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Prajapati S, Ninneman S, Zarrabi I, Daubert D, Wang IC, Hsu YT. Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years. J Periodontol 2023; 94:1045-1054. [PMID: 36748281 DOI: 10.1002/jper.22-0424] [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: 07/18/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Lateral-window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years. METHODS Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical-related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP. RESULTS A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05). CONCLUSIONS With inherent limitation, the findings with up to 9 years of follow-up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.
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Affiliation(s)
| | - Shale Ninneman
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | | | - Diane Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - I-Chung Wang
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
| | - Yung-Ting Hsu
- Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington, USA
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Wang XW, Yang HF, Wang EB, Cui XY, Zhao YJ, Jiang JH. Slim the face or not: 3D change of facial soft and hard tissues after third molars extraction: a pilot study. BMC Oral Health 2023; 23:508. [PMID: 37479973 PMCID: PMC10362706 DOI: 10.1186/s12903-023-03214-5] [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: 02/23/2023] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Whether slim the face or not after removed third molars is the concern of some orthodontic treatment candidates. The aim of this article is to explore the volume changes of facial soft and hard tissues after third molars extraction, as well as develop a reproducible clinical protocol to precisely assess facial soft tissue volume change. METHODS A non-randomized, non-blind, self-controlled pilot study was conducted. 24 adults aged 18-30 had ipsilateral third molars extracted. The body weight change was controlled within 2 kg. Structured light scans were taken under a standardized procedure pre-extraction (T0), three (T1), and six (T2) months post-extraction; CBCTs were taken at T0 and T2. The projection method was proposed to measure the soft tissue volume (STV) and the soft tissue volume change (STVC) by the Geomagic software. The hard tissue volume change (HTVC) was measured in the Dragonfly software. RESULTS The final sample size is 23, including 5 males (age 26.6 ± 2.5 years) and 18 females (age 27.3 ± 2.5 years). The HTVC was - 2.33 ± 0.46ml on the extraction side. On the extraction side, the STV decreased by 1.396 (95% CI: 0.323-2.470) ml (P < 0.05) at T1, and increased by 1.753 (95% CI: -0.01-3.507) ml (P = 0.05) at T2. T2 and T0 had no difference (P > 0.05). The inter and intra-raters ICC of the projection method was 0.959 and 0.974. There was no correlation between the STVC and HTVC (P > 0.05). CONCLUSIONS After ipsilateral wisdom teeth extraction, the volume of hard tissue on the extraction side reduces, and the volume of facial soft tissue does not change evidently. However, further research with large sample size is still needed. The STV measurement has excellent repeatability. It can be extended to other interested areas, including forehead, nose, paranasal, upper lip, lower lip and chin, which is meaningful in the field of orthodontics and orthopedics. TRIAL REGISTRATION ChiCTR, ChiCTR1800018305 (11/09/2018), http://www.chictr.org.cn/showproj.aspx?proj=28868 .
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Affiliation(s)
- Xin-Wen Wang
- Third Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, CN, China
| | - Hui-Fang Yang
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, CN, China
| | - En-Bo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, CN, China
| | - Xin-Yu Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, #22 Zhongguancun South Avenue, Haidian District, Beijing, CN, 100081, China
| | - Yi-Jiao Zhao
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, CN, China
| | - Jiu-Hui Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, #22 Zhongguancun South Avenue, Haidian District, Beijing, CN, 100081, China.
