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Mihailidis DN, Stratis A, Gingold E, Carlson R, DeForest W, Gray J, Lally MT, Pizzutiello R, Rong J, Spelic D, Hilohi MC, Massoth R. AAPM Task Group Report 261: Comprehensive quality control methodology and management of dental and maxillofacial cone beam computed tomography (CBCT) systems. Med Phys 2024; 51:3134-3164. [PMID: 38285566 DOI: 10.1002/mp.16911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/31/2024] Open
Abstract
Cone-beam computed tomography (CBCT) systems specifically designed and manufactured for dental, maxillofacial imaging (MFI) and otolaryngology (OLR) applications have been commercially available in the United States since 2001 and have been in widespread clinical use since. Until recently, there has been a lack of professional guidance available for medical physicists about how to assess and evaluate the performance of these systems and about the establishment and management of quality control (QC) programs. The owners and users of dental CBCT systems may have only a rudimentary understanding of this technology, including how it differs from conventional multidetector CT (MDCT) in terms of acceptable radiation safety practices. Dental CBCT systems differ from MDCT in several ways and these differences are described. This report provides guidance to medical physicists and serves as a basis for stakeholders to make informed decisions regarding how to manage and develop a QC program for dental CBCT systems. It is important that a medical physicist with experience in dental CBCT serves as a resource on this technology and the associated radiation protection best practices. The medical physicist should be involved at the pre-installation stage to ensure that a CBCT room configuration allows for a safe and efficient workflow and that structural shielding, if needed, is designed into the architectural plans. Acceptance testing of new installations should include assessment of mechanical alignment of patient positioning lasers and x-ray beam collimation and benchmarking of essential image quality performance parameters such as image uniformity, noise, contrast-to-noise ratio (CNR), spatial resolution, and artifacts. Several approaches for quantifying radiation output from these systems are described, including simply measuring the incident air-kerma (Kair) at the entrance surface of the image receptor. These measurements are to be repeated at least annually as part of routine QC by the medical physicist. QC programs for dental CBCT, at least in the United States, are often driven by state regulations, accreditation program requirements, or manufacturer recommendations.
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Affiliation(s)
- Dimitris N Mihailidis
- University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania, USA
| | | | - Eric Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ray Carlson
- Radiological Physics Services, Inc, Plymouth, Michigan, USA
| | | | | | - Mary T Lally
- Intersocietal Accreditation Commission, Ellicott City, Maryland, USA
| | | | - John Rong
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - David Spelic
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Mike C Hilohi
- Food and Drug Administration, Center for Device and Radiological Health, Silver Spring, Maryland, USA
| | - Richard Massoth
- Sunflower Medical Physics, LLC, Sioux Falls, South Dakota, USA
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BATISTA ES, FRANCO A, SOARES MQS, NASCIMENTO MDCC, JUNQUEIRA JLC, OENNING AC. Assessment of cone beam computed tomography for determining position and prognosis of interradicular mini-implants. Dental Press J Orthod 2022; 27:e222190. [PMID: 36449961 PMCID: PMC9707856 DOI: 10.1590/2177-6709.27.5.e222190.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the influence of dynamic visualization of cone beam computed tomography (CBCT) scans on orthodontist's assessment of positioning status and prognosis of interradicular mini-implants (MI). METHODS Three MI positions were virtually simulated in thirty CBCT volumes: (1) MI 1 mm from the lamina dura (LD), (2) MI touching the LD and (3) MI overlapping the LD. Each position was exposed to orthodontists (n = 35) as panoramic reconstruction, sagittal reconstruction and a sequence of axial slices. Each orthodontist evaluated the MI position (relationship with the LD) and scored the prognosis using a four-point scale (the higher the score, the better the prognosis). Kappa, Friedman and Nemenyi statistics were used. RESULTS Statistically significant associations were detected between the prognosis scores and the type of image visualized (p<0.05). The dynamic visualization of the CBCT volume (axial slices) was associated with higher scores for prognosis and more reliable evaluation of MI positioning. Inconsistent outcomes were more frequently associated with panoramic and sagittal reconstructions. CONCLUSION The dynamic visualization of axial slices allowed orthodontists to perform better assessment of MI position and considerably affected prognosis judgment.
