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Liu Z, Yang D, Zhang M, Liu G, Zhang Q, Li X. Inferior Alveolar Nerve Canal Segmentation on CBCT Using U-Net with Frequency Attentions. Bioengineering (Basel) 2024; 11:354. [PMID: 38671776 PMCID: PMC11048269 DOI: 10.3390/bioengineering11040354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Accurate inferior alveolar nerve (IAN) canal segmentation has been considered a crucial task in dentistry. Failing to accurately identify the position of the IAN canal may lead to nerve injury during dental procedures. While IAN canals can be detected from dental cone beam computed tomography, they are usually difficult for dentists to precisely identify as the canals are thin, small, and span across many slices. This paper focuses on improving accuracy in segmenting the IAN canals. By integrating our proposed frequency-domain attention mechanism in UNet, the proposed frequency attention UNet (FAUNet) is able to achieve 75.55% and 81.35% in the Dice and surface Dice coefficients, respectively, which are much higher than other competitive methods, by adding only 224 parameters to the classical UNet. Compared to the classical UNet, our proposed FAUNet achieves a 2.39% and 2.82% gain in the Dice coefficient and the surface Dice coefficient, respectively. The potential advantage of developing attention in the frequency domain is also discussed, which revealed that the frequency-domain attention mechanisms can achieve better performance than their spatial-domain counterparts.
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Affiliation(s)
- Zhiyang Liu
- College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
- Tianjin Key Laboratory of Optoelectronic Sensor and Sensing Network Technology, College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
| | - Dong Yang
- College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
| | - Minghao Zhang
- College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
| | - Guohua Liu
- College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
- Tianjin Key Laboratory of Optoelectronic Sensor and Sensing Network Technology, College of Electronic Information and Optical Engineering, Nankai University, Tianjin 300350, China
| | - Qian Zhang
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Xiaonan Li
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, China
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Elgarba BM, Fontenele RC, Tarce M, Jacobs R. Artificial intelligence serving pre-surgical digital implant planning: A scoping review. J Dent 2024; 143:104862. [PMID: 38336018 DOI: 10.1016/j.jdent.2024.104862] [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: 12/14/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVES To conduct a scoping review focusing on artificial intelligence (AI) applications in presurgical dental implant planning. Additionally, to assess the automation degree of clinically available pre-surgical implant planning software. DATA AND SOURCES A systematic electronic literature search was performed in five databases (PubMed, Embase, Web of Science, Cochrane Library, and Scopus), along with exploring gray literature web-based resources until November 2023. English-language studies on AI-driven tools for digital implant planning were included based on an independent evaluation by two reviewers. An assessment of automation steps in dental implant planning software available on the market up to November 2023 was also performed. STUDY SELECTION AND RESULTS From an initial 1,732 studies, 47 met eligibility criteria. Within this subset, 39 studies focused on AI networks for anatomical landmark-based segmentation, creating virtual patients. Eight studies were dedicated to AI networks for virtual implant placement. Additionally, a total of 12 commonly available implant planning software applications were identified and assessed for their level of automation in pre-surgical digital implant workflows. Notably, only six of these featured at least one fully automated step in the planning software, with none possessing a fully automated implant planning protocol. CONCLUSIONS AI plays a crucial role in achieving accurate, time-efficient, and consistent segmentation of anatomical landmarks, serving the process of virtual patient creation. Additionally, currently available systems for virtual implant placement demonstrate different degrees of automation. It is important to highlight that, as of now, full automation of this process has not been documented nor scientifically validated. CLINICAL SIGNIFICANCE Scientific and clinical validation of AI applications for presurgical dental implant planning is currently scarce. The present review allows the clinician to identify AI-based automation in presurgical dental implant planning and assess the potential underlying scientific validation.
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Affiliation(s)
- Bahaaeldeen M Elgarba
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium & Department of Prosthodontics, Faculty of Dentistry, Tanta University, 31511 Tanta, Egypt.
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Mihai Tarce
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China & Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals, Campus Sint-Rafael, 3000 Leuven, Belgium & Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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3
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Xu W, Wang B, Jia L, Ge S, Shao J. Three-dimensional analysis of mandibular and mental canals corroborating with teeth and mental foramen by cone beam computed tomography. J Oral Rehabil 2023; 50:1456-1464. [PMID: 37702213 DOI: 10.1111/joor.13583] [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: 06/27/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This study aimed to analyse the 3D patterns of the mandibular and mental canals (MDC and MC) referring to the surrounding prominent surgical landmarks such as teeth and mental foramen by cone beam computed tomography (CBCT). METHODS CBCT scans of 354 patients aged 18-67 years with mandibular first premolar to second molar were included and reconstructed 3-dimensionally (3D) by mimics. The parameters of MDC and MC were measured referring to teeth and mental foramen. RESULTS From the first premolars to the second molars, the mandibular canals showed a trend of gradually closer to the cementoenamel junction (CEJ) of the adjacent teeth and farther away from the buccal cortical plate. The distance of the MDC with the root apexes (RA) was relatively constant from the first premolar to the first molar, but became much closer to the second molar. About 10.8% of the second molars had MDC-RA distances of shorter than 2 mm, and 1.34% even had the MDC superior to the RA. Moreover, the Type III of MC presented in 66.0% of the subjects and had a relatively longer length. Besides, the existence of Type I MC may be related to the MDC featuring with close distances to the RA and CEJ of the adjacent teeth. CONCLUSION Dentists and surgeons should know the patterns of mandibular and mental canals. A better understanding of the MDC and MC and their relationship to local anatomical landmarks may facilitate the planning of surgeries and alert potential nerve injuries in the operative procedures.
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Affiliation(s)
- Wenke Xu
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Bing Wang
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Lu Jia
- Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Shaohua Ge
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Jinlong Shao
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
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Chun SY, Kang YH, Yang S, Kang SR, Lee SJ, Kim JM, Kim JE, Huh KH, Lee SS, Heo MS, Yi WJ. Automatic classification of 3D positional relationship between mandibular third molar and inferior alveolar canal using a distance-aware network. BMC Oral Health 2023; 23:794. [PMID: 37880603 PMCID: PMC10598947 DOI: 10.1186/s12903-023-03496-9] [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: 05/11/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
The purpose of this study was to automatically classify the three-dimensional (3D) positional relationship between an impacted mandibular third molar (M3) and the inferior alveolar canal (MC) using a distance-aware network in cone-beam CT (CBCT) images. We developed a network consisting of cascaded stages of segmentation and classification for the buccal-lingual relationship between the M3 and the MC. The M3 and the MC were simultaneously segmented using Dense121 U-Net in the segmentation stage, and their buccal-lingual relationship was automatically classified using a 3D distance-aware network with the multichannel inputs of the original CBCT image and the signed distance map (SDM) generated from the segmentation in the classification stage. The Dense121 U-Net achieved the highest average precision of 0.87, 0.96, and 0.94 in the segmentation of the M3, the MC, and both together, respectively. The 3D distance-aware classification network of the Dense121 U-Net with the input of both the CBCT image and the SDM showed the highest performance of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve, each of which had a value of 1.00. The SDM generated from the segmentation mask significantly contributed to increasing the accuracy of the classification network. The proposed distance-aware network demonstrated high accuracy in the automatic classification of the 3D positional relationship between the M3 and the MC by learning anatomical and geometrical information from the CBCT images.
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Affiliation(s)
- So-Young Chun
- Interdisciplinary Program in Bioengineering, Graduate School of Engineering, Seoul National University, Seoul, South Korea
| | - Yun-Hui Kang
- Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, South Korea
| | - Su Yang
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Se-Ryong Kang
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | | | - Jun-Min Kim
- Department of Electronics and Information Engineering, Hansung University, Seoul, South Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Won-Jin Yi
- Interdisciplinary Program in Bioengineering, Graduate School of Engineering, Seoul National University, Seoul, South Korea.
- Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
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Öztürk K, Kuzu TE, Gürgan CA, Önder GÖ, Yay A. The effect of different treatment protocols with diode laser on regeneration in axonetmesis ınjuries of the ınferior alveolar nerve: an animal study. Lasers Med Sci 2023; 38:169. [PMID: 37515606 DOI: 10.1007/s10103-023-03834-x] [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: 02/11/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
The inferior alveolar nerve can be damaged during dental procedures, leading to symptoms, such as tingling, numbness, and reduced quality of life. Recovery depends on factors such as medications, surgery, and photobiomodulation therapy. Photobiomodulation therapy has shown the potential to improve nerve function and reduce regeneration time; however, there is no standard treatment protocol yet. This study aimed to examine the effect of diode lasers on nerve regeneration in patients with axonetmesis injuries. In this experiment on animals, Wistar rats' damaged sensory systems were treated with lasers to restore them. Animals were randomly divided into six groups: a sham group, a control group, and four laser treatment groups(1st group: performed every day, 10 sessions; 2nd group: performed every 2 days, 10 sessions; 3rd group: performed every day, 20 sessions; and 4th group: performed every 2 days, 20 sessions). Sensory function was determined using the Semmes-Weinstein monofilament test, which was repeated after the surgical procedure. The results showed that the 20-session group had the best improvement, most closely resembling the group without sensory test damage. The histomorphometric results showed that the number of axons was significantly lower in the group that received 10 daily sessions and in the control group than in the undamaged nerve. Axon diameter was lower in all groups than in the sham group. In conclusion, the remarkable aspect of this study is that consecutive-day 20-session laser treatment showed better improvement than the over-the-day 20-session treatment protocol.
