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Kim KH, Kim JE, Lee SS, Lee C, Choi M, Yong HS, Jung SE, Heo MS, Huh KH. Developing evidence-based clinical imaging guidelines for the diagnosis of vertically fractured teeth. Oral Radiol 2024; 40:471-483. [PMID: 38976094 PMCID: PMC11379765 DOI: 10.1007/s11282-024-00766-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/30/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVES This study aimed to develop an evidence-based clinical imaging guideline for teeth suspected with vertical root fractures. METHODS An adaptation methodology based on the Korean Clinical Imaging Guidelines (K-CIG) was used in the guideline development process. After searching for guidelines using major databases such as Ovid-Medline, Elsevier-Embase, National Guideline Clearinghouse, and Guideline International Network, as well as domestic databases such as KoreaMed, KMbase, and KoMGI, two reviewers analyzed the retrieved articles. The retrieved articles were included in this review using well-established inclusion criteria. RESULTS Twenty articles were identified through an online search, of which three were selected for guideline development. Based on these three guidelines, this study developed specific recommendations concerning the optimal imaging modality for diagnosing teeth suspected of vertical root fractures. CONCLUSIONS Periapical radiography is the preferred method for assessing teeth with mastication-related pain and suspected vertical root fractures. However, if intraoral radiographs do not provide sufficient information about root fractures, a small FOV CBCT may be considered. However, the use of CBCT in endodontically treated teeth is significantly constrained by the presence of artificial shading.
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Affiliation(s)
- Ki-Hong Kim
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Chena Lee
- Department of Oral & Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Miyoung Choi
- Division for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Seung Eun Jung
- Department of Radiology, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Deng H, Wang J, Liu L, Li Y. Feasibility and accuracy of a task-autonomous robot for zygomatic implant placement. J Prosthet Dent 2023:S0022-3913(23)00710-2. [PMID: 38016868 DOI: 10.1016/j.prosdent.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023]
Abstract
STATEMENT OF PROBLEM Zygomatic implants (ZIs) should be placed accurately as planned preoperatively to minimize complications and maximize the use of the remaining bone. Current digital techniques such as static guides and dynamic navigation are affected by human error; therefore, new techniques are required to improve the accuracy of ZI placement. PURPOSE The purpose of this clinical study was to assess the feasibility and accuracy of a task-autonomous robot for ZI placement. MATERIAL AND METHODS Patients indicated for ZI placement were enrolled, and an appropriate surgical positioning piece was selected based on the presence of natural teeth in the maxilla. Preoperative cone beam computed tomography (CBCT) scanning was performed with the surgical positioning piece, and virtual implant design and socket preparation procedures were initiated. Implant socket preparation and placement were automatically performed by the robot according to the preoperative plan under the supervision of the surgeon. Postoperative CBCT scanning was performed to evaluate deviations between the virtual and actual implants. All quantitative data were expressed as standardized descriptive statistics (mean, standard deviation, minimum, maximum, and 95% confidence interval [CI]). The Shapiro-Wilk test was used to assess the normal distribution of all variables (α=.05). RESULTS Six participants were enrolled, and 8 ZIs were inserted. No intraoperative or postoperative complications were observed. Robotic ZI placement showed a global coronal deviation of 0.97 mm (95% CI: 0.55 to 1.39 mm), a global apical deviation of 1.27 mm (95% CI: 0.71 to 1.83 mm), and an angular deviation of 1.48 degrees (95% CI: 0.97 to 2.00 degrees). CONCLUSIONS Task-autonomous robots can be used for ZI placement with satisfactory accuracy. Robotic ZI surgery can be an alternative to static guidance and dynamic navigation to improve the accuracy of implant placement.
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Affiliation(s)
- Huanze Deng
- Doctoral student, Department of Stomatology, Fourth Medical Centre, Chinese PLA General Hospital, Beijing, PR China; and Medical School of Chinese PLA, Beijing, PR China
| | - Jing Wang
- Head Nurse, Department of Stomatology, Fourth Medical Centre, Chinese PLA General Hospital, Beijing, PR China
| | - Le Liu
- Attending, Department of Stomatology, Fourth Medical Centre, Chinese PLA General Hospital, Beijing, PR China
| | - Yanfeng Li
- Professor, Department of Stomatology, Fourth Medical Centre, Chinese PLA General Hospital, Beijing, China, Beijing, PR China; and Medical School of Chinese PLA, Beijing, PR China.
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Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. Saudi Dent J 2023; 35:780-784. [PMID: 38025595 PMCID: PMC10658366 DOI: 10.1016/j.sdentj.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/19/2023] [Accepted: 07/02/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Cone-beam computed tomography (CBCT) is a valuable tool in endodontics, particularly for assessing root morphology. AIM To understand the importance of root morphology in endodontic treatment. METHODOLOGY A comprehensive search of various databases was performed, and 804 studies were identified. After evaluating the studies using the inclusion criteria and eliminating duplicates, 12 articles were included in this review. RESULTS CBCT assessment demonstrated a high prevalence of single canals in maxillary incisors, varying root configurations in maxillary first premolars, and diverse anatomical distributions in mandibular molars, such as C-shaped canals, more commonly observed in women. CONCLUSION The findings from this review concluded that CBCT is a valuable tool for the diagnosis and treatment of root canal anomalies in endodontics.
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Affiliation(s)
- Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudia Arabia
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Urban I, Sanz-Sánchez I, Monje A, Montero E. Complications and treatment errors in peri-implant hard tissue management. Periodontol 2000 2023; 92:278-298. [PMID: 37016554 DOI: 10.1111/prd.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/14/2022] [Accepted: 08/21/2022] [Indexed: 04/06/2023]
Abstract
Bone augmentation procedures aim to regenerate the deficient alveolar ridge to properly place dental implants that are completely surrounded by bone. However, these are invasive and technically demanding surgeries that are not free of either complications or treatment errors. Careful patient selection and preparation is a mandatory process to reduce the rate of complications in bone regeneration procedures, irrespective of the technique used. It is important to assess the cost benefit of the intervention and to evaluate the potential impact on the patient's quality of life, especially in the elderly and medically compromised patients. Most common postoperative complications are wound dehiscences, which may be reduced, at least partially, by proper knowledge of the surgical technique and the craniofacial anatomy. Other complications that may appear are postoperative infections or nerve injuries. The aim of this narrative review is to summarize the best available scientific evidence on the incidence of complications, as well as the ideal strategies for their prevention and management. Depending on the severity of the complication, treatment approaches may vary and can include drug prescription or even surgical re-entries to remove exposed barrier membranes or contaminated bone grafts. Adequate prevention and proper management of complications associated with bone augmentation interventions are a requirement for clinicians carrying out these demanding procedures. A series of cases illustrating proper management of complications in different clinical scenarios is presented.
