Yukiko Matsuda

Assessment of the blood supply to the lingual surface of the mandible for reduction of bleeding during implant surgery

OBJECTIVES The aim of this study was to assess the frequency of the foramina and their canals on the lingual surface of the mandible using computed tomography (CT), which was carried out for dental implant planning. MATERIAL AND METHODS First, the visibility of the lingual canals of the CT image was verified by dissecting five cadavers. CT images of 200 patients, who had decided on implant treatment, were used in this study. The visibility of the foramina and their canals on the lingual surface of the mandible were assessed. RESULTS The foramina were divided into two groups by the positions of the mandible, the medial lingual foramen and the lateral lingual foramen. At least one foramen was found in all patients. In the medial group, a higher level of mental spine was seen in 190 patients, the same level of mental spine was observed in 99 patients and a lower level of mental spine was observed in 114 patients. The lateral lingual foramina were found in 160/200 patients and 88/200 patients presented bilaterally. CT can predict the position and the size of the foramina and their canals on the lingual surface of the mandible. All the patients had more than one foramen in the middle of the lingual surface of the mandible on the CT image. CONCLUSION The frequency of the lingual foramina in the medial region was 100% and that in the lateral region was 80%. It would also be useful to emphasize the significant variation in the precise location of these lingual foramina, and that these can only be visualized presurgically with volumetric imaging modalities, such as CT or Cone beam 3D systems.

Effects of exposure reduction on the accuracy of an intraoral photostimulable-phosphor imaging system in detecting incipient proximal caries

Digital imaging systems for use in intraoral radiography are becoming common in clinical practice, although its physical properties such as resolution and available dynamic range may be inferior to conventional film systems. The purpose of this study was to determine the diagnostic accuracy in detecting incipient proximal caries using a digital system with storage phosphor plate (Digora®) in comparison with a conventional intraoral film (Kodak Ektaspeed Plus®). Thirty-one extracted upper premolars were selected. Of the 62 surfaces, 33 had proximal caries with discoloration or incipient lesions, and the rest showed no evidence of caries verified on strict inspection using fiber-optic transillumination. All teeth were radiographed following the paralleling technique (60 kV, 40 cm focus-to-film distance). Exposure was adjusted to Ektaspeed Plus film, while reduced to 1/2, 1/4, and 1/8 on Digora®. The films and digital images were evaluated by three observers, using a confidence rating for the presence of caries. On Digora®, the observers could control contrast and brightness. The results showed that Digora® had better performance in detecting caries than the film, even when the exposure was used for the film, although there were no statistically significant differences. The results suggest that the storage phosphor plate system may be used clinically to diagnose incipient proximal caries, while reducing the exposure to the patient.

Accessory mandibular foramina: a CT study of 300 cases

PurposeThe aim of the study was to assess the distribution of accessory foramina in the mandibular body with computed tomography (CT).Materials and methodsThe CT images of the mandibular body in 300 subjects (183 females and 117 males aged between 12 and 85 years) were retrospectively analysed for the presence of accessory foramina. The buccal and lingual surfaces were examined by dividing them into anterior and posterior quadrants.ResultsOf the 300 subjects, 26 presented with accessory foramina on buccal posterior aspect and 70 subjects presented on buccal anterior aspect. Further, on the lingual posterior aspect, 132 subjects presented with accessory foramina and 59 subjects presented on lingual anterior aspect. Most of the subjects with accessory foramina in the buccal posterior, buccal anterior and lingual anterior regions had accessory foramina on other aspects of the mandible as well.ConclusionA substantial number of subjects presented with accessory foramina on the lingual posterior aspect when compared to other aspects. Nevertheless, the number of subjects with accessory foramina on other aspects of the mandible was considerable and cannot be ignored. It is suggested that when an accessory foramen is identified in an individual on a particular aspect of the mandibular body, it is highly probable that he will exhibit accessory foramina on other aspects as well.

