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Theodoridis C, Damaskos S, Angelopoulos C. Frequency and Clinical Significance of Incidental Findings on CBCT Imaging: a Retrospective Analysis of Full-Volume Scans. J Oral Maxillofac Res 2024; 15:e5. [PMID: 38812950 PMCID: PMC11131377 DOI: 10.5037/jomr.2024.15105] [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: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 05/31/2024]
Abstract
Objectives This retrospective study aims to identify incidental findings in cone-beam computed tomography scans of patients irradiated for preoperative evaluation for implant placement and obtained using the same imaging unit as well as the same field of view. The incidence of each incidental finding, as well as the overall incidence, were calculated and the findings were ranked according to their clinical significance. Material and Methods A total of 741 cone-beam computed tomography (CBCT) examinations with extended field of view (15 x 15 cm) were retrospectively evaluated for incidental findings (IFs). These were identified, recorded, classified as to their location, and ranked according to their clinical significance. Results The vast majority of CBCT examinations presented at least one IF, resulting in a surprisingly high prevalence in total. If extreme anatomical variants are considered (nasal septum deviation, sinus septations etc.), the cumulative prevalence exceeds 99%. IFs of major significance, that may require immediate attention, are beyond 10% in frequency. Conclusions We found high prevalence of incidental findings on cone-beam computed tomography examinations performed for preoperative evaluation for implant placement (99.5% if anatomical variants included). Most incidental findings were of minor significance. Although the number of incidental findings that require immediate attention is relatively low, there is a considerable number of cases that need periodic evaluation and/or referral.
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Affiliation(s)
- Charis Theodoridis
- Department of Preventive Dentistry - Periodontology and Implant Biology, Aristotle University of Thessaloniki, 3 Kavalas Str., 565625, Sykies, ThessalonikiGreece.
| | - Spyros Damaskos
- Department of Oral Diagnosis and Radiology, Dental School of Athens, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, AthensGreece.
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, Dental School of Athens, National and Kapodistrian University of Athens, 2 Thivon Str, 11527, Goudi, AthensGreece.
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Heller ZA, Hogge M, Ragan MR, Portnof JE. Applications of Cone Beam Computed Tomography Scans in Dental Medicine and Potential Medicolegal Issues. Dent Clin North Am 2024; 68:55-65. [PMID: 37951637 DOI: 10.1016/j.cden.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
A cone beam central tomography (CBCT) scan produces images in orthogonal and non-orthogonal with great spatial resolution. When a dental health care practitioner (DHP) orders a CBCT scan, they should consider if it is truly indicated, as CBCT scans carry up to four times the dosage of radiation compared to panoramic radiographs. Any diagnostic imaging obtained of a patient should include a formal interpretive report commenting on the findings within the imaging. Ordering of limited field of view (FOV) CBCT scans and failing to report on abnormal findings present outside of the region of interest (ROI) is a potential medicolegal issue.
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Affiliation(s)
- Zachary A Heller
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA.
| | - Maritzabel Hogge
- Department of Maxillofacial Medicine, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Michael R Ragan
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA
| | - Jason E Portnof
- Department of Oral and Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3050 South University Drive, Davie, FL 33314, USA; Private Practice, 9980 North Central Park Boulevard, Suite 113, Boca Raton, FL 33428, USA
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Etemad L, Mehta S, Lurie AG, Tadinada A. Prevalence and Clinical Significance of Incidental Findings in the Maxillofacial Complex of Adolescent Orthodontic Patients: A Retrospective Cone Beam Computed Tomography Analysis. Cureus 2023; 15:e47480. [PMID: 38022275 PMCID: PMC10663048 DOI: 10.7759/cureus.47480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence and severity of incidental findings in the maxillofacial complex of orthodontic patients imaged with cone beam computed tomography (CBCT) and assign those findings an appropriate clinical significance. METHODOLOGY Incidental findings (IF) were identified in 250 CBCT scans of adolescent orthodontic patients (aged 13-18 years) with a large field-of-view and categorized based on their anatomic location and placed into one of six subgroups based on anatomic region: i) sino-nasal, ii) dentoalveolar, iii) nasooropharyngeal airway, iv) temporomandibular joint, v) neck, vi) calcifications, and vi) miscellaneous findings. Additionally, findings were assigned a clinical significance score based on severity on a scale of mild, moderate and severe. Mild IF was defined as an IF that does not require any further investigation or referral. Moderate IF was defined as an IF that has the tendency to become clinically significant and should be observed periodically. IFs that warrant further investigation and/or intervention were designated as severe. RESULTS The percentage of IFs in sino-nasal and dento-alveolar regions were 44.7% and 19.1% respectively. The percentage of IFs with mild, moderate, and severe clinical significance were 27%, 72%, and 1%, respectively. Out of the IFs involving calcifications, 80.8% were stylohyoid calcifications and <1% were cranial cavity IFs such as petroclinoid calcifications and falx cerebri calcifications. Among the sino-nasal findings, 1.2% were identified as severe. CONCLUSION The sino-nasal region had the highest frequency of IFs. Understanding the prevalence of incidental findings and its clinical relevance is important for clinicians to allow for appropriate monitoring and timely treatment of patients.
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Affiliation(s)
- Lily Etemad
- Orthodontics, Siddiqui Orthodontics, Ann Arbor, USA
| | - Shivam Mehta
- Orthodontics, Marquette University School of Dentistry, Milwaukee, USA
| | - Alan G Lurie
- Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, USA
| | - Aditya Tadinada
- Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, USA
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Ahmed J, Gupta A, Shenoy N, Sujir N, Muralidharan A. Prevalence of Incidental Maxillary Sinus Anomalies on CBCT Scans: A Radiographic Study. Diagnostics (Basel) 2023; 13:2918. [PMID: 37761284 PMCID: PMC10528184 DOI: 10.3390/diagnostics13182918] [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: 08/18/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant (p = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.
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Affiliation(s)
| | | | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal 575001, Karnataka, India; (J.A.); (A.G.); (N.S.); (A.M.)
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Al-Tayar B, Al-Somairi MAA, ALshoaibi LH, Wang X, Wang J, Liu J, Al-Tayar B, An X, Si Q. Impact of molar teeth distalization by clear aligners on temporomandibular joint: a three-dimensional study. Prog Orthod 2023; 24:25. [PMID: 37455279 DOI: 10.1186/s40510-023-00474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Maxillary molar distalization is a common technique used in the non-extraction treatment of Angle Class II malocclusion that can effectively correct the molar relationship and create spaces for anterior teeth alignment. However, this approach may also impact the temporomandibular joint (TMJ) due to predictable changes in the posterior vertical dimension. Despite its widespread use, Class II malocclusions correction by molar distalization with clear aligners has not been investigated for their effects on the TMJ. Therefore, this study aimed to analyze the impact of sequential molar distalization using clear aligners on the TMJ. METHODS Three-dimensional CBCT scans of 23 non-growing patients (7 males, 16 females; mean age 29.8 ± 4.6 years) with skeletal class I or II malocclusion and a bilateral molar class II relationship treated by sequential upper molars distalization with orthodontic clear aligners (Invisalign, Align Technology, San Josè, Ca, USA). A total of 46 joints were examined before and after molar distalization using Anatomage InvivoDental 6.0.3. Linear and angular measurements of the mandibular joint were measured, including joint parameters, inclination, position, and the dimension of the condyle and articular fossa. In addition, 3D volumetric spaces of the joint were analyzed. All data were statistically analyzed by paired T test to determine the differences between the pre-and post-orthodontic procedures. RESULTS No statistically significant differences were found in all primary effects resulting from maxillary molars distalization by clear aligners on TMJ components measurements and joint spaces between T0 and T1. Meanwhile, statistically significant differences were observed in the linear position of the upper molars and the molar relationship parameter with at least P ≤ 0.05. CONCLUSION Treatment by sequential upper molars distalization with clear aligners does not lead to significant TMJ parameters changes in condyle and fossa spaces, dimensions, and positions.
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Affiliation(s)
- Barakat Al-Tayar
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
- Orthodontics Division, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Majedh A A Al-Somairi
- Orthodontics Department, School of Stomatology, China Medical University, Shenyang, 110000, China
| | - Lina H ALshoaibi
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoli Wang
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Junbin Wang
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Jiajie Liu
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Baher Al-Tayar
- Graduate Student of Dental Health Science, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Dentistry, Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Xiaoli An
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China.
| | - Qingzong Si
- Department of Oral Medicine, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
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Marques FBC, Siqueira de Lima L, Coqueiro RDS, Pithon MM, Ruellas ACDO, Maciel JVB, Nojima MDCG. Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00103-8. [PMID: 36967314 DOI: 10.1016/j.ajodo.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. METHODS Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n = 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n = 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. RESULTS Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P = 0.412 and P = 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P = 0.011, P = 0.024, and P = 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P = 0.008), mandibular ramus height (P = 0.004), condyle height (P = 0.010) and gonion to midsagittal plane distance (P = 0.018). CONCLUSIONS Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.