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Affiliation(s)
- Kübra Öztürk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
| | - Turan Emre Kuzu
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Cem A Gürgan
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Gözde Özge Önder
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Arzu Yay
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Dhanaraj SP, Anguswamy S, Dominic N, Sarfoji A, Kayathri, Sukanya A. Management of post-implant inferior alveolar neuropathy, utilizing autologous fibrin glue, concentrated growth factors and enriched bone graft matrix-A case report with 5 years follow-up. Indian J Dent Res 2023; 34:329-331. [PMID: 38197358 DOI: 10.4103/ijdr.ijdr_833_21] [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: 01/11/2024] Open
Abstract
This case report explains meticulous management of 5 year old, inferior alveolar nerve neuropathy, following placement of dental implants in the mandible. The imperative situation was that 'implants placed were not in contact with the nerve, but triggered neuralgic pain'. The objective of the treatment was to identify, and eliminate the causative factor, and to promote nerve regeneration, with pain relief. Treatment protocol and inferior alveolar nerve [IAN] sensory function evaluation were done following 'Inferior Alveolar Nerve Injury during Dental Implant Placement Surgery Protocol' [IANIDIS-Protocol]. Impregnation of autologous concentrated growth factors and enriched bone graft matrix [Sticky BoneTM], at the surgical site, aided effective hard and soft tissue regeneration, restoring comfort to the patient.
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Affiliation(s)
- Siva Prakash Dhanaraj
- Department of Prosthodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Sriganesh Anguswamy
- Department of Conservative Dentistry and Endodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Narmadha Dominic
- Department of Prosthodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Arun Sarfoji
- Department of Prosthodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Kayathri
- Department of Prosthodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ashwini Sukanya
- Department of Prosthodontics, Prakash Dental Centre, Chennai, Tamil Nadu, India
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Urban I, Sanz-Sánchez I, Monje A, Montero E. Complications and treatment errors in peri-implant hard tissue management. Periodontol 2000 2023; 92:278-298. [PMID: 37016554 DOI: 10.1111/prd.12472] [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: 04/22/2022] [Revised: 08/14/2022] [Accepted: 08/21/2022] [Indexed: 04/06/2023]
Abstract
Bone augmentation procedures aim to regenerate the deficient alveolar ridge to properly place dental implants that are completely surrounded by bone. However, these are invasive and technically demanding surgeries that are not free of either complications or treatment errors. Careful patient selection and preparation is a mandatory process to reduce the rate of complications in bone regeneration procedures, irrespective of the technique used. It is important to assess the cost benefit of the intervention and to evaluate the potential impact on the patient's quality of life, especially in the elderly and medically compromised patients. Most common postoperative complications are wound dehiscences, which may be reduced, at least partially, by proper knowledge of the surgical technique and the craniofacial anatomy. Other complications that may appear are postoperative infections or nerve injuries. The aim of this narrative review is to summarize the best available scientific evidence on the incidence of complications, as well as the ideal strategies for their prevention and management. Depending on the severity of the complication, treatment approaches may vary and can include drug prescription or even surgical re-entries to remove exposed barrier membranes or contaminated bone grafts. Adequate prevention and proper management of complications associated with bone augmentation interventions are a requirement for clinicians carrying out these demanding procedures. A series of cases illustrating proper management of complications in different clinical scenarios is presented.
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Affiliation(s)
- Istvan Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, International University of Catalonia, Barcelona, Spain
- Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
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Rizzo G, Prado MC, Rigo L. Prevalence of dental implant positioning errors: A cross-sectional study. Imaging Sci Dent 2022; 52:343-350. [PMID: 36605853 PMCID: PMC9807798 DOI: 10.5624/isd.20220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose This study evaluated the prevalence of dental implant positioning errors and the most frequently affected oral regions. Materials and Methods A sample was obtained of CBCT images of 590 dental implants from 230 individuals who underwent diagnosis at a radiology center using cone-beam computed tomography from 2017 to 2020. The following variables were considered: thread exposure, violation of the minimum distance between 2 adjacent implants and between the implant and tooth, and implant contact with anatomical structures. Descriptive data analysis and the Pearson chi-square test (P<0.05) were performed to compare findings according to mouth regions. Results Most (74.4%) of the 590 implants were poorly positioned, with the posterior region of the maxilla being the region most frequently affected by errors. Among the variables analyzed, the most prevalent was thread exposure (54.7%), followed by implant contact with anatomical structures, violation of the recommended distance between 2 implants and violation of the recommended distance between the implant and teeth. Thread exposure was significantly associated with the anterior region of the mandible (P<0.05). The anterior region of the maxilla was associated with violation of the recommended tooth-implant distance (P<0.05) and the recommended distance between 2 adjacent implants (P<0.05). Implant contact with anatomical structures was significantly more likely to occur in the posterior region of the maxilla (P<0.05). Conclusion Many implants were poorly positioned in the posterior region of the maxilla. Thread exposure was particularly frequent and was significantly associated with the anterior region of the mandible.
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Affiliation(s)
- Gabriel Rizzo
- Faculty of Odontology, Meridional Faculty, Passo Fundo, RS, Brazil
| | - Mayara Colpo Prado
- Graduate Program in Dentistry, Meridional Faculty, Passo Fundo, RS, Brazil
| | - Lilian Rigo
- Graduate Program in Dentistry, Meridional Faculty, Passo Fundo, RS, Brazil
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Srivastava A. Considerations and techniques for removal of osseointegrated implants. J Prosthet Dent 2022; 128:843-844. [DOI: 10.1016/j.prosdent.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
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Zhang YY, Liu F, Fang ZH, Li YL, Liao HL, Song QX, Zhou C, Shen JF. Differential roles of NMDAR subunits 2A and 2B in mediating peripheral and central sensitization contributing to orofacial neuropathic pain. Brain Behav Immun 2022; 106:129-146. [PMID: 36038077 DOI: 10.1016/j.bbi.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022] Open
Abstract
The spinal N-methyl-d-aspartate receptor (NMDAR), particularly their subtypes NR2A and NR2B, plays pivotal roles in neuropathic and inflammatory pain. However, the roles of NR2A and NR2B in orofacial pain and the exact molecular and cellular mechanisms mediating nervous system sensitization are still poorly understood. Here, we exhaustively assessed the regulatory effect of NMDAR in mediating peripheral and central sensitization in orofacial neuropathic pain. Von-Frey filament tests showed that the inferior alveolar nerve transection (IANX) induced ectopic allodynia behavior in the whisker pad of mice. Interestingly, mechanical allodynia was reversed in mice lacking NR2A and NR2B. IANX also promoted the production of peripheral sensitization-related molecules, such as interleukin (IL)-1β, tumor necrosis factor (TNF)-α, brain-derived neurotrophic factor (BDNF), and chemokine upregulation (CC motif) ligand 2 (CCL2), and decreased the inward potassium channel (Kir) 4.1 on glial cells in the trigeminal ganglion, but NR2A conditional knockout (CKO) mice prevented these alterations. In contrast, NR2B CKO only blocked the changes of Kir4.1, IL-1β, and TNF-α and further promoted the production of CCL2. Central sensitization-related c-fos, glial fibrillary acidic protein (GFAP), and ionized calcium-binding adaptor molecule 1 (Iba-1) were promoted and Kir4.1 was reduced in the spinal trigeminal caudate nucleus by IANX. Differential actions of NR2A and NR2B in mediating central sensitization were also observed. Silencing of NR2B was effective in reducing c-fos, GFAP, and Iba-1 but did not affect Kir4.1. In contrast, NR2A CKO only altered Iba-1 and Kir4.1 and further increased c-fos and GFAP. Gain-of-function and loss-of-function approaches provided insight into the differential roles of NR2A and NR2B in mediating peripheral and central nociceptive sensitization induced by IANX, which may be a fundamental basis for advancing knowledge of the neural mechanisms' reaction to nerve injury.
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Affiliation(s)
- Yan-Yan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhong-Han Fang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue-Ling Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hong-Lin Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qin-Xuan Song
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Zhou
- Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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11
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Jung JH, Ko JH, Ku JK, Kim JY, Huh JK. Sensory change after implant surgery: related factors for recovery. J Korean Assoc Oral Maxillofac Surg 2022; 48:297-302. [DOI: 10.5125/jkaoms.2022.48.5.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Joon-Ho Jung
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Ji-Hoon Ko
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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12
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Non-thermal plasma directly accelerates neuronal proliferation by stimulating axon formation. Sci Rep 2022; 12:15868. [PMID: 36151253 PMCID: PMC9508269 DOI: 10.1038/s41598-022-20063-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/08/2022] [Indexed: 11/08/2022] Open
Abstract
Among the various methods, Non Thermal Plasma (NTP) has been recently introduced and is being studied to recover the damaged nerve. In the recent years, several studies have suggested that NTP accelerates nerve cell regeneration, but the mechanism remains unknown. This study evaluated the effect of NTP on neuronal proliferation in SH-SY5Y (Human neuroblastoma cells) cells differentiated by retinoic acid (RA) and investigated the mechanism by which NTP promotes cell proliferation. We analyzed the morphology of differentiated SH-SY5Y cells, and performed western blot analysis and reverse transcription polymerase chain reaction (RT-PCR). Immunofluorescence analysis was performed in an in vivo study by categorizing Wistar A rats into three groups: non-nerve damage (Non-ND), nerve damage (ND), and nerve damage + NTP treatment (ND + NTP). The cell morphology analysis revealed that the number of cells increased and axonal elongation progressed after NTP treatment. In addition, western blots indicated that tau expression increased significantly after NTP treatment. The RT-PCR results revealed that the expression of tau, wnt3a, and β-catenin increased after NTP treatment. The in vivo immunofluorescence assay showed that NTP increased the markers for tau and S100B while regulating the over-expression of MAP2 and GAP43. NTP treatment accelerated cell proliferation and regeneration of damaged neurons in differentiated SH-SY5Y cells. These results establish the fact of NTP as a noninvasive and effective treatment for nerve injury.
