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Etemad L, Mehta S, Lurie AG, Tadinada A. Prevalence and Clinical Significance of Incidental Findings in the Maxillofacial Complex of Adolescent Orthodontic Patients: A Retrospective Cone Beam Computed Tomography Analysis. Cureus 2023; 15:e47480. [PMID: 38022275 PMCID: PMC10663048 DOI: 10.7759/cureus.47480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence and severity of incidental findings in the maxillofacial complex of orthodontic patients imaged with cone beam computed tomography (CBCT) and assign those findings an appropriate clinical significance. METHODOLOGY Incidental findings (IF) were identified in 250 CBCT scans of adolescent orthodontic patients (aged 13-18 years) with a large field-of-view and categorized based on their anatomic location and placed into one of six subgroups based on anatomic region: i) sino-nasal, ii) dentoalveolar, iii) nasooropharyngeal airway, iv) temporomandibular joint, v) neck, vi) calcifications, and vi) miscellaneous findings. Additionally, findings were assigned a clinical significance score based on severity on a scale of mild, moderate and severe. Mild IF was defined as an IF that does not require any further investigation or referral. Moderate IF was defined as an IF that has the tendency to become clinically significant and should be observed periodically. IFs that warrant further investigation and/or intervention were designated as severe. RESULTS The percentage of IFs in sino-nasal and dento-alveolar regions were 44.7% and 19.1% respectively. The percentage of IFs with mild, moderate, and severe clinical significance were 27%, 72%, and 1%, respectively. Out of the IFs involving calcifications, 80.8% were stylohyoid calcifications and <1% were cranial cavity IFs such as petroclinoid calcifications and falx cerebri calcifications. Among the sino-nasal findings, 1.2% were identified as severe. CONCLUSION The sino-nasal region had the highest frequency of IFs. Understanding the prevalence of incidental findings and its clinical relevance is important for clinicians to allow for appropriate monitoring and timely treatment of patients.
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Affiliation(s)
- Lily Etemad
- Orthodontics, Siddiqui Orthodontics, Ann Arbor, USA
| | - Shivam Mehta
- Orthodontics, Marquette University School of Dentistry, Milwaukee, USA
| | - Alan G Lurie
- Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, USA
| | - Aditya Tadinada
- Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, USA
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Alghofaily M, Alsufyani N, Althumairy RI, AlSuhaibani A, Alfawzan F, AlSadhan L. Odontogenic Factors Associated with Maxillary Sinus Schneiderian Membrane Thickness and their Relationship to Chronic Sinonasal Symptoms: An Ambispective Cohort Study. Diagnostics (Basel) 2023; 13:2710. [PMID: 37627969 PMCID: PMC10453369 DOI: 10.3390/diagnostics13162710] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/13/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Odontogenic sinusitis is a common maxillary sinus disease. It develops due to the violation of the Schneiderian membrane due to pathological, iatrogenic, or traumatic causes from dental and dentoalveolar structures. The aim of this cohort study was to investigate local and systemic factors associated with Schneiderian mucosal thickening (MT) in patients referred for evaluation of apical periodontitis (AP) and examine their relationship with chronic sinonasal symptoms. Cone-beam computed tomography (CBCT) scans of 197 patients referred for evaluation of endodontic diseases were reviewed. Mucosal thickening in relation to the affected tooth was measured in the coronal section in millimeters at the maximum area perpendicular to the bone. Based on this measurement, the sinus floor was categorized for MT as present (>1 mm) or absent (<1 mm). The sociodemographic and clinical characteristics of the study participants were assessed and compared according to the presence or absence of MT. Furthermore, the relationship between odontogenic sinusitis and chronic sinonasal symptoms was assessed using a chronic sinusitis survey. Male patients had a higher MT than female patients. The presence of periapical lesions and inadequate endodontic treatment were significantly associated with MT. The multivariate logistic regression model showed that the presence of AP increased the odds of MT by approximately 2.5 times (p = 0.028), and nasal obstruction was significantly higher in patients diagnosed with mucosal thickness at different times of their follow-up period (p = 0.018). MT was 2.5 times more likely in the presence of apical periodontitis, and nasal obstruction was the most significant factor associated with the presence of MT.
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Affiliation(s)
- Maha Alghofaily
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
| | - Noura Alsufyani
- Oral & Maxillofacial Radiology, Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
- School of Dentistry, Department of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Riyadh I. Althumairy
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
| | - Amal AlSuhaibani
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
| | - Fatimah Alfawzan
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
| | - Lama AlSadhan
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:1684. [PMID: 37238169 PMCID: PMC10217207 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- 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 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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Talwade P, Deshpande PS, Pene S, Kumar S, Kudagi V, Limaye M. Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study. Int J Clin Pediatr Dent 2023; 16:292-294. [PMID: 37519960 PMCID: PMC10373774 DOI: 10.5005/jp-journals-10005-2528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Objectives The study was conducted to assess the prevalence of incidental paranasal sinus pathologies in children on computed tomography (CT) scans. Materials and methods A nonrandomized retrospective study was done on CT scans of 232 pediatric patients taken in the past 6 months duration. These scans were evaluated in different age groups from 0-13 years who had visited or were admitted to the hospital for various other head and neck-related problems. Each scan was examined for incidental pathologic findings in all the paranasal sinuses. The data were analyzed using descriptive statistics and Fisher's exact test to determine non-random associations between variables. Results A total of 232 subjects were examined, amongst which 72 (31.03%) had incidental sinus pathologies. Multiple sinus pathologies were found in 36 subjects, 28 had single sinus involvement, and four showed no development of frontal sinus at the age of 11 years. Four subjects had pathology in multiple sinuses as well as no development of frontal sinus at the age of 6-7 years age range. Conclusion Sinus pathologies are not unusual in the asymptomatic children population, and the incidence is almost equivalent to that of the adult population. Early identification can aid in diagnosing orofacial pain of unknown origin and also if children are susceptible to upper respiratory tract infections and their secondary effects like sleep apnea, mouth breathers, etc. How to cite this article Talwade P, Deshpande PS, Pene S, et al. Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study. Int J Clin Pediatr Dent 2023;16(2):292-294.
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Affiliation(s)
- Priyanka Talwade
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Prasannasrinivas S Deshpande
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Shailesh Pene
- Department of Interventional Radiology, Narayana Multispecialty Hospital, Mysuru, Karnataka, India
| | - Shruti Kumar
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Vishal Kudagi
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Mrinal Limaye
- Department of Periodontology and Implantology, KVG Dental College and Hospital, Sullia, Karnataka, India
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5
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Areizaga-Madina M, Pardal-Peláez B, Montero J. Maxillary Sinus Pathology and its Relationship with Pathology and Dental Treatments. Systematic Review. REVISTA ORL 2023. [DOI: 10.14201/orl.29553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction and objective: The aim of this review is to evaluate to what extent sinus pathology originates from dental pathology or treatment, and to assess the occurrence frequency of sinus pathology in its different forms using cone beam computed tomography (CBCT).
Method: The literature review was conducted using PubMed, Scopus and the Cochrane Library. Forty-two articles were included (25 case series, ten cross- sectional studies, three case-control studies, two cohort studies, one prospective study, and one retrospective study).
Results: Forty-two articles involving a total of 13,191 patients and 17,374 CBCTs were included in this review. The most frequent pathological findings were, by a considerable degree, inflammatory diseases, which represented 75.16% of the total findings, followed by infection (12.13%), tumours (6.88%), and high pneumatisation (2.07%). Within dental pathology, there is a direct Pearson correlation with polyps (1) and opacification (0.999), and an almost direct correlation with retention cysts (0.981) and sinus-associated dental elements (0.972).
Conclusions: Our results further support the argument that dental modifications and treatments are an important cause of sinus pathology. For this reason, dental aetiologies must be taken into account by both dentists, maxillofacial surgeons and ENT when considering the most appropriate treatment for patients with maxillary sinusitis.