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Affiliation(s)
- Fernanda Blaudt Carvalho Marques
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lilian Siqueira de Lima
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raildo da Silva Coqueiro
- Department of Health I, School of Dentistry, Universidade Estadual do Sudoeste da Bahia, Jequié, Bahia, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, School of Dentistry, Universidade Estadual do Sudoeste da Bahia, Jequié, Bahia, Brazil
| | - Antônio Carlos de Oliveira Ruellas
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Matilde da Cunha Gonçalves Nojima
- Department of Pedodontics and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Talwade P, Deshpande PS, Pene S, Kumar S, Kudagi V, Limaye M. Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study. Int J Clin Pediatr Dent 2023; 16:292-294. [PMID: 37519960 PMCID: PMC10373774 DOI: 10.5005/jp-journals-10005-2528] [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] [Indexed: 08/01/2023] Open
Abstract
Objectives The study was conducted to assess the prevalence of incidental paranasal sinus pathologies in children on computed tomography (CT) scans. Materials and methods A nonrandomized retrospective study was done on CT scans of 232 pediatric patients taken in the past 6 months duration. These scans were evaluated in different age groups from 0-13 years who had visited or were admitted to the hospital for various other head and neck-related problems. Each scan was examined for incidental pathologic findings in all the paranasal sinuses. The data were analyzed using descriptive statistics and Fisher's exact test to determine non-random associations between variables. Results A total of 232 subjects were examined, amongst which 72 (31.03%) had incidental sinus pathologies. Multiple sinus pathologies were found in 36 subjects, 28 had single sinus involvement, and four showed no development of frontal sinus at the age of 11 years. Four subjects had pathology in multiple sinuses as well as no development of frontal sinus at the age of 6-7 years age range. Conclusion Sinus pathologies are not unusual in the asymptomatic children population, and the incidence is almost equivalent to that of the adult population. Early identification can aid in diagnosing orofacial pain of unknown origin and also if children are susceptible to upper respiratory tract infections and their secondary effects like sleep apnea, mouth breathers, etc. How to cite this article Talwade P, Deshpande PS, Pene S, et al. Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study. Int J Clin Pediatr Dent 2023;16(2):292-294.
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Affiliation(s)
- Priyanka Talwade
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Prasannasrinivas S Deshpande
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Shailesh Pene
- Department of Interventional Radiology, Narayana Multispecialty Hospital, Mysuru, Karnataka, India
| | - Shruti Kumar
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Vishal Kudagi
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Mrinal Limaye
- Department of Periodontology and Implantology, KVG Dental College and Hospital, Sullia, Karnataka, India
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Oueiss A, Camia J, Masucci C, Charavet C, Joseph C. Exploring the mylohyoid area as a reference for three-dimensional digital mandibular superimposition. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:672-676. [PMID: 35907610 DOI: 10.1016/j.jormas.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION the quantification of tooth movements should be obtained at different specific times and compared at different stages for every orthodontic treatment. These movements are generally measured on teleradiographs or casts. The use of Cone Beam Computed tomography (CBCT) for maxillary superimposition is clearly established in the literature, but not well defined for mandibular superimposition. This study aims to explore and evaluate the accuracy of the mylo-hyoid area as a reference for mandibular Digital Dental Cast (DDC) three-dimensional (3D) superimposition. MATERIALS AND METHODS the study compared mandibular 3D overlays with profile teleradiographs in 30 patients followed at Nice Saint Roch University Hospital. The molar and incisor coordinates on the 3D superimposition based on the mylo-hyoid area were compared to the ones on the 2D lateral cephalogram. Differences between the two methods of superimposition were assessed using paired t-tests. RESULTS No statistically significant difference was observed between the lateral cephalogram-based and mandibular DDC superimposition methods in 3D sagittal and vertical displacements of the lower first molars and central incisors. CONCLUSION The study showed the mylo-hyoid area to be an accurate superimposition landmark for the 3D evaluation of mandibular orthodontic tooth displacement. This method is also applicable for patients with conventional orthodontic treatment records. Other studies should be conducted on larger populations, subgroups (malocclusions, therapeutics) and on the use of an intra-oral camera.
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Affiliation(s)
- A Oueiss
- Nice University Hospital, France; Côte d'Azur University, Nice, France; Department of orthodontics and dentofacial orthopedics, faculty of dentistry, Nice, France.
| | - J Camia
- Nice University Hospital, France; Côte d'Azur University, Nice, France; Department of orthodontics and dentofacial orthopedics, faculty of dentistry, Nice, France
| | - C Masucci
- Nice University Hospital, France; Côte d'Azur University, Nice, France; Department of orthodontics and dentofacial orthopedics, faculty of dentistry, Nice, France
| | - C Charavet
- Nice University Hospital, France; Côte d'Azur University, Nice, France; Department of orthodontics and dentofacial orthopedics, faculty of dentistry, Nice, France; UPR 7354 MICORALIS laboratory, Nice, France
| | - C Joseph
- Nice University Hospital, France; Côte d'Azur University, Nice, France; Department of orthodontics and dentofacial orthopedics, faculty of dentistry, Nice, France; Department of pediatric dentistry, faculty of dentistry, Nice, France; UPR 7354 MICORALIS laboratory, Nice, France
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Dental and Maxillofacial Cone Beam CT-High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management. Diagnostics (Basel) 2022; 12:diagnostics12051036. [PMID: 35626192 PMCID: PMC9139763 DOI: 10.3390/diagnostics12051036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/08/2022] [Accepted: 04/16/2022] [Indexed: 12/04/2022] Open
Abstract
Cone beam computed tomography (CBCT) is increasingly used for dental and maxillofacial imaging. The occurrence of incidental findings has been reported, but clinical implications of these findings remain unclear. The study’s aim was to identify the frequency and clinical impact of incidental findings in CBCT. A total of 374 consecutive CBCT examinations of a 3 year period were retrospectively evaluated for the presence, kind, and clinical relevance of incidental findings. In a subgroup of 54 patients, therapeutic consequences of CBCT incidental findings were queried from the referring physicians. A total of 974 incidental findings were detected, involving 78.6% of all CBCT, hence 2.6 incidental findings per CBCT. Of these, 38.6% were classified to require treatment, with an additional 25.2% requiring follow-up. Incidental findings included dental pathologies in 55.3%, pathologies of the paranasal sinuses and airways in 29.2%, osseous pathologies in 14.9% of all CBCT, and findings in the soft tissue or TMJ in few cases. Clinically relevant dental incidental findings were detected significantly more frequently in CBCT for implant planning compared to other indications (60.7% vs. 43.2%, p < 0.01), and in CBCT with an FOV ≥ 100 mm compared to an FOV < 100 mm (54.7% vs. 40.0%, p < 0.01). Similar results were obtained for paranasal incidental findings. In a subgroup analysis, 29 of 54 patients showed incidental findings which were previously unknown, and the findings changed therapeutical management in 19 patients (35%). The results of our study highlighted the importance of a meticulous analysis of the entire FOV of CBCT for incidental findings, which showed clinical relevance in more than one in three patients. Due to a high number of clinically relevant incidental findings especially in CBCT for implant planning, an FOV of 100 × 100 mm covering both the mandible and the maxilla was concluded to be recommendable for this indication.
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Panwar P, Chandran A, Patil M, Nachiappan S, Nagarajappa A, Kolte D, Babu JS, Swarnalatha C, Nayyar A. Accidental pathological findings in asymptomatic maxillary sinuses in patients referred for head and neck cone-beam computed tomography: A cross-sectional study analysis. JOURNAL OF MEDICAL SIGNALS & SENSORS 2022; 12:138-144. [PMID: 35755975 PMCID: PMC9215838 DOI: 10.4103/jmss.jmss_96_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 05/09/2021] [Accepted: 05/26/2021] [Indexed: 11/04/2022]
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Serindere G, Bilgili E, Yesil C, Ozveren N. Evaluation of maxillary sinusitis from panoramic radiographs and cone-beam computed tomographic images using a convolutional neural network. Imaging Sci Dent 2022; 52:187-195. [PMID: 35799961 PMCID: PMC9226235 DOI: 10.5624/isd.20210263] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Gozde Serindere
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ersen Bilgili
- Department of Dentomaxillofacial Radiology, Izmir Education Dental Hospital, Izmir, Turkey
| | - Cagri Yesil
- Department of Computer Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Turkey
| | - Neslihan Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
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Dong Q, Shi H, Jia Q, Tian Y, Zhi K, Zhang L. Analysis of Three-Dimensional Morphological Differences in the Mandible between Skeletal Class I and Class II with CBCT Fixed-Point Measurement Method. SCANNING 2021; 2021:9996857. [PMID: 34040691 PMCID: PMC8121591 DOI: 10.1155/2021/9996857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/21/2021] [Accepted: 04/24/2021] [Indexed: 06/12/2023]
Abstract
This study was aimed at determining the three-dimensional differences in the mandible morphology between skeletal class I and II patients, at exploring the pathogenic mechanisms and morphological characteristics of skeletal class II, and at providing clinical references. The subjects were assigned to two groups according to the size of ANB angle: skeletal class I (2° < ANB angle < 5°) and skeletal class II (5° < ANB angle < 8°). After cone-beam computed tomography (CBCT) scanning, 31 landmarks and 25 measurement items were determined by In Vivo Dental 5.1 software (Anatomage, CA) for statistical analysis. The results were as follows: Co-Go, Go-Me, and CdM-CdD in skeletal class II cases were smaller than those in skeletal class I, and GoR-Me-GoL, GoR-Me-CoL, and, Ig-Men were larger than those in skeletal class I cases. In conclusion, there were significant differences in the three-dimensional morphology of the mandible between skeletal class I and class II patients. The vertical growth of the ramus, the horizontal growth of the mandibular body, and the condyle in skeletal class II patients were smaller than those in skeletal class I cases. In skeletal class II, the growth of the anterior part of the mandible in the vertical direction was larger than that in skeletal class I, and the shape of the mandible was more extended.
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Affiliation(s)
- Qiang Dong
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, 266003 Shandong, China
- School of Stomatology of Qingdao University, Qingdao, 266003 Shandong, China
| | - HaoYu Shi
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Tai'an, 271016 Shandong, China
| | - Qi Jia
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Tai'an, 271016 Shandong, China
| | - Yueyi Tian
- The Conversationalist Club, School of Stomatology, Shandong First Medical University, Tai'an, 271016 Shandong, China
| | - Keqian Zhi
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, 266003 Shandong, China
| | - Lu Zhang
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, 266003 Shandong, China
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Effectiveness of 2D radiographs in detecting CBCT-based incidental findings in orthodontic patients. Sci Rep 2021; 11:9280. [PMID: 33927309 PMCID: PMC8085218 DOI: 10.1038/s41598-021-88795-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/16/2021] [Indexed: 01/12/2023] Open
Abstract
Some craniofacial diseases or anatomical variations are found in radiographic images taken for other purposes. These incidental findings (IFs) can be detected in orthodontic patients, as various radiographs are required for orthodontic diagnosis. The radiographic data of 1020-orthodontic patients were interpreted to evaluate the rates of IFs in three-dimensional (3D) cone-beam-computed tomography (CBCT) with a large field of view (FOV) and investigate the effectiveness and accuracy of two-dimensional (2D) radiographs for detecting IFs compared to CBCT. Prevalence and accuracy in five areas was measured for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The accuracies of various 2D-radiograph were compared through a proportion test. A total of 709-cases (69.5%) of 1020-subjects showed one or more IFs in CBCT images. Nasal cavity was the most affected area. Based on the CBCT images as a gold standard, different accuracies of various 2D-radiographs were observed in each area of the findings. The highest accuracy was confirmed in soft tissue calcifications with comprehensive radiographs. For detecting nasal septum deviations, postero-anterior cephalograms were the most accurate 2D radiograph. In cases the IFs were not determined because of its ambiguity in 2D radiographs, considering them as an absence of findings increased the accuracy.
