Advances in Oral and Maxillofacial Diagnostic Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 11501

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Guest Editor
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
Interests: dentomaxillofacial radiology; CBCT; digital radiology; implant radiology; micro CT; T rays and dentistry
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Special Issue Information

Dear Colleagues,

Radiology has always been an integral part of clinical dentistry in the fields of surgery, implantology, pathology, endodontics and conservative and prosthetic rehabilitation along with orthodontics. Intraoral imaging continues to provide the best spatial resolution of any imaging method currently available, whether digital or film. However, as spatial information is lost when it collapses into a two-dimensional image, two or three intraoral radiographs taken from different angles are recommended in most cases. Beam angle, exposure, receptor sensitivity, processing, viewing conditions, and the localization of the lesion overlap of anatomical structures may all affect intraoral periapical imaging. Panoramic radiography, in which images of both jaws are obtained through the synchronized rotation of an X-ray source and image receptor around a motionless patient, can broadly cover both jaws and teeth without the anatomical detail available with intraoral radiography. Additionally, due to the distance between the radiation source, object, and image receiver, there is a magnification factor associated with image formation, and the projection geometry causes image distortion and the significant overlap of dental crowns. The correct preparation and positioning of patients is required to reduce the level of image degradation and ensure that image quality is not affected by ghost images. Unlike intraoral and panoramic techniques, which by their nature cannot be used to obtain information about the third dimension of teeth and adjacent structures and therefore can only provide limited information about the origin, size and location of lesions, medical computed tomography (CT) devices can provide three-dimensional images of the maxillofacial region. However, high patient doses, high costs and a lack of availability hinder the routine use of medical CT in dentistry. In response to the high demand for a technique that can provide three-dimensional data at lower costs and with lower radiation doses than conventional CT used in medical radiology, cone-beam computed tomography (CBCT) was developed and introduced specifically for dento-beam maxillofacial imaging. Magnetic Resonance Imaging and Ultrasound Imaging are other techniques which use non-ionized radiation and are increasingly used in routine dental clinic applications. Recently, 3d printing applications and the integration of artificial intelligence in oral diagnostic imaging have attracted significant attention. In this Special Issue, we will focus on different advanced application areas of diagnostic imaging for various dental specialties.

Prof. Dr. Kıvanç Kamburoğlu
Guest Editor

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Keywords

  • radiology
  • diagnostic imaging
  • dentistry

Published Papers (8 papers)

