Advances in Oral and Maxillofacial Radiology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 11899

Special Issue Editors


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Guest Editor
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Interests: tumors; imaging; CBCT; CT; diagnostic radiology; brain tumors; dynamic contrast-enhanced MRI; oral, head, and neck cancer; head and neck radiology; head and neck neoplasms

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Guest Editor
Department of Biomedical Sciences, Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University, 13 Universitatii Str., 720229 Suceava, Romania
Interests: oral and maxillofacial surgery; tissue regeneration; radiology; oral implantology; anatomy
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Special Issue Information

Dear Colleagues,

In recent years, many new technologies and applications of oral and maxillofacial radiology have emerged. The main purpose of this evolution was to develop accessible digital imaging diagnostic systems with minimal irradiation. Additionally, the design of programs used to simulate treatment plans has improved dental medical services. Oral and maxillofacial imaging offers advantages in terms of improved diagnoses and treatment quality.

Artificial intelligence (AI) has started to play an especially important role, as many original research reports have been published to describe its various applications, such as disease diagnosis and surgical planning.

The 3D imaging and modalities involving ionizing (e.g., CT and CBCT) and non-ionizing radiation (e.g., MRI and ultrasound) are continuing to develop and take on more important roles in clinical practice than before.

This Special Issue will be dedicated to review and original articles, emphasizing the involvement of current imaging techniques in oral and maxillofacial radiology for diagnosis, planning, treatment, as well as in potential innovative research.

Prof. Dr. Danisia Haba
Dr. Alexandru Nemţoi
Guest Editors

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Keywords

  • oral and maxillofacial radiology
  • dental medical services
  • artificial intelligence (AI)
  • 3D imaging
  • CT
  • CBCT
  • MRI
  • ultrasound

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Published Papers (9 papers)

