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Muacevic A, Adler JR, Satwalekar P, Nalla S, Basany RB, Sai Krishna S. Reliability of Using Texture Analysis of Periapical Radiographs Obtained Using Radiovisiography for Assessing Bone Quality in Dental Implant Planning: A Cross-Sectional Study. Cureus 2022; 14:e32860. [PMID: 36694502 PMCID: PMC9867846 DOI: 10.7759/cureus.32860] [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: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background Pre-prosthetic implant radiographic imaging helps in the quantitative and qualitative analysis of the bone structure and also enables the evaluation of the relationship between critical structures and potential implant sites. Purpose The aim of the study was to define the reliability of utilizing the analysis of textures from the periapical radiographic images obtained through Radiovisiography (RVG) in order to better plan for dental implantations. Methods A cross-sectional study was conducted using 50 intraoral periapical radiographs which were obtained through RVG performed prior to the placement of implants. The radiographs were segregated based on anatomical locations i.e. 12 for the anterior maxilla, nine for the posterior maxilla, seven for the anterior mandible, and 22 for the posterior mandible. Each of the radiographs was visually assessed by four experienced examiners, namely a Prosthodontist E1, Periodontist E2, Oral surgeon E3, and Oral radiologist E4, which was then compared to an experienced operator's tactile perception during a pilot drill for implant placement. As a reference, the Lekholm and Zarb classification was provided to all the examiners for them to qualitatively assess the bone structure in the radiographs. Results The examiners' results were correlated with the assessment provided by the experienced operator. E1 and E4 successfully assessed 42% of the radiographs while E2 had the least success with only 26%. Of the 12 anterior maxillary radiographs, only eight were accurately assessed by E1. With respect to the posterior maxilla, all examiners correctly assessed four radiographs each. Of the seven anterior mandibular radiographs, except for E2, the rest correctly assessed three radiographs each. Of the 22 posterior mandibular radiographs, only nine were accurately assessed by E4. Conclusion Intraoral periapical radiographs obtained through RVG did not meet the desired parameters for assessing the bone quality during the planning stage for implants.
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Nomiyama LM, Matumoto EK, Corrêa MG, Cirano FR, Ribeiro FV, Pimentel SP, Casati MZ. Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical trial. Clin Oral Investig 2022; 27:1665-1679. [PMID: 36401742 DOI: 10.1007/s00784-022-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The study was aimed at comparing implants installed with guided and conventional surgery. MATERIAL AND METHODS Twenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens. RESULTS S-CAIS showed less linear deviation at the apical point and the midpoint and less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers and Tf presented higher levels in CS (p < 0.05). Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique. CONCLUSION However, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic levels and bone markers. CLINICAL RELEVANCE Evaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level. TRIAL REGISTRATION ReBEC-RBR-8556fzp.
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Affiliation(s)
- Lucas Massaru Nomiyama
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Edson Ken Matumoto
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Mônica Grazieli Corrêa
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Fernanda Vieira Ribeiro
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil
| | - Marcio Zaffalon Casati
- Dental Research Division, School of Dentistry, Universidade Paulista (UNIP), São Paulo, São Paulo, Av. Dr. Bacelar, 1212, 4° Andar, Vila Clementino, São Paulo, SP, 04026-002, Brazil.
- Departamento de Odontologia, Universidade Paulista (UNIP), São Paulo, Brazil.
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Afshari A, Shahmohammadi R, Mosaddad SA, Pesteei O, Hajmohammadi E, Rahbar M, Alam M, Abbasi K. Free-Hand versus Surgical Guide Implant Placement. ADVANCES IN MATERIALS SCIENCE AND ENGINEERING 2022; 2022:1-12. [DOI: 10.1155/2022/6491134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
One of the most key areas of dentistry is dental implant surgery. The use of digital equipment and software in dentistry has developed considerably in recent years compared to other fields of medicine. Since examining the advantages and disadvantages of each approach, along with case studies, can help physicians make informed decisions, this review study aims to raise the awareness of dentists to make easier decisions about using guided or free-hand surgery. When planning for a dental implant, one of the most challenging questions that doctors face is which method to use (guided surgery or free-hand). Choosing the right method, such as other clinical considerations, will depend on the individual circumstances of each patient and the preference of the treating physician. Free-hand surgery is a cost-effective method in which the flap is reflected, and, according to the doctor's diagnostic information, an implant is placed, which in many cases is a useful method. Guided surgery has the highest level of accuracy and control, in which osteotomy is designed and printed through a digital surgery guide, and depending on the complexity of the case and the patient's anatomy, it has a higher level of value than free surgery. The surgical guide helps the surgeon make the implant surgery more accurate, safer, simpler, at a lower cost, and in less time. In fact, there are patterns that convey information about the position of the tooth to the dentist before the implant is placed.
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Affiliation(s)
- Aysooda Afshari
- Postgraduate Student of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rojin Shahmohammadi
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ozra Pesteei
- Postgraduate Student of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Emran Hajmohammadi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Orban K, Varga E, Windisch P, Braunitzer G, Molnar B. Accuracy of half-guided implant placement with machine-driven or manual insertion: a prospective, randomized clinical study. Clin Oral Investig 2021; 26:1035-1043. [PMID: 34401946 PMCID: PMC8791874 DOI: 10.1007/s00784-021-04087-0] [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: 04/23/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the accuracy of implant placement performed with either a surgical motor or a torque wrench as part of a half-guided surgical protocol. MATERIALS AND METHODS Implant insertion with half-guided surgical protocol was utilized by surgical motor (machine-driven group) or torque wrench (manual group) in the posterior maxilla. After the healing period, accuracy comparison between planned and actual implant positions was performed based on preoperative cone beam computed tomography and postoperative digital intraoral scans. Coronal, apical, and angular deviations, insertion time, and insertion torque were evaluated. RESULTS Forty patients were treated with 1 implant each; 20 implants were inserted with a surgical motor and 20 implants with a torque wrench. Global coronal and apical deviations were 1.20 ± 0.46 mm and 1.45 ± 0.79 mm in the machine-driven group, and 1.13 ± 0.38 mm and 1.18 ± 0.28 mm in the manual group (respectively). The mean angular deviation was 4.82 ± 2.07° in the machine-driven group and 4.11 ± 1.63° in the manual group. Mean insertion torque was 21.75 ± 9.75 Ncm in the machine-driven group, compared to 18.75 ± 7.05 Ncm in the manual group. Implant placement duration was 9.25 ± 1.86 s in the machine-driven group at a speed of 50 rpm, and 36.40 ± 8.15 s in the manual group. CONCLUSION No significant difference was found between the two groups in terms of accuracy and mean insertion torque, while machine-driven implant placement was significantly less time-consuming. CLINICAL RELEVANCE Optimal implant placement accuracy utilized by half-guided surgical protocol can be achieved with both machine-driven and torque wrench insertion. TRIAL REGISTRATION ID: NCT04854239.
