Reduction of cervical vertebra ghost images in panoramic radiography using vertical dual exposure

PURPOSE

To evaluate the image quality of vertical dual-exposure panoramic radiography (PR), which merges two PR images taken at different focus heights to reduce ghost images of cervical vertebrae (CV) and intervertebral spaces (IVS) in the incisor region.

METHODS

PR images of an aluminum block, a CV phantom and a human head phantom were taken at 0 mm and merged with and subtracted from PR images taken at other heights (0, 5, 10, 15, and 20 mm) to create new images, e.g., Merg0 + 15 mm and Sub0 - 10 mm. The subtracted images were analyzed subjectively according to the uniformity on the line profile. Merged images were evaluated subjectively by six raters to determine the influence of the ghost images.

RESULTS

Objective evaluation revealed a positional shift in the ghost images according to the height of the focus for both phantoms. In the subjective evaluation, the normal PR (Merg0 + 0 mm) showed the worst score, indicating strong influence of CV and IVS ghost images.

CONCLUSION

The vertical dual-exposure PR method, which merges PR images taken at the normal position and a higher X-ray focus, can reduce CV and IVS ghost images in the incisor region.

Vertical magnification correction in vertical dual-exposure panoramic radiography

PURPOSE

To clarify the magnification error caused by the degree of tilt of the incisor and the elevation of the X-ray focus position, and the verification effect of magnification correction when performing vertical dual-exposure panoramic radiography.

METHODS

Panoramic radiographic images of a phantom embedding 26 steel balls were taken at different heights (0, 5, 10, 15, and 20 mm) and tilt angles (0°, 10°, 20°, and 30°) to evaluate vertical magnification in each condition. Error and correlation coefficients in the vertical magnifications were calculated between the measured and theoretical magnification values.

RESULTS

The more the steel ball phantom was tilted, the more the images of the uppermost steel balls were laterally stretched. In the vertical direction, image magnification also influenced the tilt angle of the object in the incisal region. The range of error in vertical magnification was -0.35-0.30%. The Spearman's rank correlation coefficient between the measured and theoretical magnification value was 0.983.

CONCLUSION

Vertical magnification correction has the potential to improve image quality when merging panoramic radiographs in vertical dual-exposure panoramic radiography.

Reduction of scratch or dirt artifacts on intraoral radiographs using dual imaging plates in image processing

OBJECTIVES

Artifacts including scratches and dirt artifacts on the digital intraoral radiographs finally contribute to making inaccurate diagnoses. The aim of this study was to reduce the incidence of artifacts using dual imaging plates (DIPs) in imaging processing.

METHODS

Conventional X-rays were taken of a porcine mandible embedded in acrylic resin using a DIP which consists of a front IP (FIP) and a back IP (BIP) with some scratches and dirt. The two images of the FIP and BIP were then synthesized and averaged to obtain a conventional DIP image. The following image processing method was used to make a DIP with artifact reduction (DIP+AR) image. A subtraction image of the FIP and BIP was constructed and the standard deviation (SD) was calculated. If the pixel value was over 3SD on the subtraction images, the pixel value of the DIP was swapped with the value on the opposite side of the non-artifact pixel. The conventional and DIP+AR images were also subjectively evaluated.

RESULTS

Image processing to create a DIP+AR image was able to reduce the number of artifacts. Medians of number of artifacts evaluated were 2.00 [interquartile range (IQR), 2.50] in DIP images and 0.67 (IQR, 1.29) in DIP+AR images, indicating a significant reduction of number of artifacts in DIP+AR images.

CONCLUSIONS

DIP+AR image processing can reduce the incidence of artifacts caused by scratches and dirt, and could extend the lifespan of the IP and contribute accurate diagnosis in oral radiology.

Correction of intraoral radiography with dual imaging plates using enlargement of the horizontal direction with division into 12 blocks

PURPOSE

The dual imaging plate (DIP) method, which synthesizes intraoral radiographs from a front imaging plate (FIP) and a back imaging plate (BIP), produces adequate image quality and allows the radiation dose to be reduced. However, there are slight errors in superimposition and alignment between the FIP and BIP. The aim of this study was to establish positional correction in the DIP method and evaluate the effect.

