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Parmar S, Datarkar A, Valvi B, Deshpande A. Evaluation of maxillary alveolar ridge formation and ridge continuity after secondary alveolar bone grafting using cancellous and cortico-cancellous bone graft in unilateral cleft alveolus using cone beam computed tomographic scan - a randomized controlled trial. Oral Maxillofac Surg 2024; 28:315-321. [PMID: 36826684 DOI: 10.1007/s10006-023-01145-7] [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: 12/09/2022] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE The aim of present study was to compare and evaluate the maxillary alveolar ridge formation and ridge continuity using cancellous and corticocanellous bone graft harvested from anterior iliac crest for complete secondary unilateral cleft alveolus defects. MATERIAL AND METHOD All patients were randomized into two groups for secondary alveolar bone grafting. Group I (n = 10) patients treated with cancellous particulate bone graft and group II (n = 10) patients treated with cortico-cancellous block graft. Maxillary alveolar ridge bone formation was assessed with the help of cone beam computed tomography (CBCT) scan using Planmeca Romexis Viewer 5.0 software. Maxillary alveolar ridge continuity was assessed with axial section of CBCT scan and clinical occlusal photograph. Preoperative CBCT scan and occlusal photographs were compared with post-op 6-month CBCT scan and occlusal photographs. RESULT The mean preoperative volume of cleft defect in group I was 4.2576 cm3 whereas in group II it was 4.2268 cm3. The mean postoperative bone bridge formation after 6 months in group I was 4.055 cm3 whereas in group II it was 3.8103 cm3. Preoperative and 6-month postoperative axial sections of CBCT scans were compared and 100% maxillary alveolar ridge continuity was achieved in both groups. The preoperative and postoperative occlusal photographs of both the groups were compared and showed accurate bone and well aligned maxillary alveolar ridge formation in all patients. CONCLUSION The present study concluded that maxillary alveolar ridge formation rate is less in cortico-cancellous iliac crest block graft compared to cancellous iliac crest particulate graft, but is equally good as cancellous bone graft. CLINICAL TRIAL REGISTRATION NO (REF/2020/09/031605)/ CTRI/ 2020/09/028001.
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Affiliation(s)
- Suraj Parmar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, 440003, India
| | - Abhay Datarkar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, 440003, India
| | - Bhavana Valvi
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, 440003, India.
| | - Archana Deshpande
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, 440003, India
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Jensen ED, Jensen SW, Oliver K. Cone beam computed tomography as a first line investigation in the pediatric dental patient. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zhang Y, Chen X, Zhou Z, Hao Y, Li H, Cheng Y, Ren X, Wang X. Effects of Impacted Lower Third Molar Extraction on Periodontal Tissue of the Adjacent Second Molar. Ther Clin Risk Manag 2021; 17:235-247. [PMID: 33790564 PMCID: PMC7997553 DOI: 10.2147/tcrm.s298147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/05/2021] [Indexed: 12/19/2022] Open
Abstract
The extraction of impacted lower third molars (ILTM) is one of the most common procedures in oral-maxillofacial surgery. Being adjacent to lower second molars, most impacted lower third molars often lead to distal periodontal defects of adjacent second molars. Several symptoms may occur after extraction, such as periodontal pocket formation, loss of attachment, alveolar bone loss and even looseness of second molar resulting in extraction. The distal periodontal defects of second molars are affected by many factors, including periodontal conditions, age, impacted type of third molars, and intraoperative operations. At present, several studies have suggested that dentists can reduce the risk of periodontal defects of the second molar after ILTM extraction through preoperative evaluation, reasonable selection of flap design, extraction instruments and suture type, and necessary postoperative interventions. This review summarizes the research progress on the influence factors, interventions methods and some limitations of distal periodontal defects of adjacent second molar after extraction of impacted mandibular third molars, with the aim of opening up future directions for studying effects of ILTM extraction on periodontal tissue of the adjacent second molar.
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Affiliation(s)
- Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xiaohang Chen
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Zilan Zhou
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Yujia Hao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Huifei Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xiuyun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
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Comparison of Anatomical Features of Alveolar Cleft in Unilateral Cleft Lip and Palate Patients of Different Ages. J Craniofac Surg 2021; 31:1629-1632. [PMID: 32796297 DOI: 10.1097/scs.0000000000006580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES This study aimed to compare the anatomical features of alveolar cleft in patients with complete unilateral cleft lip and palate (UCLP) of different ages. METHODS Sixty UCLP patients were divided into 3 groups as follows: group 1 (7-12 years old), group 2 (13-18 years old) and group 3 (more than 18 years old). The radiographic images were analyzed based on cone beam computed tomography (CBCT) images. RESULTS The mean age in 3 groups was 10.45 ± 1.15, 15.05 ± 1.90, and 22.55 ± 3.00 years (P < 0.0001). The lip-palatal width in Group 2 and 3 was 15.14 ± 3.67 mm and 15.50 ± 3.92 mm, which was significantly larger than 12.97 ± 1.82 mm in Group 1 (P = 0.037). The volume of alveolar defect was 1.09 ± 0.23 cm, 1.28 ± 0.38 cm and 1.40 ± 0.58 cm in 3 groups, and the difference between any 2 of them was significant (P = 0.0004). The prevalence of ipsilateral but contralateral maxillary sinusitis was significant among 3 groups (P = 0.0015) while the other nasal deformities including nasal septum deviation and inferior turbinate hypertrophy was not found significant. CONCLUSIONS Alveolar cleft volume increased with age, which is properly due to enlarged width of lip-palatal defect. The significant higher frequencies of ipsilateral maxillary sinusitis in patients under 18 could increase the risk of bone infection.