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Affiliation(s)
- Kristof Orban
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary.
| | | | - Peter Windisch
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
| | | | - Balint Molnar
- Faculty of Dentistry, Department of Periodontology, Semmelweis University, Budapest, Hungary
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Kalaivani G, Balaji VR, Manikandan D, Rohini G. Expectation and reality of guided implant surgery protocol using computer-assisted static and dynamic navigation system at present scenario: Evidence-based literature review. J Indian Soc Periodontol 2020; 24:398-408. [PMID: 33144766 PMCID: PMC7592620 DOI: 10.4103/jisp.jisp_92_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/15/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022] Open
Abstract
In the field of modern dentistry, ideal three-dimensional positioning of dental implant with optimal prosthetic fit offers successful long-term outcomes. To achieve such accurate implant placement, presurgical evaluation of hard and soft tissue matters the most. Their efforts can be attained using various application programs such as digital imaging, implant planning software, laboratory- or computer-assisted surgical guides, and dynamic navigation approach. To overcome different opinions and choices regarding guided surgery, this article explains an evidence-based literature review to assess its various outcomes and allowing informed choices before using various guided surgical techniques based on its expectation and reality outcomes. This highlights a clinician's choice to guide his successful implant surgery without causing distress in the midway of treatment. An online search was done on PubMed/Medline database to bring in accuracy to the expertise. This review includes reference of publications from 2000 to 2019, which is related to promising outcomes using computer-assisted static or dynamic navigation system for the placement of implant. Out of these, 809 were related to the computer-guided implant placement. Relevant papers were chosen in accordance with the inclusion and exclusion criteria. This review article contemplates to reflect the fact that computer-guided approach is considered to offer more predictable, safer, and faster implant placement with the predetermined final prosthetic outfit. Thus, digital planning and placing of dental implants in the correct position keep escalating to a higher achievement levels than a classical freehand approach. Nevertheless, this guided surgical approach also holds some errors and risks, which must be identified and rectified.
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Affiliation(s)
- Gunalan Kalaivani
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | | | - Dhanasekaran Manikandan
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Govindasamy Rohini
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Chackartchi T, Romanos GE, Sculean A. Soft tissue‐related complications and management around dental implants. Periodontol 2000 2019; 81:124-138. [DOI: 10.1111/prd.12287] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Tali Chackartchi
- Department of Periodontology Faculty of Dental Medicine Hadassah & Hebrew University Jerusalem Israel
| | - Georgios E. Romanos
- Department of Periodontology School of Dental Medicine Stony Brook University Stony Brook New York USA
| | - Anton Sculean
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
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Freehand Versus Guided Surgery: Factors Influencing Accuracy of Dental Implant Placement. IMPLANT DENT 2018; 26:500-509. [PMID: 28731896 DOI: 10.1097/id.0000000000000620] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patient anatomy, practitioner experience, and surgical approach are all factors that influence implant accuracy. However, the relative importance of each factor is poorly understood. The present study aimed to identify which factors most critically determine implant accuracy to aid the practitioner in case selection for guided versus freehand surgery. METHODS One practitioner's ideal implant angulation and position was compared with his achieved position radiographically for 450 implants placed using a conventional freehand method. The relative contribution of 11 demographic, anatomical, and surgical factors to the accuracy of implant placement was systematically quantified. DISCUSSION The most important predictors of angulation and position accuracy were the number of adjacent implants placed and the tooth-borne status of the site. Immediate placement also significantly increased position accuracy, whereas cases with narrow sites were significantly more accurate in angulation. Accuracy also improved with the practitioner's experience. CONCLUSION These results suggest tooth-borne, single-implant cases performed later in the practitioner's experience are most appropriate for freehand placement, whereas guided surgery should be considered to improve accuracy for multiple-implant cases in edentulous or partially edentulous sites.
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Zhou W, Liu Z, Song L, Kuo CL, Shafer DM. Clinical Factors Affecting the Accuracy of Guided Implant Surgery—A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2018; 18:28-40. [DOI: 10.1016/j.jebdp.2017.07.007] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 07/17/2017] [Indexed: 12/22/2022]
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Min HG, Kim SG, Oh JS, You JS, Lim SC, Jeong MA. Comparative Study on Osseointegration of Implants After Flap and Flapless Surgery in the Mandible of Dogs. IMPLANT DENT 2017; 26:730-734. [PMID: 28846560 DOI: 10.1097/id.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The objective of this study was to compare the implant stability and osseointegration of implants using a flap or flapless technique. MATERIAL AND METHODS Mandibular premolars and molars were extracted from both sides in 6 dogs. After 8 weeks, 4 fixtures were implanted using either a flap or flapless technique. Implant stability quotient was measured on insertion and at 2, 4, and 8 weeks later. The animals were killed while the tissues were histologically analyzed. RESULTS Implant stability increased for 8 weeks, and no statistically significant differences were observed between the surgical protocols. Bone-implant contact showed 60.27% ± 30.99% for flapless surgery and 59.73% ± 17.12% for flap surgery. And the results of new bone formation area from total area showed 56.07% ± 27.78% for flapless surgery and 57.00% ± 14.66% for flap surgery. There were no statistically significant differences. CONCLUSION This study showed no significant difference in implant stability as well as osseointegration regardless of flap or flapless technique.
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Affiliation(s)
- Hong-Gi Min
- *Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea. †Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea. ‡Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea. §Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea. ¶Professor, Department of Pathology, School of Medicine, Chosun University, Gwangju, Republic of Korea. ‖Professor, Department of Dental Hygiene, Kangwon National University, Samcheok, Republic of Korea
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Haghanifar S, Yousefi S, Moudi E, Abesi F, Bijani A, Moghadamnia AA, Nabahati M. Accuracy of densitometry of two cone beam computed tomography equipment in comparison with computed tomography. Electron Physician 2017; 9:4384-4390. [PMID: 28713511 PMCID: PMC5498704 DOI: 10.19082/4384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/14/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The use of oral implants has been growing, and cone beam computerized tomography (CBCT) has become the method of choice for oral and maxillofacial radiology. OBJECTIVE To assess the accuracy of bone densitometry in two different CBCT devices in comparison with MDCT (multi-detector CT). METHODS Different concentrations of urografin, including 2.5%, 5%, 7.5%, 10%, 12.5%, were prepared, and the Hounsfield unit of these solution was measured by two CBCT devices (SORDEX CRANEX 3D and NEWTOM 5G) and one spiral CT device (SOMATOM SENSATION). Difference of output Hounsfield units in each concentration was compared in three devices. Correlation of devices with increase of urografin dose also was evaluated. Statistical analyses of the data were performed using SPSS18 and Kruskal-Wallis and Mann-Whitney U tests, along with Spearman's correlation coefficient. RESULTS The range of gray density for NEWTOM 5G CBCT, SORDEX 3D CBCT, and SOMATOM CT imaging systems was from 781 to 2311, 427 to 1464, and 222 to 994, respectively. There was significant difference between devices in the Hounsfield unit in all urografin concentrations (p<0.001). Also there was a significant correlation between three devices with increasing the urografin dose (p<0.05; r>0.95). CONCLUSION Our findings indicated a high correlation and linear relationship between different studied imaging systems. Although utilizing CBCT in the assessment of bone density is useful according to its lower emitted dose and less cost, clinicians should be aware of the issue that the voxel value in CBCT is not as perfect as CT.