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Akleyin E, Eskibağlar BK. Reasons for requesting cone-beam computed tomography in children and adolescents: a 10-year study. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2022.2138782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Ebru Akleyin
- Department of Paediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
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Syam S, Maheswari U. Prevalence of Incidental Findings in Maxillary Sinus Using Cone Beam Computed Tomography – A Retrospective. PHARMACOPHORE 2022. [DOI: 10.51847/0kpbfeizzo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Razi B, Perkovic A, Alvarado R, Stroud A, Ho J, Kalish LH, Campbell RG, Sacks R, Harvey RJ. Sinus Radiological Findings in General Asymptomatic Populations: A Systematic Review of Incidental Mucosal Changes. Otolaryngol Head Neck Surg 2021; 167:16-24. [PMID: 34340618 DOI: 10.1177/01945998211035097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the range of incidental mucosal changes in a general sinonasally asymptomatic population on radiology. DATA SOURCES Medline (1996-present) and Embase (1974-present) were searched on March 14, 2020, to identify articles that reported radiological sinus mucosal findings in asymptomatic population groups. Bibliographic search of included studies was conducted to identify additional articles. REVIEW METHODS The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search strategy was formulated and articles screened to extract data reporting Lund-Mackay (LM) score, presence of mucous retention cysts, and maxillary mucosal thickening. A random-effects model was used in meta-analysis. RESULTS A total of 950 articles were identified, of which 33 manuscripts met the inclusion criteria. The included studies involved 16,966 sinonasally asymptomatic subjects. The mean LM score was 2.24 (95% CI, 1.61-2.87), and an LM score of ≥4 in 14.71% (95% CI, 6.86-24.82%) was present across all general asymptomatic population groups. Mucous retention cysts were noted in 13% (95% CI, 8.33-18.55%) and maxillary mucosal thickening of ≥2 mm in 17.73% (95% CI, 8.67-29.08%). CONCLUSION The prevalence of incidental mucosal changes in a general asymptomatic population on radiology needs to be considered when making a diagnosis of chronic rhinosinusitis.
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Affiliation(s)
- Basil Razi
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia
| | - Adam Perkovic
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia
| | - Raquel Alvarado
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia
| | - Anna Stroud
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia
| | - Jacqueline Ho
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia
| | - Larry H Kalish
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia.,Faculty of Medicine, University of Sydney, Sydney, Australia.,Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, Australia
| | - Raewyn G Campbell
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia.,Department of Otolaryngology Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, Australia.,Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Raymond Sacks
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia.,Faculty of Medicine, University of Sydney, Sydney, Australia.,Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, Australia.,Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, Australia.,Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Changes in Maxillary Sinus Mucosal Thickening following the Extraction of Teeth with Advanced Periodontal Disease: A Retrospective Study Using Cone-Beam Computed Tomography. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6688634. [PMID: 33860050 PMCID: PMC8009702 DOI: 10.1155/2021/6688634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/06/2021] [Accepted: 03/13/2021] [Indexed: 11/17/2022]
Abstract
Objectives To explore the alterations in maxillary sinus mucosal thickening after extracting teeth with severe periodontal disease using cone-beam computed tomography (CBCT). Methods 30 patients with severe periodontal disease of maxillary posterior teeth that needed to be extracted and who were radiographically diagnosed with mucosal thickening (MT) in the maxillary sinus participated in the study. CBCT scans were taken before tooth extraction and 2-29 months after tooth extraction. The postextraction follow-up time was divided into two groups: group 1 (<4 months) and group 2 (≥4 months). Dimensions of maxillary sinus MT, including the MT zone length (SL) and the maximum thickness of the MT zone (ST), were evaluated preextraction and postextraction; the residual ridge height (RRH) was evaluated at the sites of extracted and nonextracted teeth. Result Of the 24 patients with unilateral tooth extraction, there was a statistically significant difference in MT between the extraction and nonextraction sides (p < 0.05). The RRH at the site of the extracted teeth was significantly lower than that of the nonextracted teeth (p < 0.05). MT decreased significantly after tooth extraction on the extraction side but not on the nonextraction side. There was no significant difference between group 1 and group 2 regarding the reduction in mucosal thickness over time. Conclusions Severe periodontitis can cause MT in the maxillary sinus. The RRH was lower at the sites of extracted teeth. MT reduced quickly by a thorough debridement after tooth extraction in 4 months. MT will not decrease further over time.
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10
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Hung K, Hui L, Yeung AWK, Wu Y, Hsung RTC, Bornstein MM. Volumetric analysis of mucous retention cysts in the maxillary sinus: A retrospective study using cone-beam computed tomography. Imaging Sci Dent 2021; 51:117-127. [PMID: 34235057 PMCID: PMC8219453 DOI: 10.5624/isd.20200267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to evaluate the volumetric characteristics of mucous retention cysts (MRCs) in the maxillary sinus and to analyze potential associations of MRCs with dentoalveolar pathologies. Materials and Methods Cone-beam computed tomography (CBCT) scans exhibiting bilateral maxillary sinuses that were acquired from January 2016 to February 2019 were initially screened. A total of 227 scans (454 sinuses) that fulfilled the inclusion criteria were included. The presence, location, and volumetric characteristics of the diagnosed MRCs were evaluated on CBCT images using the 3D-Slicer software platform. The presence of MRCs was correlated with potential influencing factors including age, sex, and dentoalveolar pathology. For MRCs located on the sinus floor, factors with a potential impact on the volume, surface, and diameter were analyzed. Results An MRC was present in 130 (28.6%) of the 454 sinuses. Most MRCs were located on the sinus walls and floor. The mean MRC volume, surface, and diameter were 551.21±1368.04 mm3, 228.09±437.56 mm2, and 9.63±5.40 mm, respectively. Significantly more sinuses with associated endodontically treated teeth/periapical lesions were diagnosed with an MRC located on the sinus floor. For MRCs located on the sinus floor, endodontic status exhibited a significant association with increased volume, surface, and diameter. Conclusion Periapical lesions might be a contributing factor associated with the presence and volume of MRCs located on the sinus floor. The 3D-Slicer software platform was found to be a useful tool for clinicians to analyze the size of MRCs before surgical interventions such as sinus floor elevation procedures.
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Affiliation(s)
- Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Liuling Hui
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiqun Wu
- Second Dental Clinic, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Richard Tai-Chiu Hsung
- School of Information Engineering, Guangdong University of Technology, Guangzhou, China.,Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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11
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Sanaullah M, Sinha A, Srivastava S, Mishra A, Singh Y, Basu S. Hidden pathologies of maxillary sinus using CBCT scans. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_36_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Amin N, Walker A, Alobid I, Anari S, Bast F, Bhalla RK, Cathcart R, Harries PG, Hathorn I, Philpott CM, Ramakrishnan Y, Stew B, Surda P, Ting F, Hopkins C. Defining appropriateness criteria for endoscopic sinus surgery in the management of adult dental implant patients with incidental maxillary sinus findings on conebeam computed tomography. Clin Otolaryngol 2020; 45:862-869. [DOI: 10.1111/coa.13609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/25/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Nikul Amin
- Guy's and St Thomas' NHS Foundation Trust London UK
| | | | - Isam Alobid
- Hospital ClínicUniversitat de BarcelonaIDIBAPSCIBERESCentro Médico Teknon Barcelona Spain
| | - Shahram Anari
- University Hospitals Birmingham NHS Trust Birmingham UK
| | - Florian Bast
- Guy's and St Thomas' NHS Foundation Trust London UK
| | - Rajiv K. Bhalla
- Manchester Academic Health Sciences CentreUniversity of Manchester Manchester UK
| | | | | | | | - Carl M. Philpott
- James Paget University Hospitals NHS Foundation Trust Gorleston‐on‐Sea UK
| | | | | | - Pavol Surda
- Guy's and St Thomas' NHS Foundation Trust London UK
| | - Fiona Ting
- Sydney Hills ENT Clinic Sydney Australia
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Gürhan C, Şener E, Mert A, Şen GB. Evaluation of factors affecting the association between thickening of sinus mucosa and the presence of periapical lesions using cone beam CT. Int Endod J 2020; 53:1339-1347. [PMID: 32627204 DOI: 10.1111/iej.13362] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022]
Abstract
AIM To evaluate the effect of various parameters of periapical lesion(s) on the amount and type of mucosal thickening using cone beam CT images. METHODOLOGY CBCT scans of 1000 patients were evaluated retrospectively for the presence of apical lesions in maxillary posterior teeth associated with sinus mucosal thickening. The number of cases with pathological mucosal thickening was recorded and classified according to the amount and type of mucosal thickening. The parameters evaluated as the cause of mucosal thickening were the type and number of posterior teeth, number of root(s), diameter of the periapical lesion and distance between maxillary sinus and lesion. Descriptive statistics and multiple logistic regression was used for data analyses. Spearman's correlation coefficient was used for pair-wise comparisons. Intrarater reliability was tested by Cohen's kappa. RESULTS Mucosal thickening associated with periapical lesions was determined in 48% of 202 cases. The most frequently detected extent of mucosal thickening was type 3 (42%), whereas flat type thickening (59%) was the most frequent type. The tooth most frequently associated with mucosal thickening was the maxillary first molar (44%). Parameters significantly affecting the extent of mucosal thickening were gender, number of roots, number of teeth with periapical lesions and diameter of periapical lesions (P < 0.05). The single parameter with an association with the type of mucosal thickening was the number of roots with an apical lesion (P < 0.05). CONCLUSION Mucosal thickening associated with periapical lesions was observed in almost 50% of all mucosal thickening cases. Therefore, collaboration amongst endodontists and otolaryngologists is mandatory to provide successful treatment and prevent recurrence of maxillary sinusitis.