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Affiliation(s)
- Istvan Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, International University of Catalonia, Barcelona, Spain
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
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Hamilton A, Singh A, Friedland B, Jamjoom FZ, Griseto N, Gallucci GO. The impact of cone beam computer tomography field of view on the precision of digital intra-oral scan registration for static computer-assisted implant surgery: A CBCT analysis. Clin Oral Implants Res 2022; 33:1273-1281. [PMID: 36239539 PMCID: PMC10091816 DOI: 10.1111/clr.14009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/11/2022] [Accepted: 10/08/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Registration of intra-oral surface scans to cone beam computer tomography (CBCT) is critical in the digital workflow for static computer-aided implant surgery (sCAIS). This study aimed to assess the impact of CBCT field of view (FoV) on the precision of digital intra-oral scan registration. MATERIALS AND METHODS Cone beam computer tomography data and intra-oral scans from 20 patients were included. Small FoV CBCT's were created by digitally segmenting a large FoV into three sextants. Virtual implant planning was performed. Digital intra-oral scans were repeatedly registered onto their corresponding large and small FoV CBCT datasets. The distances and angulations between the matching implant positions of each repeated registration were used to determine the precision of the registration process. Wilcoxon Signed Rank Paired Tests were used to compare the differences between large FoV and small FoV. The threshold for statistical significance was set at p = .05. RESULTS Differences in 3D implant position based on the registration precision between small FoV and large FoV present at both the implant entry point (0.37 ± 0.25 mm vs 0.35 ± 0.23 mm, p = .482) and implant tip (0.49 ± 0.34 mm vs 0.37 ± 0.24 mm, p < .001). Differences in overall angular precision were observed between small FOV and large FoV (1.43 ± 1.36° vs 0.51 ± 0.38°, p < .001). CONCLUSION CBCT with a small FoV is accompanied by greater precision errors in intra-oral scan registration. However, when sufficient well-distributed teeth are visible in small FoV CBCT, the precision of digital intra-oral scan registration appears to be within clinically acceptable limits for sCAIS.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Division of Oral Restorative and Rehabilitative Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Ashi Singh
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Private Practice, Sydney, New South Wales, Australia
| | - Bernard Friedland
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Faris Z Jamjoom
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Neil Griseto
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Hilgenfeld T, Saleem MA, Schwindling FS, Ludwig U, Hövener JB, Bock M, Flügge T, Eisenbeiss AK, Nittka M, Mente J, Jende JME, Heiland S, Bendszus M, Juerchott A. High-Resolution Single Tooth MRI With an Inductively Coupled Intraoral Coil-Can MRI Compete With CBCT? Invest Radiol 2022; 57:720-727. [PMID: 35640007 DOI: 10.1097/rli.0000000000000890] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aims of this study were to quantify T1/T2-relaxation times of the dental pulp, develop a realistic tooth model, and compare image quality between cone-beam computed tomography (CBCT) and high-resolution magnetic resonance imaging (MRI) of single teeth using a wireless inductively coupled intraoral coil. METHODS T1/T2-relaxometry was performed at 3 T in 10 healthy volunteers (283 teeth) to determine relaxation times of healthy dental pulp and develop a realistic tooth model using extracted human teeth. Eight MRI sequences (DESS, CISS, TrueFISP, FLASH, SPACE, TSE, MSVAT-SPACE, and UTE) were optimized for clinically applicable high-resolution imaging of the dental pulp. In model, image quality of all sequences was assessed quantitatively (contrast-to-noise ratio) and qualitatively (visibility of anatomical structures and extent of susceptibility artifacts using a 5-point scoring scale). Cone-beam computed tomography served as the reference modality for qualitative assessment. Statistical analysis was performed using 2-way analysis of variance, Fisher exact test, and Cohen κ. RESULTS In vivo, relaxometry of dental pulps revealed T1/T2 relaxation times at 3 T of 738 ± 100/171 ± 36 milliseconds. For all sequences, an isotropic resolution of (0.21 mm) 3 was achieved, with acquisition times ranging from 6:19 to 8:02 minutes. In model, the highest contrast-to-noise ratio values were observed for UTE, followed by TSE and CISS. The best image/artifact quality, however, was found for DESS (mean ± SD: 1.3 ± 0.3/2.2 ± 0.0), FLASH (1.5 ± 0.3/2.4 ± 0.1), and CISS (1.5 ± 0.4/2.5 ± 0.1), at a level comparable to CBCT (1.2 ± 0.3/2.1 ± 0.1). CONCLUSIONS Optimized MRI protocols using an intraoral coil at 3 T can achieve an image quality comparable to reference modality CBCT within clinically applicable acquisition times. Overall, DESS revealed the best results, followed by FLASH and CISS.
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Affiliation(s)
| | | | | | - Ute Ludwig
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, Kiel
| | - Michael Bock
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - Anne-Katrin Eisenbeiss
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Christian-Albrechts-University, Kiel
| | | | - Johannes Mente
- Division of Endodontics and Dental Traumatology, Department of Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany
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Abstract
Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol.
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Comparison of the accuracy of 2D and 3D cephalometry: a systematic review and meta-analysis. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Objectives
To compare the measurement of cephalometric parameters using 3D images obtained from CBCT to 2D images obtained from a conventional cephalogram.
Methods
An electronic literature search was conducted using PubMed, Embase, Web of Science, CNKI, CENTRAL, and the grey literature database of SIGLE (up to May 2021). The selection of the eligible studies, data extraction, and an evaluation for possible risk of bias (Quality Assessment of Measurement Accuracy Studies tool) were performed independently by two authors. Inconsistencies were judged by a third author. Statistical pooling, subgroup analysis, a sensitivity analysis and an evaluation of publication bias were performed using Comprehensive Meta-Analysis (version 2.2.064, Biostat, Englewood, NJ).
