CBCT Imaging of Paranasal Sinuses and Variations

Paranasal sinuses located in the bones surrounding the nasal cavity are called maxillary, ethmoid, frontal and sphenoid sinuses. In relation with their location, these sinuses contribute to the development of the facial structures, jaws and upper airway. During the developmental process of the paranasal sinuses, anatomic variations can occur in consequence of intra and extramural migration of the ethmoid air cells, overpneumatization or hypoplasia of the sinuses and bulging of the neurovascular structures to the sinuses. Some of these anatomic variations may affect the drainage pathways, pave the way for chronic infections and cause difficulties when performing paranasal sinuses surgery. Therefore, the aim of this chapter was to examine the paranasal sinus anatomic variations with cone beam computed tomography (CBCT)

Clinically applicable artificial intelligence system for dental diagnosis with CBCT

Abstract In this study, a novel AI system based on deep learning methods was evaluated to determine its real-time performance of CBCT imaging diagnosis of anatomical landmarks, pathologies, clinical effectiveness, and safety when used by dentists in a clinical setting. The system consists of 5 modules: ROI-localization-module (segmentation of teeth and jaws), tooth-localization and numeration-module, periodontitis-module, caries-localization-module, and periapical-lesion-localization-module. These modules use CNN based on state-of-the-art architectures. In total, 1346 CBCT scans were used to train the modules. After annotation and model development, the AI system was tested for diagnostic capabilities of the Diagnocat AI system. 24 dentists participated in the clinical evaluation of the system. 30 CBCT scans were examined by two groups of dentists, where one group was aided by Diagnocat and the other was unaided. The results for the overall sensitivity and specificity for aided and unaided groups were calculated as an aggregate of all conditions. The sensitivity values for aided and unaided groups were 0.8537 and 0.7672 while specificity was 0.9672 and 0.9616 respectively. There was a statistically significant difference between the groups (p = 0.032). This study showed that the proposed AI system significantly improved the diagnostic capabilities of dentists

Oral Cancer Knowledge and Awareness among Patients Referred to a University Dental Hospital in North Cyprus

Public knowledge about oral cancer may help to prevent and detect the disease at an early stage. This study aimed to evaluate the awareness and knowledge levels on oral cancer symptoms and risk factors among patients attending a faculty of dentistry in North Cyprus. A total of 250 adult dental patients participated voluntarily in a self-administered questionnaire. The questionnaire included questions on sociodemographic profile, oral cancer awareness, and knowledge. A total of 54.8% of the participants were male and 91.2% of the participants had a high school diploma and above education. Most participants were knowledgeable about oral cancer symptoms and a majority of them identified oral ulceration (64%). Tobacco cessation was the most selected option for protecting from oral cancer (79.6%). Significant differences were found between genders in current smokers, past tobacco users, alcohol users, and HPV awareness questions (p < 0.05). Furthermore, awareness and knowledge questions were compared between smoker and non-smoker participants and significant differences were found in the answers of ‘alcohol may cause mouth cancer’ and ‘quit tobacco use to prevent oral cancer’ (p < 0.05). This study showed that most of the participants were aware that tobacco cessation reduces the risk of oral cancer. The survey results showed that patients in North Cyprus are generally aware of the risk of tobacco-related oral cancer, but they demonstrate lower knowledge about other risk factors

Comparison of linear and angular measurements in CBCT scans using 2D and 3D rendering software

The aim of this study was to compare the reliability of both linear and angular measurements conducted on two-dimensional (2D) lateral cephalometric images and three-dimensional (3D) cone-beam computed tomography-generated cephalograms derived from various rendering software. Pre-treatment cephalometric digital radiographs of 15 patients and their corresponding cone beam computed tomographic images were randomly selected. Vista Dent OC as 2D, In vivo 5.1.2, Maxilim and Romexis software were used to generate cephalograms from the CBCT scans (NewTom 3G, QR Verona, Italy). In total, 19 cephalometric landmarks were identified and 18 widely used (11 linear, 7 angular) measurements were performed by an independent observer. Mann–Whitney and Kruskall–Wallis H tests were also used to compare the four methods (p 0.05). The ICCs for Vista Dent OC (2D) measurements indicated high reproducibility (p < 0.05). The 2D and 3D generated cephalograms from various rendering software were found to be similar; however, measurements on curved surfaces are not easily reproducible for 3D software