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Li Q, Wang Z, Wang C, Wang HL. Characterizing the respiratory-induced mechanical stimulation at the maxillary sinus floor following sinus augmentation by computational fluid dynamics. Front Bioeng Biotechnol 2022; 10:885130. [PMID: 35957638 PMCID: PMC9360545 DOI: 10.3389/fbioe.2022.885130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background: The relationship between maxillary sinus pneumatization and respiratory-induced fluid mechanics remains unclear. The purpose of this study was to simulate and measure the respiratory-induced mechanical stimulation at the sinus floor under different respiratory conditions and to investigate its potential effect on the elevated sinus following sinus-lifting procedures. Methods: The nasal airway together with the bilateral maxillary sinuses of the selected patient was segmented and digitally modeled from a computed tomographic image. The sinus floors of the models were elevated by simulated sinus augmentations using computer-aided design. The numerical simulations of sinus fluid motion under different respiratory conditions were performed using a computational fluid dynamics (CFD) algorithm. Sinus wall shear stress and static pressure on the pre-surgical and altered sinus floors were examined and quantitatively compared. Results: Streamlines with minimum airflow velocity were visualized in the sinus. The sinus floor pressure and the wall shear stress increased with the elevated inlet flow rate, but the magnitude of these mechanical stimulations remained at a negligible level. The surgical technique and elevated height had no significant influence on the wall pressure and the fluid mechanics. Conclusion: This study shows that respiratory-induced mechanical stimulation in the sinus floor is negligible before and after sinus augmentation.
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Affiliation(s)
- Qing Li
- Center of Digital Dentistry, Second Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Zhongyu Wang
- Center of Digital Dentistry, Second Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Chao Wang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
- *Correspondence: Chao Wang, ; Hom-Lay Wang,
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States
- *Correspondence: Chao Wang, ; Hom-Lay Wang,
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Convolutional neural network for automatic maxillary sinus segmentation on cone-beam computed tomographic images. Sci Rep 2022; 12:7523. [PMID: 35525857 PMCID: PMC9079060 DOI: 10.1038/s41598-022-11483-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/11/2022] [Indexed: 02/07/2023] Open
Abstract
An accurate three-dimensional (3D) segmentation of the maxillary sinus is crucial for multiple diagnostic and treatment applications. Yet, it is challenging and time-consuming when manually performed on a cone-beam computed tomography (CBCT) dataset. Recently, convolutional neural networks (CNNs) have proven to provide excellent performance in the field of 3D image analysis. Hence, this study developed and validated a novel automated CNN-based methodology for the segmentation of maxillary sinus using CBCT images. A dataset of 264 sinuses were acquired from 2 CBCT devices and randomly divided into 3 subsets: training, validation, and testing. A 3D U-Net architecture CNN model was developed and compared to semi-automatic segmentation in terms of time, accuracy, and consistency. The average time was significantly reduced (p-value < 2.2e−16) by automatic segmentation (0.4 min) compared to semi-automatic segmentation (60.8 min). The model accurately identified the segmented region with a dice similarity co-efficient (DSC) of 98.4%. The inter-observer reliability for minor refinement of automatic segmentation showed an excellent DSC of 99.6%. The proposed CNN model provided a time-efficient, precise, and consistent automatic segmentation which could allow an accurate generation of 3D models for diagnosis and virtual treatment planning.
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Küçükkurt S, Moharamnejad N. Comparison of the effects of three different xenogeneic bone grafts used in sinus augmentation simultaneous with dental implant placement on the survival of the implants and the dimensional changes of the region. Minerva Dent Oral Sci 2022; 70:248-256. [PMID: 35075889 DOI: 10.23736/s2724-6329.21.04521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Xenografts can be produced in various particle sizes by using different bone types. Currently, there is no consensus about the ideal type of xenograft for sinus augmentations, and this choice depends on the personal experience of clinicians. This retrospective study aimed to evaluate the effects of three different xenografts used in sinus augmentation simultaneously with implant placement on the survival of the implants and the dimensional changes of the region. METHODS One hundred nine sinus augmentations and 164 implants were evaluated in 76 patients. Three different xenografts were used: 41 Gen-Os® (250-1000µm, Corticocancellous; Tecnoss, Giaveno, Turin, Italy), 35 Bio-Oss® (1000-2000µm, Cancellous; Geistlich Biomaterials italia S.r.l., Vicenza, Italy) and 33 Apatos-Cortical® (600-1000µm, Cortical; Tecnoss). The preoperative, postoperative, and follow-up (21±8.8 month) radiographs were evaluated for the dimensional changes and the implant survivals. The data were statistically analyzed. RESULTS Among the implant failures; 3 (5.6%) in 53 implants in Apatos, 2 (3.6%) in 55 implants in Bio-Oss, 9 (16%) in 56 implants in Gen-Os, and 14 (8.5%) total implant failures were observed. This difference between the groups was statistically significant and was due to the high loss rate in the Gen-Os (P=0.044). There was a mean difference of -1.8±1.5mm between the measured bone heights on postoperative day (14.2±2.4mm) and the last follow-up (12.4±2.5 mm). While the loss of height was not affected due to the graft type (P=0.981), the general 12.6% vertical loss was statistically significant (P<0.0001), also the length of implants placed reduced this loss (P=0.036). CONCLUSIONS Within the limits of this retrospective study, it can be concluded that: 1) The sinus augmentation procedures with thicker particle size grafts achieved higher success rate; and 2) over the time, 12.6% loss may occur in the height of grafted area.
