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Automatic measurement of mandibular cortical bone width on cone-beam computed tomography images

Oral Radiology Aims and scope Submit manuscript

Abstract

Objective

The computed tomography cortical index (CTCI), computed tomography mandibular index (CTMI), and computed tomography index (inferior) [CTI(I)] are indexes obtained from cone-beam computed tomography images for the assessment of the mandibular cortex quality for implant planning or osteoporosis. However, cross-sectional image reconstruction for the measurements is labor-intensive. This study aimed to develop and evaluate a method to automatically reconstruct cross-sectional images and measure the cortex width in all areas inferior to the mental foramen (MF).

Methods

Seventy-one women (mean age: 52.4 years; range: 20–78 years) were enrolled. They were divided into four age and CTCI groups, including females younger (FY) and females older (FO) than 50 years (C1: normal, C2: mild/moderate erosion, and C3: severe porosity). Automatic and manual measurements of CTMI and CTI(I) were compared, and the inter- and intraobserver agreements were assessed using the intraclass correlation coefficient (ICC). The relationships between CTMI or CTI(I) and CTCI were also assessed.

Results

The mean processing times for reconstruction and measurements were 31.9 s and 1.22 s, respectively. ICCs for the comparison of automatic and manual measurements were 0.932 and 0.993 in the C1 and C2/C3 groups, respectively. Significant differences in CTMI and CTI(I) were observed between the FY or the FO-C1 and FO-C3 groups (p < 0.05).

Conclusion

The automatic and manual measurements showed a strong agreement. The new method could drastically reduce routine clinical workload. Additionally, our method enables the measurement of the cortex width in all the mandibular bones inferior to the MF.

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References

  1. Alamri HM, Sadrameli M, Alshalhoob MA, Sadrameli M, Alshehri MA. Applications of CBCT in dental practice: a review of the literature. Gen Dent. 2012;60:390–400.

    PubMed  Google Scholar 

  2. Becker W, Hujoel PP, Becker BE, Willingham H. Osteoporosis and implant failure: an exploratory case control study. J Periodontol. 2000;71:626–31.

    Google Scholar 

  3. von Wowern N, Gotfredsen K. Implant-supported overdentures, a prevention of bone loss in edentulous mandibles? A 5-year follow-up study. Clin Oral Implants Res. 2001;12:19–25.

    Article  Google Scholar 

  4. Amorim MA, Takayama L, Jorgetti V, Pereira RM. Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants. Osteoporos Int. 2007;19:703–9.

    Article  Google Scholar 

  5. Jemt T, Lekholm U. Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants. 1995;10:303–11.

    PubMed  Google Scholar 

  6. Trisi P, Rao W. Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res. 1999;10:1–7.

    Article  Google Scholar 

  7. Tözüm TF, Dursun E, Uysal S. Radiographic fractal and clinical resonance frequency analyses of posterior mandibular dental implants: their possible association with mandibular cortical index with 12-month follow-up. Implant Dent. 2016;25:789–95.

    Article  Google Scholar 

  8. Lekholm U, Zarb GA. Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T, editors. Tissue-integrated prosthesis: osseointegration in clinical dentistry. Chicago: Quintessence Publishing; 1985. p. 199–209.

    Google Scholar 

  9. Kim JY, Nah KS, Jung YH. Comparison of panorama radiomorphometric indices of the mandible in normal and osteoporotic women. Korean J Oral Maxillofac Radiol. 2004;34:69–74.

    Google Scholar 

  10. Klemetti E, Kolmakov S, Heiskanen P, Vainio P, Lassila V. Panoramic mandibular index and bone mineral densities in postmenopausal women. Oral Surg Oral Med Oral Pathol. 1993;75:774–9.

    Article  Google Scholar 

  11. Taguchi A, Tsuda M, Ohtsuka M, Kodama I, Sanada M, Nakamoto T, et al. Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis. Osteoporos Int. 2006;17:387–94.

