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119: TREATMENT PLAN FOR IMPACTED MAXILLARY THIRD MOLARS BASED ON RADIOLOGICAL FINDINGS VARIES AMONG ORAL SURGEONS – A WEB-BASED “PAPER” CLINIC STUDY
L. Hermann1, S.E. Nørholt1, A. Wenzel1, E. Berkhout2, L.H. Matzen1
1Aarhus University, Department of Dentistry and Oral Health, Aarhus, Denmark, 2University of Amsterdam, Department of Oral Radiology, Amsterdam, Netherlands
Aim. To identify and explore variation in treatment plans and pathological findings related to impacted maxillary second and third molars based on panoramic images and CBCT among Danish and Dutch oral and maxillofacial surgeons.
Material and Methods. This web-based “paper” clinic contained 10 cases of impacted maxillary third molars comprising relevant clinical information, panoramic images, and selected CBCT-sections. Twenty-eight surgeons were included. Treatment plan and pathological findings were evaluated based on clinical information and a panoramic image, thereafter, based on CBCT. Options for treatment plan for third molars were no treatment or third molar removal. Options for treatment plan for second molars were no treatment, second molar removal, or endodontic and/or filling therapy. The surgeons assessed pathology including external root resorption of the second molar, marginal bone loss of the second molar, and follicular space related to the impacted third molar.
Results. A change in treatment plan between the panoramic image and CBCT was registered between 0% and 43% of the surgeons among the cases. The surgeons did not agree completely on the treatment plan for the second and the third molar in any of the cases. Variation was also present among the surgeons when evaluating pathological findings. In several cases, severity of root resorption was rated worse in CBCT than in the panoramic image.
Conclusions. Variation in both treatment plan and pathological findings related to maxillary second and third molars was observed among the surgeons. No correlation between change in pathological findings and change in treatment plan was found.
238: DENTAL MATERIALS ARTIFACTS IN MRI – AN IN VIVO RETROSPECTIVE STUDY
S. Friedlander Barenboim1, K. Kur1, N. Yarom1,2, S. Kasis3, G. Greenberg4
1Sheba Medical Center, Oral Medicine, Ramat Gan, Israel, 2The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Health and Medical Sciences, Tel Aviv University, Tel Aviv, Israel, 3Sheba Medical Center, Pediatric Dental Clinic – Oral Medicine, Ramat Gan, Israel, 4Sheba Medical Center, DIAGNOSTIC IMAGING, Ramat Gan, Israel
Background: Magnetic resonance imaging (MRI) aids in diagnosing pathologies in the head and neck region. Artifacts due to dental materials might affect the ability to diagnose pathologies.
Dental materials in MRI lead to signal loss artifacts. Those artifacts will appear as black areas which may interfere with the diagnostic value in the areas of interest. Orthodontic appliances produce MRI artifacts and have been widely studied in vitro.
Aim: To investigate artifacts produced by various dental materials on MRI in vivo.
Materials and methods: Files of 50 patients under the age of 18, and 50 patients above 18 years treated in our department will be retrieved. Data regarding each patient’s dental treatment will be gathered from clinical and radiographic examinations. An experienced head and neck radiologist blinded to the patient’s dental data will examine the MRI and record the artifacts. Artifacts will be described in terms of location, size, and influence on the diagnostic value at the area of interest.
Results: Our preliminary results show that MRI signal loss produced by dental materials usually affects the close vicinity and does not alter diagnostic value in the area of interest in most cases. The most prevalent dental materials that cause artifacts other than orthodontic appliances are Preformed and PFM crowns.
Conclusions: MRI artifacts produced by dental materials reduce the diagnostic value mainly in the nearby structures. Despite the distortion produced by those dental materials, in most cases, it didn’t interfere with the interpretation of the MRI scan.
232: DEVELOPMENT OF SIMPLIFIED WORKFLOWS FOR DENTAL-DEDICATED MRI: TECHNICAL DESCRIPTION AND USER ACCEPTANCE EVALUATION
G. Wigger1, C. Hayes1, M. Hellinger1, M. Keil1, M. Van de Stadt-Lagemaat1, J. Thöne1, C. Krellmann1, G. Krüger1, A. Hausotte1, A. Greiser1
1Siemens Healthineers, Erlangen, Germany
Aim: Present the steps to enable dental assistants to operate MRI software and perform patient scans.
