1
|
Ketabi AR, Hassfeld S, Lauer HC, Piwowarczyk A. The comparison of visibility of the maxillary sinus septa between cone-beam computed tomography scans and panoramic radiograph images as dependent on the cortical bone thickness: a retrospective comparative study. Int J Implant Dent 2024; 10:23. [PMID: 38713411 PMCID: PMC11076433 DOI: 10.1186/s40729-024-00542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE To analyze the visibility of the maxillary sinus septa (MSS) in panoramic radiography (PR) versus cone beam computed tomography (CBCT) and to investigate whether the buccal cortical bone thickness (BT) or the septa dimensions influence their visibility. METHODS Corresponding PR and CBCT images of 355 patients were selected and examined for MSS visibility. The septa dimensions (width, height, depth) and the BT were measured. Results were analysed statistically. RESULTS Comparing the corresponding regions on CBCT and PR, 170 MSS were identified; however, only 106 of these were also visible using PR. The MSS visibility was significantly higher on CBCT versus PR images (P1: p = 0.039, P2: p = 0.015, M1: p = 0.041, M2: p = 0.017, M3: p = 0.000), except region C (p = 0.625). Regarding the measurements of MSS dimensions, only the height in region M1 (p = 0.013) and the width in region P2 (p = 0.034) were significantly more visible on CBCT. The BT in the area of the MSS was found to have a marginal influence on its visibility on the PR images only in regions M3 and M1 (M3: p = 0.043, M1: p = 0.047). In terms of MSS visibility based on the dimensions, significance was found for all three influencing variables only in region P2 (width; p = 0.041, height; p = 0.001, depth; p = 0.007). There were only isolated cases of further significance: M3 for width (p = 0.043), M2 for height (p = 0.024), and P1 for depth (p = 0.034), no further significance was noted. CONCLUSION MSS visibility appears significantly higher on CBCT versus PR images. It is concluded that the septa dimensions and BT can influence MSS visibility on PR images just in certain regions.
Collapse
Affiliation(s)
- Ali Reza Ketabi
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany.
- Private Dental Office of Dr Ali-Reza Ketabi, Epplestraße 29 a, 70597, Stuttgart, Germany.
| | - Stefan Hassfeld
- Department of Oral and Maxillofacial Surgery, Dortmund Hospital and Faculty of Health, Witten/Herdecke University, Muensterstr. 240, 44145, Dortmund, Germany
| | - Hans-Christoph Lauer
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany
| | - Andree Piwowarczyk
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany
| |
Collapse
|
2
|
Ayyildiz H, Akgunlu F. Are maxillary sinus variations related to maxillary sinus diameters? Oral Radiol 2023; 39:425-436. [PMID: 36094776 DOI: 10.1007/s11282-022-00655-6] [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: 01/25/2022] [Accepted: 09/05/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The reasons why the maxillary posterior region is challenging for dentists are its structure and anatomical variations. For this reason, it is necessary to have complete knowledge about the anatomy of this region. In dentistry, necessary information for the desired evaluation in this region can be provided by CBCT. The fact that it provides a three-dimensional evaluation and has measurement reliability emphasizes its importance in surgical applications. The septa, haller cell, and accessory ostium are variations of the maxillary sinus. There are few studies in the literature examining the relationship between maxillary sinus diameters and its variations. The aims of this study are to determine the prevalence of maxillary sinus variations and the average of maxillary sinus diameters, to examine their relationships according to age and gender, and to evaluate the effects of maxillary sinus diameters on variations. METHODS In this retrospective study, CBCT images of 212 patients were examined. The examined CBCT images were analysed and recorded in more than one section. Descriptive statistics, chi-square tests, independent t test, one-way Anova tests were used to evaluate the data. RESULTS As a result, a statistically significant difference was observed between the variations, gender and age groups in terms of morphometric characteristics of the maxillary sinus. The most common variation was observed to be accessory ostium. CONCLUSIONS The rate of patients with at least one anatomical variation was 77.8%. For this reason, a detailed analysis should be performed to avoid complications before surgical procedures are performed in the area.
