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Feng Y, Tao B, Fan J, Wang S, Mo J, Wu Y, Liang Q. Automatic planning of maxillary anterior dental implant based on prosthetically guided and pose evaluation indicator. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03142-x. [PMID: 38735893 DOI: 10.1007/s11548-024-03142-x] [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: 06/08/2023] [Accepted: 04/04/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Preoperative planning of maxillary anterior dental implant is a prerequisite to ensuring that the implant achieves the proper three-dimensional (3D) pose, which is essential for its long-term stability. However, the current planning process is labor-intensive and subjective, relying heavily on the surgeon's experience. Consequently, this paper proposes an automatic method for computing the optimal pose of the dental implant. METHODS The method adopts the principle of prosthetically guided dental implant placement. Initially, the prosthesis coordinate system is established to determine the implant candidate orientations. Subsequently, virtual slices of the maxilla in the buccal-palatal direction are generated according to the prosthesis position. By extracting feature points from the virtual slices, the implant candidate starting points are acquired. Then, a candidate pose set is obtained by combining these candidate starting points and orientations. Finally, a pose evaluation indicator is introduced to determine the optimal implant pose from this set. RESULTS Twenty-two cases were utilized to validate the method. The results show that the method could determine an ideal pose for the dental implant, with the average minimum distance between the implant and the left tooth root, the right tooth root, the palatal side, and the buccal side being 2.57 ± 0.53 mm, 2.59 ± 0.65 mm, 0.74 ± 0.19 mm, 1.83 ± 0.16 mm, respectively. The planning time was less than 9 s. CONCLUSION Unlike manual planning, the proposed method can efficiently and accurately complete maxillary anterior dental implant planning, providing a theoretical analysis of the success rate of the implant. Thus, it has great potential for future clinical application.
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Affiliation(s)
- Yuan Feng
- School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - BaoXin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - JiaCheng Fan
- School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - ShiGang Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - JinQiu Mo
- School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China
| | - YiQun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
| | - QingHua Liang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Dongchuan Road 800, Minhang District, Shanghai, 200240, China.
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Altalhi AM, Alharbi FS, Alhodaithy MA, Almarshedy BS, Al-Saaib MY, Al Jfshar RM, Aljohani AS, Alshareef AH, Muhayya M, Al-Harbi NH. The Impact of Artificial Intelligence on Dental Implantology: A Narrative Review. Cureus 2023; 15:e47941. [PMID: 38034167 PMCID: PMC10685062 DOI: 10.7759/cureus.47941] [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: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Implant dentistry has witnessed a transformative shift with the integration of artificial intelligence (AI) technologies. This article explores the role of AI in implant dentistry, emphasizing its impact on diagnostics, treatment planning, and patient outcomes. AI-driven image analysis and deep learning algorithms enhance the precision of implant placement, reducing risks and optimizing aesthetics. Moreover, AI-driven data analytics provide valuable insights into patient-specific treatment strategies, improving overall success rates. As AI continues to evolve, it promises to reshape the landscape of implant dentistry and lead in an era of personalized and efficient oral healthcare.
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Affiliation(s)
| | | | | | | | | | | | | | - Adeeb H Alshareef
- Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Fuglsig JMDCES, Hansen B, Schropp L, Nixdorf DR, Wenzel A, Spin-Neto R. Alveolar bone measurements in magnetic resonance imaging compared with cone beam computed tomography: a pilot, ex-vivo study. Acta Odontol Scand 2023; 81:241-248. [PMID: 36112428 DOI: 10.1080/00016357.2022.2121321] [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: 11/01/2022]
Abstract
OBJECTIVES To compare alveolar bone height and width measurements from zero-echo-time MRI (ZTE-MRI) and cone beam CT (CBCT), in human specimens. MATERIAL AND METHODS Twenty posterior edentulous sites in human cadaver specimens were imaged with CBCT and ZTE-MRI. Bone height and width at 1, 3, 5, 7 and 9 mm from the top of the alveolar ridge was measured by two trained observers in cross-sections of a site where an implant was to be planned. Twenty percent of the sample was measured in duplicate to assess method error and intra-observer reproducibility (ICC). The differences between CBCT and ZTE-MRI measurements were compared (t-test). RESULTS Inter- and intra-observer reproducibility was >0.90. The method error (average between observers) for bone height was 0.45 mm and 0.39 mm, and for bone width (average) was 0.52 mm and 0.80 mm (CBCT and ZTE-MRI, respectively). The majority of the bone measurement differences were statistically insignificant, except bone width measurements at 5 mm (p ≤ .05 for both observers). Mean measurement differences were not larger than the method error. CONCLUSION ZTE-MRI is not significantly different from CBCT when comparing measurements of alveolar bone height and width.
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Affiliation(s)
| | - Brian Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
- Department of Radiology, Medical School, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
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Park WS, Huh JK, Lee JH. Automated deep learning for classification of dental implant radiographs using a large multi-center dataset. Sci Rep 2023; 13:4862. [PMID: 36964171 PMCID: PMC10039053 DOI: 10.1038/s41598-023-32118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/22/2023] [Indexed: 03/26/2023] Open
Abstract
This study aimed to evaluate the accuracy of automated deep learning (DL) algorithm for identifying and classifying various types of dental implant systems (DIS) using a large-scale multicenter dataset. Dental implant radiographs of pos-implant surgery were collected from five college dental hospitals and 10 private dental clinics, and validated by the National Information Society Agency and the Korean Academy of Oral and Maxillofacial Implantology. The dataset contained a total of 156,965 panoramic and periapical radiographic images and comprised 10 manufacturers and 27 different types of DIS. The accuracy, precision, recall, F1 score, and confusion matrix were calculated to evaluate the classification performance of the automated DL algorithm. The performance metrics of the automated DL based on accuracy, precision, recall, and F1 score for 116,756 panoramic and 40,209 periapical radiographic images were 88.53%, 85.70%, 82.30%, and 84.00%, respectively. Using only panoramic images, the DL algorithm achieved 87.89% accuracy, 85.20% precision, 81.10% recall, and 83.10% F1 score, whereas the corresponding values using only periapical images achieved 86.87% accuracy, 84.40% precision, 81.70% recall, and 83.00% F1 score, respectively. Within the study limitations, automated DL shows a reliable classification accuracy based on large-scale and comprehensive datasets. Moreover, we observed no statistically significant difference in accuracy performance between the panoramic and periapical images. The clinical feasibility of the automated DL algorithm requires further confirmation using additional clinical datasets.