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Affiliation(s)
- Sercan Küçükkurt
- Department of Oral and Maxillofacial Surgery, Istanbul Aydin University, Istanbul, Turkey -
| | - Nima Moharamnejad
- Department of Oral and Maxillofacial Surgery, Istanbul Aydin University, Istanbul, Turkey
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Wang Z, Jia Q, Jiang HB, Han J, Zou L, Niu G. The Relation between Morphology of Maxillary Sinus after Augmentation in Three Classification Methods and Residual Bone Height: A Retrospective Study. Int J Clin Pract 2022; 2022:1850012. [PMID: 36249910 PMCID: PMC9536978 DOI: 10.1155/2022/1850012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
Maxillary sinus augmentation is critical to oral implantology, particularly in some cases. The morphology of the sinus floor reflects the lifting effect to a certain extent; however, there has been limited research on the morphology after sinus augmentation. The present study aims to investigate the relationship between residual bone height (RBH) and the morphology of the sinus floor and determine whether a correlation exists between the different evaluation classifications. Maxillary sinus floor augmentation procedures were performed in 56 patients and 68 teeth using the sinus crest approach (SCA). Imaging results obtained after one year of sinus augmentation were analyzed and simultaneously classified along the coronal plane, the sagittal plane, and the biplane (coronal-sagittal). The higher the RBH, the closer the result tends to be to A, A', or type 1 (more satisfactory). There was a significant correlation between the three different evaluation classifications (p < 0.05). The morphology of perforation cases was involved in types C, D, C', and D'. A more satisfactory post-lifting morphology (tent type and flat type) is probably related to an optimal preoperative bone height, and an unsatisfactory post-lifting morphology is related to a low preoperative sinus floor height. The sagittal plane evaluation correlates with the coronal plane and biplane evaluation and is thus more recommended.
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Affiliation(s)
- Zhi Wang
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Qi Jia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Heng Bo Jiang
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Jinan, Shandong 250117, China
| | - Jianmin Han
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Lidong Zou
- Second Clinical Division, School and Hospital of Stomatology, Peking University, Beijing 100101, China
| | - Guangliang Niu
- Department of Oral Prosthodontics, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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Vaquette C, Mitchell J, Fernandez-Medina T, Kumar S, Ivanovski S. Resorbable additively manufactured scaffold imparts dimensional stability to extraskeletally regenerated bone. Biomaterials 2021; 269:120671. [PMID: 33493771 DOI: 10.1016/j.biomaterials.2021.120671] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 12/19/2022]
Abstract
Dimensionally stable vertical bone regeneration outside of the existing bony envelope is a major challenge in the field of orofacial surgery. In this study, we demonstrate that a highly porous, resorbable scaffold fabricated using additive manufacturing techniques enables reproducible extra-skeletal bone formation and prevents bone resorption. An additively manufactured medical grade polycaprolactone (mPCL) biphasic scaffold mimicking the architecture of the jaw bone, consisting of a 3D-printed outer shell overlying an inner highly porous melt electrowritten scaffold, was assessed for its ability to support dimensionally stable bone regeneration in an extraskeletal ovine calvarial model. To investigate bone formation capacity (stage 1), 7 different constructs placed under a protective dome were assessed 8 weeks post-implantation: Empty control, Biphasic scaffold with hydrogel (PCL-Gel), PCL-Gel with 75 or 150 μg of BMP-2 (PCL-BMP-75 and PCL-BMP-150), hydrogel only (Gel), Gel