Abstract：
BACKGROUND: In in-vitro dental radiographic research, simulation of soft tissue is required to replicate the clinical condition as close as possible. This study aimed to find out which soft tissue simulation material have been studied to use in dentomaxillofacial radiology and showed similarity in radiodensity to the soft tissues of the maxillofacial region.
METHODS: In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool).
RESULTS: Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant.
CONCLUSIONS: Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.
METHODS: In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool).
RESULTS: Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant.
CONCLUSIONS: Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.
摘要：
背景：在体外牙科影像学研究中，需要模拟软组织以尽可能接近地复制临床状况。这项研究旨在找出已研究用于口腔颌面放射学的软组织模拟材料，并显示出与颌面区域软组织的放射密度相似。
方法：在本范围审查中，WebofScience,Embase,Scopus,谷歌学者和PubMed数据库于2023年4月9日进行了搜索，考虑到以下PICOS：人群：软组织模拟物，干预：基于X射线的成像，比较:-,结果：软组织模拟物的特性，研究设计：体外研究。筛选,研究选择，数据提取由两名独立研究人员完成.在有分歧的情况下，与第三名小组成员进行了磋商。使用用于体外研究的质量评估工具(QUIN工具)对所包括的研究进行质量评估。
结果：在数据库搜索中检索到的最初1172篇文章中，该综述包括13项研究。七项研究的偏倚风险较低。在8项研究中，计算机断层扫描（CT）或锥形束计算机断层扫描（CBCT），在4项研究中，在2项研究中，使用了全景X线摄影（一项研究使用了CT/CBCT和全景X线摄影）。这些研究在射线照相模式上有所不同，采集参数,选定的结果，和黄金标准。在大多数研究中(n=10，77%)，丙烯酸树脂衍生物单独或作为主要成分用于软组织模拟配方中。在8项研究(62%)中,在模拟材料中使用蜡。此外,在3项研究（23％）中，冰/水被用作主要模拟物。
结论：弹道明胶，膨胀2厘米厚的聚苯乙烯，有或没有1厘米的实用蜡，在采用CBCT扫描的标准化研究中，0.5cm的丙烯酸树脂的射线照相密度与软组织相似。对于口腔内X光片，使用自聚合丙烯酸树脂，公用事业蜡，和木头,以及一个充满水的聚甲基丙烯酸甲酯盒子，厚度范围从4到45毫米，提供合适的射线照相对比度。然而,4和8毫米的蜡和4毫米的水，射线照相对比是不合适的。此外,13-17毫米蜡和14.5毫米丙烯酸树脂在口腔内射线照相中显示出可接受的软组织密度。需要使用具有标准化条件和客观度量的不同成像方式进行进一步研究，以确认用于体外牙科放射学研究的最合适的软组织模拟材料。
方法：在本范围审查中，WebofScience,Embase,Scopus,谷歌学者和PubMed数据库于2023年4月9日进行了搜索，考虑到以下PICOS：人群：软组织模拟物，干预：基于X射线的成像，比较:-,结果：软组织模拟物的特性，研究设计：体外研究。筛选,研究选择，数据提取由两名独立研究人员完成.在有分歧的情况下，与第三名小组成员进行了磋商。使用用于体外研究的质量评估工具(QUIN工具)对所包括的研究进行质量评估。
结果：在数据库搜索中检索到的最初1172篇文章中，该综述包括13项研究。七项研究的偏倚风险较低。在8项研究中，计算机断层扫描（CT）或锥形束计算机断层扫描（CBCT），在4项研究中，在2项研究中，使用了全景X线摄影（一项研究使用了CT/CBCT和全景X线摄影）。这些研究在射线照相模式上有所不同，采集参数,选定的结果，和黄金标准。在大多数研究中(n=10，77%)，丙烯酸树脂衍生物单独或作为主要成分用于软组织模拟配方中。在8项研究(62%)中,在模拟材料中使用蜡。此外,在3项研究（23％）中，冰/水被用作主要模拟物。
结论：弹道明胶，膨胀2厘米厚的聚苯乙烯，有或没有1厘米的实用蜡，在采用CBCT扫描的标准化研究中，0.5cm的丙烯酸树脂的射线照相密度与软组织相似。对于口腔内X光片，使用自聚合丙烯酸树脂，公用事业蜡，和木头,以及一个充满水的聚甲基丙烯酸甲酯盒子，厚度范围从4到45毫米，提供合适的射线照相对比度。然而,4和8毫米的蜡和4毫米的水，射线照相对比是不合适的。此外,13-17毫米蜡和14.5毫米丙烯酸树脂在口腔内射线照相中显示出可接受的软组织密度。需要使用具有标准化条件和客观度量的不同成像方式进行进一步研究，以确认用于体外牙科放射学研究的最合适的软组织模拟材料。