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Affiliation(s)
- Won-Se Park
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
| | - Jae-Hong Lee
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, Korea.
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Ishida E, Kunimatsu R, Medina CC, Iwai K, Miura S, Tsuka Y, Tanimoto K. Dental and Occlusal Changes during Mandibular Advancement Device Therapy in Japanese Patients with Obstructive Sleep Apnea: Four Years Follow-Up. J Clin Med 2022; 11:jcm11247539. [PMID: 36556156 PMCID: PMC9782911 DOI: 10.3390/jcm11247539] [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: 09/23/2022] [Revised: 11/30/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Dentoskeletal changes caused by the long-term use of mandibular advancement devices (MADs) for obstructive sleep apnea (OSA) have rarely been investigated in Japan. We assessed the long-term dentofacial morphological changes in 15 Japanese patients with OSA who used two-piece MADs for an average of 4 years. Lateral cephalography analyses were performed initially and 4 years later (T1). The dental assessment included overjet, overbite, upper anterior facial height, lower anterior facial height (LAFH), total anterior facial height (TAFH), and anterior facial height ratio. Dental casts were digitized and analyzed using a 3D scanner. Changes in the apnea hypopnea index (AHI) and other sleep-assessment indices were assessed using polysomnography and out-of-center sleep testing. Radiography revealed lingual inclination of the maxillary central incisors, labial inclination of the mandibular central incisors, clockwise rotation of the mandible, and an increase in the TAFH and LAFH at T1. In the dental cast analysis, the diameter width and palatal depth tended to decrease and increase, respectively. There was a significant decrease in the AHI and other sleep assessment indices after using the MADs for approximately 4 years. However, these findings do not provide a strong basis and should be interpreted cautiously. Future studies should have a larger sample size and should further investigate the long-term occlusal and dental changes caused by the original MADs in Japanese patients with OSA.
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Kripfgans OD, Goli ND, Majzoub J, De Siqueira RAC, Soki F, Chan HL. Ultrasound insonation angle and scanning imaging modes for imaging dental implant structures: A benchtop study. PLoS One 2022; 17:e0270392. [PMID: 36445898 PMCID: PMC9707752 DOI: 10.1371/journal.pone.0270392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 06/09/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION High frequency ultrasound has shown as a promising imaging modality to evaluate peri-implant tissues. It is not known if the ultrasound imaging settings might influence ultrasound's ability to differentiate implant structures. The aim of this benchtop study was to evaluate the dependence of ultrasound on imaging angles and modes to measure implant geometry-related parameters. METHODS A clinical ultrasound scanner (ZS3, Mindray) with an intraoral probe (L30-8) offering combinations of harmonic and compound imaging modes was employed for imaging 16 abutments and 4 implants. The samples were mounted to a micro-positioning system in a water tank, which allowed a range of -30 to 30-degree imaging angles in 5-degree increment between the probe and samples. The abutment angle, implant thread pitch and depth were measured on ultrasound, compared to the reference readings. The errors were computed as a function of the image angles and modes. All samples were replicated 3 times for 3 image modes and 11 image angles, thus resulting in 2,340 images. RESULTS The mean errors of ultrasound to estimate 16 abutment angles, compared to the reference values, were between -1.8 to 2.7 degrees. The root mean squared error (RMSE) ranged from 1.5 to 4.6 degrees. Ultrasound significantly overestimated the thread pitch by 26.1 μm to 36.2 μm. The error in thread depth measurements were in a range of -50.5 μm to 39.6 μm, respectively. The RMSE of thread pitch and depth of the tested 4 implants was in a range of 34.7 to 56.9 μm and 51.0 to 101.8 μm, respectively. In most samples, these errors were independent of the image angle and modes. CONCLUSIONS Within the limitations of this study, high-frequency ultrasound was feasible in imaging abutments and implant fixtures independent of scanning angle within ±30° of normal incidence and for compounding and non-compounding-based imaging modes.
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Affiliation(s)
- Oliver D. Kripfgans
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Nikhila Devi Goli
- Department of Periodontics and Oral, Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
| | - Jad Majzoub
- Department of Periodontics and Oral, Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
| | | | - Fabiana Soki
- Department of Periodontics and Oral, Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
| | - Hsun-Liang Chan
- Department of Periodontics and Oral, Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
- * E-mail:
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Al-Sarem M, Al-Asali M, Alqutaibi AY, Saeed F. Enhanced Tooth Region Detection Using Pretrained Deep Learning Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15414. [PMID: 36430133 PMCID: PMC9692549 DOI: 10.3390/ijerph192215414] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/15/2023]
Abstract
The rapid development of artificial intelligence (AI) has led to the emergence of many new technologies in the healthcare industry. In dentistry, the patient's panoramic radiographic or cone beam computed tomography (CBCT) images are used for implant placement planning to find the correct implant position and eliminate surgical risks. This study aims to develop a deep learning-based model that detects missing teeth's position on a dataset segmented from CBCT images. Five hundred CBCT images were included in this study. After preprocessing, the datasets were randomized and divided into 70% training, 20% validation, and 10% test data. A total of six pretrained convolutional neural network (CNN) models were used in this study, which includes AlexNet, VGG16, VGG19, ResNet50, DenseNet169, and MobileNetV3. In addition, the proposed models were tested with/without applying the segmentation technique. Regarding the normal teeth class, the performance of the proposed pretrained DL models in terms of precision was above 0.90. Moreover, the experimental results showed the superiority of DenseNet169 with a precision of 0.98. In addition, other models such as MobileNetV3, VGG19, ResNet50, VGG16, and AlexNet obtained a precision of 0.95, 0.94, 0.94, 0.93, and 0.92, respectively. The DenseNet169 model performed well at the different stages of CBCT-based detection and classification with a segmentation accuracy of 93.3% and classification of missing tooth regions with an accuracy of 89%. As a result, the use of this model may represent a promising time-saving tool serving dental implantologists with a significant step toward automated dental implant planning.
