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Primary intraosseous squamous cell carcinoma mimicking periapical disease: a case report.

Yoon Joo CHOI ; Song Hee OH ; Ju Han KANG ; Hwa Young CHOI ; Gyu Tae KIM ; Jae Jung YU ; Yong Suk CHOI ; Eui Hwan HWANG

Imaging Science in Dentistry.2012;42(4):265-270. doi:10.5624/isd.2012.42.4.265

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.
Carcinoma, Squamous Cell ; Diagnostic Errors ; Disease Progression ; Epithelium ; Head and Neck Neoplasms ; Humans ; Jaw ; Male ; Mandible ; Middle Aged ; Molar ; Molar, Third ; Mouth Mucosa ; Osteomyelitis ; Periapical Diseases

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Unique case of a geminated supernumerary tooth with trifid crown.

Amber ATHER ; Hunaiza ATHER ; Sanket Milan SHETH ; Vidya Saraswathi MULIYA

Imaging Science in Dentistry.2012;42(3):197-200. doi:10.5624/isd.2012.42.3.197

Gemination, a relatively uncommon dental anomaly, is characterized by its peculiar representation as a tooth with a bifid crown and a common root and root canal. It usually occurs in primary dentition. To come across gemination in a supernumerary tooth is a rare phenomenon. The purpose of this paper is to present a unique case of hyperdontia wherein gemination in an impacted supernumerary tooth resulted in a trifid crown unlike the usual bifid crown. The role of conventional radiographs as well as computed tomography, to accurately determine the morphology and spatial location, and to arrive at a diagnosis, is also emphasized in this paper.
Crowns ; Dental Pulp Cavity ; Dentition, Primary ; Multidetector Computed Tomography ; Tooth ; Tooth, Impacted ; Tooth, Supernumerary

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Lipomatosis: a diverse form of hemifacial hyperplasia.

Preeti Chawla ARORA ; Hemant R UMARJI ; Aman ARORA ; Easwaran RAMASWAMI

Imaging Science in Dentistry.2012;42(3):191-195. doi:10.5624/isd.2012.42.3.191

A case of hemifacial hyperplasia that presented with muscular, skeletal, and dental hyperplasia along with lipomatous infiltration was described. Advanced imaging was useful in identifying the lipomatous infiltration present in the lesion, which raises the possibility of lipomatosis having a diverse presentation in hemifacial hyperplasia. As there was a scarcity of related literature in the field of dentomaxillofacial radiology, this report would make us familiar with its computed tomographic and magnetic resonance image findings.
Face ; Facial Asymmetry ; Hyperplasia ; Lipomatosis ; Magnetic Resonance Spectroscopy

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Clinical image quality evaluation for panoramic radiography in Korean dental clinics.

Bo Ram CHOI ; Da Hye CHOI ; Kyung Hoe HUH ; Won Jin YI ; Min Suk HEO ; Soon Chul CHOI ; Kwang Hak BAE ; Sam Sun LEE

Imaging Science in Dentistry.2012;42(3):183-190. doi:10.5624/isd.2012.42.3.183

PURPOSE: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. MATERIALS AND METHODS: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. RESULTS: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. CONCLUSION: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.
Dental Clinics ; Humans ; Quality Control ; Radiography, Panoramic ; Specialization

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Unusually large erupted complex odontoma: A rare case report.

Shivanand B BAGEWADI ; Rahul KUKREJA ; Gundareddy N SUMA ; Bhawna YADAV ; Havi SHARMA

Imaging Science in Dentistry.2015;45(1):49-54. doi:10.5624/isd.2015.45.1.49

Odontomas are nonaggressive, hamartomatous developmental malformations composed of mature tooth substances and may be compound or complex depending on the extent of morphodifferentiation or on their resemblance to normal teeth. Among them, complex odontomas are relatively rare tumors. They are usually asymptomatic in nature. Occasionally, these tumors become large, causing bone expansion followed by facial asymmetry. Odontoma eruptions are uncommon, and thus far, very few cases of erupted complex odontomas have been reported in the literature. Here, we report the case of an unusually large, painless, complex odontoma located in the right posterior mandible.
Facial Asymmetry ; Mandible ; Odontogenic Tumors ; Odontoma* ; Tooth

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Accuracy and reliability of stitched cone-beam computed tomography images.

Nicholas EGBERT ; David R CAGNA ; Swati AHUJA ; Russell A WICKS

Imaging Science in Dentistry.2015;45(1):41-47. doi:10.5624/isd.2015.45.1.41

PURPOSE: This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. MATERIALS AND METHODS: Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. RESULTS: The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. CONCLUSION: The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.
Cadaver ; Computer-Aided Design ; Cone-Beam Computed Tomography* ; Dataset ; Dental Implants ; Denture, Complete ; Gutta-Percha ; Mandible ; Stents

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Intravenous contrast media application using cone-beam computed tomography in a rabbit model.

