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Jacobs R, Fontenele RC, Lahoud P, Shujaat S, Bornstein MM. Radiographic diagnosis of periodontal diseases - Current evidence versus innovations. Periodontol 2000 2024. [PMID: 38831570 DOI: 10.1111/prd.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
Accurate diagnosis of periodontal and peri-implant diseases relies significantly on radiographic examination, especially for assessing alveolar bone levels, bone defect morphology, and bone quality. This narrative review aimed to comprehensively outline the current state-of-the-art in radiographic diagnosis of alveolar bone diseases, covering both two-dimensional (2D) and three-dimensional (3D) modalities. Additionally, this review explores recent technological advances in periodontal imaging diagnosis, focusing on their potential integration into clinical practice. Clinical probing and intraoral radiography, while crucial, encounter limitations in effectively assessing complex periodontal bone defects. Recognizing these challenges, 3D imaging modalities, such as cone beam computed tomography (CBCT), have been explored for a more comprehensive understanding of periodontal structures. The significance of the radiographic assessment approach is evidenced by its ability to offer an objective and standardized means of evaluating hard tissues, reducing variability associated with manual clinical measurements and contributing to a more precise diagnosis of periodontal health. However, clinicians should be aware of challenges related to CBCT imaging assessment, including beam-hardening artifacts generated by the high-density materials present in the field of view, which might affect image quality. Integration of digital technologies, such as artificial intelligence-based tools in intraoral radiography software, the enhances the diagnostic process. The overarching recommendation is a judicious combination of CBCT and digital intraoral radiography for enhanced periodontal bone assessment. Therefore, it is crucial for clinicians to weigh the benefits against the risks associated with higher radiation exposure on a case-by-case basis, prioritizing patient safety and treatment outcomes.
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Affiliation(s)
- Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Revilla-León M, Gómez-Polo M, Barmak AB, Inam W, Kan JYK, Kois JC, Akal O. Artificial intelligence models for diagnosing gingivitis and periodontal disease: A systematic review. J Prosthet Dent 2023; 130:816-824. [PMID: 35300850 DOI: 10.1016/j.prosdent.2022.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM Artificial intelligence (AI) models have been developed for periodontal applications, including diagnosing gingivitis and periodontal disease, but their accuracy and maturity of the technology remain unclear. PURPOSE The purpose of this systematic review was to evaluate the performance of the AI models for detecting dental plaque and diagnosing gingivitis and periodontal disease. MATERIAL AND METHODS A review was performed in 4 databases: MEDLINE/PubMed, World of Science, Cochrane, and Scopus. A manual search was also conducted. Studies were classified into 4 groups: detecting dental plaque, diagnosis of gingivitis, diagnosis of periodontal disease from intraoral images, and diagnosis of alveolar bone loss from periapical, bitewing, and panoramic radiographs. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. RESULTS Twenty-four articles were included: 2 studies developed AI models for detecting plaque, resulting in accuracy ranging from 73.6% to 99%; 7 studies assessed the ability to diagnose gingivitis from intraoral photographs reporting an accuracy between 74% and 78.20%; 1 study used fluorescent intraoral images to diagnose gingivitis reporting 67.7% to 73.72% accuracy; 3 studies assessed the ability to diagnose periodontal disease from intraoral photographs with an accuracy between 47% and 81%, and 11 studies evaluated the performance of AI models for detecting alveolar bone loss from radiographic images reporting an accuracy between 73.4% and 99%. CONCLUSIONS AI models for periodontology applications are still in development but might provide a powerful diagnostic tool.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | | | - Joseph Y K Kan
- Professor, Advanced Education in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash
| | - Orhan Akal
- Machine Learning Scientist, Boston, Mass
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Mishra S, Kumar M, Mishra L, Panda S, Panda S, Lewkowicz N, Lapinska B. Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis. Biomedicines 2023; 11:2547. [PMID: 37760988 PMCID: PMC10525952 DOI: 10.3390/biomedicines11092547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Periodontal disease is a broad term given when the periodontium is affected by inflammation. There are several methods to diagnose periodontitis, but no method to quantify the cancellous bone is presently used. For this purpose, a non-invasive tool that is efficient in analyzing bone quality called fractal analysis can be employed. The objective of the study was to utilize fractal dimension (FD) to evaluate cancellous patterns of interproximal alveolar bone using a digital intraoral periapical radiograph (IOPAR) in different clinical presentations of periodontitis classified according to the latest classification by the World Workshop for Periodontal and Peri-Implant Diseases and Conditions, 2017 (WWDC, 2017). The study aimed to numerically calculate the periodontitis changes in the cancellous bone around the affected tooth on an IOPAR using fractal analysis and to provide an additional criterion for the staging of periodontitis. In this cross-sectional observational study, 75 patients were selected and equally allotted to five groups based on the staging system proposed by the WWDC, 2017. The region of interest was selected on the IOPA radiograph of the tooth with the site having the most significant clinical attachment loss, and FD was calculated using Image J analysis. The association of gender and age with stages of periodontitis was studied using the chi-square test of independence. A comparison of % bone loss and fractal dimension among stages was studied by using the non-parametric Kruskal Wallis test. The relationship between % bone loss and fractal dimension within stages and gender was studied by using the Karl Pearson correlation. A receiver operating characteristic (ROC) curve analysis was performed for FD value as a marker of periodontitis patients. We demonstrated that the FD values decreased significantly with the increase in stages (p < 0.0001). The overall relationship between % bone loss and FD showed a significantly strong negative correlation of -0.739 (p < 0.0001), except for stages III and IV. FD can be utilized as a quantitative method for detecting cancellous bone changes in different stages of periodontitis, aiding in diagnosing periodontitis.
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Affiliation(s)
- Sukanya Mishra
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Manoj Kumar
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India;
| | - Swagatika Panda
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India;
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Natalia Lewkowicz
- Department of Periodontology and Oral Diseases, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland;
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
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Alasqah M, Alotaibi FD, Gufran K. The Radiographic Assessment of Furcation Area in Maxillary and Mandibular First Molars while Considering the New Classification of Periodontal Disease. Healthcare (Basel) 2022; 10:healthcare10081464. [PMID: 36011121 PMCID: PMC9408343 DOI: 10.3390/healthcare10081464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the radiographic reliability in the diagnosis of furcation involvement in first molars. A total of 52 subjects were included in the current study. Personal history regarding smoking was recorded and a periodontal examination was performed. Pocket depth (PD), clinical attachment level (CAL), gingival recession, and furcation involvement in all first molars were assessed for each patient. Periodontal staging and grading were evaluated using the new classification of periodontal disease. Class II and Class III furcation classification were more frequently observed in radiographs than the Class I furcation; however, no significant differences were observed. Radiographic observation of the furcation was seen more when PD and CAL were >5 mm in all molars. The presence of gingival recession and its relation to the radiographic assessment did not reveal any statistically significant association (p > 0.05) except for tooth #16. The trend of visibility of furcation radiographically was more as the grade of staging was increased. Moreover, the presence of smoking habits and visibility of furcation radiographically did not have any statistical significance. Smoking may not be a factor in the furcation involvement. There is a direct relationship between the staging and grading of the periodontitis and furcation involvement.
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Affiliation(s)
- Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | | | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
- Correspondence:
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Zardawi FM. First Molars–Incisors Rate and Pattern of Bone Loss: A Cross-Sectional Analysis of CBCT Images. Diagnostics (Basel) 2022; 12:diagnostics12071536. [PMID: 35885442 PMCID: PMC9323537 DOI: 10.3390/diagnostics12071536] [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: 05/07/2022] [Revised: 06/09/2022] [Accepted: 06/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Periodontitis causes attachment and alveolar bone loss; hence, this study aimed to determine the prevalence, frequency, and pattern of bone loss at first molar–incisor areas using Cone Beam Computed Tomography (CBCT) images. Methods: A retrospective, cross-sectional analysis was conducted of 250 randomly selected CBCT images of clearly defined full arches of patients aged from 18 to 70 years who were divided into six age groups and into male and female groups. Four sites around each tooth were scanned at several accesses for bone loss detection. Distance beyond 2 mm apical to the cementoenamel junction to the level of the remaining bone was considered to indicate bone loss. The Shapiro–Wilk test was used to test the normality of the data, and statistical tests were applied for data analysis at the 0.05 p-value level. Results: The rate and amount of bone loss within the examined sample were relatively high. The examined images generally revealed a higher rate of bone loss on proximal than on labial/buccal and lingual/palatal surfaces of the first upper and lower molars. The highest amount of bone loss among all the teeth scanned in this study was seen on the mesial and distal bone of mandibular incisors, 4.36 mm and 4.31 mm, respectively, exceeding that in the labial and lingual bone, 3.23 mm and 1.89 mm, respectively, and it was highly horizontal rather than vertical in pattern. Conclusions: Based on 250 randomly selected CBCT images of clearly defined, full upper and lower arches scanned for this study, it was concluded that the rate and amount of horizontal bone loss were less than vertical bone loss and was focused mainly in the interproximal areas of the first molars. However, the highest recorded amount of bone loss was at the proximal and labial aspects of the mandibular incisors. Furthermore, younger age groups displayed significantly higher rates and amounts of bone loss than older groups, with a slight predilection for males.
