Development of a New Cone-Beam Computed Tomography Software for Endodontic Diagnosis

Abstract

Cone-beam computed tomography (CBCT) has promoted changes in approaches in Endodontics, and enhanced decision-making in complex clinical cases. Despite the technological advancements in CBCT hardware, the interpretation of the acquired images is still compromised by viewing software packages that often have limited navigational tools and lack adequate filters to overcome some challenges of the CBCT technology such as artefacts. This study reviews the current limitations of CBCT and the potential of a new CBCT software package (e-Vol DX, CDT- Brazil) to overcome these aspects and support diagnosing, planning and managing of endodontic cases. This imaging method provide high resolution images due to submillimeter voxel sizes, dynamic multi-plane imaging navigation and ability to change the volume parameters such as slice thickness and slice intervals and data correction applying imaging filters and manipulating brightness and contrast. The main differences between e-Vol DX and other software packages are: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; Custom slice thickness adjustment, often limited and pre-defined in other applications; Custom Sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; preset imaging filters, dedicated endodontic volume rendering filters with the ability to zoom the image over 1000x (3D reconstructions) without loss of resolution and automatic imaging parameters customization for better standardization and opportunities for research; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications. This new CBCT software package may support decision-making for the treatment of complex endodontic cases and improve diagnosis and treatment results. Effective improvement of image quality favors the rational prescription and interpretation of CBCT scans.

CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study

“…imaging technique that enables the anatomic study of dental and maxillofacial bone structures in crosssectional high-resolution images in vivo. 12,13 This imaging technique also enables linear measurements of dental and bone structures to be performed with accuracy and reliability. [14][15][16][17] However, the accuracy of reformatted CBCT images is affected by technical parameters that could depend on the CBCT system, such as nominal resolution, image quality, voxel size, kV, mA, number of basis images, field of view (FOV), and the algorithm of the software used in the acquisition and reconstruction of dimensional measurements.…”

“…[14][15][16][17] However, the accuracy of reformatted CBCT images is affected by technical parameters that could depend on the CBCT system, such as nominal resolution, image quality, voxel size, kV, mA, number of basis images, field of view (FOV), and the algorithm of the software used in the acquisition and reconstruction of dimensional measurements. 12,18,19 Advanced CBCT systems with high spatial resolution, submillimeter voxel sizes, small FOV, and a smaller focal spot, are considered more accurate in regard to linear measurements. 18 Although some CBCT studies have been conducted to analyze bone thickness in maxillary and mandibular teeth, the information regarding bone thickness in the apical region have been under-represented.…”

“…The map-reading dynamic feature of the CBCT was applied as described previously, 20 were visualized using a new CBCT software program named e-Vol DX (CDT Software, Bauru, SP, Brazil). 12 The bone thickness was measured using the PreXion 3D Viewer software (TeraRecon Inc., Foster City, CA, USA). The standard reference for the location of the apical foramen was the main root canal.…”

Method to Determine the Root Canal Anatomic Dimension by using a New Cone-Beam Computed Tomography Software

“…Bueno et al (14) reviewed the current limitations of CBCT and presented the potential of a new CBCT software package (e-Vol DX, CDT-Brazil) with the ability to assist diagnosing, planning and managing of complex endodontic cases. The authors described that the differences between e-Vol DX and other software packages include: compatibility with all current CBCT scanners with the capacity to export DICOM Data, a more comprehensive brightness and contrast library, as other applications, in which adjustments are limited, do not usually support all the DICOM dynamic range features; custom slice thickness adjustment, often limited and pre-defined in other applications; custom sharpening adjustment, often limited in other applications; advanced noise reduction algorithm that enhances image quality; capture screen resolution of 192 dpi, with a 384 dpi option, in contrast to the 96 dpi of most similar applications.…”

“…The development of the e-Vol DX software (CDT Software, Bauru, SP, Brazil) enables high quality CBCT images, visualization of complex anatomical structures, precise identification of occult lesions (possibly undetected), reduction of artifacts with capability to import, work with DICOM files, and standardize image adjustments to analyze CBCT volumes from different sources (14).…”