A rater agreement study on measurements in cross-sectional CBCT images exploring the association between alveolar bone morphology and craniofacial height

Advantages of using touch-controlled, minimally invasive implantation technique on soft tissue in the aesthetic zone of maxillary anterior teeth

Endosseous implant is an ideal treatment option for the treatment of denture defects and omissions. However, how to maintain the perfect gum contour of patients has been an important research topic for stomatologists and has attracted much attention. The objective of this study was to explore the advantages of minimally invasive touch-controlled implantation in maintaining soft tissue morphology in the aesthetic area of maxillary anterior teeth. Forty patients underwent preoperative cone-beam computed tomography and were randomly divided into 2 groups: experimental group (touch-controlled, minimally invasive implantation approach, n = 20) and control group (traditional flap implantation approach, n = 20). The operative time, postoperative pain, gingival recession, and patient satisfaction were compared between the 2 groups. The independent sample t test was employed to compare the results, with a significance level of α = 0.05. Statistical significance was determined at P < .05. The operative time was 4.50 and 9.21 minutes, respectively, for 2 groups, P < .001. The mean pain scores of 2 groups were 1.09 and 2.14, respectively, at 24 hours after surgery, P < .001. The H values (the distance from the labial edge of the implant healing cap to the lowest gingival margin), 6 weeks after surgery, of 2 groups were 2.69 and 3.05, respectively, P = .023. There was a significant difference in patient satisfaction between 2 groups 24 hours after surgery (P < .001). Touch-controlled minimally invasive implantation has shorter operative time and lesser bleeding, postoperative pain, and gingival recession than traditional flap implantation, which is conducive to the preservation of gingival shape.

The evaluation of superior semicircular canal in patients with unilateral cleft lip and palate using CBCT

OBJECTIVES

The present study aims to evaluate the thickness and radiological patterns of the superior semicircular canal (SSC) in patients with unilateral cleft lip and palate (CL/P).

METHODS

Cone beam computed tomography (CBCT) images of the patients were evaluated in axial and Pöschl planes. CBCT images of 84 patients with unilateral CL/P and 168 healthy individual controls were included in the study. Three study groups were established: the CS-CL/P group (cleft side temporal bones of the CL/P patients), NCS-CL/P (non-cleft side temporal bones of the CL/P patients) and the control group. The radiological patterns of SSCs were categorized as dehiscence, papyraceous, normal, pneumatised and thick. The minimum bone thickness of SSC was measured.

RESULTS

It was found that the CS-CL/P group had a higher prevalence for SSCD compared to both the NCS-CL/P group and the control group. CS-CL/P group had a higher prevalence of dehiscence type and papyraceous type compared to the control group. The SSC thickness on the CS-CL/P patients was thinner than the NCS-CL/P patients and the control group sides (p = 0.033 and p < 0.001, respectively).

CONCLUSIONS

The mean thickness of SSC was found significantly lower in the CS-CL/P group compared to both the NCS-CL/P group and the control group. The elevated prevalence of dehiscence and papyraceous types in the CS-C/LP group compared to the control group implies that the presence of a cleft may be a predisposing factor for these types.

Application of a Cone-Beam Computed Tomography-Based Index for Evaluating Surgical Sites Prior to Sinus Lift Procedures-A Pilot Study

OBJECTIVES

Radiography-based indices can help surgeons perform detailed examinations of the surgical site and predict the surgical difficulty of cases. We aimed to develop and validate a novel CBCT-based index that can predict the surgical difficulty of sinus-augmentation procedures.

MATERIALS AND METHODS

In the first stage, five experienced dental specialists performed a review of the literature and closed group discussions and designed the novel index. In the next stage, the index was validated. CBCT scans of 30 patients scheduled for sinus-augmentation procedures were evaluated and assigned presurgical CBCT evaluation scores (PSCESs) by five examiners. Subsequently, one oral surgeon performed sinus augmentation using the lateral antrostomy technique and assigned surgical difficulty scores (SDSs) to each of the 30 cases along with 2 observers. The PSCESs and SDSs were statistically analysed to determine the interrater reliability and validity of the index.

RESULTS

The interrater agreement of the PSCES among the five presurgical evaluators was 0.85. The PSCES of the five evaluators had highly significant correlation (P < 0.001, r = 0.68 to 0.76) with the SDS. Regression analysis revealed that for every unit increase in the PSCES, there is 0.46 to 0.57 increase in the SDS value.

CONCLUSION

The results of this pilot study revealed that a novel CBCT-based index can be used as a reliable tool for predicting the surgical difficulty of sinus-augmentation procedures. However, the novel index needs to be tested on a larger sample of patients and evaluators for a more concrete validity and reliability.