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Affiliation(s)
- Faraedon Mostafa Zardawi
- Department of Periodontics, College of Dentistry, University of Sulaimani—Old Campus, Madam Mitterrand Street, Sulaymaniyah P.O. Box 1124-30, Kurdistan Region, Iraq; ; Tel.: +964-770-226-3062
- Faculty of Dentistry, Qaiwan International University, Sulaimani P.O. Box 1124-30, Kurdistan Region, Iraq
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Liquid chromatography method with tandem mass spectrometry and fluorescence detection for determination of inflammatory biomarkers in gingival crevicular fluid as a tool for diagnosis of periodontal disease. J Pharm Biomed Anal 2022; 212:114644. [DOI: 10.1016/j.jpba.2022.114644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/23/2022]
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Nikolic-Jakoba N, Barac M, Jankovic S, Aleksic Z, Spin-Neto R, Wenzel A. Effect of section thickness on cone beam computed tomography-based measurements of intrabony defects compared with clinical measurements. J Periodontol 2020; 92:670-677. [PMID: 32822070 DOI: 10.1002/jper.20-0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is unknown whether cone beam computed tomography (CBCT) image reconstruction characteristics, including section thickness, may affect linear bone measurements of periodontal intrabony defects. The aim of this study was to compare intrasurgical and CBCT-based linear measurements of intrabony defects focusing on CBCT section thickness. METHODS Sixty-six intrabony defects were assessed in 21 patients with chronic generalized severe periodontitis. Linear measurements of alveolar bone (radiographic bone level [rBL]), assessed in CBCT images at diverse section thicknesses: 0.25 mm (voxel size), 1 mm, and 3 mm, were compared with clinical bone level (cBL) measurements obtained intrasurgically. To provide identical reference points for rBL and cBL measurements, individually adjusted grooves on the reference stent were prepared for each periodontal defect site. CBCT measurements were performed in two rounds by two trained observers. Observer agreement was assessed by intraclass correlation coefficients (ICC). ANOVA assessed the difference among cBL and rBL at different section thicknesses. RESULTS Intra- and inter-observer agreement was excellent (ICC >0.99) and highly significant independent of the observer, evaluation round, and CBCT section thickness. Mean rBL in the diverse CBCT section thicknesses was very close to that measured clinically (cBL). There was no statistically significant difference between cBL and rBL for any section thickness, neither for the overall evaluated sites, nor the maxilla or mandible separately. CONCLUSIONS No statistically significant difference between clinical and radiographic bone level for 0.25-, 1-, and 3-mm CBCT section thicknesses were observed when assessing intrabony periodontal defects.
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Affiliation(s)
- Natasa Nikolic-Jakoba
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena Barac
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasa Jankovic
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Aleksic
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
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Hong HH, Mei CC, Liu HL, Liang CH, Lin CK, Lee FY, Chang CC. The correspondence of 3D supporting bone loss and crown-to-root ratio to periodontitis classification. J Clin Periodontol 2020; 47:825-833. [PMID: 32319127 DOI: 10.1111/jcpe.13296] [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: 07/10/2019] [Revised: 03/10/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
AIM Assessing the application of three-dimensional clinical attachment loss (3D-CAL), 3D supporting bone loss (3D-SBL), supracrestal tissue attachment (STA), and crown-to-root ratio (CRR) in evaluating the 2017 periodontitis classification. MATERIALS AND METHODS We analysed ninety single-rooted human premolars with micro-computed tomography. The amount of 3D-SBL, linear radiographic bone loss (RBL), and CRR corresponding to various periodontitis stages as well as the statistical significance was investigated. RESULTS From a 3D perspective, the premolars with a 21% of 3D-SBL at 2.0 mm coronal root length (RL) and 15% RBL corresponded to the periodontitis stage I. Premolars with a 44% of 3D-SBL at coronal 4.2-4.4 mm RL and 33% RBL accorded with the periodontitis stage II. Excluding the consideration of STA, CRR = 5:6 and 4:3 were associated with the levels at 15% and 33% RBL, respectively. CONCLUSIONS A greater percentage of 3D-CAL than that of 2D-CAL is significant at evaluated levels. It is feasible to correlate the 3D-SBL, 3D-CAL, and STA parameters to evaluate the stages of periodontitis severity. However, the current use of RBL and CAL as applied for staging in the 2017 classification might be inconsistent with the evaluated premolar roots length, when STA dimensions are considered.
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Affiliation(s)
- Hsiang-Hsi Hong
- Department of Periodontics, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
| | - Chih-Chun Mei
- Department of Periodontics, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
| | - Heng-Liang Liu
- Department of Prosthodontics, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
| | - Chao-Hua Liang
- Research associate, Instrument Department, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-Kai Lin
- Research associate, Instrument Department, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Fu-Ying Lee
- Department of Periodontics, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
| | - Chung-Chieh Chang
- Department of Periodontics, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan
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Icen M, Orhan K, Şeker Ç, Geduk G, Cakmak Özlü F, Cengiz Mİ. Comparison of CBCT with different voxel sizes and intraoral scanner for detection of periodontal defects: an in vitro study. Dentomaxillofac Radiol 2020; 49:20190197. [PMID: 32134338 DOI: 10.1259/dmfr.20190197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to compare the diagnostic accuracy of cone beam CT (CBCT) units with different voxel sizes with the digital intraoral scanning technique in terms of the detection of periodontal defects. METHODS AND MATERIALS The study material comprised of 12 dry skulls with maxilla and mandible. Artificial defects were created on teeth separately using burs randomly on dry skulls. In total 46 dehiscences, 10 fenestrations, 17 furcations, 12 wall defects and 13 without periodontal defect were used in the study. Each tooth with and without defects was imaged at various vertical angles using each of the following modalities: a Veraviewepocs 3D R100 CBCT device and a 3D Shape TRIOSㄾ Color P13 Shade Intraoral Scanner. RESULTS The κ values for interobserver agreement between observers ranged between 0.29 and 0.86 for the CBCT 10 × 8 cm field of view (FOV) with 0,160 mm3 voxel size; 0.35 and 1 for the CBCT 8 × 8 cm FOV with 0,125 mm3 voxel size; and 0.30 and 1 of intraoral scans. The κ values for detecting defects on anterior teeth were the least, following premolar and molar teeth both CBCT and intraoral scanning. CONCLUSIONS Smaller voxel sizes and smaller CBCT FOV has the highest sensitivity and diagnostic accuracy for detecting various periodontal defects among the scanner modalities examined. ADVANCES IN KNOWLEDGE Adequate evaluation of the condition of the alveolar bone and periodontal tissues is important for the diagnosis, treatment, and prognosis of periodontal disease. Limited examination methods, such as palpation, inspection, and periodontal probe examination, may provide insufficient information for the diagnosis of periodontal diseases.