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Affiliation(s)
- C Gürhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - E Şener
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - A Mert
- Department of Statistics, Faculty of Science, Ege University, Izmir, Turkey
| | - G B Şen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Garcia-Font M, Abella F, Patel S, Rodríguez M, González Sanchez JA, Duran-Sindreu F. Cone-beam Computed Tomographic Analysis to Detect the Association between Primary and Secondary Endodontic Infections and Mucosal Thickness of Maxillary Sinus. J Endod 2020; 46:1235-1240. [PMID: 32512066 DOI: 10.1016/j.joen.2020.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/24/2020] [Accepted: 05/22/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This retrospective study used cone-beam computed tomographic (CBCT) imaging to evaluate the differences in the mucosal thickness of the Schneiderian membrane in primary and secondary endodontic lesions. METHODS A total of 121 CBCT scans were analyzed. Clinical features such as sex, age, size and volume of the periapical lesion, dimension of the bone, morphology, and relationship between the roots and the mucosal thickness were recorded and analyzed in primary and secondary endodontic lesions in CBCT sagittal and coronal planes. Data were analyzed using the chi-square test, the Mann-Whitney U test, and multiple logistic regression (P < .05). RESULTS Statistical analysis revealed no significant differences in membrane thickness between the primary and secondary lesions in the sagittal and coronal planes (P = .08 and .06). Differences between age groups were statistically significant in both groups (P < .05). The volume of the periapical lesions of the secondary endodontic lesions were statistically greater than that of the primary lesions (P < .05). Mucosal thickness prevalence increased when the volume of the lesion was greater, and the bone dimension was narrower in maxillary second premolars and first and second molars. Teeth with 2 or more affected roots were directly related to increased sinus mucosa thickening. CONCLUSIONS CBCT images showed no differences in mucosal thickening between primary and secondary endodontic lesions.
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Affiliation(s)
- Marc Garcia-Font
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Francesc Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Shanon Patel
- Departament of Conservative Dentistry, King's College London Dental Institute, London, United Kingdom; Specialist Practice, London, United Kingdom
| | - Marta Rodríguez
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
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Santos G, Ickow I, Job J, Brooker JE, Dvoracek LA, Rigby E, Shah N, Chen W, Branstetter B, Schuster LA. Cone-Beam Computed Tomography Incidental Findings in Individuals With Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 57:404-411. [PMID: 31964169 DOI: 10.1177/1055665619897469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The use of cone-beam computed tomography (CBCT) is well-established in clinical practice. This study seeks to categorize and quantify the incidental finding (IF) rate on CBCT in patients with cleft lip and palate (CLP) prior to orthodontic or surgical treatment. METHODS This is systematic retrospective review of head and neck CBCTs in patients with nonsyndromic CLP taken between 2012 and 2019 at a single tertiary referral center. All assessments were performed independently by 4 observers (a head and neck radiologist and 3 orthodontists, including 2 fellowship-trained cleft-craniofacial orthodontists ). The images were divided into 9 anatomical areas and screened using serial axial slices and 3D reconstructions. The absolute number of IFs was reported for each area and statistical analysis was performed. RESULTS Incidental findings were found in 106 (95.5%) of the 111 patients. The most common sites were the maxilla (87.4%, principally dental anomalies), paranasal sinuses (46.8%, principally inflammatory opacification), and inner ear cavities (18.9%, principally inflammatory opacification). Eleven patients had skull malformations. Thirty-three patients had IFs in 1 anatomical area, 49 patients in 2 anatomical areas, 19 patients in 3 areas, and 5 patients presented with IFs in 4 of the 9 anatomical areas. DISCUSSION In patients with CLP, IFs on CBCT exam were present in the majority of cases. Most patients with IFs had them in multiple anatomical areas of the head and neck. The maxillary dental-alveolar complex was the most common area. Inflammatory changes in the inner ear cavities and paranasal sinuses were also common; however, cervical spine and skull abnormalities were also identified. Clinicians caring for patients with CLP should be aware of IFs, which may warrant further investigation and treatment.
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Affiliation(s)
| | - Ilana Ickow
- Department of Plastic and Reconstructive Surgery, The John Hopkins University School of Medicine, Baltimore, MD
| | - Joici Job
- Department of Radiology, Ohio State University, Columbus, OH, USA
| | - Jack E Brooker
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lucas A Dvoracek
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erick Rigby
- Law Office of Erick Rigby, Washington, PA, USA
| | - Nilesh Shah
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy Chen
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Barton Branstetter
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Prevalence of Maxillary Sinus Pathology Based on Cone-Beam Computed Tomography Evaluation of Multiethnicity Dental School Population. IMPLANT DENT 2019; 28:356-366. [PMID: 31135648 DOI: 10.1097/id.0000000000000902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The goal of the study was to evaluate prevalence of maxillary sinus pathology among populations considered for possible sinus augmentation procedures for dental implants. STUDY DESIGN Eight hundred twenty-one cone-beam computed tomography (CBCT) scans were retrospectively evaluated for prevalence of maxillary sinus pathology. Scans were classified based on the type of sinus pathology detected. Categories of sinus findings were healthy, mucosal thickening larger than 3 mm, polypoidal mucosal thickening, partial opacification, complete opacification, and others. Age, sex, ethnicity, and dentition status were evaluated to determine associated relationships with the incidence of pathology. RESULTS Sixty-two percent (62.79%) of scans presented with bilateral healthy sinuses and 37.21% of scans exhibited pathology. 73.38% of sinuses were classified as clinical healthy, 14.93% presented with mucosal thickening, 8.53% with polypoidal mucosal thickening, 2.13% with partial opacification, 0.66% with complete opacification, and 0.37% with a foreign body. Sex is found to be a significant factor with higher pathology incidence rates in male patients. Age is a significant factor with higher pathology incidence rates in older subjects. Dentition status and ethnicity did not have a significant association with pathology incidence rates. CONCLUSIONS The prevalence of maxillary sinus pathologies and associations with age, sex, ethnicity, and dentition status were obtained. Thirty-seven percent of scans would require further medical consultation before proceeding with maxillary sinus augmentation surgery for dental implants.
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Kim SW, Lee IH, Kim SW, Kim DH. Points to consider before the insertion of maxillary implants: the otolaryngologist's perspective. J Periodontal Implant Sci 2019; 49:346-354. [PMID: 31886027 PMCID: PMC6920034 DOI: 10.5051/jpis.2019.49.6.346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 01/11/2023] Open
Abstract
Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.
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Affiliation(s)
- Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Il Hwan Lee
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Soo Whan Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Küçükkurt S. Evaluation of the survival of implant placement simultaneously with sinus augmentation: relationship in maxillary sinus pathologies. Oral Radiol 2019; 36:225-237. [PMID: 31300933 DOI: 10.1007/s11282-019-00399-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/05/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This retrospective study aimed to evaluate the effects of existing maxillary sinus pathologies on the survival rates of dental implants placed simultaneously with sinus augmentation. METHODS Cone-beam computed tomography images of 88 patients (34 females, 54 males), who underwent sinus augmentation, were retrospectively analyzed and the patients were divided into two groups: with (pathology group) and without pathology (control group). All maxillary sinus pathologies were recorded and categorized into mucosal thickening ( ≥ 3 mm), antral pseudocyst (polypoid mucosal thickening), and complete opacification. Implant survival rates were evaluated after a mean follow-up period of 28.2 ± 9.8 months based on the patient's records and control radiographs. RESULTS A total of 115 maxillary sinuses of 88 patients with 168 dental implants were included in the study. Maxillary sinus pathology was detected in 45 patients in the pathology group and 43 patients in the control group. In the pathology group, one implant was lost out of 82 implants during the 27.8 ± 9.5 months follow-up period, while in the control group, 5 implants were lost out of 86 implants during the 25.1 ± 10 months follow-up period. There was no statistically significant difference in the survival rates between the two groups. CONCLUSIONS The study concluded that the presence of pathology in the maxillary sinus before surgery does not affect the survival rates of dental implants placed simultaneously with sinus augmentation. The most common pathology noted included mucosal thickening (61.4%), which was detected in 35 patients.
