maxillofacial radiology

颌面放射学
  • 文章类型: Journal Article
    背景:本研究的目的是报告155例成纤维细胞瘤(AB)的临床表现和影像学特征,代表一个详细的,大,单中心放射学研究。
    方法:回顾了11年的组织学确诊病例。从患者记录中检索人口统计学和临床数据。从可用的X射线照片中分析放射学信息。根据出现的平均年龄和病变的平均持续时间评估ABs的放射学特征。还评估了成人/儿童和性别之间的放射学特征。
    结果:边界分界缺失与高龄之间存在统计学上显著的相关性。与儿童相比,多房性病变在成人中明显更常见。多房性ABs与病变持续时间增加和平均年龄提前相关。与肿瘤相关的反应性骨变化的放射学征象在所有骨作用的平均持续时间最高时出现。骨扩张和皮质破坏与病变持续时间相关。牙齿嵌塞在儿童中更为常见。一些下颌骨病变达到明显的大小,导致上颌窦撞击,zygoma,眼眶和翼状体板。
    结论:由于不幸的医疗保健准入限制,AB增长到显著的尺寸并且表现出文献中不经常报道的特征。该分析的结果强调了通过病变的平均年龄和持续时间表达的ABs的放射学特征。这强调了及时管理这些病变的重要性。
    BACKGROUND: The purpose of the current study was to report on the clinical presentation and radiologic features of 155 cases of ameloblastoma (AB), representing a detailed, large, single-centre radiologic study.
    METHODS: Histologically confirmed cases were reviewed over 11 years. Demographic and clinical data were retrieved from the patient\'s records. Radiologic information was analysed from available radiographs. The radiologic features of ABs were assessed according to the mean age of presentation and the mean duration of the lesion. The distinguishing radiologic features between adults/children and sex were also evaluated.
    RESULTS: A statistically significant correlation existed between loss of border demarcation and advanced mean age. Multilocular lesions were markedly more common in adults compared to children. Multilocular ABs were associated with increased lesion duration and advanced mean age. Radiologic signs of reactive bony changes associated with the tumour presented at the highest mean duration of all bony effects. Bony expansion and cortical destruction were statistically correlated with lesion duration. Tooth impaction was more common in children. Some mandibular lesions reached a significant size, resulting in impingement of the maxillary sinus, zygoma, orbit and pterygoid plates.
    CONCLUSIONS: Due to unfortunate healthcare access constraints, ABs grow to significant sizes and exhibit features not often reported in the literature. The findings of this analysis highlighted the radiologic features of ABs expressed through the mean age and duration of the lesion. This emphasises the significance of timely management of these lesions.
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  • 文章类型: Journal Article
    深度学习和人工智能(AI)的最新进展深刻地影响了各个领域。包括诊断成像。集成深度学习和卷积神经网络等AI技术有可能极大地改善牙科和颌面X线摄影领域的诊断方法。进行了一项系统研究,该研究遵循了系统审查和荟萃分析(PRISMA)标准的首选报告项目,以检查AI在牙科和颌面X线摄影术中的功效和用途。纳入队列研究,病例对照研究,和随机临床试验,这项研究采用了跨学科的方法。在包括MEDLINE/PubMed和EMBASE在内的数据库中进行了从2009年到2023年的同行评审研究论文的彻底搜索。纳入标准是英语的原始临床研究,采用AI模型来识别口腔和颌面部图片中的解剖成分。识别异常,并诊断疾病。这项研究考察了许多使用尖端技术的研究,以显示牙科成像的准确性和可靠性。这些调查涵盖的任务包括年龄估计,根尖周病变检测,上颌结构的分割,评估牙面部异常,和下颌管的分割。该研究揭示了在解剖结构的精确定义和疾病识别方面的重要发展。人工智能技术在牙科成像中的使用标志着革命性的发展,将迎来一个无与伦比的准确性和有效性的时代。这些技术不仅提高了诊断准确性,实现了早期疾病检测,而且简化了复杂的程序。显著提高患者预后。人类专业知识和机器智能之间的共生合作有望实现更复杂和富有同情心的口腔医疗保健的未来。
    Recent advancements in deep learning and artificial intelligence (AI) have profoundly impacted various fields, including diagnostic imaging. Integrating AI technologies such as deep learning and convolutional neural networks has the potential to drastically improve diagnostic methods in the field of dentistry and maxillofacial radiography. A systematic study that adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards was carried out to examine the efficacy and uses of AI in dentistry and maxillofacial radiography. Incorporating