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Affiliation(s)
- Sina Haghanifar
- DDS., Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Sajad Yousefi
- DDS., Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ehsan Moudi
- DDS., Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Farida Abesi
- DDS., Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- MD., Babol University of Medical Sciences, Babol, Iran
| | - Ali Akbar Moghadamnia
- Pharm. D., Ph.D. of Pharmacology, Professor, Department of Physiology and Pharmacology, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Nabahati
- MD., Assistant Professor, Department of Radiology, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
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Arcuri L, Lorenzi C, Cecchetti F, Germano F, Spuntarelli M, Barlattani A. Full digital workflow for implant-prosthetic rehabilitations: a case report. ORAL & IMPLANTOLOGY 2017; 8:114-121. [PMID: 28042423 DOI: 10.11138/orl/2015.8.4.114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of the present study was to describe a proof of concept digital workflow for the implant-prosthetic treatment in partially edentate patients and evaluate its clinical performance. METHODS A 55-year-old woman with a Kennedy class III bilateral edentulism in the mandible has been selected for a computer guided implantology according with the Smart Fusion® protocol (NobelBiocare, Kloten, Switzerland). After the template-guided implant placement, an immediate loading of the implants has been performed. QuickTemp conical temporary abutments were selected to deliver immediately prefabricated cement-retained provisionals. Two months after an impression was taken with an intraoral digital scanner (3Shape Trios3, Copenhagen, Denmark). The provisional restoration optical scanning was used to transfer the functionalized prosthetic contour to be duplicated into the definitive porcelain fused to zirconia restoration cemented on customized titanium abutments. RESULTS A satisfying esthetic and functional result has been achieved. No biological and mechanical complications were recorded. CONCLUSIONS The investigated fully digital implant-prosthetic protocol provided a smooth, complication free and time effective treatment alternative to the conventional workflow. Besides the fully digital workflow allowed the surgical and prosthetic decision making and the communication within the dental team and with the patient. Further improvements heading to a direct match between the intraoral scan and the CBCT are strongly advised in order to create the so-called virtual patient.
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Affiliation(s)
- L Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - C Lorenzi
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Cecchetti
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Germano
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - M Spuntarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - A Barlattani
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Amorfini L, Migliorati M, Drago S, Silvestrini-Biavati A. Immediately Loaded Implants in Rehabilitation of the Maxilla: A Two-Year Randomized Clinical Trial of Guided Surgery versus Standard Procedure. Clin Implant Dent Relat Res 2016; 19:280-295. [DOI: 10.1111/cid.12459] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/09/2016] [Accepted: 09/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Leonardo Amorfini
- Researcher, Department of Surgical Sciences and Integrated Diagnostic; University of Genova; Genova Italy
| | - Marco Migliorati
- Adjunct Assistant Professor, Department of Orthodontics; University of Genova; Genova Italy
| | - Sara Drago
- Researcher, Department of Orthodontics; University of Genova; Genova Italy
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Laederach V, Mukaddam K, Payer M, Filippi A, Kühl S. Deviations of different systems for guided implant surgery. Clin Oral Implants Res 2016; 28:1147-1151. [DOI: 10.1111/clr.12930] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/30/2022]
Affiliation(s)
- V. Laederach
- Department of Oral Surgery, Oral Radiology and Oral Medicine; School of Dentistry; University of Basel; Basel Switzerland
| | - K. Mukaddam
- Department of Oral Surgery, Oral Radiology and Oral Medicine; School of Dentistry; University of Basel; Basel Switzerland
| | - M. Payer
- Department of Oral Surgery and Radiology; School of Dentistry; Medical University of Graz; Graz Austria
| | - A. Filippi
- Department of Oral Surgery, Oral Radiology and Oral Medicine; School of Dentistry; University of Basel; Basel Switzerland
| | - S. Kühl
- Department of Oral Surgery, Oral Radiology and Oral Medicine; School of Dentistry; University of Basel; Basel Switzerland
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Ceramic brackets and low friction : A possible synergy in patients requiring multiple MRI scanning. J Orofac Orthop 2016; 77:214-23. [PMID: 27098639 DOI: 10.1007/s00056-016-0027-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/12/2015] [Indexed: 10/21/2022]
Abstract
AIM To investigate any advantages of low friction biomechanics in orthodontic patients with fixed appliances without producing metal artifacts during magnetic resonance imaging (MRI). MATERIALS AND METHODS Frictional resistance generated by bracket-wire-ligature systems was analyzed via an experimental model that reproduced upper canine misalignment. Each sample was tested 10 consecutive times in a dry state; a total of 160 tests were carried out. We documented the frictional forces generated by a 0.012- and 0.014-inch superelastic nickel-titanium wire (SENT) with ceramic self-ligating brackets (SLB) with metal insert and ceramic monocrystalline brackets with nonconventional elastic ligatures (NCEL) in conjunction with various degrees of canine misalignment (1.5, 3.0, 4.5, and 6.0 mm). Comparisons between the frictional forces released by the two different bracket-wire-ligature systems were made by conducting 3-way analysis of variance (ANOVA) with Tukey HSD pairwise test (P < 0.005). RESULTS We observed no clinically relevant difference between the frictional forces released by ceramic SLB and ceramic brackets in conjunction with a 0.012- and 0.014-inch SENT. Statistically significant differences were apparent with a 0.012-inch SENT at 4.5 and 6.0 mm of canine misalignment, where the SLB revealed higher frictional forces. CONCLUSIONS Ceramic brackets with NCEL revealed frictional forces similar to those generated in conjunction with ceramic SLB, thereby helping to avoid metal artifacts in case of expected necessary MRI during orthodontic treatment with fixed appliances.
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Kose TE, Demirtas N, Cakir Karabas H, Ozcan I. Evaluation of dental panoramic radiographic findings in edentulous jaws: A retrospective study of 743 patients "Radiographic features in edentulous jaws". J Adv Prosthodont 2015; 7:380-5. [PMID: 26576254 PMCID: PMC4644779 DOI: 10.4047/jap.2015.7.5.380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions.
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Affiliation(s)
- Taha Emre Kose
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Nihat Demirtas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Hulya Cakir Karabas
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Ilknur Ozcan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Frascaria M, Casinelli M, Marzo G, Gatto R, Baldi M, D'Amario M. Digital Implant Planning for a Minimally Invasive Surgery Approach: A Case Letter of a Full-Arch Rehabilitation. J ORAL IMPLANTOL 2015; 41:205-8. [DOI: 10.1563/aaid-joi-d-12-00232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Massimo Frascaria
- Division of Implantology and Prosthetic Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - Matteo Casinelli
- Division of Implantology and Prosthetic Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - Giuseppe Marzo
- Division of Implantology and Prosthetic Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - Roberto Gatto
- Division of Implantology and Prosthetic Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - Mario Baldi
- Division of Restorative Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
| | - Maurizio D'Amario
- Division of Restorative Dentistry, Department of Clinical Medicine, Public Health, Life and Environment Sciences, Dental Clinic, University of L'Aquila, L'Aquila, Italy
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Egbert N, Cagna DR, Ahuja S, Wicks RA. Accuracy and reliability of stitched cone-beam computed tomography images. Imaging Sci Dent 2015; 45:41-7. [PMID: 25793182 PMCID: PMC4362990 DOI: 10.5624/isd.2015.45.1.41] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/25/2014] [Accepted: 12/31/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study was performed to evaluate the linear distance accuracy and reliability of stitched small field of view (FOV) cone-beam computed tomography (CBCT) reconstructed images for the fabrication of implant surgical guides. MATERIALS AND METHODS Three gutta percha points were fixed on the inferior border of a cadaveric mandible to serve as control reference points. Ten additional gutta percha points, representing fiduciary markers, were scattered on the buccal and lingual cortices at the level of the proposed complete denture flange. A digital caliper was used to measure the distance between the reference points and fiduciary markers, which represented the anatomic linear dimension. The mandible was scanned using small FOV CBCT, and the images were then reconstructed and stitched using the manufacturer's imaging software. The same measurements were then taken with the CBCT software. RESULTS The anatomic linear dimension measurements and stitched small FOV CBCT measurements were statistically evaluated for linear accuracy. The mean difference between the anatomic linear dimension measurements and the stitched small FOV CBCT measurements was found to be 0.34 mm with a 95% confidence interval of +0.24 - +0.44 mm and a mean standard deviation of 0.30 mm. The difference between the control and the stitched small FOV CBCT measurements was insignificant within the parameters defined by this study. CONCLUSION The proven accuracy of stitched small FOV CBCT data sets may allow image-guided fabrication of implant surgical stents from such data sets.