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Madhok S, Kiruthika S, Prabhu K, Abraham S, Kabilan P, Nithyapriya S. Mylohyoid Ridge as a Predictor of Available Bone for Implant Placement: A Cone-Beam Computed Tomography (CBCT) Retrospective Observational Study. Cureus 2022; 14:e27470. [PMID: 36060375 PMCID: PMC9421098 DOI: 10.7759/cureus.27470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/29/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: The posterior mandibular region, due to the presence of vital structures, poses a high risk during implant placement because of its susceptibility to neurovascular injury and perforation of the lingual cortex. A breach in implant length and available bone height may lead to serious intraoperative and postoperative complications. Prediction of the exact location of the inferior alveolar nerve and submandibular fossa anatomy is a prerequisite for ideal implant placement, which is always not possible with conventional radiographic and clinical techniques. Materials and methods: One hundred ten cone-beam computed tomographies (CBCTs) of patients were acquired from the radiological archives of a radiological center in Chennai. DICOM files from CBCT were exported to Bly Sky Plan software. Cross-sections of the second molar and first molar were extracted following the inclusion criteria. The linear dimension between the mandibular canal and mylohyoid ridge and anatomic variables of the submandibular fossa were measured digitally on the left and right sides using software measuring tools. Descriptive statistics were done. The unilateral and bilateral site and gender differences were evaluated. Bone height superior to the mandibular canal was correlated with the submandibular fossa parameters; depth of undercut in the vertical and horizontal directions; and angle of the undercut. Results: The mandibular canal was on average 5.5 mm and 4 mm inferior to the Mylohyoid ridge in the second molar region and first molar region, respectively, with the right and left sides showing no statistically significant difference. The depth of fossa undercut in vertical and horizontal dimensions was higher in the second molar region compared to the first molar region. The height of the deepest point of the undercut in the vertical dimensions showed a positive correlation with the bone available between the mandibular canal and the mylohyoid ridge. Conclusion: Keeping 2 mm of safety factor in consideration, implants can be safely placed up to the mylohyoid ridge in 100% of cases and 2 mm below the mylohyoid ridge in 78.9% of cases in the mandibular second molar region. In keeping with a safety factor of 2 mm, implants can be safely placed up to the mylohyoid ridge in 82.6% of cases and 2 mm below the mylohyoid ridge in 43.1% of cases in the first molar region. A more pronounced undercut was seen in the second molar region than in the first molar region. Deeper fossa undercuts in vertical dimension are associated with more inferior positioning of the mandibular canal.
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14
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Martinho FC, Aldahmash SA, Cahill TY, Gupta S, Dianat O, Mostoufi B, Price JB, Griffin I, Tordik PA. Comparison of the accuracy and efficiency of a 3D dynamic navigation system for osteotomy root-end resection performed by novice and experienced endodontists. J Endod 2022; 48:1327-1333.e1. [PMID: 35839859 DOI: 10.1016/j.joen.2022.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/19/2022]
Abstract
AIM To investigate whether the 3D-dynamic navigation system (3D-DNS) can improve experienced endodontists' (EEs') and novice endodontists' (NEs') accuracy and efficiency in osteotomy and root-end resection (RER) and to verify that the 3D-DNS enables NEs to perform osteotomy and RER as accurately and efficiently as EEs. METHODS Seventy-six roots in cadaver heads were randomly divided into four groups: 3D-DNS-NE, 3D-DNS-EE, Freehanded (FH)-NE, and FH-EE (all, n=19). CBCT scans were taken pre- and postoperatively. Osteotomy and RER were planned virtually in the X-guided software (X-Nav Technologies, Lansdale). Accuracy was calculated by measuring the 2D and 3D virtual deviations and angular deflection (AD) using superimposing software (X-Nav technologies). Efficiency was determined by time of operation and the number of mishaps. RESULTS Accuracy deviations were significantly less in the 3D-DNS-EE group than in the FH-EE group (p<.05). We found lessened 2D and 3D accuracy deviations comparing the 3D-DNS-NE group to the FH-NE group (p<.05). The time required for osteotomy and RER with the 3D-DNS was ∼ ½ of that required for the FH method for both EEs and NEs (p<.05). We found no difference in the number of mishaps between the 3D-DNS and FH groups for EEs and NEs (p>.05). CONCLUSIONS The 3D-DNS improved EEs' and NEs' accuracy and efficiency in osteotomy and RER. The NEs were as efficient as the EEs using 3D-DNS. Notably, the 3D-DNS improved the NEs' accuracy compared to FH method but the 3D-DNS did not enable the NEs to perform osteotomy and RER as accurately as the EEs.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Sara A Aldahmash
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland; College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Thomas Y Cahill
- School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Swati Gupta
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland; Centreville Endodontics, Centreville, Virginia
| | - Behzad Mostoufi
- Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland
| | - Jeffery B Price
- Clinical Professor & Director of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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15
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Kim DH, Kim S. Curriculum of gross anatomy education in Korean dental hygiene programs: Perceptions of clinical dental hygienists. ANATOMICAL SCIENCES EDUCATION 2022; 15:709-718. [PMID: 34547179 DOI: 10.1002/ase.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/27/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
It is essential for dental hygienists to have basic knowledge of gross anatomy to provide efficient treatment. However, gross anatomy course is relatively neglected due to their disparity from actual clinical dental practice. This study aimed to propose an effective dental hygiene gross anatomy curriculum that reflects the opinions of professional clinical dental hygienists. The study had an online-based cross-sectional design and the survey was distributed to clinical dental hygienists via social networks (n = 200). The questionnaire consisted of questions on the utilization of anatomical knowledge in clinical practice, opinions on the contents and methods of gross anatomy education, and general characteristics. The present study found that 186 (93%) used anatomical knowledge at an above-average level. Qualitative analysis indicated that dental implant surgery, radiography, and extraction were the clinical procedures that required the most anatomical knowledge. The clinical dental hygienists answered that the most-necessary knowledge is that of the mandibular nerve, followed by that on the temporomandibular joint, mandible, maxilla, maxillary nerve, and masticatory muscle. The methods proposed to improve gross anatomy education were (in decreasing order of importance) using videos or photographs (X-rays, CT, MRI, etc.), integrating education with clinical subjects, and using a three-dimensional visualization program. Higher education levels of respondents have increased their tendency to believe that the contents and methods of the presented education were necessary. Dental hygienists who utilized anatomical knowledge more often tended to be had a greater appreciation of the necessity of all educational contents and methods.
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Affiliation(s)
- Da-Hye Kim
- Department of Dental Hygiene, Division of Health Science, Dongseo University, Busan, South Korea
| | - Soojeong Kim
- Department of Dental Hygiene, Division of Health Science, Dongseo University, Busan, South Korea
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16
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Sanz-Sánchez I, Sanz-Martín I, Ortiz-Vigón A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000 2022; 88:86-102. [PMID: 35103322 DOI: 10.1111/prd.12413] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bone-regenerative interventions aiming to restore deficient alveolar ridges, such as the use of block grafts or through the application of guided bone-regeneration principles, have reported positive outcomes in the published scientific literature. These interventions, however, are invasive, and hence, intraoperative and/or postoperative complications may occur. The types of complications and their severity may vary from the exposure of the biomaterial (membrane or graft) to postsurgical infections, neurosensorial disturbances, occurrence of hemorrhage, and pain, etc. The aim of the present narrative review was to search the available scientific evidence concerning the incidence of these complications, their effect on treatment outcomes, their clinical management and, finally, strategies aimed at prevention. Exposure of the barrier membrane or the block graft is the most common complication associated with oral regenerative interventions. To manage these complications, depending on the extent of the exposure and the presence or absence of concomitant infections, therapeutic measures may vary, from the topical application of antiseptics to the removal of the barrier membrane or the block graft. Regardless of their treatment, the occurrence of these complications has been associated with patient selection, with compliant patients (eg, nonsmokers) having a lower reported incidence of complications. Similarly, surgical factors such as correct flap elevation and a tensionless closure are of obvious importance. Finally, to prevent the incidence of complications, it appears prudent to utilize whenever possible less invasive surgical interventions.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | | | | | - Ana Molina
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
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17
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Chackartchi T, Romanos GE, Parkanyi L, Schwarz F, Sculean A. Reducing errors in guided implant surgery to optimize treatment outcomes. Periodontol 2000 2022; 88:64-72. [PMID: 35103317 DOI: 10.1111/prd.12411] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinical considerations and treatment criteria in implant placement are constantly evolving. Prosthetically driven implant surgery has become the standard of care to improve short and long-term functional and esthetic outcomes. Therefore, implant position and angulation are planned according to the available bone, anatomical structures, and the requirements of the future prosthetic superstructure. In parallel with these developments, significant progress has been made in data imaging and different software technologies to allow the integration of data within a digital file format. Digitalization in implant surgery enables optimal planning of implant position, as well as the ability to transfer this planning to the surgical field-a process defined as "computer-supported implant planning and guided surgery." The aims of the present review are as follows: (a) to critically appraise the indications and potential "added value" of guided implant surgery, elaborating the main differences between dynamic and static guidance; and (b) to discuss the most important clinical considerations relevant for the different steps of the workflow that might influence the surgical outcome and to offer recommendations on how to avoid or reduce process errors in order to optimize treatment outcomes.
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Affiliation(s)
- Tali Chackartchi
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Laszlo Parkanyi
- Department of Periodontology, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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18
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Therapy of Neurophysiological Changes after Oral and Maxillofacial Surgery—A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The purpose of this systematic review was to critically analyze the recent literature to present a guideline for management of neurophysiological changes after implant placement and oral and maxillofacial surgical procedures. Materials and methods: Three electronic databases and manual search approaches were used to identify relevant articles on neurophysiological changes. Only studies with a randomized controlled study design were included. Primary outcome was defined as the status of recovery and relief of pain states under various therapies. Two independent reviewers evaluated the data. Results: A total of eight studies from 2891 records identified met the inclusion criteria. Therapy options for patients with neurophysiological changes after implant placement and oral and maxillofacial surgery were low-level laser (LLL), stellate ganglion block (SGB), medication, and surgical removal of implants. Six studies dealt with LLL, providing a significant improvement in mechanical sensation. Only one study revealed the whole neurosensory profile including neuropathic pain states. All the included RCT studies presented at least one bias, and a considerable heterogeneity of the included studies was revealed. Conclusions: Reduced thermal sensation may be due to irritation of small fibers. LLL might help to improve nerve recovery.
