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Wang M, Liu F, Zhao X, Wu Y. Robot-assisted surgery for dental implant placement: A narrative review. J Dent 2024; 146:105034. [PMID: 38729287 DOI: 10.1016/j.jdent.2024.105034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To determine the current status and accuracy of robotic computer-assisted implant surgery (CAIS) applications by examining the associated clinical and experimental outcomes. DATA AND SOURCES PubMed, Medline, and Cochrane Library databases were searched for relevant studies published between January 2000 and November 2023, and focusing on robotic CAIS in dental implant surgery. All search results were then manually reviewed to identify only the pertinent articles. Only in vitro and clinical studies were included in this narrative review, with implant placement accuracy considered the main outcome. RESULT Based on our inclusion and exclusion criteria, we included 21 studies (with 1085 implant sites); of them, 8 were clinical studies, 12 were in vitro studies, and 1 included both an in vitro study and a case series. The ranges of the mean implant shoulder, apical, and angular deviations were respectively 0.43-1.04 mm, 0.53-1.06 mm, and 0.77°-3.77° in the clinical studies and 0.23-1.04 mm, 0.24-2.13 mm, and 0.43°-3.78° in the in vitro studies, respectively. CONCLUSION The accuracy of robotic CAIS in dental implant procedures appears to be within the clinically acceptable ranges. However, further relevant clinical trials validating the existing evidence are needed. CLINICAL SIGNIFICANCE Robotic CAIS can achieve clinically acceptable implant placement accuracy. This innovative technology may improve the precision and success rates of dental implant procedures, with benefit for surgeons and patients.
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Affiliation(s)
- MiaoZhen Wang
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
| | - Feng Liu
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China.
| | - Xu Zhao
- First Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
| | - Yuwei Wu
- Second Clinical Division, Peking University School and Hospital for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology for Stomatology & Beijing Key Laboratory for Digital Stomatology, Beijing, PR China
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Shujaat S, Alfadley A, Morgan N, Jamleh A, Riaz M, Aboalela AA, Jacobs R. Emergence of artificial intelligence for automating cone-beam computed tomography-derived maxillary sinus imaging tasks. A systematic review. Clin Implant Dent Relat Res 2024. [PMID: 38863306 DOI: 10.1111/cid.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/16/2024] [Accepted: 05/20/2024] [Indexed: 06/13/2024]
Abstract
Cone-beam computed tomography (CBCT) imaging of the maxillary sinus is indispensable for implantologists, offering three-dimensional anatomical visualization, morphological variation detection, and abnormality identification, all critical for diagnostics and treatment planning in digital implant workflows. The following systematic review presented the current evidence pertaining to the use of artificial intelligence (AI) for CBCT-derived maxillary sinus imaging tasks. An electronic search was conducted on PubMed, Web of Science, and Cochrane up until January 2024. Based on the eligibility criteria, 14 articles were included that reported on the use of AI for the automation of CBCT-derived maxillary sinus assessment tasks. The QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool was used to evaluate the risk of bias and applicability concerns. The AI models used were designed to automate tasks such as segmentation, classification, and prediction. Most studies related to automated maxillary sinus segmentation demonstrated high performance. In terms of classification tasks, the highest accuracy was observed for diagnosing sinusitis (99.7%), whereas the lowest accuracy was detected for classifying abnormalities such as fungal balls and chronic rhinosinusitis (83.0%). Regarding implant treatment planning, the classification of automated surgical plans for maxillary sinus floor augmentation based on residual bone height showed high accuracy (97%). Additionally, AI demonstrated high performance in predicting gender and sinus volume. In conclusion, although AI shows promising potential in automating maxillary sinus imaging tasks which could be useful for diagnostic and planning tasks in implantology, there is a need for more diverse datasets to improve the generalizability and clinical relevance of AI models. Future studies are suggested to focus on expanding the datasets, making the AI model's source available, and adhering to standardized AI reporting guidelines.