Collapse
Affiliation(s)
- Halil Ayyildiz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya, Türkiye.
| | - Faruk Akgunlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Selcuk University, Konya, Türkiye
| |
Collapse
|
3
|
Ketabi AR, Piwowarczyk A, Schulz MC, Lauer HC, Hassfeld S. Evaluation of the contour of edentulous jaw sections in the transversal plane and the buccolingual vertical-level disparity in CBCT and panoramic radiography images: a retrospective comparative study. Int J Implant Dent 2023; 9:1. [PMID: 36595148 PMCID: PMC9810779 DOI: 10.1186/s40729-022-00466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE This study investigates whether edentulous jaw sections in the planned implant position exhibit jaw contours funnel-shaped or exhibit pronounced retraction of the jaw (unusual jaw contours) in the transversal plane of the three-dimensional (3D) images, not visible in two-dimensional (2D) images. METHODS A total of 335 patients with an edentulous section of the jaw that required dental implants were selected. Anonymised radiologic patients' data were collected, comprising cone-beam computed tomography (CBCT) images of the edentulous jaw sections. In the first stage, unusual jaw contours were examined, including funnel-shaped or pronounced retraction of the jaw and hypodense regions with an undercut and/or bone deficit. In the second stage, the variation in the height of the alveolar ridge between the lingual and buccal contour in the edentulous jaw sections was assessed. RESULTS The CBCT images of an unusual jaw contour were observed in 8 cases (2.4%) in the maxilla on the left and 10 cases (3%) in the maxilla on the right. In the mandible, a jaw contour deviates in 39 cases (12.1%) on the left side and 39 cases (12.1%) on the right side. A height difference was detected in the upper jaw in 307 cases and the lower jaw in 265 cases. The discrepancy was 2.09 mm (± 2.25 mm) in the maxilla and 3.97 mm (± 3.45 mm) in the mandible. CONCLUSIONS The CBCT scan provides useful information to avoid complications in the preoperative planning phase and surgical planning in implant dentistry.
Collapse
Affiliation(s)
- Ali Reza Ketabi
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany. .,Private Dental Office, Epplestraße 29 a, 70597, Stuttgart, Germany.
| | - Andree Piwowarczyk
- grid.412581.b0000 0000 9024 6397Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455 Witten, Germany
| | - Matthias Christian Schulz
- grid.10392.390000 0001 2190 1447Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
| | - Hans-Christoph Lauer
- grid.7839.50000 0004 1936 9721Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
| | - Stefan Hassfeld
- grid.412581.b0000 0000 9024 6397Department of Oral and Maxillofacial Surgery, Dortmund Hospital GmbH and Faculty of Health, Witten/Herdecke University, Muensterstr. 240, 44145 Dortmund, Germany
| |
Collapse
|
4
|
ULUSOY AC, ŞENER E, ÖZDEN YÜCE M, ÖZER MA, KARAMAN A, GÖKMEN F, BOYACIOĞLU H, GÜNERİ P. THE EFFECTS OF 3D MODELING ON PLANNING OF MAXILLOFACIAL SURGERY: A Preliminary CBCT STUDY. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1035066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
5
|
Al-Haj Husain A, Döbelin Q, Giacomelli-Hiestand B, Wiedemeier DB, Stadlinger B, Valdec S. Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study. SENSORS 2021; 21:s21217402. [PMID: 34770710 PMCID: PMC8588416 DOI: 10.3390/s21217402] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 02/07/2023]
Abstract
Background: This study aimed to analyze the diagnostic reliability of radiographic assessment of cystic lesions using a pre-set, manufacturer-specific, low-dose mode compared to a standard-dose dental cone-beam computed tomography (CBCT) imaging protocol. Methods: Forty pig mandible models were prepared with cystic lesions and underwent both CBCT protocols on an Orthophos SL Unit (Dentsply-Sirona, Bensheim, Germany). Qualitative and quantitative analysis of CBCT data was performed by twelve investigators independently in SIDEXIS 4 (Dentsply-Sirona) using a trial-specific digital examination software tool. Thereby, the effect of the two dose types on overall detectability rate, the visibility on a scale of 1 (very low) to 10 (very high) and the difference between measured radiographic and actual lesion size was assessed. Results: Low-dose CBCT imaging showed no significant differences considering detectability (78.8% vs. 81.6%) and visibility (9.16 vs. 9.19) of cystic lesions compared to the standard protocol. Both imaging protocols performed very similarly in lesion size assessment, with an apparent underestimation of the actual size. Conclusion: Low-dose protocols providing confidential diagnostic evaluation with an improved benefit–risk ratio according to the ALADA principle could become a promising alternative as a primary diagnostic tool as well as for radiological follow-up in the treatment of cystic lesions.