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Al-Balaa M, Li H, Ma Mohamed A, Xia L, Liu W, Chen Y, Omran T, Li S, Hua X. Predicted and actual outcome of anterior intrusion with Invisalign assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 159:e275-e280. [PMID: 33518439 DOI: 10.1016/j.ajodo.2020.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/01/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The purpose of this study was to compare predicted anterior teeth intrusion measurements with the actual clinical intrusion measurements using cone-beam computed tomography. Understanding the precision of the software in anticipating changes may help practitioners predict the need for overcorrection. METHODS Twenty-two patients, with a mean age of 23.74 years, who underwent Invisalign (Align Technology, Santa Clara, Calif) clear aligners treatment for both arches only after having completed treatment with an initial series of aligners were included in this study. The pretreatment and posttreatment cone-beam computed tomography scans after the initial series were acquired by a single orthodontist practitioner. ClinCheck measurements were recorded with Align Technology. The long axis of the anterior tooth intrusion movement was measured in 142 teeth. A comparison between the predicted and actual measurements of anterior intrusion of the teeth was performed, and the intraclass correlation coefficients showed an almost perfect agreement in the linear measurements. RESULTS A statistically notable difference between the predicted and actual measurements of anterior intrusion. The predicted intrusion movement of the maxillary canines (P = 0.001), maxillary lateral incisors (P <0.0001), and maxillary central incisors (P <0.0001) significantly differed from the actual values. Similarly, the intrusion movement in the mandibular teeth seemed to be inaccurate, with significant differences in the mandibular canines (P <0.0001) and mandibular lateral and central incisors (P <0.0001). CONCLUSIONS The mean precision of true anterior intrusion with Invisalign clear aligners was 51.19%, and the mean amount of correction was 48.81%. The use of other supplementary methods of anterior teeth intrusion may be helpful to reduce the rate of midcourse corrections and refinements.
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Affiliation(s)
- Maher Al-Balaa
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hanyue Li
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | | | - Lulu Xia
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Liu
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yaosen Chen
- Department of Stomatology, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Tamer Omran
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shufang Li
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xianming Hua
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Anatomical characteristics of maxillary sinus antroliths and their influence on sinus membrane thickness: a retrospective cone beam computed tomography analysis. Int J Oral Maxillofac Surg 2021; 50:1107-1112. [PMID: 33431227 DOI: 10.1016/j.ijom.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/13/2020] [Accepted: 12/17/2020] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to assess the anatomy of antroliths and its influence on the thickness of the maxillary sinus membrane. Cone beam computed tomography (CBCT) was performed on 239 patients (478 sinuses). The prevalence of antroliths per sinus was 8.4%. Regarding their distribution, antroliths were predominantly unilateral (82.5%), single (67.5%), and in a dentate area (60.0%). The antroliths were mainly located in the molar region (95.0%) and in the sinus floor (77.5%). The measured dimensions of the antroliths were as follows: length 5.6±4.4mm, width 4.1±2.9mm, height 3.5±2.1mm. The relationships between the antroliths and the sinus membrane (type 1, 34.1%; type 2, 52.3%; type 3, 13.6%) indicated that sinus membranes tended to encircle antroliths, which resulted in a gradual increase in membrane thickness. The sinus membrane was found to be significantly thicker in the presence of antrolith(s) (P<0.001). Antroliths which are sufficiently large or are located adjacent to the sinus floor or lateral wall increase the risk of sinus membrane perforation during sinus augmentation procedures. Therefore, a thorough CBCT evaluation is needed to minimize the risk of complications prior to sinus augmentation procedures.
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Nature and clinical significance of incidental findings in maxillofacial cone-beam computed tomography: a systematic review. Oral Radiol 2021; 37:547-559. [PMID: 33420943 DOI: 10.1007/s11282-020-00499-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/29/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This systematic review was conducted to assess the types, potential clinical significance, and treatment implications of incidental findings (IFs) in CBCT diagnostic imaging of the maxillofacial region. MATERIAL AND METHODS The authors searched several electronic databases and grey literature without time restriction for studies on the IFs in maxillofacial CBCT. Studies that classified the IFs based on their potential clinical significance were included. The methodological quality of the included studies was evaluated by the STROBE criteria. RESULTS The online searches of the electronic databases yielded 1323 records. Five articles were included in the final qualitative analysis. The methodological quality ranged from low to moderate risk of bias. Percentages of IFs with high (requiring intervention/referral), moderate (requiring monitoring), and low clinical significance ranged from 0.3 to 31.4%, 15.6 to 28.9%, and 43.46 to 71.1%, respectively. There was an inconsistency between the studies in the clinical significance of 58.8% of the IFs identified. CONCLUSION Most IFs in maxillofacial CBCT are either normal variants or findings that do not require referral or treatment. There was no clear consensus on the recommended management of most common IFs. The lack of consensus on clinical significance emphasizes the importance of collaboration between medical and dental specialties to establish professional guidelines for the management of commonly encountered IFs in CBCT.
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Mehdizadeh M, Rezaei Z, Moghadam FG. Incidental Findings in Temporomandibular Joint Region Detected by Cone-beam Computed Tomography: A Retrospective Study. Open Dent J 2020. [DOI: 10.2174/1874210602014010337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of this study was to investigate the prevalence of Incidental Findings (IFs) in the temporomandibular joint (TMJ) region detected in Cone-Beam Computed Tomography (CBCT) scans of maxilla and mandible.
Materials and Methods:
In this study, 384 CBCT scans were reviewed for IFs of the TMJ region. Demographic data including age and sex were recorded. The scans were evaluated in multiplanar views: corrected sagittal, corrected coronal and axial sections. IFs in TMJ region were categorized into eight groups: osteoarthritis, flattening and erosion of condyle and articular eminence, osteophytes, subchondral pseudocyst, condyle hyperplasia, condyle hypoplasia, bifid condyle, and soft tissue calcification. Statistical analyses were performed using the SPSS statistic v.22.
Results:
From the CBCT scans, a total of 81 (21.1%) IFs were identified. 184 of the subjects (47.9%) were male and 200 (52.1%) were females. Their age ranged from 10 to 75 years old with a mean of 36.8 and a standard deviation of 13.9 years. The most frequent IFs were flattening and erosion of condyle and articular eminence (40.74%), followed by soft tissue calcification (30.86%). Osteoarthritis was not observed in any of the subjects. There was no significant difference between females and males in IFs of TMJ joint and its related structures. Flattening and erosion of condyle and articular eminence, soft tissue calcification, osteophytes and, subchondral pseudo cyst showed significant differences between individuals of different age ranges.
Conclusion:
While examining CBCT images, it is critical to check for evidence of IFs in the TMJ region. The findings of this study emphasize the value of a thorough examination of all areas visualized on CBCT scans even those beyond the region of interest.
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Santos G, Ickow I, Job J, Brooker JE, Dvoracek LA, Rigby E, Shah N, Chen W, Branstetter B, Schuster LA. Cone-Beam Computed Tomography Incidental Findings in Individuals With Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 57:404-411. [PMID: 31964169 DOI: 10.1177/1055665619897469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The use of cone-beam computed tomography (CBCT) is well-established in clinical practice. This study seeks to categorize and quantify the incidental finding (IF) rate on CBCT in patients with cleft lip and palate (CLP) prior to orthodontic or surgical treatment. METHODS This is systematic retrospective review of head and neck CBCTs in patients with nonsyndromic CLP taken between 2012 and 2019 at a single tertiary referral center. All assessments were performed independently by 4 observers (a head and neck radiologist and 3 orthodontists, including 2 fellowship-trained cleft-craniofacial orthodontists ). The images were divided into 9 anatomical areas and screened using serial axial slices and 3D reconstructions. The absolute number of IFs was reported for each area and statistical analysis was performed. RESULTS Incidental findings were found in 106 (95.5%) of the 111 patients. The most common sites were the maxilla (87.4%, principally dental anomalies), paranasal sinuses (46.8%, principally inflammatory opacification), and inner ear cavities (18.9%, principally inflammatory opacification). Eleven patients had skull malformations. Thirty-three patients had IFs in 1 anatomical area, 49 patients in 2 anatomical areas, 19 patients in 3 areas, and 5 patients presented with IFs in 4 of the 9 anatomical areas. DISCUSSION In patients with CLP, IFs on CBCT exam were present in the majority of cases. Most patients with IFs had them in multiple anatomical areas of the head and neck. The maxillary dental-alveolar complex was the most common area. Inflammatory changes in the inner ear cavities and paranasal sinuses were also common; however, cervical spine and skull abnormalities were also identified. Clinicians caring for patients with CLP should be aware of IFs, which may warrant further investigation and treatment.
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Affiliation(s)
| | - Ilana Ickow
- Department of Plastic and Reconstructive Surgery, The John Hopkins University School of Medicine, Baltimore, MD
| | - Joici Job
- Department of Radiology, Ohio State University, Columbus, OH, USA
| | - Jack E Brooker
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucas A Dvoracek
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erick Rigby
- Law Office of Erick Rigby, Washington, PA, USA
| | - Nilesh Shah
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy Chen
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Barton Branstetter
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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French Otorhinolaryngology Society (SFORL) good practice guidelines for dental implant surgery close to the maxillary sinus. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:53-58. [PMID: 31837968 DOI: 10.1016/j.anorl.2019.11.002] [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: 11/21/2022]
Abstract
OBJECTIVES To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift. MATERIALS AND METHODS The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version). RESULTS In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context. CONCLUSION This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices.
