SH, Yang BE. Effectiveness of creating digital twins with different digital dentition models and cone-beam computed tomography. Sci Rep 2023; 13:10603. [PMID: 37391453 PMCID: PMC10313775 DOI: 10.1038/s41598-023-37774-x] [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: 09/09/2022] [Accepted: 06/27/2023] [Indexed: 07/02/2023] Open
Abstract
Distortion of dentition may occur in cone-beam computed tomography (CBCT) scans due to artifacts, and further imaging is frequently required to produce digital twins. The use of a plaster model is common; however, it has certain drawbacks. This study aimed to assess the feasibility of different digital dentition models over that of plaster casts. Plaster models, alginate impressions, intraoral scan (IOS) images, and CBCT images of 20 patients were obtained. The desktop model scanner was used to scan the alginate impression twice, five minutes and two hours after impression-making. Using an IOS, the full arch was scanned in segments using CS 3600 and simultaneously with i700 wireless. The digital twins obtained from the alginate impression and IOS were superimposed with those obtained from the plaster cast. The differences and distances at each reference point were measured. Scans of alginate impressions after two hours showed the greatest discrepancies, but these were all less than the CBCT voxel size of 0.39 mm. Alginate impression scans and IOS are suitable supplements to CBCT compared to the plaster model. Accuracy can be improved by scanning the alginate impression within five minutes or by intraoral scanning of the entire arch with segmentation.
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Affiliation(s)
- Joo-Hee Lee
- Division of Pediatric Dentistry, Hallym University Sacred Heart Hospital, Anyang, 14066, Korea
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
| | - Hye-Lim Lee
- Division of Pediatric Dentistry, Hallym University Sacred Heart Hospital, Anyang, 14066, Korea
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
| | - In-Young Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
| | - Sung-Woon On
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
| | - Soo-Hwan Byun
- Division of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, 14066, Korea
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea
| | - Byoung-Eun Yang
- Division of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, 14066, Korea.
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea.
- Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252, Korea.
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Hassan NA, Al-radha ASD. CBCT Evaluation of Quality and Quantity of Bones for Immediate Implant Treatment Planning in Central Incisor Area in relation to Arch Form. ScientificWorldJournal 2023; 2023:8863318. [PMID: 37101786 PMCID: PMC10125741 DOI: 10.1155/2023/8863318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
Understanding the quality of the ridge and facial cortical bone in the aesthetic zone is important for treatment with an immediate dental implant. This study aimed to analyze bone density and widths of the facial cortical bone and alveolar ridge at the central incisors in relation to arch form. A total of 400 teeth from 100 cone-beam CT images were divided equally between the upper and lower central incisors. The central incisor area was assessed for the width of the facial cortical and alveolar bones at three different points (3 mm, 6 mm, and 9 mm from the cementoenamel junction). Arch forms and densities of cortical and cancellous bones in the interradicular regions were evaluated. The difference in facial cortical bone thickness at 3 points was smaller for the upper teeth than for the lower teeth on both sides. The alveolar bone width was higher in the maxilla than the mandible with highly significant differences (P < 0.001). The highest bone density was at the buccal aspect of the mandible (897.36 ± 136.72 HU), while the lowest density was at the cancellous bone of the maxilla (600.37 ± 126.63 HU). The dominant arch form was ovoid 71%, followed by square 20% and the tapering arch form 10%. The tapering arch form has the highest alveolar bone width in the upper jaw without statistical significance. The facial cortical bone thickness needs to be evaluated before implantation in the anterior region because it is less than two millimeters in both jaws. CBCT is important for the immediate implant. The ovoid shape was the dominant arch form.
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Affiliation(s)
- Nuhad A. Hassan
- Oral Medicine Department, College of Dentistry, Al-Mustansiriyah University, Baghdad, Iraq
| | - Afya Sahib Diab Al-radha
- Oral Surgery and Periodontology Department, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
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Influence of Exposure Parameters and Implant Position in Peri-Implant Bone Assessment in CBCT Images: An In Vitro Study. J Clin Med 2022; 11:jcm11133846. [PMID: 35807131 PMCID: PMC9267359 DOI: 10.3390/jcm11133846] [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: 05/11/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to assess the impact of dimensional distortion and its changes with modification of exposure setting parameters on the measurements of peri-implant bone margin. Ten titanium dental implants (InKone Primo, Global D, Paris, France) were placed in two prepared bovine ribs. Two bone models and an implant-with-transfer model were scanned with 3shape E4 (3shape, Copenhagen, Denmark) laboratory scanner. Cone beam computed tomography (CBCT) images of two bone models were taken with different values of voltage (60, 70, 80, 90 kV), tube current (4, 10 mA) and voxel size (200, 300 µm). All the data were superimposed using planning software, and the measurements of buccal bone thickness in two selected regions were performed both using CBCT and scan cross-sections. The mean squared error (MSE) being the squared differences between measurements was used in the accuracy assessment of the CBCT device. A one-way ANOVA revealed significant differences between voltage and MSE (p = 0.044), as well as implant position and MSE (p = 0.005). The distortions of measurements depend on bone margin thickness, and the higher the distance to measure, the higher the error. Accurate measurements of buccal bone thickness (MSE below 0.25) were achieved with voltage values of 70, 80, and 90 kV.
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