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Zhao F, Shi L, Huang Y, Wang Y, Yu M, Wang H. Adjacent tooth migration after maxillary first molar loss in patients with sinus augmentation: A retrospective research. Clin Implant Dent Relat Res 2023; 25:1080-1090. [PMID: 37496294 DOI: 10.1111/cid.13250] [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: 04/01/2023] [Revised: 06/23/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE The objectives of this study are to: (1) investigate the extent of antagonistic and distal neighboring tooth migration in the maxillary posterior single tooth-missing site during the healing period of bone augmentation and implant surgery; (2) identify factors associated with tooth migration. MATERIALS AND METHODS One hundred and forty-three cases that lost the maxillary first molar were included, and their CBCT data during the edentulous period were obtained. Dentition models were reconstructed from CBCT, and superimpositions were performed, followed by measuring migration distances and calculating migration rates of antagonistic and distal neighboring teeth. Factors were analyzed using multivariate generalized estimating equations (GEE). RESULTS The mean migration distances were 208 ± 137 μm and 403 ± 605 μm for antagonistic teeth and distal teeth, and the mean migration rates were 26.8 ± 21.2 μm/month and 48.5 ± 76.7 μm/month, respectively. One hundred and nineteen out of 143 distal neighboring teeth migrated toward the edentulous site, and all antagonistic teeth migrated occlusally. Occlusal contact loss and chronic apical periodontitis both significantly accelerated antagonistic tooth migration (p < 0.05), the latter also accelerated distal tooth migration (p < 0.05). Besides, the displacement of the distal teeth was somewhat accelerated by the impacted adjacent third molar and root protrusion into the sinus. CONCLUSIONS The neighboring teeth tend to migrate toward the edentulous gap in the maxillary posterior region. Occlusal contact loss and chronic apical periodontitis are two significant risk factors for accelerating antagonistic tooth migration, and for distal teeth, chronic apical periodontitis is the risk factor. The impacted adjacent third molar and root protrusion into the sinus are also potential risk factors for accelerating the migration of the maxillary distal tooth. Thus, to prevent maxillary edentulous gap reduction, the factors mentioned above should be taken into consideration when planning treatment flow.
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Affiliation(s)
- Feiya Zhao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Lei Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yilun Huang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yu Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Mengfei Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Huiming Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
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Lahoud P, Badrou A, Ducret M, Farges JC, Jacobs R, Bel-Brunon A, EzEldeen M, Blal N, Richert R. Real-time simulation of the transplanted tooth using model order reduction. Front Bioeng Biotechnol 2023; 11:1201177. [PMID: 37456726 PMCID: PMC10339382 DOI: 10.3389/fbioe.2023.1201177] [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: 04/06/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
The biomechanics of transplanted teeth remain poorly understood due to a lack of models. In this context, finite element (FE) analysis has been used to evaluate the influence of occlusal morphology and root form on the biomechanical behavior of the transplanted tooth, but the construction of a FE model is extremely time-consuming. Model order reduction (MOR) techniques have been used in the medical field to reduce computing time, and the present study aimed to develop a reduced model of a transplanted tooth using the higher-order proper generalized decomposition method. The FE model of a previous study was used to learn von Mises root stress, and axial and lateral forces were used to simulate different occlusions between 75 and 175N. The error of the reduced model varied between 0.1% and 5.9% according to the subdomain, and was the highest for the highest lateral forces. The time for the FE simulation varied between 2.3 and 7.2 h. In comparison, the reduced model was built in 17s and interpolation of new results took approximately 2.10-2s. The use of MOR reduced the time for delivering the root stresses by a mean 5.9 h. The biomechanical behavior of a transplanted tooth simulated by FE models was accurately captured with a significant decrease of computing time. Future studies could include using jaw tracking devices for clinical use and the development of more realistic real-time simulations of tooth autotransplantation surgery.