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Affiliation(s)
- Eroncy Souto BATISTA
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
| | - Ademir FRANCO
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
| | | | | | | | - Anne Caroline OENNING
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
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Ludwig B, Krause L, Venugopal A. Accuracy of Sterile and Non-Sterile CAD/CAM Insertion Guides for Orthodontic Mini-Implants. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.768103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AimThe aim of this study was to measure the transfer accuracy of computer-aided design/computer-aided manufacturing (CAD/CAM) insertion guides using mini-implants. The target value is the virtual planned position (100%). It is also clinically mandatory to use sterilised surgical guides (autoclaved at 137°C). The results obtained using sterilised and non-sterilised insertion guides were compared. In addition, the actual position of the mini-implants, as implemented, was compared with the digitally planned positions.Materials and MethodsFollowing CAD/CAM planning and production of 60 insertion guides made from synthetic resins that had been previously tested for suitability, 120 mini-implants were inserted in pairs and in blocks of the bone of the substitute material. Half of the insertion guides were sterilised, while the other half were non-sterilised. Compared with the position of the mini-implants in the digital plans, deviations in the apical and coronal distances between the mini-implants and insertion depth, as well as the included angle of the mini-implants to one another and to the surface of the bone substitute material, were determined.ResultsIn post-sterilisation, the dimensional and material changes were observed. When compared, the deviations to the virtual planned position were achieved when the performed insertion using sterilised insertion guides were lower than those achieved when using non-sterilised insertion guides. The heat treatment during the sterilisation process improved the accuracy of the insertion guides. When comparing sterile insertion guides to the digital planned position (100%), the mean coronal deviation was 0.057 mm (0.81%), the apical deviation was 0.428 mm (6.11%), and insertion depth mean deviation at the right side was 0.15 mm (2.15%), while that on the left was 0.073 mm (1.04%).ConclusionThe CAD/CAM TAD insertion guide could not achieve 100% accuracy in translating the digitally planned position into the real anatomic location. Deviations to the ideal position between 0.81 and 6.11% were observed. Clinically, for appliances that fit post-mini-implant insertion, the coronal distance of the mid-mini-implant head is the most important. At this point, the mean deviation to the planned positions is 0.81%, which is clinically acceptable and most likely reproducible by using CAD/CAM insertion guides.
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Wang TY, Kuo PJ, Fu E, Kuo HY, Nie-Shiuh Chang N, Fu MW, Shen EC, Chiu HC. Risks of angled implant placement on posterior mandible buccal/lingual plated perforation: A virtual immediate implant placement study using CBCT. J Dent Sci 2019; 14:234-240. [PMID: 31528250 PMCID: PMC6739299 DOI: 10.1016/j.jds.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/06/2019] [Indexed: 12/02/2022] Open
Abstract
Background/purpose Immediate implant placement has been considered to be a successful treatment procedure. The bone plate perforation (BPP) may be one of severe complication and potentially life-threatening situation. The aim of this virtual study is to evaluate the influences of angled implant insertion on BPP during immediate implant installation in the posterior mandible. Materials and methods Cone beam computed tomography images of 488 posterior teeth from 61 patients were selected. Virtual immediate implant placement (VIIP) was performed at each posterior tooth following the appropriate axis with the prosthetic-driven planning and different deviation angles of 3-, 6-, or 9-degree. BPP was then examined from cross-sectional images obtained. Furthermore, the relation of lingual bony morphology and BPP were also determined. Results The incidence of buccal and lingual BPP increased as the deviation angle increased in posterior mandible area. Incidence of lingual BPP was significantly influenced by angular deviation and type of lingual bony morphology after adjusting for age, gender, tooth type, and right/left side. An increase in incidence odds of over 6-fold (OR = 6.583) was noted for placements angled by 9° compared with placements made without angulation, and an increase in incidence odds of over 3-fold (OR = 3.622) was noted for teeth with the undercut-type lingual morphology compared with the other types. Conclusion The present Results indicate that accurate selection of the implant insertion angle and full awareness of the bony anatomy at the implant recipient site are essential to prevent BPP in the posterior mandible.