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13 pages, 3345 KiB  
Article
Comparison of Craniofacial Anthropometric Measurement Accuracy of Manual Technique vs. Cone-Beam CT Scanning
by Alexandru Misăiloaie, Ionuț Tărăboanță, Cristinel Ionel Stan, Cristian Constantin Budacu, Denisa-Mihaela Misăiloaie and Anca Sava
Diagnostics 2024, 14(22), 2595; https://doi.org/10.3390/diagnostics14222595 - 19 Nov 2024
Viewed by 569
Abstract
Background: This study aimed to compare the accuracy of linear measurements obtained using the classical (manual) method versus cone-beam computed tomography (CBCT) in craniofacial anthropometry, specifically targeting the infraorbital foramen (IOF). Methods: This study involved two sample groups: one of 40 dry skulls [...] Read more.
Background: This study aimed to compare the accuracy of linear measurements obtained using the classical (manual) method versus cone-beam computed tomography (CBCT) in craniofacial anthropometry, specifically targeting the infraorbital foramen (IOF). Methods: This study involved two sample groups: one of 40 dry skulls measured manually using digital calipers, and the other of 40 CBCT 3D images digitally measured. Measurements included IOF height, distances between the IOF and nasion (N), IOF and frontomalar orbital (FMO), and between the two IOFs. Statistical analysis was performed using an ANOVA, t-test, and Fisher’s test with a significance level of 0.05. Results: The manual method recorded a mean IOF height of 2.1 mm, while CBCT showed a mean of 3.52 mm. Significant differences were recorded between the two methods when measuring IOF height, with a p < 0.001. However, CBCT measurements generally yielded higher accuracy and lower variance due to the absence of significant differences (p > 0.05). The distance between the two IOFs measured by both methods differed significantly (p = 0.03157), with CBCT measurements showing higher values. Conclusions: In conclusion, although no significant differences were found in the overall accuracy of the two methods, CBCT proved to be a more reliable tool for detailed craniofacial measurements due to its higher accuracy and reproducibility. CBCT demonstrated superior consistency in measurements, offering enhanced precision in assessing craniofacial structures. These findings support the growing preference for CBCT in maxillofacial surgery, where precision is critical for successful outcomes. Nonetheless, manual techniques remain valuable in settings where advanced imaging is not accessible. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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10 pages, 6569 KiB  
Article
AI-Powered Identification of Osteoporosis in Dental Panoramic Radiographs: Addressing Methodological Flaws in Current Research
by Robert Gaudin, Shankeeth Vinayahalingam, Niels van Nistelrooij, Iman Ghanad, Wolfus Otto, Stephan Kewenig, Carsten Rendenbach, Vasilios Alevizakos, Pascal Grün, Florian Kofler, Max Heiland and Constantin von See
Diagnostics 2024, 14(20), 2298; https://doi.org/10.3390/diagnostics14202298 - 16 Oct 2024
Viewed by 1439
Abstract
Background: Osteoporosis, a systemic skeletal disorder, is expected to affect 60% of women over 50. While dual-energy X-ray absorptiometry (DXA) scans are the current gold standard for diagnosis, they are typically used only after fractures occur, highlighting the need for early detection tools. [...] Read more.
Background: Osteoporosis, a systemic skeletal disorder, is expected to affect 60% of women over 50. While dual-energy X-ray absorptiometry (DXA) scans are the current gold standard for diagnosis, they are typically used only after fractures occur, highlighting the need for early detection tools. Initial studies have shown panoramic radiographs (PRs) to be a potential medium, but these have methodological flaws. This study aims to address these shortcomings by developing a robust AI application for accurate osteoporosis identification in PRs. Methods: A total of 348 PRs were used for development, 58 PRs for validation, and 51 PRs for hold-out testing. Initially, the YOLOv8 object detection model was employed to predict the regions of interest. Subsequently, the predicted regions of interest were extracted from the PRs and processed by the EfficientNet classification model. Results: The model for osteoporosis detection on a PR achieved an overall sensitivity of 0.83 and an F1-score of 0.53. The area under the curve (AUC) was 0.76. The lowest detection sensitivity was for the cropped angulus region (0.66), while the highest sensitivity was for the cropped mental foramen region (0.80). Conclusion: This research presents a proof-of-concept algorithm showing the potential of deep learning to identify osteoporosis in dental radiographs. Furthermore, our thorough evaluation of existing algorithms revealed that many optimistic outcomes lack credibility when subjected to rigorous methodological scrutiny. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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14 pages, 3523 KiB  
Article
Accuracy of Mandibular Foramen Localization Using Digital Orthopantomogram (OPG) in Middle Eastern Population