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12 pages, 2092 KiB  
Article
Usefulness of T2-Weighted Images with Deep-Learning-Based Reconstruction in Nasal Cartilage
by Yufan Gao, Weiyin (Vivian) Liu, Liang Li, Changsheng Liu and Yunfei Zha
Diagnostics 2023, 13(19), 3044; https://doi.org/10.3390/diagnostics13193044 - 25 Sep 2023
Viewed by 764
Abstract
Objective: This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. Materials and Methods: This retrospective study included 190 set images of 38 participants, [...] Read more.
Objective: This study aims to evaluate the feasibility of visualizing nasal cartilage using deep-learning-based reconstruction (DLR) fast spin-echo (FSE) imaging in comparison to three-dimensional fast spoiled gradient-echo (3D FSPGR) images. Materials and Methods: This retrospective study included 190 set images of 38 participants, including axial T1- and T2-weighted FSE images using DLR (T1WIDL and T2WIDL, belong to FSEDL) and without using DLR (T1WIO and T2WIO, belong to FSEO) and 3D FSPGR images. Subjective evaluation (overall image quality, noise, contrast, artifacts, and identification of anatomical structures) was independently conducted by two radiologists. Objective evaluation including signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was conducted using manual region-of-interest (ROI)-based analysis. Coefficient of variation (CV) and Bland–Altman plots were used to demonstrate the intra-rater repeatability of measurements for cartilage thickness on five different images. Results: Both qualitative and quantitative results confirmed superior FSEDL to 3D FSPGR images (both p < 0.05), improving the diagnosis confidence of the observers. Lower lateral cartilage (LLC), upper lateral cartilage (ULC), and septal cartilage (SP) were relatively well delineated on the T2WIDL, while 3D FSPGR showed poorly on the septal cartilage. For the repeatability of cartilage thickness measurements, T2WIDL showed the highest intra-observer (%CV = 8.7% for SP, 9.5% for ULC, and 9.7% for LLC) agreements. In addition, the acquisition time for T1WIDL and T2WIDL was respectively reduced by 14.2% to 29% compared to 3D FSPGR (both p < 0.05). Conclusions: Two-dimensional equivalent-thin-slice T1- and T2-weighted images using DLR showed better image quality and shorter scan time than 3D FSPGR and conventional construction images in nasal cartilages. The anatomical details were preserved without losing clinical performance on diagnosis and prognosis, especially for pre-rhinoplasty planning. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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14 pages, 2159 KiB  
Article
Association between the Temporomandibular Joint Morphology and Chewing Pattern
by Sasin Sritara, Yoshiro Matsumoto, Yixin Lou, Jia Qi, Jun Aida and Takashi Ono
Diagnostics 2023, 13(13), 2177; https://doi.org/10.3390/diagnostics13132177 - 26 Jun 2023
Cited by 1 | Viewed by 1191
Abstract
This study aimed to investigate whether the morphology of the temporomandibular joint (TMJ) is associated with chewing patterns while considering skeletal morphology, sex, age, and symptoms of temporomandibular disorder (TMD). A cross-sectional observational study of 102 TMJs of 80 patients (age 16–40 years) [...] Read more.
This study aimed to investigate whether the morphology of the temporomandibular joint (TMJ) is associated with chewing patterns while considering skeletal morphology, sex, age, and symptoms of temporomandibular disorder (TMD). A cross-sectional observational study of 102 TMJs of 80 patients (age 16–40 years) was performed using pretreatment records of cone-beam computed tomography imaging of the TMJ, mandibular kinesiographic records of gum chewing, lateral and posteroanterior cephalometric radiographs, patient history, and pretreatment questionnaires. To select appropriate TMJ measurements, linear regression analyses were performed using TMJ measurements as dependent variables and chewing patterns as the independent variable with adjustment for other covariates, including Nasion-B plane (SNB) angle, Frankfort-mandibular plane angle (FMA), amount of lateral mandibular shift, sex, age, and symptoms of TMD. In multiple linear regression models adjusted for other covariates, the length of the horizontal short axis of the condyle and radius of the condyle at 135° from the medial pole were significantly (p < 0.05) associated with the chewing patterns in the frontal plane on the working side. “Non-bilateral grinding” displayed a more rounded shape of the mandibular condyle. Conversely, “bilateral grinding” exhibited a flatter shape in the anteroposterior aspect. These findings suggest that the mandibular condyle morphology might be related to skeletal and masticatory function, including chewing patterns. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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10 pages, 648 KiB  
Article
Evaluation of Dental Root Development Regarding Maxillary Canine Eruption Status after Secondary Alveolar Bone Grafting in Patients with Cleft Lip and Palate
by Melissa A. Ferguson, Sercan Akyalcin, Hugo Campos, Abigail Gliksten, Kadriye Hargett, Stephanie Yang and James MacLaine
Diagnostics 2023, 13(9), 1642; https://doi.org/10.3390/diagnostics13091642 - 06 May 2023
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Abstract
In children born with cleft lip and palate, the timing of the secondary alveolar bone graft (SABG) is crucial to its success; this involves estimating the eruption of the permanent maxillary canine. Altered dental eruption in this patient group gives impetus to the [...] Read more.