Results
A total of eight articles were eligible for final meta-analysis. The differences in two of the skeletal measurement parameters [Ar(Co)-Gn, Me-Go] and one of the dental measurement parameters (U1-L1) were found to be statistically significant when using CBCT and conventional cephalograms (P = 0.000, P = 0.004, P = 0.000, respectively).
Conclusions
CBCT can be used as a supplementary option to support conventional cephalometric measurements. In clinical situations in which three-dimensional information is required, patients can benefit from CBCT analysis to improve diagnosis and treatment planning.
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Majzoub J, Tavelli L, Barootchi S, Salami A, Inglehart MR, Kripfgans OD, Chan HL. Agreement in measurements of ultrasonography-derived periodontal diagnostic parameters among multiple raters: A diagnostic accuracy study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:375-385. [PMID: 35568639 DOI: 10.1016/j.oooo.2022.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/08/2022] [Accepted: 03/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the reproducibility of measurements of ultrasound-derived periodontal diagnostic parameters (PDPs) among raters. STUDY DESIGN Periodontists with various degrees of ultrasound experience were invited to measure 3 PDPs: soft tissue height (STH), soft tissue thickness (STT), and crestal bone thickness (CBT) on 37 human periodontal ultrasound scans acquired at the midfacial site of non-molar maxillary teeth. After an online training session and a 2-week calibration exercise, intraclass correlation coefficients (ICCs) were estimated with mixed linear regression models. The interrater mean absolute differences (MADs) were calculated among the raters and between the raters and a reference standard examiner. RESULTS Thirteen raters participated in the study. MADs among the 13 raters were 0.18 mm (STH), 0.16 mm (STT), and 0.12 mm (CBT). ICC values for STH, STT, and CBT were 0.83, 0.77, and 0.76, respectively. The MADs between the raters and the reference standard were 0.23 mm (STH), 0.19 mm (STT), and 0.14 mm (CBT). Survey results showed that ultrasound has diagnostic value and is generally easy to learn. CONCLUSIONS Within the limitations of this study, good agreement was observed among ultrasound learners with various degrees of experience when measuring ultrasound-derived PDPs.
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Affiliation(s)
- Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lorenzo Tavelli
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard, School of Dental Medicine, Boston, MA, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Ali Salami
- Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA; Department of Psychology, College of Literature, Science and Arts, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
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Chang CC, Kim SK, Lee CT. A novel approach to assess volumetric bone loss at immediate implant sites and comparison to linear measurements: a pilot study and measurement workflow. J Dent 2022; 120:104083. [PMID: 35247470 DOI: 10.1016/j.jdent.2022.104083] [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: 07/13/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Studies have evaluated changes in hard tissue following immediate implant placement (IIP) through cone beam computed tomography (CBCT) imaging, typically examining the amount of two-dimensional (2D) linear, rather than three-dimensional (3D) volumetric bone loss. This study compared the 3D volumetric changes of the alveolar bone at immediate implant sites with 2D linear measurement outcomes by using a novel image analysis workflow. METHODS Preoperative and 6-month postoperative CBCT images of patients who underwent IIP and bone grafting in the maxillary esthetic area were acquired. Linear and volumetric measurements of buccal bone dimensions were taken using a specially designed workflow. The 2D and 3D measurements were compared, and their correlations were determined. RESULTS Images from 13 patients (13 implants) were analyzed. Linear measurements revealed that the general linear buccal bone loss was less than 1mm in all segments. The 3D volumetric bone reduction (reported as median [first quantile, third quantile]) in the vertical, cervical, middle, and apical segments was 14.27 [11.33, 30.66] mm3 (51.30 [42.78, 66.91]%), 16.20 [10.35, 30.52] mm3 (18.20 [9.88, 24.74]%), 17.48 [8.42, 21.17] mm3 (24.05 [12.39, 28.22]%), and 6.87 [3.88, 9.45] mm3 (11.34 [5.14, 22.54]%), respectively. Significant positive correlations between 2D and 3D measurements were consistently identified in the cervical and middle segments, but no significant correlation was noted in the vertical segment. CONCLUSIONS The results revealed that linear measurements could not fully represent volumetric bone dimensional changes. Performing volumetric measurements and 3D rendering could be valuable in presenting the actual amount and topography of peri-implant bone remodeling. CLINICAL SIGNIFICANCE Linear measurements only partially represent the real-life event of 3D bone changes at immediate implant sites. Factors affecting hard tissue alterations following IIP should be reassessed using 3D volumetric measurement outcomes.
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Affiliation(s)
- Chi-Ching Chang
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054; Department of Periodontics, Chang Gung Memorial Hospital, No.199, Dun-Hua North Rd., Taipei, Taiwan, 105406; Chang Gung University, No.259, Wenhua 1st Rd., Taoyuan City, Taiwan, 333323
| | - Sung K Kim
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054.
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Al-Humairi A, Ip RHL, Spuur K, Zheng X, Huang B. Visual grading experiments and optimization in CBCT dental implantology imaging: preliminary application of integrated visual grading regression. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:133-145. [PMID: 34988606 DOI: 10.1007/s00411-021-00959-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 11/13/2021] [Indexed: 06/14/2023]
Abstract
This study uses a general formulation of integrated visual grading regression (IVGR) and applies it to cone beam computed tomography (CBCT) scan data related to anatomical landmarks for dental implantology. The aim was to assess and predict a minimum acceptable dose for diagnostic imaging and reporting. A skull phantom was imaged with a CBCT unit at various diagnostic exposures. Key anatomical landmarks within the images were independently reviewed by three trained observers. Each provided an overall image quality score. Statistical analysis was carried out to examine the acceptability of the images taken, using an IVGR analysis that was formulized as a three-stage protocol including defining an integrated score, development of an ordinal regression, and investigation of the possibility for dose reduction through estimated parameters. For a unit increase in the logarithm of radiation dose, the odds ratio that the integrated score for an image assessed by observers being rated in a higher category was 3.940 (95% confidence interval: 1.016-15.280). When assessed by the observers, the minimum dose required to achieve a 75% probability for an image to be classified as at least acceptable was 1346.91 mGy·cm2 dose area product (DAP), a 31% reduction compared to the 1962 mGy·cm2 DAP default dosage of the CBCT unit. The kappa values of the intra and inter-observer reliability indicated moderate agreements, while a discrepancy among observers was also identified because each, as expected, perceived visibility differently. The results of this work demonstrate the IVGR's predictive value of dose saving in the effort to reduce dose to patients while maintaining reportable diagnostic image quality.