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Affiliation(s)
- Mohammed Al-Sarem
- College of Computer Science and Engineering, Taibah University, Medina 42353, Saudi Arabia
- Department of Computer Science, Sheba Region University, Marib 14400, Yemen
| | - Mohammed Al-Asali
- College of Computer Science and Engineering, Taibah University, Medina 42353, Saudi Arabia
| | - Ahmed Yaseen Alqutaibi
- Department of Prosthodontics and Implant Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia
- Department of Prosthodontics, College of Dentistry, Ibb University, Ibb 70270, Yemen
| | - Faisal Saeed
- College of Computer Science and Engineering, Taibah University, Medina 42353, Saudi Arabia
- DAAI Research Group, Department of Computing and Data Science, School of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK
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Torabi S, Panjnoush M, Poursafar F, Taheri M, Khorsand A, Yaghobee S. Comparison of Ridge Mapping and Cone Beam Computed Tomography for the Determination of Alveolar Ridge Width. J Maxillofac Oral Surg 2022; 21:802-807. [PMID: 36274889 PMCID: PMC9474968 DOI: 10.1007/s12663-021-01530-3] [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: 11/04/2020] [Accepted: 02/06/2021] [Indexed: 10/21/2022] Open
Abstract
Objective This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) and ridge mapping for linear measurement of alveolar ridge width. Materials and methods In this cross-sectional study, 25 implant placement sites in 25 patients were selected and an acrylic stent was fabricated for each one. Three buccal-lingual point pairs were located on the stent at 4-, 7-, and 10-mm distances from the soft tissue summit of the alveolar ridge. The measurements were recorded by three examiners (two periodontists and one radiologist). Results Both techniques (CBCT and ridge mapping) overestimated alveolar ridge width compared to direct measurements, but mean differences compared to direct measurements (gold standard) were not statistically significant. The lowest mean difference compared to direct measurements was related to the ridge mapping technique, and CBCT measurements were less accurate to measure the alveolar ridge width. Conclusion In determining alveolar ridge width, ridge mapping and CBCT are both valid and useful. Ridge mapping provides high accuracy, simplicity, and lack of radiation exposure.
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Affiliation(s)
- Sepehr Torabi
- Department of Periodontics, Tehran University of Medical Sciences Dental School, Tehran, Iran
| | - Mehrdad Panjnoush
- Department of Oral and Maxillofacial Radiology, Tehran University of Medical Sciences Dental School, Tehran, Iran
| | - Farzaneh Poursafar
- Department of Periodontics, Tehran University of Medical Sciences Dental School, Tehran, Iran
| | - Mina Taheri
- Department of Periodontics, Tehran University of Medical Sciences Dental School, Tehran, Iran
| | - Afshin Khorsand
- Department of Periodontics, Tehran University of Medical Sciences Dental School, Tehran, Iran
| | - Siamak Yaghobee
- Department of Periodontics, Dental Implant Research Center, Tehran University of Medical Sciences Dental School, Tehran, Iran
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Diagnostic performance of periapical and panoramic radiography and cone beam computed tomography for detection of circumferential gaps simulating osseointegration failure around dental implants: A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e208-e222. [PMID: 34580020 DOI: 10.1016/j.oooo.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective of this study was to appraise the diagnostic performance of periapical (PR) and panoramic (PANO) radiographs and cone beam computed tomography (CBCT) in detecting artificial circumferential gaps simulating osseointegration failure around dental implants in ex vivo studies. STUDY DESIGN Seven electronic databases and three gray literature sources were searched. Studies reporting diagnostic performance measures or data allowing calculation of those measures compared with the reference standard of in situ direct measurements were considered eligible. Either the area under the receiver operating characteristic curve or accuracy was chosen to summarize findings, with diagnostic performance interpreted as poor, acceptable, excellent, or outstanding. Risk of bias (RoB) was also assessed. RESULTS The ten included studies mostly suggested overall excellent to outstanding diagnostic capability with PR and CBCT. Various enhancement filters, CBCT voxel sizes, and/or fields of view were associated with acceptable to outstanding efficacy. PANO had the poorest results, with most research demonstrating acceptable to excellent discrimination. The RoB was high for seven studies, moderate for two, and low for -one. CONCLUSIONS PR and CBCT images were generally superior to PANO for the detection of artificial bone gaps. Results should be interpreted with caution because most studies had a high RoB.
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Chan C, Mirzaians A, Le BT. Outcomes of alveolar segmental 'sandwich' osteotomy with interpositional particulate allograft for severe vertical defects in the anterior maxilla and mandible. Int J Oral Maxillofac Surg 2021; 50:1617-1627. [PMID: 34229922 DOI: 10.1016/j.ijom.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 06/07/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to report the outcomes of interpositional osteotomy with mineralized allograft in the treatment of alveolar vertical defects in preparation for implant placement. Thirteen defects (11 maxillary and two mandibular) were treated with osteotomy segments ranging in length from two to five missing teeth. The segments were positioned 5-7 mm coronally, with the gap space filled with allograft and then fixated with titanium hardware. Vertical bone augmentation was analyzed by superimposing pre- and post-surgical cone beam computed tomography images and stratified based on the length and number of missing teeth in each edentulous segment. The mean vertical bone gain was 3.7 ± 1.6 mm in the area of greatest vertical defect and the mean length of the transport segment was 20.5 ± 8.1 mm. These segments represented two-, three-, four-, or five-tooth edentulous sites; the mean vertical bone gain for these segments was 1.7 ± 0.5 mm, 3.8 ± 1.0 mm, 4.6 ± 0.9 mm, and 6.7 ± 0.0 mm, respectively. Stability of vertical height gain was found to be directly proportional to the span length of the osteotomy segment, with the largest five-tooth segment achieving the greatest gain. Vertical bone gain in two-tooth segments was minimal, indicating a moderate amount of resorption.
