scholarly journals Diagnostic tools in maxillofacial fractures: Is there really a need of three-dimensional computed tomography?

2016 ◽  
Vol 49 (02) ◽  
pp. 225-233 ◽  
Author(s):  
Sheerin Shah ◽  
Sanjeev K. Uppal ◽  
Rajinder K. Mittal ◽  
Ramneesh Garg ◽  
Kavita Saggar
Keyword(s):  
Computed Tomography ◽  
Clinical Examination ◽  
Computed Radiography ◽  
Three Dimensional ◽  
Nasal Bone ◽  
Conventional Radiography ◽  
Diagnostic Tools ◽  
Ct Reconstruction ◽  
Management Protocol ◽  
Maxillofacial Fractures

ABSTRACTIntroduction: Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Materials and Methods: Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. Results: CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. Conclusion: 3D images gave an inside out picture of the actual sites of fractures. It acted as mind’s eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT.

scholarly journals Computed Tomography evaluation of maxillofacial injuries

2017 ◽  
Vol 12 (4) ◽  
pp. 131-136
Author(s):  
V Natraj Prasad ◽  
Ashish Khanal
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Three Dimensional ◽  
Nasal Bone ◽  
Imaging Features ◽  
Maxillofacial Injuries ◽  
Female Population ◽  
Complex Anatomy ◽  
Plain Films ◽  
Maxillofacial Fractures

Background & Objectives: The maxillofacial region, a complex anatomical structure, can be evaluated by conventional (plain) films, Tomography, Multidetector Computed Tomography, Three-Dimensional Computed Tomography, Orthopantomogram and Magnetic Resonance Imaging. The study was conducted with objective of describing various forms of maxillofacial injuries, imaging features of different types of maxillofacial fractures and the advantage of using Three- Dimensional Computed Tomography reconstructed image. Materials & Methods: A hospital based cross-sectional study was conducted among 50 patients during April 2014 to September 2016 using Toshiba Aquilion Prime 160 slice Multi Detector Computed Tomography scanner.Results: The maxillofacial fractures were significantly higher in male population (88%) than female population (12 %). Road traffic accidents were the most common cause of injury others being physical assault and fall from height. It was most common in 31-40 years (26%) and 21-30 (24%) years age group. Maxillary sinus was the commonest fracture (36%) followed by nasal bone and zygomatic bone (30%), mandible and orbital bones (28%). Soft tissue swelling was the commonest associated finding. Three dimensional images (3 D) compared to the axial scans missed some fractures. However, the extension of the complex fracture lines and degree of displacement were more accurately assessed. Complex fractures found were Le fort (6%) and naso-orbito-ethmoid (4%) fractures.Conclusion: The proper evaluation of complex anatomy of the facial bones requires Multidetector Computed Tomography which offers excellent spatial resolution enabling multiplanar reformations and three dimensional reconstructions for enhanced diagnostic accuracy and surgical planning.

scholarly journals Applications of cone beam computed tomography in endodontics

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Ateksha Bhardwaj Khanna
Keyword(s):  
Computed Tomography ◽  
Treatment Planning ◽  
Cone Beam Computed Tomography ◽  
Oral Surgery ◽  
Three Dimensional ◽  
Conventional Radiography ◽  
Cone Beam ◽  
Oral Radiology ◽  
Manual Search ◽  
First Choice

Abstract Background Endodontic disease can adversely affect the quality of life and therefore early diagnosis and consequent timely treatment is of paramount importance for the Endodontist. Radiology is an essential component in treatment planning, disease monitoring and assessment of treatment outcome. Periapical radiographs and panoramic radiography are frequently utilised but they provide only two-dimensional representation of three-dimensional structures. The advent of cone beam computed tomography (CBCT) offers three-dimensional accuracy of the hard tissue images with a reasonable cost and this has revolutionised imaging of the dentomaxillofacial structures. This imaging system has been seen to overcome some limitations of conventional radiography, as brought out in this review. The improvement in the accuracy is, however, accompanied at the cost of increased radiation exposure to the patient. Nevertheless, smaller areas of exposure are normally appropriate for endodontic imaging, and adjustment in the exposure parameters can further moderate the effective dose (Loubele et al. 37(6):309-18, 2008). Aims and objectives The aim of this review is to present the pertinent literature on the various applications of cone beam computed tomography in the field of endodontics. Methods Literature was electronically searched on the following sources; Medline and Keats Library. Further, a manual search was performed on the following journals: International Endodontic Journal, Journal of Endodontics, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, Endodontology, Journal of Dental Research, European Journal of Oral Sciences & Odontology and Dentomaxillofacial Radiology. A preliminary search was performed to gain an idea of the available literature using keywords ‘Cone Beam Computed Tomography’ to view the volume of the literature evident and identify questions to be addressed in this review. The initial search showed 243 potential articles. After scrutinising the titles and abstracts of the retrieved articles, 70 relevant studies were reviewed in full text. Furthermore, ‘published guidelines on the use of CBCT’ were also searched so as to include the results as an additional source material. All the articles eligible to be included in the review were in the English language and ranged from the year 1960 to the present. Also all the studies reviewed were based on the various uses of cone beam computed tomography in the field of endodontics. The keywords used to search were ‘Cone Beam Computed Tomography (CBCT)’, ‘Conventional radiography’, ‘Applications of CBCT in endodontics’, ‘CBCT and tooth morphology’, ‘CBCT and apical periodontitis’, ‘CBCT and vertical root fractures’, ‘CBCT and resorption’, ‘CBCT and pre-surgical assessment’, ‘CBCT and dento-alveolar trauma’ and ‘CBCT and endodontic outcome’. Results Every case is unique and CBCT should be considered only after studying each case individually. CBCT imaging needs to be adopted or used where information from conventional imaging systems is either inadequate for the management of endodontic problems or inconclusive. Having said that, it is safe to state that CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses and enhanced resolution would be available.