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Affiliation(s)
- Murat Icen
- Department of Dentomaxillofacial Radiology, Nevşehir Hacı Bektaş Veli University, Faculty of Dentistry, Nevşehir, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Faculty of Dentistry, Ankara, Turkey
| | - Çiğdem Şeker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Gediz Geduk
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Fethiye Cakmak Özlü
- Department of Orthodontics, Ondokuz Mayıs University, Faculty of Dentistry, Samsun, Turkey
| | - Murat İnanç Cengiz
- Department of Periodontology, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Komšić S, Plančak D, Kašaj A, Puhar I. A Comparison of Clinical and Radiological Parameters in the Evaluation of Molar Furcation Involvement in Periodontitis. Acta Stomatol Croat 2019; 53:326-336. [PMID: 32099258 PMCID: PMC6993470 DOI: 10.15644/asc53/4/3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objective The aim of this study was to compare clinical, intra-surgical, 2D (panoramic) and 3D (CBCT)-based parameters in assessing molar furcation involvement (FI). Materials and Methods Six patients with generalized periodontitis Stage II to IV, Grade B and C who were scheduled for the periodontal flap surgical treatment were recruited in the study. In total, 38 molar teeth with 93 furcation sites were analysed. All subjects had comprehensive periodontal examination, which included an assessment of molar FI using Naber’s probe according to modified Glickman’s classification. Periodontal surgery was performed in patients with at least one maxillary molar with probing depth of ≥6 mm. This probing demonstrated lower grade of FI compared with intra-surgical findings. Results Periodontal probing, intra-surgical measurement and measurements based on CBCT significantly correlated with each other regarding the assessment of FI, with r values ranging between 0.81 to 1.00 (p<0.01). The correlation of panoramic radiograph with periodontal probing is 0.49, with CBCT 0.39 and with intra-surgical measurements 0.36. The results showed an excellent agreement and higher accuracy between intra-surgical measurements and CBCT (0.96), in contrast to clinical examination and panoramic radiography- 0.87 and 0.63 respectively. Different clinical and radiological modalities showed a correlation among each other. They are accurate and have their own benefits, which makes (renders) them useful in establishing periodontal diagnosis and treatment planning. Conclusion However, CBCT offers significant advantages including excellent agreement and higher accuracy and can be used as justified as excellent diagnostic tool in detecting and locating FI to provide a more reliable diagnosis and basis for treatment decisions.
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Affiliation(s)
- Sanja Komšić
- Dental Office Michael Wolf and Colleagues, Patrickstrasse 2, 65191 Wiesbaden
| | - Darije Plančak
- Department of Periodontology, School of Dental Medicine, University of Zagreb, and Clinical Department of Periodontology, Clinical Hospital Center
| | - Adrian Kašaj
- Department of Periodontology, Department of operative Dentistry and Periodontology, University Medical Center Mainz, Germany
| | - Ivan Puhar
- Department of Periodontology, School of Dental Medicine, University of Zagreb, and Clinical Department of Periodontology, Clinical Hospital Center
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Lima LA, Bosshardt DD, Chambrone L, Araújo MG, Lang NP. Excessive occlusal load on chemically modified and moderately rough titanium implants restored with cantilever reconstructions. An experimental study in dogs. Clin Oral Implants Res 2019; 30:1142-1154. [PMID: 31529643 DOI: 10.1111/clr.13539] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the outcomes of excessively loaded implants. MATERIAL AND METHODS In five dogs, all mandibular premolars were extracted. After 3 months, six implants (three SLA® and three SLActive®) were placed (S). After 4 weeks, implants were restored: one single crown with stable occlusal contacts (SC), one crown and a cantilever unit with excessive occlusal contacts (OL), and a non-loaded implant (NL). Bleeding-on-probing (BoP), attachment level (AL), mucosal margin (GM) were assessed. Resonance frequency analysis (RFA) was assessed weekly. Standardized X-rays were taken at S, 4 and 24 weeks. RESULTS Similar findings were observed for SLA® and SLActive® implants regarding PlI, GI, GM, AL, and BL. No significant differences were detected between baseline and 24-weeks or between treatment modalities for all clinical parameters (p > .05). Six months after loading, RFA values were significantly greater than at implant placement. No significant differences between treatment modalities were found. Linear radiographic measurements yielded similar results between SLA® and SLActive® implants. SLA® OL implants yielded a statistically significant gain on peri-implant bone density over all other groups (p = .012). Radiographic results were confirmed by descriptive histology. Technically, loosened occlusal screws occurred in 13.3% (SC = 3.3%; OL = 10%), while abutment fractures totalized 23.3% (SC = 6.6%; OL = 16.6%). CONCLUSIONS Excessive occlusal load applied to implants (SLA® or SLActive®) restored with cantilevers did not cause loss of osseointegration or significant changes in their clinical, radiographic, or histologic outcomes. Early excessive occlusal load on SLA® implants promoted a gain in peri-implant bone density. Excessively loaded implants showed more technical complications.
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Affiliation(s)
- Luiz A Lima
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Leandro Chambrone
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mauricio G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Niklaus P Lang
- School of Dental Medicine, University of Berne, Berne, Switzerland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong.,Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
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Raju N, Zhang W, Jadhav A, Ioannou A, Eswaran S, Weltman R. Cone-Beam Computed Tomography Analysis of the Prevalence, Length, and Passage of the Anterior Loop of the Mandibular Canal. J ORAL IMPLANTOL 2019; 45:463-468. [PMID: 31536439 DOI: 10.1563/aaid-joi-d-18-00236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
When placing implants in the anterior mandible, it is important to avoid damaging the mandibular nerve and its terminal extensions. The objective of this study was to determine the prevalence, length, and passage of the anterior loop of the mandibular canal, as well as the quantity of alveolar bone that is coronal to the canal, to help with implant placement in the anterior mandible. Cone-beam computerized tomography (CBCT) scans of 124 patients with 248 hemi-sections were evaluated. Anterior loop prevalence was determined using reconstructed panoramic and cross-sectional views; length was measured as the distance between the most mesial aspect of the mental foramen to the most mesial aspect of the anterior loop on cross-sectional views. The bucco-lingual position of the anterior loop inside the mandible and the apico-coronal dimensions of the alveolar bone above it were measured on cross-sectional views to determine the passage of the anterior loop and the bone available coronally, respectively. The effects of sex, age, side, and dentate status on the prevalence and length of the anterior loop were analyzed statistically. Prevalence of the anterior loop at the patient and hemi-section levels was 25% and 24%, respectively, and its median length was 1.63 mm (range, 0.52-3.92 mm). The anterior loop was apical to the mental foramen and mostly located within the buccal or middle one-third of the alveolar ridge, with an average height of coronal alveolar bone of 17.12 mm. Sex, age, side, and dentate status did not affect anterior loop prevalence and length. In conclusion, because of great variation, a case-by-case CBCT evaluation of the anterior loop is necessary before placing implants in the anterior mandible.
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Affiliation(s)
- Navin Raju
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, Texas
| | - Wenjian Zhang
- Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, Texas
| | - Aniket Jadhav
- Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, Texas
| | - Andreas Ioannou
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, Texas
| | - Sridhar Eswaran
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, Texas
| | - Robin Weltman
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, Texas
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Zasčiurinskienė E, Lund H, Lindsten R, Jansson H, Bjerklin K. Outcome of periodontal–orthodontic treatment in subjects with periodontal disease. Part II: a CBCT study of alveolar bone level changes. Eur J Orthod 2019; 41:565-574. [DOI: 10.1093/ejo/cjz039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
Aim
To examine alveolar bone level (ABL) changes before (T1) and after (T2) orthodontic treatment (OT) in subjects with periodontal disease.
Methods
The study included 50 subjects with periodontal disease. All patients received subgingival debridement following baseline examination. Control group patients received final periodontal treatment before the start of OT. For the test group patients final periodontal treatment was performed simultaneous to OT. OT was performed with a straight-wire appliance. Micro-implants or temporary crowns on implants were used for posterior anchorage when needed. ABL measurements of 3821 tooth surfaces were performed on cone beam computed tomography images.
Results
No difference was observed between mean ABL at T1 and T2. ABL remained unchanged on 69 per cent of surfaces. A mean of 15.6 (SD 7.4) per cent of surfaces experienced ABL gain, and a mean of 15.1 (SD 7.5) per cent was found with ABL loss. Small significant median ABL difference was observed on mesial and distal surfaces (P < 0.001). A significant difference was found between median ABL changes on mesial/distal in comparison to buccal/lingual surfaces (P < 0.01). Significantly more buccal (17.9 %) and lingual (18.5 %) surfaces experienced ABL loss when compared with mesial (11.3 %) and distal (12.0 %) surfaces (P < 0.001). Significant difference was found in the median ABL change of intruded (0.5 (IQR 0.94) mm) and non-intruded (−0.4 (IQR 1.07) mm) maxillary incisors (P = 0.04). Significant median ABL gain was found on the lingual surface of maxillary incisors, which were retroclined more than 8.6 degree and intruded more than 1.6 mm.
Conclusions
ABL changes after periodontal–orthodontic treatment in patients with periodontal disease were small. ABL gain was more observed on mesial and distal surfaces and ABL loss on buccal and lingual surfaces. Larger orthodontic movements of maxillary incisors influenced ABL gain.