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Affiliation(s)
- C Chan
- Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA, USA.
| | - A Mirzaians
- Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA, USA
| | - B T Le
- Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA, USA
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Kurt Bayrakdar S, Orhan K, Bayrakdar IS, Bilgir E, Ezhov M, Gusarev M, Shumilov E. A deep learning approach for dental implant planning in cone-beam computed tomography images. BMC Med Imaging 2021; 21:86. [PMID: 34011314 PMCID: PMC8132372 DOI: 10.1186/s12880-021-00618-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background The aim of this study was to evaluate the success of the artificial intelligence (AI) system in implant planning using three-dimensional cone-beam computed tomography (CBCT) images. Methods Seventy-five CBCT images were included in this study. In these images, bone height and thickness in 508 regions where implants were required were measured by a human observer with manual assessment method using InvivoDental 6.0 (Anatomage Inc. San Jose, CA, USA). Also, canals/sinuses/fossae associated with alveolar bones and missing tooth regions were detected. Following, all evaluations were repeated using the deep convolutional neural network (Diagnocat, Inc., San Francisco, USA) The jaws were separated as mandible/maxilla and each jaw was grouped as anterior/premolar/molar teeth region. The data obtained from manual assessment and AI methods were compared using Bland–Altman analysis and Wilcoxon signed rank test. Results In the bone height measurements, there were no statistically significant differences between AI and manual measurements in the premolar region of mandible and the premolar and molar regions of the maxilla (p > 0.05). In the bone thickness measurements, there were statistically significant differences between AI and manual measurements in all regions of maxilla and mandible (p < 0.001). Also, the percentage of right detection was 72.2% for canals, 66.4% for sinuses/fossae and 95.3% for missing tooth regions. Conclusions Development of AI systems and their using in future for implant planning will both facilitate the work of physicians and will be a support mechanism in implantology practice to physicians.
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Affiliation(s)
- Sevda Kurt Bayrakdar
- Department of Periodontology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, 06500, Ankara, Turkey. .,Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey.
| | - Ibrahim Sevki Bayrakdar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey.,Eskisehir Osmangazi University Center of Research and Application for Computer Aided Diagnosis and Treatment in Health, Eskisehir, Turkey
| | - Elif Bilgir
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskişehir, Turkey
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Domic D, Bertl K, Ahmad S, Schropp L, Hellén-Halme K, Stavropoulos A. Accuracy of cone-beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study. J Periodontol 2020; 92:592-601. [PMID: 32846005 PMCID: PMC8247288 DOI: 10.1002/jper.20-0222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone-beam computed tomography (CBCT) to determine the buccal bone level at titanium implants. METHODS Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface; thus, resulting in three BBT groups (i.e., >0.5 to 1.0; >1.0 to 1.5; >1.5 to 2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared with the direct measurements at the bone blocks. RESULTS While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤1.0 mm, a dehiscence was often diagnosed although not present, that is, the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm. CONCLUSIONS Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤1 mm thick, detection of the buccal bone level is largely inaccurate.
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Affiliation(s)
- Danijel Domic
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Salman Ahmad
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Lars Schropp
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
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Chan HL, Kripfgans OD. Ultrasonography for diagnosis of peri-implant diseases and conditions: a detailed scanning protocol and case demonstration. Dentomaxillofac Radiol 2020; 49:20190445. [PMID: 32017634 DOI: 10.1259/dmfr.20190445] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Ultrasonography has shown its promising diagnostic value in dental implant imaging research in the three treatment phases, namely, planning, intraoperative, and postoperative phase. With increasing awareness of peri-implant diseases and a lack of an efficient diagnostic method, the aim is to propose ultrasound imaging as a potential solution by providing a detailed scanning protocol and case demonstration. METHODS Ultrasound device specification and the setup for optimizing peri-implant tissue imaging was described. Two useful imaging modes, viz. B-mode and color flow, were introduced. Important anatomical structures for accurate diagnosis of peri-implant diseases were illustrated. Finally, a detailed scanning sequence was proposed. RESULTS Ultrasound images were acquired on live humans to exemplify the four peri-implant diseases and conditions, endorsed by the 2017 World Workshop organized by the American Academy of Periodontology and the European Federation of Periodontology. Ultrasound can provide not only cross-sectional anatomical images but also functional images (color flow images) that may be useful for evaluating the degree of peri-implant tissue inflammation. CONCLUSIONS High-frequency ultrasonography could be another cross-sectional imaging modality in adjunct to radiographs for diagnosing imminent peri-implant diseases and conditions that negatively influence quality of life of millions of patients with implants. This case study provides a framework for future related research work and clinical scanning guidelines.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA.,Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
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14
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Weiss R, Read-Fuller A. Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review. Dent J (Basel) 2019; 7:dj7020052. [PMID: 31052495 PMCID: PMC6631689 DOI: 10.3390/dj7020052] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022] Open
Abstract
Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.
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Affiliation(s)
- Robert Weiss
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
| | - Andrew Read-Fuller
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Attending Physician, Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
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15
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Özalp Ö, Tezerişener HA, Kocabalkan B, Büyükkaplan UŞ, Özarslan MM, Şimşek Kaya G, Altay MA, Sindel A. Comparing the precision of panoramic radiography and cone-beam computed tomography in avoiding anatomical structures critical to dental implant surgery: A retrospective study. Imaging Sci Dent 2019; 48:269-275. [PMID: 30607351 PMCID: PMC6305775 DOI: 10.5624/isd.2018.48.4.269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/07/2018] [Accepted: 10/19/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to evaluate the correlations between measurements made using panoramic radiography and cone-beam computed tomography (CBCT) based on certain anatomical landmarks of the jaws, with the goal of preventing complications due to inaccurate measurements in the pre-surgical planning phase of dental implant placement. Materials and Methods A total of 56 individuals who underwent panoramic radiography and a CBCT evaluation before dental implant surgery were enrolled in the study. Measurements were performed to identify the shortest vertical distance between the alveolar crest and neighboring anatomical structures, including the maxillary sinus, nasal floor, mandibular canal, and foramen mentale. The differences between the measurements on panoramic radiography and CBCT images were statistically analyzed. Results Statistically significant differences were observed between the measurements on panoramic radiography and CBCT for all anatomical structures (P<.05). The correlation coefficients (r) between the paired samples obtained from panoramic radiography and CBCT were closely correlated (P<.05), with r values varying from 0.921 and 0.979 for different anatomical regions. Conclusion The results of this study support the idea that panoramic radiography might provide sufficient information on bone height for preoperative implant planning in routine cases or when CBCT is unavailable. However, an additional CBCT evaluation might be helpful in cases where a safety margin cannot be respected due to insufficient bone height.