Analysis of the nasal bone and nasal pyramid by three-dimensional computed tomography

2007 ◽  
Vol 265 (4) ◽  
pp. 421-424 ◽  
Author(s):  
Seung Ho Lee ◽  
Tae Yong Yang ◽  
Gil Soo Han ◽  
Young Hyo Kim ◽  
Tae Young Jang
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Nasal Bone ◽  
Nasal Pyramid

scholarly journals Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Yoshihiro Onada ◽  
Takahisa Umemoto ◽  
Kimitaka Fukuda ◽  
Tomomichi Kajino
Keyword(s):  
Computed Tomography ◽  
Acromioclavicular Joint ◽  
Three Dimensional ◽  
Attachment Site ◽  
Coracoid Process ◽  
Acromioclavicular Joint Dislocation ◽  
Coracoclavicular Ligament ◽  
Ct Reconstruction ◽  
Avulsion Fractures ◽  
Satisfactory Outcome

Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia.

scholarly journals Tomografia computadorizada no planejamento cirúrgico em Periodontia: revisão de literatura

2016 ◽  
Vol 73 (4) ◽  
pp. 305
Author(s):  
Alessandra Areas e Souza ◽  
Ingrid De Assis Mota Costa ◽  
Paula Mozer Vidal
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Conventional Radiography ◽  
Bone Defects ◽  
Response To Treatment ◽  
Cone Beam ◽  
Pubmed Database ◽  
Periodontal Biotype

Objective: The aim of this study was to conduct a literature review on the use of cone-beam computed tomography in periodontics and determine the extent and severity of periodontal lesions so as to encourage the development of a new concept for diagnosis and surgical planning in periodontics. Material and methods: A literature search was conducted in PubMed database using the following keywords: computed tomography, diagnosis periodontics, bone defects, furcation lesions, and periodontal biotype. A total of 33 articles were found. Results: A review of the articles suggested benefits in using this technology in periodontal surgical planning, for treatment of furcation lesions, bone defects, and determination of periodontal biotype. Conclusion: Cone-beam computed tomography three-dimensional images is superior to conventional radiography. It also minimizes patient exposure to ionizing radiation, optimizes surgical planning, and decreases operative time, leading to a better response to treatment. This technology is very useful in clinical practice, but is not used widely in periodontics. We believe that the use of this technology should be promoted among professionals.

High-Resolution Radiography for Detecting and Measuring Micron-Scale Features

2004 ◽  
Author(s):  
Daniel H. Morse ◽  
Arlyn J. Antolak ◽  
Bernice E. Mills
Keyword(s):  
Computed Tomography ◽  
Composite Materials ◽  
Phase Contrast ◽  
Three Dimensional ◽  
Conventional Radiography ◽  
Small Scale ◽  
Micro Computed Tomography ◽  
Contrast Imaging ◽  
X Ray ◽  
Projection Radiography

X-ray radiography has long been recognized as a valuable tool for detecting internal features and flaws. Recent developments in microfabrication and composite materials have extended inspection requirements to the resolution limits of conventional radiography. Our work has been directed toward pushing both detection and measurement capabilities to a smaller scale. Until recently, we have used conventional contact radiography, optimized to resolve small features. With the recent purchase of a nano-focus (sub-micron) x-ray source, we are now investigating projection radiography, phase contrast imaging and micro-computed tomography (μ-CT). Projection radiography produces a magnified image that is limited in spatial resolution mainly by the source size, not by film grain size or detector pixel size. Under certain conditions phase contrast can increase the ability to resolve small features such as cracks, especially in materials with low absorption contrast. Micro-computed tomography can provide three-dimensional measurements on a micron scale and has been shown to provide better sensitivity than simple radiographs. We have included applications of these techniques to small-scale measurements not easily made by mechanical or optical means. Examples include void detection in meso-scale nickel MEMS parts, measurement of edge profiles in thick gold lithography masks, and characterization of the distribution of phases in composite materials. Our work, so far, has been limited to film.

CBCT IN CONSERVATIVE DENTISTRY AND ENDODONTICS - A REVIEW

2013 ◽  
Vol 5 (2) ◽  
pp. 52-55
Author(s):  
Prakash Lokhande ◽  
G.B SHIVAMURTHY ◽  
SAURAV KR SRIVASTAVA
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Three Dimensional ◽  
Conventional Radiography ◽  
Cone Beam ◽  
Effective Radiation Dose ◽  
Conservative Dentistry ◽  
Effective Radiation ◽  
Endodontic Disease ◽  
Review Current

ABSTRACT Cone beam computed tomography (CBCT) has been specifically designed to produce undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a significantly lower effective radiation dose compared with conventional computed tomography (CT). The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontics. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The aim of this paper is to review current literature on the applications and limitations of CBCT in the management of endodontic problems.

scholarly journals Feasibility of three-dimensional CT reconstruction in assessing mandibular fractures

2021 ◽  
Vol 20 ◽  
pp. e219912
Author(s):  
Victor Nogueira Moura ◽  
Emerson Nogueira ◽  
Ewerton Daniel Rocha Rodrigues ◽  
Caio Gonçalves Silva ◽  
Ricardo José De Holanda Vasconcellos
Keyword(s):  
Computed Tomography ◽  
Correct Diagnosis ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
3D Ct ◽  
Ct Reconstruction ◽  
Cross Sectional ◽  
3D Computed Tomography

Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections.

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