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Affiliation(s)
- Nicholas Egbert
- Private Practice, Reconstructive Dental Specialists of Utah, Salt Lake City, UT, USA
| | - David R Cagna
- Department of Prosthodontics, University of Tennessee Health Science Center College of Dentistry, Memphis, TN, USA
| | - Swati Ahuja
- Department of Prosthodontics, University of Tennessee Health Science Center College of Dentistry, Memphis, TN, USA
| | - Russell A Wicks
- Department of Prosthodontics, University of Tennessee Health Science Center College of Dentistry, Memphis, TN, USA
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Birkenfeld F, Becker M, Sasse M, Gassling V, Lucius R, Wiltfang J, Kern M. Detection of the genial spinal canal in atrophic mandibles with a CBCT: a cadaver study. Dentomaxillofac Radiol 2014; 44:20140290. [PMID: 25411711 DOI: 10.1259/dmfr.20140290] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The use of a single midline implant to retain a complete mandibular denture when more implants cannot be used is an incipient treatment modality. However, in the mandibular symphysis, the genial spinal canal (GSC) is an anatomical structure with neurovascular content that can be harmed during dental implant surgery. The purpose of the present study was to use CBCT of edentulous atrophic cadaver mandibles and evaluate how often the simulated placement of a single midline implant would contact the GSC if present. METHODS CBCT scans of 47 edentulous cadaver mandibles were performed. A digital simulation of the placement of a single midline implant (3.8 × 11.0 mm) was performed, and the implant-GSC contact was evaluated. RESULTS A GSC was detected in the CBCT scan of all atrophic mandibles. In 42 cases (89.4%), the single midline implant contacted the GSC. On average, the five cases without GSC contact had a higher alveolar ridge (4.1 mm) and a lower GSC (0.79 mm) than did the cases with GSC contact. CONCLUSIONS CBCT scans can adequately detect the GSC during pre-surgical diagnostics. There is a high risk of implant-GSC contact during surgery of the anterior mandible. However, the clinical relevance of such a contact is not known yet, because none of the clinical studies evaluating a single midline implant has reported any implant-GSC contact-related complications.
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Affiliation(s)
- F Birkenfeld
- 1 Department of Oral-Maxillofacial-Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
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Van de Wiele G, Teughels W, Vercruyssen M, Coucke W, Temmerman A, Quirynen M. The accuracy of guided surgery via mucosa-supported stereolithographic surgical templates in the hands of surgeons with little experience. Clin Oral Implants Res 2014; 26:1489-94. [DOI: 10.1111/clr.12494] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Gerlinde Van de Wiele
- Periodontology Section; Department of Oral Health Sciences; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - Wim Teughels
- Periodontology Section; Department of Oral Health Sciences; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - Marjolein Vercruyssen
- Periodontology Section; Department of Oral Health Sciences; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - Wim Coucke
- Clinical Biology; Scientific Institute of Public Health; Brussels Belgium
| | - Andy Temmerman
- Periodontology Section; Department of Oral Health Sciences; KU Leuven & University Hospitals Leuven; Leuven Belgium
| | - Marc Quirynen
- Periodontology Section; Department of Oral Health Sciences; KU Leuven & University Hospitals Leuven; Leuven Belgium
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Vercruyssen M, Coucke W, Naert I, Jacobs R, Teughels W, Quirynen M. Depth and lateral deviations in guided implant surgery: an RCT comparing guided surgery with mental navigation or the use of a pilot-drill template. Clin Oral Implants Res 2014; 26:1315-20. [DOI: 10.1111/clr.12460] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2014] [Indexed: 02/04/2023]
Affiliation(s)
- M. Vercruyssen
- Department of Oral Health Sciences; Periodontology; Faculty of Medicine; Catholic University Leuven; University Hospitals Leuven; Leuven Belgium
| | - W. Coucke
- Clinical Biology; Scientific Institute of Public Health; Brussels Belgium
| | - I. Naert
- Department of Oral Health Sciences; Prosthetic Dentistry; Faculty of Medicine; Catholic University Leuven; University Hospitals Leuven; Leuven Belgium
| | - R. Jacobs
- OMFS IMPATH research group; Department of Imaging & Pathology; Faculty of Medicine; Catholic University of Leuven; University Hospitals Leuven; Leuven Belgium
| | - W. Teughels
- Department of Oral Health Sciences; Periodontology; Faculty of Medicine; Catholic University Leuven; University Hospitals Leuven; Leuven Belgium
| | - M. Quirynen
- Department of Oral Health Sciences; Periodontology; Faculty of Medicine; Catholic University Leuven; University Hospitals Leuven; Leuven Belgium
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Jacobs R, Quirynen M. Dental cone beam computed tomography: justification for use in planning oral implant placement. Periodontol 2000 2014; 66:203-13. [DOI: 10.1111/prd.12051] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 01/17/2023]
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23
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Vercruyssen M, Fortin T, Widmann G, Jacobs R, Quirynen M. Different techniques of static/dynamic guided implant surgery: modalities and indications. Periodontol 2000 2014; 66:214-27. [DOI: 10.1111/prd.12056] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 02/05/2023]
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Del Neri NB, Araujo-Pires AC, Andreo JC, Rubira-Bullen IRF, Ferreira Júnior O. Zygomaticofacial foramen location accuracy and reliability in cone-beam computed tomography. Acta Odontol Scand 2014; 72:157-60. [PMID: 23808498 DOI: 10.3109/00016357.2013.814804] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study aimed to evaluate the possibility of detecting the zygomaticofacial foramen (ZFF) in cone-beam computed tomography (CBCT). MATERIALS AND METHODS This study evaluated ZFFs in 151 macerated skulls (302 zygomatic bones, ZBs) by physical inspection, in which the presence and diameters of the ZFFs were determined. These data were compared with the CBCT images of the skulls to determine the accuracy of CBCT in detecting ZFFs. The diameters were measured by insertion of steel wires with known thicknesses into the ZFFs. The CBCT images were acquired by an i-CAT Classic® (International Imaging Sciences, Hatfield, PA) connected to a workstation (Model ITOX Midtower Workstation; Imaging Sciences International®) with a 20-inch Eizo monitor. The images were generated in coronal, sagittal and axial slices to evaluate the best tomographic plane for ZFF visualization. RESULTS The incidence of ZFF found by physical inspection was one foramen in 44% of ZBs (n = 133), two foramina in 28% (n = 86), three foramina in 8% (n = 24) and four foramina in 1% (n = 2). ZFF was absent in 19% (n = 57) of ZBs. The average diameter was 0.57 mm (± 0.27 mm). All foramina were observed in all tomography images. CONCLUSION This preliminary study supports the conclusion that a CBCT scan has excellent accuracy in evaluating ZFFs.
