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Xu M, Ren H, Liu C, Zhao X, Li X. Systematic review and meta-analysis of root morphology and canal configuration of permanent premolars using cone-beam computed tomography. BMC Oral Health 2024; 24:656. [PMID: 38835024 DOI: 10.1186/s12903-024-04419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
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Affiliation(s)
- Mengchen Xu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Huiying Ren
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Congrui Liu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Xinyu Zhao
- Department of stomatology, Jinan Hospital, Jinan, Shandong, 250013, China.
| | - Xiaoyan Li
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China.
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China.
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Muller JN, Diaz A, Verzella A, Staffenberg DA, Flores RL. Quantifying Sagittal Lip Changes in Patients with Bilateral Cleft Lip Post Abbe Flap Reconstruction. Cleft Palate Craniofac J 2024:10556656241255478. [PMID: 38835231 DOI: 10.1177/10556656241255478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES To objectively quantify results of sagittal lip changes following Abbe flap reconstruction in patients with bilateral cleft lip. DESIGN Retrospective, observational study. SETTING Single institution, 8-year retrospective review. PATIENTS/PARTICIPANTS In total, 17 patients with bilateral cleft lip that underwent Abbe flap reconstruction were included in this study. INTERVENTION Patients had lateral photographs taken prior to Abbe flap reconstruction and at least 8 months post-Abbe flap. MAIN OUTCOME MEASUREMENTS Vegter's index, Sushner's S2 line and Burstone's B line reference lines were used for evaluation of sagittal lip changes. Wilcoxon signed rank tests were used in analysis. RESULTS The mean pre-Abbe flap upper to lower lip ratio, defined as Vegter's Lip Index, was 0.906 compared to a mean of 0.946 following Abbe flap reconstruction. The mean upper to lower lip ratio for Sushner's S2 and Burstone's B line exhibited an increase in upper lip sagittal projection from -0.164 to 1.459 and 0.259 to 0.957, respectively (P < 0.001). CONCLUSIONS This study quantifies sagittal changes to upper and lower lip position after Abbe flap reconstruction. These findings may aid in operative planning and patient/caregiver expectations during counseling.
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Affiliation(s)
- John N Muller
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 10016, USA
| | - Allison Diaz
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 10016, USA
| | - Alexandra Verzella
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 10016, USA
| | - David A Staffenberg
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 10016, USA
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 10016, USA
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Bastos MF, Visconti MA, Pinto RR, Junqueira RB, Verner FS. Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study. J Endod 2024; 50:835-843. [PMID: 38395388 DOI: 10.1016/j.joen.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Considering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. METHODS This ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. RESULTS In the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). CONCLUSIONS The MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.
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Affiliation(s)
- Mayara Fidelis Bastos
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rocha Pinto
- Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora/GV Campus, Governador Valadares, Brazil
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Tyndall DA, Price JB, Gaalaas L, Spin-Neto R. Surveying the landscape of diagnostic imaging in dentistry's future: Four emerging technologies with promise. J Am Dent Assoc 2024; 155:364-378. [PMID: 38520421 DOI: 10.1016/j.adaj.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Advances in digital radiography for both intraoral and panoramic imaging and cone-beam computed tomography have led the way to an increase in diagnostic capabilities for the dental care profession. In this article, the authors provide information on 4 emerging technologies with promise. TYPES OF STUDIES REVIEWED The authors feature the following: artificial intelligence in the form of deep learning using convolutional neural networks, dental magnetic resonance imaging, stationary intraoral tomosynthesis, and second-generation cone-beam computed tomography sources based on carbon nanotube technology and multispectral imaging. The authors review and summarize articles featuring these technologies. RESULTS The history and background of these emerging technologies are previewed along with their development and potential impact on the practice of dental diagnostic imaging. The authors conclude that these emerging technologies have the potential to have a substantial influence on the practice of dentistry as these systems mature. The degree of influence most likely will vary, with artificial intelligence being the most influential of the 4. CONCLUSIONS AND PRACTICAL IMPLICATIONS The readers are informed about these emerging technologies and the potential effects on their practice going forward, giving them information on which to base decisions on adopting 1 or more of these technologies. The 4 technologies reviewed in this article have the potential to improve imaging diagnostics in dentistry thereby leading to better patient care and heightened professional satisfaction.
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Capel CP, da Motta RJG, Pauwels R, Gaêta-Araujo H, Oliveira-Santos C, Tirapelli C. Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography. Dentomaxillofac Radiol 2024; 53:233-239. [PMID: 38466923 PMCID: PMC11056797 DOI: 10.1093/dmfr/twae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES This study evaluated the effect of metal artefact reduction (MAR) level and tube current on the assessment of dental implant positioning relative to the mandibular canal (MC) through cone-beam computed tomography (CBCT). METHODS Titanium dental implants were placed in dried mandibles at 0.5-mm superior to the MC (group 1/n = 8) and 0.5-mm inside the MC with perforation of the cortex (group 2/n = 10). CBCT scans were obtained with different levels of MAR (off, medium, and high) and 2 tube currents (4 and 8 mA). Four examiners analysed the images and scored the contact between the implant and the MC using a 5-point scale. Sensitivity, specificity, area under receiver operating characteristic curve (ROC), and frequency of scores were calculated. Data were compared with analysis of variance 2-way and Tukey's test and scores with Chi-square test. RESULTS Specificity and area under ROC curve decreased significantly when MAR level was high compared with MAR-medium and MAR-off. The frequency of score 3 (inconclusive) was the highest, and scores 1 and 5 (definitely no contact and definitely contact, respectively) were the lowest with MAR-high, regardless of the tube current. When MAR was off, there were higher frequencies of scores 1 and 5. CONCLUSIONS The level of MAR influences the assessment of the relationship between the dental implant and the MC. MAR-high led to lower diagnostic accuracy compared with MAR-medium and off. ADVANCES IN KNOWLEDGE This article shows that high level of MAR can interfere in the diagnostic of dental implant positioning relative to the MC, decreasing its accuracy.
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Affiliation(s)
- Camila Porto Capel
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Raphael Jurca Gonçalves da Motta
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Ruben Pauwels
- Department of Dentistry and Oral Health, Aarhus University, 8000 Aarhus, Denmark
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, 10330 Bangkok, Thailand
| | - Hugo Gaêta-Araujo
- Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Diagnosis & Oral Health, University of Louisville, School of Dentistry, 40202-1701, Louisville, KY, United States
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, 14040-904, São Paulo, Brazil
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Carneiro ALE, Reis INR, Bitencourt FV, Salgado DMRA, Costa C, Spin-Neto R. Accuracy of linear measurements for implant planning based on low-dose cone beam CT protocols: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:207-221. [PMID: 38429951 PMCID: PMC11056743 DOI: 10.1093/dmfr/twae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES The aim of this systematic review was to verify the accuracy of linear measurements performed on low-dose CBCT protocols for implant planning, in comparison with those performed on standard and high-resolution CBCT protocols. METHODS The literature search included four databases (Pubmed, Web of Science, Embase, and Scopus). Two reviewers independently screened titles/abstracts and full texts according to eligibility criteria, extracted the data, and examined the methodological quality. Risk of bias assessment was performed using the Quality Assessment Tool For In Vitro Studies. Random-effects meta-analysis was used for pooling measurement error data. RESULTS The initial search yielded 4684 titles. In total, 13 studies were included in the systematic review, representing a total of 81 samples, while 9 studies were included in the meta-analysis. The risk of bias ranged from medium to low. The main results across the studies indicate a strong consistency in linear measurements performed on low-dose images in relation to the reference methods. The overall pooled planning measurement error from low-dose CBCT protocols was -0.24 mm (95% CI, -0.52 to 0.04) with a high level of heterogeneity, showing a tendency for underestimation of real values. Various studies found no significant differences in measurements across different protocols (eg, voxel sizes, mA settings, or dose levels), regions (incisor, premolar, molar) and types (height vs. width). Some studies, however, noted exceptions in measurements performed on the posterior mandible. CONCLUSION Low-dose CBCT protocols offer adequate precision and accuracy of linear measurements for implant planning. Nevertheless, diagnostic image quality needs must be taken into consideration when choosing a low-dose CBCT protocol.
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Affiliation(s)
- Ana Luiza E Carneiro
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Isabella N R Reis
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Fernando Valentim Bitencourt
- Section for Oral Ecology and Inflammation, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
- Steno Diabetes Center Aarhus, Aarhus, 8200, Denmark
| | - Daniela M R A Salgado
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health—Section for Oral Radiology and Endodontics, Aarhus University, Aarhus, 8000, Denmark
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Karkle A, Slaidina A, Zolovs M, Vaskevica A, Meistere D, Bokvalde Z, Neimane L. Comparative Analysis of Examination Methods for Periapical Lesion Diagnostics: Assessing Cone-Beam Computer Tomography, Ultrasound, and Periapical Radiography. Diagnostics (Basel) 2024; 14:766. [PMID: 38611679 PMCID: PMC11011571 DOI: 10.3390/diagnostics14070766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
INTRODUCTION Periapical lesions of teeth are typically evaluated using periapical X-rays (PA) or cone-beam computer tomography (CBCT); however, ultrasound imaging (US) can also be used to detect bone defects. A comparative analysis is necessary to establish the diagnostic accuracy of US for the detection of periapical lesions in comparison with PA and CBCT. OBJECTIVES This study aimed to evaluate and compare the measurement precision of US against PA and CBCT in detecting periapical lesions. METHODS This study included 43 maxillary and mandibular teeth with periapical lesions. All teeth were examined clinically, radiographically, and ultrasonographically. Observers evaluated and measured the periapical lesions on CBCT, PA, and US images. RESULTS The comparison of lesion size showed that it differs significantly between the different methods of examination. A statistically significant difference was found between CBCT and US (mean difference = 0.99 mm, 95% CI [0.43-1.55]), as well as between CBCT and PA (mean difference = 0.61 mm, 95% CI [0.17-1.05]). No difference was found between the US and PA methods (p = 0.193). CONCLUSION US cannot replace PA radiography in detecting pathologies but it can accurately measure and characterize periapical lesions with minimal radiation exposure. CBCT is the most precise and radiation-intensive method so it should only be used for complex cases.
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Affiliation(s)
- Aleksandra Karkle
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Anda Slaidina
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
- Department of Prosthetic Dentistry, Riga Stradins University, LV-1007 Riga, Latvia
| | - Maksims Zolovs
- Statistics Unit, Riga Stradins University, LV-1007 Riga, Latvia;
- Institute of Life Sciences and Technology, Daugavpils University, LV-5401 Daugavpils, Latvia
| | - Anete Vaskevica
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Dita Meistere
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
| | - Zanda Bokvalde
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
| | - Laura Neimane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, LV-1007 Riga, Latvia; (A.V.); (Z.B.)