cohort studies, case-control studies, and randomized clinical trials, the study used an interdisciplinary methodology. A thorough search spanning peer-reviewed research papers from 2009 to 2023 was done in databases including MEDLINE/PubMed and EMBASE. The inclusion criteria were original clinical research in English that employed AI models to recognize anatomical components in oral and maxillofacial pictures, identify anomalies, and diagnose disorders. The study looked at numerous research that used cutting-edge technology to show how accurate and dependable dental imaging is. Among the tasks covered by these investigations were age estimation, periapical lesion detection, segmentation of maxillary structures, assessment of dentofacial abnormalities, and segmentation of the mandibular canal. The study revealed important developments in the precise definition of anatomical structures and the identification of diseases. The use of AI technology in dental imaging marks a revolutionary development that will usher in a time of unmatched accuracy and effectiveness. These technologies have not only improved diagnostic accuracy and enabled early disease detection but have also streamlined intricate procedures, significantly enhancing patient outcomes. The symbiotic collaboration between human expertise and machine intelligence promises a future of more sophisticated and empathetic oral healthcare.
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  • 文章类型: Journal Article
    目的:调查偶然发现的发生率和进一步牙科治疗的需求,并分析锥形束计算机断层扫描(CBCT)中视野大小(FOV)和年龄对植入前计划的影响。
    方法:对404个CBCT扫描进行回顾性检查,以了解偶然发现和进一步牙科治疗的需要。对不同年龄(<40岁,40-60年,>60岁)和FOV组(小型,中等,大)。评估了内部检验者和interexaminer协议。
    结果:在82%的扫描中发现了至少一个偶然发现,总共766个。在大FOV的扫描中发现了更多的偶然发现(98%与72%,OR=22.39大vs.小视场,p<0.0001)和>60岁的患者扫描(OR=5.37患者年龄>60岁与<40年,p=0.0003)。由于偶然发现,31%的患者需要进一步的牙科治疗。大FOV的扫描更有可能需要进一步治疗(OR=3.55大vs.小视场,p<0.0001)。部分性脑萎缩症和大FOV被确定为进一步治疗的危险因素(p=0.0003和p<0.0001)。根据偶然发现,患者的进一步转诊被判断为5%。考试者内部和考试者之间的协议非常好(kappa=0.944/0.805)。
    结论:在部分缺牙患者和60岁以上的患者中发现了大量需要进一步牙科治疗的偶然发现。在老年患者的植入前规划中,选择大视场CBCT扫描,包括最近没有做X光检查的牙槽骨区域,帮助检测治疗相关的偶然发现。
    OBJECTIVE: To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning.
    METHODS: 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated.
    RESULTS: In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient\'s age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805).
    CONCLUSIONS: A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
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  • 文章类型: Journal Article
    UNASSIGNED: This study aimed to analyze the effects of standard and high-resolution exposures on the diagnostic accuracy of CBCT in the evaluation of dental implant dimensions.
    UNASSIGNED: A descriptive-analytical study was carried out on 40 dry human mandibles with appropriate ridge quality based on panoramic radiography. CBCT (Soredex, Cranex 3D, Finland) with a large field of view (FOV) and CMOS flat panel detector were used. CBCT with standard and a high resolution was performed in each mandible. Axial images, reconstructed by OnDemand 3D software, were processed to prepare cross-sectional images from the areas marked by gutta-percha, and then measured by a ruler with an accuracy of 0.01 millimeter in the computer. Measurements were recorded by two observers and the obtained data were compared with the real ones.