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19
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Cutolo MA, Cafiero C, Califano L, Giaquinto M, Cusano A, Cutolo A. Feasibility analysis of an ultrasound on line diagnostic approach for oral and bone surgery. Sci Rep 2022; 12:905. [PMID: 35042892 PMCID: PMC8766520 DOI: 10.1038/s41598-022-04857-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/15/2021] [Indexed: 11/08/2022] Open
Abstract
During implant surgery procedures, surgical precision is an essential prerequisite for the functional and aesthetic success of the prosthetic crown to be placed on the dental implant. A modern implant surgical approach should be standardized as much as possible to guarantee extreme precision in the insertion of the implant into the upper and lower bone jaws. Among the most common surgical errors during implant surgery there is the over-preparation of the surgical alveolus with possible damage to the contiguous anatomical structures. To avoid this problem, in the recent years, there has been an increasing attention to the development of new control techniques. In this paper, we describe an innovative ultrasound approach, which exploits the integration of an electro-acoustic transducer with the surgical drill used for realizing the alveolus in the bone that will host the implant. Specifically, he proposed approach is based on the "time-of-flight" detection technique for measuring the thickness of the residual bone subjected to the drilling. In order to demonstrate the feasibility of the proposed approach, here we report on a detailed numerical analysis aimed at studying the propagation of ultrasonic waves through the drill-bit and through the involved tissues. The obtained results confirm the validity of our approach, and enable for a future first prototype implementation of a hi-tech surgical drill-bit, which in general is suitable not only for dental implant surgery but also for other uses in oral surgery, maxillofacial surgery and for bone surgery.
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Affiliation(s)
- Maria Alessandra Cutolo
- Regional Center on Information Communication Technology (CeRICT) scrl, 82100, Benevento, Italy
| | - Carlo Cafiero
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy
| | - Luigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy
| | - Martino Giaquinto
- Optoelectronics Group, Engineering Department, University of Sannio, 82100, Benevento, Italy.
| | - Andrea Cusano
- Optoelectronics Group, Engineering Department, University of Sannio, 82100, Benevento, Italy
| | - Antonello Cutolo
- Department of Electrical Engineering and Information Technology, University of Naples "Federico II", 80121, Naples, Italy
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20
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Iwanaga J, Takeshita Y, Matsushita Y, Hur MS, Ibaragi S, Tubbs RS. What are the retromolar and bifid/trifid mandibular canals as seen on cone-beam computed tomography? Revisiting classic gross anatomy of the inferior alveolar nerve and correcting terminology. Surg Radiol Anat 2021; 44:147-156. [PMID: 34854962 DOI: 10.1007/s00276-021-02862-y] [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: 10/22/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Since cone-beam computed tomography was developed, a number of radiological studies on the bifid mandibular canals (BMCs) and trifid mandibular canals (TMCs) have been reported. However, many of the suggested subtypes of the BMC described in the literature seem to be normal branches of the inferior alveolar nerve. This might be due to a lack of revisiting classic anatomical studies in the field of radiology. Therefore, such studies are revisited here. METHODS A database search using PubMed and Google Scholar was conducted on BMC and TMC. Eighty-nine articles underwent full-text assessment. The reported three classifications of BMC and the six modified classifications were reviewed and compared to the intramandibular inferior alveolar nerve branches. RESULTS Some subtypes of BMC and TMC simply represent normal inferior alveolar nerve branches, i.e., retromolar branch, molar branch (alveolar branch/dental branch), large mental branch, or communicating branch. Others such as Naitoh's type III BMC and forward canal might be a true BMC. CONCLUSION We found that the bifid mandibular canal is an additional intramandibular canal running parallel to the mandibular canal with/without confluence with the main canal through comparison of classifications of BMC/TMC between the radiology and anatomy fields.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA. .,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA. .,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan. .,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Matsushita
- University of Texas Health Science Center at Houston School of Dentistry, Houston, USA
| | - Mi-Sun Hur
- Department of Anatomy, Catholic Kwandong University College of Medicine, Gangneung, Korea
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,University of Queensland, Brisbane, Australia
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21
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Esteve-Pardo G, De-Larriva E, Salgado A, Bernabeu-Esclapez A, Bardaji JA, Esteve-Colomina L. Is Inferior Alveolar Nerve Block Needed to Perform Implant Surgery in the Posterior Mandible? A Randomized Controlled Trial. J Oral Maxillofac Surg 2021; 80:490-500. [PMID: 34762850 DOI: 10.1016/j.joms.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE There is no agreement in the literature on whether inferior alveolar nerve block (IANB) or infiltration (INF) is the anesthetic technique of choice for placing implants in the posterior mandible. This study aimed to compare the efficacy of the 2 techniques using articaine 4% with epinephrine 1:100,000. MATERIAL AND METHODS The trial was a comparison between 2 parallel groups of patients, who received implants distal to the mental foramen, either with IANB or INF. The anesthetic technique was the predictor variable. The primary outcome was patients' perceived pain by a numerical rating scale (NRS) in incision, osteotomy and suture. The secondary outcome, patients' satisfaction, was equally recorded 12 hours after surgery. The dataset were first analyzed by descriptive statistics. Then, Mann-Whitney test, Spearman's coefficient and regression models were used. This trial followed the recommendations of the Consort Statement for reporting RCTs. RESULTS Ninety-six patients (41 men, 55 women, mean age 55.76 years) were randomly assigned to either group, IANB or INF, of 48 patients each. Only 20% of patients reported pain values >0 (range 0-4 of 10). Medians were: 0 (0-0) for both groups (P = .956, .175 and .908, incision, osteotomy and suture, respectively). Mean satisfaction was high in both groups, 9.0 ± 1.0, median 10; and 8.8 ± 1.7, median 9, for IANB and INF (P = .695). Hence, the anesthetic technique did not generate statistically significant differences. Five potential influencing variables that were measured did not significantly affect pain levels or patient satisfaction in either group. CONCLUSIONS According to the results, an IANB might not be necessary for standard implant surgery in the posterior mandible, and infiltration of articaine 4% with epinephrine 1:100,000 appears to be sufficient. Further research is needed to check if these results are extensible to other anesthetic drugs.
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Affiliation(s)
- G Esteve-Pardo
- Private Practice, Master Degree in Biotechnology and Bioengineering in Bioengineering Institute, Miguel Hernández University of Elche, Spain
| | | | - A Salgado
- Private Practice, Teaching Assistant, Miguel Hernández University of Elche, Spain
| | | | - J A Bardaji
- Private practice, Assistant Professor, Periodontology & Osseointegration Department, Universidad Católica, Valencia, Spain
| | - L Esteve-Colomina
- Private Practice, Master Degree in Biotechnology and Bioengineering in Bioengineering Institute, Miguel Hernández University of Elche, Spain.
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22
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Takiguchi M, Sato I, Li ZL, Miyaso H, Kawata S, Itoh M. Characteristics of Mandibular Canal Branches Related to Nociceptive Marker. J Dent Res 2021; 100:623-630. [PMID: 33402027 DOI: 10.1177/0022034520979639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
It is difficult to correlate the direction of mandibular canal branches (MCBs) with altered sensation in dental treatments. In contrast, calcitonin gene-related peptide (CGRP) is related to vasodilation, bone formation, and the interaction with the peripheral nervous system. Therefore, we investigated the detailed morphological characteristics of MCBs using cone-beam computed tomography (CBCT) and observation of the CGRP distribution around the MCB. The MCB measurements were evaluated using principal component analysis (PCA) to identify morphological correlations. A total of 168 sides of mandibles from 84 cadavers were analyzed in this study. Most of the MCBs were primarily in the direction of the clock model from X to XI in sagittal sections and XII to I in coronal sections of the mandible. The structure of the MCB was divided into the fine canal branch (60.4%, 223/369), partial branch (24.4%, 90/369), and no canal branch (15.2%, 56/369). PCA indicated that the measurement element with the MCB and its structures were correlated in contrast to tooth factors. Positive CGRP reactions were clearly observed in the no-canal branch group compared to other groups. These data provide useful suggestions for MCB dynamics and information for clinical dental treatment.
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Affiliation(s)
- M Takiguchi
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - I Sato
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Z L Li
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - H Miyaso
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - S Kawata
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - M Itoh
- Department of Anatomy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
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23
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Ichiki S, Muraoka H, Hirahara N, Ito K, Okada H, Kaneda T. Age Affects Alveolar Bone Height and Width in Patients Undergoing Dental Implant Treatment: Findings from Computed Tomography Imaging. J HARD TISSUE BIOL 2021. [DOI: 10.2485/jhtb.30.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shungo Ichiki
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Hirotaka Muraoka
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Naohisa Hirahara
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Kotaro Ito
- Department of Radiology, Nihon University School of Dentistry at Matsudo
| | - Hiroyuki Okada
- Department of Oral Pathology, Nihon University School of Dentistry at Matsudo
| | - Takashi Kaneda
- Department of Radiology, Nihon University School of Dentistry at Matsudo
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24
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Conti PCR, Bonjardim LR, Stuginski-Barbosa J, Costa YM, Svensson P. Pain complications of oral implants: Is that an issue? J Oral Rehabil 2020; 48:195-206. [PMID: 33047362 DOI: 10.1111/joor.13112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 01/03/2023]
Abstract
The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP). Though relatively rare, PTNP has a profound impact on patient's quality of life. Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition. In case of the PTNP, different management modalities, including antidepressant and membrane stabilizer medications, as well as peripheral strategies, as the use of topical medication and the botulin toxin are presented and discussed.