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Neugebauer J, Stachulla G, Ritter L, Dreiseidler T, Mischkowski RA, Keeve E, Zöller JE. Computer-aided manufacturing technologies for guided implant placement. Expert Rev Med Devices 2014; 7:113-29. [DOI: 10.1586/erd.09.61] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Assaf M, Gharbyah AZA. Accuracy of computerized vertical measurements on digital orthopantomographs: posterior mandibular region. J Clin Imaging Sci 2014; 4:7. [PMID: 25806135 PMCID: PMC4286816 DOI: 10.4103/2156-7514.148274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/09/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Orthopantomographs are commonly used for diagnosis in clinical dentistry. Although the manufacturers claim a constant magnification effect, the reliability of measuring dimensions on the panoramic radiographs is not clear. The aim of this study was to evaluate the accuracy of measuring vertical dimensions in the posterior mandibular area on digital orthopantomographs. MATERIALS AND METHODS A retrospective survey of 20 orthopantomographs with unrestored implants (only with cover screw) in the mandibular posterior region (molars and premolars) was conducted. All radiographs were taken using the same machine by skilled technicians. Two examiners were asked to measure the vertical dimension of the implants seen on the radiographs viewed using two differently sized display screens. Inter-examiner and intra-examiner reliability tests were performed. Differences between the measured length and the actual length using each screen type were compared. RESULTS High coefficients of reliability were observed on intra- and inter-examiner correlation. The overall reliability of measuring the vertical dimensions of implants between both examiners for the large screen and the small screen were 97.4% (Cronbach's alpha 0.993) and 94.0% (Cronbach's alpha 0.984), respectively. There were no significant differences between the errors seen with either the large screen or the small screen, when each of them was compared to the original length (P = 0.146). CONCLUSION This study shows that vertical dimensions in the posterior mandibular region (molar and premolars) can be reliably measured on an orthopantomograph using a calibrated machine and special software.
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Affiliation(s)
- Mohammad Assaf
- Department of Periodontology and Preventive Dentistry, Al-Quds University, Jerusalem, Palestine ; Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine
| | - Alaa' Z Abu Gharbyah
- Alpha Clinic, Private Practice Limited to Periodontology and Dental Implants, Ramallah, Palestine
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Vasak C, Strbac GD, Huber CD, Lettner S, Gahleitner A, Zechner W. Evaluation of Three Different Validation Procedures regarding the Accuracy of Template-Guided Implant Placement: An In Vitro Study. Clin Implant Dent Relat Res 2013; 17:142-9. [DOI: 10.1111/cid.12085] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christoph Vasak
- Department of Oral Surgery; Bernhard Gottlieb University School of Dentistry; Medical University of Vienna; Vienna Austria
| | - Georg D. Strbac
- Department of Oral Surgery; Bernhard Gottlieb University School of Dentistry; Medical University of Vienna; Vienna Austria
| | - Christian D. Huber
- Department of Oral Surgery; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Stefan Lettner
- Department of Oral Surgery; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - André Gahleitner
- Department of Oral Surgery; Bernhard Gottlieb University School of Dentistry; Medical University of Vienna; Vienna Austria
| | - Werner Zechner
- Bernhard Gottlieb University School of Dentistry; Medical University of Vienna; Vienna Austria
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Cushen SE, Turkyilmaz I. Impact of operator experience on the accuracy of implant placement with stereolithographic surgical templates: An in vitro study. J Prosthet Dent 2013; 109:248-54. [DOI: 10.1016/s0022-3913(13)60053-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Pauwels R, Nackaerts O, Bellaiche N, Stamatakis H, Tsiklakis K, Walker A, Bosmans H, Bogaerts R, Jacobs R, Horner K. Variability of dental cone beam CT grey values for density estimations. Br J Radiol 2013; 86:20120135. [PMID: 23255537 DOI: 10.1259/bjr.20120135] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the use of dental cone beam CT (CBCT) grey values for density estimations by calculating the correlation with multislice CT (MSCT) values and the grey value error after recalibration. METHODS A polymethyl methacrylate (PMMA) phantom was developed containing inserts of different density: air, PMMA, hydroxyapatite (HA) 50 mg cm(-3), HA 100, HA 200 and aluminium. The phantom was scanned on 13 CBCT devices and 1 MSCT device. Correlation between CBCT grey values and CT numbers was calculated, and the average error of the CBCT values was estimated in the medium-density range after recalibration. RESULTS Pearson correlation coefficients ranged between 0.7014 and 0.9996 in the full-density range and between 0.5620 and 0.9991 in the medium-density range. The average error of CBCT voxel values in the medium-density range was between 35 and 1562. CONCLUSION Even though most CBCT devices showed a good overall correlation with CT numbers, large errors can be seen when using the grey values in a quantitative way. Although it could be possible to obtain pseudo-Hounsfield units from certain CBCTs, alternative methods of assessing bone tissue should be further investigated. ADVANCES IN KNOWLEDGE The suitability of dental CBCT for density estimations was assessed, involving a large number of devices and protocols. The possibility for grey value calibration was thoroughly investigated.
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Affiliation(s)
- R Pauwels
- Department of Oral Health Sciences, University of Leuven, Leuven, Belgium.
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Juluri R, Moran M, Suzuki JB, Khocht A. A comparison of computed tomography scans and digital periapical radiographs ridge height measurements. J ORAL IMPLANTOL 2013; 41:125-31. [PMID: 23368722 DOI: 10.1563/aaid-joi-d-12-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To investigate the agreement between computerized tomography scans (CT) and intraoral periapical digital radiographs (PA) alveolar ridge height measurements in maxillary and mandibular posterior regions. We reviewed 100 implant patient radiographic records and identified 27 mandibular sites in 19 patients and 23 maxillary sites in 13 patients with available CT scans and matching PA radiographs. The distance from the crest of the ridge to the floor of the maxillary sinus or to the superior border of the inferior alveolar canal was measured. PAs were measured with Dexis software v. 8.0 and CTs were measured with Simplant software v. 11.02. Two examiners (RJ and MM) recorded the measurements separately; each examiner recorded two readings. The average of the 4 readings was used for data analysis. Absolute agreement: Paired t test comparing ridge-height measurements between the two imaging methods showed no differences for maxillary sites (P > 0.2) and significant differences for the mandibular sites (CT > PA, P = 0.0009). Relative agreement: Kendall rank correlation analysis of ridge-height measurements between the 2 imaging methods showed a high positive correlation for maxillary sites (Kendall's tau = 0.76, P = 0.0001) and moderate correlation for the mandibular sites (Kendall's tau = 0.46, P = 0.001). Maxillary PAs tend to approximate CT ridge-height measurements. By contrast mandibular PAs tend to underestimate the distance from the crest of the ridge to the inferior alveolar canal.