containing 75 or 150 μg of BMP-2 (Gel-BMP-75 and Gel-BMP-150). To assess dimensional stability (stage 2), in a separate cohort, 5 animals were similarly implanted with 2 samples of each of the Gel-BMP-150 and PCL-BMP-150 groups, and after 8 weeks of healing, the protective domes were removed and titanium implants were placed in the regenerated bone and allowed to heal for a further 8 weeks. Bone formation and osseointegration were assessed using micro-computed tomography, histology and histomorphometry. In stage 1, enhanced bone formation was found in the BMP-2 containing groups, especially the PCL-BMP constructs whereby regeneration of full bone height was achieved in a reproducible manner. There was no significant bone volume increase with the higher dose of BMP-2. In the dimensional stability assessment (stage 2), after the rtemoval of the protective dome, the biphasic scaffold prevented bone resorption whereas in the absence of the scaffold, the bone previously formed in the hydrogel underwent extensive resorption. This was attributed to the space maintenance properties and dimensional stability of the biphasic scaffold. Titanium implants osseointegrated into the newly formed bone within the biphasic scaffolds. In conclusion, additively manufactured biphasic scaffolds functionalized with BMP-2 facilitated dimensionally stable bone regeneration that supported dental implant osseointegration.
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Affiliation(s)
- C Vaquette
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - J Mitchell
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - T Fernandez-Medina
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
| | - S Kumar
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - S Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
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Mendes LD, Bustamante RPC, Vidigal BCL, Favato MN, Manzi FR, Cosso MG, Zenóbio EG. Effect of amount of biomaterial used for maxillary sinus lift on volume maintenance of grafts. J Clin Exp Dent 2020; 12:e830-e837. [PMID: 32994871 PMCID: PMC7511044 DOI: 10.4317/jced.56315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/14/2020] [Indexed: 11/11/2022] Open
Abstract
Background Regardless of the kind of biomaterial used for the graft, it is clear that, over time, the graft undergoes dimensional changes that could influence the final bone volume obtained, which could alter the stability of the installed implants. The aim of the present study was to compared and correlated the graft behavior with the amount (in grams) of xenogeneic and alloplastic biomaterials used in grafts for maxillary sinus lift.
Material and Methods This retrospective cohort study used 148 CBCT images of 74 grafts from 68 maxillary sinuses lift patients in a university, post-graduate clinic. The weights of biomaterials, categorized in intervals according to amount used, were correlated with the graft volumes at V1 (10 days) and V2 (180 days). Kruskal-Wallis test was used to evaluate the possible bias effect of weight on graft maintenance.
Results Mean weights of biomaterials used were: Bio-Oss Small® (1.58g); Bio-Oss Large® (1.35g); Endobon® (0.72g); BoneCeramic®+Emdogaim® (0.96g); Cerasorb® (1.13g) and Osteogen® (2.70g). No significant differences (p>0.05). Were found for the influence of these mean amounts in graft maintenance: Bio-Oss Small® (18); Bio-Oss Large® (10); Endobon® (17); BoneCeramic®+Emdogaim® (10); Cerasorb® (11); and Osteogen® (08) at V1 and V2. However, when biomaterials were categorized by intervals, all Cerasorb® interval groups showed statistically significant differences (p<0.001) in graft volume at V2.
Conclusions The amounts of the biomaterials used could influence the final volume; depending on the biomaterial characteristics. Implant installation was possible with all studied grafts, although graft volume shrinkage should be considered when selecting biomaterial for sinus lift. Key words:Biocompatible materials; cone beam computed tomography; maxillary sinus; hydroxyapatites.