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Affiliation(s)
- Ahmed Al-Humairi
- School of Dentistry, The University of Queensland, Herston, QLD, Australia.
| | - Ryan H L Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Kelly Spuur
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Xiaoming Zheng
- School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Boyen Huang
- Department of Primary Dental Care, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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12
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Digital workflow for 3D printed implant surgical guides. J Prosthet Dent 2022; 127:205. [PMID: 35241263 DOI: 10.1016/j.prosdent.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Gonçalves WF, Garcia LDFR, Vieira-Schuldt DP, Bortoluzzi EA, Dias-Júnior LCDL, Teixeira CDS. Guided Endodontics in Root Canals with Complex Access: Two Case Reports. Braz Dent J 2022; 32:115-123. [PMID: 35019015 DOI: 10.1590/0103-6440202104537] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/05/2021] [Indexed: 01/17/2023] Open
Abstract
This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.
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Affiliation(s)
- Wesley Fernandes Gonçalves
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Daniela Peressoni Vieira-Schuldt
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eduardo Antunes Bortoluzzi
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Luiz Carlos de Lima Dias-Júnior
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Cleonice da Silveira Teixeira
- Department of Dentistry - Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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14
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Chagas MM, Kobayashi-Velasco S, Gimenez T, Cavalcanti MGP. Diagnostic accuracy of imaging examinations for peri-implant bone defects around titanium and zirconium dioxide implants: A systematic review and meta-analysis. Imaging Sci Dent 2022; 51:363-372. [PMID: 34987996 PMCID: PMC8695475 DOI: 10.5624/isd.20210120] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/08/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose This systematic review and meta-analysis assessed the diagnostic accuracy of imaging examinations for the detection of peri-implant bone defects and compared the diagnostic accuracy between titanium (Ti) and zirconium dioxide (ZrO2) implants. Materials and Methods Six online databases were searched, and studies were selected based on eligibility criteria. The studies included in the systematic review underwent bias and applicability assessment using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and a random-effect meta-analysis. Summary receiver operating characteristic (sROC) curves were constructed to compare the effect of methodological differences in relation to the variables of each group. Results The search strategy yielded 719 articles. Titles and abstracts were read and 61 studies were selected for full-text reading. Among them, 24 studies were included in this systematic review. Most included studies had a low risk of bias (QUADAS-2). Cone-beam computed tomography (CBCT) presented sufficient data for quantitative analysis in ZrO2 and Ti implants. The meta-analysis revealed high levels of inconsistency in the latter group. Regarding sROC curves, the area under the curve (AUC) was larger for the overall Ti group (AUC=0.79) than for the overall ZrO2 group (AUC=0.69), but without a statistically significant difference between them. In Ti implants, the AUCs for dehiscence defects (0.73) and fenestration defects (0.87) showed a statistically significant difference. Conclusion The diagnostic accuracy of CBCT imaging in the assessment of peri-implant bone defects was similar between Ti and ZrO2 implants, and fenestration was more accurately diagnosed than dehiscence in Ti implants.
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Affiliation(s)
- Mariana Murai Chagas
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Thais Gimenez
- Graduate Program in Dentistry, Ibirapuera University, São Paulo, São Paulo, Brazil
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15
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Sinjab K, Kripfgans OD, Ou A, Chan HL. Ultrasonographic evaluation of edentulous crestal bone topography: A proof-of-principle retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:110-117. [PMID: 34511351 PMCID: PMC8688229 DOI: 10.1016/j.oooo.2021.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/24/2021] [Accepted: 07/10/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Edentulous crestal bone ridge assessment, an essential task for planning of implant and bone regenerative procedures, is performed through radiographs. Ultrasonography, providing point of care and cross-sectional images without radiation, could be an adjunct for this purpose. The aim was to investigate the feasibility of ultrasound (US) in assessing bone ridge width (BRW) and crestal bone surface quality (CBSQ) compared with cone beam computed tomography (CBCT). STUDY DESIGN Records of patients who were planned for implant placement in at least 1 healed edentulous ridge space with available CBCT and US images were included. The BRWs at 1, 2, and 3 mm from the crest were measured and compared. The CBSQ agreement evaluated using a 3-tier grading system was calculated. RESULTS A total of 45 sites were included. The mean correlation of BRW was 0.97. The mean BRW differences ranged from 0.048 mm (95% confidence interval, -0.69 to 0.78 mm) at the 1-mm level to 0.18 mm (95% confidence interval, -0.92 to 1.3 mm) at the 3-mm level. There was a 91% agreement in CBSQ between the 2 methods. CONCLUSIONS Preliminary data with a limited clinical sample size suggested that US is feasible in evaluating crestal BRW and surface quality assessment compared with CBCT.
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Affiliation(s)
- Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D. Kripfgans
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA,Department of Radiology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Alice Ou
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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16
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Maret D, Vergnes JN, Peters OA, Peters C, Nasr K, Monsarrat P. Recent Advances in Cone-beam CT in Oral Medicine. Curr Med Imaging 2021; 16:553-564. [PMID: 32484089 DOI: 10.2174/1573405615666190114152003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Affiliation(s)
- Delphine Maret
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,AMIS Laboratory - Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean-Noel Vergnes
- Epidemiology and Public Health Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Christine Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States
| | - Karim Nasr
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France
| | - Paul Monsarrat
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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17
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Bertram A, Eckert AW, Kolk A, Emshoff R. Panoramic prediction equations to estimate implant- to-mandibular canal dimensions in the mandibular posterior region: implications for dental implant treatment. Head Face Med 2021; 17:19. [PMID: 34107989 PMCID: PMC8188713 DOI: 10.1186/s13005-021-00270-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background To develop and cross-validate site-specific panoramic radiography (PAN) analysis prediction equations of implant-to-mandibular canal dimensions (IMCD) in mandibular regions posterior to the mental foramen, and to help determine in which instances CBCT technology will be a justified adjunct in clinical practice. Methods IMCD by PAN (Pan-D) from implant site-specific regions (first premolar, second premolar, first molar, and second molar sites) were collected from 40- to 70-year-old adolescents. They were randomly assigned to validation (n = 144) and cross-validation (n = 148) groups. The cone-beam computed tomography (CBCT) technique was used as the criterion method for the estimation of IMCD (CBCT-D). The PAN analysis equations were developed using stepwise multiple regression analysis and cross-validated using the Bland–Altman approach. Results There was a significant relationship between PAN-D and CBCT-D for both validation (R2 = 57.8 %; p < .001) and cross-validation groups (R2 = 52.5 %; p < .001). Root means-squared error (RMSE) and pure error (PE) were highest for the first molar (RMSE = 1.116 mm, PE = 1.01 mm) and the second molar region (RMSE = 1.162 mm, PE = 1.11 mm). Conclusions PAN-D has the potential to be developed as an indirect measure of IMCD. However, the findings suggest to exclude scoring of the first and second molars when assessing IMCD via PAN. Use of CBCT may be justified for all IMCD estimations in the first and second molars regions. Trial registration This study has been registered and approved by the Ethics Committee of the Martin-Luther University, Halle, Germany (2020-034).