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Koop R, Vercruyssen M, Vermeulen K, Quirynen M. Tolerance within the sleeve inserts of different surgical guides for guided implant surgery. Clin Oral Implants Res 2012; 24:630-4. [DOI: 10.1111/j.1600-0501.2012.02436.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Richard Koop
- Department of Periodontology; Catholic University Leuven; Kapucijnenvoer 7; B-3000; Leuven; Belgium
| | - Marjolein Vercruyssen
- Department of Periodontology; Catholic University Leuven; Kapucijnenvoer 7; B-3000; Leuven; Belgium
| | - Kim Vermeulen
- Department of Periodontology; Catholic University Leuven; Kapucijnenvoer 7; B-3000; Leuven; Belgium
| | - Marc Quirynen
- Department of Periodontology; Catholic University Leuven; Kapucijnenvoer 7; B-3000; Leuven; Belgium
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Olszewski R. Surgical Engineering in Cranio-Maxillofacial Surgery: A Literature Review. JOURNAL OF HEALTHCARE ENGINEERING 2012. [DOI: 10.1260/2040-2295.3.1.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Katsoulis J, Enkling N, Takeichi T, Urban IA, Mericske-Stern R, Avrampou M. Relative Bone Width of the Edentulous Maxillary Ridge. Clinical Implications of Digital Assessment in Presurgical Implant Planning. Clin Implant Dent Relat Res 2012; 14 Suppl 1:e213-23. [DOI: 10.1111/j.1708-8208.2012.00441.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Klinke T, Daboul A, Maron J, Gredes T, Puls R, Jaghsi A, Biffar R. Artifacts in magnetic resonance imaging and computed tomography caused by dental materials. PLoS One 2012; 7:e31766. [PMID: 22384071 PMCID: PMC3285178 DOI: 10.1371/journal.pone.0031766] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 01/16/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Artifacts caused by dental restorations, such as dental crowns, dental fillings and orthodontic appliances, are a common problem in MRI and CT scans of the head and neck. The aim of this in-vitro study was to identify and evaluate the artifacts produced by different dental restoration materials in CT and MRI images. METHODS Test samples of 44 materials (Metal and Non-Metal) commonly used in dental restorations were fabricated and embedded with reference specimens in gelatin moulds. MRI imaging of 1.5T and CT scan were performed on the samples and evaluated in two dimensions. Artifact size and distortions were measured using a digital image analysis software. RESULTS In MRI, 13 out of 44 materials produced artifacts, while in CT 41 out of 44 materials showed artifacts. Artifacts produced in both MRI and CT images were categorized according to the size of the artifact. SIGNIFICANCE Metal based restoration materials had strong influence on CT and less artifacts in MRI images. Rare earth elements such as Ytterbium trifluoride found in composites caused artifacts in both MRI and CT. Recognizing these findings would help dental materials manufacturers and developers to produce materials which can cause less artifacts in MRI and CT images.
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Affiliation(s)
- Thomas Klinke
- Polyclinic of Prosthodontics and Biomaterials, Greifswald University. Greifswald, Germany
| | - Amro Daboul
- Polyclinic of Prosthodontics and Biomaterials, Greifswald University. Greifswald, Germany
- * E-mail:
| | - Juliane Maron
- Polyclinic of Prosthodontics and Biomaterials, Greifswald University. Greifswald, Germany
| | - Tomasz Gredes
- Polyclinic of Orthodontics, Greifswald University. Greifswald, Germany
| | - Ralf Puls
- Institute of Diagnostics, Radiology and Neuroradiology, Greifswald University, Greifswald, Germany
| | - Ahmad Jaghsi
- Polyclinic of Prosthodontics and Biomaterials, Greifswald University. Greifswald, Germany
| | - Reiner Biffar
- Polyclinic of Prosthodontics and Biomaterials, Greifswald University. Greifswald, Germany
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Bone density changes around teeth during orthodontic treatment. Clin Oral Investig 2011; 15:511-9. [PMID: 20393863 DOI: 10.1007/s00784-010-0410-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 03/22/2010] [Indexed: 01/16/2023]
Abstract
The objective of this study was to evaluate bone density changes around the teeth during orthodontic treatment by using cone beam computed tomography (CBCT). CBCT was used to measure the bone densities around six teeth (both maxilla central incisors, lateral incisors, and canines) before and after 7 months of orthodontic treatment in eight patients. In addition, each root was divided into three portions (cervical, intermediate, and apical) to determine whether the bone density change varied with tooth level. The mean reduction in bone density around the measured teeth was 24% after orthodontic treatment. The bone density reduction around teeth was largest for the upper-right and upper-left central incisor (29% and 26%, respectively) and ranged from 20% to 23% for the other four teeth. The mean bone density reduction did not differ significantly between the cervical, portion, and apical portions of the teeth (26%, 22%, and 24%, respectively). CBCT is useful for evaluating bone density changes around teeth during orthodontic treatment. The bone density around the teeth reduced significantly after the application of orthodontic forces for 7 months.
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Kim YK, Park JY, Kim SG, Kim JS, Kim JD. Magnification rate of digital panoramic radiographs and its effectiveness for pre-operative assessment of dental implants. Dentomaxillofac Radiol 2011; 40:76-83. [PMID: 21239569 DOI: 10.1259/dmfr/20544408] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the accuracy and effectiveness of digital panoramic radiographs for pre-operative assessment of dental implants. METHODS We selected 86 patients (221 implants) and calculated the length of the planned implant based on the distance between a selection of critical anatomical structures and the alveolar crest using the scaling tools provided in the digital panoramic system. We analysed the magnification rate and the difference between the actual inserted implant length and planned implant length according to the location of the implant placement and the clarity of anatomical structures seen in the panoramic radiographs. RESULTS There was no significant difference between the planned implant length and actual inserted implant length (P > 0.05). The magnification rate of the width and length of the inserted implants, seen in the digital panoramic radiographs, was 127.28 ± 13.47% and 128.22 ± 4.17%, respectively. The magnification rate of the implant width was largest in the mandibular anterior part and there was a significant difference in the magnification rate of the length of implants between the maxilla and the mandible (P < 0.05). When the clarity of anatomical structures seen in the panoramic radiographs is low, the magnification rate of the width of the inserted implants is significantly higher (P < 0.05), but there is no significant difference between the planned implant length and actual inserted implant length according to the clarity of anatomical structures (P < 0.05). CONCLUSIONS Digital panoramic radiography can be considered a simple, readily available and considerably accurate pre-operative assessment tool in the vertical dimension for dental implant therapy.
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Affiliation(s)
- Y-K Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Republic of Korea
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Vasak C, Watzak G, Gahleitner A, Strbac G, Schemper M, Zechner W. Computed tomography-based evaluation of template (NobelGuide™)-guided implant positions: a prospective radiological study. Clin Oral Implants Res 2011; 22:1157-1163. [DOI: 10.1111/j.1600-0501.2010.02070.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Corpas LDS, Jacobs R, Quirynen M, Huang Y, Naert I, Duyck J. Peri-implant bone tissue assessment by comparing the outcome of intra-oral radiograph and cone beam computed tomography analyses to the histological standard. Clin Oral Implants Res 2010; 22:492-9. [PMID: 21143531 DOI: 10.1111/j.1600-0501.2010.02029.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The present study aims to identify radiographic methods revealing data that are most representative for the true peri-implant bone as assessed by histology. MATERIALS AND METHODS Eighty implants were placed in 10 minipigs. To assess matching between different image modalities, measurements conducted on intra-oral digital radiographs (IO), cone beam computer tomography (CBCT) and histological images were correlated using Spearman's correlation. Paired tests (Wilcoxon test) were used to determine changes in the bone parameters after 2 and 3 months of healing. RESULTS Significant correlations between bone defect depth on IO and histological slices (r= + 0.7, P<0.01), as well as on CBCT images and histological slices (r= + 0.61, P<0.01), were found. CBCT and IO images deviate, respectively, 1.20 and 1.17 mm from the histology regarding bone defects. No significant correlations were detected between fractal analysis on CBCT, intra-oral radiography and histology. For bone density assessment, significant but weaker correlations (r= + 0.5, P<0.01) were found for intra-oral radiography vs. histology. Significant marginal bone-level changes could be observed after 3 months of healing using intra-oral radiography. CONCLUSIONS This study allowed linking radiographic bone defect depth to the histological observations of the peri-implant bone. Minute bone changes during a short-term period can be followed up using digital intra-oral radiography. Radiographic fractal analysis did not seem to match histological fractal analysis. CBCT was not found to be reliable for bone density measures, but might hold potential with regard to the structural analysis of the trabecular bone.