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Affiliation(s)
- Tian-You Wang
- Department of Dentistry, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Jan Kuo
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Earl Fu
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Dentistry, Tzu Chi General Hospital, Xindian, New Taipei City, Taiwan
| | - Hsin-Yu Kuo
- Taipei Medical University, College of Dental Medicine, Taipei, Taiwan
- Department of Prosthodontics, Taipei Medical University Hospital, Taiwan
| | | | - Min-Wen Fu
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - E-Chin Shen
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Dentistry, Tzu Chi General Hospital, Xindian, New Taipei City, Taiwan
| | - Hsien-Chung Chiu
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Corresponding author. Department of Periodontology, School of Dentistry, National Defense Medical Center, P.O. Box 90048-507, Taipei, Taiwan, ROC. Fax: +886 2 87927145.
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Kang Q, Cha C, Huang D, Zuo S, Yan X. Evaluation of palatal support tissues for placement of orthodontic mini-implants in mouth breathers with high-narrow palates versus nose breathers with normal palates: a retrospective study. Clin Oral Investig 2019; 24:1259-1267. [PMID: 31302770 DOI: 10.1007/s00784-019-03004-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: 11/19/2018] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to compare the palatal total support tissues (TSTs) and bone support tissues (BSTs) at 5-mm paramedian section to the midsagittal suture between mouth breathers with high-narrow palates and nose breathers with normal palates and confirm the practicability and limitation on superimposition of lateral cephalograms and plaster models for orthodontic mini-implant (OMI) implantation in these patients. MATERIAL AND METHODS The sample consisted of 27 mouth breathers with high-narrow palates (study group (SG)) and 27 nose breathers with normal palates (control group (CG)). Upper digital dental models were superimposed with corresponding cone beam computed tomography (CBCT) images; then, TSTs and BSTs vertical to the curvature of the palatal mucosa were measured on the 5-mm paramedian section to the midsagittal suture. The measuring sites were the third ruga (R) and the sites anterior and posterior to R at 2-mm interval (A2, A4, A6, and A8; P2, P4, P6, and P8) along the palatal mucosa outline. TSTs and BSTs were also measured on the superimposition of lateral cephalograms and plaster models, and the site with the largest TST value in each patient was recorded. Descriptive statistics, independent-samples t test, and hierarchical clustering heat map were used for statistical analysis. RESULTS The greatest average values of TSTs and BSTs in SG were 12.24 ± 2.63 mm and 9.59 ± 2.36 mm at P2 site, and those in CG were 12.96 ± 2.39 mm and 10.56 ± 2.38 mm at R site, respectively. The average values of both TSTs and BSTs in SG were less than those in CG at all insertion sites. Significant differences (P < 0.05) were found at A4, A6, and R for TSTs and at R and P4 for BSTs. P2 and R were clustered together for both TSTs and BSTs by the cluster analysis on heat map in both SG and CG. In both groups, only one patient from SG was found to have the insertion site with the largest TST value on 2D superimposition located in the blue area on the heat map, where the measurement values of TSTs were less than 8.5 mm and those of BSTs were less than 5 mm. CONCLUSIONS Mouth breathers with high-narrow palates may have less palatal support tissues than nose breathers with normal palates at 5-mm paramedian section to the midsagittal suture of palate. The site a little posterior to R is more suitable for OMI implantation in mouth breathers. Two-dimensional superimposition of lateral cephalograms and plaster models can provide relatively effective assessment for the site choice of OMI implantation in both mouth breathers with high-narrow palates and nose breathers with normal palates. CLINICAL RELEVANCE Three-dimensional superimposition of CBCT data and digital dental model can provide accurate information for palatal OMI implantation. Meanwhile, 2D superimposition of lateral cephalograms and plaster models can be used for assessing the implantation sites at 5-mm paramedian section to the midsagittal suture of palates in mouth breathers under most conditions even those who have less palatal support tissues.
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Affiliation(s)
- Qichao Kang
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Chang Cha
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Desheng Huang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Sihui Zuo
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Xiulin Yan
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China.