Skeletal maturity assessment with the use of cone-beam computerized tomography

OBJECTIVE The aim of the study was to compare cervical vertebrae maturity assessed with the use of cone-beam computerized tomography (CBCT) with the hand-wrist maturation method and cervical vertebrae maturation assessed with the use of lateral cephalography for the assessment of skeletal maturity. STUDY DESIGN Assessment of skeletal maturation was done using skeletal maturity indicators (SMI) from hand-wrist radiography, cervical vertebrae maturity index (CVMI) from CBCT and lateral cephalography (cephalo-CVMI). The Spearman correlation coefficient was used for statistical analysis. RESULTS We observed a significant relationship between CBCT-CVMI and cephalo-CVMI as well as between CBCT-CVMI and SMI stages. The Spearman correlation coefficient value between CBCT-CVMI and cephalo-CVMI was 0.975 (P < .0001) and between CBCT-CVMI and SMI was 0.961(P < .0001). CONCLUSIONS Cervical vertebrae maturity assessment with CBCT provided a reliable assessment of pubertal growth spurt, and therefore CBCT can be used to assess skeletal maturity.

Effect of computer assistance on observer performance of approximal caries diagnosis using intraoral digital radiography

Logicon Caries Detector™ (LDDC) is the only commercially available computer-assisted diagnostic system for caries diagnosis. The object of this study is to elucidate the efficacy of LDDC when used by inexperienced dentists. Fifty extracted teeth were imaged using an RVG6000. Seven dentists who had just passed the Japanese National Dental Board Examination observed those images without LDDC (woLDDC) and assessed the probability that caries lesions were present, then re-assessed the same teeth using LDDC (wLDDC). The areas under the receiver operating characteristic curves (Az) were compared. No statistically significant difference was found between woLDDC Az values and wLDDC Az values when caries lesions of all depths were considered. When positive cases were restricted to caries lesions in the inner half of the enamel or to dentine caries lesions, however, wLDDC Az values were significantly larger than woLDDC (p = 0.043 and 0.018, respectively).

Usefulness of proton density and T2-weighted vs. T1-weighted MRI in diagnoses of TMJ disk status.

ABSTRACT The aim of this study was to test the hypothesis that proton density and T2-weighted magnetic resonance (MR) images are more useful than T1-weighted MR images in the diagnoses of disk displacement, disk reduction, and disk shape. The subject group consisted of 92 patients referred for bilateral MRI imaging because of diagnosed signs of temporomandibular disorders (TMD). In the experimental group (52 patients), both T2-weighted and proton density images were made. In the control group (40 patients), only T1-weighted images were taken. The images were evaluated by two oral radiologists relative to their usefulness as a diagnostic aid and rated as either good or fair in each diagnostic category. The percentages of ratings that were good were higher (p<0.01) for T2-weighted and proton density images than for T1-weighted images in all three types of diagnoses (Fishers Exact test). In conclusion, T2-weighted and proton density-weighted images were found to be more useful than T1-weighted images in the diagnoses of disk status.

Comparison between RVG UI sensor and Kodak InSight film for detection of incipient proximal caries

ObjectThe purpose of this study was to compare the efficacy of the four combination modes of Trophy RadioVisioGraphy UI sensor (Trex-Trophy Radiology Inc., Marne-la-Valee, France) and Kodak InSight film (Eastman Kodak Co., Rochester, NY) for detecting proximal dental caries.Materials and MethodsThirty extracted human upper premolars were selected. Of 60 surfaces, 25 had carious lesions in the form of small cavities, and the rest showed no evidence of caries as verified by a micro computed tomogram (micro CT; XCT Research SA+, Stratec Medizintechnik GmbH, Pforzheim, Germany). All teeth were radiographed with the paralleling technique (60kV, 40 cm focus-to-sensor distance). Four combination modes (high-resolution caries mode—HRC; high-sensitivity caries mode—HSC; high-resolution periodontal mode—HRP; and high-resolution endo mode—HRE) were used. Exposure was set at 0.12 sec for HRC, 0.08 sec for HSC, 0.16 sec for HRP, 0.12 sec for HRE, and 0.16 sec for the Kodak InSight film. The resulting images were evaluated by three oral radiologists. The same three observers evaluated the digital images, and were allowed to use the contrast and brightness controls in doing so. Possible differences in ROC curve areas among image modalities were assessed by the Friedman test.ResultsThe mean ROC curve areas were 0.66±0.11 for HRC, 0.78±0.02 for HSC, 0.76±0.04 for HRE, 0.77±0.04 for HRP, and 0.71±0.09 for the Kodak InSight film. There were no statistically significant differences between HRC, HSC, HRE, HRP and the Kodak InSight film in terms of proximal caries detection.ConclusionThe four modes of RVG UI system are each a viable alternative to intraoral film for the detection of incipient dental caries.