- RSU Institute of Stomatology, LV-1007 Riga, Latvia;
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Biel P, Jurt A, Chappuis V, Suter VGA. Incidental findings in cone beam computed tomography (CBCT) scans for implant treatment planning: a retrospective study of 404 CBCT scans. Oral Radiol 2024; 40:207-218. [PMID: 38102453 DOI: 10.1007/s11282-023-00723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning. METHODS 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated. RESULTS In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient's age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805). CONCLUSIONS A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
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Affiliation(s)
- Philippe Biel
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Alice Jurt
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Valerie G A Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Han S, Fan X, Wang S, Du H, Liu K, Ji M, Xiao D. Dehiscence and fenestration of skeletal Class III malocclusions with different vertical growth patterns in the anterior region: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2024; 165:423-433. [PMID: 38127040 DOI: 10.1016/j.ajodo.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION This study aimed to evaluate the incidence and distribution of alveolar bone dehiscence and fenestration in skeletal Class III malocclusions with different vertical growth patterns in the anterior region using cone-beam computed tomography (CBCT). METHODS In this retrospective study, 84 patients with skeletal Class III malocclusions who underwent CBCT were selected. This study included 28 patients with hypodivergence (mean age, 22.9 ± 3.9 years), 28 with normodivergence (mean age, 21.0 ± 3.0 years), and 28 with hyperdivergence (mean age, 21.0 ± 3.7 years). Teeth in the anterior region were examined using CBCT to detect dehiscence and fenestration. The incidences of dehiscence and fenestration in the anterior teeth region were recorded, and statistical analysis was conducted using SPSS software (version 25.0, IBM, Armonk, NY). RESULTS Among the patients with skeletal Class III malocclusions, dehiscence and fenestration were prone to occur in the mandible. Dehiscence and fenestration were more prevalent in patients with hyperdivergence compared with in patients with hypodivergence and normodivergence. CONCLUSIONS Dehiscence and fenestration are prevalent among patients with skeletal Class III malocclusion. Furthermore, the occurrence of alveolar bone defects is higher in patients with hyperdivergence.
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Affiliation(s)
- Shaobo Han
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Xiangfei Fan
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Song Wang
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Hongyu Du
- Postgraduate of School of Medicine, Nankai University, Tianjin, China
| | - Kexin Liu
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Mengting Ji
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Danna Xiao
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China.
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Savoldi F, Dagassan-Berndt D, Patcas R, Mak WS, Kanavakis G, Verna C, Gu M, Bornstein MM. The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing. Dentomaxillofac Radiol 2024; 53:178-188. [PMID: 38265247 PMCID: PMC11003665 DOI: 10.1093/dmfr/twae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/14/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.
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Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032, Switzerland
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
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Michelinakis G, Apostolakis D, Nikolidakis D, Blum IR. A comprehensive review and update on the current state of computer-assisted rehabilitation in implant dentistry. Prim Dent J 2024; 13:64-73. [PMID: 38424692 DOI: 10.1177/20501684241231672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
AIM This paper provides a comprehensive review of the established concepts and newer developments related to computer-assisted implant rehabilitation. METHODS Two independent researchers searched the English literature published to 31st December 2023 in the PubMed/Medline database for primary and secondary research and related publications on computer-assisted implant planning, computer-assisted implant placement and computer-assisted implant restoration. RESULTS A total of 58,923 papers were identified, 198 relevant papers were read in full text and 110 studies were finally included. Computer-assisted implant rehabilitation was found to result in more precise implant positioning than freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. CONCLUSION Computer-assisted surgery is particularly indicated in cases of critical anatomy, but may encounter limitations in terms of cost, restricted mouth opening, visibility and adjustment of the surgical guides and the need for prior familiarisation with the procedure. Nonetheless, this surgical technique reduces the post-implant placement complication rate.
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Affiliation(s)
- George Michelinakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Apostolakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Dimitrios Nikolidakis
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- George Michelinakis DDS, MSc, MPhil Prosthodontist, Crete Implants Private Dental Practice, Heraklion, Crete, Greece
- Dimitrios Apostolakis DDS, MSc, MSc Radiologist, Dental Radiology in Crete, Heraklion, Crete, Greece
- Dimitrios Nikolidakis DDS, MSc, PhD Periodontist, Clinic Perio, Private Dental Practice, Heraklion, Crete, Greece
- Igor R. Blum DDS, PhD, Dr Med Dent, MSc, MA (Educ), MFDS RCS (Eng), MFDS RCS (Edin), FDS (Rest Dent) RCS (Eng), FFDRCSI, FCGDent, PGCHE, FHEA, FICD, LLM (Medico-Legal Law) Professor/Consultant & Specialist in Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Doan MK, Long JR, Verhey E, Wyse A, Patel K, Flug JA. Cone-Beam CT of the Extremities in Clinical Practice. Radiographics 2024; 44:e230143. [PMID: 38421913 DOI: 10.1148/rg.230143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Cone-beam CT (CBCT) is a promising tool with increasing applications in musculoskeletal imaging due to its ability to provide thin-section CT images of the appendicular skeleton and introduce weight bearing, which accounts for loading forces that typically interact with and affect this anatomy. CBCT devices include an x-ray source directly opposite a digital silicon detector panel that performs a single rotation around an object of interest, obtaining thin-section images. Currently, the majority of research has been focused on the utility of CBCT with foot and ankle pathologic abnormalities, due to the complex architectural arrangement of the tarsal bones and weight-bearing nature of the lower extremities. Associated software can provide a variety of options for image reconstruction, including metal artifact reduction, three-dimensional biometric measurements, and digitally reconstructed radiographs. Advancements in this technology have allowed imaging of the knee, hip, hand, and elbow. As more data are published, it is becoming evident that CBCT provides many additional benefits, including fast imaging time, low radiation dose, lower cost, and small equipment footprint. These benefits allow placement of CBCT units outside of the traditional radiology department, including the orthopedic clinic setting. These technologic developments have motivated clinicians to define the scope of CBCT for diagnostics, surgical planning, and longitudinal imaging. As efforts are made to create standardized protocol and measurements, the current understanding and surgical approach for various orthopedic pathologic conditions will continue to shift, with the hope of improving outcomes. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Matthew K Doan
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
| | - Jeremiah R Long
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
| | - Erik Verhey
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
| | - Aaron Wyse
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
| | - Karan Patel
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
| | - Jonathan A Flug
- From Mayo Clinic Alix School of Medicine, 5777 East Mayo Blvd, Scottsdale, AZ 85054 (M.K.D., E.V.); and Departments of Radiology (J.R.L., A.W., J.A.F.) and Orthopedic Surgery (K.P.), Mayo Clinic Arizona, Phoenix, Ariz
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13
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Cattaneo PM, Holm A, Yung AKC, Isidor S, Cornelis MA. A Three-Dimensional Evaluation of Skeletal and Dentoalveolar Changes in Growing Class II Patients after Functional Appliance Therapy: A Retrospective Case-Control Study. J Clin Med 2024; 13:1315. [PMID: 38592176 PMCID: PMC10932136 DOI: 10.3390/jcm13051315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Background: The aim was to assess three-dimensionally mandibular and maxillary changes in growing Class II patients treated with removable functional appliances followed by fixed appliances. Methods: Twenty-four Class II patients (age range: 9 to 14, mean: 12.1 ± 1.1 years) treated with removable functional appliances followed by fixed appliances (functional appliance group-FAG) were retrospectively selected and compared to an age-matched control group (CG) treated with fixed appliances only. To be included in the study, pre- and post-treatment CBCT scans had to be available. The CBCTs were used to analyze, in 3D, the changes following treatment and growth. Results: Before treatment, overjet (FAG: 9 mm ± 2.8 (mean ± standard deviation); CG: 4 mm ± 1.7), ANB (FAG: 5.7° ± 2.0; CG: 3.2° ± 1.4), and effective mandibular length (FAG: 113.0 mm ± 4.1; CG: 116.6 mm ± 5.9) were statistically significantly different between the two groups. After treatment, overjet (FAG: -6.8 mm ± 2.8; CG: -1.8 mm ± 1.8) and effective mandibular length (FAG: 6.3 mm ± 2.6; CG: 3.9 mm ± 2.6) statistically significantly changed. There was a significant difference in the treatment effect between the FAG and the CG in overjet, ANB, and effective mandibular length. Conclusions: The results indicate that functional appliances are effective in correcting Class II malocclusions. The growth modification in the FAG resulted in an increase in mandibular length. Yet, the final length of the mandible in the FAG was smaller when compared to the CG.
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Affiliation(s)
- Paolo M. Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, 720 Swanston Street, Carlton, Melbourne, VIC 3053, Australia;
| | - Annemarie Holm
- Private Practice, Fisketorvet 4-6, 7.sal, 5000 Odense, Denmark
| | | | | | - Marie A. Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, 720 Swanston Street, Carlton, Melbourne, VIC 3053, Australia;
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Popkowski A, Rhodes SC, Hatton JF. Proposed Diagnostic Reference Levels in the Missouri/Southern Illinois Region Associated with Cone-beam Computed Tomography Use in Endodontics. J Endod 2024:S0099-2399(24)00099-2. [PMID: 38382736 DOI: 10.1016/j.joen.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Diagnostic reference levels (DRLs) are intended to improve patient safety and ensure that patient ionizing radiation doses are as low as reasonably achievable. The purpose of this dosimetry study was to establish regional DRL levels for cone-beam computed tomography (CBCT) imaging for specialty endodontics. Another aim was to compare phantom-measured ionizing radiation dose index 1 (DI1) index doses to the manufacturer-provided dose area product (DAP) radiation output values for each of the CBCT machines studied, to ascertain their degree of correlation. DAP refers to the dose area product, a measure of radiation dose monitoring which represents the dose within the beam times the area within the beam at that position. METHODS A thimble ionization chamber and polymethyl methacrylate phantom were used to obtain DI1 values using the SEDENTEXTCT method from 21 different CBCT units. DRLs were calculated based on the 75th percentile (third quartile) of the median output values. RESULTS The proposed DRL from the CBCT units surveyed has a DAP value of 838 mGy cm2 and a DI1 value of 3.924 mGy. DAP versus DI1 values of 500.6 mGy cm2 versus 2.006 mGy, and 838 mGy cm2 versus 3.906 mGy represented the third quartile of the median values for the 4-cm × 4-cm and 5-cm × 5-cm field of views (FOVs), respectively. CONCLUSIONS The DI1 and DAP values strongly correlated when 3 outlier CBCT machines (J Morita Veraview X800) using a novel 360° (full rotation) acquisition mode were excluded. The importance of selectable exposure parameters as directly related to ionizing radiation output is illustrated among the CBCT units surveyed. Although the actual FOV that is selected is ultimately dictated by the specific clinical requirements, a 4-cm × 4-cm FOV is recommended for specialist endodontics practice, whenever clinically practical, based on the decreased ionizing radiation output, as compared to that from a 5-cm × 5-cm FOV.
