Objective: The aim of this study was to investigate the use of dental cone beam CT (CBCT) grey values for density estimations by calculating the correlation with multislice CT (MSCT) values and the grey value error after recalibration. Methods: A polymethyl methacrylate (PMMA) phantom was developed containing inserts of different density: air, PMMA, hydroxyapatite (HA) 50 mg cm 23, HA 100, HA 200 and aluminium. The phantom was scanned on 13 CBCT devices and 1 MSCT device. Correlation between CBCT grey values and CT numbers was calculated, and the average error of the CBCT values was estimated in the medium-density range after recalibration. Results: Pearson correlation coefficients ranged between 0.7014 and 0.9996 in the full-density range and between 0.5620 and 0.9991 in the medium-density range. The average error of CBCT voxel values in the medium-density range was between 35 and 1562. Conclusion: Even though most CBCT devices showed a good overall correlation with CT numbers, large errors can be seen when using the grey values in a quantitative way. Although it could be possible to obtain pseudo-Hounsfield units from certain CBCTs, alternative methods of assessing bone tissue should be further investigated. Advances in knowledge: The suitability of dental CBCT for density estimations was assessed, involving a large number of devices and protocols. The possibility for grey value calibration was thoroughly investigated.
Dental implants are now broadly used to replace missing teeth, and the presence of infectious complications is rising. Dental implant therapy as a local risk factor for the onset of osteomyelitis and its management have not been widely explored. Here, we report an unusual case of mandibular suppurative osteomyelitis caused by Streptococcus intermedius in a healthy and immunocompetent patient secondary to mandibular implants. We describe how surgery combined with systemic application of antibiotics allowed conservation of the dental implants in the mandibular bone, discuss the probable source of contamination, and present the follow-up of the osteomyelitis.
The method is known to correlate with microarchitectural changes in bone and could be a useful approach to characterized osseointegrated grafts.
Les patients, comme les chirurgiens-dentistes, attendent beaucoup de l’orthodontiste pour les guider dans la prédiction d’évolution des dents de sagesse (DDS). L’imagerie est un outil clé pour la prise de décision et l’analyse pré-opératoire. Cet article est une synthèse des découvertes fortuites radiologiques liées à la troisième molaire mandibulaire et montre l’intérêt du CBCT. La pathologie associée à la troisième molaire est plus souvent observée dans le CBCT que dans la panoramique. Plus de troisièmes molaires seraient enlevées si les résultats pathologiques étaient basés sur le CBCT.
Le CBCT (Cone Beam Computed Tomography) s’est imposé comme l’examen radiologique de choix à visée squelettique des articulations temporomandibulaires (ATM). Le CBCT est indiqué, en complément d’un panoramique dentaire : en cas de suspicion de dysfonctionnement discal : Syndrome algodysfonctionnel de l’appareil manducateur (SADAM) ou Désordre Temporo Mandibulaire (DTM). dans d’autres situations évocatrices de pathologies de l’ATM (traumatisme, contexte inflammatoire, malformation congénitale…). Les pathologies les plus fréquentes sont en rapport avec un dysfonctionnement discal : anomalies fonctionnelles (limitation d’ouverture buccale et trismus) et arthrose. Dans ces deux cas un traitement symptomatique fonctionnel est mis en place. Les autres pathologies sont plus rares : arthrites inflammatoires ou infectieuses, fractures, ankyloses, ostéonécrose aseptique d’un condyle, pathologies congénitales, tumeurs le plus souvent bénignes…
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