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Affiliation(s)
- Annika Bertram
- Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Alexander W Eckert
- University Clinic of Oral and Maxillofacial Surgery, Martin-Luther University, Halle-Wittenberg, Germany
| | - Andreas Kolk
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Rüdiger Emshoff
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria. .,Private Practice Oral and Maxillofacial Surgery, Freilassing, Germany.
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18
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Kunzendorf B, Naujokat H, Wiltfang J. Indications for 3-D diagnostics and navigation in dental implantology with the focus on radiation exposure: a systematic review. Int J Implant Dent 2021; 7:52. [PMID: 34041613 PMCID: PMC8155130 DOI: 10.1186/s40729-021-00328-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background Dental implants are a common restorative method used to replace missing teeth. Implant placement techniques guided by three-dimensional imaging and navigation are becoming more widely available. Objective The present review focused on the following questions: 1. What are the advantages and disadvantages of 2-D versus 3-D imaging in dental implantology? 2. What are the advantages and disadvantages of freehand implant placement in comparison with navigation-guided implant placement? Methods A systematic review was performed, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. The following libraries were searched for relevant literature: PubMed, Embase, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) Online, and the Cochrane Library. The risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SiGN) checklist. A total of 70 studies were included after screening, and the evidence from these was gathered for review. Results Three-dimensional imaging is advantageous in terms of image quality, and it provides a distortion-free evaluation of the implant site. However, it is also associated with higher costs and increased radiation exposure. Dynamic and static navigation are equal in accuracy and are both more accurate compared with the freehand method. No benefit in terms of implant survival could be demonstrated within the first 5 years for any specific method. Discussion A panoramic X-ray with a reference body often provides sufficient imaging and is the primary method for two-dimensional imaging. Cone beam computed tomography with low-dose protocol settings should be used if three-dimensional imaging is needed. Navigational support should be considered in the event of especially complex cases. Conclusion The guidance technique used for implant placement should be decided on an individual basis. With the increasing availability of three-dimensional imaging, there should also be an increase in awareness of radiation exposure. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00328-9.
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Affiliation(s)
- Burkhard Kunzendorf
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
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19
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Siqueira R, Sinjab K, Pan YC, Soki F, Chan HL, Kripfgans O. Comprehensive peri-implant tissue evaluation with ultrasonography and cone-beam computed tomography: A pilot study. Clin Oral Implants Res 2021; 32:777-785. [PMID: 33866602 DOI: 10.1111/clr.13758] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The aim of the present study was to explore the feasibility of ultrasonography (US) for clinical imaging of peri-implant tissues. MATERIAL AND METHODS Patients with ≥1 implant, a cone-beam computed tomography (CBCT) scan, an US scan, and clinical photographs taken during the surgery were included. The crestal bone thickness (CBT) and facial bone level (FBL) were measured on both US and CBCT modalities, and direct FBL measurements were also made on clinical images. US measurements were compared with CBCT and direct readings. RESULTS A total of eight implants from four patients were included. For FBL measurements, US and direct (r2 = 0.95) as well as US and CBCT (r2 = 0.85) were highly correlated, whereas CBCT correlated satisfactorily with the direct reading (r2 = 0.75). In one implant without facial bone, CBCT was not able to measure CBT and FBL accurately. The estimated bias for CBT readings was 0.17 ± 0.23 mm (p = .10) between US and CBCT. US blood flow imaging was successfully recorded and showed a wide dynamic range among patients with different degrees of clinical inflammation. CONCLUSION US is a feasible method to evaluate peri-implant facial crestal bone dimensions. Additional US features, for example, functional blood flow imaging, may be useful to estimate the extent and severity of inflammation.
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Affiliation(s)
- Rafael Siqueira
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Ying-Chun Pan
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
| | - Fabiana Soki
- Department of Periodontics and Oral Medicine and Division of Oral Pathology/Medicine/Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver 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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20
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Križaj Dumić A, Pajk F, Olivi G. The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial. Clin Implant Dent Relat Res 2021; 23:309-316. [PMID: 33686771 PMCID: PMC8359241 DOI: 10.1111/cid.12991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023]
Abstract
Background Post‐extraction bone resorption may affect the outcome of ensuing restorations. Purpose This study aimed to evaluate a comprehensive laser post‐extraction protocol by comparing resulting alveolar bone regeneration with that obtained after standard extraction procedure. Materials and Methods About 53 simple extractions were randomized to either laser or control group. In the laser group, erbium (Er:YAG; 2940 nm) and neodymium (Nd:YAG; 1064 nm) lasers were used for degranulation, disinfection, de‐epithelialization of the surrounding gingiva, clot stabilization, and photobiomodulation. The primary outcome measure was change in bone density in the extraction area between day 1 and 4 months after extraction. Patients were monitored for potential side effects. Results Increase in bone density at the follow‐up CBCT was significantly higher in laser than in control group (p < 0.001). No post‐operative pain, bleeding, or swelling was present in the laser group. In the control group, one patient had bleeding 3–5 days after extraction, two patients had swelling and three patients reported post‐operative pain rated 3–5 on a 0–10 pain scale up to 3 days after extraction. Conclusions The proposed laser post‐extraction procedure is a safe and effective method to improve post‐extraction bone healing.