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Affiliation(s)
- Arthur Popkowski
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
| | - S Craig Rhodes
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri.
| | - John F Hatton
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
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Davidopoulou S, Karakostas P, Batas L, Barmpalexis P, Assimopoulou A, Angelopoulos C, Tsalikis L. Multidimensional 3D-Printed Scaffolds and Regeneration of Intrabony Periodontal Defects: A Systematic Review. J Funct Biomater 2024; 15:44. [PMID: 38391897 PMCID: PMC10889986 DOI: 10.3390/jfb15020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The utilization of regenerative techniques in periodontology involves tailoring tissue engineering principles to suit the oral cavity's unique environment. Advancements in computer-assisted technology, specifically utilizing cone beam computed tomography (CBCT), enabled the fabrication of 3D-printed scaffolds. The current review aims to explore whether 3D-printed scaffolds are effective in promoting osteogenesis in patients with periodontal defects. METHODS A thorough exploration was undertaken across seven electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Cochrane, Web of Science, Ovid) to detect pertinent research in accordance with specified eligibility criteria, aligning with the PRISMA guidelines. Two independent reviewers undertook the screening and selection of manuscripts, executed data extraction, and evaluated the bias risk using the Newcastle-Ottawa Scale for non-randomized clinical trials and SYRCLE's risk of bias tool for animal studies. RESULTS Initially, 799 articles were identified, refined by removing duplicates. After evaluating 471 articles based on title and abstract, 18 studies remained for full-text assessment. Eventually, merely two manuscripts fulfilled all the eligibility criteria concerning human trials. Both studies were prospective non-randomized clinical trials. Moreover, 11 animal studies were also included. CONCLUSIONS The use of multidimensional, 3D-printed, customized scaffolds appears to stimulate periodontal regeneration. While the reported results are encouraging, additional studies are required to identify the ideal characteristics of the 3D scaffold to be used in the regeneration of periodontal tissue.
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Affiliation(s)
- Sotiria Davidopoulou
- Department of Operative Dentistry, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Karakostas
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Leonidas Batas
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Barmpalexis
- Department of Pharmaceutical Technology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Andreana Assimopoulou
- Organic Chemistry Lab, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis & Radiology, School of Dentistry, National and Kapodistrian University of Athens, 10679 Athina, Greece
| | - Lazaros Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Verykokou S, Ioannidis C, Soile S, Angelopoulos C, Theodoridis K, Arampatzis AS, Assimopoulou AN, Christofilos D, Kapourani A, Pantazos I, Barmpalexis P, Boutsi AM, Potsiou C. The Role of Cone Beam Computed Tomography in Periodontology: From 3D Models of Periodontal Defects to 3D-Printed Scaffolds. J Pers Med 2024; 14:207. [PMID: 38392640 PMCID: PMC10890394 DOI: 10.3390/jpm14020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
The treatment of osseous defects around teeth is a fundamental concern within the field of periodontology. Over the years, the method of grafting has been employed to treat bone defects, underscoring the necessity for custom-designed scaffolds that precisely match the anatomical intricacies of the bone cavity to be filled, preventing the formation of gaps that could allow the regeneration of soft tissues. In order to create such a patient-specific scaffold (bone graft), it is imperative to have a highly detailed 3D representation of the bone defect, so that the resulting scaffold aligns with the ideal anatomical characteristics of the bone defect. In this context, this article implements a workflow for designing 3D models out of patient-specific tissue defects, fabricated as scaffolds with 3D-printing technology and bioabsorbable materials, for the personalized treatment of periodontitis. The workflow is based on 3D modeling of the hard tissues around the periodontal defect (alveolar bone and teeth), scanned from patients with periodontitis. Specifically, cone beam computed tomography (CBCT) data were acquired from patients and were used for the reconstruction of the 3D model of the periodontal defect. The final step encompasses the 3D printing of these scaffolds, employing Fused Deposition Modeling (FDM) technology and 3D-bioprinting, with the aim of verifying the design accuracy of the developed methodοlogy. Unlike most existing 3D-printed scaffolds reported in the literature, which are either pre-designed or have a standard structure, this method leads to the creation of highly detailed patient-specific grafts. Greater accuracy and resolution in the macroarchitecture of the scaffolds were achieved during FDM printing compared to bioprinting, with the standard FDM printing profile identified as more suitable in terms of both time and precision. It is easy to follow and has been successfully employed to create 3D models of periodontal defects and 3D-printed scaffolds for three cases of patients, proving its applicability and efficiency in designing and fabricating personalized 3D-printed bone grafts using CBCT data.
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Affiliation(s)
- Styliani Verykokou
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Charalabos Ioannidis
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Sofia Soile
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Theodoridis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasios S Arampatzis
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Andreana N Assimopoulou
- Laboratory of Organic Chemistry, School of Chemical Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios Christofilos
- School of Chemical Engineering & Physics Laboratory, Faculty of Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Afroditi Kapourani
- Laboratory of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Pantazos
- Laboratory of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Barmpalexis
- Laboratory of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Argyro-Maria Boutsi
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Chryssy Potsiou
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
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Cheung MC, Peters OA, Parashos P. Global cone-beam computed tomography adoption, usage and scan interpretation preferences of dentists and endodontists. Int Endod J 2024; 57:133-145. [PMID: 37970748 DOI: 10.1111/iej.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/18/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023]
Abstract
AIM This study investigated the adoption of cone-beam computed tomography (CBCT) by dentists and endodontists around the world, including their preferences in endodontic CBCT usage. METHODOLOGY An online questionnaire surveyed dental association members in Australia and New Zealand, and endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA, about their CBCT training history, considerations in acquisition/interpretation, access to and usage of CBCT, preferred scan interpreter, and preferred endodontic scan settings. Data were analysed with Chi-squared, independent sample t-tests, Cochran's Q and McNemar's tests. RESULTS Responses from 578 endodontic specialists or postgraduates (Group E) and 185 non-endodontic dentists (Group NE) were included. Continuing professional education (CPE) was the most common source of CBCT training (69.2%). Factors considered in CBCT acquisition/interpretation included beam hardening (75.4%), radiation exposure (61.1%) and patient movement (58.3%). Group E reported higher CBCT usage (90.8%) than Group NE (45.4%, p < .001) and greater workplace access to CBCT (81.1% vs. 25.9%, p < .001). Scans were interpreted by the respondent in most workplace scans (83.3%) and externally taken scans (60.5%); Group E were significantly more likely to interpret themselves than Group NE. Small field of view (83.6%) and high resolution (86.6%) were most preferred as settings for endodontic CBCTs; Group NE were less likely to choose these settings. There were some geographic variations within Group E. CONCLUSIONS CBCT training was most commonly acquired via CPE. Endodontic respondents reported very high CBCT usage and access in the workplace. There are educational implications regarding CBCT limitations, appropriate applications and interpretation.
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Affiliation(s)
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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Chawshli OF, Hasan HS, Yalda FA, Al-Talabani SZ. The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail. Orthod Craniofac Res 2024; 27:118-125. [PMID: 37496467 DOI: 10.1111/ocr.12700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND OBJECTIVES The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. MATERIALS AND METHODS Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. RESULTS The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. CONCLUSION This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.
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Affiliation(s)
- Omar Fawzi Chawshli
- The Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Hasan Sabah Hasan
- Orthodontic Department, Azadi Dental Center, General Directorate of Hawler, Ministry of Health, Erbil, Iraq
- Orthodontic Department, Privet Specialized Dental Clinic, Erbil, Iraq
| | - Fedil Andraws Yalda
- The Department of Oral Diagnosis, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Shaho Z Al-Talabani
- P.O.P Department, College of Dentistry, Hawler Medical University, Erbil, Iraq
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Viscardi D, Carini F, Saggese V, Carini F. Analysis of implant precision in guided surgery: comparison of two methods. Minerva Dent Oral Sci 2024; 73:27-36. [PMID: 37733331 DOI: 10.23736/s2724-6329.23.04833-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Implantology represents the therapy of choice for the rehabilitation of a partially or totally edentulous jaw in a healthy patient. Nowadays, it is possible to exploit of modern preoperative planning software, increasingly precise radiographic examinations (CBCT) and CAD/CAM technologies that allow designing devices directly on the computer to be sent to a milling center which produces the desired product, such as stereolithographic templates. METHODS The prospective clinical study in question aims to evaluate the accuracy between two different surgical guides using peek and metal guide bushings. Twenty-nine implants were placed: for the control group, 17 3i, T3 implants were used, while for the test group, 12 Xive S plus implants were used. RESULTS The result obtained shows that the deviations in the distribution of the control group and the test group are the same in the apical-coronal, vestibulo-palatal and mesio-distal direction. For the control group, the mean deviation was 1.394±0.644923 at the entry point of the implants and 1.85655±1.0765 at the most apical point of the implants. For the test group the mean deviation was 1.10157±0.312721 at the entry point of the implants and 1.54514±0.572100 at the most apical point of the implants. CONCLUSIONS The peek guide bushings have the same deviation as the metal ones. There is no difference in the method used, but precision must be sought in other elements, such as the patient's anatomy and maximum precision in the guide production phase.
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Affiliation(s)
- Daniele Viscardi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy -
| | - Fabio Carini
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | - Fabrizio Carini
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Perondi I, Taschieri S, Baruffaldi M, Fornara R, Francetti L, Corbella S. The Correlation between Intraorifice Distance and the Anatomical Characteristics of the Second Mesiobuccal Canal of Maxillary Molars: A CBCT Study. Int J Dent 2024; 2024:6636637. [PMID: 38318327 PMCID: PMC10843869 DOI: 10.1155/2024/6636637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/08/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Missing anatomy is one of the main causes of endodontic failures, and accurate knowledge of teeth anatomy is a prerequisite for adequate root canal treatment. The aim of the present cone beam computed tomography (CBCT) study was to describe the anatomical characteristics of the mesiobuccal (MB) root canals of maxillary molars and to understand if a correlation exists between the position of the canal orifices and the anatomical features of the root. Methods For the purposes of the study, a total of 100 CBCT scans of maxillary molars with two MB canals were selected and studied. The features of root canal anatomy of the MB root of the same teeth were analyzed and recorded (root length, confluence, and Vertucci classification). The distance between MB1 and MB2 orifices and the palatal orifice were recorded, as well as the distance between the orifices and the line joining the palatal orifice and the others. A statistical analysis was performed by providing descriptive measures, the measure of the correlation between different parameters, and the influence of some of these measures on the presence of a confluence between MB1 and MB2. Results It resulted that the most frequent configuration is type II Vertucci. The length measured on the sagittal plane was significantly correlated to the presence of a confluence in the MB root. When the root length was higher than 14.56 mm, the confluence is three times more frequent than when the length is lower (OR = 3.635). The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for length on the sagittal plane was 0.632 (P=0.036). Conclusions The presence of a confluence between the MB canals of maxillary molars is correlated to the length of the root that could be measured on the sagittal plane and to the distance between the canal orifices. The relative position of the root canal orifices in relation to anatomic landmarks needs to be further explored.
