Editorial

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Open AccessEditorial

An Update on Advanced Diagnostic Imaging in Dentistry

by Dario Di Nardo, Alessio Zanza, Francesco Pagnoni, Edit Xhajanka and Luca Testarelli

Diagnostics 2022, 12(5), 1041; https://doi.org/10.3390/diagnostics12051041 - 21 Apr 2022

Cited by 1 | Viewed by 1208

Abstract

In recent years, CBCT has proved to be extremely widely used and widespread in dentistry [...] Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

Research

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10 pages, 1355 KiB

Open AccessArticle

Root Resorptions on Adjacent Teeth Associated with Impacted Maxillary Canines

by Sanja Simić, Predrag Nikolić, Jelena Stanišić Zindović, Radovan Jovanović, Ivana Stošović Kalezić, Aleksandar Djordjević and Vesna Popov

Diagnostics 2022, 12(2), 380; https://doi.org/10.3390/diagnostics12020380 - 01 Feb 2022

Cited by 5 | Viewed by 4295

Abstract

Aim: Through the use of CBCT images, many unidentified features of impacted canines can be easily resolved. The potential collision of impacted maxillary canines and adjacent teeth could lead to root resorption (RR). The aim of this study is to examine the prevalence, [...] Read more.

Aim: Through the use of CBCT images, many unidentified features of impacted canines can be easily resolved. The potential collision of impacted maxillary canines and adjacent teeth could lead to root resorption (RR). The aim of this study is to examine the prevalence, location and severity of RR on adjacent teeth caused by impacted maxillary canines and the association between the adjacent teeth and the features of maxillary impacted canines on CBCT. Methods: This study examined 89 subjects with 108 maxillary impacted canines, having had no previous orthodontic treatment (mean age: 18.3 ± 4.1 years). The following impacted-canine-related parameters were analyzed on the CBCT images: location; RR levels on adjacent teeth; occlusal line and midline distances of impacted canines; and the angulations of impacted canines to the midline, lateral incisor and occlusal line. Logistic regression was used to evaluate the association between RR and the measured parameters on CBCT. Results: In this study, we found that the majority of our patients with impacted maxillary canines were female (62.5%). Of the total 108 maxillary impacted canines, 60.2% resorbed the adjacent teeth of the affected quadrants. Lateral incisors were the most affected (34.3%). The mean age of subjects with RR was 16.7 ± 3.5 years. The frequency of RR was statistically significantly higher in female subjects (40.4%). Slight RR was the most frequent (30.5%) and the highest incidence noted at the apical third of the root (29.6%). Regarding the impacted maxillary canine angulation to the midline and adjacent tooth, higher values of angulation caused severe forms of RR (p < 0.05). Conclusion: The sensitivity of CBCT allows for the accurate diagnosis of the location and the degree of RR, alongside the angulation and distance of impacted canines to adjacent teeth. The association between the linear and angular features of the impacted maxillary canines and RR was confirmed. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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20 pages, 4505 KiB

Open AccessArticle

The Reliability of Two- and Three-Dimensional Cephalometric Measurements: A CBCT Study

by Chenshuang Li, Hellen Teixeira, Nipul Tanna, Zhong Zheng, Stephanie Hsiang Yi Chen, Min Zou and Chun-Hsi Chung

Diagnostics 2021, 11(12), 2292; https://doi.org/10.3390/diagnostics11122292 - 07 Dec 2021

Cited by 15 | Viewed by 2686

Abstract

Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed [...] Read more.

Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed tomography (CBCT) images not only allow three-dimensional (3D) analysis, but also enable the extraction of two-dimensional (2D) images without magnification. To evaluate the most reliable cephalometric analysis method, we extracted 2D lateral cephalometric images with and without magnification from twenty full-cranium CBCT datasets; images were extracted with magnification to mimic traditional lateral cephalograms. Cephalometric tracings were performed on the two types of extracted 2D lateral cephalograms and on the reconstructed 3D full cranium images by two examiners. The intra- and inter-examiner intraclass correlation coefficients (ICC) were compared between linear and angular parameters, as well as between CBCT datasets of adults and children. Our results showed that overall, tracing on 2D cephalometric images without magnification increased intra- and inter-examiner reliability, while 3D tracing reduced inter-examiner reliability. Angular parameters and children’s images had the lowest inter- and intra-examiner ICCs compared with adult samples and linear parameters. In summary, using lateral cephalograms extracted from CBCT without magnification for tracing/analysis increased reliability. Special attention is needed when analyzing young patients’ images and measuring angular parameters. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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13 pages, 2306 KiB

Open AccessArticle

Real-Time Monitoring and Quantitative Evaluation of Resin In-Filtrant Repairing Enamel White Spot Lesions Based on Optical Coherence Tomography

by Sujuan Zeng, Yuhang Huang, Wenyan Huang, Janak L. Pathak, Yanbing He, Weijian Gao, Jing Huang, Yiqing Zhang, Jian Zhang and Huixian Dong

Diagnostics 2021, 11(11), 2046; https://doi.org/10.3390/diagnostics11112046 - 04 Nov 2021

Cited by 5 | Viewed by 1834

Abstract

The aim of the present study was to explore the feasibility of real-time monitoring and quantitative guiding the repair of enamel white spot lesions (WSLs) with resin infiltration by optical coherence tomography (OCT). Seven New Zealand rabbits were treated with 37% phosphoric acid [...] Read more.