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Affiliation(s)
- Livia dos Santos Corpas
- BIOMAT Research Group and Periodontology Department, Oral Imaging Centre Department of Dentistry, Faculty of Medicine, Catholic University of Leuven, Belgium.
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Schropp L, Stavropoulos A, Gotfredsen E, Wenzel A. Comparison of panoramic and conventional cross-sectional tomography for preoperative selection of implant size. Clin Oral Implants Res 2010; 22:424-9. [PMID: 21054555 DOI: 10.1111/j.1600-0501.2010.02006.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To compare panoramic and conventional cross-sectional tomography for preoperative selection of implant size for three implant systems (Brånemark, Straumann(®), 3i). MATERIAL AND METHODS Presurgical panoramic (Pan) and cross-sectional tomograms (Tomo) of 121 implant sites in 121 patients scheduled for single-tooth implant treatment were recorded; in 70 of the Pans (Pan-B), a metal ball was placed in the edentulous area. By means of dedicated software, an implant with subjectively determined proper dimensions for the respective site was outlined by manually placing four reference points in each image by three observers. Additionally, four reference points corresponding to the margins of the metal ball were manually placed in Pan-Bs. The length and width of the implant were calculated after calibration to the reference ball (true magnification) in Pan-Bs and to a "standard" calibration method in all images (magnification factor 1.25 in Pans and 1.7 in Tomos). Based on the corrected dimensions, the nearest, smaller implant size was selected among those available in each of the three implant systems. RESULTS When comparing Pans with Tomos, selected implant size differed in on average 89% of the cases. The length differed in 69% and the width in 66%. Implants planned on Tomos were longer than those planned on Pans in 47% and narrower in 30% (<10% in posterior regions). The Straumann(®) system, with the smallest range of available implant sizes was significantly less affected by the radiographic method compared with the other two systems. CONCLUSION The selected implant size differed considerably when planned on panoramic or cross-sectional tomographs.
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Affiliation(s)
- Lars Schropp
- Department of Prosthetic Dentistry, School of Dentistry, Aarhus University, Aarhus C, Denmark.
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Machtei EE, Zigdon H, Levin L, Peled M. Novel ultrasonic device to measure the distance from the bottom of the osteotome to various anatomic landmarks. J Periodontol 2010; 81:1051-5. [PMID: 20214439 DOI: 10.1902/jop.2010.090621] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The aim of the present study is to intraoperatively measure the distance from the bottom of the osteotome to the inferior alveolar canal (IAC) and maxillary sinus floor using a novel ultrasonic device and to compare the measurements to those using conventional radiographs. METHODS Patients scheduled for dental implant placement in the posterior regions were recruited for this pilot study. Mucoperiosteal flaps were elevated, and a recipient site was initiated using a standardized 2-mm-diameter pilot drill. The distance from the bottom of the osteotome to the IAC and maxillary sinus floor was assessed using a newly developed ultrasonic device and compared to a standard panoramic radiograph that was used to measure the same residual distance from the bottom of the drill. RESULTS Fourteen consecutive patients (21 implants) were enrolled. Eleven implants were placed in posterior mandibles, and 10 implants were placed in posterior maxillae. The mean +/- SE radiographic distance from the apex of the pilot drill to the nearest cortical bone was 5.64 +/- 0.51 mm, which was very similar to the distance measured by the ultrasonic device (5.22 +/- 0.37 mm; P = 0.341). In posterior mandibles (n = 11), the distances were 5.18 +/-0.61 mm (radiographic) and 5.26 +/- 0.61 mm (ultrasonic), which were not statistically significant (P = 0.593). A very strong positive correlation was observed between the two measurements in mandibles (r = 0.967; P = 0.0001). CONCLUSION The results of this in vivo study support the value of this ultrasonic system in measuring the residual osseous depth from the bottom of the osteotome to the roof of the IAC.
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Affiliation(s)
- Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
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Van de Velde T, Sennerby L, De Bruyn H. The clinical and radiographic outcome of implants placed in the posterior maxilla with a guided flapless approach and immediately restored with a provisional rehabilitation: a randomized clinical trial. Clin Oral Implants Res 2010; 21:1223-33. [DOI: 10.1111/j.1600-0501.2010.01924.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Juodzbalys G, Wang HL. Identification of the mandibular vital structures: practical clinical applications of anatomy and radiological examination methods. J Oral Maxillofac Res 2010; 1:e1. [PMID: 24421966 PMCID: PMC3886050 DOI: 10.5037/jomr.2010.1201] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 03/17/2010] [Indexed: 11/16/2022]
Abstract
Objectives The purpose of this article was to review the current
available clinical techniques and to recommend the most appropriate imaging modalities
for the identification of mandibular vital structures when planning for oral implants. Material and Methods The literature was selected through a
search of PubMed, Embase and Cochrane electronic databases. The keywords used for
search were mandibular canal, mandibular incisive canal, mental foramen, anterior
loop of the mental nerve, radiography, dental implants. The search was restricted
to English language articles, published from January 1976 to January 2010. Results In total 111 literature sources were obtained and reviewed.
The peculiarities of the clinical anatomy of mandibular canal, mandibular incisive
canal, mental foramen and anterior loop of mental nerve were discussed. Radiological
diagnostic methods currently available for the identification of the mandibular
vital structures when planning for oral implants were presented. Guidelines for
the identification of the mandibular vital structures in dental implantology were
made. Conclusions The proposed guideline provides clinicians a tool
in proper identifying the important mandibular vital structures thus minimizing
the potential complications during implant surgery.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine Lithuania
| | - Hom-Lay Wang
- Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine Lithuania
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Modern dental imaging: a review of the current technology and clinical applications in dental practice. Eur Radiol 2010; 20:2637-55. [PMID: 20544352 DOI: 10.1007/s00330-010-1836-1] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 04/15/2010] [Accepted: 04/29/2010] [Indexed: 02/02/2023]
Abstract
A review of modern imaging techniques commonly used in dental practice and their clinical applications is presented. The current dental examinations consist of intraoral imaging with digital indirect and direct receptors, while extraoral imaging is divided into traditional tomographic/panoramic imaging and the more recently introduced cone beam computed tomography. Applications, limitations and current trends of these dental "in-office" radiographic techniques are discussed.