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Affiliation(s)
- Sohaib Shujaat
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Abdulmohsen Alfadley
- King Abdullah International Medical Research Center, Department of Restorative and Prosthetic Dental Sciences, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Nermin Morgan
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmed Jamleh
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Marryam Riaz
- Department of Physiology, Azra Naheed Dental College, Superior University, Lahore, Pakistan
| | - Ali Anwar Aboalela
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
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Fok MR, Jin L. Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices. J Dent 2024; 145:104986. [PMID: 38574844 DOI: 10.1016/j.jdent.2024.104986] [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: 01/11/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice. SOURCES AND STUDY SELECTION To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration. DATA 11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low. CONCLUSION This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored. CLINICAL SIGNIFICANCE By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China.
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
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Tommasato G, Piano S, Casentini P, De Stavola L, Chiapasco M. Digital planning and bone regenerative technologies: A narrative review. Clin Oral Implants Res 2024. [PMID: 38591734 DOI: 10.1111/clr.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES The aim of this narrative review was to explore the application of digital technologies (DT) for the simplification and improvement of bone augmentation procedures in advanced implant dentistry. MATERIAL AND METHODS A search on electronic databases was performed to identify systematic reviews, meta-analyses, randomized and non-randomized controlled trials, prospective/retrospective case series, and case reports related to the application of DT in advanced implant dentistry. RESULTS Seventy-nine articles were included. Potential fields of application of DT are the following: 1) the use of intra-oral scanners for the definition of soft tissue profile and the residual dentition; 2) the use of dental lab CAD (computer-aided design) software to create a digital wax-up replicating the ideal ridge and tooth morphology; 3) the matching of STL (Standard Triangulation Language) files with DICOM (DIgital COmmunication in Medicine) files from CBCTs with a dedicated software; 4) the production of stereolithographic 3D models reproducing the jaws and the bone defects; 5) the creation of surgical templates to guide implant placement and augmentation procedures; 6) the production of customized meshes for bone regeneration; and 7) the use of static or dynamic computer-aided implant placement. CONCLUSIONS Results from this narrative review seem to demonstrate that the use of a partially or fully digital workflow can be successfully used also in advanced implant dentistry. However, the number of studies (in particular RCTs) focused on the use of a fully digital workflow in advanced implant dentistry is still limited and more studies are needed to properly evaluate the potentials of DT.
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Affiliation(s)
- Grazia Tommasato
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
| | | | | | - Luca De Stavola
- Unit of Periodontology, Dental Clinic, Department of Neurosciences, University of Padova, Padova, Italy
| | - Matteo Chiapasco
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
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Kaaber L, Matzen LH, Schropp L, Spin-Neto R. Low-dose CBCT protocols in implant dentistry: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00132-9. [PMID: 38679501 DOI: 10.1016/j.oooo.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/19/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To evaluate the state-of-the-art evidence for applying low-dose CBCT protocols in 3 stages of implant therapy (planning, insertion, and follow-up examination of peri-implantitis) and assess the overall body of evidence presented in the literature. STUDY DESIGN The search was conducted in the MEDLINE/Pubmed and Scopus databases. Studies comparing low-dose CBCT protocols to a relevant reference standard in relation to any stage of implant therapy were included. Data extraction and quality assessment were performed for all included studies. RESULTS Sixteen studies were included. Low-dose protocols were reported to result from reduction of the exposure parameters of kV, mA, resolution (through increased voxel size), exposure time, and scanning trajectory. The current literature suggests that low-dose CBCT protocols perform similarly in the 3 stages of implant therapy compared to higher resolution protocols regarding objective measurements, with adverse impacts mostly on subjective assessment of image quality. The results also suggest that CBCT-based bone measurements are similar to direct measurements, independent of the imaging protocol. Reduction in all parameters except kV seems feasible as the basis of low-dose CBCT protocols for implant therapy. CONCLUSIONS The use of low-dose CBCT protocols does not impact objective image quality assessment in any stage of implant therapy. Clinical studies are needed to indicate if the reported results can be extrapolated to improve patient care in relation to the responsible use of ionizing radiation.