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De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. Eur J Orthod 2020; 41:381-389. [PMID: 30351398 PMCID: PMC6686083 DOI: 10.1093/ejo/cjy066] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. OBJECTIVE The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. SEARCH METHODS MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. SELECTION CRITERIA The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. CONCLUSIONS CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. REGISTRATION None. CONFLICT OF INTEREST None to declare.
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Affiliation(s)
- Annelore De Grauwe
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Irem Ayaz
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Kamperos G, Theologie-Lygidakis N, Tsiklakis K, Iatrou I. A novel success scale for evaluating alveolar cleft repair using cone-beam computed tomography. J Craniomaxillofac Surg 2020; 48:391-398. [PMID: 32127303 DOI: 10.1016/j.jcms.2020.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/09/2019] [Accepted: 02/10/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Radiographic scales, based on plain radiographs, for the evaluation of alveolar cleft repair, have certain weaknesses and are thought to overestimate to some degree the success of the surgical intervention. The aim of this study was the presentation of a novel success scale for evaluating alveolar cleft repair using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Patients treated with secondary osteoplasty for unilateral or bilateral alveolar cleft were evaluated using the Bergland and Enemark scales, as well as the novel success scale, which measures the bone height, the bone width and the level of the nasal floor. RESULTS A total of 44 patients with a total of 53 alveolar cleft sites were included. According to the new scale, 60% of the cases were defined as successful, with moderate (kappa = 0.511) or substantial (kappa = 0.718) agreement, between the new scale and the Bergland or Enemark scale, respectively. Statistically significant correlation was reported between the new success scale and the closure of space of the lateral incisor, the patient's age at surgery, the graft revision and the presence of residual fistula. CONCLUSIONS The novel success scale for evaluating alveolar cleft repair using CBCT takes into consideration all dimensions of the bony bridge. Future application is necessary for validation of its potential value.
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Affiliation(s)
- Georgios Kamperos
- University Department of Oral and Maxillofacial Surgery, ''P. & A. Kyriakou'' Children's Hospital (Head: Professor C. Perisanidis), School of Dentistry, National and Kapodistrian University of Athens, Greece.
| | - Nadia Theologie-Lygidakis
- University Department of Oral and Maxillofacial Surgery, ''P. & A. Kyriakou'' Children's Hospital (Head: Professor C. Perisanidis), School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology (Head: Professor K. Tsiklakis), School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Ioannis Iatrou
- University Department of Oral and Maxillofacial Surgery, ''P. & A. Kyriakou'' Children's Hospital (Head: Professor C. Perisanidis), School of Dentistry, National and Kapodistrian University of Athens, Greece
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Horner K, Barry S, Dave M, Dixon C, Littlewood A, Pang CL, Sengupta A, Srinivasan V. Diagnostic efficacy of cone beam computed tomography in paediatric dentistry: a systematic review. Eur Arch Paediatr Dent 2019; 21:407-426. [PMID: 31858481 PMCID: PMC7415745 DOI: 10.1007/s40368-019-00504-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
Abstract
Purpose To determine in which clinical situations it is indicated or contra-indicated to prescribe cone beam computed tomography (CBCT) for paediatric patients. Methods Systematic review of in vivo paediatric research studies of diagnostic efficacy using CBCT, with supplementary searches for guideline documents on CBCT and for systematic reviews permitting inclusion of ex vivo and adult studies. Results After screening, 190 publications were included, mostly case studies. No systematic reviews were found of in vivo paediatric research. Fourteen studies of diagnostic efficacy were identified. The supplementary searches found 18 guideline documents relevant to the review and 26 systematic reviews. The diagnostic efficacy evidence on CBCT was diverse and often of limited quality. There was ex vivo evidence for diagnostic accuracy being greater using CBCT than radiographs for root fractures. The multiplanar capabilities of CBCT are advantageous when localising dental structures for surgical planning. Patient movement during scanning is more common in children which could reduce diagnostic efficacy. Conclusions No strong recommendations on CBCT are possible, except that it should not be used as a primary diagnostic tool for caries. Guidelines on use of CBCT in the paediatric age group should be developed cautiously, taking into account the greater radiation risk and the higher economic costs compared with radiography. CBCT should only be used when adequate conventional radiographic examination has not answered the question for which imaging was required. Clinical research in paediatric patients is required at the higher levels of diagnostic efficacy of CBCT. Electronic supplementary material The online version of this article (10.1007/s40368-019-00504-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK.
- Dental Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK.
| | - S Barry
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - M Dave
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
| | - C Dixon
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - A Littlewood
- Information Specialist, Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
| | - C L Pang
- Division of Imaging, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - A Sengupta
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Dental Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - V Srinivasan
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
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