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Parize H, Sadilina S, Caldas RA, Cordeiro JVC, Kleinheinz J, Laganá DC, Sesma N, Bohner L. Magnetic resonance imaging for jawbone assessment: a systematic review. Head Face Med 2024; 20:25. [PMID: 38641613 PMCID: PMC11027384 DOI: 10.1186/s13005-024-00424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/18/2024] [Indexed: 04/21/2024] Open
Abstract
PURPOSE To evaluate the accuracy of magnetic resonance imaging (MRI) for jawbone assessment compared to reference-standard measurements in the literature. MATERIALS AND METHODS An electronic database search was conducted in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library in June 2022, and updated in August 2023. Studies evaluating the accuracy of MRI for jawbone assessment compared with reference-standard measurements (histology, physical measurements, or computed tomography) were included. The outcome measures included bone histomorphometry and linear measurements. The risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The review was registered in the PROSPERO database (CRD42022342697). RESULTS From 63 studies selected for full-text analysis, nine manuscripts were considered eligible for this review. The studies included assessments of 54 participants, 35 cadavers, and one phantom. A linear measurement error ranging from 0.03 to 3.11 mm was shown. The accuracy of bone histomorphometry varies among studies. Limitations of the evidence included heterogeneity of MRI protocols and the methodology of the included studies. CONCLUSION Few studies have suggested the feasibility of MRI for jawbone assessment, as MRI provides comparable results to those of standard reference tests. However, further advancements and optimizations are needed to increase the applicability, validate the efficacy, and establish clinical utility of these methods.
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Affiliation(s)
- Hian Parize
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Sofya Sadilina
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ricardo Armini Caldas
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil.
| | - João Victor Cunha Cordeiro
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
| | - Dalva Cruz Laganá
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Newton Sesma
- Department of Prosthodontics, University of São Paulo, São Paulo, Brazil
| | - Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, University Hospital Munster, Munster, Germany
- Department of Dentistry, Federal University of Santa Catarina, R. Delfino Conti, 1240 - Trindade, Florianopolis, Florianópolis, 88040-535, SC, Brazil
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Burian E, Lenhart N, Greve T, Bodden J, Burian G, Palla B, Probst F, Probst M, Beer M, Folwaczny M, Schwarting J. Detection of caries lesions using a water-sensitive STIR sequence in dental MRI. Sci Rep 2024; 14:663. [PMID: 38182726 PMCID: PMC10770403 DOI: 10.1038/s41598-024-51151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Neuroradiology, Kantonsspital Frauenfeld, Thurgau AG, Frauenfeld, Switzerland.
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, Chicago, USA
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, 80337, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Ghamri M, Dritsas K, Probst J, Jäggi M, Psomiadis S, Schulze R, Verna C, Katsaros C, Halazonetis D, Gkantidis N. Accuracy of facial skeletal surfaces segmented from CT and CBCT radiographs. Sci Rep 2023; 13:21002. [PMID: 38017262 PMCID: PMC10684569 DOI: 10.1038/s41598-023-48320-0] [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: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
The accuracy of three-dimensional (3D) facial skeletal surface models derived from radiographic volumes has not been extensively investigated yet. For this, ten human dry skulls were scanned with two Cone Beam Computed Tomography (CBCT) units, a CT unit, and a highly accurate optical surface scanner that provided the true reference models. Water-filled head shells were used for soft tissue simulation during radiographic imaging. The 3D surface models that were repeatedly segmented from the radiographic volumes through a single-threshold approach were used for reproducibility testing. Additionally, they were compared to the true reference model for trueness measurement. Comparisons were performed through 3D surface approximation techniques, using an iterative closest point algorithm. Differences between surface models were assessed through the calculation of mean absolute distances (MAD) between corresponding surfaces and through visual inspection of facial surface colour-coded distance maps. There was very high reproducibility (approximately 0.07 mm) and trueness (0.12 mm on average, with deviations extending locally to 0.5 mm), and no difference between radiographic scanners or settings. The present findings establish the validity of lower radiation CBCT imaging protocols at a similar level to the conventional CT images, when 3D surface models are required for the assessment of facial morphology.
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Affiliation(s)
- Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Jeddah Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Jannis Probst
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Maurus Jäggi
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Symeon Psomiadis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Ralf Schulze
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058, Basel, Switzerland
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland.