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Affiliation(s)
- Isabella Perondi
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Silvio Taschieri
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | | | - Luca Francetti
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Stefano Corbella
- Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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21
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Gurjar BS, Sharma V, Paliwal J, Kalla R, Meena KK, Tahir M. The role of implants and implant prostheses on the accuracy and artifacts of cone-beam computed tomography: an in-vitro study. Sci Rep 2024; 14:704. [PMID: 38184751 PMCID: PMC10771465 DOI: 10.1038/s41598-024-51293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024] Open
Abstract
To assess the accuracy of CBCT in implant-supported prostheses and to evaluate metal artifacts with and without implants or implant prostheses. Accuracy and artifacts were assessed in the dried mandible at three points on the buccal and lingual cortical plates on the mandible's body near the crest and the base. On the buccal cortical plate, these points were labelled as A, B and C near the crest and D, E and F near the base of the body of the mandible. Similarly, points a to f were marked on the lingual cortical plate corresponding to points A to F. The study had two control groups, C0 for physical linear measurement (PLM) and C1 for radiographic linear measurement (RLM) and artifact assessment. There were seven test groups, TG 1 to 7, progressing from a single implant to implant full-arch prosthesis. For accuracy assessment, PLM was compared to RLM. CBCT artifacts were investigated in images integrated at 0.25 mm, 10 mm, and 20 mm at regions of interest on concentric circles at different intersecting angles by comparing grayscale values at C1 and TG1 to 7. The data were collected and statistically analyzed. A significant difference was observed between C0 and C1, and RLM in test groups at the superior axial plane. Similarly, PLM and test RLM in the sagittal plane at A-B, B-C, and D-E were statistically significant. A significant difference between PLM and RLM was also observed in the vertical plane at A-D, B-E, and C-F. Quantification of CBCT artifacts in the presence of implants or prostheses revealed that full-arch prostheses had the highest mean grayscale value, whereas single implants with a prosthesis had the lowest. The mean grayscale change was greatest around the implant and implant prosthesis. The mean grayscale value was maximum at 20 mm voxel integration scales (VIS) and lowest at 0.25 mm. CBCT is a clinically reliable device. Metal in implants or implant-supported prostheses prevents true assessment of the peri-implant area; therefore, lower VIS is suggested in the presence of implants or implant prostheses.
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Affiliation(s)
| | - Vineet Sharma
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Jyoti Paliwal
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India.
| | - Rajani Kalla
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Kamal Kumar Meena
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
| | - Mohammed Tahir
- Department of Prosthodontics, RUHS College of Dental Sciences, Jaipur, India
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Muttanahally KS, Sheppard S, Yadav S, Tadinada A. The Utility of Cone Beam Computed Tomography Scans in Diagnosing and Treating Anterior Lesions of the Maxilla and Mandible. Cureus 2024; 16:e52804. [PMID: 38389599 PMCID: PMC10883409 DOI: 10.7759/cureus.52804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The standard screening protocol for radiographic examination in dentistry as per the American Dental Association recommendations is a panoramic radiograph (PAN) and four horizontal bitewings. PAN inherently suffers from several shortcomings like the superimposition of anatomic structures, especially of the cervical spine that obscures a significant portion of the anterior maxilla and mandible. This region has a significant amount of pathology that is not adequately imaged. Three-dimensional (3D) imaging provides circumferential information on the area of interest and adds value to the diagnosis and treatment planning of pathology, especially in the anterior maxilla and mandible. However, there is not an adequate number of well-designed studies that articulate the true value addition of 3D imaging for the evaluation of this region. OBJECTIVES The objective of this study is to evaluate the value addition of 3D imaging in diagnosing pathologies in the anterior maxilla and mandible when compared to two-dimensional PAN. MATERIALS AND METHODS A total of 25 cases that had a diagnosis of anterior pathology and had both a PAN and a cone beam computed tomography (CBCT) scan were collected for this study. An institutional review board approval to retrospectively evaluate these data was obtained. The PAN and CBCT scans were randomly evaluated by a second-year dental student, an oral and maxillofacial radiology resident in training, and a board-certified oral radiologist. The scans were evaluated using a three-point modified Likert scale, where 1 represents "not visible or clear," 2 represents "visible but not clear," and 3 represents "visible and clear." The lesions were evaluated for characteristics like lesion location, size & shape, internal contents, borders of the lesion, cortical integrity, locularity, and effect on adjacent structures like root resorption. After the evaluation was completed, a comparison of the lesion diagnosis was done with histopathology to confirm the diagnosis. The evaluators were also asked to comment on the specific feature that 3D imaging provided that added value to the case. Kappa analysis was done to evaluate inter-operator reliability. RESULTS PAN demonstrated significantly lower efficacy in identifying and diagnosing lesions. Only 56% of cases were analyzed using PAN, with 44% deemed undetectable or poorly visualized. These challenging cases necessitated CBCT scans for accurate diagnosis, which successfully diagnosed all 25 cases. The p-value of 0.0002 for PAN implies a highly significant difference from histopathology, suggesting the distinctions are not due to chance. Conversely, the p-value of 0.3273 for CBCT implies that observed differences may be random, lacking sufficient evidence to reject the null hypothesis. CBCT scans consistently outperformed PAN in visualizing various lesion characteristics, underscoring their superior diagnostic capabilities. CONCLUSIONS In this study, with a small sample size, 3D imaging provided a significant value addition to the diagnosis and treatment planning by providing additional information regarding the location, extent, internal content, and effect on adjacent structures. The practical implications for clinical settings, along with comparisons to current literature, underscore the study's distinctiveness.
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Affiliation(s)
- Kavya Shankar Muttanahally
- Oral and Maxillofacial Radiology, Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Samantha Sheppard
- Department of General Dentistry, University of Connecticut, Farmington, USA
| | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
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Pedram A, Torkzadeh A, Ghaffari R, Aryanezhad SS. Assessing Olfactory Fossa Depth and Its Relationship with the Variations in Adjacent Anatomical Structures by Using Cone Beam Computed Tomography (CBCT). Indian J Otolaryngol Head Neck Surg 2023; 75:2862-2869. [PMID: 37974708 PMCID: PMC10645708 DOI: 10.1007/s12070-023-03538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/26/2023] [Indexed: 11/19/2023] Open
Abstract
This study aimed to investigate the olfactory fossa anatomy (Keros types) and its relationship with changes in adjacent anatomical structures using cone-beam computed tomography (CBCT). In this descriptive-analytical study, the paranasal CBCT of 120 healthy adults over 18 years of age were evaluated. The olfactory fossa depth on both sides and the degree of asymmetry on both sides were reported. Correlation of olfactory fossa depth with the size of adjacent anatomical structures such as middle concha length, maximum orbital height and distance from ethmoid roof to nasal floor and ethmoid roof height to the palate in the anterior and posterior, length, and lateral angle of the lamella and cribriform plate distance. The lower concha junction was examined. The most common olfactory fossae on both sides of the Keros classification were Type II, Type I, and Type III, respectively. The mean dimensions of adjacent anatomical structures on the right and left did not differ significantly. The length and lateral angle of the lamella and the height of the ethmoid roof to the floor of the nose, and the height of the ethmoid roof to the palate in the back, on the right, and left in Type III were greater. The lateral angle of the left lamella was greater in Type III. The relationship between olfactory fossa depth and changes in anatomical structures were not significantly correlated with increasing olfactory fossa depth. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03538-2.
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Affiliation(s)
- Aida Pedram
- School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran
- Department of Oral & Maxillofacial Radiology, School of Dentistry of Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Azadeh Torkzadeh
- Department of Oral & Maxillofacial Radiology, School of Dentistry of Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Roshanak Ghaffari
- Department of Oral & Maxillofacial Radiology, School of Dentistry of Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyed Sasan Aryanezhad
- Department of Oral & Maxillofacial Radiology, School of Dentistry of Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Lintz F, Bernasconi A, Buedts K, Welck M, Ellis S, de Cesar Netto C. Ankle Joint Bone Density Distribution Correlates with Overall 3-Dimensional Foot and Ankle Alignment. J Bone Joint Surg Am 2023; 105:1801-1811. [PMID: 37616414 DOI: 10.2106/jbjs.23.00180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND Altered stress distribution in the lower limb may impact bone mineral density (BMD) in the ankle bones. The purpose of the present study was to evaluate the spatial distribution of BMD with use of weight-bearing cone-beam computed tomography (WBCT). Our hypothesis was that BMD distribution would be even in normal hindfeet, increased medially in varus hindfeet, and increased laterally in valgus hindfeet. METHODS In this study, 27 normally aligned hindfeet were retrospectively compared with 27 valgus and 27 varus-aligned hindfeet. Age (p = 0.967), body mass index (p = 0.669), sex (p = 0.820), and side (p = 0.708) were similar in the 3 groups. Hindfoot alignment was quantified on the basis of WBCT data sets with use of multiple measurements. BMD was calculated with use of the mean Hounsfield unit (HU) value as a surrogate. The HU medial-to-lateral ratio (HUR), calculated from tibial and talar medial and lateral half-volumes, was the primary outcome of the study. RESULTS The 3 groups significantly differed (p < 0.001) in terms of tibial HUR (median, 0.91 [interquartile range (IQR), 0.75 to 0.98] in valgus hindfeet, 1 [IQR, 0.94 to 1.05] in normal hindfeet, and 1.04 [IQR, 0.99 to 1.1] in varus hindfeet) and talar HUR (0.74 [IQR, 0.50 to 0.80] in valgus hindfeet, 0.82 [IQR, 0.76 to 0.87] in normal hindfeet, and 0.92 [IQR, 0.86 to 1.05] in varus hindfeet). Linear regression showed that all hindfoot measurements significantly correlated with tibial and talar HUR (p < 0.001 for all). The mean HU values for normally-aligned hindfeet were 495.2 ± 110 (medial tibia), 495.6 ± 108.1 (lateral tibia), 368.9 ± 80.3 (medial talus), 448.2 ± 90.6 (lateral talus), and 686.7 ± 120.4 (fibula). The mean HU value for each compartment was not significantly different across groups. CONCLUSIONS Hindfoot alignment and medial-to-lateral BMD distribution were correlated. In varus hindfeet, an increased HU medial-to-lateral ratio was consistent with a greater medial bone density in the tibia and talus as compared with the lateral parts of these bones. In valgus hindfeet, a decreased ratio suggested greater bone density in the lateral as compared with the medial parts of both the tibia and the talus. LEVEL OF EVIDENCE Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- François Lintz
- Department of Foot and Ankle Surgery, Clinique de l'Union, Ramsay Healthcare, Saint Jean, France
| | - Alessio Bernasconi
- Trauma and Orthopaedics Unit, Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Matthew Welck
- Royal National Orthopaedic Hospital, London, United Kingdom
| | - Scott Ellis
- The Hospital for Special Surgery, Weill Cornell Medical College, New York, NY
| | - Cesar de Cesar Netto
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa
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25
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Duong C, Zhu Q, Aseltine RH, Kuo CL, da Cunha Godoy L, Kaufman B. A Survey on Cone-beam Computed Tomography Usage Among Endodontists in the United States. J Endod 2023; 49:1559-1564. [PMID: 37657729 DOI: 10.1016/j.joen.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/03/2023]
Abstract
INTRODUCTION The aim of the study was to investigate the accessibility and frequency of cone-beam computed tomography (CBCT) usage and to assess the economic and logistical factors involved with its usage among active American Association of Endodontists (AAE) members, utilizing a web-based survey. METHODS A survey of 19 questions was sent to 3,071 AAE members addressing participant access to, along with financial and logistical aspects of CBCT imaging. Descriptive analysis was performed and Fisher exact test utilized to test associations between groups (P < .05). RESULTS The overall response rate was 14.7% (n = 544). Ninety-five percent of respondents (n = 486) had an in-office CBCT unit, with those graduating after the year 2000 statistically more likely to have one (P < .05). Utilization of CBCT imaging for every case was reported by 40% of providers. Eighty-nine percent reported taking the scan at the consultation visit and 20% included this charge with the consultation fee. For those who charged for the scan separately, 85% charged more than $100. Providers who paid off their unit did so within 1-2 years (41%), 3-4 years (36%), 4-5 years (12%), and 5+ years (11%). Limited field of view was utilized by 95% of respondents. Fifty-eight percent reported interpreting the scans themselves, 38% send only if pathology is expected, and 3% always send their scans to a radiologist. CONCLUSIONS In conclusion, accessibility and utilization of CBCT imaging among United States endodontists has increased and acquisition of this equipment has not made a long lasting financial burden on providers.