by Yasser S. Alali, Wajdi A. Mohammed (Bin), Sami M. Alotaibi, Sami Alshehri and Muath Alshayban
Diagnostics 2024, 14(19), 2173; https://doi.org/10.3390/diagnostics14192173 - 29 Sep 2024
Viewed by 960
Abstract
Background/Objectives: Locating the mandibular foramen (MF) through imaging is clinically important for inferior alveolar nerve (IAN) anesthesia and mandibular ramus osteotomies. Although cone-beam computed tomography (CBCT) is superior in imaging the mandible, an orthopantomogram (OPG) is preferred for its ease of use and [...] Read more.
Background/Objectives: Locating the mandibular foramen (MF) through imaging is clinically important for inferior alveolar nerve (IAN) anesthesia and mandibular ramus osteotomies. Although cone-beam computed tomography (CBCT) is superior in imaging the mandible, an orthopantomogram (OPG) is preferred for its ease of use and availability. Therefore, the present study aimed to evaluate the accuracy of digital OPG in localizing the MF, in a subset of the Middle Eastern population. Methods: Radiographic images (OPG and CBCT) of selected patients (adults, dentulous and no mandibular abnormalities) were used to locate the MF through digital measurements (mm) of the anteroposterior distance from the anterior border of the ramus (MF-AP) and the superoinferior position from the mandibular occlusal plane (MF-SI). Measurements were statistically compared between OPG and CBCT for accuracy. Differences in measurements between OPG and CBCT were compared against the anatomic location (right/left), age and biological sex, assuming a p-value < 0.05 as significant. Results: A total of 204 radiographic records (males: 100/females: 104/mean age: 34.65 ± 11.55 years) were evaluated. The measurements for the MF were MF-AP-OPG (right: 13.53 ± 2.44/left: 13.19 ± 2.25), MF-AP-CBCT (right: 13.61 ± 2.39/left: 13.36 ± 2.19), MF-SI-OPG (right: 5.25 ± 1.71/left: 5.41 ± 1.65) and MF-SI-CBCT (right: 5.59 ± 1.66/left: 5.52 ± 1.61). Measurements between OPG and CBCT were not significantly different, except for MF-SI (right) (p = 0.042). While the overall difference between OPG and CBCT (MF-AP/MF-SI) measurements showed a significant association (p < 0.01) with the anatomic location (right/left), a significant association (p < 0.05) with biological sex was observed only for MF-AP. Conclusions: Based on this study’s outcomes, digital OPG is an accurate modality to locate the MF based on anteroposterior (MF-AP) and superoinferior (MF-SI) measurements. This would be clinically beneficial for dental and oral surgeons to achieve the optimum IAN block anesthesia based on preoperative panoramic radiographs. Similarly, it would assist maxillofacial surgeons in planning mandibular orthognathic surgeries and ramus osteotomies without complications. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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10 pages, 659 KiB  
Article
Preoperative Cone Beam Computed Topography Assessment of Maxillary Sinus Variations in Dental Implant Patients
by Alexandru Misăiloaie, Ionuț Tărăboanță, Cristian Constantin Budacu and Anca Sava
Diagnostics 2024, 14(17), 1929; https://doi.org/10.3390/diagnostics14171929 - 1 Sep 2024
Cited by 1 | Viewed by 1140
Abstract
This study aimed to evaluate the pathological factors and anatomical variations in the maxillary sinus in patients undergoing dental implant treatment using cone beam computed tomography (CBCT). CBCT, as a key imaging technique in dentistry, offers high-resolution images to assess bone morphology and [...] Read more.
This study aimed to evaluate the pathological factors and anatomical variations in the maxillary sinus in patients undergoing dental implant treatment using cone beam computed tomography (CBCT). CBCT, as a key imaging technique in dentistry, offers high-resolution images to assess bone morphology and quality, crucial for preoperative dental implant planning. Material and methods: The study included a cohort of 200 patients recommended for CBCT as part of their preoperative evaluation. The methodology involved detailed CBCT image analysis to identify and document various anatomical variations due to pneumatization, exostosis, hypoplasia, polyps, cysts, foreign bodies, and anthroliths within the maxillary sinus. Results: Pneumatization was the most common variation, present in 77.5% of subjects. Polypoid lesions were found in 17.5% of patients, with a higher prevalence in younger age groups (57.1% in ages 20–35). Cysts and polyps affected 17.5% of subjects, predominantly males (65.7%). Anthroliths were observed in a minimal percentage (2%), and foreign bodies were found in 1.5% of the patients. Positive correlations were observed between the patient’s age and both mucosal thickness and polypoid lesions and between the patient’s gender and bone thickening (p-values < 0.05). Conclusions: The study concluded that CBCT is essential in the preoperative assessment of the maxillary sinus in dental implant candidates due to its superior imaging capabilities, allowing for the identification of critical anatomical variations and pathologies. This thorough evaluation is imperative to ensure the success of implant placement and to mitigate potential complications. However, further research with larger, more diverse populations is recommended to confirm these findings. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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19 pages, 3651 KiB  