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Affiliation(s)
- Paulo César Rodrigues Conti
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Brazil.,Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil
| | - Leonardo Rigoldi Bonjardim
- Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Yuri Martins Costa
- Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil.,Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmø University, Malmø, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON)
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Success of surgical interventions for direct dental implant-related injuries to the mandibular nerve: a review. Br J Oral Maxillofac Surg 2020; 58:795-800. [PMID: 32409132 DOI: 10.1016/j.bjoms.2020.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 04/07/2020] [Indexed: 11/23/2022]
Abstract
To the best of our knowledge there are no guidelines regarding the surgical management of dental implant-related injuries to the mandibular nerve. This review aims to investigate the success of different surgical interventions. Neurosensory injury to the mandibular branch of the trigeminal nerve can occur during administration of local anaesthetic, elevation of the flap, preparation for osteotomy, and placement of the implant. Surgical interventions include extraction of the implant, external decompression, internal neurolysis, excision of a neuroma, neurorrhaphy, nerve grafting, and low-level laser therapy. The following electronic databases were searched: MEDLINE, EMBASE, and the Cochrane Library. Primary outcome measures included patient-reported outcomes such as pain and altered sensation. A total of 185 publications were obtained, of which 21 were included in the qualitative synthesis (2 randomised controlled trials (RCT), 9 controlled cohort studies, and 10 case reports/series). They were all screened in consideration of the exclusion criteria and appraised using the Cochrane risk of bias tool, the Newcastle Ottawa scale, and the modified Newcastle Ottawa scale. Results were triangulated to evaluate their level of agreement. The extraction of dental implants less than 36hours after injury to the mandibular nerve results in the most successful resolution of neurosensory dysfunction. Various microsurgical techniques have shown less success in obtaining neurosensory recovery than extraction of the implant. However, microsurgery is worthwhile, as it improves neurosensory dysfunction and reduces dysaesthesia in the majority of patients. Direct suturing and external decompression can result in good neurosensory recovery, and nerve grafts are also successful whenever tension-free direct suturing is not possible. Low-level laser therapy has been shown to achieve some neurosensory improvement.
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Jamil FA, Mohammed JA, Hasan TA, Rzoqi MG. The reliability of surgeons to avoid traumatic insertion of dental implants into high-risk regions: a panoramic radiograph study. BMC Oral Health 2020; 20:96. [PMID: 32252728 PMCID: PMC7137271 DOI: 10.1186/s12903-020-01093-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon's decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs. METHODS Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled (first premolars [1P], second premolars [2P], first molars [1M], and second molars [2M]). All preoperative panoramic radiographs were evaluated under standard conditions. The postoperative estimation (under/over) was determined depending on the available bone height (ABH) measured from the apical end of the implant to the floor of the MS and the roof of the MC using cone beam computed tomography (CBCT). Any complication or side effect that associated with overestimated implants insertion was recorded. RESULTS The study sample included 73 patients (predominantly females) who had consecutively received 148 implants, of which 68 were inserted in the posterior maxilla and 80 in the posterior mandible. Underestimation was recorded in 93.2% of the measurements. The remaining bone height after implants insertion was < 2 mm in the majority of underestimated cases (73.9%); they were significantly (P < 0.01) more than sites with remaining bone ≥ 2 mm (26.1%). In the posterior mandible, overestimation was significantly higher than posterior maxilla. Five cases with transient paresthesia were reported in the mandibular overestimated implants. CONCLUSIONS This study specified that surgeon's choice of implants length, based on panoramic radiographs, was reliable regarding the incapability to insert implants with further length in the majority of underestimated cases, the low percent of overestimated measurements, and the minor associated complications.
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Affiliation(s)
- Firas A Jamil
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Almoadham, P.O.Box 1417, Baghdad, Iraq.
| | - Jamal A Mohammed
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Almoadham, P.O.Box 1417, Baghdad, Iraq
| | - Thair A Hasan
- Department of Oral & Maxillofacial Surgery, Dental Teaching Hospital, College of Dentistry, University of Baghdad, Bab-Almoadham, P.O.Box 1417, Baghdad, Iraq
| | - Mohammed G Rzoqi
- Department of Biomedical Applications, Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq
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Schiffers G, Arnold J, Bartella A, Mähönen P, Lethaus B. Avoiding the Alveolar Nerve Via a Real-Time Impedance Analysis: A Novel Method to Improve Implant Surgery Safety. J Med Device 2020. [DOI: 10.1115/1.4046212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Safe lower jaw implantations require precautions to avoid damaging the alveolar nerve. The prevailing methods are preoperative. In this study, we propose a novel approach to measure the distance between a pilot-drill and the alveolar nerve by employing high-frequency impedance measurements. The objective is to provide in vivo real-time information as an early warning of the proximity of the alveolar nerve. The method is examined and tested on animal samples. The impedance measurements were performed using a high-frequency network analyzer. Overall 40 pilot drillings were distributed over five sheep mandibles, with four on each side. Drillings were performed in three steps: inside the cortical layer, inside the spongiosa, and well inside the nerve canal. The inductance measurements were performed with a connected pilot drill, followed by an immediate 3D cone-beam computed tomography (CT) to measure the distance between the tip of the drill and the nerve canal. The measurements show that impedance information is a reliable indicator for proximity of the drill to the nerve. We observe a general trend of decreasing inductance as the drill approaches the nerve and find that at very high frequencies one can detect the closeness to the nerve from characteristic ratios of impedance at nearby frequencies. We report also that using phase information increases the reliability of this method. The findings provide a solid proof of concept for the proposed method. While the results are promising at this stage, the applicability for in vivo conditions requires further studies.
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Affiliation(s)
- Georg Schiffers
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstrasse 3, Aachen, Nordrhein-Westfalen DE 52074, Germany
| | - Julian Arnold
- Institute for Networked Systems, RWTH Aachen University, Aachen, Nordrhein-Westfalen 52072, Germany
| | - Alexander Bartella
- Department for Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Leipzig, Leipzig, Sachsen 04103, Germany
| | - Petri Mähönen
- Faculty of Electrical Engineering and Information Technology, Institute for Networked Systems, RWTH Aachen University, Aachen, Nordrhein-Westfalen 52072, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstrasse 3, Aachen, Nordrhein-Westfalen DE 52074, Germany; Department for Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Leipzig, Liebigstraße 12, Haus 1, Leipzig, Sachsen 04103, Germany
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Wang Z, Mudalal M, Sun Y, Liu Y, Wang J, Wang Y, Sun X, Zhou Y. The Effects of Leukocyte-Platelet Rich Fibrin (L-PRF) on Suppression of the Expressions of the Pro-Inflammatory Cytokines, and Proliferation of Schwann Cell, and Neurotrophic Factors. Sci Rep 2020; 10:2421. [PMID: 32051476 PMCID: PMC7016122 DOI: 10.1038/s41598-020-59319-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
This study evaluates the use of L-PRF as an autologous scaffold in nerve regeneration, and Schwann cells (SCs) proliferation and secretion of neurotrophic factors and its anti-inflammatory effect on SC Porphyromonas Gingivalis-Lipopolysaccharide (PG-LPS)-induced inflammatory responses in vitro. SEM was done to investigate various features of L-PRF. L-PRF-extracts was used to investigate the release of growth factors and treatment of SCs line. ELISA was applied to examine the release of IGF-1. The proliferative effect of L-PRF on SCs was assessed with CCK-8 assay. The effect of L-PRF on the mRNA and protein expression of SC neurotrophic factors were analyzed by RT-qPCR and ELISA. CCK-8 assay and RT-qPCR were used to determine the required concentration and the action time of PG-LPS before the anti-inflammatory effect of L-PRF was determined by measuring the changes in IL-1β, IL-6, and TNF-a with RT-qPCR and ELISA. There are different features in L-PRF. Fourteen days was sufficient to release adequate GF. The mRNA expressions of the pro-inflammatory cytokines were notably raised by PG-LPS in 3-hours treatment. L-PRF can increase SC proliferation, neurotrophic factors secretion, and suppress SC PG-LPS-induced inflammatory responses in vitro. L-PRF has the potential as an autologous biological additive for peripheral nerve regeneration in the event of nerve inflammation and injuries.
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Affiliation(s)
- Zhanqi Wang
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
| | - Mahmoud Mudalal
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry, The Arab American University, Jenin, 240, Palestine
| | - Yue Sun
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
| | - Yiping Liu
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
| | - Jia Wang
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
| | - Yao Wang
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China
| | - Xiaolin Sun
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China.
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China.
| | - Yanmin Zhou
- Department of Oral Implantology, Hospital of Stomatology, Jilin University, Changchun, 130021, China.
- Provincial Key Laboratory of Dental Development, Jaw Remodeling and Regeneration, Jilin University, Changchun, 130021, China.
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Kikuta S, Iwanaga J, Kusukawa J, Tubbs RS. Anatomical study: the potential movability of the inferior alveolar nerve. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:353-356. [PMID: 31227458 DOI: 10.1016/j.oooo.2019.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Nerve repair and repositioning are procedures for treating and avoiding injury to the inferior alveolar nerve during oral and maxillofacial surgery. The present study aimed to examine how the mobility of the inferior alveolar neurovascular bundle (IAB) changes with or without removing the bone around the mental foramen (MF). STUDY DESIGN Six fresh-frozen cadavers (11 sides) were dissected in this study. Osteotomy in the buccal cortical bone was performed from 5 mm posterior to the MF to the distal edge of the second molar with a high-speed drill and osteotome. Next, the distance from the lateral surface of the buccal cortical bone to the retracted IAB was measured with and without removing the bone around the MF. RESULTS The distance from the lateral surface of the buccal cortical bone to the retracted IAB without removing the bone around the MF was 0 mm on all sides. After removing the bone, the mean distance changed by 4.71 ± 1.41 mm (range 2.83-7.90). There was no statistically significant difference between the right and left sides. CONCLUSIONS The results of this study support removing the bone around the MF for increased mobility of the IAB.