Collapse
Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (Q.D.); (B.G.-H.); (B.S.)
| | - Quirin Döbelin
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (Q.D.); (B.G.-H.); (B.S.)
| | - Barbara Giacomelli-Hiestand
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (Q.D.); (B.G.-H.); (B.S.)
| | - Daniel B. Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (Q.D.); (B.G.-H.); (B.S.)
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (Q.D.); (B.G.-H.); (B.S.)
- Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã, São Paulo 2227, Brazil
- Correspondence: ; Tel.: +41-44-634-32-90
| |
Collapse
|
6
|
Takatsuka D, Tachinami H, Tomihara K, Amirreza YJ, Ikeda A, Imaue S, Fujiwara K, Sonoda T, Nakamori K, Noguchi M. Novel strategy to predict high risk of inferior alveolar nerve injury during extraction of lower third molars based on assessment of computed tomographic images of multiple anatomical features. Br J Oral Maxillofac Surg 2021; 60:570-576. [PMID: 35422310 DOI: 10.1016/j.bjoms.2021.09.014] [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: 06/22/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
Preoperative assessment is essential to prevent inferior alveolar nerve (IAN) injury during surgical extraction of the lower third molar (LM3). Here, we aimed to establish an assessment system to predict IAN injury during surgical extraction of the LM3. We conducted a retrospective cohort study on 115 patients diagnosed as 'high-risk' based on our previous risk assessment method involving three anatomical features of the inferior alveolar canal using computed tomographic (CT) images. We evaluated the occurrence of neurosensory impairment in these high-risk patients, and its association with novel anatomic features based on CT images. Neurosensory impairments were observed in 19 patients (16.5%). The inferior alveolar canal major diameter (p < 0.0001) and lingual bone thickness (p = 0.0039) were significantly associated with the occurrence of neurosensory impairment during LM3 extraction. Receiver operating characteristic curves were used to determine cut-off values of these quantitative factors to specifically predict IAN injury. Preoperative risk assessment with quantitative factors based on anatomical features observed on CT images may facilitate more appropriate surgical planning for patients at a high risk of IAN injury.
Collapse
Affiliation(s)
- Danki Takatsuka
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Hidetake Tachinami
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan.
| | - Kei Tomihara
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Younesi Jadidi Amirreza
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Atsushi Ikeda
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Shuichi Imaue
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Kumiko Fujiwara
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Tomoko Sonoda
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Kenji Nakamori
- Department of Oral and Maxillofacial Surgery, Regional Independent Administrative Corporation Naha City Hospital, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| |
Collapse
|
7
|
Schulze RKW, Drage NA. Cone-beam computed tomography and its applications in dental and maxillofacial radiology. Clin Radiol 2020; 75:647-657. [PMID: 32451060 DOI: 10.1016/j.crad.2020.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022]
Abstract
Cone-beam computed tomography (CBCT) was first used in dental and maxillofacial radiology (DMFR) at the end of the 1990s. Since then, it has been successfully established as the standard three-dimensional radiographic imaging technique in DMFR, with a wide variety of applications in this field. This manuscript briefly reviews the background information on the technology and summarises available data on effective dose and dose optimisation. In addition, typical clinical applications and indications of the technique in DMFR are presented.
