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1.
  • Ahlqvist, Jan, et al. (författare)
  • A technique for the accurate administration of corticosteroids in the temporomandibular joint.
  • 1993
  • Ingår i: Dento-Maxillo-Facial Radiology. - 0250-832X .- 1476-542X. ; 22:4, s. 211-3
  • Tidskriftsartikel (refereegranskat)abstract
    • A new technique for intra-articular injection of a corticosteroid in the temporomandibular joint (TMJ) is presented. The corticosteroid is mixed with contrast medium and the administration visualized and controlled using fluoroscopy. When superior and inferior joint spaces have been filled and the soft tissues of the joint have been identified in the fluoroscopic image, additional corticosteroid can be administered to selected sites within the TMJ.
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2.
  • Ahlqvist, Jan, et al. (författare)
  • Sources of radiographic distortion in conventional and computed tomography of the temporal bone.
  • 1998
  • Ingår i: Dento-Maxillo-Facial Radiology. - 0250-832X .- 1476-542X. ; 27:6, s. 351-7
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To identify those bony regions of the glenoid fossa where, due to the inclination, there is an increased risk of radiographic distortion in conventional and computed tomography (CT).METHODS: The inclination of the roof and posterior wall of the glenoid fossa was determined relative to established imaging planes. Measurements were performed on 50 corrected coronal MR and 50 axial CT images and 200 sagittal cryosections of 50 temporomandibular joints (TMJs). The location of regions with unfavourable bone wall inclination was identified using the condyle as a reference.RESULTS: The inclination of parts of the fossa roof exceeded the limit for reliable depiction in corrected sagittal and coronal planes in 40% and 8% of the joints respectively. The inclination of parts of the posterior wall of the fossa exceeded the limit for reliable depiction in corrected sagittal and in true sagittal planes in 100% and 84% of the joints respectively. In 84% of the joints the inclination exceeded the limit for reliable depiction in the axial plane. For both bone walls the regions with unfavourable inclination were in the medial part of the joint.CONCLUSIONS: The angulation of parts of the roof and posterior wall of the glenoid fossa in relation to established imaging planes makes them highly susceptible to distortion. The oblique coronal projection is well suited for depiction of the roof of the fossa and preferable to a sagittal projection. An oblique axial projection is required for the posterior wall.
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4.
  • Ahlqvist, Jan, et al. (författare)
  • Validity of computed tomography in imaging thin walls of the temporal bone
  • 1999
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 28:1, s. 13-19
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To evaluate the validity of computed tomography (CT) for reproduction of the bone margins of the temporomandibular joint (TMJ).METHODS: Seven TMJ specimens were examined with a CT and then cryosectioned. The bone separating the TMJ from the middle cranial fossa, middle ear and external auditory canal was measured as the full width at half maximum (FWHM). Measurements were compared with the true thickness of the bone wall.RESULTS: There was good agreement when the bone walls were thicker than 1 mm: accuracy was influenced only by the angle of the bone wall to the scanning plane. Conversely, bone walls thinner than 1 mm were reproduced with a magnification that increased with decreasing bone thickness. The difference increased further as the inclination of the bone wall became greater.CONCLUSION: Measurements performed at FWHM are reliable within +/- 10% for bone walls more than approximately 1 mm thick which form an angle of less than 35 degrees to the perpendicular of the scanning plane. For bone walls thinner than 1 mm and for those thicker than 1 mm with an inclination exceeding approximately 35 degrees, partial volume effects result in a progressively increasing magnification of bone thickness.
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5.
  • Al-Okshi, Ayman, et al. (författare)
  • Dose optimization for assessment of periodontal structures in cone beam CT examinations
  • 2016
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British institute of radiology. - 0250-832X .- 1476-542X. ; 46:3
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To investigate the relationship between dose and image quality for a dedicated dental CBCT scanner using different scanning protocols and to set up an optimal imaging protocol for assessment of periodontal structures. METHODS: Radiation dose and image quality measurements were made using 3D Accuitomo 170 (J. Morita, Kyoto, Japan) dental CBCT scanner. The SedentexCT IQ phantom was used to investigate the relationship between contrast-to-noise ratio (CNR) and dose-area product. Subjective image quality assessment was achieved using a small adult skull phantom for the same range of exposure settings. Five independent observers assessed the images for three anatomical landmarks using a three-point visual grade analysis. RESULTS: When correlating the CNR of each scanning protocol to the exposure parameters used to obtain it, CNR decreased as these parameters decreased, especially current-exposure time product. When correlating to subjective image quality, the CNR level remained acceptable when 5 mA and 17.5 s or greater was selected and 80 kV could be used without compromising the CNR. CONCLUSIONS: For a dedicated CBCT unit, changing the rotation angle from 360 degrees to 180 degrees degrades image quality. By altering tube potential and current for the 360 degrees rotation protocol, assessment of periodontal structures can be performed with a smaller dose without substantially affecting visualization.
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6.