In children born with cleft lip and palate, the timing of the secondary alveolar bone graft (SABG) is crucial to its success; this involves estimating the eruption of the permanent maxillary canine. Altered dental eruption in this patient group gives impetus to the identification of dental developmental factors concerning maxillary canine eruption, which may steer the clinical decision of SABG timing. Records of over nine hundred patients who received SABG with pre- and post-operative cone beam computed tomography (CBCT) scans were analyzed for inclusion and divided into two groups (erupting or non-erupting canine after SABG). Roots of the maxillary canines and premolars were segmented from the cementoenamel junction then linear and volumetric measurements were performed. The pre- and post-operative root length and volume differences were calculated and compared statistically using independent sample tests and paired t-tests. No statistically significant differences were found in the volume change (%), or reciprocal of mean root length in the erupted and unerupted groups in the canine, first premolar, or second premolar roots except for an association between the post-operative dental root length of the canine and the maxillary canine eruption status. Therefore, assessment of root development from pre-treatment CBCT scans was not deemed worthy from a diagnostic perspective. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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10 pages, 792 KiB  
Article
Super-Resolution of Dental Panoramic Radiographs Using Deep Learning: A Pilot Study
by Hossein Mohammad-Rahimi, Shankeeth Vinayahalingam, Erfan Mahmoudinia, Parisa Soltani, Stefaan J. Bergé, Joachim Krois and Falk Schwendicke
Diagnostics 2023, 13(5), 996; https://doi.org/10.3390/diagnostics13050996 - 06 Mar 2023
Cited by 5 | Viewed by 1971
Abstract
Using super-resolution (SR) algorithms, an image with a low resolution can be converted into a high-quality image. Our objective was to compare deep learning-based SR models to a conventional approach for improving the resolution of dental panoramic radiographs. A total of 888 dental [...] Read more.
Using super-resolution (SR) algorithms, an image with a low resolution can be converted into a high-quality image. Our objective was to compare deep learning-based SR models to a conventional approach for improving the resolution of dental panoramic radiographs. A total of 888 dental panoramic radiographs were obtained. Our study involved five state-of-the-art deep learning-based SR approaches, including SR convolutional neural networks (SRCNN), SR generative adversarial network (SRGAN), U-Net, Swin for image restoration (SwinIr), and local texture estimator (LTE). Their results were compared with one another and with conventional bicubic interpolation. The performance of each model was evaluated using the metrics of mean squared error (MSE), peak signal-to-noise ratio (PNSR), structural similarity index (SSIM), and mean opinion score by four experts (MOS). Among all the models evaluated, the LTE model presented the highest performance, with MSE, SSIM, PSNR, and MOS results of 7.42 ± 0.44, 39.74 ± 0.17, 0.919 ± 0.003, and 3.59 ± 0.54, respectively. Additionally, compared with low-resolution images, the output of all the used approaches showed significant improvements in MOS evaluation. A significant enhancement in the quality of panoramic radiographs can be achieved by SR. The LTE model outperformed the other models. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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9 pages, 2283 KiB  
Article
Evaluation of the Maxillary Sinus of Patients with Maxillary Posterior Implants: A CBCT Cross-Sectional Study
by Lucas Lenyn Vieira Chaves, Lucas P. Lopes Rosado, Saulo Machado Piccolo, Liana Matos Ferreira, Kivanç Kamburoglu, Rafael Binato Junqueira, Maurício Augusto Aquino de Castro and Francielle Silestre Verner
Diagnostics 2022, 12(12), 3169; https://doi.org/10.3390/diagnostics12123169 - 15 Dec 2022
Cited by 3 | Viewed by 2471
Abstract
Background: During oral rehabilitation, dental implants in the posterior maxilla can penetrate the maxillary sinus. The aim was to evaluate the presence of maxillary sinus abnormalities in patients with dental implants in the posterior maxillary region using cone-beam computed tomography (CBCT) images. Materials [...] Read more.
Background: During oral rehabilitation, dental implants in the posterior maxilla can penetrate the maxillary sinus. The aim was to evaluate the presence of maxillary sinus abnormalities in patients with dental implants in the posterior maxillary region using cone-beam computed tomography (CBCT) images. Materials and Methods: This was a retrospective cross-sectional study, and CBCT scans of 199 patients (459 dental implants) were evaluated. Implants were assessed according to their relative location to the maxillary sinus floor (up to 2 mm from the maxillary sinus cortex, within 2 mm to intimate contact with the maxillary sinus cortex, apical third inside the maxillary sinus, two-thirds or more inside the maxillary sinus) and bone-fixation tissue (Alveolar ridge or Bone graft). Maxillary sinus abnormalities were classified. Kappa and Weighted Kappa and the Kruskal–Wallis test were applied. Results: A higher prevalence of mucosal thickening and non-specific opacification were observed in implants located within 2 mm to intimate contact with the cortex of the maxillary sinus floor. Of the 66 implants with apical thirds located inside the maxillary sinus, 31 (46.7%) were associated with sinus abnormalities and of all implants (n = 5) with two-thirds or more located inside the maxillary sinus, all of these were associated with sinus abnormalities. No association was observed in relation to implant bone-fixation tissue. Conclusions: This study found a significant association between dental implant placement near or within the sinus and sinus abnormalities, mainly mucosal thickening and non-specific opacification. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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5 pages, 4127 KiB  
Interesting Images