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Affiliation(s)
- Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | - Burak Kocabalkan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | | | - Göksel Şimşek Kaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Gomes AM, Douglas-de-Oliveira DW, Oliveira Costa F. Could the biomarker levels in saliva help distinguish between healthy implants and implants with peri-implant disease? A systematic review. Arch Oral Biol 2018; 96:216-222. [PMID: 30300769 DOI: 10.1016/j.archoralbio.2018.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/22/2018] [Accepted: 09/11/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND The most accurate data help to minimize possible mistakes on a patient´s evaluation, as more robust findings are necessary to establish a correct diagnosis, prognosis and, consequently, better treatment. PURPOSE Could biomarker levels in the saliva help to distinguish between healthy implants and implants with peri-implant disease? MATERIALS AND METHODS An electronic database search of Pubmed/MEDLINE, Web of Science, the Cochrane Library, OVID and Scielo was performed. The articles and abstracts identified were considered relevant if they compared cytokine levels in saliva from patients with healthy implants to those in saliva from patients with untreated peri-implantitis. RESULTS Lower salivary levels of interleukin 1β were found in healthy implants than in inflamed implants. A significantly positive correlation was found between the salivary levels of IL-6 and peri-implant inflammatory conditions. The salivary concentrations of total antioxidants, urate and ascorbate were higher in healthy implants than in inflamed implants. The data extracted from the 6 studies evaluated in this review revealed heterogeneity in relation to the clinical parameters assessed, implant restoration, bone loss and peri-implant disease definitions. CONCLUSIONS There was no clear, developed basis for using any specific biomarker in a clinical setting to distinguish between healthy implants and those with peri implant disease.
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Affiliation(s)
- Alex Martins Gomes
- Department of Periodontology, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Sala 3312, Belo Horizonte, Minas Gerais 31.270-901, Brazil.
| | - Dhelfeson Willya Douglas-de-Oliveira
- Department of Periodontology, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Sala 3312, Belo Horizonte, Minas Gerais 31.270-901, Brazil
| | - Fernando Oliveira Costa
- Department of Periodontology, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Sala 3312, Belo Horizonte, Minas Gerais 31.270-901, Brazil
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Fortes JH, de Oliveira-Santos C, Matsumoto W, da Motta RJG, Tirapelli C. Influence of 2D vs 3D imaging and professional experience on dental implant treatment planning. Clin Oral Investig 2018; 23:929-936. [PMID: 29907931 DOI: 10.1007/s00784-018-2511-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/04/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study investigated whether professional experience and type of image examination (panoramic radiography (PAN) or cone beam computed tomography (CBCT)) could influence the pre-surgical planning for dental implant treatment. MATERIALS AND METHODS Six dentists, from two different levels of experience (senior (Sr) and junior (Jr)) performed simulated pre-surgical planning by using PANs and after 1 month, by using CBCTs, considering implant length (IL), implant width (IW), need for bone graft (BG), and other surgical procedures (OP). Bland-Altman test and Kappa coefficient were used to identify agreements. RESULTS Bland-Altman test showed good agreement in the plans for inter-professional (i.e., Sr vs Jr) comparisons. Bland-Altman plots displayed intra-observer agreement (i.e., differences between PAN and CBCT), showing discrepancy between imaging modalities for IL and a tendency towards selecting larger dental implant options when using PAN and smaller options with CBCT. Kappa showed almost perfect (0.81-1.0) agreement between Jr and Sr for OP (PAN and CBCT). For BG, agreement was substantial (0.61-0.80) when planning was done with PAN and CBCT. Descriptive statistics showed evidence that when Jrs used CBCT, they no longer indicated the BG they had planned when they used PAN. CONCLUSION There were differences in the pre-surgical planning for treatment with dental implants depending on the professional experience and the type of imaging examination used. CLINICAL RELEVANCE Variation in dental implant planning can affect treatment time, cost, and morbidity in patients.
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Affiliation(s)
- João Henrique Fortes
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil
| | - Christiano de Oliveira-Santos
- Departament of Stomatology, Public Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil
| | - Wilson Matsumoto
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil
| | - Raphael Jurca Gonçalves da Motta
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil
| | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 14040-904, Brazil.
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Bhaskar V, Chan HL, MacEachern M, Kripfgans OD. Updates on ultrasound research in implant dentistry: a systematic review of potential clinical indications. Dentomaxillofac Radiol 2018; 47:20180076. [PMID: 29791198 DOI: 10.1259/dmfr.20180076] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Ultrasonography has shown promising diagnostic value in dental implant imaging research; however, exactly how ultrasound was used and at what stage of implant therapy it can be applied has not been systematically evaluated. Therefore, the aim of this review is to investigate potential indications of ultrasound use in the three implant treatment phases, namely planning, intraoperative and post-operative phase. METHODS Eligible manuscripts were searched in major databases with a combination of keywords related to the use of ultrasound imaging in implant therapy. An initial search yielded 414 articles, after further review, 28 articles were finally included for this systematic review. RESULTS Ultrasound was found valuable, though at various development stages, for evaluating (1) soft tissues, (2) hard tissues (3) vital structures and (4) implant stability. B-mode, the main function to image anatomical structures of interest, has been evaluated in pre-clinical and clinical studies. Quantitative ultrasound parameters, e.g. sound speed and amplitude, are being developed to evaluate implant-bone stability, mainly in simulation and pre-clinical studies. Ultrasound could be potentially useful in all three treatment phases. In the planning phase, ultrasound could evaluate vital structures, tissue biotype, ridge width/density, and cortical bone thickness. During surgery, it can provide feedback by identifying vital structures and bone boundary. At follow-up visits, it could evaluate marginal bone level and implant stability. CONCLUSIONS Understanding the current status of ultrasound imaging research for implant therapy would be extremely beneficial for accelerating translational research and its use in dental clinics.
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Affiliation(s)
| | - Hsun-Liang Chan
- 2 Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry , Ann Arbor, MI , USA
| | - Mark MacEachern
- 3 Taubman Health Sciences Library, University of Michigan , Ann Arbor, MI , USA
| | - Oliver D Kripfgans
- 4 Department of Biomedical Engineering, College of Engineering , Ann Arbor, MI , USA.,5 Department of Radiology, University of Michigan Medical School , Ann Arbor, MI , USA
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19
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Bornstein MM, Horner K, Jacobs R. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 2018; 73:51-72. [PMID: 28000270 DOI: 10.1111/prd.12161] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest.