Collapse
Affiliation(s)
- R K W Schulze
- Department of Oral and Maxillofacial Surgery, Section of Oral Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - N A Drage
- Department of Dental and Maxillofacial Radiology, University Dental Hospital, Cardiff, UK
| |
Collapse
|
8
|
de Toledo Telles-Araújo G, Peralta-Mamani M, Caminha RDG, de Fatima Moraes-da-Silva A, Rubira CMF, Honório HM, Rubira-Bullen IRF. CBCT does not reduce neurosensory disturbances after third molar removal compared to panoramic radiography: a systematic review and meta-analysis. Clin Oral Investig 2020; 24:1137-1149. [PMID: 32052178 DOI: 10.1007/s00784-020-03231-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The current dentistry scenario is showing an increase in the availability of cone-beam computed tomography (CBCT) in dental offices. Oral surgeons are using three-dimensional information as an additional tool to assess preoperative data for lower third molar (LTM) removal in moderate and high-risk cases of inferior alveolar nerve (IAN) injury diagnosed through the panoramic radiography (PR). The aim of this study is to identify whether CBCT examination reduces neurosensoric disturbances (ND) following the removal of the LTM when compared to PR. MATERIALS AND METHODS PubMed, Embase, Web of Science, Science Direct, and Scopus electronic databases were searched for studies published up to February 2019. The gray literature was also searched including papers that eventually met the eligibility criteria. Meta-analysis was performed using the comprehensive meta-analysis software, p < 0.05 considered significant. RESULTS Among the search, 6 studies met all eligibility criteria. There was no statistically significant difference between the two groups (PR and CBCT) in all six studies regarding reducing ND (95%. Confidence interval, 0,788-1734; heterogeneity: Q = 10,361; I2 = 22.788%). CONCLUSIONS CBCT was not superior to PR in avoiding ND. However, further studies are necessary with standardized parameters for a better comparability between variables in the studies. CLINICAL RELEVANCE To better understand the CBCT clinical applicability in LTM removal to avoid unnecessary extra radiation when compared to PR to the patient and to improve patient's prognosis.
Collapse
Affiliation(s)
- Gabriel de Toledo Telles-Araújo
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Raquel D'Aquino Garcia Caminha
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Cássia Maria Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | |
Collapse
|
9
|
Araujo GDTT, Peralta-Mamani M, Silva ADFMD, Rubira CF, Honório HM, Rubira-Bullen IF. Influence of cone beam computed tomography versus panoramic radiography on the surgical technique of third molar removal: a systematic review. Int J Oral Maxillofac Surg 2019; 48:1340-1347. [DOI: 10.1016/j.ijom.2019.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
|
10
|
Contribution of cone-beam computed tomography in the decision of surgical management for bone lesions of the maxillofacial region. J Craniomaxillofac Surg 2018; 47:87-92. [PMID: 30470468 DOI: 10.1016/j.jcms.2018.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/15/2018] [Accepted: 10/15/2018] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to evaluate the contribution of cone-beam computed tomography (CBCT) in the decision of surgical management for bone lesions of the maxillofacial region. It is a retrospective cross-sectional observational study that includes a sample of panoramic radiography (PR) and CBCT from patients with some type of bone lesion in the maxillofacial region. PR and CBCT images were evaluated by three previously assessed examiners, specialists in oral and maxillofacial surgery. Each image was evaluated randomly, and a surgical procedure was suggested, initially in PR and then in CBCT. The obtained results were submitted to the McNemar test to evaluate the frequencies of changes in the surgical management between the first and the second evaluation in PR and CBCT, and intra-examiner and inter-examiner agreements were analyzed by the Cohen's kappa test. The level of significance was set at 5% (p < 0.05). Intra-examiner agreement increases when CBCT is used. Inter-examiner agreement was low, independently of the evaluated exam, which shows that the choice of treatment plan is examiner-dependent and not exam-dependent. CBCT increases the certainty of the professional in the evaluation of the bone lesions of the maxillofacial region; however, it does not change the indication of the treatment type.
Collapse
|
11
|
Dach E, Bergauer B, Seidel A, von Wilmowsky C, Adler W, Lell M, Wichmann M, Matta RE. Impact of voxel size and scan time on the accuracy of three-dimensional radiological imaging data from cone-beam computed tomography. J Craniomaxillofac Surg 2018; 46:2190-2196. [PMID: 30318325 DOI: 10.1016/j.jcms.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/06/2018] [Accepted: 09/10/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Three-dimensional (3D) radiological imaging plays an important role in surgical planning used in modern dentistry. The aim of this study was to optimize imaging parameters with a special focus on voxel size and scan time. MATERIAL AND METHODS A virtual 3D master model of a macerated human skull was generated using an industrial optical noncontact white light scanner. The skull was X-rayed with cone-beam computed tomography that was applied using different settings for voxel size and acquisition time (voxel edge length of 0.3 mm, scan times 4.8 s and 8.9 s; voxel edge length of 0.2 mm, scan times 14.7 s and 26.9 s). The scan was repeated 10 times at each setting. The CBCT scans were converted into 3D virtual models (actual value), which were superimposed with the 3D master model (reference value) to detect absolute differences. RESULTS The mean value of deviation increased with increasing voxel size and decreasing scan time. For a voxel edge length of 0.3 mm, the mean values of deviation were 0.33 mm and 0.22 mm with scan times of 4.8 s and 8.9 s, respectively. For a voxel edge length of 0.2 mm, the mean deviations were 0.16 mm and 0.14 mm with scan times of 14.7 s and 26.9 s, respectively. CONCLUSIONS When using small voxel sizes, the scan time does not have a significant impact on image accuracy and therefore the scan time can be shortened. However, for larger voxel sizes, shorter scan times can lead to increased inaccuracy.
