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    Evaluation of a Decision Support System Developed with Deep Learning Approach for Detecting Dental Caries with Cone-Beam Computed Tomography Imaging
    (Mdpi, 2023) Amasya, Hakan; Alkhader, Mustafa; Serindere, Goezde; Futyma-Gabka, Karolina; Aktuna Belgin, Ceren; Gusarev, Maxim; Ezhov, Matvey
    This study aims to investigate the effect of using an artificial intelligence (AI) system (Diagnocat, Inc., San Francisco, CA, USA) for caries detection by comparing cone-beam computed tomography (CBCT) evaluation results with and without the software. 500 CBCT volumes are scored by three dentomaxillofacial radiologists for the presence of caries separately on a five-point confidence scale without and with the aid of the AI system. After visual evaluation, the deep convolutional neural network (CNN) model generated a radiological report and observers scored again using AI interface. The ground truth was determined by a hybrid approach. Intra- and inter-observer agreements are evaluated with sensitivity, specificity, accuracy, and kappa statistics. A total of 6008 surfaces are determined as 'presence of caries' and 13,928 surfaces are determined as 'absence of caries' for ground truth. The area under the ROC curve of observer 1, 2, and 3 are found to be 0.855/0.920, 0.863/0.917, and 0.747/0.903, respectively (unaided/aided). Fleiss Kappa coefficients are changed from 0.325 to 0.468, and the best accuracy (0.939) is achieved with the aided results. The radiographic evaluations performed with aid of the AI system are found to be more compatible and accurate than unaided evaluations in the detection of dental caries with CBCT images.
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    Evaluation of changes in nasopalatine canal morphology according to dentition status by computed tomography
    (Kocaeli Üniversitesi, 2020) Aktuna Belgin, Ceren; Serindere, Gözde
    Objective: The nasopalatine canal (NPC) is one of the important anatomic structures in anterior maxilla. The aim of this study was to evaluate thechanges in NPC morphology according to dentition status in the maxillary anterior region by computed tomography (CT).Methods: Computed tomography images of 100 patients were screened retrospectively. Images were divided into two groups by dental status: anedentulous group (EG) of 50 patients who have edentulous premaxilla and a control group (CG) of 50 patients who have all incisor teeth in thepremaxillary region. After recording the age, sex, and dentition status of the patients, the NPC diameter, NPC length, incisive foramen (IF) diameter,and angle between the NPC and palatine bone were measured in sagittal sections, and the number of NPCs was determined in axial sections.Results: There was no significant difference between NPC angle and dentition status (p=0.151). The NPC diameter was significantly higher in theEG (p=0.002), as was the IF diameter (p=0.041). In addition, NPC length was significantly higher in the CG (p<0.001). A statistically significant andnegative correlation was found between age and NPC length (p<0.001), and a positive correlation was found between age and NPC diameter(p=0.004). In addition, no statistically significant difference was found between sex and other parameters (p>0.05).Conclusion: The NPC length and diameter vary according to the age and dentition status of the patient. Changes in this anatomic structure should beevaluated pre-operatively in elderly patients by three-dimensional radiographic evaluation.
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    Evaluation of error types and quality on panoramic radiography
    (International Association for Dental Research, 2019) Aktuna Belgin, Ceren; Serindere, Gözde
    Aim: The aim of this study was to investigate the prevalence of panoramic radiographic errors and to evaluate the correlation between age and panoramic radiographic error types. Methodology: A total of 500 panoramic radiographs (259 male, 241 female) which had been taken for various reasons were randomly selected from the archive of our dentomaxillofacial radiology department. Patients were divided into six age groups and by sex. The assessed errors included the tongue not in contact with the palate, slumped position, patients not biting on bite block, patient movement, the chin tipped high, the chin tipped low, the patient positioned forward, the patient positioned backward, patient’s head turned to one side, foreign bodies in the image, exposure errors, positioning error of the lips and missing image. The quality of each radiograph was rated as excellent, diagnostically acceptable or unacceptable. Results: One or more errors were detected in 317 (63.4%) of the 500 panoramic radiographs, while no error was found in 183 (36.6%) of the images. It was observed that the most common error type was the slumped position (13.2%). All of the panoramic radiographs were evaluated according to the quality criteria: only 15% of the images were classified as “excellent”, 48.2% were rated “inadequate for diagnosis” and 36.8% were graded “adequate for diagnosis”. It was recorded that “slumped position” and “patient movement” errors were statistically significant in >56 years (p<0.05). Conclusions: Patients can be protected from unnecessary radiation exposure by investigating the causes of panoramic radiographic errors and by providing appropriate training to technicians.
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    The evaluation of visibility of mandibular anatomic landmarks using panoramic radiography
    (International Association for Dental Research, 2019) Serindere, Gözde; Aktuna Belgin, Ceren
    Aim: The mandibular canal, mandibular foramen, mental foramen, and incisive canal are important anatomical structures for dental surgery. The aim of this study was to evaluate the visibility of these important landmarks in different age groups and to compare the visibility in the dentulous group with the edentulous group on panoramic radiographs. Methodology: Panoramic radiographs of 500 patients (237 males and 263 females; mean age:39.2) were evaluated for this study; the visibility of their anatomical landmarks was analyzed, and scores were noted.The data obtained were analyzed using the SPSS 21 package program.The value of p<0.05 was considered statistically significant. Results: The mandibular canal, mandibular foramen, mental foramen, and incisive canal were visible in 89.8%, 88%, 80.6%, and 12.8%of all radiographs, respectively.Twenty-three(4.6%) patients had total tooth loss.The visibility of the anatomical landmarks were most clearly observed in groups below 25 years old. Conclusions: Panoramic radiographs provide useful information on the visibility of anatomical landmarks. However, using 3D imaging methods before surgical procedures will provide more accurate results.
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    Hatay ilinde oral premalign lezyonların prevalansı: retrospektif bir çalışma
    (2020) Serindere, Gözde; Aktuna Belgin, Ceren; Gürsoy, Didar; Orhan, Kaan
    Bu çalışmanın amacı, 2017 ve 2019 yılları arasında Patoloji Anabilim Dalı'na başvuran hastalarda oral premalign lezyonların(OPL) prevalansını değerlendirmektir. Patoloji rapor arşivinde histopatolojik olarak OPL olduğu doğrulanmış toplam 194 hastageriye dönük olarak incelendi. Bunlardan 82'si (% 42,3) erkek, 112'si (% 57,7) kadındı. Cinsiyet ve yaş bilgisi tıbbi kayıtlardan eldeedildi. Patolojik sonuçlara göre OPL'ler sınıflandırıldı. 194 hastada OPL bulundu. 112 (% 57,7) kadın, 82'si (% 42,3) erkekti. Yaşdağılımına göre 10-20, 21-30, 31-40, 41-50- 51-60, 61-70, 71-80 ve 80 yaş üstü hasta sayıları 1 (% 0,5), 13 (% 6,7), 25 (% 12,9), 36(% 18,5), 50 (% 25,8), 35 (% 18,1), 20 (% 10,3) ve 14 (% 7,2) idi. En sık görülen premalign lezyon liken planus (% 50,6) olarakbulundu. Ağız boşluğunda malignite olasılığını ekarte etmek için biyopsi yapılmalıdır. OPL'lerin erken teşhisi tedavi için önemlidir.
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    Prevalence and characteristics of pneumatized articular eminence on panoramic radiographs: a retrospective study and literature review
    (Kırıkkale Üniversitesi, 2019) Serindere, Gözde; Aktuna Belgin, Ceren
    Objective: Pneumatized articular eminence (PAE) is an air filled cavity in temporal bone. The aim of this research was to evaluate the prevalence and characteristics of PAE using panoramic radiograhy. Material and Methods: The panoramic radiographs of 1000 patients were analyzed to describe prevalence and characteristics of PAE. Patients with PAE had a mean age of 35 years with a range of 19–85 years. Gender, age, localization and locularity of pneumatization were noted. Results: PAE was found in 19 (1.9%) patients with a mean age of 34.4. Twelve patients were female and seven patients were male. There was no statistically significant difference between gender and the presence of PAE (p>0.05). 12 unilateral and 7 bilateral cases were observed. Nine patients (47.4%) had PAE on the left side while three patients (15.8%) had PAE on the right side. Unilocular appearances were found in 7 patients (36.8%) while multilocular appearances were found in 11 patients (57.9%). One patient (5.3%) had both unilocular and multilocular types. Conclusion: Awareness for this anatomical variation is important for differential diagnosis from other lesions and also for planning temporomandibular joint surgery. Because of fragile structure of bone with PAE, the surgeons should be careful during temporomandibular joint operations.