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Affiliation(s)
- Christie Duong
- Division of Endodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut.
| | - Qiang Zhu
- Division of Endodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut
| | - Robert H Aseltine
- Center for Population Health, Division of Behavioral Sciences and Community Health, UConn Health, Farmington, Connecticut
| | - Chia-Ling Kuo
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, Connecticut
| | - Lucas da Cunha Godoy
- The Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, Connecticut
| | - Blythe Kaufman
- Division of Endodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut
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Elbashti M, Molinero-Mourelle P, Aswehlee A, Bornstein MM, Abou-Ayash S, Schimmel M, Ella B, Naveau A. Effect of triangular mesh resolution on the geometrical trueness of segmented CBCT maxillofacial data into STL format. J Dent 2023; 138:104722. [PMID: 37742810 DOI: 10.1016/j.jdent.2023.104722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 08/28/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVES To determine the optimal level of mesh reduction that would maintain acceptable levels of geometrical trueness while also minimizing the impact on other parameters such as file size and processing time. METHODS Intraoral and extraoral maxillofacial defects were created on 8 cadaver heads and scanned by using a CBCT scanner (NewTom 3D Imaging, Verona). DICOM data were segmented to produce head (n=8) and skull models (n=8) saved as standard tessellation language (STL) files. A further processing of head models was preformed to produce face (n=8) and ear models (n=8). A mesh reduction process was performed for each STL model (reference, R0) by generating 50% (R1), 75% (R2), and 90% (R3) reductions. The 3 datasets were compared to the R0 file using 3D evaluation software (GOM Inspect) using a global best-fit algorithm, to calculate the root mean square (RMS) deviations. Statistical analyses were performed at a level of significance of α=0.05. RESULTS There was no 3D deviation after the 50% triangular mesh reduction in the 4 datasets. Minor 3D deviations were observed after 75% reduction, in all groups. After 90% reduction, higher 3D deviations were observed, and especially in head and skull. Statistically significant increase in 3D deviations was observed with higher degrees of mesh reduction (p < 0.001). CONCLUSION The resolution of CBCT-based maxillofacial defect models can be reduced up to 50%, with neglectable concern to inaccuracy. CLINICAL SIGNIFICANCE Accurate maxillofacial models can be obtained from CBCT DICOM files after segmentation and export as STL files, even when the mesh resolution is reduced up to 50%. This information can be valuable for practitioners and researchers working with 3D models of maxillofacial defects.
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Affiliation(s)
- Mahmoud Elbashti
- Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Complutense University of Madrid, Madrid, Spain; Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
| | - Amel Aswehlee
- Department of Dental Technology, University of Tripoli, Tripoli, Libya.
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland.
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland, and Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland.
| | - Bruno Ella
- Oral Surgery Department, School of Surgery, Bordeaux University Hospital, Bordeaux, France.
| | - Adrien Naveau
- Department of Prosthodontics, University of Bordeaux, Bordeaux, France.
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Yang Q, Fan Z, Tang P, Jiang Y, Han M, Li L. Characteristics of mandibular anterior alveolar bone in patients with different degrees of periodontitis: a retrospective study based on CBCT. Clin Oral Investig 2023; 27:6709-6721. [PMID: 37777638 DOI: 10.1007/s00784-023-05280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To investigate the alveolar bone characteristics of mandibular anterior teeth in patients with periodontitis. MATERIALS AND METHODS 100 patients with periodontitis were selected and grouped according to the degrees of alveolar bone resorption, age, gender, and tooth type. The labial thickness of the alveolar bone, the degree of alveolar bone resorption, angulation between the long axis of teeth and alveolar process, alveolar bone height and density of the mandibular anterior teeth were measured. RESULTS There were significant differences in alveolar bone morphology between these three groups. Compared with the mild and moderate groups, the severe group showed that the alveolar bone in the half of the root crown was thickened, the alveolar bone height was decreased, the cancellous alveolar bone density was increased, and the cortical alveolar bone density was decreased. The resorption of alveolar bone was characterized by greater resorption of proximal bone than that of labial bone with increased bone loss. There were also differences in alveolar bone characteristics among patients of different ages, genders, and tooth types. CONCLUSIONS The morphology of the mandibular anterior alveolar bone changed accordingly with the degree of periodontitis. Labial alveolar bone thickness and cortical alveolar bone density were negatively correlated with the degree of periodontitis, while alveolar bone height and cancellous alveolar bone density were positively correlated with the degree of periodontitis. CLINICAL RELEVANCE These results allow clinicians to better understand the alveolar bone morphology of the mandibular anterior teeth in patients with periodontitis, facilitating better treatment design and avoiding complications.
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Affiliation(s)
- Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Zixin Fan
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Yue Jiang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
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Almpani K, Tran H, Ferri A, Hung M. Assessment of condylar anatomy and degenerative changes in temporomandibular joint disorders - A scoping review. J Oral Biol Craniofac Res 2023; 13:764-780. [PMID: 38028230 PMCID: PMC10665941 DOI: 10.1016/j.jobcr.2023.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/05/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Temporomandibular disorders (TMDs) are a group of conditions that cause pain and dysfunction in the temporomandibular joint (TMJ) and muscles that control mandibular movement. In most cases, the etiology is unclear and is considered multifactorial. Recent research suggests that some forms of TMD could be associated with specific TMJ morphological characteristics. This study aims to provide a review of the reported anatomical and degenerative morphological condylar characteristics of subjects with a clinical diagnosis of TMD as described with the use of CBCT imaging, as well as the detection of potential predisposing anatomical factors. This review was developed and reported in accordance with the PRISMA-ScR Checklist. A comprehensive search was performed in five databases. Reports were screened by two independent reviewers based on preselected inclusion and exclusion criteria. 45 studies were included in this review. The most frequently reported degenerative changes associated with TMD were condylar surface erosion, flattening, osteophytes, and sclerosis. Anatomical characteristics included a small condylar size and a posterior position of the condylar head in the TMJ. The anterosuperior area of the condylar head appears to be the most frequently affected. More studies are required to determine potential specific predisposing anatomical characteristics.
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Affiliation(s)
- Konstantinia Almpani
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
| | - Huy Tran
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
| | - Anna Ferri
- Roseman University of Health Sciences Library, 11 Sunset Way, Henderson, NV, 89014, USA
| | - Man Hung
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
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Buser D, Urban I, Monje A, Kunrath MF, Dahlin C. Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities. Periodontol 2000 2023; 93:9-25. [PMID: 38194351 DOI: 10.1111/prd.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024]
Abstract
Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long-term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post-extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low-substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed.
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Affiliation(s)
- Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Centre for Implantology Buser and Frei, Bern, Switzerland
| | - Istvan Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, UIC Barcelona, Barcelona, Spain
- Division of Periodontology, CICOM-Monje, Badajoz, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
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Klingler S, Biel P, Tschanz M, Schulze R. CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria. Clin Oral Investig 2023; 27:5627-5636. [PMID: 37522991 PMCID: PMC10492752 DOI: 10.1007/s00784-023-05184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice.
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Affiliation(s)
- Samuel Klingler
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Philippe Biel
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Moses Tschanz
- Information Technology (IT) Group, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Ralf Schulze
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Yao K, Xie Y, Xia L, Wei S, Yu W, Shen G. The Reliability of Three-Dimensional Landmark-Based Craniomaxillofacial and Airway Cephalometric Analysis. Diagnostics (Basel) 2023; 13:2360. [PMID: 37510103 PMCID: PMC10377994 DOI: 10.3390/diagnostics13142360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/25/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Cephalometric analysis is a standard diagnostic tool in orthodontics and craniofacial surgery. Today, as conventional 2D cephalometry is limited and susceptible to analysis bias, a more reliable and user-friendly three-dimensional system that includes hard tissue, soft tissue, and airways is demanded in clinical practice. We launched our study to develop such a system based on CT data and landmarks. This study aims to determine whether the data labeled through our process is highly qualified and whether the soft tissue and airway data derived from CT scans are reliable. We enrolled 15 patients (seven males, eight females, 26.47 ± 3.44 years old) diagnosed with either non-syndromic dento-maxillofacial deformities or OSDB in this study to evaluate the intra- and inter-examiner reliability of our system. A total of 126 landmarks were adopted and divided into five sets by region: 28 cranial points, 25 mandibular points, 20 teeth points, 48 soft tissue points, and 6 airway points. All the landmarks were labeled by two experienced clinical practitioners, either of whom had labeled all the data twice at least one month apart. Furthermore, 78 parameters of three sets were calculated in this study: 42 skeletal parameters (23 angular and 19 linear), 27 soft tissue parameters (9 angular and 18 linear), and 9 upper airway parameters (2 linear, 4 areal, and 3 voluminal). Intraclass correlation coefficient (ICC) was used to evaluate the inter-examiner and intra-examiner reliability of landmark coordinate values and measurement parameters. The overwhelming majority of the landmarks showed excellent intra- and inter-examiner reliability. For skeletal parameters, angular parameters indicated better reliability, while linear parameters performed better for soft tissue parameters. The intra- and inter-examiner ICCs of airway parameters referred to excellent reliability. In summary, the data labeled through our process are qualified, and the soft tissue and airway data derived from CT scans are reliable. Landmarks that are not commonly used in clinical practice may require additional attention while labeling as they are prone to poor reliability. Measurement parameters with values close to 0 tend to have low reliability. We believe this three-dimensional cephalometric system would reach clinical application.