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Affiliation(s)
- Eglė Zasčiurinskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Center for Oral Health, Jönköping University, Sweden
| | - Henrik Lund
- Department of Oral and Maxillofacial Radiology, Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - Rune Lindsten
- Center for Oral Health, Jönköping University, Sweden
- Departments of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Henrik Jansson
- Center for Oral Health, Jönköping University, Sweden
- Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Krister Bjerklin
- Departments of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden
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Eshraghi VT, Malloy KA, Tahmasbi M. Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease. Dent J (Basel) 2019; 7:dj7020057. [PMID: 31159356 PMCID: PMC6631177 DOI: 10.3390/dj7020057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/20/2022] Open
Abstract
The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.
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Affiliation(s)
- V Thomas Eshraghi
- Private Practice, Tualatin, OR 97062, USA.
- Private Practice, Beaverton, OR 97006, USA.
- Department of Periodontology, Oregon Health & Science University, Portland, OR 97201, USA.
| | | | - Mehrnaz Tahmasbi
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX 75246, USA.
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Shin MS, Kim YG, Shin YJ, Ko BJ, Kim S, Kim HD. Deep sequencing salivary proteins for periodontitis using proteomics. Clin Oral Investig 2018; 23:3571-3580. [PMID: 30554327 DOI: 10.1007/s00784-018-2779-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/05/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Saliva is a bodily fluid transuded from gingival crevice fluid and blood and contains many proteins. Proteins in saliva have been studied as markers for periodontal diseases. Mass spectrometric analysis is applied to investigate biomarker proteins that are related to periodontitis. MATERIAL AND METHODS Saliva samples were collected from 207 participants including 36 pairs matched for age, sex, and smoking who joined Yangpyeong health cohort. Periodontitis was defined by 2005 5th European guideline. Shotgun proteomics was applied to detect proteins from saliva samples. Principal component analysis and Ingenuity Pathway Analysis for canonical pathway and protein pathway were applied. Protein-protein interaction was also applied. Enzyme-linked immunosorbent assay (ELISA) was used to verify the candidate protein markers among another matched participants (n = 80). RESULTS Shotgun proteomics indicated that salivary S100A8 and S100A9 were candidate biomarkers for periodontitis. ELISA confirmed that both salivary S100A8 and S100A9 were higher in those with periodontitis compared to those without periodontitis (paired-t test, p < 0.05). CONCLUSION Our proteomics data showed that S100A8 and S100A9 in saliva could be candidate biomarkers for periodontitis. The rapid-test-kit using salivary S100A8 and S100A9 will be a practical tool for reducing the risk of periodontitis and promotion of periodontal health. CLINICAL RELEVANCE A rapid-test-kit using salivary biomarkers, S100A8 and S100A9, could be utilized by clinicians and individuals for screening periodontitis, which might reduce the morbidity of periodontitis and promote periodontal health.
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Affiliation(s)
- Myung-Seop Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Yun-Gon Kim
- Department of Chemical Engineering, Soongsil University, Seoul, South Korea
| | - Yoo Jin Shin
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
| | - Byoung Joon Ko
- New Drug Development Center, Osong Medical Innovation Foundation, Cheongju, South Korea
| | - Sungtae Kim
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, South Korea.,Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. .,Dental Research Institute, Seoul National University, Seoul, South Korea.
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16
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Comparison of cone-beam computed tomography with bitewing radiography for detection of periodontal bone loss and assessment of effects of different voxel resolutions: an in vitro study. Oral Radiol 2018; 35:177-183. [PMID: 30484193 DOI: 10.1007/s11282-018-0336-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/28/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of the study was to compare intraoral radiographs and CBCT images for detection of horizontal periodontal bone loss, and to investigate the diagnostic effect of different voxel resolutions in CBCT imaging. METHODS A total of 240 sites with horizontal bone loss were measured on the buccal, lingual, mesial, and distal surfaces of 60 posterior teeth in four maxillary and six mandibular bones obtained from cadavers (dry skulls). Direct measurements on the dry skulls were accepted as the gold standard values. Measurements on CBCT images at two different voxel resolutions (0.250 and 0.160 mm3) and intraoral bitewing radiographs were compared with one another and with the gold standard values. RESULTS The measurements on the CBCT images at two voxel resolutions and bitewing radiographs did not differ significantly (p > 0.05) from the direct measurements on the dry skulls. No significant difference was found between the bitewing radiographs and CBCT images for measurements in the mesial and distal regions (p > 0.05). There was no significant difference between the measurements on the buccal and lingual surfaces at the two different voxel resolutions (p > 0.05). CONCLUSIONS CBCT scans are recommended for evaluation of buccal and lingual bone loss to avoid intraoral radiographs that exceed routine examination of interproximal alveolar bone loss. Furthermore, instead of basing the voxel size on the required CBCT scans, it is recommended to select the smallest possible field of view to reduce the dose of radiation.
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17
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Zhang W, Foss K, Wang BY. A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography. BMC Oral Health 2018; 18:75. [PMID: 29724208 PMCID: PMC5934848 DOI: 10.1186/s12903-018-0544-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/27/2018] [Indexed: 11/29/2022] Open
Abstract
Background Accurate determination of bone loss at the molar furcation region by clinical detection and intraoral radiograph is challenging in many instances. Cone beam computed tomography (CBCT) is expected to open a new horizon in periodontal assessment. The purpose of this study was to compare and correlate accuracy of molar furcation assessment via clinical detection, intraoral radiography and CBCT images. Methods Eighty-three patients with chronic periodontitis who had existing CBCT scans were included. Furcation involvement was assessed on maxillary and mandibular first molars. Periodontal charts (modified Glickman’s classification), intraoral (periapical and/or bitewing) radiographs (recorded as presence or absence) and axial CBCT reconstructions were used to evaluate furcation involvement on buccal and palatal/lingual sites. The correlation of furcation assessment by the three methods was evaluated by Pearson analysis. Results There were significant correlations (p < 0.05) between clinical detection and intraoral radiography, clinical detection and CBCT, as well as intraoral radiography and CBCT at all the measured sites (r values range between 0.230 to 0.644). CBCT generally exhibited higher correlation with clinical detection relative to intraoral radiography, especially at distal palatal side of maxillary first molar (p < 0.05). In addition, CBCT provided more accurate assessment, with bone loss measurement up to 2 decimals in millimeters, whereas clinical detection had 3 classes and the intraoral radiographs usually only detected the presence of furcation involvement in Glickman Class 2 and 3. Conclusions This study validates that CBCT is a valuable tool in molar furcation assessment in addition to clinical detection and intraoral radiography.
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Affiliation(s)
- Wenjian Zhang
- Department of Diagnostic & Biomedical Sciences, University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA.
| | - Keagan Foss
- University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA
| | - Bing-Yan Wang
- Department of Periodontics & Dental Hygiene, University of Texas School of Dentistry at Houston, 7500 Cambridge Street, Houston, TX, 77054, USA
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18
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Rams TE, Listgarten MA, Slots J. Radiographic alveolar bone morphology and progressive periodontitis. J Periodontol 2018; 89:424-430. [DOI: 10.1002/jper.17-0279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/30/2017] [Accepted: 10/01/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA
- Department of Microbiology and Immunology; Temple University School of Medicine; Philadelphia PA
| | - Max A. Listgarten
- Department of Periodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA
| | - Jørgen Slots
- Division of Periodontology; Diagnostic Sciences and Dental Hygiene; University of Southern California School of Dentistry; Los Angeles CA
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19
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Haas LF, Zimmermann GS, De Luca Canto G, Flores-Mir C, Corrêa M. Precision of cone beam CT to assess periodontal bone defects: a systematic review and meta-analysis. Dentomaxillofac Radiol 2017; 47:20170084. [PMID: 28869397 DOI: 10.1259/dmfr.20170084] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard (in situ measurement). METHODS Studies in which the main objective was to evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard were selected. Four databases were searched. The studies were selected by two independent reviewers. The methodology of selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. The quality of evidence and strength of recommendation was assessed by The Grading of Recommendations Assessment Tool, Development and Evaluation. RESULTS Using a selection process in two phases, 16 studies were identified and, in seven articles meta-analysis was performed. The results from these meta-analyses showed that no difference between the measurements of CBCT and in situ for alveolar bone loss, and demonstrated a concordance of 82.82% between CBCT and in situ for the classification of the degree of furcation involvement. CONCLUSIONS Based on a moderate level of evidence, CBCT could be useful for furcation involvement periodontal cases, but it should only be used in cases where clinical evaluation and conventional radiographic imaging do not provide the information necessary for an adequate diagnosis and proper periodontal treatment planning.