  • Al-Okshi, Ayman, et al. (författare)
  • Measurability and reliability of assessments of root length and marginal bone level in cone beam CT and intraoral radiography : a study of adolescents
  • 2019
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 48:5, s. 1-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To evaluate measurability and reliability of measurements of root length and marginal bone level in CBCT, periapical (PA) and bitewing (BW) radiographs. Methods: CBCT of both jaws, PA of maxillary incisors and posterior BW radiographs of 10 adolescents (mean age 13.4) were selected. The radiographs comprised part of the baseline examinations of a trial of orthodontic treatment. Six raters assessed measurability and measured root length and marginal bone level. Three raters repeated their assessments. Measurability was expressed as frequency of interpretable sites and reliability as intraclass correlation coefficient (ICC). Results: Measurability was 100 % in CBCT and 95 % in PA of maxillary incisors for root length measurements. For marginal bone level, measurability was 100 % in CBCT, 76 % in PA and 86 % in posterior BW. Mean ICC for interrater reliability for root length measurements in CBCT was 0.88 (range 0.27-0.96 among different teeth) and 0.69 in PA of maxillary incisors. For marginal bone level measurements, mean ICC was 0.4 in CBCT, 0.38 in PA of maxillary incisors and 0.4 in posterior BW. Intrarater reliability varied among methods, root length or marginal bone level and among raters, except for root length measurements in CBCT, which presented high reliability (above 0.8) for all raters. Conclusions: As measurability and reliability were high for root length measurements in CBCT, this may be the method of choice for scientific analyses in orthodontics. For clinical praxis, we recommend PA following the "as low as diagnostically acceptable" principle, as clinical decisions seem to be influenced only when severe root resorption occurs.
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7.
  • Al-Okshi, Ayman, et al. (författare)
  • Using GafChromic film to estimate the effective dose from dental cone beam CT and panoramic radiography
  • 2013
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 42:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To demonstrate the feasibility of GafChromic(®) XR-QA2 (ISP Corp., Wayne, NJ) as a dosemeter when performing measurements of the effective dose from three cone beam CT (CBCT) units and to compare the doses from examinations of three common dental clinical situations. A second aim was to compare the radiation doses for three digital panoramic units with the doses for the CBCT units. METHODS: The CBCT units used were Veraviewepocs 3De(®) (J Morita MFG Corp., Kyoto, Japan), ProMax(®) 3D (Planmeca, Helsinki, Finland) and NewTom VGi(®) (Quantitative Radiology, Verona, Italy). GafChromic XR-QA2 films were placed between the selected layers of the head and neck of a tissue-equivalent human skull (RANDO(®) phantom; The Phantom Laboratory, Salem, NY). The exposure parameters were set using the automatic exposure control function of the units. Depending on the availability, medium and smaller field of view (FOV) scanning modes were used. The effective dose was estimated using the 2007 International Commission on Radiological Protection formalism. RESULTS: The lowest effective dose of a CBCT unit was observed for ProMax 3D, FOV 4 × 5 cm (10 μSv), the highest for NewTom VGi, FOV 8 × 8 cm-high resolution (129 μSv). The range of effective doses for digital panoramic machines measured was 8-14 μSv. CONCLUSIONS: This study demonstrates the feasibility of using radiochromic films for dental CBCT and panoramic dosimetry.
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8.
  • Andresen, Amanda K H, et al. (författare)
  • Radiographic features in 2D imaging as predictors for justified CBCT examinations of canine-induced root resorption.
  • 2021
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 51:1
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: This retrospective observational study aimed to evaluate the diagnostic accuracy of two-dimensional radiographs on canine-induced root resorption (CIRR) in lateral incisors and identify predictors of CIRR in patients with impacted maxillary canines (IMC).METHODS: Ninety-nine patients aged 9-17 years, with 156 IMCs, were included in the study. All had CBCT-volumes and two-dimensional radiographs consisting of at least one panoramic radiograph. Two radiologists jointly viewed all cases twice. First, radiographic features related to the IMC and possible CIRR were recorded from two-dimensional radiographs. Then, CIRR was determined from CBCT and according to position and extension classified as mild, moderate and severe.RESULTS: CIRRs was detected in 80% of lateral incisors (mild: 45%; moderate: 44%; severe: 11%). The sensitivity was generally low at mild and moderate cut-offs (29 and 29%), and somewhat higher for severe (50%). Corresponding specificities were 48%, 63% and 68%. Canine cusp-tip superimposing the lateral incisor's middle third and root/crown ratio >1 was positively associated with mild CIRR, with an odds ratio (OR) of 3.8 and 6.7, respectively. In addition, the root development stage was positively associated with moderate/severe CIRR when the canine root was nearly or fully developed (OR = 3.1).CONCLUSIONS: The diagnostic accuracy of two-dimensional radiographs was inadequate for detecting CIRR amongst patients referred for CBCT examinations. Based on our results, none of the suggested two-dimensional radiographic features could predict moderate/severe CIRR except for root development stage. IMC in a later stage of root development seems to be associated with a higher risk of moderate/severe CIRR.
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11.
  • Aziman, Cinar, et al. (författare)
  • A comparative study on image quality of two digital intraoral sensors.
  • 2019
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 48:7, s. 1-5
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aims of this study were to evaluate the subjective image quality and reliability of two digital sensors. In addition, the image quality of the two sensors evaluated by specialists and general dentists were compared. METHODS: 30 intraoral bitewings from five patients were included in the study, 15 were exposed with a Dixi sensor (CCD-based) and 15 with a ProSensor (CMOS-based) using modified parallel technique. Three radiologists and three general dentists evaluated the images in pair. A five-point scale was used to register the image quality. Visual grading characteristics (VGC) analysis was performed to compare the image quality and the observer agreement was assessed in terms of intra class correlation co-efficient. RESULTS: No statistically significant difference was found on image quality between the sensors. The average scores of the observer agreement were moderate with an average of 0.66 and an interval of 0.30 to 0.87, suggesting that there was a large variation on preference of image quality. However, there was a statistically significant difference in terms of the area under the VGC- curves between the specialist group and the general dentist group ( p = 0.043), in which the specialist group tended to favor the ProSensor. CONCLUSIONS: Subjective image quality of the two intraoral sensors were comparable when evaluated by both general and oral radiologists. However, the radiologists seemed to prefer the ProSensor to the Dixi as compared to general dentists. Inter- observer conformance showed a large variation on the preference of the image quality.
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13.
