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Shahmirzadi S, Maghsoodi-Zahedi T, Saadat S, Demirturk Kocasarac H, Rezvan M, Katkar RA, Nair MK. Assessment of alveolar bone changes in response to minimally invasive periodontal surgery: A cone-beam computed tomographic evaluation. Imaging Sci Dent 2022; 53:1-9. [PMID: 37006791 PMCID: PMC10060762 DOI: 10.5624/isd.20220053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST). Materials and Methods Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured. Results An average alveolar bone gain >0.5 mm following PST was identified using CBCT (P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years. Conclusion PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.
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Affiliation(s)
- Solaleh Shahmirzadi
- Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX, USA
| | | | - Sarang Saadat
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Husniye Demirturk Kocasarac
- Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | - Rujuta A. Katkar
- Division of Oral and Maxillofacial Radiology, Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Madhu K. Nair
- Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX, USA
- Department of Surgery, Baylor University Medical Center, Dallas, TX, USA
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Abstract
Optical coherence tomography (OCT) is a noninvasive diagnostic technique providing cross-sectional images of biologic structures based on the differences in tissue optical properties. OCT has been widely used in numerous clinical applications and is becoming popular as a promising technology in dentistry. Today, dental hard (tooth) and soft (hard palate mucosa and gingiva mucosa) tissues are visualized with OCT. With new developments in technology, the applications of OCT are being investigated in various fields in dentistry, such as to detect microleakage around restoration, tooth cracks/fractures, examination of periodontal tissues/pockets, early detection of oral cancerous tissues, and in endodontics for location of pulp canal.
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Affiliation(s)
- Rujuta A Katkar
- Department of Comprehensive Dentistry, UT Health, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | | | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Daniel Fried
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA 94143-0758, USA
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Abstract
Three-dimensional (3D) volume-rendered images allow 3D insight into the anatomy, facilitating surgical treatment planning and teaching. 3D printing, additive manufacturing, and rapid prototyping techniques are being used with satisfactory accuracy, mostly for diagnosis and surgical planning, followed by direct manufacture of implantable devices. The major limitation is the time and money spent generating 3D objects. Printer type, material, and build thickness are known to influence the accuracy of printed models. In implant dentistry, the use of 3D-printed surgical guides is strongly recommended to facilitate planning and reduce risk of operative complications.
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Affiliation(s)
- Rujuta A Katkar
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
| | - Robert M Taft
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, School of Dentistry, MC 7914, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Gerald T Grant
- Oral Health and Rehabilitation, University of Louisville School of Dentistry, 501 South Preston Street, Room 311, Louisville, KY 40202, USA
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Katkar RA, Geha H. Emerging Imaging Technologies in Dentomaxillofacial Radiology. Dent Clin North Am 2018; 62:xi-xii. [PMID: 29903565 DOI: 10.1016/j.cden.2018.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Rujuta A Katkar
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Hassem Geha
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
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Katkar RA. Mesially Inclined Third Molars May or May Not Be Associated With External Root Resorption in Adjacent Second Molars. J Evid Based Dent Pract 2015; 15:131-3. [PMID: 26337587 DOI: 10.1016/j.jebdp.2015.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rujuta A Katkar
- Assistant Professor, Oral & Maxillofacial Radiology, Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
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Katkar RA, Katz J, Moreb JS, Nair MK. Multiple myeloma in bisphosphonate-affected jaws--a diagnostic challenge: case report. Quintessence Int 2014; 45:613-617. [PMID: 24847501 DOI: 10.3290/j.qi.a31962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To discuss the challenges in diagnosis and appropriate management of critical underlying pathoses if a patient presents with signs and symptoms indicative of different conditions that may coexist. SUMMARY This case features clinical and radiographic challenges in reaching a diagnosis in a middle- aged man undergoing bisphosphonate therapy for multiple myeloma. The patient had history of bisphosphonaterelated osteonecrosis of the jaw (BRONJ) in the mandible. The patient presented with pain and swelling in the anterior maxilla, associated with paresthesia of upper lip. The radiographic features were suggestive of BRONJ and invasive fungal sinusitis. MRI appearance was suggestive of malignant involvement by plasmacytoma or lymphoma. Although biopsy is usually not advocated in bisphosphonate-affected jaws, it was advised in this case and was positive for multiple myeloma. Vigilance is required to correlate clinical and radiologic findings and further investigations must be considered if malignancy is suspected.