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Affiliation(s)
- Laurits Kaaber
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark.
| | - Louise Hauge Matzen
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Oral Radiology, Aarhus University, Aarhus, Denmark
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Benavides E, Krecioch JR, Connolly RT, Allareddy T, Buchanan A, Spelic D, O'Brien KK, Keels MA, Mascarenhas AK, Duong ML, Aerne-Bowe MJ, Ziegler KM, Lipman RD. Optimizing radiation safety in dentistry: Clinical recommendations and regulatory considerations. J Am Dent Assoc 2024; 155:280-293.e4. [PMID: 38300176 DOI: 10.1016/j.adaj.2023.12.002] [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: 07/26/2023] [Revised: 11/20/2023] [Accepted: 12/12/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND The value of dental radiographs to oral health care decision making must be balanced with radiation safety to minimize patient exposure and occupational risk of oral health care providers. This review summarizes recommendations and regulatory guidance regarding dental radiography and cone-beam computed tomography. An expert panel presents recommendations on radiation safety, appropriate imaging practices, and reducing radiation exposure. TYPES OF STUDIES REVIEWED A systematic search run in Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews identified relevant topical systematic reviews, organizational guidelines, and regulatory reviews published in the peer-reviewed literature since 2010. A supplemental search of the gray literature (eg, technical reports, standards, and regulations) identified topical nonindexed publications. Inclusion criteria required relevance to primary oral health care (ie, general or pediatric dentistry). RESULTS A total of 95 articles, guidance documents, and regulations met the inclusion criteria. Resources were characterized as applicable to all modalities, operator and occupational protection, dose reduction and optimization, and quality assurance and control. PRACTICAL IMPLICATIONS Understanding factors affecting imaging safety and applying fundamental principles of radiation protection consistent with federal, state, and local requirements are essential for limiting patient ionizing radiation exposure, in conjunction with implementing optimal imaging procedures to support prudent use of dental radiographs and cone-beam computed tomographic imaging. The regulatory guidance and best practice recommendations summarized in this article should be followed by dentists and other oral health care providers.
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Kashi F, Dalili Kajan Z, Yaghoobi S, Khosravifard N. Frequency of Accessory Maxillary Ostium in Patients With/Without Sinusitis, and Its Correlation with Anatomical Variations of Paranasal Sinuses: A Cone Beam Computed Tomography Study. Indian J Otolaryngol Head Neck Surg 2024; 76:1645-1654. [PMID: 38566626 PMCID: PMC10982170 DOI: 10.1007/s12070-023-04376-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/19/2023] [Indexed: 04/04/2024] Open
Abstract
This study assessed the frequency of accessory maxillary ostium (AMO) in patients with/without sinusitis and its correlation with anatomical variations using cone-beam computed tomography (CBCT). In this cross-sectional study, 244 CBCT scans were evaluated in two groups: with maxillary sinusitis having > 2 mm mucosal thickening and without max sinusitis as a normal group having normal or less than 2 mm mucosa. The CBCT scans of each group were carefully evaluated for the presence/absence of AMO, patency/obstruction of the primary maxillary ostium (PMO), and the presence of anatomical variations of the paranasal sinuses. Data were analyzed by independent t-test, Pearson Chi-square test, and Fisher's exact test (alpha = 0.05). CBCT scans of 134 females (54.9%) and 110 males (45.1%) with a mean age of 34.16 ± 19.01 years were evaluated. The presence of AMO had no significant correlation with maxillary sinusitis (P = 0.104). The two groups had no significant difference in the frequency of Haller cell, nasal septal deviation, and concha bullosa (P > 0.05). However, the frequency of paradoxical concha (PC; P < 0.001) and bifid concha (BC; P = 0.017) was significantly higher in the normal group, and the frequency of PMO obstruction was significantly higher in the sinusitis group (P < 0.001). AMO had no significant correlation with any anatomical variation in any group (P > 0.05). Gender had a significant effect on the presence of AMO (P = 0.013). The presence of AMO had no significant correlation with maxillary sinusitis. However, its frequency was significantly higher in females in normal group and males with sinusitis. The presence of AMO had no significant correlation with anatomical variations.