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Abdalla-Aslan R, Friedlander-Barenboim S, Aframian DJ, Maly A, Nadler C. Ameloblastoma incidentally detected in cone-beam computed tomography sialography: A case report and review of the literature. J Am Dent Assoc 2019; 149:1073-1080. [PMID: 30497576 DOI: 10.1016/j.adaj.2018.09.003] [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: 03/06/2018] [Revised: 08/26/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OVERVIEW Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings. CASE DESCRIPTION In this case report, the authors describe an otherwise healthy 45-year-old man who was referred from the Sjogren's Syndrome Center in Jerusalem, Israel, for bilateral parotid CBCT sialographic imaging owing to xerostomia lasting for 4 months. CBCT sialographic imaging using iodine contrast material showed normal glandular structure and activity according to the postcannulation panoramic imaging. CBCT sialographic imaging routine volume interpretation revealed a lesion in the mandibular area causing destruction and perforation of the cortical plates, partial disappearance of adjacent lamina dura, and resorption of adjacent teeth, suggesting an aggressive benign tumor. Histopathologic examination confirmed mural cystic ameloblastoma, which was resected with preservation of the mental nerve and the lower mandibular border. The patient received bone graft and implants, with regular follow-ups and no recurrence after 4 years. CONCLUSIONS AND PRACTICAL IMPLICATIONS This case strengthens the need for thorough examination of the whole CBCT imaging volume within and outside the region of interest to detect incidental findings with clinical importance.
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21
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Prevalence of Maxillary Sinus Pathology Based on Cone-Beam Computed Tomography Evaluation of Multiethnicity Dental School Population. IMPLANT DENT 2019; 28:356-366. [PMID: 31135648 DOI: 10.1097/id.0000000000000902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The goal of the study was to evaluate prevalence of maxillary sinus pathology among populations considered for possible sinus augmentation procedures for dental implants. STUDY DESIGN Eight hundred twenty-one cone-beam computed tomography (CBCT) scans were retrospectively evaluated for prevalence of maxillary sinus pathology. Scans were classified based on the type of sinus pathology detected. Categories of sinus findings were healthy, mucosal thickening larger than 3 mm, polypoidal mucosal thickening, partial opacification, complete opacification, and others. Age, sex, ethnicity, and dentition status were evaluated to determine associated relationships with the incidence of pathology. RESULTS Sixty-two percent (62.79%) of scans presented with bilateral healthy sinuses and 37.21% of scans exhibited pathology. 73.38% of sinuses were classified as clinical healthy, 14.93% presented with mucosal thickening, 8.53% with polypoidal mucosal thickening, 2.13% with partial opacification, 0.66% with complete opacification, and 0.37% with a foreign body. Sex is found to be a significant factor with higher pathology incidence rates in male patients. Age is a significant factor with higher pathology incidence rates in older subjects. Dentition status and ethnicity did not have a significant association with pathology incidence rates. CONCLUSIONS The prevalence of maxillary sinus pathologies and associations with age, sex, ethnicity, and dentition status were obtained. Thirty-seven percent of scans would require further medical consultation before proceeding with maxillary sinus augmentation surgery for dental implants.
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Koparal M, Yalcın ED, Aksoy O, Ozcan-Kucuk A. Evaluation of maxillary sinus volume and surface area in children with β-thalassaemia using cone beam computed tomography. Int J Pediatr Otorhinolaryngol 2019; 125:59-65. [PMID: 31260809 DOI: 10.1016/j.ijporl.2019.06.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Among children with β-thalassaemia, skeletal changes and abnormalities, such as decreased volume or obliteration of the sinus, result primarily from hypertrophy and expansion of the erythroid marrow due to ineffective erythropoiesis. This study evaluated the volumes and surface areas of the maxillary sinuses of children with β-thalassaemia using cone beam computed tomography (CBCT), and compared these findings with corresponding measurements in age- and sex-matched control children. METHODS CBCT images were retrospectively evaluated for 16 children with β-thalassaemia, 19 children with a class I skeletal pattern (class I group), and 18 children with a class II skeletal pattern (class II group). After three-dimensional analyses and segmentation of each maxillary sinus, the volumes and surface areas were calculated. RESULTS The volumes and surface areas of the right (p > 0.05 and p > 0.05) and left maxillary sinuses (p > 0.05 and p > 0.05) and SNA angles (p > 0.05) were not significantly different among the groups. The ANB (p < 0.05) and SNGoMe (p < 0.05) angles were significantly greater and the SNB (p < 0.05) angle was significantly smaller in the class II and thalassaemia groups than in the class I group. CONCLUSION Children with thalassaemia tended to have lower maxillary sinus volumes and surface areas on both right and left sides, compared to those of children with class I and class II skeletal patterns; however, these differences were not statistically significant. In children with thalassaemia, a large intermaxillary discrepancy (ANB) indicated a tendency toward the class II skeletal pattern.
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Affiliation(s)
- Mahmut Koparal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Merkez, 02200, Adıyaman, Turkey.
| | - Eda Didem Yalcın
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Sehitkamil, 27410, Gaziantep, Turkey.
| | | | - Ayse Ozcan-Kucuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mersin University, 33343, Mersin, Turkey.
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Kim SH, Oh JS, Jang YJ. Incidence and Radiological Findings of Incidental Sinus Opacifications in Patients Undergoing Septoplasty or Septorhinoplasty. Ann Otol Rhinol Laryngol 2019; 129:122-127. [PMID: 31540552 DOI: 10.1177/0003489419878453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Although the routine use of computed tomography (CT) is controversial, it is employed in the preoperative screening of patients undergoing septoplasty or septorhinoplasty. The aim of this study was to evaluate the incidence and radiological characteristics of incidentally found sinus pathologies on screening CT in patients who underwent elective septoplasty or septorhinoplasty. METHODS We retrospectively reviewed the patients who underwent septoplasty and septorhinoplasty performed by a single surgeon (Y.J.J.) at Asan Medical Center between January 2016 and December 2017. CT images of 372 patients who had agreed to undergo preoperative CT were reviewed to determine the location and extent of incidental sinus opacifications. RESULTS Of the 372 patients, 107 (28.8%) showed incidental sinus lesions on CT images. Opacifications were mainly found in the maxillary sinus (73, 68.2%), followed by the ethmoid (34, 31.8%), sphenoid (10, 9.3%), and frontal (3, 2.8%) sinuses. The most common sinus lesion was retention cyst (55, 51.4%), and the second most common one was opacification and mucosal thickening (46, 43%). Other lesions such as osteoma (3, 2.8%), dental cyst (2, 1.9%), and mucocele (1, 0.9%) were rarely found. CONCLUSIONS In patients undergoing septoplasty or septorhinoplasty, the incidence of incidental sinus lesions was approximately 28.8% (107/372). This results indicate that preoperative CT in patients undergoing septoplasty or septorhinoplasty might be helpful to surgeons not only for better understanding the anatomical detail but also for detecting hidden paranasal sinus disease.
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Affiliation(s)
- Sung Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Republic of Korea
| | - Jin Seok Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, Republic of Korea
| | - Yong Ju Jang
- Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
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Kim J, Jang H. A review of complications of maxillary sinus augmentation and available treatment methods. J Korean Assoc Oral Maxillofac Surg 2019; 45:220-224. [PMID: 31508355 PMCID: PMC6728618 DOI: 10.5125/jkaoms.2019.45.4.220] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.
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Affiliation(s)
- Joongmin Kim
- Department of Oral and Maxillofacial Surgery, Private Clinic, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan, Korea
| | - Hyonseok Jang
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan, Korea
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Dief S, Veitz-Keenan A, Amintavakoli N, McGowan R. A systematic review on incidental findings in cone beam computed tomography (CBCT) scans. Dentomaxillofac Radiol 2019; 48:20180396. [PMID: 31216179 DOI: 10.1259/dmfr.20180396] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT. METHODS AND MATERIALS The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies. RESULTS The original search retrieved 509 abstracts of which only 10 articles met the inclusion criteria. The sample size varied between 90 and 1000 participants. The frequency of IFs of the selected articles were 24.6-94.3%. The most common non-threatening IFs were found in the airway, such as mucous retention cyst (55.1%) and sinusitis (41.7%). Other non-threatening IFs were soft tissue calcifications such as calcified stylohyloid ligament (26.7%), calcified pineal gland (19.2%), and tonsillolith (14.3%). Threatening IFs were rare findings (1.4%). Three articles reported incidental carotid artery calcifications with a prevalence of 5.7-11.6%. Pathological findings were not common between the articles, but still relevant (2.6%). The studies had a risk of bias varying from moderate to low. CONCLUSIONS There is a high frequency of IFs, yet not all of them require immediate medical attention. The low prevalence of threatening IFs emphasizes that CBCT should not be considered a substitution for conventional radiographs, but when used, the scans should be evaluated by a maxillofacial radiologist.
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Affiliation(s)
| | - Analia Veitz-Keenan
- NYU College of Dentistry, NY, USA.,Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, NY, USA
| | - Niloufar Amintavakoli
- NYU College of Dentistry, NY, USA.,Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, NY, USA
| | - Richard McGowan
- NYU College of Dentistry, NY, USA.,NYU Library, Department of Epidemiology and Health Promotion, NY, USA
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Bajoria AA, Sarkar S, Sinha P. Evaluation of Odontogenic Maxillary Sinusitis with Cone Beam Computed Tomography: A Retrospective Study with Review of Literature. J Int Soc Prev Community Dent 2019; 9:194-204. [PMID: 31058071 PMCID: PMC6489515 DOI: 10.4103/jispcd.jispcd_435_18] [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] [Received: 12/20/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
Aim and Objectives: The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and determine whether any tooth or any tooth root, was more frequently associated with this disease. Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed. Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus. Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.