METHODS

Six sets of two imaging plates were used for imaging a mesh plate and a porcine mandible phantom. Subtraction images between FIP and BIP images were synthesized in four steps: correcting horizontal and vertical direction, rotation, enlargement ratio, and enlargement ratio into 12 blocks. Variance of the pixel value on the subtraction images at each step was compared to evaluate the alignment of FIP and BIP images.

RESULTS

The variance of the pixel values in the subtraction images was gradually and significantly decreased by each step of image processing (P < 0.01), indicating that the degree of alignment of FIP and BIP images improved during the image processing.

CONCLUSION

The present study revealed that it is possible to synthesize more precise DIP images using an additional four-step image processing technique.

Preliminary evaluation of dual imaging plate intraoral radiography

PURPOSE

This study evaluated the contrast-to-noise ratio (CNR), spatial resolution, and subjective quality of dual imaging plates (DIP) intraoral radiography.

METHODS

The DIP and conventional single IP (CSIP) methods both used YCR DT-1 imaging plates (Yoshida Co.). The DIP, comprising a front IP (FIP) and back IP (BIP), was constructed. DIP images were synthesized from the FIP and BIP images. An aluminum step phantom was used to measure the CNR. A line pair gauge was used to measure the spatial imaging resolution. A phantom comprising a porcine mandible embedded in acrylic resin was used for subjective evaluation.

RESULTS

The CNR of the DIP image was 32% higher than that of the FIP image. The spatial resolution achieved using the FIP, DIP, and CSIP was highly comparable except above 4 line pairs/mm, where that of the CSIP was highest. In subjective evaluation, the noise in the DIP images was significantly lower than in those obtained using the FIP and CSIP.

CONCLUSION

The CNR of the DIP was higher than that of the FIP. The decrease in spatial resolution of the DIP was limited. The subjective image quality of the DIP was higher than that of the FIP.

Newly developed mastication activity reduction procedure rapidly induces abnormal atrophic change of the mandibular condyle in young and elder experimental animal models

This study was performed to develop a new rat model of reduced masticatory activity in order to assess the effect of this reduction on the morphology of the temporomandibular joint (TMJ) over time. Female rats were used, and ovariectomy was performed to simulate aged/postmenopausal status. Twenty-four SD rats aged 6 weeks were divided into four groups: ovariectomy/sham procedure (Ov/S); ovariectomy/reduced masticatory activity (Ov/RMA); non-Ov/S (NO/S); and non-Ov/RMA (NO/RMA). The RMA procedure involved grinding down the edges of the upper and mandibular incisors by about 3 mm and supplying the rats with a powdered diet. The bilateral TMJ was examined by micro-computed tomography at 0, 1, 2, 4, 6, and 8 weeks after the start of RMA. Condylar width was greater in the NO/S group than in the Ov/S group after the 2nd week, showing that ovariectomy reduced the width of the condyle. After the 2nd week, significant differences in condylar width were apparent between the NO/S and NO/RMA groups, and between the Ov/S and Ov/RMA groups. This RMA procedure appeared to provide a good model of reduced masticatory activity. The present findings in female rats suggest that reduction of appropriate mastication activity in the growth period results in poor growth of the mandibular condyle and immediately induces atrophy of the mandibular condyle under conditions simulating aged/postmenopausal status.