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Affiliation(s)
- Faezeh Kashi
- Department of Maxillofacial Radiology, Guilan University of Medical Sciences, End of Professor Samii Blvd, Rasht, 41941-73774 Iran
| | - Zahra Dalili Kajan
- Department of Maxillofacial Radiology, Guilan University of Medical Sciences, End of Professor Samii Blvd, Rasht, 41941-73774 Iran
- Department of Maxillofacial Radiology, Dental Sciences Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soophia Yaghoobi
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Pei X, Liu X, Iao S, Ma F, Li H, Sun F. Accuracy of 3 calibration methods of computer-assisted dynamic navigation for implant placement: An in vitro study. J Prosthet Dent 2024; 131:668-674. [PMID: 35431027 DOI: 10.1016/j.prosdent.2022.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Dynamic navigation for implant placement has been reported to be more accurate than freehand surgery. However, the accuracy of the calibration methods used for navigation in partially edentulous individuals with distal extensions remains unknown. PURPOSE The purpose of this in vitro study on dental models was to evaluate the accuracy of 3 calibration methods of dynamic navigation for implant placement in the distal extension of partially edentulous arches. MATERIAL AND METHODS Eleven standardized polyurethane mandibular models with distal extensions were prepared. The left first molar, second molar, and second premolar from each model (33 tooth sites) were randomly assigned to 1 of the 3 calibration methods: U-shaped tube embedded with radiopaque markers, anatomic tooth cusps, and bone markers with the random number table method. Preoperative and postoperative cone beam computed tomography images were obtained for deviation analyses. The primary outcomes were 3-dimensional (3D) deviation at the implant platform and apex and angular deviation. Differences among the test groups were analyzed by using a 1-way analysis of variance (ANOVA) and the least significant difference (LSD) post hoc test (α=.05). RESULTS The mean ±standard deviation 3D deviations were 0.78 ±0.34, 1.86 ±0.91, and 1.44 ±0.57 mm at the implant platform and 0.79 ±0.35, 2.19 ±1.01, and 1.49 ±0.50 mm at the apex in the U-shaped tube, tooth cusp, and bone marker groups, respectively. The 3D deviations at the implant platform and apex were significantly different among the groups (P<.01). The angular deviation was 1.36 ±0.54, 2.95 ±2.07, and 2.92 ±2.45 degrees, with no significant differences among the groups (P=.092). CONCLUSIONS In the dynamic navigation of implant placement in the distal extension of partially edentulous arches, the U-shaped tube calibration with radiopaque markers was more accurate than the anatomic tooth cusp or bone marker calibration.
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Affiliation(s)
- Xiyan Pei
- Lecturer, First Clinic Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xiaoqiang Liu
- Associate Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Siniong Iao
- PhD student, Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Feifei Ma
- Lecturer, First Clinic Division, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Hong Li
- Lecturer, First Clinic Division, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Feng Sun
- Clinical Professor, First Clinic Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
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Oliveira ML, Bornstein MM, Dagassan-Berndt D. Feasibility of frozen soft tissues to simulate fresh soft tissue conditions in cone beam CT scans. Dentomaxillofac Radiol 2024; 53:196-202. [PMID: 38290763 PMCID: PMC11003664 DOI: 10.1093/dmfr/twae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES To evaluate the feasibility of frozen soft tissues in simulating fresh soft tissues of pig mandibles using cone beam CT (CBCT). METHODS Two fresh pig mandibles with soft tissues containing 2 tubes filled with a radiopaque homogeneous solution were scanned using 4 CBCT units and 2 field-of-view (FOV) sizes each. The pig mandibles were deep-frozen and scanned again. Three cross-sections were exported from each CBCT volume and grouped into pairs, with one cross-section representing a fresh and one a frozen mandible. Three radiologists compared the pairs and attributed a score to assess the relative image quality using a 5-point scale. Mean grey values and standard deviation were obtained from homogeneous areas in the tubes, compared using the Wilcoxon matched-pair signed-rank test and subjected to Pearson correlation analysis between fresh and frozen physical states (α = .05). RESULTS Subjective evaluation revealed similarity of the CBCT image quality between fresh and frozen states. The distribution of mean grey values was similar between fresh and frozen states. Mean grey values of the frozen state in the small FOV were significantly greater than those of the fresh state (P = .037), and noise values of the frozen state in the large FOV were significantly greater than those of the fresh state (P = 0.007). Both mean grey values and noise exhibited significant and positive correlations between fresh and frozen states (P < 0.01). CONCLUSIONS The freezing of pig mandibles with soft tissues may serve as a method to prolong their usability and working time when CBCT imaging is planned.
