PURPOSE: To evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus and periapical, periodontal lesions and to clarify the usefulness of the reconstructed 3-dimensional images to the dental clinical aspects. MATERIALS AND METHODS: 33 sides of maxillae of the hemi-sectioned Korean heads were used in this study. Periapical radiographs, computed tomography and DentaScan reformatted cross-sectional images were taken for the radiographic evaluation of the peiapical and peiodontal lesions of the maxillary teeth and inferior wall of maxillary sinus. RESULTS: Compared the degree of accuracy and findings of dental and periapical pathoses on the intraoral radiographs and DentaScan reformatted images with the cross-sectioned specimens, the DentaScan reformatted cross-sectional images were more accurate and more effective than the intraoral radiography with a viewpoint of the detection of dental and periapical pathoses. CONCLUSION: Comparing the lesions of specimens with intraoral radiographies and DentaScan reformatted images, the dental and periodontal pathoses and topographical structures were more clearly observed in the DentaScan reformatted images, providing the possibility of more applications of reformatted images to clinical dentistry.
Dentistry ; Head ; Maxilla ; Maxillary Sinus* ; Radiography ; Tooth

With the CT findings as gold standard, the sensitivity, the specificity, and the diagnostic accuracy of WatersO radiography and WatersO radiography with panoramic radiography were compared in the diognosis of antral mucosal thickening of 16 patients. Three oral radiologists and three non-oral radiologists interpreted the WatersO radiographs and after 4 weeks, interpreted the WatersO radiographs and panoramic radiographs simutaneously. The interpretation was the existence or the non-existence of the mucosal thickening on the medial, the posterolateral, the floor, and the roof of maxillary sinus. The obtained results were as followed ; 1. In oral radiologist group, the sensitivity, specificity and diagnostic accuracy of WatersO film were 0.7250, 0.8489 and 0.7578 respectively. 2. The sensitivity and the diagnostic accuracy in oral radiologist group were higher than those of non-oral radiologist group (P<0.05), but there was no significant difference between two groups in the specificity>0.05). 3. There was no significant difference of the diagnostic abilities except the specificity in oral radiologist group between WatersO radiography and WatersO radiography with panoramic radiography (p>0.05). 4. The sensitivity and the diagnostic accuracy were the highest in the case of medial wall interpretation, the specificity was the highest in the posterioateral wall. 5. In the posterolateral wall and the floor, the sensiticity and the diagnostic accuracy of oral radiologist group were higher than those of non-oral radiologist group (P<0.05).
Diagnosis* ; Humans ; Maxillary Sinus ; Radiography* ; Radiography, Panoramic* ; Sensitivity and Specificity

PURPOSE: The purpose of this study was to compare the accuracy of postoperative maxillary cyst (POMC) diagnosis by panoramic radiographs versus computed tomography (CT) and by oral and maxillofacial radiologists versus non-specialists. MATERIALS AND METHODS: Sixty-five maxillary sinuses with POMCs and 63 without any lesion were assessed using panoramic radiographs and CT images by five oral and maxillofacial radiologists and five non-specialists on a five-point scale. The areas under receiver operating characteristic (ROC) curves were analyzed to determine the differences in diagnostic accuracy between the two imaging modalities and between the two groups of observers. The intra-observer agreement was determined, too. RESULTS: The diagnostic accuracy of CT images was higher than that of panoramic radiographs in both groups of observers (p<0.05). The diagnostic accuracy of oral and maxillofacial radiologists for each method was higher than that of non-specialists (p<0.05). CONCLUSION: The use of CT improves the diagnosis of POMC, and radiological training and experience leads to more accurate evaluation.
Diagnosis ; Maxillary Sinus ; Pro-Opiomelanocortin ; Radiography, Panoramic ; ROC Curve