Micro-CT observation of in vivo temporal change in mandibular condyle morphology in BMAL1 knockout mice

Brain and muscle Arnt-like protein-1 (BMAL1) knockout mice exhibit accelerated aging, abnormal glucose metabolism, and impaired adipocyte differentiation, among other phenotypes, which are effects associated with the BMAL1 gene. No study has investigated temporal changes in the deformation of the mandibular condyle and the presence of calcification in areas surrounding the mandibular condyle. In a study of 12 C57/BL strain mice under inhalation anesthesia, we collected images of the mandibular condyle at 6 weeks after birth and then every 5 weeks from 10 to 25 weeks after birth. At 25 weeks, deformation of the mandibular condyle was seen in 8 of 12 joints in BMAL1 knockout mice and in 2 of 12 joints in wild-type mice. At 20 and 25 weeks, deformation in areas surrounding the mandibular condyle, which are known to undergo calcification, was seen in 2 of 12 joints in BMAL1 knockout mice and in 0 of 12 joints in wild-type mice. BMAL1 knockout mice exhibited premature aging of the mandibular condyle, which suggests that circadian rhythms affect mandibular condyle morphology.

Spatial and Temporal Brain Responses to Noxious Heat Thermal Stimuli in Burning Mouth Syndrome

Burning mouth syndrome (BMS) is an idiopathic orofacial pain condition. Although the pathophysiology of BMS is not clearly understood, central and peripheral neuropathic mechanisms are thought to be involved. The authors compared brain response to noxious heat stimuli in 16 right-handed women with primary BMS and 15 sex- and age-matched right-handed healthy female controls. A thermal stimulus sequence of 32 °C to 40 °C to 32 °C to 49 °C was repeated 4 times in a cycle. Warm and noxious heat stimuli were delivered with a Peltier thermode placed on the right palm or right lower lip for 32 s each in a session. Functional magnetic resonance imaging data were obtained by recording echoplanar images with a block design. Statistical Parametric Mapping 8 software was used to analyze the data. Patients and controls both reported feeling more pain during palm stimulation than during lip stimulation. Repetition of noxious heat stimulus on the lower lip but not on the palm induced habituation in brain activity in the cingulate cortex without reduction in pain perception. Multiple regression analysis revealed a correlation between perceived pain intensity and suppression of brain activity in the anterior cingulate cortex when the repeated thermal sequence was applied at the lower lip. Furthermore, the response of the parahippocampal area differed in BMS patients and controls when the same repeated thermal sequence was applied at the palm. The authors’ findings indicate that BMS patients show specific brain responses due to impaired function of the central and peripheral nervous systems (clinical trial registration: UMIN000015002).

Short-term effects of orthognathic surgery on somatosensory function and recovery pattern in the early postoperative period

We examined the short-term surgical effects of orthognathic surgery on somatosensory function. Observations were made over a short period: 3 months postoperatively. In total, 14 patients and 32 healthy controls participated. Among the 14 patients, one underwent bilateral sagittal split osteotomy alone and 13 underwent bilateral sagittal split osteotomy in combination with a Le Fort I osteotomy. A modified quantitative sensory testing (QST) protocol (the German Research Network on Neuropathic Pain, DFNS) was used to evaluate clinically the skin of the chin for sensory disturbances before surgery and at 1 week, 1 month, and 3 months postoperatively. A visual analog scale and the Japanese Version of the McGill Pain Questionnaire were completed by all participants. Both sides of the mandible showed postoperative functional loss in cold detection threshold, warmth detection threshold, thermal sensory limen, and mechanical detection threshold. All function gradually recovered to baseline conditions at 3 months postoperatively. Cold detection threshold, warmth detection threshold, thermal sensory limen, and mechanical detection threshold appeared to be useful QST parameters for evaluating neurosensory disturbances during the early postoperative period. (J Oral Sci 58, 177-184, 2016).

p38 phosphorylation in medullary microglia mediates ectopic orofacial inflammatory pain in rats

Background

Orofacial inflammatory pain is likely to accompany referred pain in uninflamed orofacial structures. The ectopic pain precludes precise diagnosis and makes treatment problematic, because the underlying mechanism is not well understood. Using the established ectopic orofacial pain model induced by complete Freund’s adjuvant (CFA) injection into trapezius muscle, we analyzed the possible role of p38 phosphorylation in activated microglia in ectopic orofacial pain.