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Affiliation(s)
- Atul Anand Bajoria
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Shromona Sarkar
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Pallawi Sinha
- Consultant Prosthodontist, KIIT University, Bhubaneswar, Odisha, India
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Hammoud K, Lanfranchi M, Adams D, Bedi HS, Mehan WA. Prevalence and Reporting Rates of Incidental Dental Disease on Head CT Examinations. Acad Radiol 2018; 25:1318-1324. [PMID: 29503176 DOI: 10.1016/j.acra.2018.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES Routine head computed tomography (CT) examinations often inadvertently include dental pathology which is often overlooked. The purpose of this study is to examine the prevalence of dental disease incidentally present and detected on head CT examinations, and to determine the effect of the institution of a dental disease field or macro in a standardized head CT dictation template on the rate of reporting dental disease. MATERIALS AND METHODS Head CT examinations were retrospectively and randomly selected from all examinations performed 6 months before, and 6 months after the institution of a dental disease field in a standardized head CT template. Dental findings were recorded from the initial finalized report. Examination images were subsequently reviewed for the presence of dental disease by two neuroradiologists who were blinded to the original reports and to each other's findings. RESULTS One hundred examinations were reviewed in the analysis. At our institution, 33% of the randomly selected head CT examinations included the level of the teeth (100/307). Dental disease was determined to be present in 40%-41% of these cases. Only 11% of the initial reports mentioned dental disease (P < .01). Addition of a dental disease field in the dictation template resulted in no significant difference in reporting dental disease (14% vs 8%, P = .371). CONCLUSIONS Incidental dental disease is common and frequently underreported. Inclusion of a dental disease field in a standardized template does not significantly improve the rate of reporting dental disease.
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Affiliation(s)
- Khaled Hammoud
- Department of Radiology, Tufts Medical Center, Room 441, Floating Building, 800 Washington Street, Boston, MA 02111.
| | - Michael Lanfranchi
- Department of Radiology, Tufts Medical Center, Room 441, Floating Building, 800 Washington Street, Boston, MA 02111
| | - Daniel Adams
- Department of Radiology, University of Washington, Seattle, Washington
| | - Harprit S Bedi
- Department of Radiology, Saint Elizabeth's Medical Center, Brighton, Massachusetts
| | - William A Mehan
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
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Lombardo L, Arreghini A, Guarneri MP, Lauritano D, Nardone M, Siciliani G. Unexpected artefacts and occult pathologies under CBCT. ORAL & IMPLANTOLOGY 2018; 10:97-104. [PMID: 29876034 DOI: 10.11138/orl/2017.10.2.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To present the most frequent occult pathologies unexpectedly encountered via cone-beam computed tomography (CBCT), with particular reference to the diagnostic role of the dentist and that of the radiographer, with a view to clarifying where the diagnostic responsibility lies. Material and methods A narrative literature review on the most diffused occult pathologies under CBCT was conducted, with iconographical guide as an example for each category. Results The most frequent forms of unexpected pathologies encountered are: the presence of foreign bodies, airway anomaly, and the presence of radio-opacity or -transparency in the maxillofacial district. Conclusions The orthodontists must know that they are responsible to recognize these frequent, and potentially serious, pathologies of the head and neck. If the dentist feels unable to take on this responsibility, he or she should, however, be sure to have the scans read by a specialist radiologist.
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Affiliation(s)
- L Lombardo
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - A Arreghini
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - M P Guarneri
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - D Lauritano
- Department of Translational Medicine and Surgery, Neuroscience Center of Milan, University of Milano Bicocca, Monza, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - G Siciliani
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
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Incidental findings during head and neck MRI screening in 1717 patients with temporomandibular disorders. Oral Radiol 2018; 35:135-142. [DOI: 10.1007/s11282-018-0327-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
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Park JH, Chae JM, Bay RC, Kim MJ, Lee KY, Chang NY. Evaluation of factors influencing the success rate of orthodontic microimplants using panoramic radiographs. Korean J Orthod 2018; 48:30-38. [PMID: 29291186 PMCID: PMC5702776 DOI: 10.4041/kjod.2018.48.1.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/22/2017] [Accepted: 07/10/2017] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this study was to investigate factors influencing the success rate of orthodontic microimplants (OMIs) using panoramic radiographs (PRs). Methods We examined 160 OMIs inserted bilaterally in the maxillary buccal alveolar bone between the second premolars and first molars of 80 patients (51 women, 29 men; mean age, 18.0 ± 6.1 years) undergoing treatment for malocclusion. The angulation and position of OMIs, as well as other parameters, were measured on PRs. The correlation between each measurement and the OMI success rate was then evaluated. Results The overall success rate was 85.0% (136/160). Age was found to be a significant predictor of implant success (p < 0.05), while sex, side of placement, extraction, and position of the OMI tip were not significant predictors (p > 0.05). The highest success rate was observed for OMIs with tips positioned on the interradicular midline (IRML; central position). Univariate analyses revealed that the OMI success rate significantly increased with an increase in the OMI length and placement height of OMI (p = 0.001). However, in simultaneous analyses, only length remained significant (p = 0.027). Root proximity, distance between the OMI tip and IRML, interradicular distance, alveolar crest width, distance between the OMI head and IRML, and placement angle were not factors for success. Correlations between the placement angle and all other measurements except root proximity were statistically significant (p < 0.05). Conclusions Our findings suggest that OMIs positioned more apically with a lesser angulation, as observed on PRs, exhibit high success rates.
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Affiliation(s)
- Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea, Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, AZ, USA.,Department of Orthodontics and Wonkwang Dental Research Institute, University of Wonkwang School of Dentistry, Iksan, Korea
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, A. T. Still University, Mesa, AZ, USA
| | - Mi-Jung Kim
- Department of Orthodontics, University of Wonkwang School of Dentistry, Iksan, Korea
| | - Keun-Young Lee
- Department of Orthodontics, Wonkwang University Sanbon Dental Hospital, Gunpo, Korea
| | - Na-Young Chang
- Department of Orthodontics and Wonkwang Dental Research Institute, University of Wonkwang School of Dentistry, Iksan, Korea
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da Costa ED, Verner FS, Peyneau PD, de Freitas DQ, de Almeida SM. Diagnosis of ethmoid sinolith by cone-beam computed tomography: case report and literature review. Oral Radiol 2017; 35:68-72. [PMID: 30484175 DOI: 10.1007/s11282-017-0310-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 11/28/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to report the first case of diagnosis of a rare ethmoid sinolith by cone-beam computed tomography (CBCT) and discuss the importance of carefully assessing the entire volume of the images regardless of the region of interest. CASE PRESENTATION A 22-year-old woman underwent CBCT examination to assess the upper permanent canine teeth. Analysis of the entire volume of CBCT revealed an oval-shaped hyperdense, homogeneous, expansive formation with defined boundaries located in the ethmoid bone. The differential diagnosis of a sinolith in the ethmoid sinus was confirmed after removal of the lesion by nasoendoscopy and histopathological examination. CONCLUSION The diagnosis of lesions in the ethmoid sinus is challenging because of the complex anatomy of this region. Considering the limitations of two-dimensional X-ray examination, CBCT examination has become an important imaging modality for the diagnosis of these calcifications. In addition, the ability of the dental surgeon to assess the entire volume of the CBCT images and the knowledge of imaging features of these calcifications allows for recognition of incidental findings, facilitating early diagnosis and appropriate treatment.
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Affiliation(s)
- Eliana Dantas da Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av Limeira, 901, Areião, Piracicaba, São Paulo, 13414-018, Brazil.
| | - Francielle Silvestre Verner
- Division of Oral Radiology, Department of Dentistry, Federal University of Juiz de Fora/Governador Valadares Advanced Campus, Av Doutor Raimundo Rezende, 330-Centro, Governador Valadares, Minas Gerais, 35012-140, Brazil
| | - Priscila Dias Peyneau
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av Limeira, 901, Areião, Piracicaba, São Paulo, 13414-018, Brazil
| | - Deborah Queiroz de Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av Limeira, 901, Areião, Piracicaba, São Paulo, 13414-018, Brazil
| | - Solange Maria de Almeida
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av Limeira, 901, Areião, Piracicaba, São Paulo, 13414-018, Brazil
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Costa F, Emanuelli E, Robiony M. Incidence of Maxillary Sinus Disease Before Sinus Floor Elevation Surgery as Identified by Cone-Beam Computed Tomography: A Literature Review. J ORAL IMPLANTOL 2017; 44:161-166. [PMID: 29116888 DOI: 10.1563/aaid-joi-d-17-00209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study is to review the literature to assess the incidence of maxillary sinus disease before sinus floor elevation surgery (SFE) as identified by cone-beam computerized tomography (CBCT). Only studies in which CBCT was performed in patients for dental implant placement in the past 10 years were considered. Eleven studies were identified. A total of 1792 patients were collected. All the studies reviewed reported on thickening of the sinus mucosa as a criterion for sinus disease with different threshold values. All studies reported mucosal thickening (MT) ranging between 25.5% and 93.1%. The mean incidence of MT was 54.99%. Two studies examined the correlation of MT with clinical symptoms. Three studies reported evaluation of the ostiomeatal complex (OMC). There is a high probability of detecting a certain degree of MT in patients referred for SFE. There is no consensus regarding the threshold values beyond which MT is considered pathological. Independently from the threshold values or the type of MT, the studies lack correlation with clinical data regarding patients' sinusitis-related history or symptoms. CBCT with a large field of view to evaluate the OMC is appropriate in patients scheduled for SFE. Future studies should include a systematic correlation with clinical symptoms and the possible presence of OMC obstruction. A clinical assessment that includes nasal endoscopy is indicated when MT and obstruction of the OMC are identified. Surgical correction of OMC obstruction seems to be appropriate to increase the success rate and to avoid possible complication after SFE.
