Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery – A clinical trial

Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.

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Impact of Image Filters and Observations Parameters in CBCT for Identification of Mandibular Osteolytic Lesions

International Journal of Dentistry ◽

10.1155/2012/239306 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Bruna Moraes Monteiro ◽

Denys Silveira Nobrega Filho ◽

Patrícia de Medeiros Loureiro Lopes ◽

Marcelo Augusto Oliveira de Sales

Keyword(s):

Computed Tomography ◽

Sensitivity And Specificity ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Osteolytic Lesions ◽

Cbct Image ◽

Image Filters ◽

Observation Protocol

The aim of this study was to analyze the influence of filters (algorithms) to improve the image of Cone Beam Computed Tomography (CBCT) in diagnosis of osteolytic lesions of the mandible, in order to establish the protocols for viewing images more suitable for CBCT diagnostics. 15 dry mandibles in which perforations were performed, simulating lesions, were submitted to CBCT examination. Two examiners analyzed the images, using filters to improve image Hard, Normal, and Very Sharp, contained in the iCAT Vision software, and protocols for assessment: axial; sagittal and coronal; and axial, sagittal and coronal planes simultaneously (MPR), on two occasions. The sensitivity and specificity (validity) of the cone beam computed tomography (CBCT) have been demonstrated as the values achieved were above 75% for sensitivity and above 85% for specificity, reaching around 95.5% of sensitivity and 99% of specificity when we used the appropriate observation protocol. It was concluded that the use of filters (algorithms) to improve the CBCT image influences the diagnosis, due to the fact that all measured values were correspondingly higher when it was used the filter Very Sharp, which justifies its use for clinical activities, followed by Hard and Normal filters, in order of decreasing values.

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Applications of Cone-Beam Computed Tomography in Oral and Maxillofacial Surgery: An Overview of Published Indications and Clinical Usage in United States Academic Centers and Oral and Maxillofacial Surgery Practices

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2015.10.018 ◽

2016 ◽

Vol 74 (4) ◽

pp. 668-679 ◽

Cited By ~ 23

Author(s):

Jeffrey B. Carter ◽

Jeffrey D. Stone ◽

Robert S. Clark ◽

James E. Mercer

Keyword(s):

United States ◽

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Maxillofacial Surgery ◽

Cone Beam ◽

Oral And Maxillofacial Surgery

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Comparison of the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the diagnosis of carious lesions in vitro.

Journal Of Oral Research ◽

10.17126/joralres.2020.091 ◽

2020 ◽

Vol 9 (6) ◽

pp. 466-473

Author(s):

Jorge A. Beltrán ◽

◽

Roberto A. León-Manco ◽

Maria Eugenia Guerrero ◽

◽

...

Keyword(s):

Computed Tomography ◽

Dental Caries ◽

Diagnostic Accuracy ◽

Sensitivity And Specificity ◽

Cone Beam Computed Tomography ◽

Area Under The Curve ◽

Cone Beam ◽

Occlusal Surfaces ◽

Caries Lesions

Objective: The objective of the study was to compare the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the detection of in vitro caries lesions. Material and Methods: One hundred teeth (46 molars and 54 premolars) were evaluated, including 176 proximal surfaces and 90 occlusal surfaces, with or without dental caries lesions. Digital images of all teeth were obtained using specific intraoral radiographs, VistaScan DürrDental®phosphor-plate radiography, XIOS XG Sirona® digital sensor radiography, and CBCT I-CATTM. Observers evaluated the images for the detection of caries lesions. The teeth were clinically sectioned and stereomicroscopy served as a validation tool. The relationship of sensitivity and specificity between all systems was determined through the ROC curve using Az values. Results: The values of the area under the curve (Az) selected for the CBCT I-CATTM system were 0.89 (0.84-0.93), for conventional radiography 0.71 (0.66-0.76), digital sensor radiography 0.74 (0.70-0.78) and digital radiography with phosphor-plates 0.73 (0.69-0.77). Statistically significant differences were found between the CBCT I-CATTM system and intraoral radiographic systems (p<0.01). The sensitivity and specificity values for the CBCT I-CATTM were 0.84 and 0.93 respectively. Conclusion: CBCT has a high sensitivity and specificity compared to intraoral radiographic systems for the diagnosis of dental caries lesions in vitro.

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