Article
Aspects of Occlusal Recordings Performed with the T-Scan System and with the Medit Intraoral Scanner
by Angelica Diana Popa, Diana Elena Vlăduțu, Adina Andreea Turcu, Daniel Adrian Târtea, Mihaela Ionescu, Cătălin Păunescu, Răzvan Sabin Stan and Veronica Mercuț
Diagnostics 2024, 14(13), 1457; https://doi.org/10.3390/diagnostics14131457 - 8 Jul 2024
Cited by 2 | Viewed by 1563
Abstract
Introduction: Dental occlusion refers to the static and dynamic relationships that are established between the teeth of the two arches and is an important factor in the homeostasis of the dento-maxillary system. The objective of the present study was to compare two digital [...] Read more.
Introduction: Dental occlusion refers to the static and dynamic relationships that are established between the teeth of the two arches and is an important factor in the homeostasis of the dento-maxillary system. The objective of the present study was to compare two digital occlusal analysis systems: the T-Scan III system and the Medit I600 intraoral scanner. Materials and Methods: The study was carried out on 20 students from the Faculty of Dental Medicine Craiova, whose dental occlusion was assessed with the T-Scan III system and with the Medit I600 intraoral scanner. Dental occlusion was assessed in the maximum intercuspation position, the edge-to-edge protrusion position, and the edge-to-edge position in right and left laterotrusion. The images of the 2D occlusal contact areas obtained by both methods were converted to .jpeg format and then transferred to Adobe Photoshop CS6 2021 (Adobe Systems, San Jose, CA, USA) for comparison. The recorded data were statistically processed. Results: Analyzing the data provided by the two digital occlusal analysis systems, it was found that the T-Scan III system provided data related to the amplitude of the occlusal forces, the surface on which they were distributed (the contact surface), the dynamics of the occlusal contacts, and the proportion in which they were distributed at the level of the two hemiarches, and the Medit I600 intraoral scanner performed an evaluation of the occlusal interface of the two arches, highlighting the extent of the contact areas with the degree of overlapping of the occlusal components. Although both methods of occlusal analysis recorded the highest values for the maximum intercuspation position, the results could not be compared. Conclusions: The two digital systems provide different data in occlusal analysis. As the T-Scan III system is considered the gold standard for occlusal analysis, more studies are needed to understand the data provided by the Medit I600 intraoral scanner and their significance. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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11 pages, 4258 KiB  
Article
Pre- and Post-Operative Cone Beam Computed Tomography Assessment of the Temporomandibular Joint in Patients with Orthognathic Surgery
by Thomas J. Vogl, Wael Zyada, Rania Helal, Nagy N. Naguib, Neelam Lingwal and Nour-Eldin A. Nour-Eldin
Diagnostics 2024, 14(13), 1389; https://doi.org/10.3390/diagnostics14131389 - 29 Jun 2024
Cited by 1 | Viewed by 1040
Abstract
This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent [...] Read more.
This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent to 158 TMJs) (mean age = 26.62 ± 9.5 years) with a bilateral sagittal split osteotomy with or without Le Fort I surgeries (n = 29 Class II DFD, n = 50 Class III DFD) was performed. This included the compartmental measurement of TMJ spaces, in addition to the measurement of intercondylar distances and angles. Condylar position centricity was assessed using the Pullinger and Hollender formula. Clinical data were analysed for DFD class, the type of surgery and post-operative CBCT timing. Pre- and post-operative measurements were compared statistically using a paired t-test, Wilcoxon signed-rank test, and Stuart–Maxwell test. TMJ condyles tended to relocate post-operatively in a posterosuperior position with internal rotation in Class II DFD and a superior position with internal rotation in Class III DFD. However, the overall changes were within <0.5 mm translation and <4° rotation and the number of concentrically positioned condyles (according to the Pullinger and Hollender formula) did not change significantly. Orthognathic surgery is associated with minor post-operative translational and rotational condylar positional changes in Class II and III DFDs. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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14 pages, 1740 KiB  
Article
The Impact of AI on Metal Artifacts in CBCT Oral Cavity Imaging
by Róża Wajer, Adrian Wajer, Natalia Kazimierczak, Justyna Wilamowska and Zbigniew Serafin
Diagnostics 2024, 14(12), 1280; https://doi.org/10.3390/diagnostics14121280 - 17 Jun 2024
Cited by 2 | Viewed by 1547
Abstract