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Affiliation(s)
| | - Franja Pajk
- LA&HA - Laser and Health Academy, Ljubljana, Slovenia
| | - Giovanni Olivi
- Università Cattolica del Sacro Cuore di Roma, Rome, Italy.,InLaser Rome, Advanced Center for Esthetic and Laser Dentistry, Rome, Italy
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21
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Bernaerts A, Barbier L, Abeloos J, De Backer T, Bosmans F, Vanhoenacker FM, Casselman J. Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists. Semin Musculoskelet Radiol 2020; 24:499-509. [PMID: 33036038 DOI: 10.1055/s-0040-1701496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.
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Affiliation(s)
- Anja Bernaerts
- Department of Radiology, GZA Hospitals, Antwerp, Belgium
| | - Lieven Barbier
- Training Center for Dental Students of the KU Leuven, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Johan Abeloos
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Tom De Backer
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Frederik Bosmans
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan Casselman
- Department of Radiology, GZA Hospitals, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Radiology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
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22
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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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23
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Kim MJ, Lee SS, Choi M, Yong HS, Lee C, Kim JE, Heo MS. Developing evidence-based clinical imaging guidelines of justification for radiographic examination after dental implant installation. BMC Med Imaging 2020; 20:102. [PMID: 32867728 PMCID: PMC7457348 DOI: 10.1186/s12880-020-00501-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to develop evidence-based clinical imaging guidelines to assess the proper implant location following implant surgery and identify potential complications during follow-up. Methods The guideline development process employed an adaptation methodology in accordance with the Korean clinical imaging guidelines (K-CIG). Core (Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, and Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched used to retrieve guidelines, and two reviewers analyzed the retrieved articles. The articles were included in this review using well-established inclusion criteria. Results Our online search identified 66 articles, of which 3 were selected for the development of the guidelines. Consequently, based on these three guidelines, we formulated distinct recommendations regarding the appropriate imaging modalities that should be used following implant placement. Conclusions Conventional imaging (e.g., periapical or panoramic radiography) should be the first choice for assessing the implant following its placement and osseointegration. The metal artifacts in Cone Beam Computed Tomography (CBCT) should be considered. However, CBCT is recommended for patients with sensory abnormalities following dental implant surgery to evaluate and identify the underlying cause of implant complications and to determine the appropriate treatment.
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Affiliation(s)
- Min-Ji Kim
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
| | - Miyoung Choi
- Division for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Chena Lee
- Department of Oral & Maxillofacial Radiology Yonsei University College of Dentistry, Seoul, Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
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24
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Kamburoğlu K, Ereş G, Akgün C. Qualitative and Quantitative Assessment of Alveolar Bone Destruction in Adult Rats Using CBCT. J Vet Dent 2020; 36:245-250. [PMID: 32207386 DOI: 10.1177/0898756420911108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cone-beam computed tomography (CBCT) has strong potential to be utilized in various aspects of veterinary dentistry. Using ex vivo rat maxillary bone and teeth, the purpose of this study was to compare gray value, surface area, and volumetric measurements of teeth with and without experimental periodontitis by CBCT. Periodontitis was induced in 36 molar teeth, while 36 teeth with a healthy periodontium served as control. Images of each specimen along with teeth were obtained using CBCT. The following measurements for each tooth with periodontitis (n = 36) were recorded: gray value measurement, width, height, depth, surface area, and volume of the alveolar bone loss. For the control group (n = 36), gray value measurement, surface area, and volume of the alveolar bone were recorded. All measurements were repeated after 3 weeks. As the gold standard, the rat maxillas were decalcified and paraffin-embedded for further immunocytochemical study. One-way analysis of variance (ANOVA) was used. Significance level was set at P < .05. Correlation values for gray value, width, height, depth, surface area, and volume measurements were 0.983, 0.966, 0.962, 0.880, 0.998, and 0.999, respectively, for the first and second measurements. One way ANOVA showed statistically significant differences between teeth with and without alveolar bone destruction conducted for gray value, surface area, and volume measurements (P = .000). Mean gray value, surface area, and volume measurements decreased 56.46%, 81.89%, and 78.56%, respectively, for teeth with alveolar bone destruction in comparison to healthy teeth. Cone-beam computed tomography provided useful qualitative and quantitative information regarding induced periodontitis in the rat maxilla.
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Affiliation(s)
- Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gülden Ereş
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Ceren Akgün
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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25
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Beals DW, Parashar V, Francis JR, Agostini GM, Gill A. CBCT in Advanced Dental Education: A Survey of U.S. Postdoctoral Periodontics Programs. J Dent Educ 2020; 84:301-307. [PMID: 32176341 DOI: 10.21815/jde.019.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/19/2019] [Indexed: 09/01/2023]
Abstract
Historically, predoctoral and advanced dental education programs used two-dimensional panoramic and periapical radiographs for implant planning. Three-dimensional (3D) Cone Beam Computed Tomography (CBCT) imaging has improved visualization of anatomic structures that can positively influence implant planning and surgical implant placement. The aim of this study was to assess how U.S. postdoctoral periodontics programs have incorporated CBCT technology into their curricula. A ten-question survey was sent to all 57 U.S. postdoctoral periodontics programs in November-December 2018. Thirty-seven responses were received, for a 65% response rate. All participating programs reported providing residents access to CBCT machines, and most of their residents received some training in the acquisition and interpretation of CBCT images. Nearly all (95%) participating programs provided training to apply implant planning software. Among the participating programs, 14% reported using a surgical guide fabricated with a CBCT scan 76-100% of the time, and 60% reported obtaining a CBCT scan for implant cases 76-100% of the time. These results suggest that, while residents are receiving training in CBCT and implant planning, it is not used often. There may be merit in adopting the American Academy of Oral and Maxillofacial Radiology's recommendation to use 3D imaging for all implant planning, with CBCT as the imaging modality of choice.