Maxillary sinus elevation has been widely used to enable insertion of endosseous implants in severely resorbed maxilla. Maxillary sinusitis after this procedure was considered to be the major drawback, therefore, preoperative evaluation of paranasal sinus is considered to be important. In order to evaluate the condition of the sinus, we used Waters' projection. In this study, asymptomatic patients were evaluated by Waters' view, and compared to timing to assess the sinus cavity.METHODS: The retrospective study was based on 14 patients who were performed sinus elevation surgery in Seoul National University Dental Hospital. These patients did not show any signs of maxillary sinusitis. These patients were taken Waters' view at preoperative, postoperative 1 day, 3 months, 6 months. In Waters' view, presence of air fluid level, radiopacity of sinus wall, or radiopacity of entire maxillary sinus were evaluated. The density, and sinus dimension changes were assessed using Adobe Photoshop CS5(R) (Adobe Systems Inc., San Jose, CA, USA).RESULTS: Findings of Waters views in patients with clear maxillary sinus at preoperative time were followed by elevated sinus floor with transplanted bone, mucosal swelling, and air fluid level. At postoperative 3 months, and 6 months, the radiographic findings were similar to preoperative state. By contrast, patients with preoperative mucosal swelling, or haziness in sinus cavity showed radiopacity entire sinus in Waters' view. In cases of the patients who were treated with simultaneous treatment to mucosal swelling, good status of sinus cavity were found.CONCLUSION: Although Waters' projections provide the limited information, and is less sensitive method compared with computed tomography, it is simple, easy, and economical method to assess of maxillary sinus. We suggest using Waters' view as radiographic routine tool for evaluation of sinus condition, especially in the sinus elevation surgery.]]>
Floors and Floorcoverings ; Humans ; Maxilla ; Maxillary Sinus ; Maxillary Sinusitis ; Radiography, Dental ; Retrospective Studies ; Sinus Floor Augmentation ; Sinusitis ; Transplants

OBJECTIVES: This study was performed to evaluate whether there is the difference of graft height changes in radiographic evaluation in single implants and multiple implants after maxillary sinus floor augmentation with an auto-xenograft mixture. METHODS: The study group comprised 29 patients (16 men, 13 women; mean age, 56.5+/-12.4 years; range, 27 to 87 years) treated at the implant clinic of the Ewha Womans University Mokdong Hospital. They were treated with the sinus floor augmentation of lateral window technique and simultaneous placement of dental implants. Their implants have been evaluated for 42.4+/-10.5 months. To evaluate the height of grafted material, the real implant length was compared with that of panoramic radiography evaluated by a digital caliper (PACS program), and then the real height of grafted material was assumed. SPSS 19.0 was used in statistical analysis. Wilcoxon singed rank test was utilized for P value and Mann-Whitney for statistical significance in the changes of grafted height between single implants and multiple implants. The level of statistical significance was defined as P<0.001. RESULTS: The evaluated graft height in single implants' group decreased to 0.60+/-0.54 mm at the time of delivery (after 7.5 months, P=0.001), in multi-unit implants' group to 0.96+/-0.84 mm (after 6.5 months, P<0.001). The evaluated graft height in single implants' group decreased to 1.11+/-0.75 mm at the last follow-up (after 43.5 months, P=0.001), in multi-unit implants' group to 1.52+/-0.99 mm (after 41.8 months, P<0.001). Mann-Whitney test was used for the difference between single implants and multi-unit implants. There was no difference in two groups at the time of delivery and the last follow-up (P>0.001). CONCLUSION: There was no statistical significance of radiographic graft height after maxillary sinus floor augmentation between single implants and multiple implants.
Dental Implants ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; Radiography, Panoramic ; Sinus Floor Augmentation ; Transplants

PURPOSE: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. MATERIALS AND METHODS: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. RESULTS: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). CONCLUSION: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.
Dental Clinics ; Humans ; Inflammation ; Maxillary Sinus* ; Radiography ; Radiography, Panoramic* ; ROC Curve

Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of 49.4+/-11.3 years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was 27.6%+/-2.2% in radiologist and 31.9%+/-5.8% in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.
Dentists ; Diagnosis ; Female ; Humans ; Incidence ; Male ; Maxilla ; Maxillary Sinus* ; Prevalence ; Radiography ; Radiography, Panoramic