  • Bagesund, M, et al. (författare)
  • Correlation between quantitative salivary gland scintigraphy and salivary secretion rates in children and young adults treated for hematological, malignant and metabolic diseases
  • 2000
  • Ingår i: Dento-Maxillo-Facial Radiology. - 0250-832X .- 1476-542X. ; 29:5, s. 264-271
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To study the correlation between whole salivary secretion rates and different variables from the radionuclide time-activity curve and to determine a reliable region for background correction in salivary gland scintigraphy. Methods: Salivary gland scintigraphy (SGS) was performed before bone marrow transplantation or more than 4 years later in 23 patients aged 13.5 (s.d. 4.9) years. Unstimulated and stimulated whole salivary secretion rates were measured before SGS. Six different methods for background correction were evaluated. Results: The unstimulated secretion rate was significantly correlated (P<0.05) with the percentage stimulated secretion (S) and reaccumulation-slope (RS) after stimulation. The stimulated secretion rate was significantly correlated with RS, S and down-slope (DS). The temporal region above the parotid glands and the area above the thyroid gland was used for subtraction of background radiation for the parotid and submandibular glands respectively showed a strong correlation between repeated measurements of the variables analysed. The mean maximum uptake was 0.73-1.34% of total dose injected. Conclusions: The salivary scintigraphic variables which correlated more strongly with salivary secretion rates were RS, S and DS. The temporal region above the parotid gland and the area above the thyroid gland can be used reliably for correction background radiation in the analysis of the time-activity curve in SGS of the parotid and submandibular glands respectively.
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14.
  • Belmans, N, et al. (författare)
  • Method validation to assess in vivo cellular and subcellular changes in buccal mucosa cells and saliva following CBCT examinations
  • 2019
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 48:6, s. 20180428-
  • Tidskriftsartikel (refereegranskat)abstract
    • Cone-beam CT (CBCT) is a medical imaging technique used in dental medicine. However, there are no conclusive data available indicating that exposure to X-ray doses used by CBCT are harmless. We aim, for the first time, to characterize the potential age-dependent cellular and subcellular effects related to exposure to CBCT imaging. Current objective is to describe and validate the protocol for characterization of cellular and subcellular changes after diagnostic CBCT. Methods: Development and validation of a dedicated two-part protocol: 1) assessing DNA double strand breaks (DSBs) in buccal mucosal (BM) cells and 2) oxidative stress measurements in saliva samples. BM cells and saliva samples are collected prior to and 0.5 h after CBCT examination. BM cells are also collected 24 h after CBCT examination. DNA DSBs are monitored in BM cells via immunocytochemical staining for γH2AX and 53BP1. 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxo-dG) and total antioxidant capacity are measured in saliva to assess oxidative damage. Results: Validation experiments show that sufficient BM cells are collected (97.1 ± 1.4 %) and that γH2AX/53BP1 foci can be detected before and after CBCT examination. Collection and analysis of saliva samples, either sham exposed or exposed to IR, show that changes in 8-oxo-dG and total antioxidant capacity can be detected in saliva samples after CBCT examination. Conclusion: The DIMITRA Research Group presents a two-part protocol to analyze potential age-related biological differences following CBCT examinations. This protocol was validated for collecting BM cells and saliva and for analyzing these samples for DNA DSBs and oxidative stress markers, respectively.
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15.
  • Belmans, N, et al. (författare)
  • Radiobiological risks following dentomaxillofacial imaging: should we be concerned?
  • 2021
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 50:6, s. 20210153-
  • Tidskriftsartikel (refereegranskat)abstract
    • This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR). Methods: Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields. Results: There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children. Conclusions In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.
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18.
  • Bou Serhal, C, et al. (författare)
  • Perioperative validation of localisation of the mental foramen
  • 2002
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British institute of radiology. - 0250-832X .- 1476-542X. ; 31:1, s. 39-43
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To assess the accuracy of panoramic radiography and spiral or computed tomography for the localisation of the mental foramen.MATERIALS AND METHODS: The distance from the alveolar crest to the mental foramen was measured from panoramic radiographs, spiral tomograms and CT scans. The same distance was measured during implant surgery using a specially designed caliper.RESULTS: Panoramic radiography showed more deviation (+0.6 mm) from the perioperative measurements than either spiral or computed tomography (+0.4 and -0.3 mm respectively). The difference was significant (P<0.05). In general, distances were overestimated on the panoramic radiographs.CONCLUSIONS: Cross-sectional imaging techniques are recommended for the pre-operative planning of implants in the posterior mandible.
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19.
  • Brasil, DM, et al. (författare)
  • Image quality optimization of narrow detector dental computed tomography for paediatric patients
  • 2019
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 48:5, s. 20190032-
  • Tidskriftsartikel (refereegranskat)abstract
    • Dental CBCT exposure parameters should be optimized according to patient-specific indications, mainly for children that are most vulnerable to harmful effects of ionizing radiation. The aim of this study was to determine optimized kV settings for paediatric acquisitions for a dental CBCT device. Methods: Clinical and quantitative evaluations of image quality were performed using 5 and 10 years old (y/o) anthropomorphic phantoms. Technical evaluation was performed with the SEDENTEXCT-IQ phantom. Images were obtained using a PaX-i3D Green CBCT (Vatech, Korea) device, combining tube voltages ranging from 85 to 110 kV and 2 fields of view (FOVs: 21 × 19 and 12 × 9 cm), while maintaining the radiation dose fixed by adjusting the mA accordingly. Clinically, observers assessed images based on overall quality, sharpness, contrast, artefacts, and noise. For quantitative evaluation, mean grey value shift, % increase standard deviation, % beam-hardening and contrast-to-noise ratio were calculated. For technical evaluation, segmentation accuracy, contrast-to-noise ratio and full width at half maximum were measured. Biplot graphs were used to choose representative parameters, from which the best kV was selected for each protocol and evaluation. kV values that had no statistical differences (p > 0.05) with the best kV chosen were considered as having the same quality. Results: Clinically, 95 kV was found as a cut-off value. From the quantitative aspect, 85 kV (p < 0.05) showed the worst quality, except in 12 × 9 cm 5 y/o. Technically, 85 and 110 kV in the large FOV showed significantly worse quality for the large FOV. Conclusion: For paediatric indications, 95 kV or higher (and correspondingly low mA values) was found as optimal.
