The efficacy of ultrasonography in monitoring the healing of jaw lesions

PURPOSE: This study aimed to assess the reliability of ultrasonography (US) in comparison with cone-beam computed tomography (CBCT) as a tool for monitoring the healing of jaw lesions. MATERIALS AND METHODS: Twenty-one radiolucent lesions in jaws referred to the Oral Surgery Department at our institution were selected for this study. All lesions underwent CBCT and US examinations. The anteroposterior, superoinferior, and mesiodistal dimensions of the lesions were measured on CBCT and US images before surgery and at 6 months after surgery. The dimensions were compared between the US and CBCT images. Blood-flow velocity around the lesions was measured by color Doppler before surgery and at 1 week and 6 months after surgery to assess the capability of US to show changes in blood-flow velocity around the lesion. RESULTS: Before surgery, there were no significant differences between US and CBCT in the mesiodistal and anteroposterior dimensions, although a significant difference was found in the superoinferior dimension (P < .05). However, at 6 months after surgery, significant differences were found between US and CBCT in all dimensions, and it is likely that the US measurements more accurately reflected the extent of healing. The average blood-flow velocity increased at 1 week after surgery (5.84 cm/s) compared with the velocity before surgery (4 cm/s) (P < .05). Then, at 6 months after surgery, the blood-flow velocity significantly decreased (3.53 cm/s) compared to the velocity measured at 1 week after surgery (P < .05). CONCLUSION: US with color Doppler was confirmed to be a more efficient tool than CBCT for monitoring bone healing.

IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

PURPOSE: The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. MATERIALS AND METHODS: A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. RESULTS: The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). CONCLUSION: IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

Osteoporosis prediction from the mandible using cone-beam computed tomography

PURPOSE: This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. MATERIALS AND METHODS: Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cmx15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. RESULTS: RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. CONCLUSION: Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

[Digital radiographic images comparison with subtraction radiography in bone density evaluation around dental implants]

The reduction of alveolar crestal bone density is one of the earlier signs of periimplant disease and precedes the loss of height of the alveolar crest, because of that early detection of the small changes in density is important and lead to the early onset of treatment and increases its success's percentage. This study aimed to evaluate the ability of the direct conventional digital method in detection of density changes around dental implants by the mean value of the gray level of the histogram of the selected area comparing with radiographic subtraction method. Twenty one Ankylos dental implants in the upper and lower jaw were monitored by standardized direct digital periapical radiographs 1 week after surgery and 4 months later. manipulated by radiographic subtraction method through EMAGO software. Control regions C1, C2, C3 and test regions ROI[1], ROI[2] were selected and the radiographic density was obtained by the histogram of these selected areas. This process was carried out in the conventional digital radiographs and radiographic subtraction images. After that statistical analysis were performed. The mean value of bone density change according to the conventional digital method was 11.19 +/- 5.95 and according to the radiographic subtraction method was13.12 +/- 9.36 . and the conventional digital method confirmed its ability because there was no statistically significant difference between the two methods [P>0.05]. Monitoring of peri-implant bone density by the mean gray value of the histogram in a selected area can be assessed either by the radiographic subtraction method or by the conventional digital method

[Evaluation of the color digital subtraction technique in assessing peri-implant bone changes in dental X-ray imaging]

To report the results of evaluation of the color digital subtraction technique in assessing quality and quantity peri-implant bone changes in dental x-ray imaging. Twenty dental implants were performed in the maxillary posterior regions of 20 patients [age range 22 - 39]. Digital periapical radiographic images were taken for implants in 5 consecutive follow up visits and processed using Emago advanced/5.3 software program. A region of interest [ROI] were determined in the mesial cervical area of each implant in the resulted images from which the total surface resorption [TS], the surface of bone resorption [RS] and the radiographic bone density alteration were calculated for comparison. Color subtraction precisely determined the bone alterations [TS and RS] as indicated by the statistically significant inverse relationship between each of them with radiographic bone density alteration; however, it was higher for RS [0.914 - 0.984] than TS [0.549 - 0.897]. Color coding logarithm of digital color subtraction technique in X-ray dental imaging is precise in detecting and computing the quantitative and qualitative peri-implant bone changes

[Digital subtraction technique in studying the bone quality alterations around dental implants: a comparison study between linear and logarithmic subtraction images]

The aim was to evaluate the efficiency of the digital logarithmic subtraction method in assessing the alteration of bone density around the dental implants; comparison with the digital linear subtraction method. Forty dental implants were set in the posterior mandibles of 40 patients. A standard reference periapical digital Image [A] was taken one-week post-surgical. Three images [B1, B2 and B3] were taken 3 months later. These images were treated separately by digital linear and logarithmic subtractions using Emago advanced/5,3 software; so, 120 linear subtraction and 120 logarithmic subtraction images were obtained. A region of interest [ROI] was determined distal to each implant cervical area and radiographic bone density was obtained. The mean value of the total digital subtraction evaluated by logarithmic subtraction was significantly more compared to what was evaluated by linear subtraction [21.70 +/- 9.36 and 17.24 +/- 8.98 respectively; P<0.000], counter to the mean values of the total change of the digital subtraction [0.58 +/- 0.53 and 1.89 +/- 1.38 respectively; P<0.000] and the percentage of the total change of the digital subtraction [3.41 +/- 6.64 and 13.08 +/- 10.96 respectively; P<0.000] which were less. The digital logarithmic subtraction is a precise method in evaluating the alteration of the bone density.