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Affiliation(s)
- Letícia Fernanda Haas
- 1 Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - G De Luca Canto
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil.,3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- 3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Márcio Corrêa
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
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20
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Zhang W, Rajani S, Wang BY. Comparison of periodontal evaluation by cone-beam computed tomography, and clinical and intraoral radiographic examinations. Oral Radiol 2017; 34:208-218. [PMID: 30484028 DOI: 10.1007/s11282-017-0298-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/12/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Cone-beam computed tomography (CBCT) has been widely used in many fields of dentistry. However, little is known about the accuracy of CBCT for evaluation of periodontal status. The objective of this study was to compare and correlate periodontal assessments among CBCT, clinical attachment loss (CAL) measurement, and periapical (PA)/bitewing (BW) radiography. METHODS Eighty patients (28 males, 52 females; age range, 19-84 years) from the University of Texas School of Dentistry at Houston were evaluated retrospectively. Measurements were taken on the central incisors, canines, and first molars of the right maxilla and left mandible. CAL was extracted from periodontal charts. The radiographic distance from the cementum-enamel junction (CEJ) to the alveolar crest was measured for tooth mesial and distal sites on PA/BW and CBCT images using MiPacs software and Anatomage Invivo software, respectively. One-way ANOVA and Pearson analysis were performed for statistical analyses. RESULTS The CEJ-crest distances for CBCT, PA/BW, and CAL were 2.56 ± 0.12, 2.04 ± 0.12, and 2.08 ± 0.17 mm (mean ± SD), respectively. CBCT exhibited larger values than the other two methods (p < 0.05). There were highly significant positive correlations among CBCT, PA/BW, and CAL measurements at all examined sites (p < 0.001). The Pearson correlation coefficient was higher for CBCT with CAL relative to PA/BW with CAL, but the difference was not significant (r = 0.64 and r = 0.55, respectively, p > 0.05). CONCLUSIONS This study validates the suitability of CBCT for periodontal assessment. Further studies are necessary to optimize the measurement methodology with CBCT.
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Affiliation(s)
- Wenjian Zhang
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 5366, Houston, TX, 77054, USA.
| | - Shazia Rajani
- Dental Hygiene Program, School of Dentistry, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 5366, Houston, TX, 77054, USA
| | - Bing-Yan Wang
- Department of Periodontics and Dental Hygiene, School of Dentistry, University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 5366, Houston, TX, 77054, USA
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21
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Anter E, Zayet MK, El-Dessouky SH. Accuracy and precision of cone beam computed tomography in periodontal defects measurement (systematic review). J Indian Soc Periodontol 2016; 20:235-43. [PMID: 27563194 PMCID: PMC4976541 DOI: 10.4103/0972-124x.176389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 01/07/2016] [Indexed: 02/06/2023] Open
Abstract
Systematic review of literature was made to assess the extent of accuracy of cone beam computed tomography (CBCT) as a tool for measurement of alveolar bone loss in periodontal defect. A systematic search of PubMed electronic database and a hand search of open access journals (from 2000 to 2015) yielded abstracts that were potentially relevant. The original articles were then retrieved and their references were hand searched for possible missing articles. Only articles that met the selection criteria were included and criticized. The initial screening revealed 47 potentially relevant articles, of which only 14 have met the selection criteria; their CBCT average measurements error ranged from 0.19 mm to 1.27 mm; however, no valid meta-analysis could be made due to the high heterogeneity between the included studies. Under the limitation of the number and strength of the available studies, we concluded that CBCT provides an assessment of alveolar bone loss in periodontal defect with a minimum reported mean measurements error of 0.19 ± 0.11 mm and a maximum reported mean measurements error of 1.27 ± 1.43 mm, and there is no agreement between the studies regarding the direction of the deviation whether over or underestimation. However, we should emphasize that the evidence to this data is not strong.
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Affiliation(s)
- Enas Anter
- Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Mohammed Khalifa Zayet
- Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Sahar Hosny El-Dessouky
- Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Charavet C, Lecloux G, Bruwier A, Rompen E, Maes N, Limme M, Lambert F. Localized Piezoelectric Alveolar Decortication for Orthodontic Treatment in Adults: A Randomized Controlled Trial. J Dent Res 2016; 95:1003-9. [PMID: 27129491 DOI: 10.1177/0022034516645066] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This randomized controlled trial aimed to evaluate the benefits and clinical outcomes of piezocision, which is a minimally invasive approach to corticotomy that is used in orthodontic treatments. Twenty-four adult patients presenting with mild overcrowdings were randomly allocated to either a control group that was treated with conventional orthodontics or a test group that received piezo-assisted orthodontics. The piezocisions were performed 1 wk week after the placement of the orthodontic appliances. Neither grafting material nor sutures were used. All patients were followed every 2 wk, and archwires were changed only when they were no longer active. The periods required for the completion of the overall orthodontic treatments were calculated, and the periodontal parameters were evaluated at baseline and at the end of the orthodontic treatment. Patient-centered outcomes were assessed with a visual analog scale; analgesic use following the procedures was also recorded. The patient characteristics were similar between the 2 groups. The overall treatment time was significantly reduced by 43% in the piezocision group as compared with the control group. In both groups, periodontal parameters (i.e., recession depth, pocket depth, plaque index, and papilla bleeding index) remained unchanged between the baseline and treatment completion time points. No increase in root resorption was observed in either group. Scars were observed in 50% of the patients in the piezocision group. Analgesic consumption was similar following orthodontic appliance placement and piezocision surgery. Patient satisfaction was significantly better in the piezocision group than in the control group. In these conditions, the piezocision technique seemed to be effective in accelerating orthodontic tooth movement. No gingival recessions were observed. The risk of residual scars might limit the indications for piezocision in patients with a high smile line (ClinicalTrials.gov NCT02590835).
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Affiliation(s)
- C Charavet
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium
| | - G Lecloux
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
| | - A Bruwier
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium
| | - E Rompen
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
| | - N Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liège, University of Liège, Belgium
| | - M Limme
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium
| | - F Lambert
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
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Guo YJ, Ge ZP, Ma RH, Hou JX, Li G. A six-site method for the evaluation of periodontal bone loss in cone-beam CT images. Dentomaxillofac Radiol 2015; 45:20150265. [PMID: 26509657 DOI: 10.1259/dmfr.20150265] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES In contrast to two-dimensional planar images, a measuring point is hardly repeatedly determined in a CBCT image when alveolar bone loss is assessed. Thus, the aim of the present study was to propose a six-site measuring method, which is closely related to anatomical structure, for the evaluation of alveolar bone loss in CBCT images. METHODS 150 measuring points in 11 molars and 14 premolars from 6 patients (2 males and 4 females) were included. CBCT images of the teeth were acquired prior to periodontal surgery. Four observers measured the distances between cemento-enamel junctions and the apical bases of the periodontal bone defect at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal and disto-lingual/palatal sites in CBCT images. Direct measurements of the six sites were correspondingly obtained in the subsequent periodontal surgeries. Differences between the distances measured in the CBCT images and during the surgery were analysed. Interobserver and intraobserver variances were tested. RESULTS No statistically significant difference was found between the surgical and CBCT measurements (p = 0.84). Diagnostic coincidence rates of four observers were 86.7%, 87.3%, 88.7% and 88.0%, respectively. The interobserver (p = 0.95) and intraobserver (p = 0.30) variances were not significant. CONCLUSIONS The six-site measuring method validated in the present study may be a useful three-dimensional measuring method for the evaluation of periodontal disease.
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Affiliation(s)
- Yu-Jiao Guo
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Zhi-pu Ge
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Ruo-han Ma
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Jian-xia Hou
- 2 Department of Periodontology, Outpatient Center, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Gang Li
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
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24
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Zhao H, Li C, Lin L, Pan Y, Wang H, Zhao J, Tan L, Pan C, Song J, Zhang D. Assessment of Alveolar Bone Status in Middle Aged Chinese (40-59 Years) with Chronic Periodontitis--Using CBCT. PLoS One 2015; 10:e0139553. [PMID: 26431206 PMCID: PMC4592243 DOI: 10.1371/journal.pone.0139553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/14/2015] [Indexed: 11/18/2022] Open
Abstract
Objective This study used con-beam computed tomography (CBCT) to investigate the prevalence and severity of alveolar bone loss in middle-aged (40–59 years) Chinese with chronic periodontitis. Materials and Methods The study group comprised 145 dentate individuals aged 40 to 59 years residing in China who suffered from chronic periodontitis. CBCT and the application of NNT software were used to examine the level and location of alveolar bone loss. Results The study revealed that 40–59 year old patients with chronic periodontitis had severe bone loss. At 5,286 sites (34.7%), alveolar bone loss was mild; severe alveolar bone loss was found at 5,978 sites (39.2%). A comparison of bone loss in different jaws revealed that the area with the highest degree of bone loss was on the lingual side of the maxillary molar (56.3 ± 7.2%), and that the area with the lowest degree was primarily on the lingual side of the mandibular canine (27.5 ± 6.3%). There was a lower degree of alveolar bone loss in males than females. Differences were observed when comparing the incidence of bone loss between males and females (P < 0.05). Menopause in females and smoking in both genders may affect the level of bone loss. Male smokers experienced a greater degree of bone loss (41.67 ± 5.76%) than male non-smokers (32.95 ± 4.31%). A 42.23 ± 6.34% bone loss was found in menopausal females versus 31.35 ± 3.62% in non-menopausal females. Conclusions The study revealed that different sites and teeth exhibited a diverse degree of bone loss. In middle-aged patients with chronic periodontitis, the highest degrees of bone loss in the incisors, premolars, and molars were on the lingual side, mesial side and lingual side, respectively. Menopause in females and smoking may affect the level of bone loss.