    UNASSIGNED: The results showed suitable repeatability in radiologic measurements (r = 0.971), which is indicative of the high reliability of intraobserver measurement. The measurement of width with high-resolution exposure indicated a significant difference with the real condition (P < 0.001); however, this difference was not significant in the case of standard resolution (P > 0.05). Measurement of height with high resolution showed a significant difference with the real condition in the right mandible (P = 0.04) and left mandible (P = 0.05); however, this difference was not significant in standard resolution (P > 0.05).
    UNASSIGNED: Based on our findings, the standard CBCT resolution modality is suggested for dental implant images due to its higher accuracy than high-resolution methods for diagnosing the implant dimensions.
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  • 文章类型: Editorial
    ChatGenerativePre-TrainedTransformer(ChatGPT)是一种开放式人工智能(AI)驱动的聊天机器人,具有各种临床和学术牙科应用,包括口腔颌面放射学(OMFR)。如果给出了适当的提示,则可以将应用程序扩展到生成诸如口腔放射学报告之类的文档。存在与该任务相关联的各种挑战。像其他领域一样,可以合并ChatGPT以生成内容并回答与口腔放射学相关的多项选择题。然而,它的性能仅限于回答基于图像的问题。ChatGPT可以帮助科学写作,但由于内容缺乏有效性,因此无法指定为作者。这篇社论概述了当前版本的ChatGPT在OMFR学术环境中的潜在应用和局限性。
    Chat Generative Pre-Trained Transformer (ChatGPT) is an open artificial intelligence (AI)-powered chatbot with various clinical and academic dentistry applications, including oral and maxillofacial radiology (OMFR). The applications can be extended to generating documents such as oral radiology reports if appropriate prompts are given. There are various challenges associated with this task. Like other fields, ChatGPT can be incorporated to generate content and answer oral radiology-related multiple-choice questions. However, its performance is limited to answering image-based questions. ChatGPT can help in scientific writing but can not be designated as an author due to the lack of validity of the content. This editorial outlines the potential applications and limitations of the current version of ChatGPT in OMFR academic settings.
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  • 文章类型: Journal Article
    在发展中国家,由于患者因素和医疗机构的限制,许多诊断的成釉细胞瘤(AB)病例在接受治疗方面有明显的延迟.
    使用全景射线照片和锥形束计算机断层扫描成像分析延迟治疗的ABs的放射学进展。
    在10年的研究期间,回顾性分析了经组织病理学证实的AB病例,随访X线片显示未治疗。包括57例初始和107例随访X光片。每个后续的X光片都被分析边界的变化,局部性,对周围结构和病变大小的影响。
    界限不清的病变普遍增加,7例从最初的单眼外观转变为多房型外观。在后续行动中,皮质变薄和皮质破坏增加。从最初到随访,成釉细胞瘤的平均大小增加了三倍。回归分析显示,病变持续时间和长度之间存在统计学上的显着关系(p=0.001)。当仅使用每位患者的第一个和最后一个观察结果时,持续时间和总体病变尺寸之间存在统计学上的显着关系(p=0.044)。
    考虑到侵略性和无限的增长潜力,延迟治疗的ABs可能表现出广泛的生长,使他们最终的管理复杂化。
    本研究旨在通过强调延迟治疗的不利影响来提高对AB患者及时管理的重要性的认识。
    UNASSIGNED: In developing countries, many diagnosed cases of ameloblastoma (AB) have a significant delay in receiving treatment because of patient factors and healthcare facility constraints.
    UNASSIGNED: The radiologic progression of ABs with delayed treatment was analysed using panoramic radiographs and cone-beam computed tomography imaging.
    UNASSIGNED: Histopathologically confirmed cases of AB with follow-up radiographs indicating no treatment were retrospectively reviewed over a study period of 10 years. Fifty-seven cases with 57 initial and 107 follow-up radiographs were included. Each follow-up radiograph was analysed for changes in borders, locularity, effects on surrounding structures and lesion size.