Collapse
Affiliation(s)
- Eva Dach
- Department of Prosthodontics (Head: Professor Dr. M. Wichmann), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany
| | - Bastian Bergauer
- Department of Prosthodontics (Head: Professor Dr. M. Wichmann), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany
| | - Anna Seidel
- Department of Prosthodontics (Head: Professor Dr. M. Wichmann), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany
| | - Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery (Head: Professor Dr. med. Dr. med. Dent. M. Kesting), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology (Head: Professor Dr. O. Gefeller), Friedrich-Alexander-University of Erlangen-Nürnberg, Universitätsstraße 22, 91054, Erlangen, Germany
| | - Michael Lell
- Institute of Radiology and Nuclear Medicine (Head: Professor Dr. M. Lell), Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Germany
| | - Manfred Wichmann
- Department of Prosthodontics (Head: Professor Dr. M. Wichmann), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany
| | - Ragai-Edward Matta
- Department of Prosthodontics (Head: Professor Dr. M. Wichmann), Erlangen University Hospital, Glückstraße 11, 91054, Erlangen, Germany.
| |
Collapse
|
12
|
Thiele OC, Nolte IM, Mischkowski RA, Safi AF, Perrin J, Zinser M, Zöller JE, Kreppel M. Craniomaxillofacial patient-specific CAD/CAM implants based on cone-beam tomography data - A feasibility study. J Craniomaxillofac Surg 2018; 46:1461-1464. [PMID: 29958732 DOI: 10.1016/j.jcms.2018.05.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/27/2018] [Accepted: 05/30/2018] [Indexed: 12/22/2022] Open
Abstract
Customized implants have simplified surgical procedures and have improved patient outcome in craniomaxillofacial surgery. Traditionally, patient-specific data is gathered by conventional computed tomography (CT). However, cone-beam CT (CBCT) can generate a 3D reconstruction of the area of interest with a lower dose of radiation at reduced cost. In this study, we investigated the feasibility of using CBCT data to design and generate customized implants for patients requiring craniomaxillofacial reconstruction. We used CBCT to generate 62 implants for 51 consecutive patients admitted to our department between January 2015 and December 2017. The indications for reconstruction and types of reconstruction were very variable. In all cases, the implants were well fitted and no implant-related complications were detected. Pre-surgical planning was faster and more efficient as we did not have to consult a radiologist. Although CBCT data is more difficult to process than conventional CT data for the implant provider, the clinical advantages are pronounced and we now use CBCT as standard in our department. In conclusion, we have shown that using CBCT to design and manufacture customized implants for reconstruction of the craniomaxillofacial area is feasible and recommend this approach to other departments.
Collapse
Affiliation(s)
- Oliver C Thiele
- Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, (Head: Prof. R. A. Mischkowski, MD, DDS), Ludwigshafen, Germany.