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Affiliation(s)
- Luciene-Dornas Mendes
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Roberta-Paula-Colen Bustamante
- Post-graduate, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno-César-Ladeira Vidigal
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mario-Nazareno Favato
- Post-graduate, Dentistry Department Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Flávio-Ricardo Manzi
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mauricio-Greco Cosso
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Elton-Gonçalves Zenóbio
- Associated Professor, Dentistry Department, Implant Master's Program Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Xu J, Wang S, Zhou Z, Liu J, Jiang X, Chen X. Automatic CT image segmentation of maxillary sinus based on VGG network and improved V-Net. Int J Comput Assist Radiol Surg 2020; 15:1457-1465. [PMID: 32676871 DOI: 10.1007/s11548-020-02228-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/06/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE The analysis of the maxillary sinus (MS) can provide an assessment for many clinical diagnoses, so accurate CT image segmentation of the MS is essential. However, common segmentation methods are mainly done by experienced doctors manually, and there are some challenges such as low efficiency and precision. As for automatic methods, the initial seed points and adjustment of various parameters are required, which will affect the segmentation efficiency. Thus, accurate, efficient, and automatic segmentation method of MS is critical to promote the clinical application. METHODS This paper proposed an automatic CT image segmentation method of MS based on VGG network and improved V-Net. The VGG network was established to classify CT slices, which can avoid the failure of CT slice segmentation without MS. Then, we proposed the improved V-Net based on edge supervision for segmenting MS regions more effectively. The edge loss was integrated into the loss of the improved V-Net, which could reduce region misjudgment and improve the automatic segmentation performance. RESULTS For the classification of CT slices with MS and without MS, the VGG network had a classification accuracy of 97.04 ± 2.03%. In the segmentation, our method obtained a better result, in which the segmentation Dice reached 94.40 ± 2.07%, the Iou (intersection over union) was 90.05 ± 3.26%, and the precision was 94.72 ± 2.64%. Compared with U-Net and V-Net, it reduced region misjudgment significantly and improved the segmentation accuracy. By analyzing the error map of 3D reconstruction, it was mainly distributed in ± 1 mm, which demonstrated that our result was quite close to the ground truth. CONCLUSION The segmentation of the MS can be realized efficiently, accurately, and automatically by our method. Meanwhile, it not only has a better segmentation result, but also improves the doctor's work efficiency, which will have significant impact on clinical applications in the future.
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Affiliation(s)
- Jiangchang Xu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - Shiming Wang
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - Zijie Zhou
- Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiannan Liu
- Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyi Jiang
- Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China.
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Kwon JJ, Hwang J, Kim YD, Shin SH, Cho BH, Lee JY. Automatic three-dimensional analysis of bone volume and quality change after maxillary sinus augmentation. Clin Implant Dent Relat Res 2019; 21:1148-1155. [PMID: 31651078 DOI: 10.1111/cid.12853] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/08/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Maxillary sinus augmentation is a widely used surgical procedure to increase the bone volume before implant placement. In order to predict the stability of the implant, analysis of the change in bone volume and quality after a sinus graft procedure is necessary. The purpose of this study was to analyze the change in volume and quality of bone graft material after maxillary sinus augmentation using cone beam computed tomography (CBCT). METHODS AND MATERIALS Maxillary sinus lift procedures using bovine bone materials (Bio-Oss, Geistrich, Swiss) without immediate implantation were performed at the Pusan National University Dental Hospital in 22 patients, from 2014 to 2017. CBCT images were captured before surgery (T1), a day after surgery (T2), and after 4 to 7 months at follow-up (T3). The T2 and T3 images were registered to the T1 image using histogram matching and intensity-based registration. A total of 30 sinuses were analyzed three-dimensionally (3-D), using self-made software MATLAB 2018a (MathWorks, Natick, Massachusetts). The volume and structural indices of the bone graft material were measured and analyzed. RESULTS The average volume of graft material showed a decrease, while the average gray value showed an increase during the follow-up period, but these changes were not statistically significant. The structural indices of the graft material after histogram matching showed a significant difference in homogeneity, connectivity, thickness, and roughness at the postoperative follow-up. CONCLUSIONS The volume and gray value showed no statistically significant changes after the maxillary sinus lift procedures. The results of this study show that structural analysis using histogram matching can be used as a promising tool to analyze the quality of graft materials.
