Atlas of Dentomaxillofacial Anatomical Imaging

229 Pages·2022·21.358 MB·English

by  Antigoni Delantoni (editor), Kaan Orhan (editor)

Atlas of
Dentomaxillofacial
Anatomical Imaging
Antigoni Delantoni
Kaan Orhan
Editors
123
Atlas of Dentomaxillofacial Anatomical
Imaging
Antigoni Delantoni • Kaan Orhan
Editors
Atlas of Dentomaxillofacial
Anatomical Imaging
Editors
Antigoni Delantoni Kaan Orhan
Faculty of Dentistry DentoMaxillofacial Radiology
Aristotle University of Thessaloniki Ankara University
Thessaloniki, Greece Ankara, Turkey
ISBN 978-3-030-96839-7 ISBN 978-3-030-96840-3 (eBook)
https://doi.org/10.1007/978-3-030-96840-3
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
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To my family and students,
And to my mentor from whom I learned Anatomy,
Prof. Dr. Bayram Ufuk Şakul
To my family from who I learn daily,
And to my teachers who made me love anatomy
Preface
Accurate interpretation of indications for treatment is the cornerstone of suc-
cess in medicine. The book examines the relation between clinical features,
diagnosis, and choice of minimally invasive technique for a range of dento-
maxillofacial anatomy and disorders. It explains how selection of imaging
technique is intimately related to clinical and diagnostic aspects and how
recognition of this relation forms the foundation for an optimal outcome. In
addition to examining the various modalities, careful attention is paid to the
role of including the latest imaging techniques. The book will provide detailed
discussion of the pathology, treatment, and prognosis of common and rare
diseases, congenital/developmental malformations, and more in dentomaxil-
lofacial area which is underestimated and also not well known by radiolo-
gists. This comprehensive imaging book will help radiologists and dentists in
their training and daily practice. Pathological descriptions of radiologic diag-
noses help clarify the pathophysiology of the disease. Pearls and pitfalls of
imaging interpretation are presented for quick reference. Authors are world-
renowned dentomaxillofacial radiology experts.
In this book, the chapters fall into several categories: The anatomy, tech-
nique, and fundamentals of 2D modality are discussed in Chapters 1–6.
Chapters 7 to 9 briefly review general considerations for 3D CBCT/MDCT in
head and neck as well as its anatomy, Chapter 10 physical principles of ultra-
sound as well as finally, advanced MRI, angiography and micro-CT imaging
in Chapters 11–15.
This is an outstanding book for learning and understanding the DMFR
imaging in dentomaxillofacial radiology that will stimulate both radiologists
and students to seek a more in-depth appreciation of the subject and its con-
tribution to the scientific community of radiology. As a result, this book offers
a comprehensive review of the state of the art in dentomaxillofacial
imaging.
Thessaloniki, Greece Antigoni Delantoni
Ankara, Turkey Kaan Orhan
July 2021
vii
Contents
1 Introduction to Dentomaxillofacial Imaging . . . . . . . . . . . . . . . . 1
Kaan Orhan and Antigoni Delantoni
2 Basic Principles of Intraoral Radiography . . . . . . . . . . . . . . . . . . 7
Antigoni Delantoni and Kaan Orhan
3 Intraoral Radiographic Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . 15
Antigoni Delantoni and Kaan Orhan
4 Basic Principles of Panoramic Radiography . . . . . . . . . . . . . . . . 25
Kaan Orhan and Antigoni Delantoni
5 Panoramic Radiographic Anatomy . . . . . . . . . . . . . . . . . . . . . . . . 39
Kaan Orhan and Antigoni Delantoni
6 Cephalometric Radiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Athina Chatzigianni
7 Basic Principles of Computer Tomography
(MDCT/CBCT). The Use of MDCT
and CBCT in Dentomaxillofacial Imaging . . . . . . . . . . . . . . . . . . 73
Antigoni Delantoni and Alexandros Sapountzis
8 CBCT Anatomical Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Spyros Damaskos and Antigoni Delantoni
9 MDCT Soft Tissue Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Antigoni Delantoni and Kaan Orhan
10 Dentomaxillofacial Ultrasonography: Basic Principles
and Radiographic Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Antigoni Delantoni and Apostolos Sarafopoulos
11 Basics of Magnetic Resonance Imaging (MRI) . . . . . . . . . . . . . . 169
Ingrid Rozylo-Kalinowska
12 MRI Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Ingrid Rozylo-Kalinowska
13 Principles of Maxillofacial Angiography . . . . . . . . . . . . . . . . . . . 183
Stefanos Finitsis
ix
x Contents
14 Imaging of the Most Common Dental Pathologies . . . . . . . . . . . 191
Kaan Orhan, Berkan Celikten, and Aysenur Oncu
15 Micro-CT in Dentistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Kaan Orhan, Bora Akat, and Berkan Celikten
1
Introduction to Dentomaxillofacial
Imaging
Kaan Orhan and Antigoni Delantoni
1.1 Introduction patient’s medical history. A proper radiograph
will ensure a good diagnosis and thus proper
The correct diagnosis for the treatment of oral treatment of the patient. Taking dental radio-
and maxillofacial pathologies has an important graphs correctly the first time saves the patient
place for accurate treatment. Radiographic imag- unnecessary radiation exposure and the practice
ing is an important element in the diagnosis. time and expense. There are several methods that
Because of the anatomic complexity of the dento- can be used in dental radiology from conven-
maxillofacial region and wide variety of diseases, tional to 3D contemporary advanced techniques.
the diagnosis can be problematic. Radiographs Depending on the pathology one should know
are an essential part of proper diagnosis. From about the proper indication and also the use of
the early days of dental radiography, the clinical radiology technique esp. dose concentrations.
objective has been to produce accurate images of The objective of this textbook is to offer the
dental structures that are normally visually reader a concise summary of the fundamentals