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20
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Vidor MM, Liedke GS, Fontana MP, da Silveira HLD, Arus NA, Lemos A, Vizzotto MB. Is cone beam computed tomography accurate for postoperative evaluation of implants? An in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:500-505. [PMID: 28867464 DOI: 10.1016/j.oooo.2017.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/18/2017] [Accepted: 07/22/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT) for evaluation of the bone-implant interface in comparison with periapical radiography. STUDY DESIGN Titanium implants were inserted in 74 bovine rib blocks in intimate contact with bone walls and with a gap of 0.125 mm (simulating failure in the osseointegration process). Periapical radiographs were taken with conventional film, and CBCT scans were acquired with i-CAT (0.2 mm and 0.125 mm voxel) and Kodak (0.2 mm and 0.076 mm voxel) units. Three examiners evaluated the images using a 5-point scale. Diagnostic accuracy was analyzed through sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC) with 95% confidence intervals (CIs). Intra- and interexaminer agreements were analyzed through Kendall's concordance test. RESULTS Intra- and interexaminer agreements showed satisfactory results. The greatest accuracy was observed with conventional radiography (AUC = 0.963; CI 95% = 0.891-0.993). I-CAT 0.125-mm images showed good accuracy (AUC = 0.885; CI 95% = 0.790-0.947), with no significant difference compared with conventional radiography. Kodak images had high specificity and low sensitivity, presenting more false-negative results. CONCLUSIONS Conventional radiography showed the highest accuracy for assessment of the bone-implant interface. However, CBCT (i-CAT; 0.125-mm voxel), if available or if performed for preoperative assessment of another implant site, may provide similar accuracy.
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Affiliation(s)
- Michele Machado Vidor
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gabriela Salatino Liedke
- Oral Radiology, Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Mathias Pante Fontana
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Heraldo Luis Dias da Silveira
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Nadia Assein Arus
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Mariana Boessio Vizzotto
- Oral Radiology, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Sahota J, Bhatia A, Gupta M, Singh V, Soni J, Soni R. Reliability of Orthopantomography and Cone-beam Computed Tomography in Presurgical Implant Planning: A Clinical Study. J Contemp Dent Pract 2017; 18:665-669. [PMID: 28816186 DOI: 10.5005/jp-journals-10024-2103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Preoperative diagnosis and treatment planning are fundamental requirements to ensure success rate of implant. Cone-beam computed tomography (CBCT) provides all three dimensions and has been proved as a tool for radiology, especially in the success of implant. This study was conducted to evaluate the reliability of orthopantomography (OPG) and CBCT in presurgical implant planning. MATERIALS AND METHODS The study was conducted on 110 partially or completely edentulous adult patients (male 50 and female 60). Patient information regarding name, age, gender, and so forth was recorded. Thorough clinical examination was done to locate the edentulous site for the placement of implant. All patients were subjected to OPG and CBCT. The OPG was taken with digital panoramic unit (Planmeca) operating at 120 kVp, 2 mA, and exposure time of 17 seconds. The CBCT was taken using NewTom machine with field of view 11 × 8 cm and resolution of 0.3 × 0.3 × 0.3 mm operating at 120 kVp at 5 mA. NNT software with slice thickness of 0.1 mm was used in this study. Measurement of bone height and distance from anatomical structures was done on OPG, whereas bone height and bone width were measured on CBCT scan in all three planes, such as coronal plane, sagittal plane, and axial plane. The measurement was done by two experienced observers. RESULTS The present study comprised 110 patients (male 50 and female 60). About 102 (16.7%) implants were placed in anterior region, and 508 (83.3%) implants were placed in posterior region. Implant site was incisor region (55), canine (30), premolar (250), and molar (275). The difference was significant (p < 0.01). Variations are usually observed in presurgical planning with CBCT and OPG. The length and width of implant remained unchanged in 90 and 85% of the cases respectively. In 8% of cases, OPG revealed more length of implant than CBCT, whereas only in 2% cases CBCT revealed more length of implant than OPG. The difference was significant (p < 0.05). When we compared the diameter, OPG revealed more diameter in 10% of cases, whereas CBCT only revealed 5% of cases. The difference was significant (p < 0.05). Observer found CBCT as effective in 95% of cases and ineffective in only 5% of cases, whereas OPG was effective in 78% of cases and ineffective in 22% of cases. The different was significant (p < 0.05). CONCLUSION The CBCT being three-dimensional provides detailed information that two-dimensional radiographs cannot offer, which aids in precision to further improve the entire implant process. CLINICAL SIGNIFICANCE In recent times, implant has become the treatment of choice for edentulous patients. The CBCT has increased the success rate of implant due to its high resolution, ability to demonstrate anatomical structures more effectively than other radiographic diagnostic tools.
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Affiliation(s)
- Jasjit Sahota
- Department of Periodontics, Maharaja Ganga Singh Dental College & Research Centre, Sri Ganganagar, Rajasthan, India, Phone: +919501544877, e-mail:
| | - Aditya Bhatia
- Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Megha Gupta
- Department of Oral and Maxillofacial Surgery, SGT Dental College Hospital & Research Institute, Gurgaon, Haryana, India
| | - Vishal Singh
- Department of Prosthodontics, Vananchal Dental College Garhwa, Jharkhand, India
| | - Juhi Soni
- Department of Oral Pathology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Richa Soni
- Department of Oral Pathology, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
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Lee D, Park S, Noh WC, Im JS, Kim C. Photoacoustic imaging of dental implants in a porcine jawbone ex vivo. OPTICS LETTERS 2017; 42:1760-1763. [PMID: 28454154 DOI: 10.1364/ol.42.001760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Currently, x-ray-based imaging is used before and after the dental implant treatment, but the ionizing radiation is potentially harmful to patients and operators. Here, we demonstrate ex vivo photoacoustic imaging of a dental implant embedded in a porcine jawbone. By layering biological tissue over the jawbone to mimic a clinical environment, we demonstrate 10 mm deep imaging. Our results show that photoacoustic imaging can provide jawbone anatomical information, the location of an embedded implant fixture, and the thickness of the soft tissue above the jawbone.