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Tang Y, Zhai S, Yu H, Qiu L. Clinical feasibility evaluation of a digital workflow of prosthetically oriented onlay bone grafting for horizontal alveolar augmentation: a prospective pilot study. BMC Oral Health 2023; 23:824. [PMID: 37904141 PMCID: PMC10614392 DOI: 10.1186/s12903-023-03556-0] [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: 03/13/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Onlay bone grafting is considered highly reliable for reconstructing severe horizontal bone defects. A critical problem is how to achieve precise position of the bone block to control alveolar ridge dimensions. This research aims to establish a digital workflow for prosthetically oriented onlay bone grafting and evaluate its accuracy and efficiency. METHODS This prospective pilot study investigated eight patients who required implant restoration in the esthetic area with horizontal alveolar bone defects. The workflow includes preoperative virtual planning, design and manufacture of patient-specific templates, bone grafting surgery, and implant insertion. Primary outcomes were graft accuracy, defined by root mean square estimate (RMSE) values between preoperatively designed and actual implanted outer contours of bone blocks. Secondary outcomes were bone graft and implant success rates. Besides, the surgeons used the visual analog scale (VAS) to rate the intuitiveness, ease of understanding, and helpfulness of the workflow. RESULTS No bone grafts or implants failed in any of the eight patients, resulting in a 100% success rate. The RMSE values between the preoperative design and the implanted outer contour of bone blocks were 0.41 ± 0.15 mm. The digital approach showed advantages in intuitiveness (9.3 ± 0.5), understanding (9.0 ± 0.5), and helpfulness (8.4 ± 1.1) according to surgeons' VAS scores. CONCLUSIONS A digital workflow provided encouraging results, in terms of accuracy and efficacy, for horizontal bone augmentation. TRIAL REGISTRATION This study was registered in the National Clinical Trials Registry in 16/02/2023 under the identification number ChiCTR2300068361.
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Affiliation(s)
- Yiman Tang
- 4Th Division, Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral, Beijing, 100081, People's Republic of China
| | - Shuyong Zhai
- Dental Digital & Esthetics Laboratory, Beijing Shengzhuo Dental Corporation, Beijing, People's Republic of China
| | - Huajie Yu
- 4Th Division, Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral, Beijing, 100081, People's Republic of China.
| | - Lixin Qiu
- 4Th Division, Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral, Beijing, 100081, People's Republic of China.
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Burian E, Feuerriegel G, Sollmann N, Burian G, Palla B, Griesbauer M, Bumm C, Probst M, Beer M, Folwaczny M. Visualization of clinically silent, odontogenic maxillary sinus mucositis originating from periapical inflammation using MRI: a feasibility study. Clin Oral Investig 2023:10.1007/s00784-023-04986-4. [PMID: 37039958 DOI: 10.1007/s00784-023-04986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the following clinical question: among patients with periapical inflammatory processes in the maxilla, does the use of magnetic resonance imaging (MRI), as compared to conventional periapical (AP) and panoramic radiography (OPT), improve diagnostic accuracy? METHODS Forty-two subjects with generalized periodontitis were scanned on a 3 T MRI. Sixteen asymptomatic subjects with mucosal swelling of the maxillary sinus were enrolled in the study. Periapical edema was assessed using short tau inversion recovery (STIR) sequence. Apical osteolysis and mucosal swelling were assessed by MRI, AP, and OPT imaging using the periapical index score (PAI). Comparisons between groups were performed with chi-squared tests with Yates' correction. Significance was set at p < 0.05. RESULTS Periapical lesions of maxillary premolars and molars were identified in 16 subjects, 21 sinuses, and 58 teeth. Bone edema and PAI scores were significantly higher using MRI as compared to OPT and AP (p < 0.05). Using the STIR sequence, a significant association of PAI score > 1 and the presence of mucosal swelling in the maxillary sinus was detected (p = 0.03). CONCLUSION Periapical inflammation and maxillary mucositis could be visualized using STIR imaging. The use of MRI may help detect early, subtle inflammatory changes in the periapical tissues surrounding maxillary dentition. Early detection could guide diagnostic criteria, as well as treatment and prevention.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, IL, USA
| | - Magdalena Griesbauer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caspar Bumm
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Munich, Germany
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6
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Fuglsig JMDCES, Hansen B, Schropp L, Nixdorf DR, Wenzel A, Spin-Neto R. Alveolar bone measurements in magnetic resonance imaging compared with cone beam computed tomography: a pilot, ex-vivo study. Acta Odontol Scand 2023; 81:241-248. [PMID: 36112428 DOI: 10.1080/00016357.2022.2121321] [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: 11/01/2022]
Abstract
OBJECTIVES To compare alveolar bone height and width measurements from zero-echo-time MRI (ZTE-MRI) and cone beam CT (CBCT), in human specimens. MATERIAL AND METHODS Twenty posterior edentulous sites in human cadaver specimens were imaged with CBCT and ZTE-MRI. Bone height and width at 1, 3, 5, 7 and 9 mm from the top of the alveolar ridge was measured by two trained observers in cross-sections of a site where an implant was to be planned. Twenty percent of the sample was measured in duplicate to assess method error and intra-observer reproducibility (ICC). The differences between CBCT and ZTE-MRI measurements were compared (t-test). RESULTS Inter- and intra-observer reproducibility was >0.90. The method error (average between observers) for bone height was 0.45 mm and 0.39 mm, and for bone width (average) was 0.52 mm and 0.80 mm (CBCT and ZTE-MRI, respectively). The majority of the bone measurement differences were statistically insignificant, except bone width measurements at 5 mm (p ≤ .05 for both observers). Mean measurement differences were not larger than the method error. CONCLUSION ZTE-MRI is not significantly different from CBCT when comparing measurements of alveolar bone height and width.