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Affiliation(s)
- Pierre Lahoud
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Division of Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Arif Badrou
- Laboratoire de Mécanique Des Contacts Et Structures, CNRS/INSA, Villeurbanne, France
| | - Maxime Ducret
- Laboratoire de Biologie Tissulaire Et Ingénierie Thérapeutique, UMR5305 CNRS/UCBL, Lyon, France
- Hospices Civils de Lyon, Lyon, France
- Faculty of Odontology, Lyon 1 University, Lyon, France
| | - Jean-Christophe Farges
- Laboratoire de Biologie Tissulaire Et Ingénierie Thérapeutique, UMR5305 CNRS/UCBL, Lyon, France
- Hospices Civils de Lyon, Lyon, France
- Faculty of Odontology, Lyon 1 University, Lyon, France
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Aline Bel-Brunon
- Laboratoire de Mécanique Des Contacts Et Structures, CNRS/INSA, Villeurbanne, France
| | - Mostafa EzEldeen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - Nawfal Blal
- Laboratoire de Mécanique Des Contacts Et Structures, CNRS/INSA, Villeurbanne, France
| | - Raphaël Richert
- Laboratoire de Mécanique Des Contacts Et Structures, CNRS/INSA, Villeurbanne, France
- Hospices Civils de Lyon, Lyon, France
- Faculty of Odontology, Lyon 1 University, Lyon, France
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Grandoch A, Oeser J, Zöller JE, Große Hokamp N, Lichtenstein T, Neugebauer J. Morphological Studies to Identify the Nasopalatine and Inferior Alveolar Nerve Using a Special Head and Neck MRI Coil. J Craniofac Surg 2023; 34:1351-1356. [PMID: 36879392 DOI: 10.1097/scs.0000000000009219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 10/18/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Procedures in oral and maxillofacial surgery bear a high risk of nerve damage. Three-dimensional imaging techniques can optimize surgical planning and help to spare nerves. The aim of this study was to investigate the diagnostic value of a 1.5 T magnetic resonance imaging (MRI) scanner with a dedicated dental signal amplification coil for the assessment of nerves in the oral cavity as compared with cone beam computed tomography (CBCT). METHODS Based on 6 predefined criteria, the assessability of the inferior alveolar and nasopalatine nerves in CBCT and MRI with a dedicated 4-channel dental coil were compared in 24 patients. RESULTS Compared with CBCT, MRI with the dental coil showed significantly better evaluability of the inferior alveolar nerve in the sagittal and axial plane and the nasopalatine nerve in the axial plane. In the sagittal plane; however, the assessability of the nasopalatine nerve was significantly better in CBCT as compared with MRI. Yet, pertaining to overall assessability, no significant differences between modalities were found. CONCLUSIONS In this pilot study, it can be reported that 1.5- T MRI with a dedicated dental coil is at least equivalent, if not superior, to CBCT in imaging nerve structures of the stomatognathic system. CLINICAL RELEVANCE Preoperative, 3-dimensional images are known to simplify and refine the planning and execution of operations in maxillofacial surgery. In contrast to computed tomography and CBCT, MRI does not cause radiation exposure while enabling visualization of all relevant hard and soft tissues and, therefore, holds an advantage over well-established techniques.
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Affiliation(s)
- Andrea Grandoch
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Julia Oeser
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Joachim E Zöller
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
| | - Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Thorsten Lichtenstein
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne
| | - Jörg Neugebauer
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne
- Dr Bayer and Colleagues Group office for dentistry, Landsberg am Lech, Germany
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Juerchott A, Roser CJ, Saleem MA, Nittka M, Lux CJ, Heiland S, Bendszus M, Hilgenfeld T. Diagnostic compatibility of various fixed orthodontic retainers for head/neck MRI and dental MRI. Clin Oral Investig 2023; 27:2375-2384. [PMID: 36640179 PMCID: PMC10160193 DOI: 10.1007/s00784-023-04861-2] [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: 05/24/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the diagnostic MRI compatibility of different fixed orthodontic retainers using a high-resolution 3D-sequence optimized for artifact reduction. MATERIALS AND METHODS Maxillary and mandibular retainers made of five different materials were scanned in vitro and in vivo at 3 T MRI using an MSVAT-SPACE sequence. In vitro, artifact volumes were determined for all maxillary and mandibular retainers (AVmax; AVmand). In vivo, two independent observers quantified the extent of artifacts based on the visibility of 124 dental and non-dental landmarks using a five-point rating scale (1 = excellent, 2 = good, 3 = acceptable, 4 = poor, 5 = not visible). RESULTS Rectangular-steel retainers caused the largest artifacts (AVmax/AVmand: 18,060/15,879 mm3) and considerable diagnostic impairment in vivo (mean landmark visibility score ± SD inside/outside the retainer areas: 4.8 ± 0.8/2.9 ± 1.6). Smaller, but diagnostically relevant artifacts were observed for twistflex steel retainers (437/6317 mm3, 3.1 ± 1.7/1.3 ± 0.7). All retainers made of precious-alloy materials produced only very small artifact volumes (titanium grade 1: 70/46 mm3, titanium grade 5: 47/35 mm3, gold: 23/21 mm3) without any impact on image quality in vivo (each retainer: visibility scores of 1.0 ± 0.0 for all landmarks inside and outside the retainer areas). CONCLUSIONS In contrast to steel retainers, titanium and gold retainers are fully compatible for both head/neck and dental MRI when using MSVAT-SPACE. CLINICAL RELEVANCE This study demonstrates that titanium and gold retainers do not impair the diagnostic quality of head/neck and dental MRI when applying an appropriate artifact-reduction technique. Steel retainers, however, are not suitable for dental MRI and can severely impair image quality in head/neck MRI of the oral cavity.