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Affiliation(s)
- Haijiao Zhao
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Chen Li
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Li Lin
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Yaping Pan
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
- * E-mail: ;
| | - Hongyan Wang
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Jian Zhao
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Lisi Tan
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Chunling Pan
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Jia Song
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
| | - Dongmei Zhang
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, No.117, Nanjing North Street, Heping District, Shenyang, Liaoning, People’s Republic of China
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Castro-Ruiz CT, Noriega J, Guerrero ME. Validity of ridge mapping and cone beam computed tomography in dental implant therapy. J Indian Soc Periodontol 2015; 19:290-3. [PMID: 26229269 PMCID: PMC4520113 DOI: 10.4103/0972-124x.154189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 02/09/2015] [Indexed: 11/04/2022] Open
Abstract
AIM The purpose of this study was to compare the validity of alveolar ridge measurements obtained with ridge mapping (RM) technique against cone beam computed tomography (CBCT) measurements. MATERIALS AND METHODS Twenty partially edentulous patients were recruited for implant placement in the Clinic of San Martin de Porres University. For all the measurements, a vacuum-formed stent was fabricated for each subject. A buccal and lingual point was made in the stent to provide a reference of measurement for each implant site. RM measurements with the stent were obtained before and after surgical flap reflection. Two calibrated observers made the CBCT images measurements. T-test was used for the statistical analysis. Values <0.05 were considered statistically significant. Also, specificity and sensibility of CBCT and RM were compared. Intra-class correlation coefficient (ICC)_ was measure between CBCT measurements. RESULTS A total of 62 implants sites were evaluated. No statistical significant differences were obtained with CBCT and RM measurements (P = 0,207). Detecting proper buccal-lingual ridge, the sensitivity and specificity were 59% and 91% for RM while CBCT obtained 92% of sensitivity and 94% of specificity. Concordance was found "good" (ICC 0.82). CONCLUSION Both methods provide valid measurements. Even though, we found diagnostic limitations in the RM, it demonstrated to be a useful method for its exactitude, low cost, the immediate result and no need of radiation. CBCT was recommended when the bone ridge width and height were in the less than ideal for conventional dental implant placement.
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Affiliation(s)
- Carmen Teresa Castro-Ruiz
- Specialty of Periodontics and Dental Implants, Cientifica del Sur University, Lima, Perú ; Specialty of Periodontics, San Martín de Porres University, Lima, Perú
| | - Jorge Noriega
- Specialty of Periodontics, San Martín de Porres University, Lima, Perú
| | - Maria Eugenia Guerrero
- Specialty of Periodontics and Dental Implants, Cientifica del Sur University, Lima, Perú
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Bagis N, Kolsuz ME, Kursun S, Orhan K. Comparison of intraoral radiography and cone-beam computed tomography for the detection of periodontal defects: an in vitro study. BMC Oral Health 2015; 15:64. [PMID: 26016804 PMCID: PMC4446848 DOI: 10.1186/s12903-015-0046-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/12/2015] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) unit with digital intraoral radiography technique for detecting periodontal defects. Methods The study material comprised 12 dry skulls with maxilla and mandible. Artificial defects (dehiscence, tunnel, and fenestration) were created on anterior, premolar and molar teeth separately using burs. In total 14 dehiscences, 13 fenestrations, eight tunnel and 16 without periodontal defect were used in the study. These were randomly created on dry skulls. Each teeth with and without defects were images at various vertical angles using each of the following modalities: a Planmeca Promax Cone Beam CT and a Digora photostimulable phosphor plates. Specificity and sensitivity for assessing periodontal defects by each radiographic technique were calculated. Chi-square statistics were used to evaluate differences between modalities. Kappa statistics assessed the agreement between observers. Results were considered significant at P < 0.05. Results The kappa values for inter-observer agreement between observers ranged between 0.78 and 0.96 for the CBCT, and 0.43 and 0.72 of intraoral images. The Kappa values for detecting defects on anterior teeth was the least, following premolar and molar teeth both CBCT and intraoral imaging. Conclusions CBCT has the highest sensitivity and diagnostic accuracy for detecting various periodontal defects among the radiographic modalities examined.
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Affiliation(s)
- Nilsun Bagis
- Faculty of Dentistry, Department of Periodontology, Ankara University, 06560, Besevler, Ankara, Turkey.
| | - Mehmet Eray Kolsuz
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, 06560, Ankara, Turkey.
| | - Sebnem Kursun
- Ministry of Health, Bolu Oral and Dental Health Centre, 14000, Bolu, Turkey.
| | - Kaan Orhan
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, 06560, Ankara, Turkey.
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Grover V, Malhotra R, Kapoor A, Mankotia CS, Bither R. Correlation of the interdental and the interradicular bone loss: A radiovisuographic analysis. J Indian Soc Periodontol 2014; 18:482-7. [PMID: 25210264 PMCID: PMC4158591 DOI: 10.4103/0972-124x.138701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 12/09/2013] [Indexed: 11/22/2022] Open
Abstract
Background: Presence of furcation involvement indicates advanced periodontitis, and a potentially less-favorable prognosis, for the affected tooth and its diagnosis has always been an enigma. The present study was carried out to measure and correlate the interdental and interradicular bone loss in patients suffering from periodontitis using radiovisuography (RVG) for the purpose of early furcation diagnosis. Materials and Methods: A total of 50 patients suffering from chronic generalized periodontitis and with furcation involvement in mandibular molars were selected. Under standardized conditions, RVGs were taken and the morphologic measurements defining the furcation areas were recorded and analyzed. Result: Interradicular bone loss of about 0.8 mm or more, was observed in the study subjects only when the bone loss at the interdental area was minimal of 3.7 mm. The correlation between the interradicular and the interdental bone loss was statistically highly significant (T-test, P < 0.001). A stronger correlation was observed in subjects above 40 years of age as compared with the younger subjects. There was not much difference in the degree of correlation between the interradicular and the interdental bone loss when compared in the context of gender. Conclusion: The very first millimeter of interradicular bone loss was seen when the interdental bone loss was around 4 mm. Therefore, to detect the earliest lesions of furcations, the interdental bone loss can be kept as an approximate guide for the comprehensive diagnosis and management of such sites/patients. The current investigation paves the path for future longitudinal studies with larger samples to ascertain these findings.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Ranjan Malhotra
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Anoop Kapoor
- Department of Periodontics and Oral Implantology, M.N.D.A.V Dental college and Hospital, Solan, Himachal Pradesh, India
| | - Chahat Singh Mankotia
- Department of Periodontics and Oral Implantology, National Dental College and Hospital, Gulabgarh, Derabassi, Punjab, India
| | - Rupika Bither
- Department of Periodontics and Oral Implantology, Laxmi Bai Dental College, Patiala, Punjab, India
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Diagnostic Applications of Cone-Beam CT for Periodontal Diseases. Int J Dent 2014; 2014:865079. [PMID: 24803932 PMCID: PMC3997156 DOI: 10.1155/2014/865079] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/03/2014] [Indexed: 01/31/2023] Open
Abstract
Objectives. This paper aims to review the diagnostic application of cone beam computed tomography (CBCT) in the field of periodontology. Data. Original articles that reported on the use of CBCT for periodontal disease diagnosis were included. Sources. MEDLINE (1990 to January 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “CBCT,” “volumetric CT,” “periodontal disease ,” and “periodontitis.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. Bony defects, caters, and furcation involvements seem to be better depicted on CBCT, whereas bone quality and periodontal ligament space scored better on conventional intraoral radiography. CBCT does not offer a significant advantage over conventional radiography for assessing the periodontal bone levels.