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22.
  • Brasil, DM, et al. (författare)
  • Monitoring cone-beam CT radiation dose levels in a University Hospital
  • 2023
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 52:3, s. 20220213-
  • Tidskriftsartikel (refereegranskat)abstract
    • To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. Methods: An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. Results: A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. Conclusions: Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.
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23.
  • Brown, J, et al. (författare)
  • Basic training requirements for the use of dental CBCT by dentists : a position paper prepared by the European Academy of DentoMaxilloFacial Radiology
  • 2014
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 43:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Cone beam CT (CBCT) is a relatively new imaging modality, which is now widely available to dentists for examining hard tissues in the dental and maxillofacial regions. CBCT gives a three-dimensional depiction of anatomy and pathology, which is similar to medical CT and uses doses generally higher than those used in conventional dental imaging. The European Academy of DentoMaxilloFacial Radiology recognizes that dentists receive training in two-dimensional dental imaging as undergraduates, but most of them have received little or no training in the application and interpretation of cross-sectional three-dimensional imaging. This document identifies the roles of dentists involved in the use of CBCT, examines the training requirements for the justification, acquisition and interpretation of CBCT imaging and makes recommendations for further training of dentists in Europe who intend to be involved in any aspect of CBCT imaging. Two levels of training are recognized. Level 1 is intended to train dentists who prescribe CBCT imaging, such that they may request appropriately and understand the resultant reported images. Level 2 is intended to train to a more advanced level and covers the understanding and skills needed to justify, carry out and interpret a CBCT examination. These recommendations are not intended to create specialists in CBCT imaging but to offer guidance on the training of all dentists to enable the safe use of CBCT in the dentoalveolar region.
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26.
  • Candemil, AP, et al. (författare)
  • Influence of the exomass on the detection of simulated root fracture in cone-beam CT - an ex-vivo study
  • 2021
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 50:4, s. 20200450-
  • Tidskriftsartikel (refereegranskat)abstract
    • To evaluate the influence of exomass-related metal artefacts on the detection of simulated vertical root fracture (VRF) in cone-beam computed tomography (CBCT). Methods: Twenty teeth were endodontically instrumented and VRF was induced in half of them. All teeth were individually placed in an empty socket of a human mandible. Metallic materials were differently arranged in the exomass [zone outside of the field of view (FOV) but between the X-ray source and the receptor] and/or endomass (zone inside of the FOV), and CBCT scans were obtained. Four radiologists evaluated the presence of VRF using a 5-point scale. Sensitivity, specificity, and area under the receiver operating curve (AUC) were compared using ANOVA. Also, the tooth of interest was replaced with a tube filled with a radiopaque solution and all CBCT scans were repeated to analyse the data objectively. Mean grey and noise values were obtained from the tube and compared using ANOVA followed by Tukey’s test (α = 0.05). Results: Mean grey values were significantly lower and noise was significantly higher when metallic materials were present in the endomass or both the exomass and endomass. Sensitivity, specificity, and AUC were not influenced by the artefacts from the metallic materials irrespective of the arrangement condition. Conclusions: Exomass-related metal artefacts did not influence the diagnosis of simulated VRF in CBCT.
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27.
  • Christell, Helena, et al. (författare)
  • Variation in costs of cone beam CT examinations among health care systems
  • 2012
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 41:7, s. 571-577
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Methods: Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients’ and accompanying persons’ time, ‘‘out of pocket’’ costs for examination fee and visits). Results: The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range J148 000–227 000). Variation in indirect costs were mainly owing to examination fees (range J0–102.02). Conclusions: Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances.
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28.
  • Custódio, Antônio Luís Neto, et al. (författare)
  • Positioning accuracy assessment of minimally invasive percutaneous injection techniques for the treatment of temporomandibular disorders.
  • 2021
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 50:2
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE:The aim of the present study was to evaluate the accuracy of an extraoral CBCT-planned 3D-printed surgical guide aimed to percutaneous injection of substances into the temporomandibular joint (TMJ) and the lateral pterygoid muscle (LPM).METHODS:Nine human cadaver heads were used. Pre-planning CBCT and facial scans were obtained and three percutaneous injection sites were planned: one for the lower compartment of the TMJ and two for the LPM. A digital surgical guide was then designed with small titanium sleeves and printed by a 3D printer. After the injections, new CBCT scans with the needles in place were obtained in order to assess the accuracy of the procedure in relation to the virtual planning.RESULTS:The mean values for angle deviation were very low (range 1.13o-4.08o), the same happening for the mean difference in the length reached (range 1.82–2.64 mm), as well as for the mean difference in the needle tip dislocation (range 0.94–2.03 mm).CONCLUSION:The guide seems to be a reliable tool for accurate percutaneous injection of drugs into the inferior compartment of the TMJ and the LPM. Further studies are necessary to test the efficacy and validate the method in an in vivo study.
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29.