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Affiliation(s)
- Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Christoph J Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Muhammad Abdullah Saleem
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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Wei SM, Li Y, Deng K, Lai HC, Tonetti MS, Shi JY. Does machine-vision-assisted dynamic navigation improve the accuracy of digitally planned prosthetically guided immediate implant placement? A randomized controlled trial. Clin Oral Implants Res 2022; 33:804-815. [PMID: 35652362 DOI: 10.1111/clr.13961] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This randomized controlled clinical trial was designed to compare the accuracy of machine-vision (MV)-based dynamic navigation (DN)-assisted immediate implant placement with the conventional freehand technique. MATERIAL AND METHODS A total of 24 subjects requiring immediate implant placement in maxillary anterior teeth were randomly assigned to either the control (freehand by an experienced surgeon, n = 12) or the test group (MV-DN, n = 12). Implant platform, implant apex, angular, and depth deviations with respect to prosthetically guided digital planning and differences in implant insertion torque (ITV) and implant stability quotient (ISQ) were compared between the groups. RESULTS MV-DN resulted in more accurate immediate implant position: significantly smaller global platform deviation (1.01 ± 0.41 mm vs. 1.51 ± 0.67 mm, p = .038), platform depth deviation (0.44 ± 0.46 mm vs. 0.95 ± 0.68 mm, p = .045), global apex deviation (0.88 ± 0.43 mm vs. 1.94 ± 0.86 mm, p = .001), and lateral apex deviation (0.68 ± 0.30 mm vs. 1.61 ± 0.88 mm, p = .004) were found in MV-DN compared to controls. No significant intergroup differences were observed for ITV and ISQ. CONCLUSIONS MV-DN achieved more precise immediate implant position and comparable primary stability. Further trials are necessary to assess the benefits in terms of esthetics and tissue health/stability.
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Affiliation(s)
- Shi-Min Wei
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuan Li
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ke Deng
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hong-Chang Lai
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,European Research Group on Periodontology, Genova, Italy
| | - Jun-Yu Shi
- Shanghai PerioImplant Innovation Center and Department of Oral and Maxillo-Facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Schwindling FS, Juerchott A, Boehm S, Rues S, Kronsteiner D, Heiland S, Bendszus M, Rammelsberg P, Hilgenfeld T. Three-dimensional accuracy of partially guided implant surgery based on dental magnetic resonance imaging. Clin Oral Implants Res 2021; 32:1218-1227. [PMID: 34352147 DOI: 10.1111/clr.13819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To measure in vivo 3D accuracy of backward-planned partially guided implant surgery (PGIS) based on dental magnetic resonance imaging (dMRI). MATERIAL AND METHODS Thirty-four patients underwent dMRI examinations. Tooth-supported templates were backward planned using standard dental software, 3D-printed, and placed intraorally during a cone beam computed tomography (CBCT) scan. Treatment plans were verified for surgical viability in CBCT, and implants were placed with guiding of the pilot drill. High-precision impressions were taken after healing. The 3D accuracy of 41 implants was evaluated by comparing the virtually planned and definitive implant positions with respect to implant entry point, apex, and axis. Deviations from the dMRI-based implant plans were compared with the maximum deviations calculated for a typical single implant. RESULTS Twenty-eight implants were placed as planned in dMRI. Evaluation of 3D accuracy revealed mean deviations (99% confidence intervals) of 1.7 ± 0.9mm (1.2-2.1mm) / 2.3 ± 1.1mm (1.8-2.9 mm) / 7.1 ± 4.8° (4.6-9.6°) for entry point / apex / axis. The maximum deviations calculated for the typical single implant surpassed the upper bounds of the 99% CIs for the apex and axis, but not for the entry point. In the 13 other implants, dMRI-based implant plans were optimized after CBCT. Here, deviations between the initial dMRI plan and definitive implant position were only in part higher than in the unaltered group (1.9 ± 1.7 mm [0.5-3.4 mm] / 2.5 ± 1.5 mm [1.2-3.8 mm] / 6.8 ± 3.8° [3.6-10.1°] for entry point / apex / axis). CONCLUSIONS The 3D accuracy of dMRI-based PGIS was lower than that previously reported for CBCT-based PGIS. Nonetheless, the values seem promising to facilitate backward planning without ionizing radiation.