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Affiliation(s)
- Sercan Küçükkurt
- Department of Oral and Maxillofacial Surgery, Istanbul Aydın University, Istanbul, Turkey.
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Dief S, Veitz-Keenan A, Amintavakoli N, McGowan R. A systematic review on incidental findings in cone beam computed tomography (CBCT) scans. Dentomaxillofac Radiol 2019; 48:20180396. [PMID: 31216179 DOI: 10.1259/dmfr.20180396] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT. METHODS AND MATERIALS The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies. RESULTS The original search retrieved 509 abstracts of which only 10 articles met the inclusion criteria. The sample size varied between 90 and 1000 participants. The frequency of IFs of the selected articles were 24.6-94.3%. The most common non-threatening IFs were found in the airway, such as mucous retention cyst (55.1%) and sinusitis (41.7%). Other non-threatening IFs were soft tissue calcifications such as calcified stylohyloid ligament (26.7%), calcified pineal gland (19.2%), and tonsillolith (14.3%). Threatening IFs were rare findings (1.4%). Three articles reported incidental carotid artery calcifications with a prevalence of 5.7-11.6%. Pathological findings were not common between the articles, but still relevant (2.6%). The studies had a risk of bias varying from moderate to low. CONCLUSIONS There is a high frequency of IFs, yet not all of them require immediate medical attention. The low prevalence of threatening IFs emphasizes that CBCT should not be considered a substitution for conventional radiographs, but when used, the scans should be evaluated by a maxillofacial radiologist.
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Affiliation(s)
| | - Analia Veitz-Keenan
- NYU College of Dentistry, NY, USA.,Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, NY, USA
| | - Niloufar Amintavakoli
- NYU College of Dentistry, NY, USA.,Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, NY, USA
| | - Richard McGowan
- NYU College of Dentistry, NY, USA.,NYU Library, Department of Epidemiology and Health Promotion, NY, USA
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Bajoria AA, Sarkar S, Sinha P. Evaluation of Odontogenic Maxillary Sinusitis with Cone Beam Computed Tomography: A Retrospective Study with Review of Literature. J Int Soc Prev Community Dent 2019; 9:194-204. [PMID: 31058071 PMCID: PMC6489515 DOI: 10.4103/jispcd.jispcd_435_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
Aim and Objectives: The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and determine whether any tooth or any tooth root, was more frequently associated with this disease. Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed. Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus. Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.
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Affiliation(s)
- Atul Anand Bajoria
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Shromona Sarkar
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Pallawi Sinha
- Consultant Prosthodontist, KIIT University, Bhubaneswar, Odisha, India
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Kalyvas D, Kapsalas A, Paikou S, Tsiklakis K. Thickness of the Schneiderian membrane and its correlation with anatomical structures and demographic parameters using CBCT tomography: a retrospective study. Int J Implant Dent 2018; 4:32. [PMID: 30338431 PMCID: PMC6193890 DOI: 10.1186/s40729-018-0143-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/27/2018] [Indexed: 11/09/2022] Open
Abstract
Background The aims of the present study were to determine the thickness of the Schneiderian membrane and identify the width of the maxillary sinus, which is indicated by the buccal and lingual walls of the sinus angle between. Furthermore, to investigate the possibility of a correlation between the aforementioned structures and also other anatomical and demographic parameters using CBCTs for dental implant surgical planning. Methods The study included CBCT images of 76 consecutive patients with field-of-view 15 × 12 or 12 × 8cm. Reformatted cross-sectional CBCT slices were analyzed with regard to the thickness of the Schneiderian membrane designated by the medial and the lateral walls of the sinus, in three different standardized points of reference. Age, gender, and position of the measurement were evaluated as factors that could influence the dimensions of the anatomical structures, using univariate and multivariate random effects regression model. Results The mean thickness of the Schneiderian membrane was 1.60 ± 1.20 mm. The average thickness revealed now differentiation by age (p = 0.878), whereas gender seemed to influence the mean thickness (p = 0.010). Also, the thickness of the Schneiderian membrane increased from medial to distal (p = 0.060). The mean value of the angle designated by buccal and lingual walls of the sinus was 73.41 ± 6.89 °. The angle measurements revealed no correlation with age, but a tendency towards lower mean angles in females (2.5 ° on average, p = 0.097). According to the anatomical position of the measurement, a differentiation was also detected. No correlation between thickness of the Schneiderian membrane and the angle of the walls of the sinus was concluded (p = 0.662). Conclusions This study demonstrated that the thickness of the Schneiderian membrane and the width of the maxillary sinus can only be affected by gender and anatomical position, but not by the age of the patient.
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Affiliation(s)
- Demos Kalyvas
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece.
| | - Andreas Kapsalas
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece
| | - Sofia Paikou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece
| | - Konstantinos Tsiklakis
- Oral Diagnosis & Radiology Clinic, School of Dentistry, National and Kapodistrian University of Athens, Greece, Thivon 2 str, 11527, Athens, Greece
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Retrospective Analysis of Sinus Membrane Thickening: Profile, Causal Factors, and Its Influence on Complications. IMPLANT DENT 2018; 26:868-874. [PMID: 29053486 DOI: 10.1097/id.0000000000000667] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To retrospectively determine the profile of the sinus membrane (SM), potential factors affecting SM thickening (SMT), and the correlation between SMT and sinus augmentation (SA) complications. MATERIALS AND METHODS In the patients who received lateral SA, SMT was classified in sagittal sections of cone-beam computed tomography according to its thickness and morphology. The correlation between SMT and the following factors was analyzed: age, sex, endodontic and periodontic statuses of neighboring teeth, and shape of the sinus inferior border. The association between SMT and SA complications was investigated. RESULTS SMT of ≤2 mm was prevalent (60%). Irregular SM was mostly observed for SMT of >2 mm. There was no statistically significant association between SMT and the included factors. SMT did not significantly correlate with either perforation or postoperative complications. There was a statistically significant increase in implant failure when SMT was >2 mm, but it was hard to determine that the failure was solely affected by SMT. CONCLUSION SMT was not influenced by the factors included in this study, and it might not be a risk factor for SA and implant failure.
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Bornstein MM, Horner K, Jacobs R. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 2018; 73:51-72. [PMID: 28000270 DOI: 10.1111/prd.12161] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest.
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Horwitz Berkun R, Polak D, Shapira L, Eliashar R. Association of dental and maxillary sinus pathologies with ear, nose, and throat symptoms. Oral Dis 2017; 24:650-656. [PMID: 29121436 DOI: 10.1111/odi.12805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/01/2017] [Accepted: 10/16/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate the correlation between cone-beam computerized tomography (CBCT) findings in the maxillary sinus, ear-nose-throat (ENT) symptoms and dental pathologies in asymptomatic patients. MATERIALS AND METHODS A total 81 patients were referred for CBCT and filled a standard ENT visual analog scale (VAS) questionnaire. CBCT images were analyzed for sinus ostium obstruction, Schneiderian membrane thickening, sinus floor turbidity, and the presence of polyps. Dental pathologies were evaluated with the aid of CBCT images, periapical X-rays, and clinical examination. A possible correlation between the CBCT findings and the ENT/dental parameters was examined by applying Student's t test and the chi-squared test. RESULTS Despite being asymptomatic, most of the 81 patients reported ENT symptoms in the questionnaire, thereby indicating that these symptoms were mainly subclinical. A significant correlation was found between the presence of polyps in the sinus and a decrease in smell/taste. Obstruction of the sinus meatus was associated with coughing; turbidity was associated with ear congestion. Thickening of the Schneiderian membrane showed an association with both coughing and ear congestion. The mean number of missing posterior teeth correlated with postnasal drip and nasal congestion. Periapical pathology was associated with nasal discharge/runny nose. CONCLUSION The results emphasize the need to evaluate ENT symptoms when radiographic findings are identified in CBCT.