obscured and not always readily visualized. An and principles of dental radiology. In addition,
early method for aligning the X-ray beam and the more common osseous pathologic lesions
image receptor with the teeth and jaws was the will be given along the chapters. This book is
bisecting-angle technique. intended to be a handy resource for the student
Dentists, should make sure that operators do and the practicing clinicians.
not take for granted the impact of their actions
when they take X-rays. Radiographs which are
based on the patient’s intraoral examination are 1.2 W hat Does the Clinician
taken and always following a review of the Need in Terms of Imaging?
In today’s dental practice, one should only use
a well-designed X-ray machine where the time
K. Orhan (*)
Department of DentoMaxillofacial Radiology, exposure controls are electronic and thus accu-
Faculty of Dentistry, Ankara University, rately deliver the proper exposure to patients. In
Ankara, Turkey
most countries, these are the only types of controls
e-mail: [email protected]
that pass inspection. If one is not using a machine
A. Delantoni
that uses electronic controls, they should replace
Department of Dentoalveolar Surgery, Implant
it as soon as possible. To obtain proper images
Surgery and Radiology, Faculty of Dentistry, Aristotle
University of Thessaloniki, Thessaloniki, Greece of the oral cavity and dental tissues, one must at
e-mail: [email protected] all times be aware of the basic rule of radiology:
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 1
A. Delantoni, K. Orhan (eds.), Atlas of Dentomaxillofacial Anatomical Imaging,
https://doi.org/10.1007/978-3-030-96840-3_1
2 K. Orhan and A. Delantoni
ALARA (as low as reasonablyAttainable). This Precautions during irradiation: For radiation
means dentists are taking images using As-Low- control reasons, lead aprons and collars should be
As-Reasonably-Achievable doses of radiation. In applied to all patients, regardless of patient age or
order to be protected from the biological effects the number of films to be taken, to protect the
of radiation, some precautions must be taken and thyroid and gonad areas. Appropriate kVp should
also proper use of radiographs should be known be selected for diagnostic purposes. Generally
by the professions. Dose limitations are at the 70–100 kVp is a suitable range for various pur-
forefront of these measures: poses in dentistry. When kVp decreases, the
energy of the beam decreases, the image contrast
1. Necessity of applications: Radiation applica- increases, when kVp increases, the energy of the
tions that will not provide a clear benefit beam increases and the image contrast decreases.
should be avoided. (Justification: High-contrast images are useful in monitoring
justification-necessity). very different densities within a structure, such as
2. Optimization (Best of the Alternatives): caries or soft tissue calcifications, while low-con-
Considering the economic and social factors, trast images are useful in identifying dissimilar
all irradiation should be kept at the lowest densities, such as early and minor bone changes
level possible. in periodontal disease. The films should be placed
3. Dose limitation: the maximum permissible correctly in the mouth and moving of the films
doses (MPD: maximum permissible dose) should be avoided. This minimizes distortion and
should not be exceeded. The exposure and dose prevents unnecessary radiation of the patient’s
reduction, as well as clinical indications must be hand when using bi-secting technique. However,
established after careful clinical examination. the use of the parallel technique should be per-
formed with the proper film holders. This pre-
Maximum patient benefit should be targeted, vents possible exposure to patient’s hand and
with minimum patient and operator dose. provides proper placement of the film with a
Considering the presence of risk, although it is reduction of patient’s exposure dose. The parallel
minimal in all individuals, efforts should be made technique is a more suitable technique in terms of
to use as low as possible doses, and all unneces- protection because it allows the closest image to
sary exposures should be avoided. When follow- its real size with more parallel rays.
ing these basic rules, the amount of radiation to Precautions after irradiation: The proper
which both the patient, the practitioner and the selection of the appropriate technique, its correct
environment will be exposed can be minimized application of the chosen technique, the preven-
in occupational radiation applications. tion of film repetitions, and the obtaining of high
Moreover, the clinician should take care all quality radiographs with minimal radiation are
precautious; before irradiation, during irradia- important. The radiographs should be evaluated
tion, and after irradiation. with a proper display (preferably dedicated medi-
Precautions before irradiation: Determining cal displays). The environment in which the
the appropriate indication and technique for the assessment takes place should be semi-dark.
patient, after the anamnesis and clinical examina- Window light or unit light are not suitable for
tion. It should be noted whether there is a sys- examining films. Quality assurance programs:
temic condition (such as pregnancy in female Every clinic should have a quality assurance pro-
patients), the use of Pb aprons, reducing the num- tocol in order to consistently obtain high quality
ber of films and exposure time should be taken images with minimal exposure. Continuous edu-
into consideration. The indication for taking cation programs should be followed in order to
radiographs in children and young people should follow the innovations in imaging technology and
be reduced as much as possible. The X-ray equip- new information on radiation safety. Dental clini-
ment should be safe, well-calibrated, and periodi- cians should combine the clinical examination to
cally maintained and checked. possible diagnosis, and then refer for imaging to