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Affiliation(s)
- Fabio Costa
- 1 Maxillofacial Surgery Unit, Azienda Ospedaliero Universitaria of Udine, Udine, Italy
| | - Enzo Emanuelli
- 2 Department of Otorhinolaryngology and Otologic Surgery, Azienda Ospedaliera-Policlinico of Padova, Padova, Italy
| | - Massimo Robiony
- 3 Department of Medical and Biological Science, Azienda Ospedaliero Universitaria of Udine, University of Udine, Udine, Italy
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Orhan K, Avsever H, Aksoy S, Seki U, Bozkurt P. Temporomandibular joint MR images: Incidental head and neck findings and pathologies. Cranio 2017; 37:121-128. [DOI: 10.1080/08869634.2017.1383744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kaan Orhan
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University , Ankara, Turkey
| | - Hakan Avsever
- Gulhane Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Health Sciences University , Ankara, Turkey
| | - Seçil Aksoy
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Near East University , Mersin, Turkey
| | - Umut Seki
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University , Ankara, Turkey
| | - Poyzan Bozkurt
- Faculty of Dentistry, Department of Oral/Maxillofacial Surgery, Ankara University , Ankara, Turkey
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Altındağ A, Avsever H, Borahan O, Akyol M, Orhan K. Incidental Findings in Cone-Beam Computed Tomographic Images: Calcifications in Head and Neck Region. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background/Aim: The use of CBCT in dentistry has been increasing popularity nowadays. CBCT images provide valuable information from anatomic structures and pathologies. Images obtained with CBCT allow for more appropriate treatment planning. The purpose of this study was to assess the calcifications which were found incidentally on CBCT images and to reveal the frequency and characteristics. Material and Methods: A total of 691 CBCT images which obtained from the patients were assessed. Demographic data and calcifications which were found out of primarily interest area were noted. The incidental findings were categorized and analyzed using descriptive statistics. Results: 945 calcifications were discovered on 318(46.02%) of the 691 patients’ images. 373(53.98%) scans showed no calcificated findings. The age range of patients was from 5 to 84 years. The most common calcification was tonsillolith (86.03%), followed by stylohyoid calcifications (6.24%), antrolith and subdermal calcifications (2.33%). Conclusion: Calcified lesions in head and neck region were commonly seen in CBCT images. Although the most of the calcifications are asymptomatic and require no treatment but correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans. It will also provide the ability comprehensively evaluation of underlying diseases and practitioners will have life-saving information by early diagnosis.
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Affiliation(s)
- Ali Altındağ
- Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara , Turkey
| | - Hakan Avsever
- Gulhane Training&Reserach Hospital, Health Sciences University, Dentistry Center, Department of Dentomaxillofacial Radiology, Ankara , Turkey
| | - Oguz Borahan
- Marmara University, Department of Dentomaxillofacial Radiology, Istanbul , Turkey
| | - Mesut Akyol
- Yildirim Beyazit University, Department of Biostatistics, Ankara , Turkey
| | - Kaan Orhan
- Ankara University, Faculty of Dentistry Department of Dentomaxillofacial Radiology, Ankara , Turkey
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Characterization of the Maxillary Sinus Using Cone Beam Computed Tomography. A Retrospective Radiographic Study. IMPLANT DENT 2017; 25:762-769. [PMID: 27540848 DOI: 10.1097/id.0000000000000485] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the anatomical findings and alterations of the maxillary sinus in asymptomatic patients observed by cone beam computed tomography. MATERIALS AND METHODS A cross-sectional retrospective study of the anatomical variations and alterations of the maxillary sinus was made in 160 patients-71 males (44.3%) and 89 females (55.6%), with an age range of 18 to 74 years-measuring the thickness of the Schneiderian membrane and the cortical thickness of the lower margin of the maxillary sinus (in its most caudal portion), and correlations among the different study variables were assessed. RESULTS Sinus pneumatization was the most frequent anatomical finding (81.3%). A negative correlation was observed between the thickness of the Schneiderian membrane and the presence of Underwood septa (P < 0.005). Mucosal thickening of more than 2 mm was directly correlated with the presence of maxillary sinus lesions (opacification, discontinuity of the floor of the sinus, polypoid lesions, or air-liquid levels). CONCLUSION The presence or absence of septa seems to be related to the thickness of the Schneiderian membrane.
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Bulbul E, Yanik B, Demirpolat G. Detection of Dental Pathologies in Routine Paranasal CT Scans: A Retrospective Study. J Clin Diagn Res 2017; 11:TC17-TC20. [PMID: 28893000 DOI: 10.7860/jcdr/2017/27461.10287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/26/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Multidetector Computed Tomography (MDCT) is a widespread method for evaluating paranasal sinuses and nasal cavity in daily practice. The maxillary teeth are in field of view in a paranasal sinus CT scan and it is possible to detect dental pathologies with CT. AIM To determine the incidence of maxillary teeth pathologies in routine paranasal sinus CT scans. MATERIALS AND METHODS A retrospective study was conducted. Consecutive 395 paranasal sinus CT scans were evaluated. All CT images were obtained with a 64 detector-CT. Patients with previous facial trauma, operation, invasive tumors and repeated exams were excluded. Detected findings were classified as "tooth loss, dental restorations or procedures and dental pathologies (carious lesions, dental developmental anomalies, periapical lesions and periodontal diseases). The proportion of findings was reported as simple percentiles. RESULTS Three hundred and eighty-four CT scans were included in the study. Dental restorations or procedures were determined in 129 (33.5%) patients. A total of 34 (8.8%) patients had normal teeth count and morphology. A total of 264 (64.3%) patients had at least one tooth loss. A total of 195 (51%) patients had at least one or more dental pathology. Number of dental carious lesions, dental developmental anomalies, periapical lesions and periodontal disease were 104 (27.0%), 78 (14.3%), 46 (11.9%), 44 (11.4%), respectively. CONCLUSION Dental pathologies were encountered in more than half of the patients. Detecting dental pathologies may prevent tooth loss and improve oral health. The radiologist should keep in mind dental pathologies while evaluating paranasal sinus CT in daily practice.
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Affiliation(s)
- Erdogan Bulbul
- Assistant Professor, Department of Radiology, Faculty of Medicine, Balikesir University, Turkey
| | - Bahar Yanik
- Professor, Department of Radiology, Faculty of Medicine, Balikesir University, Turkey
| | - Gulen Demirpolat
- Associate Professor, Department of Radiology, Faculty of Medicine, Balikesir University, Turkey
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Ata-Ali J, Diago-Vilalta JV, Melo M, Bagán L, Soldini MC, Di-Nardo C, Ata-Ali F, Mañes-Ferrer JF. What is the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to maxillofacial cone beam computed tomography? A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e400-e409. [PMID: 28578369 PMCID: PMC5549512 DOI: 10.4317/medoral.21456] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 05/05/2017] [Indexed: 01/18/2023] Open
Abstract
Background When considering dental implant rehabilitation in atrophic posterior sectors, the maxillary sinuses must be evaluated in detail. Knowledge of the anatomical variations and of the potential lesions found in these structures conditions the outcome of sinus lift procedures and therefore of the dental implants. A systematic review is made to determine the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to cone beam computed tomography (CBCT). Material and Methods A PubMed (MEDLINE) literature search was made of articles published up until 20 December 2015. The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The quality of the studies included in the review was assessed using the Methodological Index for Nonrandomized Studies (MINORS). Results The combinations of search terms resulted in a list of 3482 titles. Twenty-three studies finally met the inclusion criteria and were entered in the systematic review, comprising a total of 11,971 patients. The most common anatomical variations were pneumatization and sinus septa. The prevalence of maxillary sinus disease ranged from 7.5% to 66%. The most common pathological findings of the maxillary sinus were mucosal thickening, sinusitis and sinus opacification. Conclusions Although the main indication of CBCT of the maxillary sinus in dentistry is sinus floor elevation/treatment planning and evaluation prior to dental implant placement, this imaging modality is increasingly also used for endodontic and periodontal purposes. There is no consensus regarding the cutoff point beyond which mucosal thickening of the maxillary sinus should be regarded as pathological, and the definition of maxillary sinusitis moreover varies greatly in the scientific literature. In this regard, international consensus is required in relation to these concepts, with a clear distinction between healthy and diseased maxillary sinuses. Key words:Maxillary sinus, cone beam computed tomography, dental implant, maxillary sinus floor augmentation, sinus membrane, sinus floor elevation.
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Affiliation(s)
- J Ata-Ali
- Public Dental Health Service, Arnau de Vilanova Hospital, San Clemente Street 12, 46015-Valencia, Spain,
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Incidental findings on cone-beam computed tomographic images: paranasal sinus findings and nasal septum variations. Oral Radiol 2017; 34:40-48. [PMID: 30484091 DOI: 10.1007/s11282-017-0283-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE CBCT applications have received widespread acceptance in dentistry. CBCT scans provide three-dimensional information on anatomic structures and characteristics of pathologies, rather than the two-dimensional information obtained with the conventional techniques. The purpose of this study was to evaluate incidental findings in out-of-interest areas on CBCT images and to reveal their frequency and characteristics. METHODS A total of 691 CBCT scans from 691 patients were assessed. Demographic data, CBCT indications, and incidental findings outside the primary area of interest, such as anatomical variations and pathologies, were noted. The incidental findings were categorized and analyzed using descriptive statistics. RESULTS In total, 1109 incidental findings in paranasal sinuses were noted on 548 of the 691 CBCT scans. The highest rate of incidental findings was maxillary sinus findings, followed by concha bullosa and septum deviation. The most frequently observed pathology was mucosal thickening, followed by polypoid mucosal thickening in the maxillary sinus. CONCLUSIONS While most incidental findings require no treatment, some conditions will necessitate modification of the treatment plan. Therefore, dental practitioners should be aware of incidental findings and anatomical variations. Correct identification of these findings will reduce unnecessary further diagnostic assessments and allow selection of more appropriate treatment plans.
