Density estimation based on the Hounsfield unit value of cone beam computed tomography imaging of the jawbone system

Genisa, Maya; Shuib, Solehuddin; Rajion, Zainul Ahmad; Arief, Erry Mochamad; Hermana, Maman

doi:10.1177/0954411918806333

Cited by 12 publications

(13 citation statements)

References 15 publications

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“…Predicting cortical bone densities and thickness by cortical shells of the ROIs using clinical CT provided excellent correlations with micro CT results 29,30 . The accuracy of bone densities calculated from Hounsfield units (HUs) from CT data has been demonstrated 31 , and three-dimensionally (3D) reconstructed axial CT images could accurately define the border of the cortical bone 32,33 . Therefore, owing to advances of 3D-modeling technology using CT images, cortical bone density and thickness of craniofacial structures could be evaluated in routine clinics.…”

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confidence: 99%

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Hong

Kang

2020

Sci Rep

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this study aimed to clarify how masticatory muscle atrophy induced by botulinum toxin (BtX) injection affects cortical bone quality of the mandible using 3D modeling technology. A total of 39 young (26.9 ± 6.0 years) and 38 post-menopausal (55.3 ± 6.3 years) females were included. Computed tomography (CT) images were obtained before and after 12 months of treatment. Predictor variables were application of a stabilization splint, and/or two times of BtX injection in the bilateral temporalis and masseter muscles within a six-month interval. Outcome variables were changes in average Hounsfield units (HU) and cortical thickness of region of interest (ROI). 3D mandibular models were reconstructed using CT images, and models were used to calculate average HU and cortical thickness of Rois, including inferior half of the lateral surface of ascending ramus, coronoid process, and temporomandibular joint condyle. Cortical bone quality at muscle insertion site was influenced by decreased muscle thickness but seemed not to be affected by decreased functional loading. Reduced functional loading seemed to influence cortical bone quality of the condyles. These effects were more remarkable in post-menopausal females. Hence, decreased masticatory muscle thickness may lead to alterations of the mandibular cortical structures, especially in post-menopausal females. Bone is a dynamic structure that continuously undergoes a remodeling process through resorption and apposition to meet environmental requirements. The adaptation rate of the bone to functional loading is mediated by dynamic forces of the associated muscles 1. Skeletal muscles transduce mechanical loading to the bone in three ways: (1) the tensile force developed by a muscle contraction at its insertion site, (2) the compressive force developed by muscles that transduce loading across the joints, and (3) the bending force experienced by long bone associated muscles for lifting distally held objects 2. The role of mechanical stimulation by muscles to maintain bone density has been well known and the association among the amount of physical activity, body muscle mass, and quality of both cortical and trabecular bones has also been investigated 3-6. Botulinum toxin (BTX) acts as a pre-synaptic neurotoxin that blocks neuromuscular transmission by inhibiting acetylcholine release from the motor and sympathetic nerve terminals 7 as well as inflammatory mediators including substance P and glutamate 7,8. Muscle paralysis induced by BTX injection was related with not only reduced active loading but also an increased passive elastic modulus of muscle fiber bundles 9. BTX has been used not only for cosmetic purposes but also to improve symptoms associated with temporomandibular disorders (TMDs), myofascial pain syndrome, and headaches. The majorities of adverse effects associated with the application of BTX in the orofacial region are mild and transient including bruising, swelling, pain around the injection site, and masticatory muscle weakness 10. Several previous studies have rev...

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confidence: 99%

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Hong

Kang

2020

Sci Rep

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“…The Hounsfield Scale (HU) was used to understand bone regeneration. Bone density measurements from X-ray absorption, generate attenuation coefficients used to measure degenerative bone changes, and provide parameters for planning oral rehabilitation with osseointegrated implants 19,20 . For our study, the HU Scale was a measure of bone healing, and demonstrated that S53P4 maintained high tissue attenuation coefficients, without necessarily indicating bone consolidation.…”

Section: Discussionmentioning

confidence: 99%

“…For bone regeneration analyses, T1 and T2 tomograms were compared. Parameters included bone attenuation density/coefficients, and followed the Hounsfield Scale 19 , 20 . To this end, coordinates X/Y were located in the linear half of bone gaps, using the cursor in the 2D function of the Radiant DICOM viewer software (Medixant).…”