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Affiliation(s)
- Kan Yao
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Yilun Xie
- Department of Stomatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Liang Xia
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Silong Wei
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Wenwen Yu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Guofang Shen
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Zhang L, Zhang Y, Xu Q, Shu J, Xu B, Liu L, Chen H, Hu Y, Li Y, Song L. Increased risks of maxillary sinus mucosal thickening in Chinese patients with periapical lesions. Heliyon 2023; 9:e18050. [PMID: 37519707 PMCID: PMC10372233 DOI: 10.1016/j.heliyon.2023.e18050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives This study aimed to evaluate the effects of factors related to periapical lesions (PALs) on sinus membrane thickening (SMT) in the Chinese population using cone-beam computed tomography (CBCT). Methods In this retrospective study, CBCT images (n = 512) of maxillary sinuses of 446 patients were evaluated by two examiners for SMT and PALs, PAL size, and the distance between the maxillary sinus floor (MSF), and the PAL's edge/root apex. The data were analyzed using analysis of variance, the Kruskal-Wallis test, χ2-test, and logistic regression. Results A binary logistic regression model showed that the prevalence and severity of SMT > 2 mm were significantly associated with older age (>60 years) (odds ratio [OR]: 4.03, 95% confidence interval [CI]): 2.24-7.72, P < 0.001], male sex (OR: 2.08, 95% CI: 1.21-3.56, P < 0.006), and PALs (OR: 6.89, 95% CI: 3.93-12.08, P < 0.001). The type of contact and penetration between the MSF and PALs or root apex showed a more significant relation with SMT > 2 mm than did distance after adjusting for confounding factors, including age and sex (PALs: OR = 10.17 and 14.57, P < 0.001; root apex: OR = 3.49 and 5.86, P < 0.001). Conclusions The prevalence and severity of SMT were significantly associated with older age, male sex, PALs, PAL size, and the distance between the MSF and PALs/root apex. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of SMT of dental origin.
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Affiliation(s)
- Limin Zhang
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yanan Zhang
- Department of Stomatology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, China
| | - Qimei Xu
- School of Stomatology, Bengbu Medical College, Bengbu, Anhui 233000, China
| | - Jingjing Shu
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bin Xu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liuhui Liu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Huijuan Chen
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yue Hu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yinghua Li
- Clinical Laboratory, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liang Song
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
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Sennimalai K, Selvaraj M, Kharbanda OP, Kandasamy D, Mohaideen K. MRI-based cephalometrics: a scoping review of current insights and future perspectives. Dentomaxillofac Radiol 2023; 52:20230024. [PMID: 36809112 PMCID: PMC10304848 DOI: 10.1259/dmfr.20230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE This review aims to explore the current status of magnetic resonance imaging (MRI) as a cephalometric tool, summarize the equipment design and methods, and propose recommendations for future research. METHODS A systematic search was conducted in electronic databases, including PubMed, Ovid MEDLINE, Scopus, Embase, Web of Science, EBSCOhost, LILACS, and Cochrane Library, using broad search terms. The articles published in any language till June 2022 were considered. Cephalometric studies conducted using the MRI dataset on human participants, phantom or cadaver were included. Two independent reviewers assessed the final eligible articles using the quality assessment score (QAS). RESULTS Nine studies were included in the final assessment. Studies used various methods, including 1.5 T or 3 T MRI systems and 3D or 2D MRI datasets. Among the imaging sequences, T1-weighted, T2-weighted and black bone MR images were used for cephalometric analysis. In addition, the reference standards varied among studies, such as traditional 2D cephalogram, cone-beam CT and phantom measurements. The mean QAS of all the included studies was 79% (± 14.4%). The main limitation of most studies was the small sample size and the heterogeneity of the methods, statistical tools used, and metric outcomes assessed. CONCLUSIONS Despite the heterogeneity and lack of metrological evidence on the effectiveness of MRI-based cephalometric analysis, the preliminary results demonstrated by in vivo and in vitro studies are encouraging. However, future studies exploring MRI sequences specific to cephalometric diagnosis are required for wider adoption of this technique in routine orthodontic practice.
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Affiliation(s)
- Karthik Sennimalai
- Department of Orthodontics, All India Institute of Medical Sciences, Jammu, 184120, Jammu & Kashmir, India
| | - Madhanraj Selvaraj
- Division of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | | | - Devasenathipathy Kandasamy
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, Delhi, India
| | - Kaja Mohaideen
- Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, 174001, Himachal Pradesh, India
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Ludwigs L, Pape C, Visse HS, Runte C, Meyer U, Dirksen D. Cross Sectional Analysis of Eurasian Skull Anatomy for 3D Cephalometry-Normative Data Reveal Four Different Skull Types. J Pers Med 2023; 13:1018. [PMID: 37374007 DOI: 10.3390/jpm13061018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The unsolved problem in three-dimensional surgical planning for patients with facial deformity, dysgnathia, or asymmetry is the lack of a normative database of "norm skulls" that can be used as treatment objectives. A study was conducted on 90 Eurasian persons (46 male and 44 female adults) for whom cone beam-computed tomography images were available. Inclusion criteria were adult patients with a skeletal Class I pattern, proper interincisal relationship with normal occlusion, the absence of an open bite both in the anterior and posterior region, and a normal and balanced facial appearance; patients with dysgnathia and malformations were excluded. A total of 18 landmarks were digitized and 3D cephalometric measurements were performed and analyzed by means of proportions calculated from the landmarks. Male and female skulls were analyzed, as well as subdivisions revealed by cluster analysis. The data showed that four subtypes of skulls were distinguishable with statistical significance (p < 0.05). A male and a female type subdivided in a brachiocephalic and dolichocephalic phenotype could be identified. For each type, a mean shape was calculated by a Procrustes transformation, which, in turn, was used to create four template skulls from a male and a female skull. This was accomplished by fitting the polygon models of the two skulls to each of the two subtypes based on the landmarks marked on them using a thin plate spline transformation. The normative data of the subtypes can individually serve as a guide for orthodontic surgery in the Eurasian population, which is especially helpful in 3D planning and the execution of craniofacial operations.
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Affiliation(s)
- Leon Ludwigs
- Department of Prosthetic Dentistry and Biomaterials, University of Münster, Albert-Schweitzer-Campus 1, Building W30, D-48149 Münster, Germany
| | - Christian Pape
- Department of Prosthetic Dentistry and Biomaterials, University of Münster, Albert-Schweitzer-Campus 1, Building W30, D-48149 Münster, Germany
| | - Helena Sophie Visse
- Department of Prosthetic Dentistry and Biomaterials, University of Münster, Albert-Schweitzer-Campus 1, Building W30, D-48149 Münster, Germany
| | - Christoph Runte
- Department of Prosthetic Dentistry and Biomaterials, University of Münster, Albert-Schweitzer-Campus 1, Building W30, D-48149 Münster, Germany
| | - Ulrich Meyer
- Clinic for Jaw, Face and Skull-Surgery Münster, Schorlemerstraße 26, D-48143 Münster, Germany
| | - Dieter Dirksen
- Department of Prosthetic Dentistry and Biomaterials, University of Münster, Albert-Schweitzer-Campus 1, Building W30, D-48149 Münster, Germany
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Fan W, Zhang J, Wang N, Li J, Hu L. The Application of Deep Learning on CBCT in Dentistry. Diagnostics (Basel) 2023; 13:2056. [PMID: 37370951 DOI: 10.3390/diagnostics13122056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Cone beam computed tomography (CBCT) has become an essential tool in modern dentistry, allowing dentists to analyze the relationship between teeth and the surrounding tissues. However, traditional manual analysis can be time-consuming and its accuracy depends on the user's proficiency. To address these limitations, deep learning (DL) systems have been integrated into CBCT analysis to improve accuracy and efficiency. Numerous DL models have been developed for tasks such as automatic diagnosis, segmentation, classification of teeth, inferior alveolar nerve, bone, airway, and preoperative planning. All research articles summarized were from Pubmed, IEEE, Google Scholar, and Web of Science up to December 2022. Many studies have demonstrated that the application of deep learning technology in CBCT examination in dentistry has achieved significant progress, and its accuracy in radiology image analysis has reached the level of clinicians. However, in some fields, its accuracy still needs to be improved. Furthermore, ethical issues and CBCT device differences may prohibit its extensive use. DL models have the potential to be used clinically as medical decision-making aids. The combination of DL and CBCT can highly reduce the workload of image reading. This review provides an up-to-date overview of the current applications of DL on CBCT images in dentistry, highlighting its potential and suggesting directions for future research.
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Affiliation(s)
- Wenjie Fan
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jiaqi Zhang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Nan Wang
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jia Li
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Hu
- Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Wieschollek S, Knie C, Megerle K. Cone-beam computed tomography in the treatment of distal radius fractures. HANDCHIR MIKROCHIR P 2023; 55:174-185. [PMID: 37307810 DOI: 10.1055/a-2055-2591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Cone-beam computed tomography (CBCT) is a relatively new imaging technique in hand surgery. Being the most common fractures in adults, distal radius fractures are of special importance not only to hand surgeons. The quantity alone calls for fast, efficient and reliable diagnostic procedures. Surgical techniques and possibilities are progressing, especially regarding intra-articular fracture patterns. The demand for exact anatomic reduction is high. There is an overall consensus regarding the indication for preoperative three-dimensional imaging and it is frequently used. Typically, it is obtained by multi-detector computed tomography (MDCT). Postoperative diagnostic procedures are usually limited to plain x-rays. Commonly accepted recommendations regarding postoperative 3D imaging are not yet established. There is a lack of relevant literature. In case of an indication for a postoperative CT scan, it is generally also obtained by MDCT. CBCT for the wrist is not widely used as yet. This review focuses on the potential role of CBCT in the perioperative management of distal radius fractures. CBCT allows for high-resolution imaging with a potentially lower radiation dose compared with MDCT, both with and without implants. It is easily available and can be operated independently, thus being time-efficient and making daily practice easier. Due to its many advantages, CBCT is a recommendable alternative to MDCT in the perioperative management of distal radius fractures.