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Alsufyani NA. Cone beam computed tomography incidental findings of the cervical spine and clivus: retrospective analysis and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e197-e217. [PMID: 28411008 DOI: 10.1016/j.oooo.2017.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 02/14/2017] [Accepted: 02/20/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this study was to analyze and describe incidental findings in the cervical spine (C-spine) and the clivus encountered in cone beam computed tomography (CBCT) imaging. The wide range of possible anatomic variants and pathoses is discussed in the context of the medical and dental literature to clarify their radiographic appearance and clinical implications as a guide for the oral and maxillofacial radiologist. STUDY DESIGN A retrospective analysis of radiographic reports was conducted based on CBCT images from 2 oral and maxillofacial imaging centers. Reports documenting incidental findings in the C-spine or the clivus were selected. Data on patient age and sex were collected, and each incidental finding was categorized as degenerative, congenital, or developmental/pathologic. Each finding is discussed with clinical importance and is pictorially presented. RESULTS From a total of 7689 CBCT reports, there were 732 incidental findings (9.5%) in the C-spine or the clivus. Most findings were in the C-spine (92.3%), were degenerative in nature (78.7%), and occurred in females in their sixth decade. Logistic regression analysis showed that the odds of presenting with a degenerative incidental finding in the C-spine or the clivus did not differ based on sex but were 5.5 times (95% confidence interval, 3.77-8.04) higher if the patient was aged 50 years or older. CONCLUSIONS This review is the largest and the first to characterize incidental findings in the C-spine and the clivus. Such findings were reported in 9.5% of radiographic reports. Several presented as uncommon congenital variants that are not usually spotlighted during oral and maxillofacial radiology training.
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Affiliation(s)
- Noura A Alsufyani
- Assistant Professor, Oral & Maxillofacial Radiology, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada; Assistant Professor, College of Dentistry, King Saud University, Saudi Arabia.
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Wan Abdul Razak WS, Sherriff M, Bister D, Seehra J. Bond strength of stainless steel orthodontic brackets bonded to prefabricated acrylic teeth. J Orthod 2017; 44:105-109. [PMID: 28300497 DOI: 10.1080/14653125.2017.1296636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this in-vitro study was to evaluate the force to debond stainless steel orthodontic brackets bonded to acrylic teeth using different combinations of adhesive and surface treatments. MATERIALS AND METHODS One hundred prefabricated upper lateral incisor acrylic teeth were divided into 4 equal groups: Transbond XT® adhesive only (Group 1, control), Transbond XT® adhesive with sandblasting (Group 2), Transbond XT® adhesive with abrasion / + methyl methacrylate (MMA) (Group 3) and Triad® Gel only (Group 4). The force in Newtons (N) to debond the brackets was measured. One-way analysis of variance (ANOVA) and pairwise multi-comparison of means (Šidak's adjustment) were undertaken. RESULTS The highest force to debond was recorded for Group 2 (275.7 N; SD 89.0) followed by Group 3 (241.9 N; SD 76.0), Group 1 (142.7 N; SD 36.7) and Group 4 (67.9 N; SD 21.1). Significant differences in bond strength measurements between the experimental groups were detected. Mean force values for the groups revealed no significant differences between Group 2 and Group 3 (p>0.05). CONCLUSIONS Both sandblasting and surface abrasion/+ application of methyl methacrylate (MMA) in combination with Transbond XT® adhesive are recommended for bonding stainless orthodontic brackets to acrylic teeth.
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Affiliation(s)
- Wan Salbiah Wan Abdul Razak
- a Department of Orthodontics , King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust , London , UK
| | - Martyn Sherriff
- b School of Oral and Dental Sciences, Bristol Dental Hospital, University of Bristol and Kings College London Dental Institute, Guy's and St Thomas NHS Foundation Trust , London , WC2R 2LS , United Kingdom.,c Kings College London Dental Institute at Guy's, King's College and St Thomas' Hospitals , London , UK
| | - Dirk Bister
- a Department of Orthodontics , King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust , London , UK
| | - Jadbinder Seehra
- a Department of Orthodontics , King's College London Dental Institute, Floor 22, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust , London , UK
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Cone Beam CT in Diagnosis and Surgical Planning of Dentigerous Cyst. Case Rep Dent 2017; 2017:7956041. [PMID: 28293442 PMCID: PMC5331280 DOI: 10.1155/2017/7956041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/06/2017] [Accepted: 01/15/2017] [Indexed: 11/18/2022] Open
Abstract
Diagnosis and preoperative planning are critical in the execution of any surgical procedure. Panoramic radiography is a routine method used in dentistry to assist clinical diagnosis; however, with this technique 3D anatomical structures are compressed into 2D images, resulting in overlapping of structures which are of interest in the diagnosis. In this study we report the case of a patient who presented with a dentigerous cyst of expressive dimensions in the body of the mandible region. The surgery was planned and executed after observing the margins of the lesion by Cone Beam Computed Tomography (CBCT). We conclude that CBCT is a precise method to help diagnosis; it provides greater accuracy in surgical treatment planning through 3D image display, allowing more effective results.
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Zain-Alabdeen EH, El Khateeb SM. Incidental cone beam computed tomographic findings among Taibah University patients, KSA: A retrospective study. J Taibah Univ Med Sci 2016; 12:131-138. [PMID: 31435227 PMCID: PMC6694891 DOI: 10.1016/j.jtumed.2016.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/18/2016] [Accepted: 10/23/2016] [Indexed: 12/21/2022] Open
Abstract
Objectives The aim of this study was to retrospectively evaluate the prevalence, type, and location of incidental findings by cone beam computed tomography (CBCT) scans. This study was performed to diagnose dental problems in the female population at Taibah University Dental Clinics (TUDC), KSA. Methods A series of 150 consecutive CBCT scans were identified between January 2014 and February 2016. The record was retrieved from the Carestream (CS) R4 Clinical and Practice Management Software database of TUDC. We retrospectively assessed them for incidental findings and then summarized and categorized them into five anatomical regions: nasopharyngeal airway, temporomandibular joint (TMJ), paranasal sinuses, dental findings, and alveolar bone region. We then analysed the frequency and percentage of findings in each category. Results A total of 248 incidental findings were reported in 83 of 90 scans (2.76 findings/scan). The prevalence of all incidental findings was 92.2%. The most common incidental findings were located in the paranasal sinuses and alveolar area, each representing about a quarter (27.4%) of all of the findings. Other common findings were in the TMJ (22.9%), followed by those in the nasopharyngeal airway (10.9%), dental area (10.5%), and others (0.8%). Conclusion This study confirms the high prevalence of incidental maxillofacial findings as shown by CBCT scans in a sample of female patients at TUDC. This emphasizes the need to thoroughly examine CBCT volumes for clinically significant findings inside and beyond the region of interest for the benefit of patients and the protection of practitioners.
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Affiliation(s)
- Ebtihal H Zain-Alabdeen
- Department of Oral and Basic Clinical Sciences, College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
| | - Sara M El Khateeb
- Department of Oral and Basic Clinical Sciences, College of Dentistry, Taibah University, Almadinah Almunawwarah, KSA
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Lopes IA, Tucunduva RMA, Handem RH, Capelozza ALA. Study of the frequency and location of incidental findings of the maxillofacial region in different fields of view in CBCT scans. Dentomaxillofac Radiol 2016; 46:20160215. [PMID: 27604390 DOI: 10.1259/dmfr.20160215] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify the type and frequency of incidental findings (IFs) in the maxillofacial region of CBCT scans with different sizes of field of view (FOV), and the clinical relevance of the findings was classified as requirement or not of monitoring, treatment or referral to a specialist. METHODS We analyzed 150 CBCT examinations, divided according to the size of the FOV into 3 groups: 6-cm maxilla, 6-cm mandible and 13-cm maxilla/mandible. The IFs were categorized into six areas: airway, temporomandibular joint (TMJ), bone, lesions of the jaws, teeth and soft-tissue calcifications. RESULTS The results showed 560 IFs that were found in 92% of the samples studied. A total of 225 IFs were found in examinations of the maxilla group, 99 findings in the mandible group and 236 findings in the maxilla/mandible group. The IFs were most frequent in the tooth zone (27.32%), followed by airways, soft-tissue calcifications, TMJ, bone, lesions of the jaw and other findings. We also found that 43.46% of the IFs did not need treatment or referral to another professional, 28.97% findings required the acquisition of new images for monitoring and 27.55% findings needed treatment or referral. CONCLUSIONS The present study confirmed the high frequency of IFs in CBCT scans. It was concluded that it is necessary to interpret and report the total volume obtained in CBCT examinations and not only the purpose of the examination region.
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Affiliation(s)
- Ivna A Lopes
- 1 Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rosana M A Tucunduva
- 1 Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Roberta H Handem
- 1 Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana Lucia A Capelozza
- 1 Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Syed AZ, Zahedpasha S, Rathore SA, Mupparapu M. Evaluation of canalis basilaris medianus using cone-beam computed tomography. Imaging Sci Dent 2016; 46:141-4. [PMID: 27358822 PMCID: PMC4925651 DOI: 10.5624/isd.2016.46.2.141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/14/2016] [Accepted: 02/24/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.