Association among Orthodontic Malocclusions, Paranasal Sinuses Anatomic Variations and Adenoid Vegetation in Children Using CBCT

The aim of this study is to evaluate the relationship between orthodontic malocclusion, paranasal sinus (PS) variations, and adenoid vegetation in a group of pediatric patients with chronic rhinosinusitis. Clinical and radiographical data were retrospectively evaluated and 58 patients were diagnosed as having chronic sinus disease. Cone-beam computed tomography (CBCT) images were acquired with Newtom-3G. Anatomical variations of the PS were assessed on every section. Additionally, for cephalometric analysis, the images were imported into the InVivoDental software program. A total of 252 anatomical variations, which encompassed 19 different types, were detected in the current study. Concha bullosa was the most common anatomical variation, at 72.4%. Septum deviation was the second most common one, at 67.2%. The Class III group exhibited a significantly higher prevalence of concha bullosa and secondary middle turbinate than the other groups. While adenoid vegetation was most common in the Class III group, sinusitis and antral disease were most common in the Class II group. Overall, Class III subjects exhibited fewer PS variations. In conclusion, concha bullosa emerged as the most prevalent anatomical variation, with distinctive patterns observed across different malocclusion groups. Therefore, CBCT is useful, especially in pediatric patients, due to its low dose advantage

Evaluation of Visual Evoked Potentials in Children with Neurofibromatosis Type 1 and Comparison With Radiological Findings

Amaç: Nörofibramotozis Tip 1 (NF tip 1)’li çocukların desen görsel uyarılmış (pattern visual evoked potentials; P-VEP) potansiyellerini değerlendirmek ve P-VEP sonuçlarının, optik gliom ve NF Tip 1 ilişkili bilinmeyen parlak objeler (unidentified brigtht objects; UBO) ile korelasyonunu irdelemek amaçlanmıştır. Gereç ve Yöntem: 2017-2020 yılları arasında XXXXXXXXXXXXX Çocuk Nöroloji Polikliniği’nde NF Tip 1 tanısı ile takip edilen, yaş ortalaması 9,61±3,7 yaş olan, 16 (%57)’sı erkek, 28 çocuk hastanın P-VEP P 100 latans değerleri, yaş ve cinsiyeti benzer 28 sağlıklı çocuktan oluşan kontrol grubunun P100 latansları ile karşılaştırıldı. Sonuç: Hastaların %82’sinde beyin magnetik resonans görüntülemede UBO, %21’inde optik gliom saptandı. Hasta grubunda P100 latansları kontrol grubuna göre anlamlı olarak daha uzun idi (p=0.013, p=0.043). Optik gliomu olan hastaların P100 latanslarının, optik gliomun anotomik lokalizasyonu ile uyumlu şekilde, optik gliomu olmayan hastalara göre anlamlı olarak daha uzun olduğu görüldü (p=0.042, p=0.025). Sonuç: Bu çalışma ile P-VEP testinin NF Tip 1’li çocuklarda görme yollarının fonksiyonel değerlendirmesinde kullanılabilecek objektif bir elektrofizyolojik test olduğu gösterilmiştir. NF Tip 1’li çocukların klinik takibinde P-VEP testinin kullanılmasının özellikle optik gliomların erken dönem tespitinde yararlı olabileceğini düşünmekteyiz

A Fused Deep Learning Architecture for the Detection of the Relationship between the Mandibular Third Molar and the Mandibular Canal

The study aimed to generate a fused deep learning algorithm that detects and classifies the relationship between the mandibular third molar and mandibular canal on orthopantomographs. Radiographs (n = 1880) were randomly selected from the hospital archive. Two dentomaxillofacial radiologists annotated the data via MATLAB and classified them into four groups according to the overlap of the root of the mandibular third molar and mandibular canal. Each radiograph was segmented using a U-Net-like architecture. The segmented images were classified by AlexNet. Accuracy, the weighted intersection over union score, the dice coefficient, specificity, sensitivity, and area under curve metrics were used to quantify the performance of the models. Also, three dental practitioners were asked to classify the same test data, their success rate was assessed using the Intraclass Correlation Coefficient. The segmentation network achieved a global accuracy of 0.99 and a weighted intersection over union score of 0.98, average dice score overall images was 0.91. The classification network achieved an accuracy of 0.80, per class sensitivity of 0.74, 0.83, 0.86, 0.67, per class specificity of 0.92, 0.95, 0.88, 0.96 and AUC score of 0.85. The most successful dental practitioner achieved a success rate of 0.79. The fused segmentation and classification networks produced encouraging results. The final model achieved almost the same classification performance as dental practitioners. Better diagnostic accuracy of the combined artificial intelligence tools may help to improve the prediction of the risk factors, especially for recognizing such anatomical variations