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Affiliation(s)
- Stefanie Wieschollek
- Zentrum für Handchirurgie, Mikrochirurgie und plastische Chirurgie, Schön Klinik München Harlaching, München, Germany
| | - Careen Knie
- Zentrum für Handchirurgie, Mikrochirurgie und plastische Chirurgie, Schön Klinik München Harlaching, München, Germany
| | - Kai Megerle
- Zentrum für Handchirurgie, Mikrochirurgie und plastische Chirurgie, Schön Klinik München Harlaching, München, Germany
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Grandoch A, Oeser J, Zöller JE, Große Hokamp N, Lichtenstein T, Neugebauer J. Morphological Studies to Identify the Nasopalatine and Inferior Alveolar Nerve Using a Special Head and Neck MRI Coil. J Craniofac Surg 2023; 34:1351-1356. [PMID: 36879392 DOI: 10.1097/scs.0000000000009219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 10/18/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Procedures in oral and maxillofacial surgery bear a high risk of nerve damage. Three-dimensional imaging techniques can optimize surgical planning and help to spare nerves. The aim of this study was to investigate the diagnostic value of a 1.5 T magnetic resonance imaging (MRI) scanner with a dedicated dental signal amplification coil for the assessment of nerves in the oral cavity as compared with cone beam computed tomography (CBCT). METHODS Based on 6 predefined criteria, the assessability of the inferior alveolar and nasopalatine nerves in CBCT and MRI with a dedicated 4-channel dental coil were compared in 24 patients. RESULTS Compared with CBCT, MRI with the dental coil showed significantly better evaluability of the inferior alveolar nerve in the sagittal and axial plane and the nasopalatine nerve in the axial plane. In the sagittal plane; however, the assessability of the nasopalatine nerve was significantly better in CBCT as compared with MRI. Yet, pertaining to overall assessability, no significant differences between modalities were found. CONCLUSIONS In this pilot study, it can be reported that 1.5- T MRI with a dedicated dental coil is at least equivalent, if not superior, to CBCT in imaging nerve structures of the stomatognathic system. CLINICAL RELEVANCE Preoperative, 3-dimensional images are known to simplify and refine the planning and execution of operations in maxillofacial surgery. In contrast to computed tomography and CBCT, MRI does not cause radiation exposure while enabling visualization of all relevant hard and soft tissues and, therefore, holds an advantage over well-established techniques.
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Affiliation(s)
- Andrea Grandoch
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Julia Oeser
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Joachim E Zöller
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Thorsten Lichtenstein
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Jörg Neugebauer
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
- Dr Bayer and Colleagues Group office for dentistry, Landsberg am Lech, Germany
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Bazzani M, Cevidanes LHS, Al Turkestani NN, Annarumma F, McMullen C, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Franchi L, Ngan P, He H, Angelieri F, Aghazada H, Migliorati M. Three-dimensional comparison of bone-borne and tooth-bone-borne maxillary expansion in young adults with maxillary skeletal deficiency. Orthod Craniofac Res 2023; 26:151-162. [PMID: 35737876 PMCID: PMC10257795 DOI: 10.1111/ocr.12595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the transverse dental and skeletal changes in patients treated with bone-anchored palatal expander (bone-borne, BB) compared to patients treated with tooth and bone-anchored palatal expanders (tooth-bone-borne, TBB) using cone-beam computer tomography (CBCT) and 3D image analysis. METHODS The sample comprised 30 patients with transverse maxillary discrepancy treated with two different types of appliances: bone-borne (Group BB) and tooth-bone-borne (Group TBB) expanders. CBCT scans were acquired before (T1) and after completion of maxillary expansion (T2); the interval was 5.4 ± 3.4 and 6.2 ± 2.1 months between the T1 and the T2 scans of Group TBB (tooth-bone-borne) and Group BB (bone-borne), respectively. Transverse, anteroposterior and vertical linear and angular three-dimensional dentoskeletal changes were assessed after cranial base superimposition. RESULTS Both groups displayed marked transverse skeletal expansion with a greater ratio of skeletal to dental changes. Greater changes at the nasal cavity, zygoma and orbital levels were found in Group BB. A relatively parallel sutural opening in an anterior-posterior direction was observed in Group TBB; however, the Group BB presented a somewhat triangular (V-shaped) opening of the suture that was wider anteriorly. Small downward-forward displacements were observed in both groups. Asymmetric expansion occurred in approximately 50% of the patients in both groups. CONCLUSION Greater skeletal vs dental expansion ratio and expansion of the circummaxillary regions were found in Group BB, the group in which a bone-borne expander was used. Both groups presented skeletal and dental changes, with a similar amount of posterior palate expansion. Asymmetric expansion was observed in both groups.
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Affiliation(s)
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Najla N Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Craig McMullen
- Private Practice of Orthodontics, Brighton, Michigan, USA
| | - Antonio C O Ruellas
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Marcus V N N Rego
- Department of Orthodontics, Centero Universitário Uninovafapi, Teresina, Brazil
| | - Marilia S Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, West Virginia, USA
| | - Hong He
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fernanda Angelieri
- Department of Orthodontics, Methodist University of São Paulo, São Paulo, Brazil
| | | | - Marco Migliorati
- Department of Orthodontics, Genoa University School of Dentistry, Genoa, Italy
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Nomura Y, Watanabe H, Tomisato H, Kawashima S, Miura M. Gumbel distribution-based technique enables quantitative comparison between streak metal artifacts of multidetector row CT and cone-beam CT: a phantom study. Phys Eng Sci Med 2023; 46:801-812. [PMID: 37052806 DOI: 10.1007/s13246-023-01252-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023]
Abstract
Cone-beam computed tomography (CBCT), derived from multidetector row CT (MDCT), has a high spatial resolution and has recently been applied to various organs. One of the severe limitations common to CBCT and MDCT is metal artifacts. In particular, streak metal artifacts (SMAs) between multiple metal materials often hinder diagnosis. However, no studies have quantitatively compared the strength of SMAs in MDCT and CBCT. Nomura et al. reported an evaluation method specialized in SMAs of CBCT using the Gumbel distribution (GD), which can also be applied to SMAs of MDCT (Oral Surg Oral Med Oral Pathol Oral Radiol 131: 494-502, 2021, https://doi.org/10.1016/J.OOOO.2020.08.031 ). This study aimed to quantitatively compare SMAs occurring between titanium materials on MDCT and CBCT images using the GD-based method. The SMAs were investigated as follows: A hydroxyapatite block was sandwiched between two titanium rods to generate an SMA. They were placed in an acrylic phantom, simulating a human head, and scanned using an MDCT scanner and two CBCT scanners. The obtained images were analyzed using Gumbel plots and location parameters, and the SMA strength was calculated. The results showed that the SMAs on the MDCT images were significantly weaker than those on the CBCT images. In the CBCT scans, a smaller volume CT dose index value caused stronger SMAs. These results indicate that MDCT is more advantageous than CBCT in terms of SMA reduction when bone morphology between titanium materials must be evaluated. The characteristic should be considered in clinical cases.
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Affiliation(s)
- Yoshikazu Nomura
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Hiroshi Watanabe
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroshi Tomisato
- Radiology Center, Division of Integrated Facilities, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Sakurako Kawashima
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Masahiko Miura
- Department of Dental Radiology and Radiation Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Marques FBC, Siqueira de Lima L, Coqueiro RDS, Pithon MM, Ruellas ACDO, Maciel JVB, Nojima MDCG. Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00103-8. [PMID: 36967314 DOI: 10.1016/j.ajodo.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. METHODS Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n = 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n = 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. RESULTS Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P = 0.412 and P = 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P = 0.011, P = 0.024, and P = 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P = 0.008), mandibular ramus height (P = 0.004), condyle height (P = 0.010) and gonion to midsagittal plane distance (P = 0.018). CONCLUSIONS Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.
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Affiliation(s)
- Fernanda Blaudt Carvalho Marques
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lilian Siqueira de Lima
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raildo da Silva Coqueiro
- Department of Health I, School of Dentistry, Universidade Estadual do Sudoeste da Bahia, Jequié, Bahia, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, School of Dentistry, Universidade Estadual do Sudoeste da Bahia, Jequié, Bahia, Brazil
| | - Antônio Carlos de Oliveira Ruellas
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Matilde da Cunha Gonçalves Nojima
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Coelho MS, Rios MDA. Current status of cone-beam computed tomography teaching in Brazilian undergraduate endodontic programs - A web-based survey. J Dent Educ 2023; 87:358-363. [PMID: 36319187 DOI: 10.1002/jdd.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/06/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
PURPOSES This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs. METHODS One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic. RESULTS Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images. CONCLUSIONS The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic.
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Affiliation(s)
| | - Marcos de Azevêdo Rios
- Endodontic Department, State University of Feira de Santana (UEFS), Feira de Santana, Brazil
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Yang P, Xuan B, Li G, Qi S. Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis. BMC Oral Health 2023; 23:127. [PMID: 36841769 PMCID: PMC9960480 DOI: 10.1186/s12903-023-02832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVE This systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination. METHODS We performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2-0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I2 statistics, in which I2 > 50% was considered substantial heterogeneity. RESULTS A total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = - 0.56, 95%-CI = - 0.99 ~ - 0.13, p = 0.01). Because of the high heterogeneity among the studies (I2 = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I2 = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD = - 0.35, 95%-CI = - 0.59 ~ - 0.11, p = 0.004). CONCLUSION This review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.
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Affiliation(s)
- Pan Yang
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China
| | - Bin Xuan
- Department of Stomatology, Aerospace Center Hospital, Beijing, China
| | - Gang Li
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China
| | - Senrong Qi
- Department of Oral & Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
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Mirdad A, Alaqeely R, Ajlan S, Aldosimani MA, Ashri N. Incidence of maxillary sinus septa in the saudi population. BMC Med Imaging 2023; 23:23. [PMID: 36739395 PMCID: PMC9898957 DOI: 10.1186/s12880-023-00980-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/30/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The variability in the maxillary sinus anatomy makes dental implant planning challenging. One of the anatomical landmarks that could affect the decision for implant placement around the maxillary sinus is the sinus septa. This study aimed to retrospectively determine the prevalence, anatomical distribution, and morphology of the maxillary sinus septa. MATERIALS AND METHODS This study included 309 CBCT images that were analyzed to determine the prevalence, height, location, and orientation of the maxillary sinus septa. Descriptive statistics, Mann‒Whitney U tests, and Kruskal‒Wallis tests were used for data analysis. RESULTS A total of 618 maxillary sinuses were analyzed. Maxillary septa were present in 30% (n = 188) of the sinuses and in approximately 45% of the analyzed images. The mean height of the septa was 5.09 mm. The presence of bilateral septa was evident in 49 subjects (35.25%). Female subjects were significantly more likely to have only one septum (n = 67, 53.6%, p < 0.05). CONCLUSION The presence of septa is very common, found in one-third to approximately half of the evaluated cases, which warrants careful examination before any surgical interventions to avoid possible complications.