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Affiliation(s)
- Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira 901, Piracicaba, SP, 13414-903, Brazil
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
| | - Dorothea Dagassan-Berndt
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, 4058, Switzerland
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Assaf M, Beshtawi K. Radiographic Diagnostic Choices of Palestinian Dentists for Implant Therapy. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S159-S161. [PMID: 38595422 PMCID: PMC11000929 DOI: 10.4103/jpbs.jpbs_434_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 04/11/2024] Open
Abstract
Aim To report the radiographic preferences during dental implant therapy in Palestine. Materials and Methods Fourteen multiple-choice questions were delivered in electronic and hardcopy formats questionnaires during the Sixth International Implantology Conference (Palestine). The questions investigated the radiographic techniques that are mostly used based on various clinical scenarios and treatment phases. Results One hundred and thirty-seven responses were captured. The majority of the participants were general dentists with implant experience (79.6%). Less than a third of the participants (27.2%) were members of the Palestinian Association of Dental Implantology. The majority (85.9%) of them have their practice in a city zone. Panoramic radiograph (PAN) combined with cone beam computed tomography (CBCT) was the most preferred radiographic technique during the planning stage. Conclusion PAN and CBCT was the preferred choice during the planning stages. A PAN was preferred postoperatively and if no complications were associated. In the case of symptomatic patients, CBCT was the radiograph of choice.
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Affiliation(s)
- Mohammad Assaf
- Associate Professor, Department of Periodontology, Faculty of Dentistry, Al-Quds University, Palestine
| | - Khaled Beshtawi
- Assistant Professor, Department of Maxillofascial Surgery, Arab American University, Palestine
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Cucchi A, Maiani F, Franceschi D, Sassano M, Fiorino A, Urban IA, Corinaldesi G. The influence of vertical ridge augmentation techniques on peri-implant bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2024; 26:15-65. [PMID: 38114425 DOI: 10.1111/cid.13282] [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: 03/23/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to peri-implant bone loss (PBL), after at least 12 months of functional loading. MATERIAL AND METHODS The search was conducted to find all the studies about VRA and measurements of PBL with at least 12 months follow-up. Three pairwise meta-analysis (MA) was performed to completely evaluate the outcomes. RESULTS A total of 42 studies were included, of which 11 were randomized clinical trials (RCTs). RCTs were available only for guided bone regeneration (GBR), onlay, and inlay techniques. The weighted mean estimate (WME) of PBL value was found to be 1.38 mm (95% confidence interval [95% CI]: 1.10-1.66) after a mean follow-up of 41.0 ± 27.8 months. GBR, Inlay, Onlay, osteodistraction, and SBB represented in weight 32.9%, 30.6%, 25.0%, 7.6%, and 3.9%, respectively; and their WME (95% CI) were 1.06 (0.87-1.26) mm, 1.72 (1.00-2.43) mm, 1.31 (0.87-1.75) mm, 1.81 (0.87-1.75) mm, and 0.66 (0.55-0.77) mm, respectively. Among the secondary outcomes, the analysis was conducted for vertical bone gain, healing complication rate, surgical complication rate, implant survival, and success rate. CONCLUSIONS The primary findings of the meta-analysis, based on the changes between final and baseline values, showed that the peri-implant bone loss could be influenced by the type of intervention but there is a need to evaluate in RCTs the behavior of the peri-implant bone levels after long-term follow-up for all techniques.
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Affiliation(s)
| | | | - Debora Franceschi
- Department of Experimental and Clinic Medicine, University of Florence, Firenze, Italy
| | - Michele Sassano
- Department of Life Sciences and Public Health, Catholic University of The Sacred Heart, Rome, Italy
| | - Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Napoli, Italy
| | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics, University of Szeged, Szeged, Hungary
- Urban Regeneration Institute, Budapest, Hungary
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Saini RS, Alshadidi AAF, Rakhra J, Aldosari LIN, Hassan SAB, Quadri SA, Madhav V, Avetisyan A, Heboyan A. Text mining analysis of scientific literature on digital intraoral scanners in dentistry: Bibliometric analysis. Digit Health 2024; 10:20552076241260837. [PMID: 38840660 PMCID: PMC11151775 DOI: 10.1177/20552076241260837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
Objective This study aimed to provide valuable insights into the current research status and gaps in digital intraoral scanner literature in dentistry. Methodology Scopus Search Query TITLE-ABS-KEY (intraoral AND scanners AND (dentistry OR digital AND dentistry)). The search query used in Scopus for the bibliometric analysis was "TITLE-ABS-KEY (intraoral AND scanners AND (dentistry OR digital AND dentistry))." This query indicates that the analysis focused on documents in which the title, abstract, or keywords contained the terms "intraoral," "scanners," and either "dentistry" or "digital dentistry." Results The analysis covers a timespan from 1998 to 2023 and includes 331 documents sourced from 136 publications. The annual growth rate of research in this field is reported to be 15.9%, indicating a steady increase over time. Among the top sources, the "Journal of Esthetic and Restorative Dentistry" and the "Journal of Prosthetic Dentistry" have the highest number of articles, indicating their significance in the field. Some notable authors and their corresponding statistics include WÖSTMANN B, with 15 articles and a fractionalized value of 3.16, and SCHLENZ MA, with 14 articles and a fractionalized value of 2.91. The United States has the highest number of articles, indicating a significant presence in research publications. Germany closely follows this, demonstrating a notable contribution to the scientific community. Conclusions This bibliometric analysis of intraoral scanners used in dentistry provided valuable insights into the current state of research and scholarly publications in this field. This analysis sheds light on the trends, patterns, and advancements in the use of these scanners in dental practice.
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Affiliation(s)
- Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | | | - Saeed Awod Bin Hassan
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | - V.N.V Madhav
- Department of Prosthodontics, YCMM & RDF's Dental College and Hospital, Ahmednagar, India
| | - Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
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13
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Madi M, Tabassum A, Attia D, Al Muhaish L, Al Mutiri H, Alshehri T, Zakaria O, Aljandan B. Knowledge and attitude of dental students regarding etiology, diagnosis, and treatment of peri-implantitis. J Dent Educ 2024; 88:100-108. [PMID: 37870085 DOI: 10.1002/jdd.13397] [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: 06/10/2023] [Revised: 09/06/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE The objective of this study was to assess the level of knowledge and attitude of dental students about the etiology, diagnosis, and management of peri-implantitis. METHODS An online cross-sectional study that targeted senior undergraduate dental students at the College of Dentistry was conducted. A closed-ended survey consisting of 28 questions was designed. Three sections were created: 1) participants' characteristics; 2) Knowledge of peri-implantitis etiology, risk factors, diagnosis, and complications; 3) The use of antibiotics in peri-implantitis, diagnosis, and treatment methods. SPSS version 22 (IBM Corp.) was used for data analysis. Counts and percentages were calculated for correct answers in each section. RESULTS A total of 267 dental students responded to the questionnaire. The majority of the participants (81.6%) were knowledgeable about peri-implantitis being an inflammatory reaction, and a lesser percentage (77.9%) knew that bacterial plaque is an etiologic factor for peri-implant diseases. 82.0% of the participants identified smoking as a risk factor, followed by periodontitis (80.5%). Regarding implant complications, 57.3% of the participants considered implant mobility as a definitive indication for implant removal. More than half of the participants reported using crater-like bone defects surrounding implants to diagnose peri-implantitis. The most commonly used antibiotic was amoxicillin (34.1%), followed by amoxicillin combined with metronidazole (26.9%). CONCLUSION Most participants had a basic understanding of the etiology and risk factors of peri-implantitis. On the other hand, more courses addressing peri-implantitis diagnosis are needed.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Afsheen Tabassum