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Affiliation(s)
| | - Brian Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
- Department of Radiology, Medical School, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, Aarhus, Denmark
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Feuerriegel GC, Ritschl LM, Sollmann N, Palla B, Leonhardt Y, Maier L, Gassert FT, Karampinos DC, Makowski MR, Zimmer C, Wolff KD, Probst M, Fichter AM, Burian E. Imaging of traumatic mandibular fractures in young adults using CT-like MRI: a feasibility study. Clin Oral Investig 2023; 27:1227-1233. [PMID: 36208329 PMCID: PMC9985557 DOI: 10.1007/s00784-022-04736-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess and compare the diagnostic performance of CT-like images based on a three- dimensional (3D) T1-weighted spoiled gradient-echo sequence (3D T1 GRE) with CT in patients with acute traumatic fractures of the mandible. MATERIALS AND METHODS Subjects with acute mandibular fractures diagnosed on conventional CT were prospectively recruited and received an additional 3 T MRI with a CT-like 3D T1 GRE sequence. The images were assessed by two radiologists with regard to fracture localization, degree of dislocation, and number of fragments. Bone to soft tissue contrast, diagnostic confidence, artifacts, and overall image quality were rated using a five-point Likert-scale. Agreement of measurements was assessed using an independent t-test. RESULTS Fourteen subjects and 22 fracture sites were included (26 ± 3.9 years; 4 females, 10 males). All traumatic fractures were accurately detected on CT-like MRI (n = 22, κ 1.00 (95% CI 1.00-1.00)). There was no statistically significant difference in the assessment of the fracture dislocation (axial mean difference (MD) 0.06 mm, p = 0.93, coronal MD, 0.08 mm, p = 0.89 and sagittal MD, 0.04 mm, p = 0.96). The agreement for the fracture classification as well as the inter- and intra-rater agreement was excellent (range κ 0.92-0.98 (95% CI 0.96-0.99)). CONCLUSION Assessment of mandibular fractures was feasible and accurate using CT-like MRI based on a 3D T1 GRE sequence and is comparable to conventional CT. CLINICAL RELEVANCE For the assessment of acute mandibular fractures, CT-like MRI might become a useful alternative to CT in order to reduce radiation exposure particularly in young patients.
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Affiliation(s)
- Georg C Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago, Chicago, USA
| | - Yannik Leonhardt
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa Maier
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian T Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas M Fichter
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Zhu N, Liu J, Ma T, Zhang Y, Lin Y. Fully digital versus conventional workflow for horizontal ridge augmentation with intraoral block bone: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:809-820. [PMID: 36068075 DOI: 10.1111/cid.13129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To compare the outcome and efficiency of the computer-aided intraoral block bone grafting procedure with those of the conventional technique for the augmentation of horizontal ridge defects. MATERIALS AND METHODS A total of 28 patients with single missing tooth in esthetic zone with class IV horizontal alveolar bone defect in need of dental implant restoration were recruited. Computer-aided design of the implant restoration and intraoral block bone grafting was performed for all the participants. The patients were randomly and equally divided into guide and control groups. A fully guided bone harvesting, trimming, and grafting surgery was executed in the guide group. The control group patients underwent surgery without any guide. After 6 months, all the patients underwent implant placement. The primary outcomes were the root mean square estimate (RMSE) values between the outer contours of the actual implanted and planned bone block as well as the RMSE values between the inner surface of the implanted bone block and the original bone surface of the recipient site immediately after surgery. The secondary outcomes were the trimming time of bone block and the surgery-associated complications. The postoperative visual analog scale (VAS) of pain, swelling, and mouth opening difficulty was recorded. RESULTS All 28 patients underwent intraoral block bone grafting, followed by the placement of implant after 191.8 ± 19.69 days. The RMSE values between the outer contours of the implanted and planned bone blocks were significantly lower in the guide group (0.37 ± 0.16 mm) as compared to those in the control group (0.72 ± 0.29 mm) (p = 0.0007). The RMSE values between the inner contours of the graft block and original bone at the recipient site were lower in the guide group (0.35 ± 0.15 mm) as compared to those in the control group (0.48 ± 0.17 mm) (p = 0.043). The duration of bone block trimming was shorter in the guide group (401.51 ± 97.60 s) as compared to the control group (602.36 ± 160.57 s) (p = 0.0005). In the control group, two patients received secondary bone grafting, one patient experienced bleeding of donor site and temporary hypoesthesia of the lower lip and chin skin, and one patient developed temporary sensitivity of the adjacent tooth. CONCLUSIONS As compared to the conventional procedure, the fully digital workflow in the present study seemed to be a more accuracy and effective protocol for horizontal ridge augmentation with intraoral block bone. TRIAL REGISTRATION Chictr.org.cn (ChiCTR2000036390).
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Affiliation(s)
- Ning Zhu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jiayu Liu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ting Ma
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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