Min Sung KIM ; Bok Yeol KIM ; Hwa Young CHOI ; Yoon Joo CHOI ; Song Hee OH ; Ju Hee KANG ; Sae Rom LEE ; Ju Han KANG ; Gyu Tae KIM ; Yong Suk CHOI ; Eui Hwan HWANG

Imaging Science in Dentistry.2015;45(1):31-39. doi:10.5624/isd.2015.45.1.31

PURPOSE: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. MATERIALS AND METHODS: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. RESULTS: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. CONCLUSION: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.
Adipose Tissue ; Administration, Intravenous ; Anesthesia, General ; Animals ; Body Weight ; Cone-Beam Computed Tomography* ; Contrast Media* ; Ear ; Femoral Vein ; Models, Animal ; Multidetector Computed Tomography ; Rabbits ; Radiography ; Salivary Glands ; Veins

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Accuracy of virtual models in the assessment of maxillary defects.

Kivanc KAMBUROGLU ; Sebnem KURSUN ; Cenk KILIC ; Tuncer OZEN

Imaging Science in Dentistry.2015;45(1):23-29. doi:10.5624/isd.2015.45.1.23

PURPOSE: This study aimed to assess the reliability of measurements performed on three-dimensional (3D) virtual models of maxillary defects obtained using cone-beam computed tomography (CBCT) and 3D optical scanning. MATERIALS AND METHODS: Mechanical cavities simulating maxillary defects were prepared on the hard palate of nine cadavers. Images were obtained using a CBCT unit at three different fields-of-views (FOVs) and voxel sizes: 1) 60x60 mm FOV, 0.125 mm3 (FOV60); 2) 80x80 mm FOV, 0.160 mm3 (FOV80); and 3) 100x100 mm FOV, 0.250 mm3 (FOV100). Superimposition of the images was performed using software called VRMesh Design. Automated volume measurements were conducted, and differences between surfaces were demonstrated. Silicon impressions obtained from the defects were also scanned with a 3D optical scanner. Virtual models obtained using VRMesh Design were compared with impressions obtained by scanning silicon models. Gold standard volumes of the impression models were then compared with CBCT and 3D scanner measurements. Further, the general linear model was used, and the significance was set to p=0.05. RESULTS: A comparison of the results obtained by the observers and methods revealed the p values to be smaller than 0.05, suggesting that the measurement variations were caused by both methods and observers along with the different cadaver specimens used. Further, the 3D scanner measurements were closer to the gold standard measurements when compared to the CBCT measurements. CONCLUSION: In the assessment of artificially created maxillary defects, the 3D scanner measurements were more accurate than the CBCT measurements.
Cadaver ; Cone-Beam Computed Tomography ; Dimensional Measurement Accuracy ; Linear Models ; Maxillofacial Prosthesis ; Palate, Hard ; Silicones

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Reproducibility of the sella turcica landmark in three dimensions using a sella turcica-specific reference system.

Pisha PITTAYAPAT ; Reinhilde JACOBS ; Guillaume A ODRI ; Karla de Faria VASCONCELOS ; Guy WILLEMS ; Raphael OLSZEWSKI

Imaging Science in Dentistry.2015;45(1):15-22. doi:10.5624/isd.2015.45.1.15

PURPOSE: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a threedimensional (3D) model by using a new sella-specific landmark reference system. MATERIALS AND METHODS: Thirty-two cone-beam computed tomographic scans (3D Accuitomo(R) 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim(R) software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). RESULTS: The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from 0.43+/-0.34 mm to 0.51+/-0.46 mm. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p<0.0011). The interobserver reproducibility of sella landmarks was good, with >50% precision in locating the landmark within 1 mm. CONCLUSION: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.
Cephalometry ; Cone-Beam Computed Tomography ; Imaging, Three-Dimensional ; Orthodontics ; Retrospective Studies ; Sella Turcica*

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Volumetric quantification of bone-implant contact using micro-computed tomography analysis based on region-based segmentation.

Sung Won KANG ; Woo Jin LEE ; Soon Chul CHOI ; Sam Sun LEE ; Min Suk HEO ; Kyung Hoe HUH ; Tae Il KIM ; Won Jin YI

Imaging Science in Dentistry.2015;45(1):7-13. doi:10.5624/isd.2015.45.1.7

PURPOSE: We have developed a new method of segmenting the areas of absorbable implants and bone using region-based segmentation of micro-computed tomography (micro-CT) images, which allowed us to quantify volumetric bone-implant contact (VBIC) and volumetric absorption (VA). MATERIALS AND METHODS: The simple threshold technique generally used in micro-CT analysis cannot be used to segment the areas of absorbable implants and bone. Instead, a region-based segmentation method, a region-labeling method, and subsequent morphological operations were successively applied to micro-CT images. The three-dimensional VBIC and VA of the absorbable implant were then calculated over the entire volume of the implant. Two-dimensional (2D) bone-implant contact (BIC) and bone area (BA) were also measured based on the conventional histomorphometric method. RESULTS: VA and VBIC increased significantly with as the healing period increased (p<0.05). VBIC values were significantly correlated with VA values (p<0.05) and with 2D BIC values (p<0.05). CONCLUSION: It is possible to quantify VBIC and VA for absorbable implants using micro-CT analysis using a region-based segmentation method.
Absorbable Implants ; Absorption ; Image Processing, Computer-Assisted ; Osseointegration ; X-Ray Microtomography

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