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Affiliation(s)
- Shogo Kikuta
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Seattle Science Foundation, Seattle, WA, USA
| | - Joe Iwanaga
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Seattle Science Foundation, Seattle, WA, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - R Shane Tubbs
- Seattle Science Foundation, Seattle, WA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
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Na JY, Han SS, Jeon K, Choi YJ, Choi SH, Lee C. Prognosis in case of nerve disturbance after mandibular implant surgery in relation to computed tomography findings and symptoms. J Periodontal Implant Sci 2019; 49:127-135. [PMID: 31098333 PMCID: PMC6494770 DOI: 10.5051/jpis.2019.49.2.127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/13/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate the computed tomography (CT) imaging findings and clinical symptoms of patients who complained of neurosensory disturbances after mandibular implant surgery, and to investigate the relationships of these parameters with the prognosis for recovery. Methods CT scans were reviewed in 56 patients with nerve disturbance after mandibular implant surgery. Two oral radiologists classified the imaging findings into intrusion, contact, close, and separate groups according to the distance from the inferior border of the implant to the roof of the mandibular canal (MC). The symptoms of 56 patients were classified into 8 groups and the frequency of each group was investigated. Patients were categorized according to symptom improvement into no recovery and recovery groups, and the relationships of recovery with the CT classification and specific symptom groups were analyzed. Results Thirty-eight of the 56 nerve disturbance cases showed improvement. The close and separate groups in the CT classification had a strong tendency for recovery (90.9% and 81.8%, respectively) (P<0.05). Although the lowest recovery rate was found in the intrusion group, it was non-negligible, at 50%. The 6 patients with a worm crawling feeling all improved, while the 8 cases with a tightening sensation showed the lowest recovery rate, at 12.5%, and the symptom of a tightening sensation occurred only in the intrusion and contact groups. Conclusions The closer the implant fixture was to the MC on CT images, the less likely the patient was to recover. Regarding paresthesia symptoms, while a worm crawling feeling is thought to be a predictor of recovery, a tightening sensation appeared to be associated with a lower recovery rate.
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Affiliation(s)
- Ji Yeon Na
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - KugJin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong Ho Choi
- Department of Periodontology, Yonsei University College of Dentistry, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
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Sahl E, Alqahtani A, Alqahtani NM, Gallez F. Partial Explantation of Failed Dental Implants Placed in Mandibular Canal: A Case Report. J ORAL IMPLANTOL 2019; 44:456-461. [PMID: 30715964 DOI: 10.1563/aaid-joi-d-17-00304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
One of the most important concerns during posterior mandibular implant placement is avoiding the mandibular canal. Nerve injury can be very disturbing to the patient, possibly causing mild paresthesia to complete anesthesia. Explantation of a dental implant that gas violated the mandibular canal is the most recommended treatment. However, an osseointegrated implant that placed in the mandibular canal can be left if the patient shows no symptoms. In this case report, we describe a technique to maintain the apexes of the implants while partially removing fractured osseointegrated implants previously placed in the mandibular canal.
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Affiliation(s)
- Erik Sahl
- 1 Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Ali Alqahtani
- 2 Department of Periodontics, King Khalid University, Abha, Saudi Arabia
| | - Nasser M Alqahtani
- 2 Department of Periodontics, King Khalid University, Abha, Saudi Arabia
| | - Fabrice Gallez
- 3 Private practice in periodontics and implant surgery, San Jose, Calif
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Jorba-García A, Figueiredo R, González-Barnadas A, Camps-Font O, Valmaseda-Castellón E. Accuracy and the role of experience in dynamic computer guided dental implant surgery: An in-vitro study. Med Oral Patol Oral Cir Bucal 2019; 24:e76-e83. [PMID: 30573712 PMCID: PMC6344002 DOI: 10.4317/medoral.22785] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/24/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To compare the accuracy of implant placement using the conventional freehand method and a dynamic navigation system; to assess the role of the surgeon's experience in implant placement using these two methods. MATERIAL AND METHODS A randomized in-vitro study was conducted. Six resin mandible models and 36 implants were used. Two researchers with differing clinical experience (novice and experienced) placed implants using either the Navident dynamic navigation system (navigation group) or the conventional freehand method (freehand group). Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT image. Descriptive and bivariate analyses of the data were performed. RESULTS The navigation group showed significantly higher accuracy for all the variables studied except 3D entry and depth deviation. This system significantly enhanced the accuracy of the novice professional in several outcome variables in comparison with the freehand implant placement method. However, when the implants were placed by the experienced clinician the dynamic navigation system only improved angulation deviation. Significant differences were found between the 2 professionals when the freehand method was employed. Similar deviations were observed for the implants placed with the navigation system. CONCLUSIONS Dynamic computer assisted surgery systems allow more accurate implant placement in comparison with the conventional freehand method, regardless of the surgeon's experience. However, this system seems to offer more advantages to novice professionals, since it allows them to reduce their deviations significantly and achieve similar results to those of experienced clinicians.
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Affiliation(s)
- A Jorba-García
- Facultat de medicina i ciències de la salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern; 2a planta, Despatx 2.9, C/ Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Spain,
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Vázquez-Delgado E, Viaplana-Gutiérrez M, Figueiredo R, Renton T, Gay-Escoda C, Valmaseda-Castellón E. Prevalence of neuropathic pain and sensory alterations after dental implant placement in a university-based oral surgery department: A retrospective cohort study. Gerodontology 2018; 35:117-122. [DOI: 10.1111/ger.12326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Eduardo Vázquez-Delgado
- Temporomandibular Disorders and Orofacial Pain Unit; Oral Surgery and Implantology Master Degree Program; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Marta Viaplana-Gutiérrez
- Oral Surgery and Implantology Master's Degree Program; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Rui Figueiredo
- Oral Surgery and Implantology Master's Degree Program; Oral Surgery; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- IDIBELL Institute; Barcelona Spain
| | - Tara Renton
- Oral Surgery; Kings College London; London UK
| | - Cosme Gay-Escoda
- IDIBELL Institute; Barcelona Spain
- Oral and Maxillofacial Surgery; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- Oral Surgery and Implantology; EHFRE International University/FUCSO; Barcelona Spain
- Department of Oral Surgery, Implantology and Maxillofacial Surgery; Teknon Medical Center; Barcelona Spain
| | - Eduard Valmaseda-Castellón
- Oral Surgery and Implantology Master's Degree Program; Oral Surgery; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- IDIBELL Institute; Barcelona Spain
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Wanner L, Ludwig U, Hövener JB, Nelson K, Flügge T. Magnetic resonance imaging-a diagnostic tool for postoperative evaluation of dental implants: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:e103-e107. [PMID: 29501353 DOI: 10.1016/j.oooo.2018.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Compared with cone beam computed tomography (CBCT), magnetic resonance imaging (MRI) might be superior for the diagnosis of nerve lesions associated with implant placement. STUDY DESIGN A patient presented with unilateral pain associated with dysesthesia in the region of the right lower lip and chin after implant placement. Conventional orthopantomography could not identify an association between the position of the inferior alveolar nerve and the implant. For 3-dimensional display of the implant in relation to the surrounding anatomy, CBCT was compared with MRI. RESULTS MRI enabled the precise depiction of the implant position and its spatial relation to the inferior alveolar nerve, whereas the nerve position and its exact course within the mandible could not be directly displayed in CBCT. CONCLUSION MRI may be a valuable, radiation-free diagnostic tool for the visualization of intraoral hard and soft tissues, offering an objective assessment of nerve injuries by a direct visualization of the inferior alveolar neurovascular bundle.
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Affiliation(s)
- Laura Wanner
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Ute Ludwig
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Jan-Bernd Hövener
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, García-Delgado R, Catena A, Galindo-Moreno P. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Patol Oral Cir Bucal 2017; 22:e630-e635. [PMID: 28809376 PMCID: PMC5694187 DOI: 10.4317/medoral.21905] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/07/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL). STUDY DESIGN In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined. RESULTS Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p<0.001; right and left, respectively) and lateral (r=-0.274, p=0.001; r=-0.285, p<0.001; right and left, respectively), particularly at the level of the premolars. Additionally, the presence (r=-0.181, p=0.001; r=-0.163, p=0.002; right and left, respectively) and anterior extension (r=-0.180, p=0.009; r=-0.285, p=0.05; right and left, respectively) of the AL was found to be inversely correlated with the age of the patient. CONCLUSIONS This analysis of a Caucasian population has found that the older the patient, the lower the incidence of the loop and the shorter its anterior extension.
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Affiliation(s)
- M Velasco-Torres
- School of Dentistry, University of Granada, 18071 Granada, Spain,
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Hartmann A, Welte-Jzyk C, Seiler M, Daubländer M. Neurophysiological changes associated with implant-associated augmentation procedures in the lower jaw. Clin Implant Dent Relat Res 2017; 19:725-732. [PMID: 28556476 DOI: 10.1111/cid.12500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neurophysiological changes after oral and maxillofacial surgery remain one of the topics of current research. PURPOSE This study evaluated if implant placement associated with augmentation procedures increases the possibility of sensory disturbances or result in impaired quality of life during the healing period. MATERIAL AND METHODS Patients who had obtained an implant placement in the lower jaw in combination with augmentation procedures were examined by implementing a comprehensive Quantitative Sensory Testing (QST) protocol for extra- and intraoral use. As augmentation procedures, we used Guided Bone Regeneration (Group A) and Customized Bone Regeneration (Group B) techniques. Patients were tested bilaterally at the chin and mucosal lower lip. Results were compared to a group without augmentation procedures (Group C). Patients' quality of life and psychological comorbidity after the surgical procedures was assessed with the Oral Health Impact Profile and the Hospital Anxiety and Depression Scale. RESULTS For groups A (n = 20) and B (n = 8), mechanical QST parameters showed no significant differences in all qualities of the inferior alveolar nerve compared to the contralateral side and compared to the nonaugmentation control group (n = 32) as well. Evaluation of quality of life and psychological factors showed no statistical differences. CONCLUSIONS Augmentation procedures did not increase sensory disturbances, indicating no changes in the neurophysiological pathways. Extended augmentation procedures did not lead to sensory changes either or result in an impaired quality of life or modified anxiety and depression scores.