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Affiliation(s)
- R Horwitz Berkun
- Department of Periodontology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - D Polak
- Department of Periodontology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - L Shapira
- Department of Periodontology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - R Eliashar
- Department of Otolaryngology/Head & Neck Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Vidal F, Coutinho TM, Carvalho Ferreira DD, Souza RCD, Gonçalves LS. Odontogenic sinusitis: a comprehensive review. Acta Odontol Scand 2017; 75:623-633. [PMID: 28877613 DOI: 10.1080/00016357.2017.1372803] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.
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Affiliation(s)
- Fábio Vidal
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | | | - Dennis de Carvalho Ferreira
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
- Oral Medicine, Veiga de Almeida University, Rio de Janeiro, Brazil
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The effect of demographic and disease variables on Schneiderian membrane thickness and appearance. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:568-576. [PMID: 29029989 DOI: 10.1016/j.oooo.2017.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/29/2017] [Accepted: 09/02/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the prevalence of sinus mucosal thickening (MT) and mucosal appearance (MA) in a patient population as detected with cone beam computed tomography (CBCT) and to determine the effects of various disease and demographic factors on MT and MA. STUDY DESIGN The retrospective study consisted of CBCT images of 1000 maxillary arches in 500 patients. The arches were divided into 3 groups (atrophic, partially atrophic, and nonatrophic) according to the type of the maxillary dental crest. The CBCT scans were assessed to detect the prevalence of maxillary sinus MT and MA. χ2 analysis was used to determine the significance of association of periodontal bone loss (PBL), periapical (PA) status, alveolar crest type, age, and gender on sinus MT and MA. RESULTS MT was significantly associated with PBL (P = .004), PA status (P = .001), and gender (P < .01). MA was significantly associated with PBL (P = .038), PA status (P = .009), and gender (P < .020). There were no significant associations between age or crest type and either MT or MA. CONCLUSIONS Periodontal bone loss, PA lesions, and gender may have an association with MT of the maxillary sinus.
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Altındağ A, Avsever H, Borahan O, Akyol M, Orhan K. Incidental Findings in Cone-Beam Computed Tomographic Images: Calcifications in Head and Neck Region. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background/Aim: The use of CBCT in dentistry has been increasing popularity nowadays. CBCT images provide valuable information from anatomic structures and pathologies. Images obtained with CBCT allow for more appropriate treatment planning. The purpose of this study was to assess the calcifications which were found incidentally on CBCT images and to reveal the frequency and characteristics. Material and Methods: A total of 691 CBCT images which obtained from the patients were assessed. Demographic data and calcifications which were found out of primarily interest area were noted. The incidental findings were categorized and analyzed using descriptive statistics. Results: 945 calcifications were discovered on 318(46.02%) of the 691 patients’ images. 373(53.98%) scans showed no calcificated findings. The age range of patients was from 5 to 84 years. The most common calcification was tonsillolith (86.03%), followed by stylohyoid calcifications (6.24%), antrolith and subdermal calcifications (2.33%). Conclusion: Calcified lesions in head and neck region were commonly seen in CBCT images. Although the most of the calcifications are asymptomatic and require no treatment but correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans. It will also provide the ability comprehensively evaluation of underlying diseases and practitioners will have life-saving information by early diagnosis.
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Affiliation(s)
- Ali Altındağ
- Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara , Turkey
| | - Hakan Avsever
- Gulhane Training&Reserach Hospital, Health Sciences University, Dentistry Center, Department of Dentomaxillofacial Radiology, Ankara , Turkey
| | - Oguz Borahan
- Marmara University, Department of Dentomaxillofacial Radiology, Istanbul , Turkey
| | - Mesut Akyol
- Yildirim Beyazit University, Department of Biostatistics, Ankara , Turkey
| | - Kaan Orhan
- Ankara University, Faculty of Dentistry Department of Dentomaxillofacial Radiology, Ankara , Turkey
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Characterization of the Maxillary Sinus Using Cone Beam Computed Tomography. A Retrospective Radiographic Study. IMPLANT DENT 2017; 25:762-769. [PMID: 27540848 DOI: 10.1097/id.0000000000000485] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the anatomical findings and alterations of the maxillary sinus in asymptomatic patients observed by cone beam computed tomography. MATERIALS AND METHODS A cross-sectional retrospective study of the anatomical variations and alterations of the maxillary sinus was made in 160 patients-71 males (44.3%) and 89 females (55.6%), with an age range of 18 to 74 years-measuring the thickness of the Schneiderian membrane and the cortical thickness of the lower margin of the maxillary sinus (in its most caudal portion), and correlations among the different study variables were assessed. RESULTS Sinus pneumatization was the most frequent anatomical finding (81.3%). A negative correlation was observed between the thickness of the Schneiderian membrane and the presence of Underwood septa (P < 0.005). Mucosal thickening of more than 2 mm was directly correlated with the presence of maxillary sinus lesions (opacification, discontinuity of the floor of the sinus, polypoid lesions, or air-liquid levels). CONCLUSION The presence or absence of septa seems to be related to the thickness of the Schneiderian membrane.
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Incidental findings on cone-beam computed tomographic images: paranasal sinus findings and nasal septum variations. Oral Radiol 2017; 34:40-48. [PMID: 30484091 DOI: 10.1007/s11282-017-0283-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE CBCT applications have received widespread acceptance in dentistry. CBCT scans provide three-dimensional information on anatomic structures and characteristics of pathologies, rather than the two-dimensional information obtained with the conventional techniques. The purpose of this study was to evaluate incidental findings in out-of-interest areas on CBCT images and to reveal their frequency and characteristics. METHODS A total of 691 CBCT scans from 691 patients were assessed. Demographic data, CBCT indications, and incidental findings outside the primary area of interest, such as anatomical variations and pathologies, were noted. The incidental findings were categorized and analyzed using descriptive statistics. RESULTS In total, 1109 incidental findings in paranasal sinuses were noted on 548 of the 691 CBCT scans. The highest rate of incidental findings was maxillary sinus findings, followed by concha bullosa and septum deviation. The most frequently observed pathology was mucosal thickening, followed by polypoid mucosal thickening in the maxillary sinus. CONCLUSIONS While most incidental findings require no treatment, some conditions will necessitate modification of the treatment plan. Therefore, dental practitioners should be aware of incidental findings and anatomical variations. Correct identification of these findings will reduce unnecessary further diagnostic assessments and allow selection of more appropriate treatment plans.
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Maska B, Lin GH, Othman A, Behdin S, Travan S, Benavides E, Kapila Y. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening. Int J Implant Dent 2017; 3:1. [PMID: 28101784 PMCID: PMC5243237 DOI: 10.1186/s40729-017-0064-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/13/2017] [Indexed: 11/23/2022] Open
Abstract
Background Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this retrospective study was to evaluate the outcomes of dental implant placement in sinus-augmented areas with preexisting sinus mucosal thickening. Methods This study involved the review of cone-beam computed tomographic (CBCT) scans taken on patients that underwent both maxillary sinus elevation with grafting and implant placement at the University of Michigan School of Dentistry from 2004 to 2014. Cases with documented radiographic and clinical follow-up were included. The data analyses revealed the following. Results A total of 29 CBCT scans met the inclusion criteria for evaluation, and 93.1% of them had maxillary sinus mucosal/tissue thickening. Specifically, 6.9% of cases exhibited no thickening, 6.9% had minimal thickening (1–2 mm), 20.7% of cases had moderate thickening (2–5 mm), and 65.5% had severe thickening (>5 mm). We propose these categorical measurements of tissue thickening as a new “mucosal thickening index.” The tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening (p = 0.0043). These data indicate that there is high implant and grafting success rate (100%) in the maxillary sinus despite large and varied physiologic sinus mucosal/tissue thickening. Conclusions Based on study findings, this research will help guide dental practitioners regarding cases that exhibit mucosal thickening. These data support the concept that physiologic mucosal thickening in varied ranges is not associated with implant or grafting failure in the maxillary sinus.
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Affiliation(s)
- Bartosz Maska
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA
| | - Guo-Hao Lin
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA.,Department of Surgical Sciences, School of Dentistry, Marquette University, 1801 W Wisconsin Ave, Milwaukee, WI, USA
| | - Abdullah Othman
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA.,Department of Periodontology & Dental Hygiene, University of Detroit Mercy, 2700 Martin Luther King Jr. Blvd, Detroit, MI, USA
| | - Shabnam Behdin
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA.,Department of Periodontics, School of Dental Medicine, Case Western Reserve University, 2124 Cornell Rd, Cleveland, OH, USA
| | - Suncica Travan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA
| | - Yvonne Kapila
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA. .,Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, 513 Parnassus Ave, S612D, Box 0422, San Francisco, 94143, CA, USA.