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Is Cone-Beam Computed Tomography Always Necessary for Dental Implant Placement? J Oral Maxillofac Surg 2017; 75:285-289. [DOI: 10.1016/j.joms.2016.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/07/2016] [Accepted: 11/07/2016] [Indexed: 11/17/2022]
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Luo T, Shi C, Zhao X, Zhao Y, Xu J. Automatic Synthesis of Panoramic Radiographs from Dental Cone Beam Computed Tomography Data. PLoS One 2016; 11:e0156976. [PMID: 27300554 PMCID: PMC4907432 DOI: 10.1371/journal.pone.0156976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 05/23/2016] [Indexed: 11/19/2022] Open
Abstract
In this paper, we propose an automatic method of synthesizing panoramic radiographs from dental cone beam computed tomography (CBCT) data for directly observing the whole dentition without the superimposition of other structures. This method consists of three major steps. First, the dental arch curve is generated from the maximum intensity projection (MIP) of 3D CBCT data. Then, based on this curve, the long axial curves of the upper and lower teeth are extracted to create a 3D panoramic curved surface describing the whole dentition. Finally, the panoramic radiograph is synthesized by developing this 3D surface. Both open-bite shaped and closed-bite shaped dental CBCT datasets were applied in this study, and the resulting images were analyzed to evaluate the effectiveness of this method. With the proposed method, a single-slice panoramic radiograph can clearly and completely show the whole dentition without the blur and superimposition of other dental structures. Moreover, thickened panoramic radiographs can also be synthesized with increased slice thickness to show more features, such as the mandibular nerve canal. One feature of the proposed method is that it is automatically performed without human intervention. Another feature of the proposed method is that it requires thinner panoramic radiographs to show the whole dentition than those produced by other existing methods, which contributes to the clarity of the anatomical structures, including the enamel, dentine and pulp. In addition, this method can rapidly process common dental CBCT data. The speed and image quality of this method make it an attractive option for observing the whole dentition in a clinical setting.
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Affiliation(s)
- Ting Luo
- School of Mathematical Sciences, Capital Normal University, Beijing, China
- Beijing Higher Institution Engineering Research Center of Testing and Imaging, Beijing, China
| | - Changrong Shi
- School of Mathematical Sciences, Capital Normal University, Beijing, China
- Beijing Higher Institution Engineering Research Center of Testing and Imaging, Beijing, China
| | - Xing Zhao
- School of Mathematical Sciences, Capital Normal University, Beijing, China
- Beijing Higher Institution Engineering Research Center of Testing and Imaging, Beijing, China
- * E-mail:
| | - Yunsong Zhao
- School of Mathematical Sciences, Capital Normal University, Beijing, China
- Beijing Higher Institution Engineering Research Center of Testing and Imaging, Beijing, China
| | - Jinqiu Xu
- School of Mathematical Sciences, Capital Normal University, Beijing, China
- Beijing Higher Institution Engineering Research Center of Testing and Imaging, Beijing, China
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Wikner J, Friedrich RE, Rashad A, Schulze D, Hanken H, Heiland M, Gröbe A, Riecke B. Obstacles in spatial evaluation of CBCT-reformatted panoramic imaging. Dentomaxillofac Radiol 2016; 45:20150436. [PMID: 26959644 DOI: 10.1259/dmfr.20150436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Conventional panoramic radiography (cPR) underlines procedure-related limitations in the display of objects. CBCT is presumed to overcome these constraints. To virtualize a cPR view, reformatted panoramic images (rPIs) can be generated. This study evaluated the rPI with regard to its susceptibility to sterical object deposition in comparison with cPR. METHODS A specially developed implant model with dental implants each of 4.0-mm diameter and 11.0-mm length was depositioned by shift, rotation and tilt of 5.00 mm (±0.01 mm) of horizontal shift and 5.0° (±0.167°), respectively, on a highly precise goniometer rotation table, and cPRs and rPIs were generated. Automated evaluation of the cPRs was carried out using a specially developed software. rPIs were processed and analyzed by a semi-automated image analysis. RESULTS Object deposition lead to distortive effects in the rPI analogue to cPR, but they appear in display only. Objects illustrated in the rPI were dimensionally correct, but sterical relations are elusive. Results are obtained for the horizontal shift, declination and reclination, lateral tilt and rotation. CONCLUSIONS Distortions within the rPI represent the illustration of the hyperbolic-shaped layer out of the three-dimensional data set. With this study, we demonstrated these procedure-related inherent but practically underestimated consequences. Effects of sterical object malpositioning must be compensated by the observer by adequate virtual adjustment of the processed layer. Accurate virtual adjustment leads to vertical dimensions. Sterical relations, e.g. angulation of two objects, are irretraceable unless precisely referenced.
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Affiliation(s)
- Johannes Wikner
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Reinhard E Friedrich
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ashkan Rashad
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dirk Schulze
- 2 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henning Hanken
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Gröbe
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Riecke
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Dagassan-Berndt DC, Zitzmann NU, Walter C, Schulze RKW. Implant treatment planning regarding augmentation procedures: panoramic radiographs vs. cone beam computed tomography images. Clin Oral Implants Res 2015; 27:1010-6. [DOI: 10.1111/clr.12666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Dorothea C. Dagassan-Berndt
- Department for Oral Surgery, Oral Radiology and Oral Medicine; School of Dental Medicine; University of Basel; Basel Switzerland
| | - Nicola U. Zitzmann
- Department of Periodontology, Endodontology, and Cariology; University of Basel; Basel Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology, and Cariology; University of Basel; Basel Switzerland
| | - Ralf K. W. Schulze
- Department of Oral Surgery (and Oral Radiology); University Medical Center of the Johannes Gutenberg; University Mainz; Mainz Germany
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Zhang W, Skrypczak A, Weltman R. Anterior maxilla alveolar ridge dimension and morphology measurement by cone beam computerized tomography (CBCT) for immediate implant treatment planning. BMC Oral Health 2015; 15:65. [PMID: 26059796 PMCID: PMC4460662 DOI: 10.1186/s12903-015-0055-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/03/2015] [Indexed: 01/07/2023] Open
Abstract
Background Implants have been widely used to restore missing teeth. Limited information on applied anatomy at the anterior maxilla compromises the clinical outcome for implant placement in this region. In the current study, Cone Beam Computerized Tomography (CBCT) was used to measure alveolar ridge and buccal undercut dimension at the anterior maxilla to help develop treatment planning for immediate implant placement. Methods CBCT scans were screened to include 51 subjects with full dentition at right maxilla. Measurements were taken at the cross sectional views in the middle of the maxillary right central incisor, lateral incisor, and canine regions. Alveolar height was measured from the alveolar crest to floor of nasal fossa. Alveolar width was measured from the buccal to palatal cortical plate at the coronal, middle, and apical third of the distance from the alveolar crest to floor of the nasal fossa. Buccal undercut location was measured from where the buccal cortical plate started dipping to a line extending at the alveolar crest that was perpendicular to the long axis of the alveolar ridge. The buccal undercut depth was measured from the deepest point of the undercut at the buccal plate to a line tangent to the buccal plate paralleling the long axis of ridge. Results Alveolar width increased from coronal to apical direction for each tooth. Mean alveolar widths (mm) were: central incisor, 9.55; lateral incisor, 8.30; canine, 9.62. The lateral incisor had a significantly smaller alveolar width than the other anterior teeth. No significant difference in ridge height was noted among the teeth. Undercut locations from the alveolar crest (mm) were: central incisor, 5.84; lateral incisor, 3.59; canine, 5.11. Undercut depths (mm) were: central incisor, 0.76; lateral incisor, 0.87; canine, 0.73. The percentages of teeth with buccal undercuts were: central incisor, 41 %, lateral incisor, 77 %, and canine 33 %. Male demonstrate significant larger ridge width compared with females for all three teeth. Conclusions At anterior maxilla, the lateral incisor has the thinnest alveolar bone, and most frequently exhibits a buccal undercut which is the closest to alveolar ridge compared with other maxillary anterior teeth.