Results

Mechanical allodynia in the lateral facial skin was induced following trapezius muscle inflammation, which accompanied microglial activation with p38 phosphorylation and hyperexcitability of wide dynamic range (WDR) neurons in the trigeminal spinal subnucleus caudalis (Vc). Intra-cisterna successive administration of a p38 mitogen-activated protein kinase selective inhibitor, SB203580, suppressed microglial activation and its phosphorylation of p38. Moreover, SB203580 administration completely suppressed mechanical allodynia in the lateral facial skin and enhanced WDR neuronal excitability in Vc. Microglial interleukin-1β over-expression in Vc was induced by trapezius muscle inflammation, which was significantly suppressed by SB203580 administration.

Conclusions

These findings indicate that microglia, activated via p38 phosphorylation, play a pivotal role in WDR neuronal hyperexcitability, which accounts for the mechanical hypersensitivity in the lateral facial skin associated with trapezius muscle inflammation.

Efficacy of distortion correction on diffusion imaging: comparison of FSL eddy and eddy_correct using 30 and 60 directions diffusion encoding

Diffusion imaging is a unique noninvasive tool to detect brain white matter trajectory and integrity in vivo. However, this technique suffers from spatial distortion and signal pileup or dropout originating from local susceptibility gradients and eddy currents. Although there are several methods to mitigate these problems, most techniques can be applicable either to susceptibility or eddy-current induced distortion alone with a few exceptions. The present study compared the correction efficiency of FSL tools, "eddy_correct" and the combination of "eddy" and "topup" in terms of diffusion-derived fractional anisotropy (FA). The brain diffusion images were acquired from 10 healthy subjects using 30 and 60 directions encoding schemes based on the electrostatic repulsive forces. For the 30 directions encoding, 2 sets of diffusion images were acquired with the same parameters, except for the phase-encode blips which had opposing polarities along the anteroposterior direction. For the 60 directions encoding, non-diffusion-weighted and diffusion-weighted images were obtained with forward phase-encoding blips and non-diffusion-weighted images with the same parameter, except for the phase-encode blips, which had opposing polarities. FA images without and with distortion correction were compared in a voxel-wise manner with tract-based spatial statistics. We showed that images corrected with eddy and topup possessed higher FA values than images uncorrected and corrected with eddy_correct with trilinear (FSL default setting) or spline interpolation in most white matter skeletons, using both encoding schemes. Furthermore, the 60 directions encoding scheme was superior as measured by increased FA values to the 30 directions encoding scheme, despite comparable acquisition time. This study supports the combination of eddy and topup as a superior correction tool in diffusion imaging rather than the eddy_correct tool, especially with trilinear interpolation, using 60 directions encoding scheme.

Interaction of IL-1β and P2X(3) receptor in pathologic masseter muscle pain

The exact mechanism underlying chronic masseter muscle pain, a conspicuous symptom in temporomandibular disorder, remains unclear. We investigated whether expression of P2X3 receptor (P2X3R) is involved in mechanical hyperalgesia after contraction of masseter muscle (CMM). As compared with sham rats, the head-withdrawal threshold (HWT) to mechanical pressure stimulation of masseter muscle (MM) (but not after similar stimulation of facial skin) was significantly lower, and IL-1β level was significantly higher, in CMM rats on day 7 after CMM. The mean percentage of FG-labeled P2X3R-positive neurons was significantly increased in TG following successive IL-1β injections into the MM for 7 days. Successive administration of an IL-1β receptor-antagonist into the MM attenuated the increase of P2X3-IR cells in the TG. ATP release from MM after 300-g pressure stimulation of MM was also significantly enhanced after CMM. Administration into MM of the selective P2X3,2/3 receptor antagonist A-317491 attenuated the decrement of HWT in CMM rats. A significant increase in HWT was also observed at 30 min after A-317491 (60 µg) injection in IL-1β-injected rats. These findings suggest that P2X3R expression associated with enhanced IL-1β expression and ATP release in MM has a possible important role in MM mechanical hyperalgesia after excessive muscular contraction.