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Miniplate With a Bendable C-Tube Head Allows the Clinician to Alter Biomechanical Advantage in Extremely Complicated Anatomic Structure. J Craniofac Surg 2017; 28:817-820. [PMID: 28045812 DOI: 10.1097/scs.0000000000003382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS This article reports C-tube miniplates as a practical temporary anchorage device choice to treat open bite patients with maxillary sinus pneumatization. METHODS The C-tube components are titanium anchor plates and monocortical screws that are basically similar to any other miniplate systems, but it has the unique characteristic of the tube head to be malleable. The manipulation of the head part is easy due to the composition of pure titanium. The I-shaped C-tube with 3 holes and T-shaped C-tube miniplates were placed above the apices of maxillary molars as an absolute anchorage system to intrude the posterior maxilla. The bending of the tube heads assisted in reduction of severe open bite patient with maxillary sinus pneumatization. RESULTS Sinus perforation during placement of skeletal anchorage system weakens stability of the anchorage and further cause complications. Placement of titanium C-tube miniplates allowed reliable skeletal anchorage and avoided maxillary sinus perforation in patients with extreme pneumatizations. Simple bending of C-tube miniplates ensured increased orthodontic intrusion force without having to replace them, and eliminated consequences such as perforation of maxillary sinus, sinusitis, soft tissue irritation, or infection. CONCLUSIONS Anatomic difficulties in the placement of temporary anchorage device can be easily managed by using the bendable C-tube miniplate. It can serve as a great alternative over miniscrews or regular miniplates with reduced risk of sinus perforation and ability to bend the head portion to control orthodontic vectors and forces.
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Rosenthal PA, Lundy KC, Massoglia DP, Payne EH, Gilbert G, Gebregziabher M. Incidental paranasal sinusitis on routine brain magnetic resonance scans: association with atherosclerosis. Int Forum Allergy Rhinol 2016; 6:1253-1263. [PMID: 27509266 DOI: 10.1002/alr.21824] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/17/2016] [Accepted: 06/19/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Incidental paranasal sinusitis (IPS) is common on imaging for non-sinusitis disorders, usually without symptoms or obstructive features, and possibly arising from periodontitis (PD). PD associations with atherosclerosis have been widely reported. We test if IPS may also be associated with atherosclerosis. METHODS IPS was scored retrospectively in a random sample of 180 magnetic resonance (MR) brain scans and compared with chart review for atherosclerosis (all subtypes), rhinosinusitis, and related factors (smoking, asthma, and relevant surgery). IPS was scored out of 30, from all sinuses, with maxillary sinuses weighted double volumetrically. Significant IPS (Sig IPS) was designated as 6 or more out of 30. Bivariate logistic regression was used to test for associations of Sig IPS to the clinical data, with multivariate analysis then testing for potential confounders. RESULTS A total of 173 subjects were analyzed (7 exclusions). MR indications included suspected acute/prior stroke (22.0%). Sig IPS found in 20 (11.6%). Positive histories for atherosclerosis were cerebral, 57 (32.9%); coronary, 48 (27.7%); and peripheral arterial disease, 14 (8.1%). IPS ≥6 was strongly associated with cerebrovascular disease (odds ratio [OR] 6.0, p < 0.001), and less robustly to smoking (OR 2.9, p = 0.07) and rhinosinusitis (OR 2.4, p = 0.09). No associations with coronary or peripheral artery diseases were found. After controlling for smoking and rhinosinusitis, yielding significant subclinical sinusitis, the link of Sig IPS to cerebrovascular disease persisted (modified OR 5.2, p = 0.002). CONCLUSION Significant incidental sinusitis, which is mostly subclinical sinusitis, is associated with cerebrovascular disease but not other atheroscleroses. This suggests possible common causation of both by PD.
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Affiliation(s)
| | | | | | - Elizabeth H Payne
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC.,Medical University of South Carolina, Charleston, SC.,The Emmes Corporation in Rockville, MD
| | - Gregory Gilbert
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC
| | - Mulugeta Gebregziabher
- Ralph H. Johnson VA Medical Center, Bee Street, Charleston, SC.,Medical University of South Carolina, Charleston, SC
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Abstract
OBJECTIVES To evaluate the maxillary sinus volumes in unilaterally impacted canine patients and to compare the volumetric changes that occur after the eruption of canines to the dental arch using cone beam computed tomography (CBCT). MATERIALS AND METHODS Pre- (T0) and posttreatment (T1) CBCT records of 30 patients were used to calculate maxillary sinus volumes between the impacted and erupted canine sides. The InVivoDental 5.0 program was used to measure the volume of the maxillary sinuses. The distance from impacted canine cusp tip to the target point on the palatal plane was also measured. RESULTS Right maxillary sinus volume was statistically significantly smaller compared to that of the left maxillary sinus when the canine was impacted on the right side at T0. According to the T1 measurements there was no significant difference between the mean volumes of the impaction side and the contralateral side. The distance from the canine tip to its target point on the palatal plane were 17.17 mm, and the distance from the tip to the target point was 15.14 mm for the left- and right-side impacted canines, respectively, and there was a significant difference between the mean amount of change of both sides of maxillary sinuses after treatment of impacted canines. CONCLUSIONS Orthodontic treatment of impacted canines created a significant increase in maxillary sinus volume when the impacted canines were closer with respect to the maxillary sinus.
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Insua A, Monje A, Chan HL, Zimmo N, Shaikh L, Wang HL. Accuracy of Schneiderian membrane thickness: a cone-beam computed tomography analysis with histological validation. Clin Oral Implants Res 2016; 28:654-661. [PMID: 27140833 DOI: 10.1111/clr.12856] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Cone-beam computed tomography (CBCT) has been used in the literature to evaluate Schneiderian membrane thickness (SMT), but its accuracy has never been validated. The primary aim of this study was to compare the SMT measured by CBCT to the gold standard histological assessment. The correlations between SMT and anatomical structures of the maxillary sinus and alveolar bone were also tested. MATERIALS AND METHODS Fourteen fresh cadaver heads were used for the study, and 28 sinus lift augmentation procedures were performed to obtain the membrane samples. Samples were fixed in formalin and stained with hematoxylin-eosine and Masson trichrome. Specimens were measured by optic microscope at three points, and a mean was obtained. Anatomical landmarks were used to accurately position the CBCT slice, so the SMT could be measured in predetermined locations. Wilcoxon signed-rank test was used to compare values of histological and CBCT measurements, and Spearman's correlation coefficient was calculated to examine the relationship between thickness and anatomical parameters. RESULTS A total of 597 histological measurements were performed, and the mean SMT thickness was 0.30 ± 0.17 mm. The mean CBCT membrane thickness was 0.79 ± 0.52 mm. A statistically significant difference from histological and radiological readings was observed (P = 0.000). Interestingly, 87.77% histological measurements had membrane less than 0.5 mm in thickness compared to 26.66% in CBCT assessment. CONCLUSIONS Within the limitation of this study, the median histological Schneiderian membrane thickness was 0.30 mm. Cone-beam computed tomography assessment was 2.6 times higher than the histological examination.
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Affiliation(s)
- Angel Insua
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nouf Zimmo
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Lujain Shaikh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Dindaroğlu F, Yetkiner E. Cone Beam Computed Tomography in Orthodontics. Turk J Orthod 2016; 29:16-21. [PMID: 30112468 DOI: 10.5152/turkjorthod.2016.15-00026r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/21/2016] [Indexed: 11/22/2022]
Abstract
The advent of three-dimensional (3D) imaging technology has caused a significant change in the diagnostic approach practiced in dentistry, and in particular, orthodontics. Although conventional imaging methods such as orthopantomography and lateral cephalometric and anteroposterior graphs provide sufficient information in mild to moderate orthodontic anomalies, 3D imaging can be a necessity in severe skeletal anomalies or tooth impactions. Computed tomography (CT) has been frequently used when detailed 3D imaging is necessary despite its relatively high cost, low vertical resolution, and high dose of radiation. In contrast to conventional CT application, the development of cone beam computed tomography (CBCT) technology has had important advantages over the conventional method, such as minimization of the radiation dose, image accuracy, rapid scan time, fewer image artifacts, chair-side image display, and real-time analysis. These advantages have provided dental practitioners the opportunity to benefit more frequently from 3D imaging by relatively diminishing radiation dose considerations, financial burden, and availability, in particular. Therefore, the aim of this review is to highlight the current understanding of CBCT practice in orthodontics and to summarize clinically relevant conditions.