Frequency of azole resistance in clinical and environmental strains of Aspergillus fumigatus in Turkey: a multicentre study

Objectives Aspergillus fumigatus causes several diseases in humans and azole resistance in A. fumigatus strains is an important issue. The aim of this multicentre epidemiological study was to investigate the prevalence of azole resistance in clinical and environmental A. fumigatus isolates in Turkey. Methods Twenty-one centres participated in this study from 1 May 2018 to 1 October 2019. One participant from each centre was asked to collect environmental and clinical A. fumigatus isolates. Azole resistance was screened for using EUCAST agar screening methodology (EUCAST E.DEF 10.1) and was confirmed by the EUCAST E.DEF 9.3 reference microdilution method. Isolates with a phenotypic resistance pattern were sequenced for the cyp51A gene and microsatellite genotyping was used to determine the genetic relationships between the resistant strains. Results In total, resistance was found in 1.3% of the strains that were isolated from environmental samples and 3.3% of the strains that were isolated from clinical samples. Mutations in the cyp51A gene were detected in 9 (47.4%) of the 19 azole-resistant isolates, all of which were found to be TR34/L98H mutations. Microsatellite genotyping clearly differentiated the strains with the TR34/L98H mutation in the cyp51A gene from the strains with no mutation in this gene. Conclusions The rate of observed azole resistance of A. fumigatus isolates was low in this study, but the fact that more than half of the examined strains had the wild-type cyp51A gene supports the idea that other mechanisms of resistance are gradually increasing.This work was partly supported by Bursa Uludag University Scientific Research Projects Commission (QUAP[T]-2015-5) and Ener Private Health Service Company.Bursa Uludag University Scientific Research Projects Commission [QUAP[T]-2015-5]; Ener Private Health Service Compan

Evaluation of Perimandibular Neurovascularization With Accessory Mental Foramina Using Cone-Beam Computed Tomography in Children

Orhan, Kaan/0000-0001-6768-0176WOS: 000330129000019PubMed: 23851871Objectives: The purpose of this study was to clarify the perimandibular neurovascularization with mandibular accessory mental foramina in a children population using cone-beam computed tomography (CBCT) to avoid complications during anesthetic and surgical procedures. Methods: This retrospective study evaluated cone-beam CT images for bifid mandibular canals in the mandibles of 63 children (35 girls, 28 boys; age range, 7-16 years; mean age, 12.3 years). Both right and left sides were examined from CT images (n = 126), including axial, sagittal, cross-sectional, and panoramic views as well as reconstructed three-dimensional images, as necessary. The course, length, and superior and inferior angles between canals were classified and measured. Results: Bifid mandibular canals were observed in 34 (27%) of the 126 sides examined. The most frequently encountered type of bifid canal was the retromolar canal (11.1%), followed by the forward (7.14%), buccolingual (6.35%), and dental canal (2.4%). Mean lengths of bifid canals were 10.2 mm on the right side and 10.6 mm on the left side. Mean superior angles were 131 degrees on the right side and 147 degrees on the left side, whereas mean inferior angles were 47 degrees on the right side and 34 degrees on the left side. No statistically significant differences were found in the lengths or angles between the right and left sides or between boys and girls (P < 0.05). The most common position for the mental foramen was between the first and second premolars, and an accessory mental foramen was observed in 4 children (6.34%). Conclusions: This study utilized CBCT images to identify bifid mandibular canals and accessory mental foramina in children. Cone-beam CT was found to be a useful technique for detecting secondary canals. However, despite the fact that CBCT uses less ionizing radiation than other types of three-dimensional imaging, unless the diagnostic information provided through CBCT improves treatment results, CBCT should not be recommended for use in children or adolescents