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Tilen R, Patcas R, Bornstein MM, Ludwig B, Schätzle M. The nasopalatine canal, a limiting factor for temporary anchorage devices: a cone beam computed tomography data study. Eur J Orthod 2019; 39:646-653. [PMID: 28379399 DOI: 10.1093/ejo/cjx022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives There is only little knowledge on topographical predispositions of the nasopalatine canal as a limiting factor for insertion of mid-palatal temporary anchorage devices (TAD). The purpose of the study was to assess the course of the nasopalatine canal, the adjacent vertical bone quantity, and whether it might differ among vertical facial types, using pre-existing cone beam computed tomography (CBCT) scans. Material and Methods Out of a consecutive sample collected from April 2008 to August 2012, only patient data depicting both upper and lower jaw completely were evaluated retrospectively. The linear measurements were taken on the respective midsagittal view perpendicular to the palate at the level of 1st molar/2nd premolar (5/6), 2nd premolar/1st premolar (4/5), and 1st premolar/canine (3/4). Screen-prints were used to measure the inclination of the nasopalatine canal in relation to the maxillary jaw base. Maxillary and mandibular divergence was assessed on rendered lateral cephalograms. Results Out of 3869 pre-existing consecutive CBCT scans, data from 398 patients met the inclusion criteria and could be extracted. The mean vertical bone was 4.09 mm at the 5/6 level, 5.22 mm at the 4/5 level, and 3.14 mm at the 3/4 level, respectively. A statistically significant negative correlation exists between jaw divergence and the canal angulation with regard to the maxillary base. A statistically significant negative correlation exists between the canal angulation and vertical bone measurements at the 4/5 and 3/4 levels. Conclusions Vertical bone volume is sufficient at 4/5 level for TAD placement, and bares only a small risk for neuro-sensory impairment. Therefore, only in rare cases a CBCT is justified for palatal implant placement. The course of the nasopalatine canal is negatively correlated with the vertical skeletal facial pattern pointing to the fact that in hypodivergent patients a TAD might be placed in a more distal or paramedian region.
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Affiliation(s)
- Raphael Tilen
- Clinic for Orthodontics and Pediatric Dentistry, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich, Switzerland
| | - Raphael Patcas
- Clinic for Orthodontics and Pediatric Dentistry, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich, Switzerland
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Marc Schätzle
- Clinic for Orthodontics and Pediatric Dentistry, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich, Switzerland
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Hourfar J, Bister D, Lux CJ, Al-Tamimi B, Ludwig B. Anatomic landmarks and availability of bone for placement of orthodontic mini-implants for normal and short maxillary body lengths. Am J Orthod Dentofacial Orthop 2017; 151:878-886. [PMID: 28457265 DOI: 10.1016/j.ajodo.2016.09.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Increasing numbers of orthodontic mini-implants are placed in the anterior maxilla. To our knowledge, bone levels and root proximity of patients with cephalometrically short maxillae have not been investigated before. The first, second, and third rugae were used as clinical reference lines, and the aim of this study was to measure bone availability in that area by comparing patients with short and normal maxillary body lengths. METHODS The sample consisted of 21 patients in each group: short maxillary body length and normal maxillary body length. The patients' study models were bisected, and the outline of the palatal contour was marked on the surface. The models were scanned, and the palatal contours were superimposed on the palatal structures of their respective initial cephalometric headfilms, and the vertical and oblique bone levels of the sagittal plane were compared using the Student t test. The level of significance was set at P <0.05. RESULTS Compared with maxillae of normal maxillary body length, less bone was available in maxillae of short maxillary body length. However, the differences did not reach clinical or statistical significance (P >0.05) at the third rugae. CONCLUSIONS Almost equivalent average bone depth at the third rugae in patients with normal and short maxillary body lengths suggests that this site can be used for 8-mm long obliquely inserted orthodontic mini-implants.