    Article  Google Scholar 

  12. Delvin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2007;104:822–8.

    Google Scholar 

  13. Horner K, Delvin H. The relationship between mandibular bone mineral density and panoramic radiographic measurements. J Dent. 1998;26:337–43.

    Article  Google Scholar 

  14. Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. 1996;25:263–7.

    Article  Google Scholar 

  15. Koh KJ, Kim KA. Utility of the computed tomography indices on cone beam computed tomography images in the diagnosis of osteoporosis in women. Imaging Sci Dent. 2011;41:101–6.

    Article  Google Scholar 

  16. Aydin U, Bulut A, Bulut OE, Ankara TR, Nevesehir TR. Assessment of maxillary and mandibular bone quality. EPOS. ECR 2017; C-2194. https://doi.org/10.1594/erc2017/c-2194.

  17. Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis agains disability study. J Bone Miner Metab. 2009;27:620–8.

    Article  Google Scholar 

  18. Ogura I, Sasaki Y, Sue M, Oda T, Kameta A, Hayama K. Aging and cortical bone density of mandible with CBCT. Int J Diagn Imaging. 2018;5:23–7.

    Article  Google Scholar 

  19. Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res. 1994;102:68–72.

    PubMed  Google Scholar 

  20. Ledgerton D, Horner K, Delvin H, Worthington H. Panoramic mandibular index as a radiomorphometric tool: an assessment of precision. Dentomaxillofac Radiol. 1997;26:95–100.

    Article  Google Scholar 

  21. Benson BW, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol. 1991;71:349–56.

    Article  Google Scholar 

  22. Choen JA. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull. 1968;70:213–30.

    Article  Google Scholar 

  23. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.

    Article  Google Scholar 

  24. Güngör E, Yildirim D, Çevik R. Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry. J Oral Sci. 2016;58:185–94.

    Article  Google Scholar 

  25. Brasileiro CB, Chalub LLFH, Abreu MHNG, Barreiros ID, Amaral TMP, Kakehasi AM, et al. Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis. Arch Osteoporos. 2017;12:26.

    Article  Google Scholar 

  26. Gomes CC, de Rezende Barbosa GL, Bello RP, Bóscolo FN, de Almeida SM. A comparison of the mandibular index on panoramic and cross-sectional images from CBCT exams from osteoporosis risk group. Osteoporos Int. 2014;25:1885–90.

    PubMed  Google Scholar 

  27. Koseoglu Secgin C, Gulsahi A, Yavuz Y, Kamburoglu K. Comparison of mandibular index values determined from standard panoramic versus cone beam computed tomography reconstructed images. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127:257–64.

    Article  Google Scholar 

  28. Miliuniene E, Alekna V, Peciuliene V, Tamulaitiene M, Maneliene R. Relationship between mandibular cortical bone height and bone mineral density of lumbar spine. Stomatologija. 2008;10:72–5.

    PubMed  Google Scholar 

  29. Zebaze RMD, Ghasem-Zadeh A, Bohte A, Iuliano-Burns S, Mirams M, Price RI, et al. Intracortical remodelling and porosity in the distal radius and post-mortem femurs of women: a cross-sectional study. Lancet. 2010;375:1729–36.

    Article  Google Scholar 

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Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TM, MN and TH. The first draft of the manuscript was written by TM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takashi Mizukuchi.

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Conflict of interest

Mizukuchi has a patent JP6674614 issued. Munetaka Naitoh, Toshimitsu Hishikawa, Satoshi Nishida, Akio Mitani, Eiichiro Ariji, Shuji Koyama declares that he has no conflict of interest.

Human rights statements

All procedures were undertaken following the ethical standards of the responsible committee on human experimentation (institutional and national) and the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients before they were included in the study.

Animal rights statements

This article does not contain any studies with animal subjects performed by any of the authors.

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Mizukuchi, T., Naitoh, M., Hishikawa, T. et al. Automatic measurement of mandibular cortical bone width on cone-beam computed tomography images. Oral Radiol 37, 412–420 (2021). https://doi.org/10.1007/s11282-020-00469-4

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  • DOI: https://doi.org/10.1007/s11282-020-00469-4

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