Digital subtraction radiography evaluation of the bone repair process of chronic apical periodontitis after root canal treatment

Silva, J. Benfica e; Leles, Cláudio Rodrigues; Alencar, Ana Helena Gonçalves de; Nunes, Carla A. B. C. M.

doi:10.1111/j.1365-2591.2010.01735.x

Cited by 13 publications

(15 citation statements)

References 22 publications

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“…In the 1980s, the introduction of subtraction radiography enabled the visualization of bone changes and allowed reliable monitoring of density changes in different clinical situations. 13 Benfica e Silva et al 13 used the "digital subtraction radiography" software to perform the radiographic subtraction technique to evaluate the bone healing process of chronic periapical lesion after root canal treatment. The results showed that, by analyzing the intensity of the pixels and their gray tones, the method could determine the progress of apical healing.…”

Section: Discussionmentioning

confidence: 99%

Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases

Villoria¹,

Lenzi²,

Soares³

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To describe the use of open-source software for the post-processing of CBCT imaging for the assessment of periapical lesions development after endodontic treatment. Methods: CBCT scans were retrieved from endodontic records of two patients. Threedimensional virtual models, voxel counting, volumetric measurement (mm 3 ) and mean intensity of the periapical lesion were performed with ITK-SNAP v. 3.0 software. Threedimensional models of the lesions were aligned and overlapped through the MeshLab software, which performed an automatic recording of the anatomical structures, based on the best fit. Qualitative and quantitative analyses of the changes in lesions size after treatment were performed with the 3DMeshMetric software. Results: The ITK-SNAP v. 3.0 showed the smaller value corresponding to the voxel count and the volume of the lesion segmented in yellow, indicating reduction in volume of the lesion after the treatment. A higher value of the mean intensity of the segmented image in yellow was also observed, which suggested new bone formation. Colour mapping and "point value" tool allowed the visualization of the reduction of periapical lesions in several regions. Conclusions: Researchers and clinicians in the monitoring of endodontic periapical lesions have the opportunity to use open-source software.

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Section: Discussionmentioning

confidence: 99%

Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases

Villoria¹,

Lenzi²,

Soares³

et al. 2017

Dentomaxillofacial Radiology

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“…DSR has been used both in vitroand in clinical studies as a sensitive tool to monitor minor bone changes, including mineral loss and gain. [9][10][11][12][13][14][15][16][17][18] The DSR method is based on the digital alignment and superimposition of two radiographs of the same region obtained at different time. 19 A subtracted image is produced using a specific software system algorithm that converts the two radiographic images into a homogeneous grey background of 128 pixels.…”

Section: Introductionmentioning

confidence: 99%

“…Unchanged regions present grey pixel values close to 128, while higher values indicate mineral density gain and lower values are compatible with density loss. [17][18][19][20] DSR is commonly used for different purposes in dentistry and subtracted images can be obtained from conventional or digital radiographs. These two-dimensional images of three-dimensional structures can provide only limited information about a region of interest, due to superposition, inherent to bidimensional radiographs, which leads to a limited three-dimensional visualization at different depth levels.…”

Section: Introductionmentioning

confidence: 99%

Detection of Bone Mineral Density Changes by Subtraction of Cone-Beam Computed Tomography Images: A Pilot Study

Sousa¹

2017

JDHODT

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The objective in this study was to investigate the feasibility of digital subtraction technique using cone beam computed tomography (CBCT) images to assess mineral density changes in dry mandibular bone tissue. A simulated procedure to mimic periapical bone loss was performed in 12 alveolar sockets of a dry mandible by controlled application of 0.1ml of a 70% perchloric acid solution. Digital periapical radiographs and CBCT exams were taken at baseline and after 2, 4 and 24hours. Simulated mineral gain was also performed in four alveolar sockets using a bone substitute in differing amounts (baseline, 0.07 and 0.14g) aggregated in a wax medium. All images were subtracted from baseline, resulting in four subtracted images (S 0-S 1-S 2-S 3) for simulated bone loss and three subtracted images for mineral gain (S 0-S 1-S 2) from periapical radiographs and CBCT. Quantitative analysis of mineral density was performed to assess pixel value changes in a grey scale ranging from 0 (black) to 255 (white) pixels. A gradual decrease in pixel values from S 0 to S 3 was observed in all images (p<0.001). Pairwise comparison between periapical radiographs and CBCT slices showed no significant differences, although the subtle changes in the S 1 images (after 2hours) were less apparent in the periapical radiographs. A continuous progressive gain in mineral bone was also observed from baseline to S 1 and S 2. The results suggest that subtracted CBCT images can be used to monitor mineral bone changes based on the pixel grey values of images, with potential application for evaluation of bone repair.

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“…Whilst subtraction radiography facilitates assessment of periapical bone tissue changes over time, it has been tested in only a few clinical follow‐up studies (Nicopoulou‐Karayianni et al. 2002, Benfica e Silva et al. 2010).…”

Section: Introductionmentioning

confidence: 99%

Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review

et al. 2012

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This systematic review evaluates the diagnostic accuracy of radiographic methods employed to indicate presence/absence and changes over time of periapical bone lesions. Also investigated were the leads radiographic images may give about the nature of the process and the condition of the pulp in nonendodontically treated teeth. Electronic literature search included the databases PubMed, Embase and CENTRAL from January 1950 to June 2011. All languages were accepted provided there was an abstract in English. The MeSH terms were 'Cone beam computed tomography (CBCT)', 'Radiography, panoramic', 'Periapical diseases', 'Dental pulp diseases', 'Sensitivity and specificity', 'receiver operating characteristics (ROC) curve', 'Cadaver', 'Endodontics' and 'Radiography dental'. Two reviewers independently assessed abstracts and full text articles. An article was read in full text if at least one of the two reviewers considered an abstract to be potentially relevant. Altogether, 181 articles were read in full text. The GRADE approach was used to assess the quality of evidence of each radiographic method based on studies of high or moderate quality. Twenty-six studies fulfilled criteria set for inclusion. None was of high quality; 11 were of moderate quality. There is insufficient evidence that the digital intraoral radiographic technique is diagnostically as accurate as the conventional film technique. The same applies to CBCT. No conclusions can be drawn regarding the accuracy of radiological examination in identifying various forms of periapical bone tissue changes or about the pulpal condition.

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Digital subtraction radiography evaluation of the bone repair process of chronic apical periodontitis after root canal treatment

Abstract: Digital subtraction radiography is a useful method for evaluating the progress of bone repair after root canal treatment. Noticeable mineral gain was observed approximately 90 days after root canal filling and definite bone repair after 180 days.

Cited by 13 publications

References 22 publications

Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases

Post-processing open-source software for the CBCT monitoring of periapical lesions healing following endodontic treatment: technical report of two cases

Detection of Bone Mineral Density Changes by Subtraction of Cone-Beam Computed Tomography Images: A Pilot Study

Radiological diagnosis of periapical bone tissue lesions in endodontics: a systematic review

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