Radiographic Evaluation of Osteoporosis Through Detection of Jaw Bone Changes: a Simplified Early Osteoporosis Detection Effort

Osteoporosis has become a worldwide problem and has been known as a silence disease. Nowadays, there are a lot of diagnostic tools for detecting osteoporosis. Eighty eight postmenopausal were included and underwent digital panoramic, digital periapical, and conventional radiography. Ultrasound bone densitometry of os calcis used as gold standard. Correlation between stiffness index (SI) with a digital dental, digital panoramic and conventional dental radiography are 0.170 (p = 0.11), -0382 (p = 0.001) and 0.246 (p = 0.021) respectively. Significant relationship was found between the SI only with digital panoramic and conventional dental. The highest correlation was found between SI values with mandibular Inferior Cortex on digital panoramic (-0.382, Pearson Correlation Tests). Correlation between digital panoramic radiographs and the SI values was the highest of the three radiographic modalities in this study. This indicates that evaluation of cortical bone is more accurate than cancellous bone. Bone quality evaluation in patients at high risk for osteoporosis using panoramic and dental conventional radiograph by dentist, contributes in preventing further occurrence of osteoporosis which in turn could reduce mortality and morbidity of osteoporosis in Indonesia

Low Body Mass Index as a Risk Factor for the Onset of Porosity of the Mandibular Bone in the Elderly

Objective: To investigate whether a low body mass index (BMI) has a significant relationship with mandibular bone porosity progression by conducting a mandibular inferior cortex (MIC) classification in elderly Japanese people. Material and Methods: A total of 266 study subjects, aged 70 at baseline, were recruited for this study, conducted from 1998 to 2007. The subjects were divided into two groups according to changes in the MIC on serial panoramic radiographs during this nine-year study period: a no change group (MIC-NC) and a change group (MIC-C). All subjects in the MIC-C showed changes trending toward greater fragility. We evaluated the BMI at baseline. Logistic regression analysis was performed to assess the relationship between the MIC condition during the nine-year period (0: MIC-NC, 1: MIC-C) and BMI (kg/m2) adjusted for gender, current health status (CHS), and smoking habit (SH) at baseline. Results: The mean and standard deviations of the BMI at baseline in the MIC-NC and MIC-C were 22.8 ± 2.1 and 21.8 ± 2.5 kg/m2 for males and 23.1 ± 2.9 and 21.9 ± 2.4 kg/m2 for females. There was a significant relationship between the MIC condition and the BMI in both males (p=0.04) and females (p=0.01). The logistic regression analysis revealed a significant association between the MIC condition over the nine-year period and the BMI (OR=0.84, p=0.003), which was adjusted depending on the gender (OR=5.18, p=0.000), CHS (OR=0.53, p=0.015), and SH (OR=4.15, p=0.002) at baseline. Conclusion: A low BMI carries a risk of developing mandibular bone porosity by measuring the MIC condition in panoramic radiographs

Lateral cephalometric radiograph analysis on obstructive sleep apnea patients

Objectives: This review article is aimed to investigate changes in anatomical factors in Obstructive Sleep Apnea (OSA) patients through means of a cephalometric radiograph, which covers relation and size. Review: This literature review used online databases (PubMed and Scopus) discussing obstructive sleep apnea (OSA) in adults aged 18-80 years, using cephalometric analysis, and several keywords such as “obstructive sleep apnea and cephalometry” were employed to do the literature search. The search was limited to full-text articles written in English and published during the 2011-2021 period. Articles were selected by complying with literature review guidelines. Conclusion: Dentists can detect OSA early through lateral radiograph, which is originally an early screening tool, by paying attention to patients’ position during exposure, irradiation condition (kV, mA and Sec) and patient position in OSA diagnosis in regards to hard and soft tissue being evaluated. The specific craniofacial morphological variable could be a reliable parameter in determining the existence of OSA

Vertical Angulation Alteration Tolerance in the Periapical Radiograph of Maxillary Incisor (An in vitro Study)