  • De Almeida, Fernando Jose Mota, et al. (författare)
  • CBCT influences endodontic therapeutic decision-making in immature traumatized teeth with suspected pulp necrosis : a before-after study
  • 2021
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology (BIR). - 0250-832X .- 1476-542X. ; 50:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate the impact of cone-beam computed tomography (CBCT) in endodontic therapeutic decision-making of immature traumatized teeth with suspected pulp necrosis.Methods: Over two years, consecutive patients with a dental trauma in their front teeth (apex >0.5 mm) and with suspected pulp necrosis based on clinical and radiographic findings were referred to a specialist clinic in Sweden. Fifteen patients aged 6-13 (18 teeth) were included and clinically examined by an endodontist. Intraoral radiographs and CBCT examinations were obtained. Five practitioners, three endodontists and two residents in endodontics, used these examinations to determine the most appropriate treatment for the 18 cases (all central incisors) on two occasions scheduled 19 weeks apart. On the first occasion, the practitioners had access to clinical information and the intraoral radiographs ('before' CBCT); on the second occasion, the practitioners had also access to a radiologist report and the CBCT images ('after' CBCT). Their treatment plans - no treatment, watchful waiting, endodontic orthograde treatment, or extraction - were made anonymously and independently. Results were analysed using descriptive statistics and Wilcoxon signed-rank test.Results: 'After' CBCT, practitioners changed treatment plans in 30% of the 90 assessments, 74% of which were more aggressive (p = 0.028). In 49% of the assessments, practitioners who chose the watchful and waiting treatment plan 'before' CBCT changed to a more aggressive therapy such as endodontic orthograde treatment and extraction 'after' CBCT (p = 0.005).Conclusion: This study provides evidence that CBCT influences endodontic therapeutic decision-making regarding immature traumatised teeth with suspected pulp necrosis, chiefly when expectant management (i.e., watchful and waiting) was selected before access to CBCT.
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30.
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31.
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32.
  • Economopoulos, TL, et al. (författare)
  • A contrast correction method for dental images based on histogram registration
  • 2010
  • Ingår i: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 39:5, s. 300-313
  • Tidskriftsartikel (refereegranskat)abstract
    • Contrast correction is often required in digital subtraction radiography when comparing medical data acquired over different time periods owing to dissimilarities in the acquisition process. This paper focuses on dental radiographs and introduces a novel approach for correcting the contrast in dental image pairs. The proposed method modifies the subject images by applying typical registration techniques on their histograms. The proposed histogram registration method reshapes the histograms of the two subject images in such a way that these images are matched in terms of their contrast deviation. The method was extensively tested over 4 sets of dental images, consisting of 72 registered dental image pairs with unknown contrast differences as well as 20 dental pairs with known contrast differences. The proposed method was directly compared against the well-known histogram-based contrast correction method. The two methods were qualitatively and quantitatively evaluated for all 92 available dental image pairs. The two methods were compared in terms of the contrast root mean square difference between the reference image and the corrected image in each case. The obtained results were also verified statistically using appropriate t-tests in each set. The proposed method exhibited superior performance compared with the well-established method, in terms of the contrast root mean square difference between the reference and the corrected images. After suitable statistical analysis, it was deduced that the performance advantage of the proposed approach was statistically significant.
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33.
  • Economopoulos, T, et al. (författare)
  • Automatic correspondence using the enhanced hexagonal centre-based inner search algorithm for point-based dental image registration
  • 2008
  • Ingår i: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 37, s. 185-204
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: In this paper, the enhanced hexagonal centre-based inner search (EHCBIS) algorithm, for automatic point correspondence, is proposed for dental image registration. Methods: The presented algorithm is incorporated within a general registration scheme, which is based on extracting a set of candidate points on the reference image, finding their corresponding points in the image to be transformed (float image) using the proposed algorithm and applying a suitable geometrical transformation towards automatic registration. The performance of the proposed algorithm is evaluated against three well-known methods for automatic correspondence, the self-organizing maps, the automatic extraction of corresponding points and the trimmed iterative closest point method, in terms of registration accuracy. Results: Qualitative and quantitative results on registering 123 dental pairs show that the proposed algorithm outperforms the other methods for automatic correspondence with or without the presence of noise. Conclusions: The EHCBIS method is capable of defining automatically corresponding points in dental image pairs. It can be incorporated within a general scheme for point-based registration of dental radiographs acquired with or without rigorous a priori standardization. The applied projective transformation provides a reliable model for registering intraoral radiographs. The methodology does not require any segmentation prior to alignment providing subtraction radiographs and fused images for clinical evaluation regarding the evolution of a disease or the response to a therapeutic scheme.
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34.
  • Effects of contrast equalization on energy imparted to the patient: a comparison of two dental generators and two types of intraoral film.
  • 1994
  • Ingår i: Dento-Maxillo-Facial Radiology. - 0250-832X .- 1476-542X. ; 23:2, s. 83-90
  • Tidskriftsartikel (refereegranskat)abstract
    • Technical evolution in maxillofacial radiology has in the last decade provided faster films and the constant potential generator. The consequences of these innovations for radiographic contrast and energy imparted to the patient are analysed. On the basis of physical measurements a test model has been developed for correcting exposure parameters in order to maintain or restore image contrast. These measurements are expressed in and developed from basic radiological concepts and physical formulas presented in an earlier paper (Helmrot E. et al., Dentomaxillofac. Radiol. 1991; 20: 135-46). The test model can also be used to demonstrate the balance between contrast and energy imparted to the patient in the radiographic process. Changing to constant potential generators and faster film may each result in a degradation in contrast, which is possible to restore by a controlled adjustment of the kV-setting. Maintenance of constant image quality results in a slight reduction in the net gain in energy imparted, due to the generator and/or film shift. When, for example, a conventional single-pulse generator operated at 65kVp tube potential was replaced by a modern constant potential unit, the kV-setting had to be decreased by 5 to 8 kV to maintain the same radiographic contrast. This correction could be done without increasing energy imparted to the patient, taking into account the fact that the spectral characters of the photon energy are not identical. If, in addition, faster intraoral film with lower film contrast was introduced, together with the constant potential unit, the kV-setting had to be further decreased to maintain the radiographic contrast.