Sinoscopy as an endoscopic investigative method of examining the maxillary sinus offers the advantage of a direct local interpretation in contrast to the usual indirect methods. The beginning of sinoscopy dates back to Hirschmann (1903) and Spielberg (1922). During the last 20 years, this method has been reintroduced and refined. In spite of a large number of articles about sinoscopy from Europe, there have been no articles about sinoscopy from Korea. In the present study, 182 maxillary sinuses were examined by sinoscopy and PNS Xpray for diagnostic reasons. The failure rate in sinoscopy was 3.8% and the rate of incomplete sinoscopy was inferior to X-ray. The detection rate of antral secretion by sinoscopy was higher than by Xpray. In the bacteriological study of antral secretions the percentage of no-growth specimens was 75.7%. In all approximately ten strains of bacteria were isolated from the secretions. Among them, streptococcus was the most common organism found. Therapeutic sinoscopy was performed in 16 patients who suffered from subacute or chronic maxillary sinusitis. In 8 of these patients, local treatment during therapeutic sinoscopy improved the mucosal appearance.
Adolescent ; Adult ; Child ; Comparative Study ; Endoscopy* ; Female ; Human ; Male ; Maxillary Sinus*/radiography ; Maxillary Sinus*/secretion ; Middle Age ; Sinusitis/diagnosis* ; Sinusitis/radiography ; Sinusitis/therapy

PURPOSE: To evaluate the precision of measurements taken of dental implants in bucco-lingually sectioned views of the maxilla by linear tomograms of the panorama and to assess the visibility of the inferior wall of the maxillary sinus. MATERIALS AND METHODS: Eighty sites prepared with implants of gutta percha cone in the sockets of the upper premolars and molars of 10 dry skulls were radiographically examined using linear tomograms of panorama, and scanned coronally and axially by computed tomography. The differences in mm between the measurements in bucco-lingually sectioned images of maxillary alveolar bone and the true length and width of the implanted gutta percha cones were compared as mean values (mean) and standard deviations (SD) for each radiographic technique. Linear tomography of panorama was compared with computed tomography for visualization of the relationship between the inferior wall of maxillary sinus and the end of each implant. RESULTS: The deviations between the actual implant length and the measured values taken from the linear tomograms (0.44 +/-0.39 mm) was significantly less than the measured values from the multiplanar reconstructed images of the axially scanned computed tomogram (1.21+/-0.90 mm). There was statistically significant difference (p< 0.05) between two techniques in the differences between the measurements and true implant length. The relationship of the inferior border of maxillary sinus with end of implant was worse identified with the linear tomogram of panorama (68%) than the multiplanar reconstructed image of axially scanned computed tomogram (99%). CONCLUSION: We could not find any differences in the accuracy of length measurement between the linear tomogram of panorama and computed tomogram, but computed tomogram allowed for a better visualization of the inferior wall of the maxillary sinus than the linear tomogram.
Bicuspid ; Dental Implants ; Gutta-Percha ; Maxilla ; Maxillary Sinus* ; Molar ; Radiography, Panoramic ; Skull ; Tomography, X-Ray

PURPOSE: This study was performed to evaluate the diagnostic efficacy of panoramic radiography and cone-beam computed tomography (CBCT) in detecting sinus pathology. MATERIALS AND METHODS: This study was based on a retrospective evaluation of patients who had undergone both a panoramic radiograph and a CBCT exam. A total of 100 maxillary sinuses were evaluated. Four examiners with various levels of expertise evaluated the images using a five-point scoring system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of the two modalities. The image analysis was repeated twice, with at least two weeks between the evaluation sessions. Interobserver reliability was assessed using Cronbach's alpha, and intraobserver reliability was assessed using Cohen's kappa. RESULTS: Maxillary sinus pathology was detected in 72% of the patients. High interobserver and intraobserver reliability were observed for both imaging modalities and among the four examiners. Statistical analyses using ROC curves demonstrated that the CBCT images had a larger area under the curve (0.940) than the panoramic radiographs (0.579). CONCLUSION: Three-dimensional evaluation of the sinus with CBCT was significantly more reliable in detecting pathology than panoramic imaging.
Cone-Beam Computed Tomography ; Dental Implants* ; Humans ; Maxillary Sinus* ; Pathology ; Radiography, Panoramic ; Retrospective Studies ; ROC Curve