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Nair UP, Yazdi MH, Nayar GM, Parry H, Katkar RA, Nair MK. Configuration of the inferior alveolar canal as detected by cone beam computed tomography. J Conserv Dent 2013; 16:518-21. [PMID: 24347885 PMCID: PMC3842719 DOI: 10.4103/0972-0707.120964] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/15/2013] [Accepted: 09/13/2013] [Indexed: 11/04/2022] Open
Abstract
AIMS The aim of this study is to evaluate the course of the inferior alveolar canal (IAC) including its frequently seen variations in relation to root apices and the cortices of the mandible at fixed pre-determined anatomic reference points using cone beam volumetric computed tomography (CBVCT). MATERIAL AND METHODS This retrospective study utilized CBVCT images from 44 patients to obtain quantifiable data to localize the IAC. Measurements to the IAC were made from the buccal and lingual cortical plates (BCP/LCP), inferior border of the mandible and the root apices of the mandibular posterior teeth and canine. Descriptive analysis was used to map out the course of the IAC. RESULTS IACs were noted to course superiorly toward the root apices from the second molar to the first premolar and closer to the buccal cortical plate anteriorly. The canal was closest to the LCP at the level of the second molar. In 32.95% of the cases, the canal was seen at the level of the canine. CONCLUSIONS This study indicates that caution needs to be exercised during endodontic surgical procedures in the mandible even at the level of the canine. CBVCT seems to provide an optimal, low-dose, 3D imaging modality to help address the complexities in canal configuration.
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Affiliation(s)
- Umadevi P Nair
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
| | - Mehran H Yazdi
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
| | - Gautam M Nayar
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
| | - Heath Parry
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
| | - Rujuta A Katkar
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
| | - Madhu K Nair
- Department of Endodontics and Diagnostic Sciences, University of Florida, College of Dentistry, Florida, USA
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Katkar RA, Kummet C, Dawson D, Moreno Uribe L, Allareddy V, Finkelstein M, Ruprecht A. Comparison of observer reliability of three-dimensional cephalometric landmark identification on subject images from Galileos and i-CAT cone beam CT. Dentomaxillofac Radiol 2013; 42:20130059. [PMID: 23833319 DOI: 10.1259/dmfr.20130059] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Recently, there has been increasing interest in the use of cone beam CT (CBCT) for three-dimensional cephalometric analysis and craniofacial reconstruction in orthodontic and orthognathic surgical treatment planning. However, there is a need to redefine the cephalometric landmarks in three dimensional cephalometric analysis and to demonstrate the reproducibility of landmark identification on the type of CBCT machine being used. METHODS CBCT images of 20 subjects aged 15-25 years were selected, ten each from Galileos(®) (Sirona Dental Systems Inc., Bensheim, Germany) and Next Generation i-CAT(®) (Imaging Sciences International, Hatfield, PA). 2 observers located 18 landmarks on each subject twice using Dolphin-3D v. 11 software (Dolphin Imaging and Management Systems, Chatsworth, CA). Inter- and intraobserver reliability was assessed using Euclidean distances and linear mixed models. RESULTS Overall, the intra- and interobserver reliability was excellent for both machines. The landmarks Gonion, Nasion, Orbitale and Anterior Nasal Spine (ANS) showed the greatest median Euclidean distances for both intra- and interobserver measurements. There were significant observer effects in the unified models for Sella, Menton and all six dental landmarks. For Sella, the distances between the measures were significantly smaller (more closely spaced) on the i-CAT machine than on the Galileos in both intra- and interobserver measurements. CONCLUSIONS The intra- and interobserver reliability was excellent for both machines. Some of the landmarks were not as reproducible as others. Which machine produced the highest reliability depended on the landmark considered.
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Affiliation(s)
- R A Katkar
- Department of Oral and Maxillofacial Radiology, University of Florida, College of Dentistry, Gainesville, FL
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Katkar RA, Katkar AS. Central giant cell granulomas: a systematic review of the radiographic characteristics with the addition of 20 new cases published in Dentomaxillofacial Radiology 2002; 31: 213-217. Dentomaxillofac Radiol 2012; 41:177; author reply 178. [PMID: 22301641 PMCID: PMC3520372 DOI: 10.1259/dmfr/55044845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- RA Katkar
- Department of Oral Pathology, Radiology and Medicine, The University of Iowa College of Dentistry
| | - AS Katkar
- Department of Oral Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA USA E-mail:
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