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Affiliation(s)
- Amani Mirdad
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Razan Alaqeely
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sumaiah Ajlan
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mazen A. Aldosimani
- grid.56302.320000 0004 1773 5396Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nahid Ashri
- grid.56302.320000 0004 1773 5396Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Pandey A, K P, Avinash A, Pathivada L, Kumar B, Kapur D. Comparative volumetric analysis of three different obturating materials in primary molars under cone beam computed tomography: an in-vitro study. Minerva Dent Oral Sci 2023; 72:31-36. [PMID: 36197278 DOI: 10.23736/s2724-6329.22.04679-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND To increase the success rate of the endodontic treatment in primary teeth various, obturating materials have been introduced to meet the specific requirements for deciduous dentition and to create a three-dimensional (3D) seal to prevent recurrence of bacterial infection. This study was conducted to compare and evaluate the three-dimensional seal and volumetric filling of primary canals obturated with different medicaments using cone beam computed tomography (CBCT). METHODS In-vitro cross sectional study was designed with sample size of 108 specimens. Thirty-six extracted primary molars were selected for the study and randomly divided into 3 groups A (Metapex; Meta Biomed, Osong-eup, Korea), B (Endoflas; Sanlor Laboratories, Cali, Colombia) and C (Zinc oxide eugenol; DPI India Ltd., Mumbai, India). After access opening, canals were prepared up to 30 no k- file followed by obturation with Metapex, Endoflas and Zinc oxide eugenol in respective groups. CBCT was done before and after the obturation for volumetric analysis. The data obtained were analyzed to attain POV (percentage of obturated volume) and PVV (percentage volume of voids). RESULTS The percentage of obturated volume (POV) was highest for Endoflas group (88.87) followed by Metapex (83.58) and ZnO (72.78) and the difference was statistically significant. Whereas the percentage volume of voids (PVV) was more in Zinc oxide eugenol group (27.22) followed by Metapex (16.42) and least voids were seen in Endoflas group (11.14). CONCLUSIONS Voids were found in all three obturating materials. Endoflas showed superior three-dimensional (3D) sealing capability whereas ZnO eugenol having least sealing capacity.
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Affiliation(s)
- Anil Pandey
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India -
| | - Premkishore K
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Alok Avinash
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Lumbini Pathivada
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Brij Kumar
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Dhani Kapur
- Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
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Yang P, Guo X, Mu C, Qi S, Li G. Detection of vertical root fractures by cone-beam computed tomography based on deep learning. Dentomaxillofac Radiol 2023; 52:20220345. [PMID: 36802858 PMCID: PMC9944014 DOI: 10.1259/dmfr.20220345] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the performance of ResNet models in the detection of in vitro and in vivo vertical root fractures (VRF) in Cone-beam Computed Tomography (CBCT) images. METHODS A CBCT image dataset consisting of 28 teeth (14 intact and 14 teeth with VRF, 1641 slices) from 14 patients, and another dataset containing 60 teeth (30 intact and 30 teeth with VRF, 3665 slices) from an in vitro model were used for the establishment of VRFconvolutional neural network (CNN) models. The most popular CNN architecture ResNet with different layers was fine-tuned for the detection of VRF. Sensitivity, specificity, accuracy, PPV (positive predictive value), NPV (negative predictive value), and AUC (the area under the receiver operating characteristic curve) of the VRF slices classified by the CNN in the test set were compared. Two oral and maxillofacial radiologists independently reviewed all the CBCT images of the test set, and intraclass correlation coefficients (ICCs) were calculated to assess the interobserver agreement for the oral maxillofacial radiologists. RESULTS The AUC of the models on the patient data were: 0.827(ResNet-18), 0.929(ResNet-50), and 0.882(ResNet-101). The AUC of the models on the mixed data get improved as:0.927(ResNet-18), 0.936(ResNet-50), and 0.893(ResNet-101). The maximum AUC were: 0.929 (0.908-0.950, 95% CI) and 0.936 (0.924-0.948, 95% CI) for the patient data and mixed data from ResNet-50, which is comparable to the AUC (0.937 and 0.950) for patient data and (0.915 and 0.935) for the mixed data obtained from the two oral and maxillofacial radiologists, respectively. CONCLUSIONS Deep-learning models showed high accuracy in the detection of VRF using CBCT images. The data obtained from the in vitro VRF model increases the data scale, which is beneficial to the training of deep-learning models.
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Affiliation(s)
| | | | | | - Senrong Qi
- Department of Oral and Maxillofacial Radiology, Beijing Stomatology Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
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Ketabi AR, Piwowarczyk A, Schulz MC, Lauer HC, Hassfeld S. Evaluation of the contour of edentulous jaw sections in the transversal plane and the buccolingual vertical-level disparity in CBCT and panoramic radiography images: a retrospective comparative study. Int J Implant Dent 2023; 9:1. [PMID: 36595148 PMCID: PMC9810779 DOI: 10.1186/s40729-022-00466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE This study investigates whether edentulous jaw sections in the planned implant position exhibit jaw contours funnel-shaped or exhibit pronounced retraction of the jaw (unusual jaw contours) in the transversal plane of the three-dimensional (3D) images, not visible in two-dimensional (2D) images. METHODS A total of 335 patients with an edentulous section of the jaw that required dental implants were selected. Anonymised radiologic patients' data were collected, comprising cone-beam computed tomography (CBCT) images of the edentulous jaw sections. In the first stage, unusual jaw contours were examined, including funnel-shaped or pronounced retraction of the jaw and hypodense regions with an undercut and/or bone deficit. In the second stage, the variation in the height of the alveolar ridge between the lingual and buccal contour in the edentulous jaw sections was assessed. RESULTS The CBCT images of an unusual jaw contour were observed in 8 cases (2.4%) in the maxilla on the left and 10 cases (3%) in the maxilla on the right. In the mandible, a jaw contour deviates in 39 cases (12.1%) on the left side and 39 cases (12.1%) on the right side. A height difference was detected in the upper jaw in 307 cases and the lower jaw in 265 cases. The discrepancy was 2.09 mm (± 2.25 mm) in the maxilla and 3.97 mm (± 3.45 mm) in the mandible. CONCLUSIONS The CBCT scan provides useful information to avoid complications in the preoperative planning phase and surgical planning in implant dentistry.
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Affiliation(s)
- Ali Reza Ketabi
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany. .,Private Dental Office, Epplestraße 29 a, 70597, Stuttgart, Germany.
| | - Andree Piwowarczyk
- grid.412581.b0000 0000 9024 6397Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455 Witten, Germany
| | - Matthias Christian Schulz
- grid.10392.390000 0001 2190 1447Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
| | - Hans-Christoph Lauer
- grid.7839.50000 0004 1936 9721Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
| | - Stefan Hassfeld
- grid.412581.b0000 0000 9024 6397Department of Oral and Maxillofacial Surgery, Dortmund Hospital GmbH and Faculty of Health, Witten/Herdecke University, Muensterstr. 240, 44145 Dortmund, Germany
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Grassi R, Guerra E, Berritto D. Bone fractures difficult to recognize in emergency: May be cone beam computed tomography (CBCT) the solution? LA RADIOLOGIA MEDICA 2023; 128:1-5. [PMID: 36683134 DOI: 10.1007/s11547-022-01584-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/20/2022] [Indexed: 01/23/2023]
Abstract
CBCT is an imaging tool represented by an X-ray computed tomography delivering a conic-shape X-rays source. This system produces volumetric data during a single rotation of both X-ray beam and detector around the stationary patient. CBCT is able to produce three-dimensional images as for MDCT, however, accounting some advantages over it: lower radiation dose, faster volumetric dataset acquisition, higher spatial resolution and bone contrast. For these reasons, CBCT has recently been described and adopted for extremities imaging in orthopedics. Misinterpretation of fractures may determine a delayed treatment and poor outcome for patients treated in the ED. CBCT, by easily identifying occult cortical fractures and using a lower dose of radiation, is proposed as an alternative or supplement to direct radiograms, optimizing the cost-effectiveness ratio and limiting the number of unnecessary immobilizations. The first experiences document excellent performance of CBCT in emergency radiology departments, especially thanks to transverse imaging in trauma of the extremities.
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Affiliation(s)
- Roberto Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Egidio Guerra
- Division of Radiology, "Ospedale Policlinico di Foggia", Foggia, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
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Travessas JAC, dos Santos AM, Buligon RP, Arús NA, da Silveira PFT, da Silveira HLD, Vizzotto MB. Validation and comparison of volume measurements using 1 multidetector computed tomography and 5 cone-beam computed tomography protocols: An in vitro study. Imaging Sci Dent 2022; 52:399-408. [PMID: 36605864 PMCID: PMC9807801 DOI: 10.5624/isd.20220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose The purpose of this study was to compare volume measurements obtained using 2 image software packages on Digital Imaging and Communications in Medicine (DICOM) images acquired from 1 multidetector computed tomography and 5 cone-beam computed tomography devices, using different protocols for physical volume measurements. Materials and Methods Four pieces of bovine leg were prepared. Marrow was removed from 3 pieces, leaving cortical bone exposed. The resulting space of 1 piece was filled with water, another was filled with propylene glycol, and the third was left unfilled. The marrow in the fourth sample was left fully intact. Volume measurements were obtained after importing DICOM images into the Dolphin Imaging 11.95 and ITK-SNAP software programs. Data were analyzed using 3-way analysis of variance with a generalized linear model to determine the effects of voxel size, software, and content on percentage mean volume differences between tomographic protocols. A significance level of 0.05 was used. Results The intraclass correlation coefficients for intraobserver and interobserver reliability were, respectively, 0.915 and 0.764 for the Dolphin software and 0.894 and 0.766 for the ITK-SNAP software. Three sources of statistically significant variation were identified: the interaction between software and content (P=0.001), the main effect of content (P=0.014), and the main effect of software (P=0.001). Voxel size was not associated with statistically significant differences in volume measurements. Conclusion Both content and software influenced the accuracy of volume measurements, especially when the content had gray values similar to those of the adjacent tissues.
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Affiliation(s)
- Juliana Andréa Corrêa Travessas
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alessandra Mendonça dos Santos
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rodrigo Pagliarini Buligon
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Nádia Assein Arús
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Heraldo Luis Dias da Silveira
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mariana Boessio Vizzotto
- Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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50
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CATTANEO PM, CORNELIS MA. Digital workflows in Orthodontic postgraduate training. Semin Orthod 2022. [DOI: 10.1053/j.sodo.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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