ABSTRACT
OBJECTIVES: Foreign bodies (FBs) account for 3.8% of all pathologies of the head and neck region, and approximately one third of them are missed on initial examination. Thus, FBs represent diagnostic challenges to maxillofacial surgeons, rendering it necessary to employ an appropriate imaging modality in suspected cases. MATERIALS AND METHODS: In this cross-sectional study, five different materials, including wood, metal, glass, tooth and stone, were prepared in three sizes (0.5, 1, and 2 mm) and placed in three locations (soft tissue, air-filled space and bone surface) within a sheep's head (one day after death) and scanned by panoramic radiography, cone-beam computed tomography (CBCT), and ultrasonography (US) devices. The images were reviewed, and accuracy of the detection modalities was recorded. The data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U-test, Friedman, Wilcoxon signed-rank and kappa tests (P < 0.05). RESULTS: CBCT was more accurate in detection of FBs than panoramic radiography and US (P < 0.001). Metal was the most visible FB in all of modalities. US was the most accurate technique for detecting wooden materials, and CBCT was the best modality for detecting all other materials, regardless of size or location (P < 0.05). The detection accuracy of US was greater in soft tissue, while both CBCT and panoramic radiography had minimal accuracy in detection of FBs in soft tissue. CONCLUSION: CBCT was the most accurate detection modality for all the sizes, locations and compositions of FBs, except for the wooden materials. Therefore, we recommend CBCT as the gold standard of imaging for detecting FBs in the maxillofacial region.
Subject(s)
Cone-Beam Computed Tomography , Cross-Sectional Studies , Foreign Bodies , Glass , Head , In Vitro Techniques , Neck , Oral and Maxillofacial Surgeons , Pathology , Radiography, Panoramic , Tooth , Ultrasonography , WoodABSTRACT
OBJECTIVES@#Foreign bodies (FBs) account for 3.8% of all pathologies of the head and neck region, and approximately one third of them are missed on initial examination. Thus, FBs represent diagnostic challenges to maxillofacial surgeons, rendering it necessary to employ an appropriate imaging modality in suspected cases.@*MATERIALS AND METHODS@#In this cross-sectional study, five different materials, including wood, metal, glass, tooth and stone, were prepared in three sizes (0.5, 1, and 2 mm) and placed in three locations (soft tissue, air-filled space and bone surface) within a sheep's head (one day after death) and scanned by panoramic radiography, cone-beam computed tomography (CBCT), and ultrasonography (US) devices. The images were reviewed, and accuracy of the detection modalities was recorded. The data were analyzed statistically using the Kruskal-Wallis, Mann-Whitney U-test, Friedman, Wilcoxon signed-rank and kappa tests (P < 0.05).@*RESULTS@#CBCT was more accurate in detection of FBs than panoramic radiography and US (P < 0.001). Metal was the most visible FB in all of modalities. US was the most accurate technique for detecting wooden materials, and CBCT was the best modality for detecting all other materials, regardless of size or location (P < 0.05). The detection accuracy of US was greater in soft tissue, while both CBCT and panoramic radiography had minimal accuracy in detection of FBs in soft tissue.@*CONCLUSION@#CBCT was the most accurate detection modality for all the sizes, locations and compositions of FBs, except for the wooden materials. Therefore, we recommend CBCT as the gold standard of imaging for detecting FBs in the maxillofacial region.
ABSTRACT
Statement of the Problem: The diagnosis of vertical root fracture [VRF] is a challenging task
Purpose: This in vitro study compared cone beam computed tomography [CBCT] imaging with digital periapical radiography [DPR] made by three different horizontal angels [20 degree mesial, 0 degree and 20 degree distal] for accurate diagnosis of VRF
Materials and Method: Among 120 posterior teeth included in this study, 60 were vertically fractured. Fractured and non-fractured teeth were randomly distributed into three groups defined as group 1 with no filling in the root canal, group 2 with gutta-percha in the canal, and group 3 with the intracanal post. All samples were placed in a dry mandible and imaged with CBCT and DPR techniques. Two blind observers investigated the images
Results: CBCT had higher sensitivity but lower specificity compared with DPR, except for the intracanal post group in which the sensitivity of DPR was higher; though the chi-square test showed the differences to be statistically insignificant. The sensitivity, specificity, and accuracy of CBCT and DPR were reduced in the cases that gutta-percha or post were present in the canal. Inter-observer agreement was higher for CBCT. A set of three DPRs with different horizontal angels were significantly more sensitive for VRF recognition than a single orthogonal DPR
Conclusion: Based on our results, there was no significant difference between CBCT and a set of three DPRs with different angulations for VRF detection in posterior teeth. Therefore, it is suggested to consider DPRs with three different horizontal angels [20 degree mesial, 0 degree and 20 degree distal] for radiographic evaluation before CBCT examination