Objective: This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity. Materials and Methods: This retrospective study included 70 patients, 61 of [...] Read more.
Objective: This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity. Materials and Methods: This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with the ClariCT.AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales. Results: Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR (p < 0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity (p < 0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least. Conclusions: AI-based noise reduction using ClariCT.AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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14 pages, 1406 KiB  
Article
Relationship of Maxillary Sinus Volume and Nasal Septum Deviation: A Cone Beam Computed Tomography Study
by Amanda B. Rodriguez Betancourt, Leidy J. Martinez Somoza, Carlos Romero Mesa, Tolga Fikret Tozum, Carlos Fernando Mourão, Jamil Awad Shibli and Lina J. Suárez
Diagnostics 2024, 14(6), 647; https://doi.org/10.3390/diagnostics14060647 - 19 Mar 2024
Viewed by 1963
Abstract
The present study was designed to test the hypothesis that there would be a correlation between nasal septum deviation (NSD) and a decreased maxillary sinus volume (MSV) in a Colombian population, using Cone Beam Computed Tomography (CBCT); other sinusal anatomical structures found during [...] Read more.
The present study was designed to test the hypothesis that there would be a correlation between nasal septum deviation (NSD) and a decreased maxillary sinus volume (MSV) in a Colombian population, using Cone Beam Computed Tomography (CBCT); other sinusal anatomical structures found during the reading were described and analyzed. A retrospective analysis of 537 CBCT scans of adult patients taken between January 2014 and January 2017 included measuring the maxillary sinus diameter in the vertical, horizontal, and sagittal planes. NSD was quantified and related to MSV using the same field of view (FOV). The volume of the right and left maxillary sinuses showed a median and interquartile range (IQR) of 8.18 mm3 (IQR: 6.2–10.33) and 8.3 mm3 (IQR: 6.4–10.36). Statistically significant differences were observed between sex and right and left MSV (p = 0.000), with higher MSV in men. The presence of NSD was observed in 96.81% of the sample and was evaluated in degrees, observing a median of 11° (IQR: 7–16) where 40% of the sample had moderate angles (9–15°). There was no correlation between NSD and a decreased MSV in the population studied. Detailed CBCT analysis with a large FOV is crucial for the analysis of anatomical structures before performing surgical procedures that involve the MS as a preventive diagnostic and therapeutic step for appropriate treatment. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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6 pages, 6320 KiB  
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Misleading Imaging Findings: Bilateral Mylohyoid Defect Presenting as a Submandibular Mass Due to Sublingual Gland Protrusion
by Dagnija Grabovska, Junsiyuan Li, Maija Radziņa and Arturs Balodis
Diagnostics 2024, 14(24), 2833; https://doi.org/10.3390/diagnostics14242833 - 16 Dec 2024
Viewed by 666
Abstract
Background/Objectives: The muscular base of the oral cavity is formed of the mylohyoid muscle, which forms a sling inferior to the tongue. The muscle is often discontinuous, and defects may include salivary tissues, fat, and/or blood vessels. Hypertrophic sublingual glands located in mylohyoid [...] Read more.
Background/Objectives: The muscular base of the oral cavity is formed of the mylohyoid muscle, which forms a sling inferior to the tongue. The muscle is often discontinuous, and defects may include salivary tissues, fat, and/or blood vessels. Hypertrophic sublingual glands located in mylohyoid defects can be herniated into bilateral submandibular spaces and present as palpable masses. The etiology of this condition may be congenital or acquired, and although such anatomical variations are common, they often go unrecognized in clinical practice. Sialoceles are cyst-like structures that result from chronic inflammation or ductal injury, indicating underlying problems with drainage efficiency. Methods: In this case series, we present two patients. Results: The first patient is a 44-year-old female who presented with a slowly enlarging right submandibular mass for two years, while the second is a 70-year-old female who presented with nonspecific neck discomfort, lacking palpable masses. In both, initial imaging (ultrasound and CT) was inconclusive. MRI revealed right sublingual gland herniation through a mylohyoid defect (mylohyoid boutonniere) in both cases. Conclusions: This highlights the importance of comprehensive imaging in the diagnosis of submandibular masses and emphasizes the need for considering mylohyoid boutonniere in cases of bilateral submandibular masses. Further research is warranted into the sialoceles associated with salivary gland abnormalities. Full article
(This article belongs to the Special Issue Advances in Oral and Maxillofacial Radiology)
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