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Affiliation(s)
- Jin-Ju Kwon
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - JaeJoon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Yong-Deok Kim
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Korea
| | - Jae-Yeol Lee
- Department of Oral and Maxillofacial Surgery, Pusan National University, Dental Research Institute, Yangsan, Korea
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Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Eghbali A. A 2-year prospective case series on volumetric changes, PROMs, and clinical outcomes following sinus floor elevation using deproteinized bovine bone mineral as filling material. Clin Implant Dent Relat Res 2019; 21:301-309. [PMID: 30740863 DOI: 10.1111/cid.12730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited. PURPOSE First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes. MATERIALS AND METHODS Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered. RESULTS Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm3 at 2 weeks, 1201.21 mm3 at 3 months, and 1130.13 mm3 at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions. CONCLUSION Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.
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Affiliation(s)
- Faris Younes
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
| | - Robbert Cleymaet
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Aryan Eghbali
- Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Periodontology and Oral Implantology, Dental School, Ghent University, Ghent, Belgium
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Sudheesh Kumar P, Hashimi S, Saifzadeh S, Ivanovski S, Vaquette C. Additively manufactured biphasic construct loaded with BMP-2 for vertical bone regeneration: A pilot study in rabbit. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 92:554-564. [DOI: 10.1016/j.msec.2018.06.071] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/29/2018] [Accepted: 06/30/2018] [Indexed: 12/18/2022]
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Cruz AD, Peixoto GA, Aguiar MF, Camargo GACG, Homs N. Surgeons' Performance Determining the Amount of Graft Material for Sinus Floor Augmentation Using Tomography. Braz Dent J 2018; 28:385-390. [PMID: 29297561 DOI: 10.1590/0103-6440201601442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach's a. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm3) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better.
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Affiliation(s)
- Adriana Dibo Cruz
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | - Guilherme Alvares Peixoto
- Postgraduate Program, Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | - Marcelo Freitas Aguiar
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
| | | | - Nicolas Homs
- Specific Formation Dept., Dental School, UFF - Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil
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Subantral Augmentation With Mineralized Cortical Bone Allograft Material: Clinical, Histological, and Histomorphometric Analyses and Graft Volume Assessments. IMPLANT DENT 2017; 25:353-60. [PMID: 26866847 DOI: 10.1097/id.0000000000000391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to clinically and histologically evaluate the effect of using mineralized cortical bone allograft in sinus lift augmentation and to 3-dimensionally quantify volumetric changes in maxillary sinuses augmented over a 2-year period. MATERIALS AND METHODS Eleven patients affected with less than 3 mm of residual ridge were enrolled in the study. After sinus grafting with a mineralized bone allograft, the site was covered with a collagen wound dressing. During implant placement 4 months later, a biopsy was obtained for histological and histomorphometry evaluations. Bone volume changes were also evaluated. RESULTS Biopsies showed mature cancellous bone with a predominantly lamellar structure. The well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Histomorphometry evaluations revealed a mean 43.76 ± 1.47% of bone marrow, 40.16 ± 1.35% of mineralized bone and 16.59 ± 0.55% of woven bone. The mean of residual particles was 0.47 ± 0.01%. Volumetric measurements showed a mean volume of grafted material 16.24 ± 1.55 cm at T0, 14.48 ± 1.48 cm at T1, and 13.06 ± 1.39 cm at T2. The mean volume retraction was 10.83% of the initial total volume at (T0-T1) and 9.8% at (T1-T2). CONCLUSIONS The clinical and histological results indicated that mineralized cortical bone allograft promoted de novo bone formation and can be used for sinus lift procedure.