The aim of the present study was to explore the feasibility of real-time monitoring and quantitative guiding the repair of enamel white spot lesions (WSLs) with resin infiltration by optical coherence tomography (OCT). Seven New Zealand rabbits were treated with 37% phosphoric acid etchant for 15 min to establish the model of enamel demineralization chalk spots of upper incisors, which were repaired by Icon resin infiltrant. OCT, stereo microscope (SM) imaging, scanning electron microscope (SEM) imaging and hematoxylin eosin (HE) staining were used to image each operation step. The changes of WSLs of enamel before and in the process of restoration with resin infiltrant showed specific performance in OCT images, which were consistent with the corresponding results of stereomicroscope and SEM. OCT can non-invasively and accurately image the whole process of repairing enamel demineralization layer with resin infiltration real-time, which can effectively guide the clinical use of resin infiltrant to repair enamel WSLs and be used as an imaging tool to evaluate the process and effect of restoration with resin infiltrant at the same time. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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9 pages, 1308 KiB

Open AccessArticle

Positive Predictive Value of Panoramic Radiography for Assessment of the Relationship of Impacted Mandibular Third Molars with the Mandibular Canal Based on Cone-Beam Computed Tomography: A Cross-Sectional Study

by Maryam Tofangchiha, Soheil Koushaei, Maryam Mortazavi, Zahra Souri, Ahad Alizadeh and Romeo Patini

Diagnostics 2021, 11(9), 1578; https://doi.org/10.3390/diagnostics11091578 - 31 Aug 2021

Cited by 4 | Viewed by 2477

Abstract

The aim of the present study was to assess the positive predictive value (PPV) of panoramic radiographic signs in the assessment of the relationship between impacted mandibular third molars (IMTMs) and the mandibular canal (MC). This cross-sectional study was conducted by reviewing 102 [...] Read more.

The aim of the present study was to assess the positive predictive value (PPV) of panoramic radiographic signs in the assessment of the relationship between impacted mandibular third molars (IMTMs) and the mandibular canal (MC). This cross-sectional study was conducted by reviewing 102 cone-beam computed tomography (CBCT) and panoramic radiographs of patients with IMTMs and radiographic signs of the contact of the IMTMs with the MC on panoramic radiographs (i.e., root apex darkening and interference with the white line). A positive relationship of the IMTM roots with the MC based on CBCT findings was recorded as the gold standard. The PPV of panoramic radiographic signs was calculated for the detection of the relationship of the IMTM root with the MC. The IMTMs were in contact with the MC on CBCT scans in 90.1% of the cases. The PPV of root apex darkening and the interference with the white line was found to be 89.09% (95% CI: (77.75, 95.88)) and 91.48% (95% CI: (79.62, 97.63)), respectively. The MC had a buccal position in 63.7%, and a lingual position in 35.2%, of the cases. The contact of IMTMs with the MC was more commonly seen in patients with a lingual position (100% of the samples). The IMTM root apex darkening and interference with the white line of the MC on panoramic radiographs had a high PPV for determination of the contact of IMTMs with the MC. Thus, presence of the above-mentioned risk factors indicates the need for subsequent 3D radiographic assessments. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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6 pages, 1218 KiB

Open AccessCommunication

To the Question on the Use of Multivariate Analysis and 2D Visualisation of Synchrotron ATR-FTIR Chemical Imaging Spectral Data in the Diagnostics of Biomimetic Sound Dentin/Dental Composite Interface

by Pavel Seredin, Dmitry Goloshchapov, Vladimir Kashkarov, Yuri Ippolitov, Ivan Ippolitov and Jitraporn Vongsvivut

Diagnostics 2021, 11(7), 1294; https://doi.org/10.3390/diagnostics11071294 - 19 Jul 2021

Cited by 9 | Viewed by 2189

Abstract

In this short communication, we provide information on the use of the hierarchical cluster analysis of synchrotron ATR-FTIR 2D chemical imaging spectral data as a useful and powerful approach to the microspectroscopic diagnostics of molecular composition in the hybrid sound dentin/dental composite interfaces [...] Read more.