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Affiliation(s)
- Jan Hourfar
- Private Practice, Reinheim, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher J Lux
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Bouthayna Al-Tamimi
- Dental and Maxillofacial Surgery Department, Great Ormond Street Hospital, NHS Foundation Trust, London, United Kingdom
| | - Björn Ludwig
- Private Practice, Traben-Trarbach, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany.
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Sumer A, Caliskan A, Uzun C, Karoz T, Sumer M, Cankaya S. The evaluation of palatal bone thickness for implant insertion with cone beam computed tomography. Int J Oral Maxillofac Surg 2016; 45:216-20. [DOI: 10.1016/j.ijom.2015.09.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 07/14/2015] [Accepted: 09/16/2015] [Indexed: 10/22/2022]
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Kapila SD, Nervina JM. CBCT in orthodontics: assessment of treatment outcomes and indications for its use. Dentomaxillofac Radiol 2015; 44:20140282. [PMID: 25358833 DOI: 10.1259/dmfr.20140282] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics.
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Affiliation(s)
- S D Kapila
- Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann Arbor, MI, USA
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Kim YJ, Lim SH, Gang SN. Comparison of cephalometric measurements and cone-beam computed tomography-based measurements of palatal bone thickness. Am J Orthod Dentofacial Orthop 2014; 145:165-72. [PMID: 24485730 DOI: 10.1016/j.ajodo.2013.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 10/01/2013] [Accepted: 10/01/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the relationships between cephalometric measurements and cone-beam computed tomography-based measurements of the palatal bone thickness. METHODS Thirty sets of cone-beam computed tomography images and lateral cephalograms were used. Palatal bone thicknesses were measured anteroposteriorly from between the first and second premolars to between the first and second molars using both imaging methods, and also laterally from 1.5 mm off-center to 10 mm off-center in the cone-beam computed tomography images. Repeated-measures analysis of variance was used to examine the differences between the measurements. RESULTS Bland-Altman plots showed that the 95% limits of agreement were smallest at 5 mm off-center (-0.2 ± 1.7 mm). The 5-mm off-center measurements were the only ones for which there were no statistically significant differences compared with the cephalometric measurements in all anteroposterior areas. The measurements at 1.5 mm off-center were significantly thicker than the cephalometric measurements only from the area between the second premolar and the first molar to the area between the first and second molars. CONCLUSIONS Among the areas measured, the bone at 5 mm off-center is most likely to be depicted in cephalograms as palatal bone contours.
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Affiliation(s)
- Young-Jae Kim
- Postgraduate student, Department of Orthodontics, School of Dentistry, Chosun University, Gwangju, Korea
| | - Sung-Hoon Lim
- Professor, Department of Orthodontics, School of Dentistry, Chosun University, Gwangju, Korea.
| | - Sung-Nam Gang
- Assistant professor, Department of Orthodontics, School of Dentistry, Chosun University, Gwangju, Korea
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Fäh R, Schätzle M. Complications and adverse patient reactions associated with the surgical insertion and removal of palatal implants: a retrospective study. Clin Oral Implants Res 2013; 25:653-8. [DOI: 10.1111/clr.12152] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Reto Fäh
- Department of Orthodontics and Paediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Marc Schätzle
- Department of Orthodontics and Paediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Soardi CM, Zaffe D, Motroni A, Wang HL. Quantitative comparison of cone beam computed tomography and microradiography in the evaluation of bone density after maxillary sinus augmentation: a preliminary study. Clin Implant Dent Relat Res 2012; 16:557-64. [PMID: 23157713 DOI: 10.1111/cid.12016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Cone beam computed tomography (CBCT) and microradiographic analyses were comparatively performed in maxillary sinus augmentation to preliminarily verify the diagnostic potential of CBCT on the evaluation of bone regeneration. MATERIALS AND METHODS A two-stage protocol was conducted in 19 consenting patients, all having the crestal bone ≤2 mm, in private dental office. Mineralized human bone allograft particles were used to augment sinus using lateral window approach. A succession of CBCT scans of the maxilla was taken before surgery, after sinus augmentation, and immediately after implant insertion. Using virtual probes, CBCT data were processed by medical imaging software and expressed as gray level (GL). A bone core biopsy was taken at implant placement, 6 months after surgery. Microradiography of transverse sections, taken 6, 8, and 10 mm from the crestal surface, of methacrylate-embedded biopsies was performed to analyze and to evaluate the mineralized material amount (MM%). RESULTS A total of 21 sinus augmentations were performed. CBCT (mean GL: 646-693) data were not statistically different when comparing 6-, 8-, and 10-mm sites to after grafting/implant-insertion values. Furthermore, microradiographic (mean MM%: 45.3-48.3) data were not statistically different comparing 6-, 8-, and 10-mm sites, due to variation of values among patients. A GL and MM% parallelism was identified considering each patient, instead. A significant correlation (p < .001) between GL and MM% was found after both Wilcoxon test for paired data and simple linear regression analysis. CONCLUSIONS The preliminary result clearly demonstrated the predictability of the CBCT analysis. Due to the limited sample and great variations of the MM% recorded in patients, further clinical and morphometric studies are needed to fulfill diagnostic expectations.