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Roeder F, von Rechenberg I, d’Hoedt B, Schulze R. Spatial relation between a rigid (digital) intraoral X-ray receptor and longitudinal axes of maxillary teeth. Clin Oral Investig 2010; 15:715-9. [DOI: 10.1007/s00784-010-0430-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Accepted: 05/11/2010] [Indexed: 10/19/2022]
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Shahbazian M, Xue D, Hu Y, van Cleynenbreugel J, Jacobs R. Spiral computed tomography based maxillary sinus imaging in relation to tooth loss, implant placement and potential grafting procedure. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2010; 1:e7. [PMID: 24421963 PMCID: PMC3886045 DOI: 10.5037/jomr.2010.1107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 12/09/2009] [Indexed: 11/17/2022]
Abstract
Objectives The purpose of the present study was to explore the maxillary sinus
anatomy, its variations and volume in patients with a need for maxillary implant
placement. Material and Methods Maxillary sinus data of 101 consecutive
patients who underwent spiral computed tomography (CT) scans for preoperative implant
planning in the maxilla at the Department of Periodontology, University Hospital,
Catholic University of Leuven, Leuven, Belgium were retrospectively evaluated. The
alveolar bone height was measured on serial cross-sectional images between alveolar
crest and sinus floor, parallel to the tooth axis. In order to describe the size
of the maxillary sinus anteroposterior (AP) and mediolateral (ML) diameters of the
sinus were measured. Results The results indicated that the alveolar bone height
was significantly higher in the premolar regions in comparison to the molar region
(n = 46, P < 0.01). The age showed negative relation to bone dimension (r = - 0.32,
P = 0.04). Anterior and posterior border of the maxillary sinuses were mostly located in
the first premolar (49%) and second molar (84%) regions, respectively. Maxillary
sinus septa were indentified in 47% of the maxillary antra. Almost 2/3 (66%) of
the patients showed major (> 4 mm) mucosal thickening mostly at the level of the
sinus floor. The present sample did not allow revealing any significant difference
(P > 0.05) in maxillary sinus dimensions for partially dentate and edentulous subjects. Conclusions Cross-sectional imaging can be used in order to
obtain more accurate information on the morphology, variation, and the amount of
maxillary bone adjacent to the maxillary sinus.
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Affiliation(s)
- Maryam Shahbazian
- Oral Imaging center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
| | - Dong Xue
- Qian Dental Clinic, DanDong PR China
| | - Yuqian Hu
- Qian Dental Clinic, DanDong PR China
| | - Johan van Cleynenbreugel
- ; Oral Imaging center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
| | - Reinhilde Jacobs
- Oral Imaging center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven Belgium
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Widmann G, Zangerl A, Keiler M, Stoffner R, Bale R, Puelacher W. Flapless implant surgery in the edentulous jaw based on three fixed intraoral reference points and image-guided surgical templates: accuracy in human cadavers. Clin Oral Implants Res 2010; 21:835-41. [PMID: 20345381 DOI: 10.1111/j.1600-0501.2009.01884.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In edentulous patients, accurate and stable positioning of a surgical template is impeded by the mobile mucosal tissue. The objective was to evaluate the accuracy of flapless computer-assisted template-guided surgery in an edentulous human cadaver specimen using three fixed oral reference points (FRP) for fixation of the registration mouthpiece and the consecutive surgical template. MATERIAL AND METHODS Oral implants were planned on the computed tomography (CT) of an edentulous human cadaver specimen. Surgical templates have been fabricated using a multipurpose navigation system. Both the registration mouthpiece and consecutive surgical template were supported via three FRP. Study implants were inserted through the guide sleeves and the accuracy was evaluated on a post-surgical CT of the cadaver jaws fused with the pre-surgical planning CT. A Matlab script enabled comparison of the planned surgical path with the study implants. RESULTS In five maxillary and three mandibular edentulous human cadaver specimens, a total of 51 implants (35 implants in the maxilla and 16 implants in the mandible) have been placed. The mean+/-standard deviation total error (Euclidean distance)/lateral error (normal deviation) were 1.1+/-0.6/0.7+/-0.5 mm at the implant base and 1.2+/-0.7/0.9+/-0.7 mm at the implant tip. The mean angular error was 2.8+/-2.2 degrees. CONCLUSIONS Flapless surgery based on FRP-supported image-guided surgical templates may provide similar accuracy as reported for tooth-supported surgical templates or surgical navigation.
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Affiliation(s)
- Gerlig Widmann
- SIP - Department for Microinvasive Therapy, Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
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Fuh LJ, Huang HL, Chen CS, Fu KL, Shen YW, Tu MG, Shen WC, Hsu JT. Variations in bone density at dental implant sites in different regions of the jawbone. J Oral Rehabil 2010; 37:346-51. [PMID: 20113389 DOI: 10.1111/j.1365-2842.2010.02061.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The survival rate of dental implants is markedly influenced by the quality of the bone into which they are placed. The purpose of this study was to determine the trabecular bone density at potential dental implant sites in different regions of the Chinese jawbone using computed tomography (CT) images. One hundred and fifty-four potential implant sites (15 in the anterior mandible, 47 in the anterior maxilla, 55 in the posterior mandible, and 37 in the posterior maxilla) were selected from the jawbones of 62 humans. The data were subjected to statistical analysis to determine any correlation between bone density (in Hounsfield units, HU) and jawbone region using the Kruskal-Wallis test. The bone densities in the four regions decreased in the following order: anterior mandible (530 +/- 161 HU, mean +/- s.d.) approximately equal anterior maxilla (516 +/- 132 HU) > posterior mandible (359 +/- 150 HU) approximately equal posterior maxilla (332 +/- 136 HU). The CT data demonstrate that trabecular bone density varies markedly with potential implant site in the anterior and posterior regions of the maxilla and mandible. These findings may provide the clinician with guidelines for dental implant surgical procedures (i.e., to determine whether a one-stage or a two-stage protocol is required).
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Affiliation(s)
- L-J Fuh
- School of Dentistry, College of Medicine, China Medical University, Taichung, Taiwan
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Garg AK. Radiographic Modalities for Dental Implants. IMPLANT DENT 2010. [DOI: 10.1016/b978-0-323-05566-6.00006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Roeder F, Brüllmann D, d'Hoedt B, Schulze R. Ex vivo radiographic tooth length measurements with the reference sphere method (RSM). Clin Oral Investig 2009; 14:645-51. [PMID: 19830462 DOI: 10.1007/s00784-009-0350-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Accepted: 09/22/2009] [Indexed: 11/29/2022]
Abstract
A reference-based radiographic "reference sphere method" (RSM) for accurate length measurements in (dental) projection radiographs for the assessment of tooth length in dry human mandible sections is evaluated. RSM determines the depth coordinates of reference spheres placed in the object plane from the elliptical distortion of their shadows. Two segments (one canine and one molar) of dry human mandibles were exposed 95 times at different angulations (0-40°) on a dental charge-coupled device receptor. Three steel spheres (diameters d (1) = 2.00 mm, d (2) = 3.00 mm) were attached roughly coplanar with the tooth's main axis. Radiographs were assessed once by visual inspection plus manual landmark identification with a mouse-driven cursor. The results were compared to the true tooth length assessed after extraction and to a conventional method (C), i.e., the rule of proportion based on magnification of the sphere shadows. Mean relative length error was 2.28% (d (1)) and 0.46% (d (2)) for RSM and -13.58% (d (1)) and -9.90% (d (2)) for C. For both methods, length errors were significantly (p < 0.0001) correlated with the inclination relative to the receptor. RSM allows for complete a posteriori determination of the imaging geometry under the assumption of a known source-to-receptor distance. One specific application is foreshortening correction of objects coplanar with the reference spheres. Remaining errors are mainly due to incorrect landmark definition. In our setup, these were exaggerated by the visual/manual image-evaluation process. Automated image analysis has been shown for similar tasks to minimize these errors considerably.
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Affiliation(s)
- Felix Roeder
- Department of Oral Surgery (and Oral Radiology), University Medical Center of the Johannes-Gutenberg-University Mainz, Dental School, Augustusplatz 2, 55131 Mainz, Germany.
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Comparison Between Implants Inserted With and Without Computer Planning and Custom Model Coordination. J Craniofac Surg 2009; 20:1086-92. [DOI: 10.1097/scs.0b013e3181abb322] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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