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Affiliation(s)
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sophia Boehm
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Dorothea Kronsteiner
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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Probst FA, Burian E, Malenova Y, Lyutskanova P, Stumbaum MJ, Ritschl LM, Kronthaler S, Karampinos D, Probst M. Geometric accuracy of magnetic resonance imaging-derived virtual 3-dimensional bone surface models of the mandible in comparison to computed tomography and cone beam computed tomography: A porcine cadaver study. Clin Implant Dent Relat Res 2021; 23:779-788. [PMID: 34318580 DOI: 10.1111/cid.13033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Providing accurate 3-dimensional virtual bone surface models is a prerequisite for virtual surgical planning and additive manufacturing in craniomaxillofacial surgery. For this purpose, magnetic resonance imaging (MRI) may be a radiation-free alternative to computed tomography (CT) and cone beam computed tomography (CBCT). PURPOSE The aim of this study was to assess the geometric accuracy of 3-dimensional T1-weighted MRI-derived virtual bone surface models of the mandible in comparison to CT and CBCT. MATERIALS AND METHODS Specimens of the mandible from porcine cadavers were scanned with (1) a 3-dimensional T1-weighted MRI sequence (0.6 mm isotropic voxel) optimized for bone imaging, (2) CT, and (3) CBCT. Cortical mandibular structures (n = 10) were segmented using semiautomated and manual techniques. Imaging-based virtual 3-dimensional models were aligned with a high-resolution optical 3-dimensional surface scan of the dissected bone (=ground truth) and global geometric deviations were calculated (mean surface distance [MSD]/root-mean-square distance [RMSD]). Agreement between the imaging modalities was assessed by equivalence testing and Bland-Altman analysis. RESULTS Intra- and inter-rater agreement was on a high level for all modalities. Global geometric deviations (MSD/RMSD) between optical scans and imaging modalities were 0.225 ± 0.020 mm/0.345 ± 0.074 mm for CT, 0.280 ± 0.067 mm/0.371 ± 0.074 mm for MRI, and 0.352 ± 0.076 mm/0.454 ± 0.071 mm for CBCT. All imaging modalities were statistically equivalent within an equivalence margin of ±0.3 mm, and Bland-Altman analysis indicated high agreement as well. CONCLUSIONS The results of this study indicate that the accuracy and reliability of MRI-derived virtual 3-dimensional bone surface models is equal to CT and CBCT. MRI may be considered as a reliable alternative to CT and CBCT in computer-assisted craniomaxillofacial surgery.