Accuracy of Digora System in Detecting Artificial Peri-implant Bone Defects

This study was done to compare the diagnostic accuracy in detecting simulated intrabony defects around fixtures using Digora (DIG; Sordex Orion Corporation, Helsinki, Finland) compared with Ektaspeed Plus film (PLS; Eastman Kodak Co., Rochester, NY). Three titanium implant fixtures were placed in molar areas of three cadavers. Bone defects were created in the interproximal alveolar crest. Exposure time was adjusted to a PLS film and reduced to 1/5 only for DIG (1/5 DIG). The results of four observers were assessed. Sensitivity, specificity, accuracy, and under the receiver operator char-acteristic curve (ROC) area were evaluated. Statistical analyses were performed by using Friedman test and one-way ANOVA test. Mean sensitivity/specificity were 0.60/0.85 (DIG), 0.54/0.81 (1/5 DIG), and 0.64/0.58 (PLS). There were no statistically significant differences in the diagnostic accuracies. Digora had an equivalent performance to radiographic film in detecting intrabony defects adjacent to the implants, notwithstanding the amount of 1/5 of the exposure time.

Radiopacity Measurement of Restorative Resins Using Film and Three Digital Systems for Comparison with ISO 4049: International Standard.

This study compared Ultra Speed Occlusal Film (USOF) and 3 digital systems in determining the radiopacity of 5 different restorative resins in terms of equivalents of aluminum thickness. Whether those digital systems could be used to determine whether radiopacity was in line with International Organization for Standardization (ISO) recommendations was also investigated. Disks of each of 5 restorative resins and an aluminum step wedge were exposed at 65 kVp and 10 mA on USOF and imaged with each digital system. Optical density on the film was measured with a transmission densitometer and the gray values on the digital images using Image J software. Graphs showing gray value/optical density to step wedge thickness were constructed. The aluminum equivalent was then calculated for all the resins using a regression equation. All the resins were more radiopaque than 1 mm of aluminum, and therefore met the ISO 4049 recommendations for restorative resins. Some resins showed statistically higher aluminum equivalents with digital imaging. The use of traditional X-ray films is declining, and digital systems offer many advantages, including an easy, fast, and reliable means of determining the radiopacity of dental materials.

Characteristic Findings on Panoramic Radiography and Cone-beam CT to Predict Paresthesia after Extraction of Impacted Third Molar

The purpose of this study was to compare findings on the relationship between impacted molar roots and the mandibular canal in panoramic and three-dimensional cone-beam CT (CBCT) images to identify those that indicated risk of postoperative paresthesia. The relationship between impacted molars and the mandibular canal was first classified using panoramic images. Only patients in whom the molar roots were either in contact with or superimposed on the canal were evaluated using CBCT. Of 466 patients examined using both panoramic and CBCT images, 280 underwent surgical extraction of an impacted molar, and 15 of these (5%) reported postoperative paresthesia. The spatial relationship between the impacted third molar root and the mandibular canal was determined by examining para-sagittal sections (lingual, buccal, inter-radicular, inferior, and combinations) obtained from the canal to the molar root and establishing the proximity of the canal to the molar root (in contact with or without loss of the cortical border and separate). The results revealed that darkening of the roots with interruption of the mandibular canal on panoramic radiographs and the inter-radicular position of the canal in CBCT images were characteristic findings indicative of risk of postoperative paresthesia. These results suggest that careful surgical intervention is required in patients with the above characteristics.