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Affiliation(s)
- Wenjian Zhang
- Department of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
| | - Adam Skrypczak
- Junior Dental Student, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
| | - Robin Weltman
- Department of Periodontics and Dental Hygiene, The University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
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Bertl K, Hirtler L, Dobsak T, Heimel P, Gahleitner A, Ulm C, Plenk H. Radiological assessment of the inferior alveolar artery course in human corpse mandibles. Eur Radiol 2014; 25:1148-53. [PMID: 25413966 DOI: 10.1007/s00330-014-3484-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 09/10/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES CT assessment of the entire course of the inferior alveolar artery (IAA) within the mandibular canal. METHODS After contrast medium injection (180 or 400 mg/ml iodine concentration) into the external carotid arteries of 15 fresh human cadaver heads, the main IAA's position in the canal (cranial, buccal, lingual or caudal) was assessed in dental CT images of partially edentulous mandibles. RESULTS The course of the main IAA could be followed at both iodine concentrations. The higher concentration gave the expected better contrast, without creating artefacts, and improved visibility of smaller arteries, such as anastomotic sections, dental branches and the incisive branch. The main IAA changed its position in the canal more often than so far known (mean 4.3 times, SD 1.24, range 2-7), but with a similar bilateral course. A cranial position was most often detected (42 %), followed by lingual (36 %), caudal (16 %) and buccal ( 6 %). CONCLUSIONS With this non-invasive radiologic method, the entire course of the main IAA in the mandibular canal could be followed simultaneously with other bone structures on both sides of human cadaver mandibles. This methodology allows one to amend existing anatomical and histological data, which are important for surgical interventions near the mandibular canal. KEY POINTS • Contrast medium injection displayed the inferior alveolar artery's course on mandibular CTs • An iodine concentration of 400 mg/ml enabled visibility until the chin • Frequent position changes of the artery in the mandibular canal were detected • Cranial and lingual positions were most often determined • Course similarities on the respective left and right sides were found.
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Affiliation(s)
- Kristina Bertl
- Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria,
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Rondon RHN, Pereira YCL, do Nascimento GC. Common positioning errors in panoramic radiography: A review. Imaging Sci Dent 2014; 44:1-6. [PMID: 24701452 PMCID: PMC3972400 DOI: 10.5624/isd.2014.44.1.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/11/2013] [Accepted: 09/25/2013] [Indexed: 11/21/2022] Open
Abstract
Professionals performing radiographic examinations are responsible for maintaining optimal image quality for accurate diagnoses. These professionals must competently execute techniques such as film manipulation and processing to minimize patient exposure to radiation. Improper performance by the professional and/or patient may result in a radiographic image of unsatisfactory quality that can also lead to a misdiagnosis and the development of an inadequate treatment plan. Currently, the most commonly performed extraoral examination is panoramic radiography. The invention of panoramic radiography has resulted in improvements in image quality with decreased exposure to radiation and at a low cost. However, this technique requires careful, accurate positioning of the patient's teeth and surrounding maxillofacial bone structure within the focal trough. Therefore, we reviewed the literature for the most common types of positioning errors in panoramic radiography to suggest the correct techniques. We would also discuss how to determine if the most common positioning errors occurred in panoramic radiography, such as in the positioning of the patient's head, tongue, chin, or body.
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Affiliation(s)
- Rafael Henrique Nunes Rondon
- Stomathology and Oral Diagnostic Program, School of Dentistry of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Yamba Carla Lara Pereira
- Biology Dental Buco Graduate Program, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Brazil
| | - Glauce Crivelaro do Nascimento
- Psychobiology Graduate Program, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Comparison of mesiodistal space measurements of single-implant sites on panoramic and oblique images generated by cone-beam CT. Surg Radiol Anat 2013; 36:255-8. [PMID: 23978871 DOI: 10.1007/s00276-013-1190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To compare the mesiodistal space measurements of single-implant sites on panoramic and oblique images generated by cone-beam CT (CBCT). METHODS CBCT images for 101 single-implant sites of 66 patients referred for pre-surgical radiographic implant planning were selected for the study; 15-mm-thickness panoramic images were reformatted and used for measuring mesiodistal space dimensions. The measurements were repeated and compared with those of thin oblique images (200-300 μ) using Wilcoxon signed rank test. The correlation between measurements in addition to intra-observer agreement was evaluated by Pearson's correlation coefficients. RESULTS All mesiodistal space measurements on panoramic and oblique images generated by CBCT were strongly correlated and there were no statistically significant differences between them (P < 0.05). CONCLUSIONS Both panoramic and oblique images generated by CBCT can be used for measuring mesiodistal space dimensions of single-implant sites.
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