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Affiliation(s)
- Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Yoana Malenova
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | - Plamena Lyutskanova
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU München, Munich, Germany
| | | | - Lucas Maximilian Ritschl
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, 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
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8
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Herpel C, Schwindling FS, Held T, Christ L, Lang K, Schwindling M, Moratin J, Zaoui K, Moutsis T, Plinkert P, Herfarth K, Freudlsperger C, Rammelsberg P, Debus J, Adeberg S. Individualized 3D-Printed Tissue Retraction Devices for Head and Neck Radiotherapy. Front Oncol 2021; 11:628743. [PMID: 33833988 PMCID: PMC8021903 DOI: 10.3389/fonc.2021.628743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Radiotherapy for head and neck cancer may cause various oral sequelae, such as radiation-induced mucositis. To protect healthy tissue from irradiation, intraoral devices can be used. Current tissue retraction devices (TRDs) have to be either individually manufactured at considerable cost and time expenditure or they are limited in their variability. In this context, a 3D-printed, tooth-borne TRD might further facilitate clinical use. Methods A novel approach for the manufacturing of TRDs is described and its clinical application is analysed retrospectively. The devices were virtually designed for fabrication by 3D-printing technology, enabling—in only a single printing design—caudal or bi-lateral tongue displacement, as well as stabilization of a tongue-out position. For a total of 10 patients undergoing radiotherapy of head and neck tumors, the devices were individually adapted after pre-fabrication. Technical and clinical feasibility was assessed along with patient adherence. Tissue spacing was calculated by volumetric analysis of tongue retraction. In one exemplary case, radiotherapy treatment plans before and after tissue displacement were generated and compared. The reproducibility of maxillomandibular relation at device re-positioning was quantified by repeated intraoral optical scanning in a voluntary participant. Results 3D-printing was useful for the simplification of TRD manufacture, resulting in a total patient treatment time of less than 30 min. The devices were tolerated well by all tested patients over the entire radiation treatment period. No technical complications occurred with the devices. The TRDs caused an effective spacing of the healthy adjacent tissue, e.g., the tongue. Position changes of maxillomandibular relation were limited to a mean value of 98.1 µm ± 29.4 µm root mean square deviation between initial reference and follow-up positions. Conclusions The presented method allows a resource-efficient fabrication of individualized, tooth-bourne TRDs. A high reproducibility of maxillomandibular relation was found and the first clinical experiences underline the high potential of such devices for radiotherapy in the head and neck area.
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Affiliation(s)
- Christopher Herpel
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Thomas Held
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Leo Christ
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Kristin Lang
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | | | - Julius Moratin
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Karim Zaoui
- Department of Otorhinolaryngology, University of Heidelberg, Heidelberg, Germany
| | - Tracy Moutsis
- Department of Otorhinolaryngology, University of Heidelberg, Heidelberg, Germany
| | - Peter Plinkert
- Department of Otorhinolaryngology, University of Heidelberg, Heidelberg, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), partner site Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Adeberg
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,German Cancer Consortium (DKTK), partner site Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
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9
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Rojo-Sanchis J, Soto-Peñaloza D, Peñarrocha-Oltra D, Peñarrocha-Diago M, Viña-Almunia J. Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies. BMC Oral Health 2021; 21:143. [PMID: 33752651 PMCID: PMC7986564 DOI: 10.1186/s12903-021-01495-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 03/07/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. METHODS An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Qh test and I2 index for heterogeneity was estimated. RESULTS 2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75-1.05 mm) and 1-2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2-2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets. CONCLUSIONS Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.
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Affiliation(s)
- Julio Rojo-Sanchis
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, Valencia, 46010, Spain
| | - David Soto-Peñaloza
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, Valencia, 46010, Spain
| | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, Valencia, 46010, Spain
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, Valencia, 46010, Spain
| | - José Viña-Almunia
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, Valencia, 46010, Spain.
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10
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Juerchott A, Sohani M, Schwindling FS, Jende JME, Kurz FT, Rammelsberg P, Heiland S, Bendszus M, Hilgenfeld T. Comparison of non‐contrast‐enhanced dental magnetic resonance imaging and cone‐beam computed tomography in assessing the horizontal and vertical components of furcation defects in maxillary molars: An in vivo feasibility study. J Clin Periodontol 2020; 47:1485-1495. [DOI: 10.1111/jcpe.13374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/18/2020] [Accepted: 09/22/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Alexander Juerchott
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
| | | | | | - Johann M. E. Jende
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