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Affiliation(s)
- Amely Hartmann
- Department of Oral and Maxillofacial Surgery, Private Practice Dr. Seiler and colleagues, Filderstadt, Germany
| | - Claudia Welte-Jzyk
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marcus Seiler
- Department of Oral and Maxillofacial Surgery, Private Practice Dr. Seiler and colleagues, Filderstadt, Germany
| | - Monika Daubländer
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Sant'Anna CBM, Zuim PRJ, Brandini DA, Guiotti AM, Vieira JB, Turcio KHL. Effect of Acupuncture on Post-implant Paresthesia. J Acupunct Meridian Stud 2017; 10:131-134. [PMID: 28483185 DOI: 10.1016/j.jams.2017.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/06/2016] [Accepted: 01/06/2017] [Indexed: 11/25/2022] Open
Abstract
Paresthesia is defined as an alteration in local sensibility, associated with numbness, tingling, or unpleasant sensations caused by nerve lesions or irritation. It can be temporary or permanent. The treatment protocol for facial paresthesia is primarily based on the use of drugs and implant removal, which may not be completely effective or may require other risk exposure when there is no spontaneous regression. However, other therapeutic modalities such as acupuncture can be used. The aim of this study is to report a case of a patient with paresthesia of the inferior alveolar nerve and pain caused by an implant surgery performed 2 years earlier. The patient received acupuncture treatment during 4 months of weekly sessions. Six points were used: Large Intestine (LI4), Large Intestine (LI11), Stomach (ST36), Liver (LR3), Extra Head and Neck (E-HN-18), and Stomach (ST5). The visual analog scale was used before and after each session for the analysis of paresthesia and pain, together with assessment of the paresthesia by delimitation of the desensitized region of the skin and presented discomfort. Pain remission and reduction in the size of the paresthesia area occurred after four sessions.
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Affiliation(s)
| | - Paulo Renato Junqueira Zuim
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, Univ Estadual Paulista-UNESP, Brazil
| | - Daniela Atili Brandini
- Department of Integrated Clinic, Dental School of Araçatuba, Univ Estadual Paulista-UNESP, Brazil
| | - Aimée Maria Guiotti
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, Univ Estadual Paulista-UNESP, Brazil
| | - Joao Batista Vieira
- Department of Pathology and Clinical Propedeutics, Dental School of Araçatuba, Univ Estadual Paulista-UNESP, Brazil
| | - Karina Helga Leal Turcio
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, Univ Estadual Paulista-UNESP, Brazil
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Merigo E, Rocca JP, Oppici A, Cella L, Fornaini C. At-home laser treatment of oral neuronal disorders: Case reports. J Clin Exp Dent 2017; 9:e595-e598. [PMID: 28469830 PMCID: PMC5410685 DOI: 10.4317/jced.53373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 12/02/2016] [Indexed: 01/28/2023] Open
Abstract
The neuronal disorders occurring in the oral district are mainly anaesthesia, paraesthesia, hypoesthesia and hyperaesthesia and they may occur frequently after surgical procedures. Medical treatment depends on degree of severity of the nerve injury but, in every case, it must be immediately carried out to reduce immune inflammatory reaction. The aim of this report is to investigate the effectiveness in the recovery of the peripheral nerve lesions of a new laser device recently proposed by the commerce that, due to its reduced size and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Three different cases were treated with this "at-home approach": complete resolution of symptomatology was obtained after laser treatment with a good compliance for the patient and without reporting any side effect. Key words:Laser, biomodulation, low level laser therapy, oral neuronal disorders, at-home treatment, paresthesia.
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Affiliation(s)
- Elisabetta Merigo
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France.,"Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Jean-Paul Rocca
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France
| | - Aldo Oppici
- "Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Luigi Cella
- "Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
| | - Carlo Fornaini
- Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France.,"Guglielmo da Saliceto" Hospital, via Taverna, 1o - 29100 - Piacenza - Italy
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Hartmann A, Seeberger R, Bittner M, Rolke R, Welte-Jzyk C, Daubländer M. Profiling intraoral neuropathic disturbances following lingual nerve injury and in burning mouth syndrome. BMC Oral Health 2017; 17:68. [PMID: 28330489 PMCID: PMC5363027 DOI: 10.1186/s12903-017-0360-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/08/2017] [Indexed: 01/03/2023] Open
Abstract
Background The aim of the study was to analyse intraoral neurophysiological changes in patients with unilateral lingual nerve lesions as well as patients with Burning Mouth Syndrome (BMS) by applying a standardized Quantitative Sensory Testing (QST) protocol. Methods The study included patients suffering from a peripheral lesion of the lingual nerve (n = 4), from BMS (n = 5) and healthy controls (n = 8). Neurophysiological tests were performed in the innervation areas of the tongue bilaterally. For BMS patients the dorsal foot area was used as reference. Results For patients with peripheral lesion of the lingual nerve the affected side of the tongue showed increased thresholds for thermal (p < 0.05–0.001) and mechanical (p < 0.01–0.001) QST parameters, indicating a hypoesthesia and thermal hypofunction. In BMS patients, a pinprick hypoalgesia (p < 0.001), a cold hyperalgesia (p < 0.01) and cold/warmth hypoesthesia (p < 0.01) could be detected. Conclusions The results of this study verified the lingual nerve lesion in our patients as a peripheral dysfunction. The profile showed a loss of sensory function for small and large fibre mediated stimuli. A more differentiated classification of the lingual nerve injury was possible with QST, regarding profile, type and severity of the neurologic lesion. BMS could be seen as neuropathy with variable central and peripheral contributions among individuals resulting in chronic pain.
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Affiliation(s)
- Amely Hartmann
- Private Practice Dr. Seiler und Kollegen, Echterdinger Str. 7, 70794, Filderstadt, Germany.
| | | | - Malte Bittner
- Private Practice Dr. Meschenmoser und Dr. Bittner, Stuttgart, Germany
| | - Roman Rolke
- Department of Palliative Medicine, University of Aachen, Aachen, Germany
| | - Claudia Welte-Jzyk
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Monika Daubländer
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Kotaki S, Sakamoto J, Kretapirom K, Supak N, Sumi Y, Kurabayashi T. Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking. Dentomaxillofac Radiol 2016; 45:20160200. [PMID: 27494418 DOI: 10.1259/dmfr.20160200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Diffusion tensor imaging (DTI) can provide structural information and objective values for nerves. The aims of this study were to perform quantitative evaluation and fibre tracking of the normal inferior alveolar nerve (IAN) using DTI on 3.0-T MRI. METHODS DTI was applied to 92 IANs of 46 healthy volunteers. Circular regions of interest (ROIs) were placed on three different positions at the mandibular foramen, second molar and mental foramen of each nerve on apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps, and the ADC and FA of each ROI were measured. Differences in the values arising from the nerve positions were evaluated. Furthermore, fibre tracking of the IANs was performed by tractography, and the quality of visualization was evaluated. RESULTS There were no significant differences in the ADC and FA between the right and left sides regardless of the anteroposterior positions. Regarding differences arising from the anteroposterior measurement positions, the ADC and FA showed no significant differences (p > 0.017), except for the ADCs between the positions at the mandibular foramen and mental foramen in the left side (p = 0.0068). Overall, 70 (76%) of the 92 IANs could be visualized fully or partially by tractography. CONCLUSIONS The ADC and FA of the IAN were successfully obtained from healthy volunteers using DTI and were confirmed to be symmetrical regardless of the measurement positions. DTI is a feasible technique for the quantitative evaluation and visualization of the IAN.
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Affiliation(s)
- Shinya Kotaki
- 1 Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Junichiro Sakamoto
- 1 Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kornkamol Kretapirom
- 2 Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ngamsom Supak
- 1 Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,2 Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Yasunori Sumi
- 3 Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu-shi, Aichi, Japan
| | - Tohru Kurabayashi
- 1 Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Lee DH, An SY, Hong MH, Jeon KB, Lee KB. Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study. J Adv Prosthodont 2016; 8:207-13. [PMID: 27350855 PMCID: PMC4919491 DOI: 10.4047/jap.2016.8.3.207] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/26/2016] [Accepted: 04/26/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (α=.05). RESULTS The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.
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Affiliation(s)
- Du-Hyeong Lee
- Department of Prosthodontics, School of Dentistry, A3DI, Kyungpook National University, Daegu, Republic of Korea
| | - Seo-Young An
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Min-Ho Hong
- Department of Bio-medical Research Institute, A3DI, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Kyoung-Bae Jeon
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Department of Prosthodontics, School of Dentistry, A3DI, Kyungpook National University, Daegu, Republic of Korea
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Huang RY, Cochran DL, Cheng WC, Lin MH, Fan WH, Sung CE, Mau LP, Huang PH, Shieh YS. Risk of lingual plate perforation for virtual immediate implant placement in the posterior mandible: A computer simulation study. J Am Dent Assoc 2016; 146:735-42. [PMID: 26409983 DOI: 10.1016/j.adaj.2015.04.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/22/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study sought to determine which factors are correlated to a higher risk of lingual plate perforation (LPP) when placing a virtual implant in the area of the anticipated extraction site of the posterior mandible. METHODS Computed tomographic images of 300 patients (1,279 teeth) were analyzed in regard to the shape of the mandible (convergent, parallel, or undercut type), dimensional parameters of lingual concavity (angle, height, depth) and its relation to the inferior alveolar canal (zones A, B, C), distance from root apex to inferior alveolar canal, and probability of LPP. The odds ratio of variables was determined by multiple logistic regression modeling. RESULTS The overall probability of LPPs on virtual implant placement was 3.1%. This perforation was most commonly observed at the second molar and with a U-type ridge. After adjusting cofounders, a concave point located in zone A is 17.34 times more likely to have a LPP than one in zone C. The probability of LPPs was reduced by 34% for every 1-millimeter increase in distance from root apex to inferior alveolar canal on virtual implant placement of posterior mandible region. CONCLUSIONS Three-dimensional cone-beam computed tomographic imaging is essential for planning immediate implant placement in the anticipated extraction sites of the posterior mandible region as proved by anatomic findings that can only be understood from preoperative imaging analysis. PRACTICAL IMPLICATIONS Presurgical cross-sectional images can be analyzed to identify anatomic features relative to the lingual concavities in the posterior mandible region, which can help to avoid unpleasant complications, specifically when performing immediate implant procedures.