| | - Isabel M Nolte
- Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, (Head: Prof. R. A. Mischkowski, MD, DDS), Ludwigshafen, Germany
| | - Robert A Mischkowski
- Department of Oral, Maxillofacial and Facial Plastic Surgery, Ludwigshafen Hospital, (Head: Prof. R. A. Mischkowski, MD, DDS), Ludwigshafen, Germany
| | - Ali F Safi
- Department of Craniomaxillofacial and Plastic Surgery, University Hospital Cologne, (Head: Prof. J. E. Zöller, MD, DDS), Cologne, Germany
| | - Jason Perrin
- Department of Neurosurgery, University Hospital Mannheim, University of Heidelberg, (Head: Prof. D. Hänggi, MD), Mannheim, Germany
| | - Max Zinser
- Department of Craniomaxillofacial and Plastic Surgery, University Hospital Cologne, (Head: Prof. J. E. Zöller, MD, DDS), Cologne, Germany
| | - Joachim E Zöller
- Department of Craniomaxillofacial and Plastic Surgery, University Hospital Cologne, (Head: Prof. J. E. Zöller, MD, DDS), Cologne, Germany
| | - Matthias Kreppel
- Department of Craniomaxillofacial and Plastic Surgery, University Hospital Cologne, (Head: Prof. J. E. Zöller, MD, DDS), Cologne, Germany
| |
Collapse
|
13
|
Candemil AP, Salmon B, Freitas DQ, Ambrosano GM, Haiter-Neto F, Oliveira ML. Metallic materials in the exomass impair cone beam CT voxel values. Dentomaxillofac Radiol 2018; 47:20180011. [PMID: 29582689 DOI: 10.1259/dmfr.20180011] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To assess the influence of artefacts arising from metallic materials in the exomass on cone beam CT (CBCT) voxel values. METHODS CBCT scans were taken of a phantom composed of 16 tubes filled with a homogeneous hyperdense solution and metallic materials of different compositions (titanium, cobalt-chromium and amalgam) and numbers (one, two and three). The phantom was centred in a 5 × 5 cm field of view such that the metallic materials were located in the exomass, using three CBCT units. Voxel values were obtained from the 16 homogeneous areas and averaged. Also, standard deviation was calculated to measure voxel value variability. Analysis of variance in a factorial scheme with additional treatment 3 × 3 + 3 (material × number + control) was performed, followed by Tukey's test for multiple comparisons, and Dunnett's test for comparisons with the control groups, at a level of significance of 5%. RESULTS Metallic material in the exomass significantly reduced the mean voxel value in the CS9300 and Picasso Trio units, and increased voxel value variability in all CBCT units. Amalgam was the material that induced significantly greater reduction of the mean voxel value in the CS9300 and Picasso Trio units, and significantly greater increase in the NewTom Giano. Voxel value variability was significantly greater for amalgam in all conditions. The presence of one cylinder induced significantly less pronounced effects on the mean voxel value and voxel value variability. CONCLUSIONS Artefacts arising from metallic materials in the exomass have a negative influence on CBCT voxel values.
Collapse
Affiliation(s)
- Amanda P Candemil
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Benjamin Salmon
- 2 Department of Dental Medicine, Bretonneau Hospital, HUPNVS, AP-HP , Paris , France.,3 EA 2496 - Orofacial Pathologies, Imaging and Biotherapies Lab, Sorbonne Paris Cité - Paris Descartes University. , Paris , France
| | - Deborah Q Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Glaucia Mb Ambrosano
- 4 Department of Community Dentistry, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Francisco Haiter-Neto
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Matheus L Oliveira
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| |
Collapse
|
14
|
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.
Collapse
Affiliation(s)
- J Ata-Ali
- Public Dental Health Service, Arnau de Vilanova Hospital, San Clemente Street 12, 46015-Valencia, Spain,
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Analyzing the teeth next to the alveolar cleft: Examination and treatment proposal prior to bone grafting based on three-dimensional versus two-dimensional diagnosis-A diagnostic study. J Craniomaxillofac Surg 2017; 45:1272-1277. [PMID: 28684068 DOI: 10.1016/j.jcms.2017.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/04/2017] [Accepted: 05/29/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The objective was to evaluate the diagnostic and prognostic value of three-dimensional (3D) cone beam computed tomography (CBCT) on information about the cleft and alignment of cleft neighboring teeth. MATERIALS AND METHODS Panoramic X-rays, small-volume CBCTs, and study casts of 20 patients with a total of 22 alveolar clefts were analyzed prior to secondary bone grafting. Six maxillofacial surgeons and 6 orthodontists rated the following parameters: visibility of alveolar cleft expansion, position and probability of alignment of cleft neighbored teeth. Two-dimensional (2D) X-rays and casts were rated first; CBCT and casts followed at least 4 weeks later. Radiologic bone height in the region of the former alveolar cleft, as well as alignment and reasons for nonalignment of cleft neighbored teeth, were recorded 4 years later. RESULTS The rate of proper proposals regarding the real treatment outcome using 2D- or 3D-material did not differ statistically. Although 5%-45% of the proposals were changed when using 3D instead of 2D records, Fleiss multirater kappas showed no essential differences. Raters' profession and experience had no influence on the rate of correct proposals. CONCLUSION In orthodontics, small-volume CBCT may be justified only as supplement to a routine panoramic X-ray, and only in selected cases or for surgical preparation.
Collapse
|