Primary Chronic Sclerosing Osteomyelitis: A New Diagnostic Tool
by Anne-Sophie Lacagne, Laurence May, Marie Nicod Lalonde, John O. Prior and Martin Broome
Diagnostics 2023, 13(23), 3571; https://doi.org/10.3390/diagnostics13233571 - 29 Nov 2023
Viewed by 715
Abstract
Aims: Primary chronic sclerosing osteomyelitis is a rare and complex pathology and remains a diagnostic and therapeutic challenge. Our aim is to show our experience with a new diagnostic tool. Material and Methods: Four patients aged from 26 to 67 were referred to [...] Read more.
Aims: Primary chronic sclerosing osteomyelitis is a rare and complex pathology and remains a diagnostic and therapeutic challenge. Our aim is to show our experience with a new diagnostic tool. Material and Methods: Four patients aged from 26 to 67 were referred to the department of oral and maxillofacial surgery of University Hospital CHUV in Lausanne between January 2010 and December 2018 for chronic mandibular pain without infectious signs nor symptoms. All patients underwent three-phase bone scintigraphy and anti-granulocyte antibody scintigraphy. Results: Three-phase bone scintigraphy demonstrated radiotracer uptake at the zone of pain, whereas anti-granulocyte antibody scintigraphy showed no uptake, thus rendering an infectious origin unlikely. Conclusion: A combination of the two different scintigraphies should be considered in order to guide the clinician in the diagnosis of primary chronic sclerosing osteomyelitis, thus preventing patients from undergoing unnecessary imagery and useless treatment, and also allowing an early diagnosis. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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9 pages, 2650 KiB  
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A Case of Broken Local Anesthetic Needle in the Pterygomandibular Space; Diagnostic Approaches and Surgical Management
by Ziad Malkawi, Alaa Alayeh, Abedalaziz Alshawa, Ola Shaban, Omar Al Saraireh, Hashem Malkawi, Hamzah Babkair, Ismail Abdouh and Najla Dar-Odeh
Diagnostics 2023, 13(19), 3050; https://doi.org/10.3390/diagnostics13193050 - 25 Sep 2023
Viewed by 915
Abstract
Needle fracture during dental local anesthetic injections is a rare but significant, potentially serious complication. Various approaches for the location and removal of broken needles have been described; however, there are several difficulties and concerns related to the potential complications and critical anatomic [...] Read more.
Needle fracture during dental local anesthetic injections is a rare but significant, potentially serious complication. Various approaches for the location and removal of broken needles have been described; however, there are several difficulties and concerns related to the potential complications and critical anatomic challenges peculiar to the head and neck region. In this case, we describe the diagnostic approaches utilized in locating a broken needle that migrated in the pterygomandibular space following gag reflex, and sudden head movement of a middle-aged male patient. A meticulous diagnostic approach was employed to locate the needle utilizing CBCT scan, CT scan with contrast, and C-arm X-ray machine. The needle was successfully retrieved using an angled hemostat inserted through an oral incision, guided by a C-arm X-ray machine and ENT endoscopic instruments. While careful planning could prevent many complications that may arise during oral surgical procedures, inadvertent events leading to serious complications should be addressed using the appropriate and timely diagnostic techniques pre-and intra-operatively. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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12 pages, 654 KiB  
Systematic Review
Cone-Beam Computed Tomography as a Prediction Tool for Osteoporosis in Postmenopausal Women: A Systematic Literature Review
by Abulfaz Isayev, Nigiar Velieva, Luljeta Isedisha, Zhala Isayeva, Kıvanç Kamburoğlu and Fatih Kuyumcu
Diagnostics 2023, 13(6), 1027; https://doi.org/10.3390/diagnostics13061027 - 08 Mar 2023
Viewed by 1179
Abstract
This literature review was conducted to analyze the capability of cone-beam computed tomography (CBCT) to accurately identify low bone mass density in women. A systematic search of MEDLINE, Embase, Scopus, Google Scholar, the Cochrane Library, and Science Direct was performed to identify relevant [...] Read more.
This literature review was conducted to analyze the capability of cone-beam computed tomography (CBCT) to accurately identify low bone mass density in women. A systematic search of MEDLINE, Embase, Scopus, Google Scholar, the Cochrane Library, and Science Direct was performed to identify relevant articles, and the Cochrane risk of bias criterion was used to determine the methodological quality of the included studies. All ten included studies assessed primary research on the capacity of CBCT to accurately diagnose insufficient bone mineral density. All relevant data were extracted, and the results were summarized narratively. The results indicated that the CBCT has good sensitivity and specificity and high accuracy in predicting osteoporosis. Four of the included studies measured qualitative values, while the others concentrated on quantitative values and found lower values in osteoporosis patients compared to those of osteopenic and healthy patients. All the studies compared CBCT grayscale values with dual energy X-ray absorptiometry scores, which strengthened our confidence in the accuracy of CBCT’s diagnostic capability. CBCT is considered a feasible predictive tool for detecting patients who are at risk of osteoporosis, although further research is needed to confirm the evidence and enhance its common use among health care professionals. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Diagnostic Imaging)
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