Visibility of the mandibular canal: from two-dimensional radiography to three-dimensional imaging

Introduction: The mandibular canal (MC), located within the mandible, carries the inferior alveolar nerve and the inferior alveolar vessels. This neurovascular bundle is at risk during mandibular surgical procedures. Therefore, an adequate preoperatively evaluation of the MC could lead to safer treatment with less postoperative complications. Aim: The aim of this paper was to review the most common radiographic techniques of the MC for better preoperative planning in dentistry. Methods: Three radiographic techniques (periapical, panoramic and cone-beam computed tomography) along with their advantages and disadvantages are hereby reviewed with special emphasis on their clinical applicability in the dentist’s everyday practice. Discussion: Panoramic radiography and cone-beam computed tomography technology are considered very useful in the assessment of the MC. Conclusion: All techniques reviewed in this paper except the periapical radiography can be useful in the visibility of the MC

A 3D environment for surgical planning and simulation

The use of Computed Tomography (CT) images and their three-dimensional (3D) reconstruction has spread in the last decade for implantology and surgery. A common use of acquired CT datasets is to be handled by dedicated software that provide a work context to accomplish preoperative planning upon. These software are able to exploit image processing techniques and computer graphics to provide fundamental information needed to work in safety, in order to minimize the surgeon possible error during the surgical operation. However, most of them carry on lacks and flaws, that compromise the precision and additional safety that their use should provide. The research accomplished during my PhD career has concerned the development of an optimized software for surgical preoperative planning. With this purpose, the state of the art has been analyzed, and main deficiencies have been identified. Then, in order to produce practical solutions, those lacks and defects have been contextualized in a medical field in particular: it has been opted for oral implantology, due to the available support of a pool of implantologists. It has emerged that most software systems for oral implantology, that are based on a multi-view approach, often accompanied with a 3D rendered model, are affected by the following problems: unreliability of measurements computed upon misleading views (panoramic one), as well as a not optimized use of the 3D environment, significant planning errors implied by the software work context (incorrect cross-sectional planes), and absence of automatic recognition of fundamental anatomies (as the mandibular canal). Thus, it has been defined a fully 3D approach, and a planning software system in particular, where image processing and computer graphic techniques have been used to create a smooth and user-friendly completely-3D environment to work upon for oral implant planning and simulation. Interpolation of the axial slices is used to produce a continuous radiographic volume and to get an isotropic voxel, in order to achieve a correct work context. Freedom of choosing, arbitrarily, during the planning phase, the best cross-sectional plane for achieving correct measurements is obtained through interpolation and texture generation. Correct orientation of the planned implants is also easily computed, by exploiting a radiological mask with radio-opaque markers, worn by the patient during the CT scan, and reconstructing the cross-sectional images along the preferred directions. The mandibular canal is automatically recognised through an adaptive surface-extracting statistical-segmentation based algorithm developed on purpose. Then, aiming at completing the overall approach, interfacing between the software and an anthropomorphic robot, in order to being able to transfer the planning on a surgical guide, has been achieved through proper coordinates change and exploiting a physical reference frame in the radiological stent. Finally, every software feature has been evaluated and validated, statistically or clinically, and it has resulted that the precision achieved outperforms the one in literature

Segmentasi mental foramen di mandibula pada citra radiografi panoramik dengan Self-Organizing Map