| | - Felix T. Kurz
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthodontics Heidelberg University Hospital Heidelberg Germany
| | - Sabine Heiland
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
| | - Martin Bendszus
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology Heidelberg University Hospital Heidelberg Germany
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11
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Use of dental MRI for radiation-free guided dental implant planning: a prospective, in vivo study of accuracy and reliability. Eur Radiol 2020; 30:6392-6401. [PMID: 32960331 PMCID: PMC7599174 DOI: 10.1007/s00330-020-07262-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/20/2020] [Accepted: 09/04/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate the accuracy and reliability of dental MRI for static guided implant surgery planning. MATERIALS AND METHODS In this prospective study, a 0.4-mm isotropic, artifact-suppressed, 3T MRI protocol was used for implant planning and surgical guide production in participants in need of dental implants. Two dentists decided on treatment plan. Surgical guides were placed intraorally during a subsequent reference cone beam computed tomography (CBCT) scan. Inter-rater and inter-modality agreement were assessed by Cohen's kappa. For each participant, dental MRI and CBCT datasets were co-registered to determine three-dimensional and angular deviations between planned and surgically guided implant positions. RESULTS Forty-five implants among 30 study participants were planned and evaluated (17 women, 13 men, mean age 56.9 ± 13.1 years). Inter-rater agreement (mean κ 0.814; range 0.704-0.927) and inter-modality agreement (mean κ 0.879; range 0.782-0.901) were both excellent for the dental MRI-based treatment plans. Mean three-dimensional deviations were 1.1 ± 0.7 (entry point) and 1.3 ± 0.7 mm (apex). Mean angular deviation was 2.4 ± 1.5°. CBCT-based adjustments of MRI plans were necessary for implant position in 29.5% and for implant axis in 6.8% of all implant sites. Changes were larger in the group with shortened dental arches compared with those for tooth gaps. Except for one implant site, all guides were suitable for clinical use. CONCLUSION This feasibility study indicates that dental MRI is reliable and sufficiently accurate for surgical guide production. Nevertheless, more studies are needed to increase its accuracy before it can be used for implant planning outside clinical trials. KEY POINTS • An excellent reliability for the dental MRI-based treatment plans as well as agreement between dental MRI-based and CBCT-based (reference standard) decisions were noted. • Ideal implant position was not reached in all cases by dental MRI plans. • For all but one implant site surgical guides derived from dental MRI were sufficiently accurate to perform implant placement (mean three-dimensional deviations were 1.1 ± 0.7 (entry point) and 1.3 ± 0.7 mm (apex); mean angular deviation was 2.4 ± 1.5°).
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12
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Probst FA, Schweiger J, Stumbaum MJ, Karampinos D, Burian E, Probst M. Magnetic resonance imaging based
computer‐guided
dental implant surgery—A clinical pilot study. Clin Implant Dent Relat Res 2020; 22:612-621. [DOI: 10.1111/cid.12939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/23/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery University Hospital, LMU Munich Munich Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry University Hospital, LMU Munich Munich Germany
| | | | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar Technical University Munich Munich Germany
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13
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Roser C, Hilgenfeld T, Sen S, Badrow T, Zingler S, Heiland S, Bendszus M, Lux CJ, Juerchott A. Evaluation of magnetic resonance imaging artifacts caused by fixed orthodontic CAD/CAM retainers-an in vitro study. Clin Oral Investig 2020; 25:1423-1431. [PMID: 32785849 PMCID: PMC7878219 DOI: 10.1007/s00784-020-03450-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/07/2020] [Indexed: 12/27/2022]
Abstract
Objectives Magnetic resonance imaging (MRI) image quality can be severely impaired by artifacts caused by fixed orthodontic retainers. In clinical practice, there is a trend towards using computer-aided design/computer-aided manufacturing (CAD/CAM) retainers. This study aimed to quantify MRI artifacts produced by these novel CAD/CAM retainers. Material and methods Three CAD/CAM retainers and a stainless-steel retainer (“Twistflex”; clinical reference standard) were scanned in vitro at 3-T MRI using a high-resolution 3D sequence. The artifact diameters and three-dimensional artifact volumes (AV) were determined for all mandibular (AVmand) and maxillary (AVmax) retainers. Moreover, the corresponding ratio of artifact volume to retainer volume (AV/RVmand, AV/RVmax) was calculated. Results Twistflex caused large artifact volumes (AVmand: 13530 mm3; AVmax: 15642 mm3; AV/RVmand: 2602; AV/RVmax: 2235). By contrast, artifact volumes for CAD/CAM retainers were substantially smaller: whereas artifact volumes for cobalt–chromium retainers were moderate (381 mm3; 394 mm3; 39; 31), grade-5 titanium (110 mm3; 126 mm3; 12; 12) and nickel–titanium (54 mm3; 78 mm3; 12; 14) both produced very small artifact volumes. Conclusion All CAD/CAM retainers caused substantially smaller volumes of MRI artifacts compared to Twistflex. Grade-5 titanium and nickel–titanium CAD/CAM retainers showed the smallest artifact volumes. Clinical relevance CAD/CAM retainers made from titanium or nickel–titanium may not relevantly impair image quality in head/neck and dental MRI. Artifacts caused by cobalt–chromium CAD/CAM retainers may mask nearby dental/periodontal structures. In contrast, the large artifacts caused by Twistflex are likely to severely impair diagnosis of oral and adjacent pathologies.
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Affiliation(s)
- Christoph Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Badrow
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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