In this short communication, we provide information on the use of the hierarchical cluster analysis of synchrotron ATR-FTIR 2D chemical imaging spectral data as a useful and powerful approach to the microspectroscopic diagnostics of molecular composition in the hybrid sound dentin/dental composite interfaces and materials, including ones developed with the use of biomimetic strategies. The described diagnostic approach can be successfully transferred to the analysis and visualisation of 2D spectral data, collected using laboratory Raman and FTIR microspectroscopy techniques. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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15 pages, 4970 KiB

Open AccessArticle

Mandibular Third Molar Surgery: Intraosseous Localization of the Inferior Alveolar Nerve Using 3D Double-Echo Steady-State MRI (3D-DESS)

by Adib Al-Haj Husain, Bernd Stadlinger, Sebastian Winklhofer, Marcel Müller, Marco Piccirelli and Silvio Valdec

Diagnostics 2021, 11(7), 1245; https://doi.org/10.3390/diagnostics11071245 - 12 Jul 2021

Cited by 13 | Viewed by 3169

Abstract

The aim of this study was to evaluate the inferior alveolar nerve’s (IAN) intraosseous position within the inferior alveolar canal (IAC) using a 3D double-echo steady-state MRI sequence (3D-DESS). The IAN position was prospectively evaluated in 19 patients undergoing mandibular third molar (MTM) [...] Read more.

The aim of this study was to evaluate the inferior alveolar nerve’s (IAN) intraosseous position within the inferior alveolar canal (IAC) using a 3D double-echo steady-state MRI sequence (3D-DESS). The IAN position was prospectively evaluated in 19 patients undergoing mandibular third molar (MTM) surgery. In the coronal reference layer, the IAC was divided into six segments. These segments were checked for the presence of hyperintense tubular MRI signals representing the IAN’s nervous tissue and assessed as visible/non-visible. Furthermore, the IAN in MRI and the IAC in MRI and CBCT were segmented at the third and second molar, determining the maximum diameter in all planes and a conversion factor between the imaging modalities. Regardless of the positional relationship at the third and second molar, the IAN showed the highest localization probability in the central segments (segment 2: 97.4% vs. 94.4%, segment 5: 100% vs. 91.6%). The conversion factors from IAC in CBCT and MRI to IAN in MRI, respectively, were the following: axial (2.04 ± 1.95, 2.37 ± 2.41), sagittal (1.86 ± 0.96, 1.76 ± 0.74), and coronal (1.26 ± 0.39, 1.37 ± 0.25). This radiation-free imaging modality, demonstrating good feasibility of accurate visualization of nervous tissue within the nerve canal’s osseous boundaries, may benefit preoperative assessment before complex surgical procedures are performed near the IAC. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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15 pages, 3373 KiB

Open AccessArticle

Nuclear Magnetic Resonance Microimaging for the Qualitative Assessment of Root Canal Treatment: An Ex Vivo Preliminary Study

by Silvia Capuani, Gianluca Gambarini, Renzo Guarnieri, Giulia Di Pietro, Luca Testarelli and Dario Di Nardo

Diagnostics 2021, 11(6), 1012; https://doi.org/10.3390/diagnostics11061012 - 01 Jun 2021

Cited by 4 | Viewed by 2445

Abstract

Aim: To assess the potential ability of nuclear magnetic resonance micro-imaging (mMRI) to visualize and identify soft tissue debris and unfilled spaces inside radicular canals in endodontic treated extracted teeth, for understanding the causes of treatment failure. Toward this goal, multi-parametric mMRI and [...] Read more.

Aim: To assess the potential ability of nuclear magnetic resonance micro-imaging (mMRI) to visualize and identify soft tissue debris and unfilled spaces inside radicular canals in endodontic treated extracted teeth, for understanding the causes of treatment failure. Toward this goal, multi-parametric mMRI and cone beam computed tomography (CBCT) were compared. Methodology: A non-recoverable root treated human tooth was extracted due to endodontic failure and excessive mobility. It was examined with both CBCT and mMRI: CBCT was performed with 0.125 mm voxel size (GXCB-500, Kavo-Gendex, Brea, CA, USA) and mMRI was performed with a spectrometer operating at 9.4T magnetic field (Bruker Avance-400, Bruker, Billerica, MA, USA). The mMRI images were obtained with a microimaging probe. Relaxation times (T1 and T2) and diffusion-weighted acquisition sequences were used to obtain multi-parametric maps of the extracted tooth (slice thickness of 200 µm and in plane resolution of 30 × 30 µm²). Results: T1 and T2 maps identified unfilled spaces around and close to Gutta-percha cones instead of CBCT images that were not able to highlight this aspect. T1, T2 and apparent diffusion coefficient (ADC) assumed different values in dentine and in voids, characterized by different dimensions. Moreover, they were able to discriminate between infiltrations of water only and deposits of biological material. Because Gutta-percha cones are constituted of hard, non-porous material, they do not provide a signal and in mMRI images appear as zones of noise. Conclusions: Unlike the CBCT exam, mMRI can detect soft tissue debris and unfilled spaces inside radicular canals. Therefore, this in vitro study showed the potential of mMRI to evaluate the quality of the root canal treatment, suggesting its potential benefit in determining the causes of endodontic failure, without the use of ionizing radiation. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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11 pages, 11694 KiB