Sistem berbasis komputer di bidang medis dapat digunakan untuk membantu mendiagnosis penyakit tertentu. Pembuatan sistem berbasis komputer berdasarkan citra mempunyai beberapa tahapan penting, diantaranya adalah tahapan segmentasi. Tahapan segmentasi merupakan tahapan untuk melakukan pemisahan objek terhadap background. Thresholding merupakan metode dalam melakukan segmentasi, di mana prosesnya didasarkan pada warna keabuan yang menghasilkan citra biner; 1 (putih) untuk mewakili objek dan 0 (hitam) untuk mewakili background. Mental foramen adalah bagian yang ada dalam mandibula, salah satu fungsinya untuk identifikasi forensik. Agar fungsi mental foramen bisa digunakan, maka salah satu proses yang harus dilalui adalah proses segmentasi. Tujuan penelitian ini adalah melakukan segmentasi mental foramen di mandibula citra radiografi gigi. Manfaat dari melakukan segmentasi mental foramen pada mandibula adalah dapat menampilkan informasi mental foramen di mandibula secara jelas pada citra radiografi gigi agar dapat digunakan pada proses identifikasi manusia di kedokteran forensik gigi. Adapun algoritma yang digunakan dalam melakukan thresholding adalah Self-Organizing Map (SOM), karena telah terbukti dapat melakukan segmentasi lebih baik. Tahapan penelitian ini terdiri dari 1) Pengumpulan citra radiografi panoramic didapatkan dari RSUD Ibnu Sina Gresik di Jawa Timur sebanyak 16 citra radiografi panoramic. 2)  Citra radiografi panoramic dilakukan akuisisi agar menghasilkan citra digital; 3) Perbaikan citra menggunakan ekualisasi histogram; dan 4) Pengambilan bagian mental foramen di mandibula terlebih dahulu dilakukan croping menggunakan SOM agar komputasi tidak tinggi. Berdasarkan hasil uji coba, SOM memiliki kinerja kurang bagus dalam melakukan segmentasi mental foramen pada mandibula secara sempurna, karena hanya mampu melakukan segmentasi secara baik sebanyak 3 citra dari 16 citra berdasarkan pengamatan langsung secara manual.  Computer based system in the medical field is used to assist a diagnose of certain diseases. There are several steps to process a digital image, and the necessary part of it is image segmentation. Image segmentation is applied for separating between the foreground and background of an image. Image thresholding is a basic image segmentation that produces a binary image from a gray-level image, which 1 represents as an object; otherwise, it is the background. Mental foramina is a part of the mandibular canal that is used to acknowledge of digital forensics. In this paper, we apply mental foramina image segmentation on the mandible canal in dental radiographic. The use of mental foramina segmentation is to perform its information on mandibular obviously so that it can be used for human identification in the medical of dental graphics. We utilize the Self-Organizing Map (SOM) as it has better segmentation than other algorithms. In research methodology, we divide the process as follows: 1) primary dataset of panoramic radiographic images was obtained from RSUD Ibnu Sina Gresik, East Java with the total of images is 16. 2) The acquisition of panoramic radiographic images into digital images. 3) Image enhancement using histogram equalization. 4) Mental foramina images on the mandibular canal were cropped using SOM to avoid a high computational process. The result shows that SOM achieves low evaluation of metal foramina image segmentation on the mandibular canal since it is only undertaking three out of sixteen images based on visualization measurement

Tooth segmentation using dynamic programming-gradient inverse coefficient of variation

Teeth provide meaningful clues of an individual. The growth of the teeth is correlated with the individual age. This correlation is widely used to estimate age of an individual in applications like conducting forensic odontology, immigration, and differentiating juveniles and adolescents. Current forensic dentistry largely depends on laborious investigation process that is performed manually and can be influenced by human factors like fatigue and inconsistency. Digital panoramic radiograph dental images allow noninvasive and automatic investigation to be performed. This paper presents analyses on third molar tooth segmentation for the population in Malaysia, ranging from persons age of 5 years old to 23 years old. Two segmentation techniques: gradient inverse coefficient of variation with dynamic programming (DP-GICOV) and Chan-Vese (CV) were employed and compared. Results demonstrated that the accuracy of DP-GICOV and CV were 95.3%, and 81.6%, respectively

Artificial Intelligence in Oral Health

This Special Issue is intended to lay the foundation of AI applications focusing on oral health, including general dentistry, periodontology, implantology, oral surgery, oral radiology, orthodontics, and prosthodontics, among others

Applications of Cone Beam Computed Tomography in Orthodontics and Endodontics

Stelt, P.F. van der [Promotor]Sanderink, G.C.H. [Copromotor

A Textbook of Advanced Oral and Maxillofacial Surgery

The scope of OMF surgery has expanded; encompassing treatment of diseases, disorders, defects and injuries of the head, face, jaws and oral cavity. This internationally-recognized specialty is evolving with advancements in technology and instrumentation. Specialists of this discipline treat patients with impacted teeth, facial pain, misaligned jaws, facial trauma, oral cancer, cysts and tumors; they also perform facial cosmetic surgery and place dental implants. The contents of this volume essentially complements the volume 1; with chapters that cover both basic and advanced concepts on complex topics in oral and maxillofacial surgery

CT Scanning

Since its introduction in 1972, X-ray computed tomography (CT) has evolved into an essential diagnostic imaging tool for a continually increasing variety of clinical applications. The goal of this book was not simply to summarize currently available CT imaging techniques but also to provide clinical perspectives, advances in hybrid technologies, new applications other than medicine and an outlook on future developments. Major experts in this growing field contributed to this book, which is geared to radiologists, orthopedic surgeons, engineers, and clinical and basic researchers. We believe that CT scanning is an effective and essential tools in treatment planning, basic understanding of physiology, and and tackling the ever-increasing challenge of diagnosis in our society

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery