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    Accuracy of high-resolution ultrasound (US) for gingival soft tissue thickness mesurement in edentulous patients prior to implant placement
    (2021) Sonmez, Gul; Kamburoglu, Kivanc; Gulsahi, Ayse; 33201732
    Objectives: To evaluate and compare the accuracy of high-resolution ultrasound (US) with two different cone beam CT (CBCT) units and clinical assessment for measuring gingival soft tissue thickness in edentulous patients prior to implant placement. Methods and materials: The study consisted of 40 maxillary implant sites of 40 healthy patients (20 females, 20 males; mean age, 47.88 years). We prospectively evaluated labial/buccal gingival thickness in 40 implant regions (16 anterior and 24 posterior) by using limited field of view (FOV) CBCT images and US images in comparison to gold standard transgingival probing measurements. One-way analysis of variance (ANOVA) was used to compare mean measurements obtained from CBCT (Morita and Planmeca), US, and transgingival probing. Interclass correlation coefficient (ICC) estimates were calculated based on means with two-way mixed and absolute-agreement model. Bland Altman plot was used to describe agreement between clinical vs US and CBCT measurements by constructing limits of agreement. Statistical significance was set at p < 0.05. Results: There was no significant difference between methods used according to mean gingival thickness measurements obtained from the top (p = 0.519) and bottom (p = 0.346) of the alveolar process. US and CBCT measurements highly correlated with clinical measurements for both top and bottom alveolar process gingival thickness (p < 0.001). Distribution of differences between clinical measurements and both CBCT measurements showed statistically significant differences according to 0 (p < 0.05). Distribution of differences between clinical measurements and US measurements did not show statistically significant difference (p > 0.05). Conclusion: High-resolution US provided accurate information for the measurement of gingival soft tissue thickness in edentulous patients prior to implant placement.
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    Effect of cone beam computed tomography voxel size and dental specialty status on the agreement of observers in the detection and measurement of periapical lesions
    (2021) Kamburoglu, Kivanc; Koc, Emre; Sonmez, Gul; Elbahary, Shlomo; Rosen, Eyal; Tsesis, Igor; 34120879
    Objective. To compare observer agreement between endodontists and oral and maxillofacial radiologists (OMRs) in the detection and measurement of periapical lesions as depicted in cone beam computed tomography (CBCT) with 2 voxel sizes. Study Design. In total, 256 CBCT images of maxillary molars were evaluated by 2 endodontists and 2 OMRs. Images were obtained at voxel sizes of 0.2 and 0.4 mm. Observers evaluated 64 endodontically and 64 nonendodontically treated teeth for the presence of periapical lesions using a 5-point confidence scale. Weighted k values were calculated to determine intra- and interobserver agreement. Intraclass correlation coefficients (ICCs) were calculated to assess intra- and interobserver agreement in width and height measurements of the lesions. Results. Intraobserver agreement ranged from fair to almost perfect, with k values higher for the OMRs than for the endodontists. Interobserver agreement between endodontists ranged from fair to moderate at the 0.2mm voxel size and was slight at 0.4 mm. Agreement between OMRs was almost perfect at 0.2 mm and ranged from substantial to almost perfect at 0.4 mm. ICC was excellent for all observers in all conditions. Conclusions. Intra- and interobserver reliability was affected by voxel size and specialty. Correlation for measurements exhibited no variation.
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    Versatility of high resolution ultrasonography in the assessment of granulomas and radicular cysts: a comparative in vivo study
    (2019) Sonmez, Gul; Kamburoglu, Kivanc; Yilmaz, Funda; Koc, Cemre; Baris, Emre; Tuzuner, Aysegul; 31188679
    Objectives: To evaluate and compare the diagnostic potential of high resolution ultrasound with periapical radiographs (PR) and CBCT in assessing granulomas and radicular cysts. Methods: This study included a total of 33 teeth from 33 patients with periapical lesions. Subjects were distributed among three groups. A consisted of teeth that were extracted. B consisted of teeth treated with root-canal treatment followed by apical surgery. C consisted of teeth treated with root-canal treatment only. Pre-treatment PR, ultrasound and CBCT images were obtained for Groups A, B and C and 6 month post-treatment PR and ultrasound images were obtained for Groups B and C. In addition, histopathological analysis was performed on lesions in Groups A and B. Lesions were classified as either cystic lesions or granulomas. Width, height, depth, surface area and volume of lesions were measured using the built-in softwares of the appropriate imaging modalities. Measurements were compared by Wilcoxon and paired sample t tests. Ultrasound and histopathological findings were compared with lc and Mc Nemar. Statistical significance was set at p < 0.05. Results: kappa coefficient (0.667; p = 0.002) suggested good agreement between ultrasound and histopathology. No statistically significant differences were found among periapical radiography, CBCT and ultrasound in the pre-treatment measurements of lesion width ( p = 0.308) or between CBCT and periapical radiography in the pre-treatment measurements of lesion height ( p = 0.863). In all cases, mean measurement values for all variables were lower for ultrasound than for CBCT. Conclusion: Ultrasound provided useful information for the diagnosis and assessment of granulomas and radicular cysts.