    UNASSIGNED: There was a general increase in poorly-demarcated lesions, with seven cases transforming from an initial unilocular to a multilocular appearance. At follow-up, there was an increase in cortical thinning and cortical destruction. Ameloblastomas presented with a three-fold increase in average size from the initial to follow-up visits. Regression analysis showed a statistically significant relationship between lesion duration and length (p = 0.001). A statistically significant relationship existed between duration and overall lesion dimensions when only the first and last observations per patient were used (p = 0.044).
    UNASSIGNED: Considering the aggressive nature and unlimited growth potential, ABs with delayed treatment may show extensive growth, complicating their eventual management.
    UNASSIGNED: This study aimed to raise awareness of the importance of the timeous management of patients with AB by highlighting the detrimental effects of delayed treatment.
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  • 文章类型: Journal Article
    目的:确定运动校正系统对锥形束计算机断层扫描(CBCT)图像质量参数的影响,神器,和对比噪声比(CNR)使用不同的运动设置。
    方法:使用SEDENTEXCTIQPhantom(利兹测试对象,约克郡,英格兰)稳定在旋转的电动转盘上。在ProMax3D上使用标准化技术因素(Planmeca,赫尔辛基,芬兰)使用不同运动设置的组合的机器,包括没有动议,三度和六度运动,在使用和不使用运动校正系统的情况下。将标准化图像导出至ImageJ软件。图像质量参数,神器,和CNR值在不同的采集设置之间进行评估和比较。
    结果:使用运动校正系统算法与不同的运动设置相比,除了六度运动的伪影值(p<0.07)外,所有参数均具有统计学上的显着差异(p<0.05)。不同运动设置对参数的影响无统计学意义。
    结论:使用运动矫正系统,ProMax3DCBCT单元中包含的基于算法的专有系统,恶化了这项体外研究中评估的图像质量特征,即工件值和CNR。其在临床环境中的使用可能限于预期患者运动并且由于年龄或疾病而不可能进行适当的头部稳定的情况。
    OBJECTIVE: Determine the effect of the motion correction system on cone-beam computed tomography (CBCT) image quality parameters, artifacts, and contrast-to-noise ratio (CNR) using different motion settings.
    METHODS: A customized phantom insert array was prepared using SEDENTEX CT IQ Phantom (Leeds Test Objects, Yorkshire, England) stabilized over a rotating electric turntable. Thirty baseline CBCT scans were acquired with standardized technique factors on the ProMax 3D (Planmeca, Helsinki, Finland) machine using combinations of different motion settings, including no motion, three- and six-degree motion, and with and without the use of a motion correction system. The standardized images were exported to ImageJ software. Image quality parameters, artifacts, and CNR values were evaluated and compared among the different acquisition settings.
    RESULTS: The use of the motion correction system algorithm compared with the different motion settings showed a statistically significant difference for all the parameters (p<0.05) except for artifact values for six-degree motion (p<0.07). The effect of different motion settings on the parameters was not statistically significant.
    CONCLUSIONS: The use of a motion correction system, a proprietary algorithm-based system incorporated in the ProMax 3D CBCT unit, deteriorates the image quality characteristics evaluated in this in vitro study, namely artifact value and CNR. Its use in clinical settings might be limited to situations where patient motion is expected and appropriate head stabilization is not possible due to age or disease.
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  • 文章类型: Journal Article
    未经评估:本研究的目的是分析人口统计学,涉及颌面部的原发性动脉瘤性骨囊肿(ABCs)的临床和放射学特征。
    UNASSIGNED:对21年(2000-2021年)影响颌面部区域的组织学确诊病例进行回顾性分析。病例是从三个国家的五个口腔病理学实验室的档案中收集的:南非,危地马拉和巴西。对信息进行了分析,重点是临床和放射谱。
    未经评估:按照纳入标准,本研究共纳入了31例原发性ABCs.男女分布几乎相等,与女性相比,男性发生ABC的年龄较早。局部肿胀是主要临床表现。ABC的下颌占优势,特别是在后部区域。所有ABC都表现为吹出的可膨胀的边界清晰的射线可透性病变,大多数具有多房性外观。在91%的病例中观察到皮质扩张,皮质完整性丧失是常见的(78%)。
    未经证实:涉及颌面部区域的原发性ABCs极为罕见,目前发表的大部分文献都是孤立病例报告。当前的研究是第一个详细介绍放射学特征的大型系列。
    UNASSIGNED: The aim of the current study was to analyse the demographic, clinical and radiological features of primary aneurysmal bone cysts (ABCs) involving the maxillofacial region.