The prevalence of vertical distortion in the periapical radiograph of the anterior maxillary teeth is quite significant and cingulum is commonly used as the reference of vertical distortion in anterior radiograph. Objective: To evaluate the limit of vertical angulation error that still can be tolerated. Methods: Periapical radiograph with vertical angle 0° was obtained from 30 maxillary incisors as reference, then the vertical angulation was changed into -10°, +10°, -15°, +15°, -20° and +20°. Long axis of the teeth was adjusted parallel to the film. Tooth length and cingulum width with vertical angulation alteration was measured and compared to the actual length. All of the measurement was tested using T test. Results: There were no significant differences between all the measurements of tooth length with the alteration in vertical angulation (p>0.05), whereas cingulum width had a significant difference at +15° and -10°, p<0.05. Conclusion: Tooth length in periapical radiograph of maxillary incisor with parallel position is still tolerable until 20º vertical angle errors. Cingulum width on radiograph with +15º vertical angle alteration is significantly narrowed and on radiograph with -10° vertical angle alteration is significantly widened

Osteoporosis detection using radiomorphometric examination and fractal dimensions through cone-beam computed tomography

Cone-beam computed tomography (CBCT) is becoming more widely used in the field of dentomaxillofacial radiography, but its utility for bone quality assessment is still limited. This study was conducted to describe the use of radiomorphometric examination and fractal dimensions (FDs) for osteoporosis risk detection through CBCT in elderly patients. Medical databases (PubMed, Scopus, Elsevier, and Directory of Open Access Journals (DOAJ)) were searched using the keywords osteoporosis, radiomorphometric, fractal dimension, and fractal analysis. The search limits applied were available full-text articles, publication years 2012-2021, and articles published available in English. Then, the articles included were systematically reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A total of four studies were included in this review. Seven radiomorphometric indices were used, and most indices were adopted from panoramic radiographs, such as the computed tomographycortical index, computed tomography mental index, computed tomography index, and four other indices along the mandible, which are the S (symphysis), A (anterior), M (molar), and P (posterior) indices. All of the radiomorphometric studies show similar results. These indices can identify osteoporosis-related changes and are useful as osteoporosis screening tools on CBCT. However, all FD studies show different methods and discover heterogeneous results. Radiomorphometric measurement methods in CBCT can be used to detect patients at risk for osteoporosis. The FD analysis method still finds heterogeneous research results, so it is recommended to standardize the method in terms of the shape, size, and location of the region of interest

Correlation of clinical and radiographic severity of periodontitis with furcation involvement: Evaluation of periapical radiographs and Cone-beam Computed Tomography

Objectives: To analyze the correlation of clinical and radiographic features in periodontitis with furcation involvement. Materials and Methods: Cross-sectional analytic study of 30 mandibular molars from 13 patients (8 males and 5 females), who had periodontitis with furcation involvement, with purposive sampling. Clinical, periapical and CBCT examination were then carried out . Assessment for clinical dan CBCT based on modified Glickman classification. Correlation test was performed with Kendall's Tau_b. Results: There was a significant difference between subjects of non CBCT group (clinical (p=0,01) and periapical (p=0,026)), with subjects examined by CBCT.  However there was no difference between the clinical and periapical group. There is a correlation between furcation involvement on CBCT and periapical group (r=0,528; p=0,003). Conclusion: There was no correlation between furcation involvement on clinical examination with periapical radiographs and CBCT. The correlation is only seen between periapical radiographs and CBCT

PENGGUNAAN RADIOGRAF GIGI UNTUK KEPENTINGAN IDENTIFIKASI FORENSIK

Background: Tooth has a unique characteristic. Teeth often used for forensic identification especially when the other parts of the body could not gave a difference feature used for identification. Discussion: Tooth is part of the body known for its resistant against external influence making it as an important primary identifier. Dental radiographic can act as a helpful tool in identification process to compare antemortem and postmortem data. Radiograph can give a detail features from the teeth and their surroundings, especially digital radiograph so it can ease the identification process. Conclusion : forensic identification using radiograph can be trusted

Cone-Beam Computed Tomography Accuracy for Morphological and Morphometric Evaluation of Mandibular Condyles Using Small FOV and Small Voxel Size