Methods: Dental-dedicated MRI workflows have been developed for several applications. The dental assistant can be guided through the workflow with adopted dental nomenclature by visual elements within the MRI user interface (UI). The MRI imaging volume is positioned automatically using landmark detection. Guiding images show how the imaging volume should be positioned and how the user can interactively modify it. Some workflows focus on the teeth in one dental sextant (e.g., endodontics), and some support bilateral scanning of two sextants (e.g., TMJ). The user can interactively select the dental sextant(s) of interest at the start. We conducted two user studies: with MR technicians (n=5) and dental assistants (n=7). The user experience of the UI was evaluated with a User Experience Questionnaire (UED) on efficiency, dependability, clarity, usefulness, and perspicuity (scale -3 to +3). Task analysis of specific steps in the workflow was rated using a 4-point scale, 1: not successful to 4: successful).
Results: The dental assistants were able to run the dental workflows in the software prototype efficiently after receiving a short introduction to the UI. For the German-speaking dental assistants, the English UI language sometimes caused issues. They judged the schematic guidance as helpful. The UI received a above 2 UEQ score, on average.
Conclusion: Within the current MRI software framework, the suggested dental-dedicated MRI workflows are easy to operate by dental assistants. A user training to introduce the software is required.
252: AN MRI INVESTIGATION OF TEMPOROMANDIBULAR JOINT DISORDERS AND HYPERTROPHIC UVULA PALATINA: IS THERE A LINK?
M. Öçbe1, U. Seki2, A. Kuran2, A. Üzel2, E.A. Sinanoğlu2
1Kocaeli Health and Technology University, Kocaeli, Turkey, 2Kocaeli University, Kocaeli, Turkey
Aim: Temporomandibular joint disorders (TMD) encompass a range of conditions affecting the jaw joint and surrounding muscles. While the etiology of TMD is multifactorial, a potential association with anatomical structures in the oral and pharyngeal region, including the uvula palatina (UP) should be examined.
Materials and Methods: Turbo Spin Echo Magnetic Resonance Imaging (TSE MRI) scans of patients diagnosed with TMD were retrospectively examined. UP dimensions were assessed and classifications made based on mediolateral dimensions into hypertrophic (H) and non-hypertrophic (NH) categories. Additionally, patients with TMD were evaluated for articular disc position, categorized as displacement with reduction (DWR) or displacement without reduction (DWOR). Statistical analysis was conducted for categorical variables with a statistical significance defined as p < 0.05.
Results: A total of 58 MR images (43 female, 15 male) were assessed, with 34 patients exhibiting DWR. The mean mediolateral dimension for UP was measured at 6.78 mm for patients with DWOR and 7.59 mm for those with DWR. The statistical analysis did not reveal a significant relationship between uvula dimensions and disc displacement (p < 0.05).
Conclusions: UP dimensions may be influenced by various factors, including anatomy and soft tissue structure within the pharyngeal region. While this study hints at a potential link between uvula morphology and TMD, further research with larger sample sizes and comprehensive evaluation of airway structures is warranted for a more definitive assessment of the relation between TMD and size of the UP.
161: QUANTITATIVE ANALYSIS OF MASSETER MUSCLE BY ULTRASONOGRAPHY ACCORDING TO DIFFERENT OCCLUSION TYPES USING EICHNER CLASSIFICATION
S. Uzun1, Z.I. Ozturk2, B. Eren2, G. Magat1, M.H. Kurt2
1Necmettin Erbakan University Faculty of Dentistry, Dentomaxillofacial Radiology, Konya, Turkey, 2Ankara University Faculty of Dentistry, Dentomaxillofacial Radiology, Ankara, Turkey
Aim: The Eichner classification is used to classify occlusal supports in the post-canine region. The aim of this study is to investigate the effects of different occlusion types based on the Eichner classification index on the quantitative features of masseter muscle by using ultrasonography (USG).
Material and Methods: An ultrasonographic examination of the thickness and elasticity values of the masseter muscle was performed. Images were acquired bilaterally in the resting position and maximum intercuspidation (MIC). Measurements were made in edentulous patients only in the resting position. The significance level was set as p=0.05.
Results: This research included a total of 120 individuals aged, comprising 60 females and 60 males. According to measurements made on the right masseter muscle in both relaxed and contracted states and the left masseter muscle in a contracted state, thicknesses in females were found to be significantly lower than those in males (p<0.01). The thickness of the right and left masseter muscles at rest in individuals aged 55 and over was significantly less than those in the 18-35 age range (p<0.01). The thicknesses of the right and left masseter muscles at rest were lower in individuals in the Eichner C3 category, while in the contracted state, they were lower in individuals in the B3 and B4 categories.
Conclusion: Ultrasonography is a useful and important diagnostic method for evaluating masseter muscle without using radiation. Thickness and elasticity of masseter muscle were significantly decreased in some groups (women, aged 55 and over, and with increased tooth loss).