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Affiliation(s)
- Ali Z Syed
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, CWRU School of Dental Medicine, Cleveland, OH, USA
| | - Samir Zahedpasha
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, CWRU School of Dental Medicine, Cleveland, OH, USA
| | - Sonali A Rathore
- Department of Oral Diagnostic Sciences, VCU School of Dentistry, Richmond, VA, USA
| | - Mel Mupparapu
- Division of Radiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Ruellas ACDO, Yatabe MS, Souki BQ, Benavides E, Nguyen T, Luiz RR, Franchi L, Cevidanes LHS. 3D Mandibular Superimposition: Comparison of Regions of Reference for Voxel-Based Registration. PLoS One 2016; 11:e0157625. [PMID: 27336366 PMCID: PMC4919005 DOI: 10.1371/journal.pone.0157625] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 06/02/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction The aim was to evaluate three regions of reference (Björk, Modified Björk and mandibular Body) for mandibular registration testing them in a patients’ CBCT sample. Methods Mandibular 3D volumetric label maps were built from CBCTs taken before (T1) and after treatment (T2) in a sample of 16 growing subjects and labeled with eight landmarks. Registrations of T1 and T2 images relative to the different regions of reference were performed, and 3D surface models were generated. Seven mandibular dimensions were measured separately for each time-point (T1 and T2) in relation to a stable reference structure (lingual cortical of symphysis), and the T2-T1 differences were calculated. These differences were compared to differences measured between the superimposed T2 (generated from different regions of reference: Björk, Modified Björk and Mandibular Body) over T1 surface models. ICC and the Bland-Altman method tested the agreement of the changes obtained by nonsuperimposition measurements from the patients’ sample, and changes between the overlapped surfaces after registration using the different regions of reference. Results The Björk region of reference (or mask) did work properly only in 2 of 16 patients. Evaluating the two other masks (Modified Björk and Mandibular body) on patients’ scans registration, the concordance and agreement of the changes obtained from superimpositions (registered T2 over T1) compared to results obtained from non superimposed T1 and T2 separately, indicated that Mandibular Body mask displayed more consistent results. Conclusions The mandibular body mask (mandible without teeth, alveolar bone, rami and condyles) is a reliable reference for 3D regional registration.
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Affiliation(s)
| | | | - Bernardo Quiroga Souki
- School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Erika Benavides
- School of Dentistry, University of Michigan, Ann Arbor, MI, United States of America
| | - Tung Nguyen
- School of Dentistry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Ronir Raggio Luiz
- Institute of Public Health Studies (IESC), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lorenzo Franchi
- Bauru Dental School, University of São Paulo, Bauru, Brazil
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Dindaroğlu F, Yetkiner E. Cone Beam Computed Tomography in Orthodontics. Turk J Orthod 2016; 29:16-21. [PMID: 30112468 DOI: 10.5152/turkjorthod.2016.15-00026r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/21/2016] [Indexed: 11/22/2022]
Abstract
The advent of three-dimensional (3D) imaging technology has caused a significant change in the diagnostic approach practiced in dentistry, and in particular, orthodontics. Although conventional imaging methods such as orthopantomography and lateral cephalometric and anteroposterior graphs provide sufficient information in mild to moderate orthodontic anomalies, 3D imaging can be a necessity in severe skeletal anomalies or tooth impactions. Computed tomography (CT) has been frequently used when detailed 3D imaging is necessary despite its relatively high cost, low vertical resolution, and high dose of radiation. In contrast to conventional CT application, the development of cone beam computed tomography (CBCT) technology has had important advantages over the conventional method, such as minimization of the radiation dose, image accuracy, rapid scan time, fewer image artifacts, chair-side image display, and real-time analysis. These advantages have provided dental practitioners the opportunity to benefit more frequently from 3D imaging by relatively diminishing radiation dose considerations, financial burden, and availability, in particular. Therefore, the aim of this review is to highlight the current understanding of CBCT practice in orthodontics and to summarize clinically relevant conditions.
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Affiliation(s)
- Furkan Dindaroğlu
- Department of Orthodontics, Ege University School of Dentistry, İzmir, Turkey
| | - Enver Yetkiner
- Department of Orthodontics, Ege University School of Dentistry, İzmir, Turkey
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El Assar de la Fuente S, Angenete O, Jellestad S, Tzaribachev N, Koos B, Rosendahl K. Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review. J Craniomaxillofac Surg 2016; 44:597-607. [PMID: 26924432 DOI: 10.1016/j.jcms.2016.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/12/2015] [Accepted: 01/26/2016] [Indexed: 11/29/2022] Open
Abstract
Juvenile idiopathic arthritis is the most common inflammatory rheumatic disease of childhood and represents a series of chronic inflammatory arthritides of unknown cause. Involvement of the temporomandibular joint has been reported in up to 87% of children with juvenile idiopathic arthritis when based on magnetic tomography imaging; it can be asymptomatic and may lead to severe long term complications. In this review a summary of the contemporary literature of imaging of the temporomandibular joint in children with juvenile idiopathic arthritis will be provided, including ultrasound which is a valuable method for guided joint injections, but does not necessarily allow detection of acute inflammation, cone beam computed tomography, which has emerged as a feasible and accurate low-dose alternative as compared to conventional computed tomography to detect destructive change, and magnetic resonance imaging which is considered the method of choice for assessing acute, inflammatory change, although the lack of normative standards remains a challenge in children.
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Affiliation(s)
| | - O Angenete
- Department of Radiology, St Olav University Hospital, Norway
| | - S Jellestad
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - N Tzaribachev
- Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany
| | - B Koos
- Department of Orthodontics, University of Rostock, Germany
| | - K Rosendahl
- Department of Radiology, Haukeland University Hospital, Bergen, Norway; University of Bergen, Department of Clinical Medicine K1, Norway.
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Bozdemir E, Gormez O, Yıldırım D, Aydogmus Erik A. Paranasal sinus pathoses on cone beam computed tomography. J Istanb Univ Fac Dent 2016; 50:27-34. [PMID: 28955552 PMCID: PMC5573450 DOI: 10.17096/jiufd.47796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/09/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose: The aim of this study was to investigate
paranasal sinus pathoses detected on cone-beam
computed tomography (CBCT) in an adult population. Patients and Methods: Three observers retrospectively
inspected 353 consecutive CBCT scans obtained in a
dentomaxillofacial radiology department for paranasal sinus
pathoses. Descriptive statistics and chi-square tests were
used to determine the prevalence of categorical parameters. Results: The age of the patients ranged from 18 to 85 years
(mean 41.27±16.76). There were 172 (48.7%) females and
181 (51.3%) males. There was a significant difference between
the genders (p=0.02), with males (53.5%) having more sinus
pathoses than females (46.5%). When the left and right sinuses
were considered together, pathoses were most commonly seen
in the maxillary sinuses (57.1%), followed by the ethmoid (53.7
%), frontal (22.6%), and sphenoid sinuses (15.8%). Mucosal
thickening was the most frequently observed abnormality
(51.7%), followed by hypoplasia (17.5%) and sinusitis (17.3%). Conclusion: CBCT is a preferable imaging method for
evaluation of paranasal sinuses. Dentomaxillofacial
radiologists should examine the whole volume of CBCT images
to ensure they do not overlook paranasal sinus pathoses.
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Affiliation(s)
- Esin Bozdemir
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ozlem Gormez
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Derya Yıldırım
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ayse Aydogmus Erik
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
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Zojaji R, Naghibzadeh M, Mazloum Farsi Baf M, Nekooei S, Bataghva B, Noorbakhsh S. Diagnostic accuracy of cone-beam computed tomography in the evaluation of chronic rhinosinusitis. ORL J Otorhinolaryngol Relat Spec 2015; 77:55-60. [PMID: 25765366 DOI: 10.1159/000373927] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/06/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study assessed the agreement of cone-beam computed tomography (CBCT) scan and sinus endoscopy findings and attempted to find a diagnostic accuracy of CBCT in patients with chronic rhinosinusitis (CRS). METHODS Forty-two patients with CRS referred to the Aria and 22 Bahman Hospitals in Mashhad, Iran, during the year 2011 were included in this cross-sectional study. Paranasal sinus CBCT scanning and endoscopy were performed in all patients. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of CBCT were determined, and the agreement between CBCT and endoscopy findings was evaluated. RESULTS In most of our findings, except for infundibulum thickening, there was a strong agreement between CBCT and paranasal sinus endoscopy, with a kappa coefficient >0.80 (p < 0.05). The sensitivity, specificity, PPV, NPV, and accuracy of CBCT were >80% for most of the findings, except for infundibulum thickening and septal deviation. CONCLUSION CBCT has nearly the same diagnostic accuracy as sinus endoscopy. The accuracy of CBCT scanning is high, and CBCT findings are well correlated with sinus endoscopy findings. Considering its high accuracy and lower costs and radiation doses, CBCT may be a proper alternative method for diagnostic sinus endoscopy in the assessment of CRS in patients with a contraindication for sinus endoscopy.
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Edwards R, Alsufyani N, Heo G, Flores-Mir C. Agreement among orthodontists experienced with cone-beam computed tomography on the need for follow-up and the clinical impact of craniofacial findings from multiplanar and 3-dimensional reconstructed views. Am J Orthod Dentofacial Orthop 2015; 148:264-73. [PMID: 26232835 DOI: 10.1016/j.ajodo.2015.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION In this study, we aimed to assess interrater and intrarater agreement among orthodontic clinicians in their assessments of reported incidental findings in regard to both the need for additional follow-up and the impact on future orthodontic treatment in large-field maxillofacial cone-beam computed tomography (CBCT) imaging. METHODS The study sample consisted of 18 nonrandomly selected large-field maxillofacial CBCT volumes containing a reported total of 88 radiographic findings. All scans were associated with formal radiologic reports. However, the suggestions of further follow-up were removed from the radiologic reports so as to not bias the 3 evaluating orthodontists in their subsequent decision making. The evaluators had on average 7.6 years of CBCT usage and self-interpretation experience. Reliability was determined by quantifying the level of agreement between the evaluators' assessments for both research questions for all 88 findings using a binary response (yes/no) as the outcome measure. The Cohen kappa statistic was calculated to quantify intrarater and interrater agreement globally for both statements. RESULTS Although interrater agreement was considerable, potential decisions with clinical impact were not consistent. This needs to be considered when interpreting maxillofacial incidental findings. Evaluators demonstrated higher levels of agreement for dentoalveolar findings compared with all other extragnathic regions when assessing clinical significance. CONCLUSIONS Among the evaluators who were considered experienced in CBCT, "fair-to-good" interrater agreement and "excellent" intrarater agreement were demonstrated in terms of the need for further follow-up and their potential impact on future orthodontic treatment.
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Affiliation(s)
| | - Noura Alsufyani
- Assistant professor, Division of Oral Medicine, Pathology and Radiology, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Giseon Heo
- Associate professor, Division of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Professor and head, Division of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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