J Periodontal Implant Sci.  2017 Jun;47(3):154-164. 10.5051/jpis.2017.47.3.154.

Three-dimensional measurement of periodontal surface area for quantifying inflammatory burden

• Park SB
• An SY
• Han WJ
• Park JT

• KMID: 2383829
• DOI: http://doi.org/10.5051/jpis.2017.47.3.154

Abstract

PURPOSE
Measurement of the root surface area (RSA) is important in periodontal treatment and for the evaluation of periodontal disease as a risk factor for systemic disease. The aim of this study was to measure the RSA at 6 mm below the cementoenamel junction (CEJ) using the Mimics software (Materialise, Leuven, Belgium).
METHODS
We obtained cone-beam computed tomography (CBCT) data from 33 patients who had visited the Department of Oral and Maxillofacial Radiology of Dankook University Dental Hospital. The patients comprised 17 men and 16 women aged from 20 to 35 years, with a mean age of 24.4 years. Only morphologically intact teeth were included in our data. Because the third molars of the maxilla and mandible have a high deformation rate and were absent in some participants, they were not included in our research material.
RESULTS
The CBCT data were reconstructed into 3-dimensional (3D) teeth models using the Mimics software, and the RSA at 6 mm below the CEJ was separated and measured using 3-Matic (Materialise). In total, 924 3D teeth models were created, and the area at 6 mm below the CEJ could be isolated in all the models. The area at 6 mm below the CEJ was measured in all teeth from the 33 patients and compared based on sex and position (maxilla vs. mandible).
CONCLUSIONS
In this study, we demonstrated that it was feasible to generate 3D data and to evaluate RSA values using CBCT and the Mimics software. These results provide deeper insights into the relationship between periodontal inflammatory burden and systemic diseases.

Keyword

Cone-beam computed tomography; Periodontal diseases; Three-dimensional imaging

MeSH Terms

Cone-Beam Computed Tomography
Female
Humans
Imaging, Three-Dimensional
Male
Mandible
Maxilla
Molar, Third
Periodontal Diseases
Risk Factors
Tooth
Tooth Cervix

Figure

• 

  Figure 1 Process of masking mandibular teeth in CBCT. (A) Thresholding mask based on the general bone value in Mimics (Materialise, Leuven, Belgium). (B) Separating soft tissue and cervical bone in the mandible, and then filling inside the cavity. (C) Extracting teeth from the mandible.CBCT: cone-beam computed tomography.

• 

  Figure 2 Process of generating the 3D structure of teeth. (A) The 3D skull model was generated using Mimics (Materialise, Leuven, Belgium). (B) The skull and teeth were separated using the region-growing method. (C) The teeth are indicated in red and orange in the maxilla, and green and blue in the mandible. The teeth were extracted and bones were deleted.3D: 3-dimensional.

• 

  Figure 3 Evaluation of the CAL in periodontitis. The CEJ is the cervical line between the crown and root. The CAL is the distance from the attachment level to the CEJ. The PPD is the distance from the attachment level to the gingival margin.CAL: clinical attachment level, CEJ: cementoenamel junction, PPD: probing pocket depth.

• 

  Figure 4 Separation of the RSA at 6 mm below the CEJ. Step 1. Generated using 3-dimensional data from CBCT. Step 2. A root line position is created around the tooth meridian and a cross section of the root at 6 mm below it. Step 3. Teeth are divided into 3 parts based on 2 apical surfaces. Step 4. The root cross section is removed. Step 5. The lower part and crown are removed, except the area 6 mm below the CEJ.RSA: root surface area, CEJ: cementoenamel junction, CBCT: cone-beam computed tomography.

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