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Affiliation(s)
| | - Vijay Parashar
- Department of Oral and Maxillofacial Radiology, Midwestern University College of Dental Medicine, Arizona
| | - John R Francis
- Department of Surgery, Midwestern University College of Dental Medicine, Arizona
| | - Gina M Agostini
- Department of Dental Research, Midwestern University College of Dental Medicine, Arizona
| | - Amanda Gill
- Midwestern University College of Dental Medicine, Arizona
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26
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Shipley T, Farouk K, El-Bialy T. Effect of high-frequency vibration on orthodontic tooth movement and bone density. J Orthod Sci 2019; 8:15. [PMID: 31497574 PMCID: PMC6702681 DOI: 10.4103/jos.jos_17_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES: Previous reports have shown that high-frequency vibration can increase bone remodeling and accelerate tooth movement. The aim of this study was to evaluate the effects of high-frequency vibration on treatment phase tooth movement, and post-treatment bone density at initiation of retention, with cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty patients with initial Class I skeletal relationships, initial minimum-moderate crowding (3–5 mm), treated to completion with clear aligners and adjunctive high-frequency vibration, (HFV group) or no vibration, (Control group) were evaluated. The patients were instructed to change aligners as soon as they become loose. Changes in bone density associated with orthodontic treatment were evaluated using i-CAT cone-beam computed tomography (CBCT) and InVivo Anatomage® software to quantify density using Hounsfield units (HU) between treated teeth in 10 different regions. HU values were averaged and compared against baseline (T1) and between the groups at initiation of retention (T2). RESULTS: The average time for aligner change was 5.2 days in the HFV group, and 8.7 days in the control group (P = 0.0001). There was significant T1 to T2 increase of HU values in the upper arch (P = 0.0001) and the lower arch (P = 0.008) in the HFV group. There was no significant change in average HU values in the upper (P = 0.83) or lower arches (P = 0.33) in the control group. The intergroup comparison revealed a significant difference in the upper, (P = 0.0001) and lower arches (P = 0.007). CONCLUSION: High-frequency vibration adjunctive to clear aligners, allowed early aligner changes that led to shorter treatment time in minimum-moderate crowded cases. At initiation of retention, the HFV group demonstrated statistically significant increase as compared with pre-treatment bone density, whereas control subjects showed no significant change from pre-treatment bone density.
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Affiliation(s)
- Thomas Shipley
- Department of Dentistry, Division of Orthodontics, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA.,Department of Orthodontics, Mesa, Arizona, USA
| | - Khaled Farouk
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt.,Department of Dentistry, Division of Orthodontics, University of Alberta, Edmonton, Canada
| | - Tarek El-Bialy
- Department of Dentistry, Division of Orthodontics, 7-020D Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta, Canada
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27
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Urban IA, Montero E, Monje A, Sanz-Sánchez I. Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:319-339. [DOI: 10.1111/jcpe.13061] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/15/2018] [Accepted: 01/06/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Istvan A. Urban
- Department of Implant Dentistry; University of Loma Linda; Loma Linda California
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Alberto Monje
- Department of Periodontology; School of Dentistry; International University of Catalonia; Barcelona Spain
- Department of Oral Surgery and Stomatology; ZMK School of Dentistry; University of Bern; Bern Switzerland
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
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28
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Abstract
Clinical assessment and conventional 2-D radiographs often provide inadequate diagnostic data for proper implant placement. Cone beam CT (CBCT) enables 3-D visualization of the alveolar ridge, aiding clinicians with identification of anatomic structures and pathologies. CBCT provides accurate linear measurements at low radiation dose compared with conventional CT scan, which helps in diagnosis and treatment planning, particularly in complex implant cases. Even though straightforward implant surgery can be performed with careful clinical and 2-D radiographic assessment, CBCT should be considered. It provides the unparalleled benefit of computer-aided implant planning, leading to improved clinical outcomes and reduced complications.
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29
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Fan Y, Glickman GN, Umorin M, Nair MK, Jalali P. A Novel Prefabricated Grid for Guided Endodontic Microsurgery. J Endod 2019; 45:606-610. [PMID: 30876703 DOI: 10.1016/j.joen.2019.01.015] [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: 09/21/2018] [Revised: 01/07/2019] [Accepted: 01/17/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to introduce a novel method using cone-beam computed tomographic (CBCT) imaging and prefabricated grids to guide apical access during endodontic microsurgery and to compare its accuracy with that of the nonguided method. METHODS Forty-two roots from human cadaver jaws were selected. Twenty-one were randomly assigned to the experimental group (grid based) and their contralateral counterparts to the control group (nonguided). Preoperative CBCT images were used to design a drill path that intended to reach the palatal/lingual aspect of the roots without attempting to complete the osteotomy or to resect the entire root end. In the experimental group, prefabricated metal grids used during imaging and surgery acted as a reference in the design and drilling. Postoperative CBCT volumes were superimposed on the preoperative volumes, and the distances between the actual drill paths and the target points were measured. A dichotomized outcome of success versus failure was also recorded and compared. Statistical analysis was performed using the paired t test and Fisher exact test. RESULTS The mean deviation of the drill paths from the target points was 0.66 mm ± 0.54 mm (mean ± standard deviation) for grid-based drilling and 1.92 mm ± 1.05 mm (mean ± standard deviation) for nonguided drilling (P < .001). Grid-based drilling was on average 1.27 mm (95% confidence interval, 0.81-1.72 mm) closer to the target point than nonguided drilling. The probability of successful drilling was also significantly higher with grids than without grids (P = .02). CONCLUSIONS The proposed method of guided osteotomy and root-end resection using prefabricated grids was more accurate than the nonguided method.
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Affiliation(s)
- Yuehong Fan
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Gerald N Glickman
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Mikhail Umorin
- Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Madhu K Nair
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, Texas
| | - Poorya Jalali
- Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.
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30
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Benouaich V, Hitzel A, Armand S. Relevance of functional imaging in dental implantology. J Clin Exp Dent 2018; 10:e1011-e1016. [PMID: 30386508 PMCID: PMC6203899 DOI: 10.4317/jced.54816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/26/2018] [Indexed: 01/16/2023] Open
Abstract
Background Despite it is widely used in many medicine fields, the use of functional imaging to examine dental implants has not been reported in the literature. This work aimed to evaluate the relevance of functional medical imaging in oral implantology. Material and Methods This single-center observational study was conducted for 6 months at the Toulouse University Hospital, France. All patients who underwent positron emission tomography with 18-fluorodeoxyglucose integrated with X-ray computed tomography (FDG PET/CT) and had dental implants were included. Metabolic activity of the peri-implant tissues was assessed qualitatively and quantitatively jointly by a nuclear physician and a dental surgeon. Results In 31 patients (121 implants), peri-implant metabolic activity was normal. In 3 patients (4 implants), localized peri-implant hypermetabolism was observed. In all the patients presenting abnormal peri-implant activity, the implants with normal activity were clinicaly and radiogicaly normal, whereas those with hypermetabolism presented peri-implantitis. Conclusions This study assess of the relevance of FDG PET/CT in oral implantology. It shows a link between peri-implant hypermetabolism and peri-implantitis. Therefore, FDG PET/CT could become a new tool for the assessment of peri-implant diseases. Key words:Dental implantation, dental implants, peri-implantitis, diagnostic imaging , imaging, three-dimensional, imaging processing, computer-assisted.
