As Low Dose as Sufficient Quality: Optimization of Cone-beam Computed Tomographic Scanning Protocol for Tooth Autotransplantation Planning and Follow-up in Children

EzEldeen, Mostafa; Stratis, Andreas; Coucke, Wim; Codari, Marina; Politis, Constantinus; Jacobs, Reinhilde

doi:10.1016/j.joen.2016.10.022

Cited by 48 publications

(36 citation statements)

References 30 publications

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“…Furthermore, for the diagnosis of zygomaticomaxillary fractures, the dose reduction through LD‐CBCT did not decrease diagnostic reliability (Rozema et al, ). Moreover, LD‐CBCT image quality was considered sufficient for various orthodontic diagnostics (Brown, Scarfe, Scheetz, Silveira, & Farman, ; Cook, Timock, Crowe, Wang, & Covell, ; Hidalgo Rivas, Horner, Thiruvenkatachari, Davies, & Theodorakou, ; Ludlow & Walker, ; Portelli et al, ), for tooth autotransplantation planning (EzEldeen et al, ), and for preimplant radiographic assessment (Liljeholm et al, ). Although no dedicated LD‐CBCT protocols have yet been tested, there is evidence from the field of endodontics and periodontology demonstrating acceptable image quality with reduced kV, mA, and exposure time (Al‐Okshi, Theodorakou, & Lindh, ; Jones, Mannocci, Andiappan, Brown, & Patel, ; Lagos de Melo et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…For observer 2, misreadings of approximately 1.3 mm were recorded. Most likely, these outliers are attributed to individual measurement errors (EzEldeen et al, 2017), and for preimplant radiographic assessment (Liljeholm et al, 2017). Although no dedicated LD-CBCT protocols have yet been tested, there is evidence from the field of endodontics and periodontology demonstrating acceptable image quality with reduced kV, mA, and exposure time (Al-Okshi, Theodorakou, & Lindh, 2017;Jones, Mannocci, Andiappan, Brown, & Patel, 2015;Lagos de Melo et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

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In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Schwindling

Hilgenfeld

Weber

et al. 2019

Clinical Oral Implants Res

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Objectives To investigate the in vitro diagnostic accuracy of low‐dose cone‐beam computed tomography (LD‐CBCT) for the detection, classification, and measurement of peri‐implant bone lesions. Material and methods Titanium dental implants with all‐ceramic single crowns (n = 24) were inserted into bovine bone. At twelve implants, four types of peri‐implant bone lesions were created. Radiographic imaging was performed using three techniques: LD‐CBCT, high‐definition CBCT (HD‐CBCT), and intraoral radiography (IR). The datasets were presented twice to four observers in a random order. Diagnostic accuracy was measured by calculating sensitivity and specificity, and analyzed using the McNemar's test at a significance level of 0.05. Absolute agreement between the defect sizes was assessed by means of intraclass correlation coefficients (ICC). Results For all three techniques, diagnostic accuracy and reliability for the detection of defects were almost perfect. The following order was found for classification of the different defect types (sensitivity/specificity): HD‐CBCT (0.96/0.99) > LD‐CBCT (0.93/0.98) > IR (0.71/0.95). No significant difference was found between the two CBCT techniques. Their performance was superior to that of IR. With regard to absolute agreement of defect size, LD‐CBCT agreement with HD‐CBCT (ICC, 95% confidence interval) was slight for defect depth (0.342, 0.181–0.625) and substantial for defect width (0.911, 0.775–0.963). Conclusion Intraoral radiography is useful for detecting peri‐implant bone lesions. LD‐CBCT provides additional information regarding the geometry of defects. The even higher diagnostic accuracy of the HD‐CBCT protocol tested needs to be carefully weighed against its radiation dose, which is 14 times higher than that of LD‐CBCT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Schwindling

Hilgenfeld

Weber

et al. 2019

Clinical Oral Implants Res

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“…The restriction of the Field of view (FOV) to the region of interest seems to be the most efficient strategy for dose reduction, appearing as a relevant source of optimization 14,18 . For this DIMITRA task, the field of 8 × 8 cm was chosen, given that it is a relatively small FOV and is capable of including both jaws of a child in a single scan.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, voxels phantoms of male children were chosen considering that MC calculations demands plenty computational time and workflow. Male/female MC simulations were subject of previous studies of our group 5,18 and it was already demonstrated that doses were slightly lower in males than females. Despite this slight disparity, difference in organ doses (+/−5%) could be considered within the statistical uncertainty of the MC dose calculation 5 .…”