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Affiliation(s)
- Furkan Dindaroğlu
- Department of Orthodontics, Ege University School of Dentistry, İzmir, Turkey
| | - Enver Yetkiner
- Department of Orthodontics, Ege University School of Dentistry, İzmir, Turkey
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Bozdemir E, Gormez O, Yıldırım D, Aydogmus Erik A. Paranasal sinus pathoses on cone beam computed tomography. J Istanb Univ Fac Dent 2016; 50:27-34. [PMID: 28955552 PMCID: PMC5573450 DOI: 10.17096/jiufd.47796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/09/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose: The aim of this study was to investigate
paranasal sinus pathoses detected on cone-beam
computed tomography (CBCT) in an adult population. Patients and Methods: Three observers retrospectively
inspected 353 consecutive CBCT scans obtained in a
dentomaxillofacial radiology department for paranasal sinus
pathoses. Descriptive statistics and chi-square tests were
used to determine the prevalence of categorical parameters. Results: The age of the patients ranged from 18 to 85 years
(mean 41.27±16.76). There were 172 (48.7%) females and
181 (51.3%) males. There was a significant difference between
the genders (p=0.02), with males (53.5%) having more sinus
pathoses than females (46.5%). When the left and right sinuses
were considered together, pathoses were most commonly seen
in the maxillary sinuses (57.1%), followed by the ethmoid (53.7
%), frontal (22.6%), and sphenoid sinuses (15.8%). Mucosal
thickening was the most frequently observed abnormality
(51.7%), followed by hypoplasia (17.5%) and sinusitis (17.3%). Conclusion: CBCT is a preferable imaging method for
evaluation of paranasal sinuses. Dentomaxillofacial
radiologists should examine the whole volume of CBCT images
to ensure they do not overlook paranasal sinus pathoses.
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Affiliation(s)
- Esin Bozdemir
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ozlem Gormez
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Derya Yıldırım
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ayse Aydogmus Erik
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
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Shueb SS, Boyer HC, Nixdorf DR. Nonodontogenic "tooth pain" of nose and sinus origin. J Am Dent Assoc 2016; 147:457-9. [PMID: 26762708 DOI: 10.1016/j.adaj.2015.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
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Aksakalli S, Yilmaz BS, Birlik M, Dadasli F, Bolukbasi E. Is There a Relationship Between Maxillary Sinus Findings and Skeletal Malocclusion? Turk J Orthod 2015. [DOI: 10.13076/tjo-d-14-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The use of conebeam computed tomography (CBCT) carries with it medicolegal risks of which the practitioner should be aware. These include licensing and malpractice liability concerns. A practitioner who intends to take and/or use CBCT scans should seek advice from his malpractice carrier before doing so. All scans should be read by someone competent to interpret them. Using the services of an out-of-state radiologist to read scans poses its own set of risks. Consultation with a malpractice carrier and dental boards is advisable in this situation.
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Affiliation(s)
- Bernard Friedland
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA.
| | - Dale A Miles
- University of Texas Dental School at San Antonio, San Antonio, TX, USA; Cone Beam Radiographic Services, Fountain Hills, AZ, USA
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Motoyoshi M, Sanuki-Suzuki R, Uchida Y, Saiki A, Shimizu N. Maxillary sinus perforation by orthodontic anchor screws. J Oral Sci 2015; 57:95-100. [DOI: 10.2334/josnusd.57.95] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mitsuru Motoyoshi
- Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
- Department of Orthodontics, Nihon University School of Dentistry
| | - Rina Sanuki-Suzuki
- Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
- Department of Orthodontics, Nihon University School of Dentistry
| | - Yasuki Uchida
- Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
- Department of Orthodontics, Nihon University School of Dentistry
| | - Akari Saiki
- Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Noriyoshi Shimizu
- Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
- Department of Orthodontics, Nihon University School of Dentistry
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Clinical importance of incidental findings reported on small-volume dental cone beam computed tomography scans focused on impacted maxillary canine teeth. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e205-9. [DOI: 10.1016/j.oooo.2014.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/23/2014] [Accepted: 09/05/2014] [Indexed: 11/24/2022]
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Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent 2014; 5:361-5. [PMID: 25191074 PMCID: PMC4147814 DOI: 10.4103/0976-237x.137949] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of the present study was to infer and to record the prevalence of incidental maxillary sinus pathologies in patients presenting with dental problems using the cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. MATERIALS AND METHODS This retrospective study has evaluated 201 patients (402 maxillary sinuses consecutive CBCT) for various incidental maxillary sinus pathologies by two observers. Pathologic findings were categorized as mucosal thickening (MT), opacification (OPA), polypoidal-mucosal thickening (PT), others (antrolith and discontinuity of the sinus floor) and no pathologic findings. Correlations for pathologic findings and the factors of age and gender were calculated. RESULTS The prevalence for total incidental findings is 59.7%. The present study showed MT (35.1%) as most prevalent finding followed by OPA in (16.6%), PT in 7.2% and others in 0.7%. There was no statistically significant difference between gender and between the age groups. There was no statistically significant difference between different indications groups for CBCT scans. CONCLUSIONS The incidental maxillary sinus abnormalities are highly prevalent in the asymptomatic dental patients; hence oral radiologists should be aware of these incidental findings and comprehensively evaluate the entire captured CBCT volume, which can help in early diagnosis, treatment and follow-up of the patient.
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Affiliation(s)
- Mamta Raghav
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Subodh Sontakke
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
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Prevalence of maxillary sinus pathology in patients considered for sinus augmentation procedures for dental implants. IMPLANT DENT 2014; 22:428-35. [PMID: 23839271 DOI: 10.1097/id.0b013e31829d1a20] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the prevalence of maxillary sinus pathology in patients presenting for implant rehabilitation involving sinus augmentation procedures. MATERIALS AND METHODS Three-dimensional images of 275 patients were evaluated. Age and gender were recorded to see if they had any relationship to the prevalence of pathology. Scans were classified into 1 of the 5 categories based on the type of sinus pathology detected: healthy, mucosal thickening > 5mm, polypoidal mucosal thickening, partial opacification and/or air fluid level, and complete opacification. RESULTS Overall, 54.9% scans were classified as healthy, and 45.1% scans were classified as exhibiting sinus pathology. Men were more likely to exhibit pathology compared with females (P < 0.01). However, age did not seem to have any relation on the prevalence of sinus pathology. Of the patients who presented with evidence of sinus pathology, 56.5% had mucosal thickening (≥ 5 mm), 28.2% with polypoidal thickening, 8.9% partial opacification and/or air/fluid level, and 6.5% complete opacification. CONCLUSIONS It is proposed that, based on the findings of this study, 45.1% patients would require further consultation before proceeding with maxillary sinus augmentation surgery.
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Kfir E, Goldstein M, Abramovitz I, Kfir V, Mazor Z, Kaluski E. The effects of sinus membrane pathology on bone augmentation and procedural outcome using minimal invasive antral membrane balloon elevation. J ORAL IMPLANTOL 2014; 40:285-93. [PMID: 24914915 DOI: 10.1563/aaid-joi-d-11-00253] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Membrane pathology tends to complicate the postprocedural course of open sinus lift by ostio-meatal complex (OMC) obstruction and consequent acute sinusitis. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology undergoing maxillary sinus floor augmentation and simultaneous implant placement using the minimal invasive antral membrane balloon elevation (MIAMBE) method. This study was a retrospective chart review of MIAMBE procedures performed in the presence of significant sinus membrane pathology. Sixteen patients with maxillary sinus membrane thickening in well-ventilated OMC as determined by dental computerized tomography underwent sinus augmentation and simultaneous implant placement using the MIAMBE technique. All 16 procedures were successfully concluded without significant procedural or postprocedural complications or implant failure. Post MIAMBE membrane pathology regressed or disappeared in 8 patients (50%) or remained unchanged in 6 patients (37.5%), while in 2 patients the sinus membrane pathology was limited to evaluation by periapical X rays. Sinus augmentation using the MIAMBE technique can be performed safely in asymptomatic patients in the presence of sinus membrane pathology if the OMC is not obstructed. In a significant proportion of these cases, complete resolution of the membrane pathology after MIAMBE is observed. When compared to open sinus lift, OMC obstruction is less likely to occur when employing the MIAMBE method.