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Temmerman A, Van Dessel J, Cortellini S, Jacobs R, Teughels W, Quirynen M. Volumetric changes of grafted volumes and the Schneiderian membrane after transcrestal and lateral sinus floor elevation procedures: A clinical, pilot study. J Clin Periodontol 2017; 44:660-671. [PMID: 28382627 DOI: 10.1111/jcpe.12728] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/29/2022]
Abstract
AIM To investigate the influence of various surgical techniques for sinus augmentation on the volumetric changes of graft, membrane and the post-operative discomfort. MATERIALS AND METHODS Eighteen patients in need of bilateral sinus floor elevation (SFE) were assigned to lateral SFE, transcrestal SFE and intralift procedures. CBCT images taken at baseline, 1 week and 6 weeks were analysed for volumetric changes in graft and Schneiderian membrane. Questionnaires were used to analyse post-op discomfort. RESULTS The overall average graft volume obtained after 1 week was 1.87 cm3 (range 0.12-4.72 cm3 ). Volumes decreased after 6 weeks to an overall mean volume of 1.33 cm3 (range 0.10-4.29 cm3 - average decrease of 27.6%). After 6 weeks, the amount of graft volume decreased in every treatment option, ranging from -23.13% for the tSFE, over -24.55% for the lSFE, to -33.71% for the IL. Although all treatment options correspond in an increase in Schneiderian membrane volume, no statistically significant correlation between this increase and loss of graft volume could be obtained for all treatments (p = 0.97). CONCLUSION All SFE techniques provided sufficient graft volume for implant treatment. All techniques provoke a partially transient swelling of the Schneiderian membrane. All techniques resulted in a decrease in graft volume after 6 weeks; however, no significant differences were obtained between treatments. Furthermore, no statistical significant correlation between the post-operative swelling of the Schneiderian membrane and reduction in graft volume at 6 weeks could be obtained.
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Affiliation(s)
- Andy Temmerman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Jeroen Van Dessel
- Department of Maxillofacial Surgery, OMFS-Impath Research Group, Leuven, Belgium
| | - Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Maxillofacial Surgery, OMFS-Impath Research Group, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, Leuven, Belgium
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Umanjec-Korac S, Parsa A, Darvishan Nikoozad A, Wismeijer D, Hassan B. Accuracy of cone beam computed tomography in following simulated autogenous graft resorption in maxillary sinus augmentation procedure: an ex vivo study. Dentomaxillofac Radiol 2016; 45:20160092. [PMID: 27225346 DOI: 10.1259/dmfr.20160092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: Maxillary sinus augmentation is a well-documented procedure with long-term success in implant dentistry. Assessing graft volume changes over time is crucial, since resorption remains a major concern. CBCT is commonly employed to assess the quantity and quality of the available bone at the implant receptor site. However, its applicability in following graft volume changes is yet to be determined. The study aimed to assess CBCT accuracy in following simulated graft resorption ex vivo. METHODS: 4 differently sized autogenous bone blocks harvested from the zygomatic buttress were bilaterally placed in the maxillary sinus of 12 human cadavers. The Accuitomo (J Morita, Kyoto, Japan) CBCT system was employed to scan each one of the 4 grafts in each of the 12 cadavers using identical settings. Gold standard graft measurements were obtained using micro-CT. One independent observer assessed the volume of each graft on CBCT images twice. Intraobserver reliability was assessed using Cohen's kappa and one-sample t-test was used to compare CBCT with micro-CT volumetric measurements. RESULTS: The mean micro-CT graft volumes were 97.12 ± 1.4, 197.32 ± 3.4, 361.41 ± 4.2 and 1040.11 ± 3.2 mm3 for Grafts 1-4, respectively, and the mean CBCT volumes of the corresponding grafts were 115.39 ± 7.01, 205.97 ± 9.91, 404.05 ± 16.81 and 1138.04 ± 20.98 mm3. CBCT measurements were statistically significantly different from micro-CT measurements (p = 0.001). Intraobserver reliability was good (r = 0.78). CONCLUSIONS: In every case, CBCT overestimated the maxillary graft volume in comparison with micro-CT. However, the measurement differences were limited and might not influence clinical performance.
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Affiliation(s)
- Sanja Umanjec-Korac
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Azin Parsa
- 2 Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Aria Darvishan Nikoozad
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Daniel Wismeijer
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Bassam Hassan
- 1 Department of Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
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