Open AccessArticle

Accuracy and Reproducibility of Facial Measurements of Digital Photographs and Wrapped Cone Beam Computed Tomography (CBCT) Photographs

by Maged Sultan Alhammadi, Abeer Abdulkareem Al-mashraqi, Rayid Hussain Alnami, Nawaf Mohammad Ashqar, Omar Hassan Alamir, Esam Halboub, Rodolfo Reda, Luca Testarelli and Shankargouda Patil

Diagnostics 2021, 11(5), 757; https://doi.org/10.3390/diagnostics11050757 - 23 Apr 2021

Cited by 43 | Viewed by 3233

Abstract

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an [...] Read more.

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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20 pages, 603 KiB

Open AccessSystematic Review

Visualization of the Inferior Alveolar Nerve and Lingual Nerve Using MRI in Oral and Maxillofacial Surgery: A Systematic Review

by Adib Al-Haj Husain, Mark Solomons, Bernd Stadlinger, Rada Pejicic, Sebastian Winklhofer, Marco Piccirelli and Silvio Valdec

Diagnostics 2021, 11(9), 1657; https://doi.org/10.3390/diagnostics11091657 - 10 Sep 2021

Cited by 21 | Viewed by 3196

Abstract

We evaluate the preoperative visualization of the inferior alveolar nerve (IAN) and lingual nerve (LN) as reported using radiation-free magnetic resonance imaging (MRI). An accurate visualization shall minimize the postoperative risk for nerve injuries in oral and maxillofacial surgery. PubMed MEDLINE, EMBASE, Biosis, [...] Read more.

We evaluate the preoperative visualization of the inferior alveolar nerve (IAN) and lingual nerve (LN) as reported using radiation-free magnetic resonance imaging (MRI). An accurate visualization shall minimize the postoperative risk for nerve injuries in oral and maxillofacial surgery. PubMed MEDLINE, EMBASE, Biosis, and Cochrane databases were selected for the PICOS search strategy by two reviewers using medical subject headings (MeSH) terms. Thirty studies were included in the systematic review. Based on these studies’ findings, the use of black bone MRI sequences, especially 3D short-tau inversion recovery (STIR), provides superior soft-tissue resolution and high sensitivity in detecting pathological changes. Due to the implementation variability regarding scan parameters and the use of different magnetic field strengths, studies with well-designed protocols and a low risk of bias should be conducted to obtain stronger evidence. With improved cost and time efficiency and considering the benefit–risk ratio, MRI is a promising imaging modality that could become part of routine clinical practice in the future. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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12 pages, 612 KiB

Open AccessSystematic Review

Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review

by Shankargouda Patil, Ahmed Alkahtani, Shilpa Bhandi, Mohammed Mashyakhy, Mario Alvarez, Riyadh Alroomy, Ali Hendi, Saranya Varadarajan, Rodolfo Reda, A. Thirumal Raj and Luca Testarelli

Diagnostics 2021, 11(7), 1208; https://doi.org/10.3390/diagnostics11071208 - 03 Jul 2021

Cited by 23 | Viewed by 3478

Abstract

Background: Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of [...] Read more.

Background: Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of treatment. This review aimed to examine the accuracy of ultrasound and compare it to radiographs in distinguishing these lesions in vivo. Methods: This review process followed the PRISMA guidelines. A literature search of databases (PubMed, Scopus, Embase, and Web of Science) was conducted without any restrictions on time. Articles available in English were included. The selection was done according to the inclusion and exclusion criteria. The QUADAS-2 tool was used to assess the quality of the studies. Results: The search provided a total of 87 articles, out of which, five were selected for the final review. In all the studies, ultrasound had higher accuracy in distinguishing periapical lesions. All the studies indicated a risk of bias, especially in patient selection. Conclusion: Within limitations, the study indicates that ultrasound is a better diagnostic tool to distinguish periapical lesions compared to radiographs but further studies with well-designed, rigorous protocols and low risk of bias are needed to provide stronger evidence. Full article

(This article belongs to the Special Issue Advanced Diagnostic Imaging in Dentistry)

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