Generation of 3D root canals from two or more oral radiographs

描述(申请人提供)：在美国，每年大约要做1500万个根管。失败率约为10%，失败的初始治疗反映了美国每年超过9亿美元的成本。虽然失败的原因有很多，但主要原因之一是无法评估根管形态的困难，即它在三维(3D)中的路径。从业者需要获得多张X光片，以便于对这条路径进行心理评估。这一估计受到3D结构以2D图像表示的事实的限制，并损害了在精神上重建完整的运河形态的能力。三维根管形态将有助于改进治疗计划，提高治疗成功的可能性。CT可能是一种选择；然而，CT技术对牙医来说并不容易获得。由于CT的高成本、患者剂量、分辨率降低、设备尺寸和相对复杂性，对于大多数牙科医生，特别是全科医生来说，在他们的办公室使用CT或拥有这样的机器是不切实际的。在拟议的研究中，我们将评估仅使用在根管手术过程中通常获得的X线片来重建三维根管形态的可行性。我们提出的技术将提供与以前仅使用CT技术所提供的相同的3D根管形态。此外，我们的技术将克服与CT相关的问题，为牙医提供一种低成本、准确和易于使用的产品，不需要为患者提供额外的剂量，并且可以在标准计算机上运行。此外，我们将通过创新的方法来克服可能限制生成的3D质量的问题，在这些方法中，我们利用其他视图中的“完成数据”。为了评估该产品的可行性，我们将(1)开发能够根据标准牙科X线片快速、轻松地可视化和量化3D根管中心线的技术，并能够对关键结构进行定量评估，并克服重叠和低信噪比的问题(2)通过将其结果与Micro-CT的结果进行比较来评估该技术的准确性，以及(3)评估所开发的技术对根管操作的影响。意义：有了我们的技术，每个牙科诊所都可以使用3D根管，只需使用他们已经获得的X光片，成本只有CT的一小部分，不需要额外的空间，而且只需点击几下鼠标，就可以轻松快速地找到3D根管。有了我们的技术，3D根管的可视化和分析很容易成为改善数百万患者牙科护理的标准。 公共卫生相关性：根管治疗决策依赖于对2D放射图像的评估和对3D根管路径的心理重建。我们开发了一种简单而准确的方法，可以从两个或更多的X线片上确定三维根管路径。它的低成本、易用性、准确性和临床影响将推动3D作为根管治疗程序的标准护理的扩展，对数百万患者的治疗决策和治疗结果产生积极影响。

DESCRIPTION (provided by applicant): About 15 million root canals are performed each year in the United States. Failure rates are about 10%, with the failed initial treatment reflecting costs in the US of over 900 million dollars per year. While there are a number of causes of the failures, one of the primary causes is the inability to assess the difficulty of the root canal's morphology, i.e., its path in three dimensions (3D). Practitioners acquire multiple radiographs to facilitate a mental estimation of this path. This estimation is limited by the fact that the 3D structures are represented in 2D images, and impairs the ability to mentally reconstruct the full morphology of the canal. 3D root canal morphology will enable improved treatment planning and improve the likelihood of success of the treatment. CT might be an option; however, CT technology is not readily available to the dentists. Because of CT's high cost, patient dose, reduced resolution, equipment size, and relative complexity, it is impractical for most dentists, in particular the general practitioner, to use CT or have such machines in their office. In the proposed research, we will evaluate the feasibility of reconstructing the 3D root canal morphology using only the radiographs that are normally acquired during a root canal procedure. Our proposed technology will provide the same the 3D root canal morphology that was previously available only using CT technology. Moreover, our technology will overcome the issues associated with CT and provide the dentist with a low cost, accurate, and easy to use product that will not require additional dose to the patient and can be run on a standard computer. In addition, we will overcome issues that could limit the quality of the generated 3D, by innovative approaches in which we take advantage of the "completing data" in the other views. To evaluate the product's feasibility, we will (1) Develop technology which allows quick and easy visualization and quantitation of 3D root canal centerlines from standard dental radiographs and allows quantitative assessment of critical structures and overcomes issues of overlap and low SNR (2) Evaluate the accuracy of the technology by comparing its results to those of micro-CT, and (3) Evaluate the impact of the developed technology on root canal procedures. Significance: With our technology, 3D root canals can be available in every dental office, using simply the radiographs they are already acquiring, at a fraction of the cost of CT, with no additional space requirements, and with the ease and speed of a few clicks of the mouse. With our technology, visualization and analysis of 3D root canals could easily become the standard of care improving dental care for millions of patients. PUBLIC HEALTH RELEVANCE: Root canal treatment decisions rely on evaluations of 2D radiographic images and mental reconstructions of the 3D root canal path. We have developed a simple and accurate method for determination of the 3D root canal path from two or more radiographic views. Its low cost, ease of use, accuracy, and clinical impact will drive expansion of 3D as the standard of care in root canal procedures positively impacting treatment decisions and treatment outcome for millions of patients.