  The objective of this study is to evaluate the accuracy of cone beam computed tomography (CBCT) in determining and visualizing the morphology and morphometry of the mandibular condyle. Narrative reviews with article searches were carried out through NCBI's PubMed database and Scopus from September 2021–October 2021, with the inclusion criteria articles published in 2011–2021.  The temporomandibular joint (TMJ) has a crucial role and is closely related to the masticatory system. The diagnosis of temporomandibular disorder (TMD) is not easy and is complex enough to require a comprehensive clinical and radiographic examination. Pathological changes such as erosion of the condyle, fracture, ankylosis, dislocation, and osteophyte can be well seen using CBCT imaging. CBCT images obtained with smaller field of view (FOV) have smaller a voxel size and a higher image resolution. FOV or scan volume refers to the anatomical area that will be included in the data volume or the area of the patient that will be irradiated. The dimension of FOV depends on the detector size and shape, the beam projection geometry, and the ability to collimate the beam. Voxel size is an important component of image quality, related to both the pixel size and the image matrix. Selection of small FOV and small voxel size is recommended because they provide better visualization and detail for the evaluation of morphology and morphometry of the condyle, especially the detection of erosion and defects on the condyle surface

Gambaran cone-beam computed tomography pada kasus Cleidocranial Displasia

Cleidocranial dysplasia (CCD) merupakan kelainan herediter yang mempengaruhi tulang dan gigi serta diwariskan secara autosomal. Meskipun radiograf dua dimensi dapat memberikan informasi diagnosis CCD, namun memiliki keterbatasan distorsi geometrik dan superimposisi. Laporan kasus ini memaparkan dua kasus CCD yang berbeda dan mengevaluasi gambaran radiograf dengan menggunakan modalitas pencitraan Cone-Beam Computed Tomography (CBCT) dengan tujuan untuk memberikan gambaran radiografis lengkap melalui CBCT sebagai salah satu alatpenunjang diagnosis yang memberikan rekonstruksi akurat, sehingga diharapkan dapat membantu dalam menegakkan diagnosis dan menentukan rencana perawatan. Dua orang pasien berusia dua belas dan sembilan tahun dikonsultasikan dari bagian Ilmu Kedokteran Gigi Anak untuk melakukan pemeriksaan pencitraan 3D CBCT. Temuan radiografik gigi multiple supernumerary di rahang atas dan bawah serta keterlambatan pertumbuhan gigi-gigi permanen pada kedua pasien, serta adanya kelainan tumbuh kembah pada struktur kranium, tulang-tulang wajah, maksila dan mandibula. CBCT mengatasi kelemahan atau kekurangan pada radiograf dua dimensi, khususnya evaluasi dalam arah bukolingual. Pencitraan 3D CBCT memungkinkan rekonstruksi yang akurat dan dari beberapa pandangan sagital, koronal dan aksial dari gigi supernumerari sehingga dapat dengan tepat menentukan jumlah, posisi, morfologi mahkota dan juga hubungannya dengan gigi permanen yang berdekatan sehingga memudahkan dalam menentukan rencana perawatan

Radiographic Evaluation of Osteoporosis through Detection of Jaw Bone Changes: A Simplified Early Osteoporosis Detection Effort

Osteoporosis has become a worldwide problem and has been known as a silence disease. Nowadays, there are a lot of diagnostic tools for detecting osteoporosis. Eighty eight postmenopausal were included and underwent digital panoramic, digital periapical, and conventional radiography. Ultrasound bone densitometry of os calcis used as gold standard. Correlation between stiffness index (SI) with a digital dental, digital panoramic and conventional dental radiography are 0.170 (p = 0.11), -0382 (p = 0.001) and 0.246 (p = 0.021) respectively. Significant relationship was found between the SI only with digital panoramic and conventional dental. The highest correlation was found between SI values with mandibular Inferior Cortex on digital panoramic (-0.382, Pearson Correlation Tests). Correlation between digital panoramic radiographs and the SI values was the highest of the three radiographic modalities in this study. This indicates that evaluation of cortical bone is more accurate than cancellous bone. Bone quality evaluation in patients at high risk for osteoporosis using panoramic and dental conventional radiograph by dentist, contributes in preventing further occurrence of osteoporosis which in turn could reduce mortality and morbidity of osteoporosis in Indonesia