Section: Methodsmentioning

confidence: 99%

Bioactive glass granules S53P4 in osteotomy Le Fort I

Cruz

Souza

Menezes³

et al. 2020

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We evaluated bioactive glass graft (S53P4) in patients undergoing Le Fort I osteotomy, with nongrafted patients as controls. Computed tomography facial scans of the 25 patients submitted for Le Fort I were divided into two groups: Group 1-S53P4 group and Group 2-without grafting. CT scans were analyzed in the immediate postoperative period (T1) and 6 months later (T2), for linear bone gap measurements, tomographic radiodensity and behavior of the maxillary sinus. A Kruskal-Wallis test on bone gap data adopted α significance levels (p ≤ 0.05). The Friedman test (p ≤ 0.05) was used to evaluate sinus reaction cores. For gap measurements, we observed a decrease in median data between T1 and T2 in both groups, with statistical significances observed between groups in T0; G1 presented statistical difference in its two studied times (p ≤ 0.0001). For bone density, the studied data behaved inversely. G1′s bone density decreased from T1 to T2, whereas in G2 there was an increase from T1 to T2. S53P4 did not elicit increased reactions and/or sinus infections in the G1 group (p ≥ 1.00). S53P4 did not impact on Le Fort I osteotomies as a coadjuvant and a favorable factor in bone formation, and appeared innocuous in the maxillary sinus. Orthognathic surgery mobilizes and repositions the jaw bone base via osteotomy, to ensure functional and aesthetic results for dental-skeletal discrepancies 1-3. Tridimensional surgical movements of the upper jaw are considered unstable with larger bone gaps, thus increasing the need for bone grafts, especially in upper jaw advances of > 4 mm, which normally generate bone discontinuities of > 3 mm 1-7. Autogenous grafts minimize large bone discontinuities in the osteotomy line 4,6-8. Similarly, several bone substitutes have been created to decrease morbidity in patients 9-11. This follows recent technological innovations that cater for increased tissue regeneration and pathogen inhibition 12-14. In 1969, Hench et al. developed materials based on bioactive glass 12,13. Since then, these materials have been used in modern clinical applications such as dentistry, orthopedic surgeries and otorhinolaryngology 12. S53P4 produces osteoconductive biological responses at tissue-biomaterial interfaces, by forming silica gel layers that attract and differentiate osteoblasts into bone. The material interacts with growth factors to stimulate angiogenesis and pathogen inhibition via elevated pH and osmotic pressure 12,13,15-17. No studies have yet explored S53P4 in linear bone defects of few walls as in Le Fort I osteotomies, considering the anatomical proximity to the maxillary sinus and its behavior in front of bioactive glass. Therefore, we evaluated S53P4 in patients undergoing Le Fort I osteotomies, with non-grafted patients as controls. Materials and methods This retrospective observational case-control study evaluated data from medical records and CT scans of individuals who underwent Le Fort I osteotomy using a bioactive glass graft, when compared with non-grafted individuals. Ethical considerations...

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“…In contrast, conventional CT scans are not only able to provide information in association with fracture patterns [9] but also provide additional information on bone properties, which are therefore called "opportunistic osteoporosis CT scans" [10]. Owing to the advances in 3D graphic processing technologies, the measurement of the thickness and density of the cortical bone in the target region of interests (ROI) using CT data has become possible [11,12]. Specifically, the average Hounsfield Unit (HU) and cortical bone thickness can be automatically calculated using a 3D graphic processing software.…”

Section: Introductionmentioning

confidence: 99%

“…The advancement in 3D graphic processing technology has made the evaluation of the cortical bone quality possible based on conventional CT images, especially in the craniofacial field [11,22]. The validity and reliability of such an assessment method in association with the measurement of the cortical bone density in the craniofacial field have been shown [11]. However, few studies have investigated the qualities of extremity skeletal cortical bone with the application of this technology [12].…”

Section: Introductionmentioning

confidence: 99%

Association between forearm cortical bone properties and handgrip strength in women with distal radius fractures: A cross-sectional study

et al. 2020

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Objectives Mechanical and biochemical bone properties are influenced by muscles. However, the muscle-bone interaction has not been fully elucidated regarding the upper extremities. The objective of the present study was to evaluate the mechanical muscle-bone interaction at the forearm by evaluating the relationship between the properties of three-dimensional (3D) forearm cortical bone models derived from conventional computed tomography (CT) images and handgrip strength (HGS). Methods A total of 108 women (mean age, 75.2 ± 9.4 years; range, 62–101 years) with a distal radius fracture who took conventional CT scans for the assessment of the fracture were included in this study. Distal radius 3D models were reconstructed and the average cortical bone density (Cd) and thickness (Ct) of the region of interest (ROI), which might be affected by the forearm flexor muscles, were calculated using a 3D modeling software. Clinical parameters including HGS, lumbar and hip bone mineral densities (BMDs), and other demographic factors were also obtained. A multivariate linear regression analysis was performed to identify relevant factors associated with HGS. Results HGS was found to be independently associated with height and Cd, but no significant difference was found between HGS and Ct, age, weight, as well as lumber and hip BMDs. Conclusions Cortical bone density might be associated with HGS, which is generated by the forearm flexor muscles. Hence, the mechanical muscle-bone interaction in the upper extremities could be supported by the present study.

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Density estimation based on the Hounsfield unit value of cone beam computed tomography imaging of the jawbone system

Cited by 12 publications

References 15 publications

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Bioactive glass granules S53P4 in osteotomy Le Fort I

Association between forearm cortical bone properties and handgrip strength in women with distal radius fractures: A cross-sectional study

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