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Graetz C, Plaumann A, Wiebe JF, Springer C, Sälzer S, Dörfer CE. Periodontal probing versus radiographs for the diagnosis of furcation involvement. J Periodontol 2014; 85:1371-9. [PMID: 24605872 DOI: 10.1902/jop.2014.130612] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Decisions in periodontal therapy for multirooted teeth are essentially based on accurate diagnosis of the furcation involvement (FI). Furcation probing (FP) is still the basic diagnostic measure, although the assessment may be difficult. The aim of this study is to evaluate the validity of FP and radiographic assessment of FI compared with visual assessment during open flap surgery (OFS). METHODS In this retrospective clinical cohort study, 215 participants with periodontal disease and at least one molar treated with OFS were enrolled, and a total of 834 molars were assigned for FI by FP and in radiographs analyzed by an experienced (EE) and less experienced examiner (LE). For the investigation, 143 panoramic radiographs (OPGs) and 77 intra-oral radiographs (I-Os) were evaluated. RESULTS The Class of FI by FP was confirmed in 56%, whereas 15% were overestimated and 29% underestimated. FI Class 0 and I had been detected with high probability (74% and 54%, respectively). Of all FI Class III, 57% were detected correctly by radiographs and 32% by FP. FP and OFS revealed a weighted κ-coefficient (κw) = 0.588; radiographs and OFS had κw = 0.542 (OPG κw = 0.555 and I-O κw = 0.521). The interrater reliability for radiographs was dependent on the experience of the examiner (EE κw = 0.618; LE κw = 0.426). CONCLUSIONS Experience in analyzing conventional radiographs increases the potential of correct diagnosis of advanced FI. The reliability of FP compared with radiographic assessment depends on the anatomy and location of the tooth. Both diagnostic tools should be used in cases of suspected FI.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
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Gundannavar G, Chinni DD, Alampalli RV. Ridge Preservation done Immediately following Extraction using Bovine Bone Graft, Collagen Plug and Collagen Membrane. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10012-1058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Semenoff L, Semenoff TAD, Pedro FLM, Volpato ER, Machado MADAM, Borges AH, Semenoff-Segundo A. Are panoramic radiographs reliable to diagnose mild alveolar bone resorption? ISRN DENTISTRY 2011; 2011:363578. [PMID: 21991470 PMCID: PMC3169835 DOI: 10.5402/2011/363578] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 03/21/2011] [Indexed: 11/24/2022]
Abstract
It is extremely important to assess variations between the most used radiographs in dental practice, since minimum distortion on obtained images may change diagnosis, treatment plan, and prognosis for the patient. For this, the distance between the enamel-cementum junction and the alveolar bone crest was measured on conventional and digitized periapical, bitewing, and panoramic radiographs and compared among them. From a total of 1484 records, 39 sets of radiographs that fulfilled the inclusion criteria of the study sample were selected. The measurements were grouped according to the intensity of bone loss. Statistically significant difference was found in the averages of the measurements assessed in radiographs with absence of bone loss between conventional panoramic and periapical radiographs, between digitized panoramic and periapical radiographs and between digitized bitewing and panoramic radiographs. By analyzing the results of this work and considering the research protocol used, one can conclude that small losses in height of alveolar bone crest observed in panoramic radiographs should be cautiously evaluated, as they may be overestimated.
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Affiliation(s)
- Larissa Semenoff
- Department of Radiology, Especialista em Radiologia, UNIDERP, Rua Ceará 333, 79003-010 Campo Grande, MS, Brazil
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Choi YJ, Heo SH, Lee JM, Cho JY. Identification of azurocidin as a potential periodontitis biomarker by a proteomic analysis of gingival crevicular fluid. Proteome Sci 2011; 9:42. [PMID: 21794177 PMCID: PMC3162872 DOI: 10.1186/1477-5956-9-42] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 07/28/2011] [Indexed: 11/18/2022] Open
Abstract
Background The inflammatory disease periodontitis results in tooth loss and can even lead to diseases of the whole body if not treated. Gingival crevicular fluid (GCF) reflects the condition of the gingiva and contains proteins transuded from serum or cells at inflamed sites. In this study, we aimed to discover potential protein biomarkers for periodontitis in GCF proteome using LC-MS/MS. Results We identified 305 proteins from GCF of healthy individuals and periodontitis patients collected using a sterile gel loading tip by ESI-MS/MS coupled to nano-LC. Among these proteins, about 45 proteins were differentially expressed in the GCF proteome of moderate periodontitis patients when compared to the healthy individuals. We first identified azurocidin in the GCF, but not the saliva, as an upregulated protein in the periodontitis patients and verified its increased expression during periodontitis by ELISA using the GCF of the classified periodontitis patients compared to the healthy individuals. In addition, we found that azurocidin inhibited the differentiation of bone marrow-derived macrophages to osteoclasts. Conclusions Our results show that GCF collection using a gel loading tip and subsequent LC-MS/MS analysis following 1D-PAGE proteomic separation are effective for the analysis of the GCF proteome. Our current results also suggest that azurocidin could be a potential biomarker candidate for the early detection of inflammatory periodontal destruction by gingivitis and some chronic periodontitis. Our data also suggest that azurocidin may have an inhibitory role in osteoclast differentiation and, thus, a protective role in alveolar bone loss during the early stages of periodontitis.
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Affiliation(s)
- Young-Jin Choi
- Department of Biochemistry, School of Dentistry, Kyungpook National University, Daegu, Korea.
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Kämmerer PW, Lehmann KM, Karbach J, Wegener J, Al-Nawas B, Wagner W. Prevalence of Peri-implant Diseases Associated with a Rough-Surface Dental Implant System: 9 Years after Insertion. ACTA ACUST UNITED AC 2011. [DOI: 10.5005/jp-journals-10012-1049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kotsakis G, Chrepa V, Katta S. Practical Application of the Newly Introduced Natural Bone Regeneration (NBR) Concept Utilizing Alloplastic Putty. ACTA ACUST UNITED AC 2011. [DOI: 10.5005/jp-journals-10012-1051] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
Before any orthodontic treatment can begin, it is essential that the patient's periodontium be in sound condition, capable of responding to the movement of teeth in a healthy fashion. Inspection of the dentition, palpation of tissues, and careful study of adequate X-Rays are all necessary for establishing a diagnosis, but review of the depth of gingival pockets with periodontal probes is the key procedure for avoiding blunders in treatment. After periodontal health has been validated, it is vital that orthodontists determine the patient's periodontal biotype by clinical observation and periodontal probing and assess the quality of the gingival attachments of the teeth that will be affected by the expansion forces of treatment. The ensemble of these criteria will dictate what treatment paths and forces the orthodontist will employ.
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Affiliation(s)
- Solenn Hourdin
- 16 bis rue Saint Melaine, place Hoche, 35000 Rennes, France.
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Vandenberghe B, Jacobs R. The influence of tube potential on periodontal bone level measurements and subjective image quality using a digital photostimulable storage phosphor sensor. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2010; 1:e5. [PMID: 24421961 PMCID: PMC3886041 DOI: 10.5037/jomr.2010.1105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 12/18/2009] [Indexed: 01/05/2023]
Abstract
Objectives The purpose of the present study was to determine
the measurement accuracy and subjective image quality for periodontal disease diagnosis
when using two X-ray tube voltages with a digital photostimulable storage phosphor
sensor. Material and Methods A digital photostimulable storage phosphor
(PSP) sensor (Vistascan) and a multipulse X-ray generator (Prostyle Intra) with
two tube voltages were used in this study. The front, premolar and molar region
of two adult human cadaver skulls jaws were imaged using the X-ray tube at 63 kV
and 70 kV, both at 8 mA and decreasing exposure times (160 ms, 120 ms and 80 ms).
A standardized exposure protocol containing waxed occlusal keys and an aiming device
ensured proper and reproducible beam alignment. Three observers assessed the digital
radiographs for 31 selected periodontal bone loss sites. Radiographic measurements
were compared to physical measurements (Standard). Subjective ratings of lamina
dura, crater defect and furcation involvement visibility, contrast perception
and bone quality were also performed. Results Multiple regression equation of the variables kV and
exposure time demonstrated no significant difference for the periodontal bone level
measurements (P > 0.05). In 90.3% and 96.7% of the measurements for 70 kV and 63
kV respectively, deviation was within 1 mm. The subjective ratings produced similar
findings in terms of image quality for both tube voltages and the three exposure
times. Conclusions The results of the present study revealed that tube
voltages of 63 kV and 70 kV provided similar accuracy and image quality for periodontal
disease diagnosis.