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Hartmann A, Welte-Jzyk C, Seiler M, Daubländer M. Neurophysiological changes associated with implant placement. Clin Oral Implants Res 2016; 28:576-581. [PMID: 27002225 DOI: 10.1111/clr.12837] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objective of the study was to evaluate the feasibility of a standardized Quantitative Sensory Testing (QST) protocol extra- and intraoral in patients to detect and quantify sensory disturbances of the inferior alveolar nerve due to the proximity of implantation procedures to the inferior alveolar nerve canal. MATERIAL AND METHODS Patients who had obtained an implant placement were examined by implementing a comprehensive QST protocol for extra- and intraoral use. The study included 33 patients after implant placement in the lower jaw and one patient suffering from an inferior alveolar nerve injury. Patients were tested bilaterally (chin and mucosal lower lip). RESULTS Comparing the implanted vs. the control side, QST parameters revealed no significant neurophysiological changes in all parameters. Evaluating the development of sensory disturbances in dependency of the proximity of the implant to the inferior alveolar nerve canal, mechanical QST parameters showed no significant correlation. The mean distance of the inserted implant to the inferior nerve canal was 2.65 ± 1.75 mm. In the case of one patient suffering from impairment of the nerve function due to implant placement, we found abnormal sensory responses to touch coexisting with numbness and temperature algesia. CONCLUSIONS Monitoring of trigeminal nerve fiber functions by QST intra- and extraoral is feasible to evaluate oral sensory pattern after implantation procedures. Sensory disturbances of the inferior alveolar nerve were shown to be avoided by keeping an average safety zone of 2.65 mm between implant and nerve.
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Affiliation(s)
- Amely Hartmann
- Private Practice Dr. Seiler und Kollegen, Filderstadt, Germany
| | - Claudia Welte-Jzyk
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marcus Seiler
- Private Practice Dr. Seiler und Kollegen, Filderstadt, Germany
| | - Monika Daubländer
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
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QIN JIE, WANG LIN, ZHENG LING, ZHOU XIAOYAN, ZHANG YIDI, YANG TINGTING, ZHOU YANMIN. Concentrated growth factor promotes Schwann cell migration partly through the integrin β1-mediated activation of the focal adhesion kinase pathway. Int J Mol Med 2016; 37:1363-70. [DOI: 10.3892/ijmm.2016.2520] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 03/01/2016] [Indexed: 11/06/2022] Open
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Qin J, Wang L, Sun Y, Sun X, Wen C, Shahmoradi M, Zhou Y. Concentrated growth factor increases Schwann cell proliferation and neurotrophic factor secretion and promotes functional nerve recovery in vivo. Int J Mol Med 2015; 37:493-500. [PMID: 26709397 DOI: 10.3892/ijmm.2015.2438] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 12/11/2015] [Indexed: 02/07/2023] Open
Abstract
Concentrated growth factor (CGF) is a newly generated complex that comprises a fibrin matrix incorporating growth factors and plasmatic and leukocyte cytokines. It has been widely used in bone regenerative medicine. However, the effect of CGF on peripheral nerve regeneration had not been previously investigated. The aim of the present study was to evaluate the possibility of using CGF for nerve regeneration by i) investigating the effect of CGF on the proliferation of Schwann cells (SCs) and secretion of neurotrophic factors nerve growth factor (NGF) and glial cell line‑derived neurotrophic factor (GDNF) in vitro; and ii) analyzing the effect of CGF on functional nerve recovery after nerve injury in vivo. CGF was prepared from venous blood taken from rats, and using scanning electron microscopy (SEM) we noted that it featured a fiber‑like appearance with pore size ranging from 0.1 to 1.0 µm. The soluble component of CGF was used to produce conditioned media with which to treat the Schwann cell line. A cell counting kit-8 assay and cell cycle analysis were both used to study the proliferative effect of CGF on SCs. Reverse transcription-quantitative PCR and western blot analysis demonstrated that there was an increase in the mRNA and protein expression of NGF and GDNF, both of which are markers of SC neurotrophic secretion. A model of sciatic nerve crush injury was established for the in vivo experiment, and CGF was found to increase the sciatic functional index (indicative of nerve function). We noted that CGF increased SC proliferation and secretion of neurotrophic factors in vitro, and promoted functional recovery after peripheral nerve injuries in vivo. These results suggest that CGF is a promising candidate biomaterial for peripheral nerve regeneration, and may potentially be utilized to repair nerve injuries.
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Affiliation(s)
- Jie Qin
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Lin Wang
- Department of Very Important People, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yue Sun
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xiaolin Sun
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Chaoju Wen
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Mahdi Shahmoradi
- Department of Bioengineering, School of Dentistry, The University of Sydney, NSW 2006, Australia
| | - Yanmin Zhou
- Department of Dental Implantology, School and Hospital of Stomatology, Jilin University, Changchun, Jilin 130021, P.R. China
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Shavit I, Juodzbalys G. Inferior alveolar nerve injuries following implant placement - importance of early diagnosis and treatment: a systematic review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2014; 5:e2. [PMID: 25635209 PMCID: PMC4306320 DOI: 10.5037/jomr.2014.5402] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/02/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. MATERIAL AND METHODS We performed literature investigation through MEDLINE (PubMed) electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. RESULTS In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. CONCLUSIONS Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes.
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Affiliation(s)
- Ilana Shavit
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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Lin MH, Mau LP, Cochran DL, Shieh YS, Huang PH, Huang RY. Risk assessment of inferior alveolar nerve injury for immediate implant placement in the posterior mandible: a virtual implant placement study. J Dent 2014; 42:263-70. [PMID: 24394585 DOI: 10.1016/j.jdent.2013.12.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/17/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To investigate the prevalence and morphological parameters of lingual concavity, and whether these factors are related to a higher risk of inferior alveolar nerve (IAN) injury when performing an immediate implant surgery in posterior mandible region. METHODS The CBCT images from 237 subjects (1008 teeth) were analysed the shape of the mandibles (C, P, U type), dimensional parameters of lingual concavity (angle, height, depth), and its relation to inferior alveolar canal (IAC) (A, B, C zone), RAC (distance from root apex to IAC) and probability of IAN injury. Multiple logistic regression modelling to determine the odds ratio of variables that made an important contribution to the probability of IAN injury and to adjust for confounding variables. RESULTS The U type ridge (46.7%) and the most concave point located at C zone (48.8%) are most prevalent in this region. The mandibular second molar presents highest risk for IAN injury than other tooth type (p<0.001), which were 3.82 times to occur IAN injury than the mandibular second premolar. The concave point located at A zone and B zone were 7.82 and 3.52 times than C zone to have IAN damage, respectively. The probability of IAN injury will reduce 26% for every 1mm increase in RAC (p<0.001). CONCLUSIONS The tooth type, morphological features of lingual concavities, and RAC are associated with risks of IAN injury during immediate implant placement. CLINICAL SIGNIFICANCE Pre-surgical mapping of the IAC and identification of its proximity relative to the lingual concavity in the posterior mandible regions may avoid unpleasant complications, specifically when performing immediate implant procedures.
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Affiliation(s)
- Ming-Hung Lin
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Lian-Ping Mau
- Department of Periodontics, Chi Mei Medical Center, Tainan, Taiwan
| | - David L Cochran
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Yi-Shing Shieh
- Department of Oral Diagnosis and Pathology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Po-Hsien Huang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
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Juodzbalys G, Kubilius M. Clinical and radiological classification of the jawbone anatomy in endosseous dental implant treatment. J Oral Maxillofac Res 2013; 4:e2. [PMID: 24422030 PMCID: PMC3886111 DOI: 10.5037/jomr.2013.4202] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 06/12/2013] [Indexed: 11/24/2022]
Abstract
Objectives The purpose of present article was
to review the classifications suggested for assessment of the jawbone anatomy, to
evaluate the diagnostic possibilities of mandibular canal identification and risk
of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as
well as to suggest new classification system of the jawbone anatomy in endosseous
dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic
databases. The keywords used for search were mandible; mandibular canal; alveolar
nerve, inferior; anatomy, cross-sectional; dental implants; classification. The
search was restricted to English language articles, published from 1972 to March
2013. Additionally, a manual search in the major anatomy and oral surgery books
were performed. The publications there selected by including clinical and human
anatomy studies. Results In total
109 literature sources were obtained and reviewed. The classifications suggested
for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal
identification and risk of inferior alveolar nerve injury, aesthetic considerations
in aesthetic zone were discussed. New classification system of the jawbone anatomy
in endosseous dental implant treatment based on anatomical and radiologic findings
and literature review results was suggested. Conclusions The
classification system proposed here based on anatomical and radiological jawbone
quantity and quality evaluation is a helpful tool for planning of treatment strategy
and collaboration among specialists. Further clinical studies should be conducted
for new classification validation and reliability evaluation.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Marius Kubilius
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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