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Abstract
Apart from a few exceptions, dental practitioners are not familiar with sectional images (as those provided by cone beam computed tomography [CBCT]). In addition, the maxillofacial region is a complex area from an anatomic point of view including structures of peculiar shape; this may add to that complexity of their appearance in CBCT. As a result, a thorough knowledge of the tomographic anatomy of the maxillofacial region was necessary. This chapter reviews pertinent anatomical structures of the maxillofacial region in the axial, coronal, sagittal planes, as well as custom planes. Related pathology is also shown and discussed.
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Prevalence of sinus membrane thickening and association with unhealthy teeth: a retrospective review of 831 consecutive patients with 1,662 cone-beam scans. J Oral Maxillofac Surg 2014; 72:2454-60. [PMID: 25236817 DOI: 10.1016/j.joms.2014.06.442] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/16/2014] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The purposes of this retrospective review of cone-beam computed tomographic (CBCT) scans were to 1) determine the prevalence of sinus membrane thickening in a consecutive series of patients; 2) identify the prevalence of healthy or unhealthy teeth associated with sinus membrane thickening; and 3) document changes of the sinus membrane after the removal of unhealthy teeth. MATERIALS AND METHODS Consecutive patients had CBCT scans examined and the sinuses were graded. Grade 1 represented membrane thickening of 0 to less than 2 mm; grade 2 represented thickening of 2 to 5 mm; grade 3 represented membrane or material thickening greater than 5 mm to the level of the ostium; and grade 4 represented soft tissue material superior to the ostium. Cross-sectional images were examined using software by the manufacturer of the CBCT scanner. Unhealthy teeth were identified. The examiner used a standardized approach in viewing the CBCT scans. Intraexaminer error was determined. RESULTS Eight hundred thirty-one patients had 1,662 sinuses evaluated, with thickening of at least 1 sinus membrane in 46.7% (388 patients) and 30.1% (469) of all sinuses evaluated. The prevalence of patients and sinuses with sinus membrane thickening according to the grading criteria was grade 2 for 36.8% of patients and 24.3% of sinuses, grade 3 for 6.0% of patients and 3.7% of sinuses, and grade 4 for 3.6% of patients and 2.2% of sinuses. Unilateral sinus disease was more common than bilateral disease. Of those sinuses with thickening, 80.6% were grade 2, 12.2% were grade 3, and 7.2% were grade 4. Of the 469 sinuses with membrane thickening, 210 were adjacent to unhealthy teeth, 233 were adjacent to healthy teeth, and 26 were in edentulous maxillas. Of the 210 unhealthy teeth, 30 had postextraction CBCT scans available for evaluation. Grade 2 sinus membrane thickening showed a 75% resolution to grade 1 after adjacent tooth removal. Grade 3 sinuses resolved in 25% to grade 1 and grade 2, with 50% remaining at grade 3. There were 2 grade 4 sinuses with follow-up scans, with 1 resolving to grade 2 and the other remaining at grade 4. CONCLUSIONS Sinus membrane thickening is present in 46.7% of patients presenting to an oral and maxillofacial surgical practice. The prevalence of sinus membrane thickening was almost equal in association with unhealthy and healthy teeth. The removal of unhealthy teeth decreased, but did not completely resolve sinus membrane thickening.
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Edwards R, Alsufyani N, Heo G, Flores-Mir C. The frequency and nature of incidental findings in large-field cone beam computed tomography scans of an orthodontic sample. Prog Orthod 2014; 15:37. [PMID: 25033888 PMCID: PMC4884029 DOI: 10.1186/s40510-014-0037-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/09/2014] [Indexed: 12/21/2022] Open
Abstract
Background The aim of this study is to evaluate the nature and frequency of incidental findings in large-field maxillofacial cone beam computed tomography (CBCT). Methods A total of 427 consecutive CBCT radiologic reports obtained for orthodontic purposes were retrospectively reviewed. Findings were summarized and categorized into six anatomic categories. Results A total of 842 incidental findings were reported in the 427 CBCT scans (1.97 findings/scan). The most prevalent findings were those located in the airway (42.3%), followed by the paranasal sinuses (30.9%), dentoalveolar (14.7%), surrounding hard/soft tissues (4.0%), temporomandibular joint (TMJ) (6.4%), and cervical vertebrae (1.3%) regions. Non-odontogenic findings, defined as those located outside the dentition and associated alveolus, represented 718 of the 842 (85.3%) findings. Conclusions This study confirms the high occurrence of incidental findings in large-field maxillofacial CBCT scans in a sample of orthodontically referred cases. The majority are extragnathic findings, which can be normally considered outside the regions of interest of many dental clinicians. Specifically, incidental findings in the naso-oropharyngeal and paranasal air sinuses are the most frequent. This underscores the need for comprehensive review of the entire data volume and the requisite to properly document all findings, regardless of the region of interest. Electronic supplementary material The online version of this article (doi:10.1186/s40510-014-0037-x) contains supplementary material, which is available to authorized users.
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Yilmaz SY, Misirlioglu M, Adisen MZ. A Diagnosis of Maxillary Sinus Fracture with Cone-Beam CT: Case Report and Literature Review. Craniomaxillofac Trauma Reconstr 2014; 7:85-91. [PMID: 25045417 DOI: 10.1055/s-0034-1371550] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 04/14/2013] [Indexed: 10/25/2022] Open
Abstract
The purpose of this article is to present the case of maxillofacial trauma patient with maxillary sinus fracture diagnosed with cone-beam computed tomography (CBCT) and to explore the applications of this technique in evaluating the maxillofacial region. A 23-year-old male patient attempted to our clinic who had an injury at midface with complaints of swelling, numbness. The patient was examined before in emergency center but any diagnosis was made about the maxillofacial trauma. The patient re-examined clinically and radiographically. A fracture on the frontal wall of maxillary sinus is determined with the aid of CBCT. The patient consulted with the department of maxillofacial surgery and it is decided that any surgical treatment was not necessary. The emerging technique CBCT would not be the primary choice of imaging maxillofacial trauma. Nevertheless, when advantages considered this imaging procedure could be the modality of choice according to the case.
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Affiliation(s)
- Selmi Yardimci Yilmaz
- Department of Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Melda Misirlioglu
- Department of Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Mehmet Zahit Adisen
- Department of Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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The frequency and nature of incidental findings in cone-beam computed tomographic scans of the head and neck region: a systematic review. J Am Dent Assoc 2014; 144:161-70. [PMID: 23372132 DOI: 10.14219/jada.archive.2013.0095] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The authors analyzed the literature critically to determine the frequency and nature of incidental findings (IFs) in cone-beam computed tomographic (CBCT) scans of the head and neck region. TYPES OF STUDIES REVIEWED The authors conducted a systematic search of several electronic databases (MEDLINE, Embase, PubMed, Scopus, Web of Science, the Cochrane Library) through July 14, 2012, as well as a limited gray-literature search (in Google Scholar). Inclusion criteria encompassed the frequency of reports of IFs in the head and neck region in CBCT imaging, regardless of the sample origin. The authors used no search limitations. They evaluated methodological quality according to 15 criteria related to study design, population characteristics and statistical analysis. RESULTS Initially, the authors identified 66 articles from the electronic database searches and another one via the gray-literature search. Once they applied the final selection criteria, they found that only five articles satisfied the inclusion criteria. In articles in which investigators reported the number of IFs as the absolute number of IFs detected, the frequency ranged from 1.3 to 2.9 IFs per CBCT scan. Conversely, in articles in which authors reported the number of IFs as the number of scans containing IFs, the frequency ranged from 24.6 to 93.4 percent of CBCT scans. Methodological quality averaged 77.2 percent (range, 60-93 percent) of the maximum possible score. CONCLUSIONS AND CLINICAL IMPLICATIONS IFs are detected relatively frequently in CBCT imaging, and considerable variation is evident in their frequency and nature. The majority are extragnathic findings (that is, those found outside the region of the dentition and alveolus), thus emphasizing the need for complete and proper review of the entire image, regardless of field of view or region of interest.
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Mossaz J, Kloukos D, Pandis N, Suter VGA, Katsaros C, Bornstein MM. Morphologic characteristics, location, and associated complications of maxillary and mandibular supernumerary teeth as evaluated using cone beam computed tomography. Eur J Orthod 2014; 36:708-18. [DOI: 10.1093/ejo/cjt101] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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