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Affiliation(s)
- Bart Vandenberghe
- Oral Imaging Center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
| | - Reinhilde Jacobs
- Oral Imaging Center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
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Moreira CHC, Zanatta FB, Antoniazzi R, Meneguetti PC, Rösing CK. Criteria adopted by dentists to indicate the extraction of periodontally involved teeth. J Appl Oral Sci 2009; 15:437-41. [PMID: 19089175 PMCID: PMC4327266 DOI: 10.1590/s1678-77572007000500012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 08/21/2007] [Indexed: 11/22/2022] Open
Abstract
When dealing with patients with periodontal disease of variable severities, dentists must often choose between treating and restoring the involved tooth or indicating its extraction. Different criteria have been adopted in this decision-making process. The purpose of this study was to evaluate the criteria adopted by dentists to indicate the extraction of teeth with periodontitis. Dentists were interviewed at their private practices in three cities of the state of Rio Grande do Sul, Brazil. The evaluated criteria included severity of attachment loss, tooth mobility, furcation involvement, prosthetic planning, periodontal-endodontic lesion, possible systemic involvement due to the presence of periodontitis, referral to a periodontist for evaluation, radiographic bone loss greater than 50%, presence of extensive caries, socio-economic and cultural status of the patient, among others. The most often adopted criteria to indicate the extraction of periodontally affected teeth were the presence of mobility (37.5%), severity of attachment loss (24.3%) and radiographic bone loss greater than 50% (21.2%). The results of the present study demonstrated the difficulties faced by dentists to indicate the extraction of teeth with severe attachment loss, in addition to the establishment of an adequate prognosis. Aspects associated with the past disease were still the most often reported to indicate the extraction of teeth for periodontal reasons.
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Corbet EF, Ho DKL, Lai SML. Radiographs in periodontal disease diagnosis and management. Aust Dent J 2009; 54 Suppl 1:S27-43. [DOI: 10.1111/j.1834-7819.2009.01141.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Demmer RT, Behle JH, Wolf DL, Handfield M, Kebschull M, Celenti R, Pavlidis P, Papapanou PN. Transcriptomes in healthy and diseased gingival tissues. J Periodontol 2009; 79:2112-24. [PMID: 18980520 DOI: 10.1902/jop.2008.080139] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Clinical and radiographic measures are gold standards for diagnosing periodontitis but offer little information regarding the pathogenesis of the disease. We hypothesized that a comparison of gene expression signatures between healthy and diseased gingival tissues would provide novel insights in the pathobiology of periodontitis and would inform the design of future studies. METHODS Ninety systemically healthy non-smokers with moderate to advanced periodontitis (63 with chronic periodontitis and 27 with aggressive periodontitis) each contributed at least two diseased interproximal papillae (with bleeding on probing [BOP], probing depth [PD] > or =4 mm, and attachment loss [AL] > or =3 mm) and a healthy papilla, if available (no BOP, PD < or =4 mm, and AL < or =2 mm). RNA was extracted, amplified, reverse-transcribed, labeled, and hybridized with whole genome microarrays. Differential expression was assayed in 247 individual tissue samples (183 from diseased sites and 64 from healthy sites) using a standard mixed-effects linear model approach, with patient effects considered random with a normal distribution and gingival tissue status considered a two-level fixed effect. Gene ontology analysis classified the expression patterns into biologically relevant categories. RESULTS Transcriptome analysis revealed that 12,744 probe sets were differentially expressed after adjusting for multiple comparisons (P <9.15 x 10(7)). Of those, 5,295 were upregulated and 7,449 were downregulated in disease compared to health. Gene ontology analysis identified 61 differentially expressed groups (adjusted P <0.05), including apoptosis, antimicrobial humoral response, antigen presentation, regulation of metabolic processes, signal transduction, and angiogenesis. CONCLUSION Gingival tissue transcriptomes provide a valuable scientific tool for further hypothesis-driven studies of the pathobiology of periodontitis.
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Affiliation(s)
- Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Nackaerts O, Jacobs R, Quirynen M, Rober M, Sun Y, Teughels W. Replacement therapy for periodontitis: pilot radiographic evaluation in a dog model. J Clin Periodontol 2008; 35:1048-52. [DOI: 10.1111/j.1600-051x.2008.01333.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vandenberghe B, Jacobs R, Yang J. Detection of periodontal bone loss using digital intraoral and cone beam computed tomography images: an in vitro assessment of bony and/or infrabony defects. Dentomaxillofac Radiol 2008; 37:252-60. [PMID: 18606746 DOI: 10.1259/dmfr/57711133] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To explore the diagnostic values of digital intraoral radiography and cone beam CT (CBCT) in the determination of periodontal bone loss, infrabony craters and furcation involvements. METHODS Accuracy assessment of the imaging modalities was conducted through bone level measurements, infrabony crater and furcation involvement classifications. For CBCT, images were obtained at 120 kV and 23.87 mAs, and observations were made on a 5.2 mm panoramic reconstruction view and on 0.4 mm thick cross-sectional slices. Intraoral radiographs of a size 2 charge-coupled device (CCD) sensor were obtained using the paralleling technique, at 60 kV (DC) and 0.28 mAs exposure. 71 human cadaver and dry skull bony defects were measured and evaluated by 3 observers. Comparison was made with the gold standard. RESULTS The mean error (gold standard deviation) of bone level measurements was 0.56 mm for intraoral radiography and 0.47 mm for the CBCT panoramic 5.2 mm reconstruction view. There were no significant differences (P = 0.165) between the two methods. However, on 0.4 mm thick cross-sections, the mean error was 0.29 mm and the Wilcoxon signed-rank test indicated a significant difference when compared with the CCD (P = 0.006). The detection of crater and furcation involvements failed in 29% and 44% for the CCD, respectively, in contrast to 100% detectability for both defects with CBCT. CONCLUSIONS CBCT on the panoramic 5.2 mm reconstruction view allowed comparable measurements of periodontal bone levels and defects as with intraoral radiography. CBCT with 0.4 mm thick cross-sections demonstrated values closer to the gold standard, indicating more accurate assessment of periodontal bone loss. Further research is needed to explore these results in vivo and to determine the use of CBCT in periodontal diagnosis.
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Affiliation(s)
- B Vandenberghe
- Oral Imaging Centre, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium
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Kim TS, Obst C, Zehaczek S, Geenen C. Detection of Bone Loss With Different X-Ray Techniques in Periodontal Patients. J Periodontol 2008; 79:1141-9. [PMID: 18597595 DOI: 10.1902/jop.2008.070578] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ti-Sun Kim
- Section of Periodontology, Department of Operative Dentistry, University Medical Hospital, Heidelberg, Heidelberg, Germany.
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Vandenberghe B, Jacobs R, Yang J. Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown. ACTA ACUST UNITED AC 2007; 104:395-401. [PMID: 17613257 DOI: 10.1016/j.tripleo.2007.03.012] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Revised: 01/06/2007] [Accepted: 03/13/2007] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of this study was to compare 2-dimensional intraoral digital images with 3-dimensional cone beam CT (CBCT) in assessment of periodontal bone levels and defects. METHODS Thirty periodontal bone defects of 2 adult human skulls (with soft tissue or substitute) were evaluated by using intraoral digital radiography and CBCT. Digital radiographs were made with a size #2 CCD sensor and a 60-kV DC x-ray unit, with 0.28, 0.42, or 0.56 mAs as respective exposure settings. For CBCT, jawbone images were obtained at 120 kV and 23.87 mAs. Periodontal bone levels and defects on both imaging modalities were assessed and compared to the gold standard. Delineation of lamina dura, crater defect, furcation involvements, contrast, and bone quality were also analyzed. RESULTS Linear measurement deviations of periodontal bone levels from the gold standard ranged from 0.19 to 1.66 mm for intraoral radiography versus 0.13 to 1.67 mm for CBCT. Accuracy was not significantly different between both imaging modalities (P = .161). Intraoral radiography scored significantly better for contrast, bone quality, and delineation of lamina dura, but CBCT was superior for assessing crater defects and furcation involvements (P = .018). CONCLUSIONS CBCT images allowed comparable measurements of periodontal bone levels and defects as intraoral radiography. CBCT images demonstrated more potential in the morphological description of periodontal bone defects, while the digital radiography provided more bone details. These findings may offer perspectives for further studies on periodontal diagnostics, prognostics, and presurgical planning with CBCT.
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Affiliation(s)
- Bart Vandenberghe
- Oral Imaging Centre, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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Affiliation(s)
- Andrea Mombelli
- Department of Periodontology and Oral Pathophysiology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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