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Siddiqi A, Kieser JA, De Silva RK, McNaughton A, Duncan WJ. Could the median-palate accommodate wide-bodied implants in order to support maxillary over-dentures? A radiomorphometric study of human cadavers. Clin Oral Implants Res 2012; 25:101-9. [DOI: 10.1111/clr.12050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Allauddin Siddiqi
- Oral Implantology Research Group, Faculty of Dentistry; Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - Jules A. Kieser
- Faculty of Dentistry; Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - Rohana K. De Silva
- Department of Oral Diagnostic & Surgical Sciences; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Andrew McNaughton
- Department of Anatomy and Structural Biology; School of Medical Sciences; Otago Centre for Confocal Microscopy; University of Otago; Dunedin New Zealand
| | - Warwick J. Duncan
- Department of Oral Sciences; Faculty of Dentistry; University of Otago; Dunedin New Zealand
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Abstract
Cone beam computed tomography (CBCT) is widely used by orthodontists to obtain three-dimensional (3-D) images of their patients. This is of value as malocclusion results from discrepancies in three planes of space. This review tracks the use of CBCT in orthodontics, from its validation as an accurate and reliable tool, to its use in diagnosing and treatment planning, and in assessing treatment outcomes in orthodontics.
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Affiliation(s)
- J M Nervina
- School of Dentistry, Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann Arbor, Michigan 48109, USA.
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Jung BA, Wehrbein H, Heuser L, Kunkel M. Vertical palatal bone dimensions on lateral cephalometry and cone-beam computed tomography: implications for palatal implant placement. Clin Oral Implants Res 2010; 22:664-8. [PMID: 21044170 DOI: 10.1111/j.1600-0501.2010.02021.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the necessity of three-dimensional imaging (computed tomography [CT]/cone-beam computed tomography [CBCT]) for paramedian insertion of palatal implants. MATERIAL AND METHODS Lateral radiographs and CBCT scans were performed from 18 human skulls. For lateral cephalometry, the nasal floor (right/left) and the oral hard palate of all skulls were lined with a tin foil for contrast enhancement. The quantity of vertical bone as measured on lateral radiographs was compared with CBCT measurements obtained in median and parasagittal planes and at minimum bone height. Spearman's rank correlation coefficients were determined for bivariate correlation analysis. RESULTS The median palatal bone height on CBCT (mean 8.98 mm; standard deviation [SD] 3.4) was markedly higher than the vertical height seen on lateral radiographs (mean 6.6 mm; SD 3.2). Comparing lateral cephalometry with CBCT, the strongest association was observed at the minimum palatal bone height (r=0.926; P<0.001; Spearman's rank correlation coefficient). CONCLUSIONS Lateral radiographs allow accurate and adequate assessment of vertical bone before paramedian insertion of palatal implants. The vertical bone dimension as displayed on lateral cephalometry reflects the minimum bone height rather than maximum bone in the median plane. Therefore, a preoperative CT or CBCT is only indicated when the lateral cephalometry reveals a marginal quantity of bone.
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Affiliation(s)
- Britta A Jung
- Department of Orthodontics, University Medical Center Mainz, Mainz, Germany.
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