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Affiliation(s)
- Vincent Benouaich
- Doctor of Dental Surgery, Department of Odontology, Toulouse University Hospital, France
| | - Anne Hitzel
- Doctor of Medicine, Department of Nuclear Medicine, Toulouse University Hospital, France
| | - Serge Armand
- Doctor of Dental Surgery, University Professor, Department of Odontology, Toulouse University Hospital, France
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31
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Vasques WF, Martins FV, Magalhães JC, Fonseca EM. A low cost minimally invasive adhesive alternative for maxillary central incisor replacement. J ESTHET RESTOR DENT 2018; 30:469-473. [PMID: 30267598 DOI: 10.1111/jerd.12409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The beneficial mechanical properties of zirconia, together with the adhesive techniques, provide a wide range of clinical applications, including the construction of thin structures and minimally invasive adhesive restorations. CLINICAL CONSIDERATIONS A periodontal disease-related missing maxillary central incisor, in a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes treated with resin-bonded fixed partial denture using the missing tooth cemented to a zirconia framework and then bonded to the abutment teeth. CONCLUSIONS According to the systemic conditions presented in this case report, using a low-cost technology and the missing tooth it was possible to obtain an easier and satisfactory esthetic and functional result. CLINICAL SIGNIFICANCE The mechanical properties of zirconia made it possible to treat a pregnant patient with chronic periodontal disease in the first trimester of pregnancy, and with type II diabetes with a thin zirconia framework and minimally invasive adhesive restorations.
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Affiliation(s)
- Wesley F Vasques
- College of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Felipe V Martins
- College of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - José Carlos Magalhães
- Department of Dental Technique, College of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Edgard M Fonseca
- Department of Dental Technique, College of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
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32
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Liedke GS, Spin-Neto R, da Silveira HED, Schropp L, Stavropoulos A, Wenzel A. Accuracy of detecting and measuring buccal bone thickness adjacent to titanium dental implants-a cone beam computed tomography in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:432-438. [PMID: 30126809 DOI: 10.1016/j.oooo.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/16/2018] [Accepted: 06/11/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aim of this study was to assess the accuracy of detecting and measuring buccal bone thickness (BBT) adjacent to titanium implants in cone beam computed tomography (CBCT) images. STUDY DESIGN Titanium implants (1, 2, or 3), abutments, and metal-ceramic crowns were inserted into 40 bone blocks with various BBTs. CBCT images were acquired in various settings: Voxel sizes (0.2 and 0.13 mm) and reconstruction section thicknesses (2.0 and 5.0 mm) were assessed by 3 examiners. True BBT was measured in digital photographs of the bone blocks. Buccal bone detection was evaluated by sensitivity and specificity. BBT was evaluated by 1-way analysis of variance (ANOVA) between the true and the CBCT measurements and by calculating the difference between the true measurement and the CBCT measurement (Di-BBT). RESULTS Detection of buccal bone exhibited high sensitivity (0.86-1) and low specificity (0.14-1). More implants in the field of view, large voxel size, and thick image reconstruction sections had a negative impact on buccal bone detection. ANOVA showed statistically significantly larger BBT for the CBCT measurements in all settings (1.07-1.21 mm) compared with the true measurements (0.85 mm). Di-BBT was mostly within 0.5 mm. CONCLUSIONS BBT adjacent to titanium implants is overestimated when evaluated on CBCT cross-sectional images.
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Affiliation(s)
- Gabriela Salatino Liedke
- Adjunct Professor, Oral Radiology, Department of Stomatology, School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Rubens Spin-Neto
- Associate Professor, Oral Radiology, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Heloisa Emilia Dias da Silveira
- Professor, Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lars Schropp
- Associate Professor, Oral Radiology, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Andreas Stavropoulos
- Professor, Dept. of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ann Wenzel
- Professor, Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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33
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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: 26] [Impact Index Per Article: 4.3] [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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Saleh MHA, Ravidà A, Suárez-López del Amo F, Lin GH, Asa'ad F, Wang HL. The effect of implant-abutment junction position on crestal bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:617-633. [DOI: 10.1111/cid.12600] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/27/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | | | - Guo-Hao Lin
- Department of Orofacial Sciences; University of California; San Francisco California
| | - Farah Asa'ad
- Department of Biomedical, Surgical & Dental Sciences; University of Milan; Milan Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
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35
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McAllister BS, Eshraghi VT. Commentary: Cone-Beam Computed Tomography: An Essential Technology for Management of Complex Periodontal and Implant Cases. J Periodontol 2017; 88:937-938. [PMID: 28967332 DOI: 10.1902/jop.2017.1710001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bradley S McAllister
- Private practice, Tualatin and Beaverton, OR.,Department of Periodontology, Oregon Health and Science University, Portland, OR
| | - V Thomas Eshraghi
- Private practice, Tualatin and Beaverton, OR.,Department of Periodontology, Oregon Health and Science University, Portland, OR
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36
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Mandelaris GA, Scheyer ET, Evans M, Kim D, McAllister B, Nevins ML, Rios HF, Sarment D. American Academy of Periodontology Best Evidence Consensus Statement on Selected Oral Applications for Cone-Beam Computed Tomography. J Periodontol 2017; 88:939-945. [DOI: 10.1902/jop.2017.170234] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- George A. Mandelaris
- Private practice, Oakbrook Terrace, Park Ridge, and Chicago, IL
- Department of Graduate Periodontics, University of Illinois College of Dentistry, Chicago, IL
| | - E. Todd Scheyer
- Private practice, Houston, TX
- University of Texas Dental School, Houston, TX
| | - Marianna Evans
- Department of Orthodontics, University of Pennsylvania, Philadelphia, PA
- Private practice, Newtown Square, PA
| | - David Kim
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA
| | - Bradley McAllister
- Private practice, Tualatin and Beaverton, OR
- Department of Periodontology, Oregon Health and Science University, Portland, OR
| | - Marc L. Nevins
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA
- Private practice, Boston, MA
| | | | - David Sarment
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
- Xoran Technologies, Ann Arbor, MI
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