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35.
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36.
  • Ekestubbe, Annika, 1953, et al. (författare)
  • Effective and organ doses from scanography and zonography: a comparison with periapical radiography.
  • 2004
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 33:2, s. 87-92
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To compare absorbed and effective doses from scanographic and zonographic examinations performed in the Scanora unit with intraoral periapical radiography. METHODS: Absorbed dose measurements were made on an anthropomorphic phantom head with LiF thermoluminescent dosemeters in the regions of the pituitary gland, eye lenses, parotid glands, submandibular glands, thyroid gland and skin. Energy imparted was calculated from the measurements of air collision kerma and effective doses by using the quotient 24 mSv J-1 between energy imparted and effective dose. The upper and lower third molar region was examined with intraoral radiographs and with ramus scanograms, dental scanograms and dental zonograms. Radiation dose measurements were also performed for Scanora panoramic radiography (jaw and dental). RESULTS: The effective doses for the ramus and dental scanograms were 0.01 mSv, similar or lower than for intraoral radiography. Zonography yielded the highest effective dose (0.03 mSv). Except for the skin doses, the salivary glands received the highest doses. Salivary gland doses were slightly higher from narrow beam than from intraoral radiography. CONCLUSIONS: Detail narrow beam radiography with the Scanora is an alternative to periapical radiography and is preferred, from a radiation dose point of view, over zonography.
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37.
  • Ekestubbe, Annika, 1953, et al. (författare)
  • Quality of digital pre-implant tomography: comparison of film-screen images with storage phosphor images at normal and low dose.
  • 2003
  • Ingår i: Dento maxillo facial radiology. - 0250-832X. ; 32:5, s. 322-6
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of this pilot study was to compare the image quality of a storage phosphor system with that of conventional film-screen in pre-implant conventional tomography, and to test the influence of radiation dose on image quality in the storage phosphor system. METHODS: Cross-sectional conventional tomographic images (Scanora) technique) were obtained on 11 patients with film-screen and with storage phosphor image plates (Digora) PCT) at normal and low doses. Ten observers graded the visibility of anatomical structures of importance for implant planning. A three-step rating scale was used, where -1 =worse, 0=equal and 1=better than the reference image. RESULTS: Although image quality was graded as equally good in the majority (59%) of images, the storage phosphor system scored significantly lower than film-screen (-0.37 vs 0.00, respectively) for all the images. Low dose storage phosphor images were rated significantly lower (-0.21) than normal dose images (0.00). CONCLUSIONS: In the majority of patients, anatomic structures of importance for implant planning are visualized equally well on storage phosphor and film-screen images. However, where differences do exist, storage phosphor images score lower than film-screen images. Dose reduction in the storage phosphor system had a negative influence on image quality.
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38.
  • Ekestubbe, Annika, 1953, et al. (författare)
  • The use of tomography for dental implant planning.
  • 1997
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 26:4, s. 206-13
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To examine the use of tomography for dental implant planning. METHODS: A questionnaire was sent to oral radiology clinics in Sweden and to implantology clinics in different parts of the world with questions on selection criteria and techniques for, and frequency of, pre-implant tomography. Differences between mean values were assessed by t-test. A new method developed by the Swedish Radiation Protection Institute was used to assess radiation absorbed dose from CT. RESULTS: Tomography was used by 93.4% of the clinics, but there was marked variation both between and within different clinical situations. It was performed in all cases by 21% and the majority used it for the evaluation of the maxilla, the posterior mandible and in single implant cases. Small clinics (< 100 patients per year) used tomography frequently and clinics in Sweden significantly more often than those in other countries. The majority had changed their policy recently, using tomography more often. CT was used by 73% of respondents, mainly the small clinics. The majority of the large clinics (> 500 patients per year) used conventional tomography. The mean absorbed dose for CT scanning protocols was 65 mGy. The variation within and between different makes of CT was considerable. CONCLUSIONS: There are large variations in frequency of use of both conventional and computed tomography for dental implant planning by different clinics who also vary in the indications for their choice. A substantial factor influencing the technique chosen was its availability rather than clinical need.
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39.
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40.
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41.
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42.
  • Fischer, Johannes, et al. (författare)
  • Observer agreement of imaging measurements used for evaluation of dentofacial deformity in juvenile idiopathic arthritis
  • 2022
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 51:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives:To examine the precision of imaging measures commonly used to assess mandibular morphology in children and adolescents with juvenile idiopathic arthritis (JIA). Secondly, to compare cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in the measurement of condylar height.Methods:Those included were children diagnosed with JIA during 2015–18 who had had an MRI, a CBCT of the temporomandibular joints (TMJs) and a lateral cephalogram (ceph) of the head within one month of each other. Agreement within and between observers and methods was examined using Bland-Altman mean-difference plots and 95% limits of agreement (LOA). A 95% LOA within 15% of the sample mean was considered acceptable. Minimal detectable change (MDC) within and between observers was estimated.Results:90 patients (33 males) were included, with a mean age of 12.8 years. For MRI, intra- and interobserver 95% LOA were relatively narrow for total mandibular length: 9.6% of the sample mean. For CBCT, condylar height, both intra- and interobserver 95% LOA were wide: 16.0 and 28.4% of the sample mean, respectively. For ceph, both intra- and interobserver 95% LOA were narrow for the SNA-angle and gonion angle: 5.9 and 8% of the sample mean, and 6.2 and 6.8%, respectively.Conclusions:We have identified a set of precise measurements for facial morphology assessments in JIA, including one MRI-based (total mandibular length), one CBCT-based (condylar height), and three ceph-based. Condylar height was higher for MRI than for CBCT; however, the measurement was too imprecise for clinical use. MDC was also determined for a series of measurements.