    UNASSIGNED: Histologically confirmed cases affecting the maxillofacial region were retrospectively reviewed over a 21-year period (2000-2021). Cases were collected from the archives of five Oral Pathology laboratories from three countries: South Africa, Guatemala and Brazil. The information was analysed, with emphasis on the clinical and radiological spectrum.
    UNASSIGNED: Following the inclusion criteria, a total of 31 cases of primary ABCs were included in the study. A nearly equal male-to-female distribution was seen, with ABCs occurring in males at an earlier age compared to females. Localised swelling was the main clinical presentation. ABCs had a mandibular predominance, particularly in the posterior regions. All ABCs presented as blow-out expansile well-demarcated radiolucent lesions with the majority having a multilocular appearance. Cortical expansion was seen in 91% of cases with loss of cortical integrity being common (78%).
    UNASSIGNED: Primary ABCs involving the maxillofacial region are extremely rare with the majority of current published literature consisting of isolated case reports. The current study is the first large series detailing the radiological features.
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  • 文章类型: Journal Article
    本研究的目的是报告72例口腔颌面部浆细胞淋巴瘤(PBL)的临床表现和影像学特征。
    对10年的PBL组织学确诊病例进行回顾性分析。从患者记录中检索人口统计学和临床数据。放射学信息是从可用的射线照相检查中获得的。
    PBL的患病率为诊断的头颈部病变的0.6%。PBL的平均年龄为39岁,表现出强烈的男性优势。所有已知逆转录病毒疾病(RVD)状态的患者均为HIV阳性。PBL有上颌好发(78%),两个颌骨的后部区域最常受到影响(76%)。大多数病例有骨累及(95%),在大多数情况下(93%),骨骼边界划分不清。PBL有导致皮质完整性丧失的倾向(96%),通过皮质侵蚀或破坏,而不是皮质扩张(2%)。
    目前关于PBL的大多数文献都集中在人口统计学上,解剖位置,和组织病理学特征,放射学特征仅在孤立病例报告中报告。这项研究是首次报道大样本中PBL的临床放射表现。这些发现可能有助于临床医生对患者进行临床诊断检查,包括获取和评估适当的先进射线照相成像。
    The purpose of the current study was to report on the clinical presentation and radiological features of 72 cases of oral and maxillofacial plasmablastic lymphomas (PBL).
    Histologically confirmed cases of PBL were retrospectively reviewed over a 10-year period. Demographic and clinical data were retrieved from the patient\'s records. Radiological information was obtained from the available radiographic examinations.
    The prevalence of PBL was 0.6% of diagnosed head and neck lesions. PBL presented at a mean age of 39 years, demonstrating a strong male predominance. All patients with a known retroviral disease (RVD) status were HIV-positive. PBL had a maxillary predilection (78%), with posterior regions of both jawbones most commonly affected (76%). Most cases had bony involvement (95%), with poorly demarcated bony borders seen in the majority of cases (93%). PBL had a tendency to cause a loss of cortical integrity (96%), either via cortical erosion or destruction, rather than cortical expansion (2%).
    Most of the current literature on PBL focuses on demographics, anatomical location, and histopathological profile, with radiological features only reported in isolated case reports. This study is the first of its kind to report on the clinicoradiological appearance of PBL in a large sample. These findings may assist clinicians in the clinical diagnostic work-up of patients, including the acquisition and assessment of appropriate advanced radiographic imaging.
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  • 文章类型: Journal Article
    The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9-86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.
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