Section: Discussionmentioning

confidence: 99%

Halve the dose while maintaining image quality in paediatric Cone Beam CT

Oenning

Pauwels

Stratis

et al. 2019

Sci Rep

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Cone beam CT (CBCT) for dentomaxillofacial paediatric assessment has been widely used despite the uncertainties of the risks of the low-dose radiation exposures. The aim of this work was to investigate the clinical performance of different CBCT acquisition protocols towards the optimization of paediatric exposures. Custom-made anthropomorphic phantoms were scanned using a CBCT unit in six protocols. CT slices were blinded, randomized and presented to three observers, who scored the image quality using a 4-point scale along with their level of confidence. Sharpness level was also measured using a test object containing an air/PMMA e,dge. The effective dose was calculated by means of a customized Monte Carlo (MC) framework using previously validated paediatric voxels models. The results have shown that the protocols set with smaller voxel size (180 µm), even when decreasing exposure parameters (kVp and mAs), showed high image quality scores and increased sharpness. The MC analysis showed a gradual decrease in effective dose when exposures parameters were reduced, with an emphasis on an average reduction of 45% for the protocol that combined 70 kVp, 16 mAs and 180 µm voxel size. In contrast, both “ultra-low dose” protocols that combined a larger voxel size (400 µm) with lower mAs (7.4 mAs) demonstrated the lowest scores with high levels of confidence unsuitable for an anatomical approach. In conclusion, a significant decrease in the effective dose can be achieved while maintaining the image quality required for paediatric CBCT.

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“…The process of 3D printing in dentistry goes through three stages, starting with data acquisition using low dose cone beam computed tomography (CBCT) [18,19] and/or intraoral scanner (IOS) [20,21], followed by processing and designing using dedicated software tools, and, finally, printing [12,22,23,24].…”

Section: Introductionmentioning

confidence: 99%

3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo

Al-Rimawi

EzEldeen

Schneider

et al. 2019

IJERPH

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(1) Background: Three-dimensional printing is progressing rapidly and is applied in many fields of dentistry. Tooth autotransplantation offers a viable biological approach to tooth replacement in children and adolescents. Restoring or reshaping the transplanted tooth to the anterior maxilla should be done as soon as possible for psychological and aesthetic reasons. However, to avoid interfering with the natural healing process, reshaping of transplanted teeth is usually delayed three to four months after transplantation. This delay creates a need for simple indirect temporary aesthetic restoration for autotransplanted teeth. The aim of this study was to develop and validate a digital solution for temporary restoration of autotransplanted teeth using 3D printing. (2) Methods: Four dry human skulls and four dry human mandibles were scanned using cone beam computed tomography to create 3D models for 15 premolars. Digital impression of the maxillary arch of one of the skulls was captured by intra oral scanner. The digital work flow for the design and fabrication of temporary veneers is presented. The seating and adaptation of the 3D printed veneers were evaluated using stereomicroscopy and micro-computed tomography. (3) Results: Evaluation of the veneer seating using stereomicroscopy showed that the mean marginal gap at all of the sides was below the cut-off value of 200 µm. The overall mean marginal gap was 99.9 ± 50.7 µm (median: 87.8 (IQR 64.2–133 µm)). The internal adaptation evaluation using micro-computed tomography showed an average median gap thickness of 152.5 ± 47.7 (IQR 129–149.3 µm). (4) Conclusions: The present concept of using temporary veneers that are designed and fabricated with CAD/CAM (computer-aided design/computer-aided manufacturing) technology using a DLP (digital light processing) printer may present a viable treatment option for restoration of autotransplanted teeth.

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As Low Dose as Sufficient Quality: Optimization of Cone-beam Computed Tomographic Scanning Protocol for Tooth Autotransplantation Planning and Follow-up in Children

Cited by 48 publications

References 30 publications

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

In vitro diagnostic accuracy of low‐dose CBCT for evaluation of peri‐implant bone lesions

Halve the dose while maintaining image quality in paediatric Cone Beam CT

3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo

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