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43.
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44.
  • Gaeta-Araujo, H, et al. (författare)
  • Cone beam computed tomography in dentomaxillofacial radiology: a two-decade overview
  • 2020
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 49:8, s. 20200145-
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to evaluate and summarise features of currently and formerly available cone beam CT (CBCT) devices from 1996 to 2019. Additionally, a recommendation for standardised reporting of CBCT characteristics was provided. Methods and materials: Information about the features of all available CBCT devices was obtained from the manufacturers’ available data. Moreover, site visits to newly developed CBCT machines’ manufacturers were performed in order to obtain relevant information. Results: A total of 279 CBCT models from 47 manufacturers located in 12 countries (Brazil, China, Denmark, Finland, France, Germany, Italy, Japan, Republic of Korea, Slovakia, Thailand, and USA) could be listed. Overall, wide variations in CBCT features and technical specifications were identified. Conclusions: CBCT in dentomaxillofacial radiology is a generic term applicable to a broad range of CBCT machines and features. Experimental outcomes and literature statements regarding radiation doses, imaging performance and diagnostic applicability of dental CBCT cannot be simply transferred from one CBCT model to another considering a wide variation in technical characteristics and clinical diagnostic performance. The information tabulated in the present study will be later provided on the International Association of DentoMaxilloFacial Radiology website ( www.iadmfr.one ).
  •  
45.
  • Gaeta-Araujo, H, et al. (författare)
  • Two decades of research on CBCT imaging in DMFR - an appraisal of scientific evidence
  • 2021
  • Ingår i: Dento maxillo facial radiology. - : British Institute of Radiology. - 0250-832X. ; 50:4, s. 20200367-
  • Tidskriftsartikel (refereegranskat)abstract
    • This article aims to appraise how scientific evidence related to CBCT has changed over the years, based on levels of evidence and diagnostic efficacy. Methods: A general search strategy was used in different databases (Pubmed, Embase, and Web of Science) to identify systematic reviews (SRs) on CBCT until November of 2020. The SRs included were divided according to different specialties of dentistry. A critical review of the articles was made, describing the level of evidence and efficacy. Results: In total, 75 articles were selected. There was an increase in the number of SRs on CBCT from 2014 onwards, as 83% of the SRs on this topic were published after 2013, and 72% between 2016 and to date. Twenty SRs (27%) performed meta-analysis. Only 28% of the SRs provided a detailed description of CBCT protocols. According to SR evidence, almost all specialties of dentistry have advanced concomitantly with the introduction of CBCT. The majority of SRs were related to clinical applications (level 2 of efficacy), followed by technical parameters (level 1 of efficacy). Only some CBCT models were mentioned in the SRs selected. Conclusion: Over the course of 20 years, SRs related to CBCT applications for a broad range of dental specialties have been published, with the vast majority of studies at levels 1 and 2 of diagnostic efficacy. Not all CBCT models available on the market have been scientifically validated. At all times, one should remain cautious as such not to simply extrapolate in vitro results to the clinical setting. Also, considering the wide variety of CBCT devices and protocols, reported results should not be overstated or generalized, as outcomes often refer to specific CBCT devices and protocols.
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46.
  • Garoff, Maria, 1979-, et al. (författare)
  • Carotid calcification in panoramic radiographs : radiographic appearance and the degree of carotid stenosis
  • 2016
  • Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 45:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Approximately 7% of patients examined with panoramic radiographs (PRs) for odontological reasons, and with incidental findings of carotid artery calcification (CAC), have significant (≥50%) carotid stenosis (SCS). The aim of this study was to determine if the radiographic appearance of CACs in PRs could be categorized such that we could improve the positive-predictive value (PPV) for SCS detection.Methods: This cross-sectional study included 278 patients with CACs identified by PRs, 127 with SCS and 151 without SCS. CACs were categorized based on the following appearances: (1) single, (2) scattered or (3) vessel-outlining. Correlates were derived for each category according to positivity or not for SCS in the corresponding neck sides. For a representative adult population (in dentistry) presenting with CACs in PRs, PPVs for SCS prediction were then calculated for three subgroups based on different combinations of appearances (2) and/or (3).Results: Vessel-outlining CACs corresponded to 65% of neck sides with SCS vs 47% without SCS (p < 0.001). Single CACs corresponded to 15% of neck sides with SCS vs 27% without SCS (p = 0.006). Scattered CACs corresponded to 20% of neck sides with SCS vs 26% without SCS (p  = 0.127). In the representative population, the PPVs for SCS detection were comparable (7.2–7.8%) for all three subgroups and when the presence of a CAC is the sole criterion (7.4%).Conclusions: Stratifying the radiographic appearance of CACs in PRs does not improve the PPV for SCS detection. Whether different radiographic appearances are associated with future risk of stroke, or other cardiovascular events, remains unknown.
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47.
  • Geraets, Wil Gm, et al. (författare)
  • Changing trabecular patterns in panoramic radiographs of Swedish women during 25 years of follow-up.
  • 2020
  • Ingår i: Dento maxillo facial radiology. - 0250-832X. ; 49:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The radiographic trabecular pattern on dental radiographs may be used to predict fractures. The aim of this study was to analyze longitudinal changes in the mandibles of 145 females between 1980 and 2005.Panoramic radiographs were obtained in 1980 and 2005. On 290 radiographs, regions of interest (ROIs) were selected in the ramus, angle and body. In all ROIs, the orientation was measured in 36 directions with the line frequency deviation method. The effects of ageing were analyzed for the fracture and the non-fracture groups separately.During the follow-up, 61 females suffered fractures of the hip, wrist, spine, leg or arm. The fracture and non-fracture groups displayed dissimilar age changes in each investigated ROI. All significant changes pertained to increasing values of line frequency deviation. With increasing age, the trabecular network in the mandible lost details and the trabeculae became more aligned in their main direction. In the "ramus", the alignment was to the 110-120˚ axis, parallel to the posterior and anterior ramus border. In the "angle", the alignment was to the 135-150˚ axis, parallel to the oblique line, and in the "body" ROI to the 150-175˚ direction, approximately parallel to the occlusal plane and inferior cortex.Most changes were consistent with the notion that the bone aged less severely in the non-fracture group. In the fracture group, the findings indicate that bone loss leads to redistribution of the remaining bone tissue in such a way that the trabeculae are accentuated perpendicular to the principal loading.
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48.
  • Geraets, Wil GM, et al. (författare)
  • Selecting regions of interest on intraoral radiographs for the prediction of bone mineral density
  • 2008
  • Ingår i: Dento-Maxillo-Facial Radiology. - : Oxford University Press (OUP). - 0250-832X .- 1476-542X. ; 37:7, s. 375-379
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: A previous study showed that the trabecular pattern on dental radiographs correlates with femoral and spinal bone mineral density (BMD). The objective of this study was to determine if the correlation is affected by the size and location of the region of interest (ROI). METHODS: In a European research project on osteoporosis, BMD was measured at the left hip and the lumbar spine of 525 women. From all subjects, intraoral radiographs were made of the premolar region in the upper and lower jaws. Two ROIs were indicated manually on each scanned image. The smallest region involved only trabecular bone and the largest also included parts of the neighbouring teeth. The ROIs were subjected to automatic image analysis, yielding 26 measurements per ROI. Stepwise linear regression was used to predict femoral and spinal BMD. RESULTS: Inner and outer regions predicted BMD equally well. The radiographs of lower and upper jaw also predicted BMD equally well. Combining inner and outer regions did not improve the prediction of femoral and spinal BMD, but combining lower and upper jaws did. CONCLUSIONS: This study shows that it is possible to include parts of neighbouring teeth in the ROI used to assess the trabecular pattern and predict BMD. This simplifies the process of selecting the ROIs because no efforts have to be made to exclude neighbouring teeth. Combining ROIs of lower and upper jaws significantly improves the prediction of BMD.
  •  
49.
  • Gullberg, Joanna, et al. (författare)
  • The challenge of applying digital image processing software on intraoral radiographs for osteoporosis risk assessment
  • 2022
  • Ingår i: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 51:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The purpose of this study was to evaluate rater agreement and the accuracy of a semi-automated software and its fully automated tool for osteoporosis risk assessment in intraoral radiographs. Methods: A total of 567 intraoral radiographs was selected retrospectively from women aged 75-80 years participating in a large population based study (SUPERB) based in Gothenburg, Sweden. Five raters assessed participants' risk of osteoporosis in the intraoral radiographs using a semi-automated software. Assessments were repeated after 4 weeks on 121 radiographs (20%) randomly selected from the original 567. Radiographs were also assessed by the soft wares' fully automated tool for analysis. Results: Overall interrater agreement for the five raters was 0.37 (95% CI 0.32-0.41), and for the five raters with the fully automated tool included as 'sixth rater' the overall Kappa was 0.34 (0.30-0.38). Intrarater agreement varied from moderate to substantial according to the Landis and Koch interpretation scale. Diagnostic accuracy was calculated in relation to reference standard for osteoporosis diagnosis which is T score values for spine, total hip and femoral neck and presented in form of sensitivities, specificities, predictive values, likelihood ratios and odds ratios. All raters' mean sensitivity, including the fully automated tool, was 40,4% (range 14,3%-57,6%). Corresponding values for specificity was 69,5% (range 59,7%-90,4%). The diagnostic odds ratios ranged between 1 and 2.7. Conclusion: The low diagnostic odds ratio and agreement between raters in osteoporosis risk assessment using the software for analysis of the trabecular pattern in intraoral radiographs shows that more work needs to be done to optimise the automation of trabecular pattern analysis in intraoral radiographs.
  •  
50.
  • Gullberg, Joanna, et al. (författare)
  • The outcome of an automated assessment of trabecular pattern in intraoral radiographs as a fracture risk predictor
  • 2022
  • Ingår i: Dentomaxillofacial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 51:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This study aims to investigate if automated analyses of the trabecular pattern in intraoral radiographs independently contribute to fracture risk assessment when other risk factors incorporated in the Fracture Risk Assessment Tool (FRAX) are taken into account. A secondary aim is to explore the correlation between the automated trabecular pattern assessment in intraoral radiographs and Trabecular Bone Score (TBS). Methods: A total of 567 intraoral radiographs from older females participating in a large population-based study (SUPERB) based in Gothenburg, Sweden, were selected to analyse trabecular pattern using semi-automated and fully automated software. Associations between trabecular pattern analysis and incident fractures were studied using Cox proportional hazard model, unadjusted and adjusted for FRAX risk factors (previous fracture, family history of hip fracture, smoking, corticosteroids, rheumatoid arthritis, without and with bone mineral density (BMD) of the femoral neck). In addition, the correlation between trabecular pattern analysis and TBS of the lumbar spine was investigated using Pearson correlation analysis. Results: Neither the unadjusted nor the adjusted trabecular pattern analysis in intraoral radiographs was significantly associated with any fracture or major osteoporotic fracture (MOF). A weak correlation was found between semi-automated trabecular pattern analysis and TBS. No correlation was found between the fully automated trabecular pattern analysis and TBS. Conclusions: The present study shows that semi-automated and fully automated digital analyses of the trabecular pattern in intraoral radiographs do not contribute to fracture risk prediction. Furthermore, the study shows a weak correlation between semi-automated trabecular pattern analysis and TBS.
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