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Luba Al Muhaish
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hadeel Al Mutiri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Badr Aljandan
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ciconelle ACM, da Silva RLB, Kim JH, Rocha BA, Dos Santos DG, Vianna LGR, Gomes Ferreira LG, Pereira Dos Santos VH, Costa JO, Vicente R. Deep learning for sex determination: Analyzing over 200,000 panoramic radiographs. J Forensic Sci 2023; 68:2057-2064. [PMID: 37746788 DOI: 10.1111/1556-4029.15376] [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: 05/23/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
The objective of this study is to assess the performance of an innovative AI-powered tool for sex determination using panoramic radiographs (PR) and to explore factors affecting the performance of the convolutional neural network (CNN). The study involved 207,946 panoramic dental X-rays and their corresponding reports from 15 clinical centers in São Paulo, Brazil. The PRs were acquired with four different devices, and 58% of the patients were female. Data preprocessing included anonymizing the exams, extracting pertinent information from the reports, such as sex, age, type of dentition, and number of missing teeth, and organizing the data into a PostgreSQL database. Two neural network architectures, a standard CNN and a ResNet, were utilized for sex classification, with both undergoing hyperparameter tuning and cross-validation to ensure optimal performance. The CNN model achieved 95.02% accuracy in sex estimation, with image resolution being a significant influencing factor. The ResNet model attained over 86% accuracy in subjects older than 6 years and over 96% in those over 16 years. The algorithm performed better on female images, and the area under the curve (AUC) exceeded 96% for most age groups, except the youngest. Accuracy values were also assessed for different dentition types (deciduous, mixed, and permanent) and missing teeth. This study demonstrates the effectiveness of an AI-driven tool for sex determination using PR and emphasizes the role of image resolution, age, and sex in determining the algorithm's performance.
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Affiliation(s)
| | - Renan Lucio Berbel da Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jun Ho Kim
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | | | | | | | | | | | | | - Renato Vicente
- Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
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15
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Kuusisto N, Abushahba F, Syrjänen S, Huumonen S, Vallittu P, Närhi T. Zirconia implants interfere with the evaluation of peri-implant bone defects in cone beam computed tomography (CBCT) images even with artifact reduction, a pilot study. Dentomaxillofac Radiol 2023; 52:20230252. [PMID: 37641961 DOI: 10.1259/dmfr.20230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Three-dimensional cone beam computed tomography (CBCT) imaging can be considered, especially in patients with complicated peri-implantitis (PI). Artifacts induced by dense materials are the drawback of CBCT imaging and the peri-implant bone condition may not be assessed reliably because the artifacts are present in the same area. This pilot study investigates the performance of the artifact reduction algorithm (ARA) of the Planmeca Viso G7 CBCT device (Planmeca, Helsinki, Finland) with three different implant materials and imaging parameters. METHODS Three pairs of dental implants consisting of titanium, zirconia, and fiber reinforced composite (FRC) were set into a pig mandible. A vertical defect simulating peri-implantitis bone loss was made on the buccal side of one of each implant. The defect was identified and measured by two observers and compared to the actual dimensions. In addition, the bone structure and the marginal cortex visibility between the implants were estimated visually. RESULTS The bone defect and its dimensions with the zirconia implant could not be identified in any image with or without the metal artifact reduction algorithm. The bone defect of titanium and FRC implants were identified with all three imaging parameters or even without ARA. The interobserver agreement between the two observers was almost perfect for all categories analyzed. CONCLUSION Peri-implantitis defect of the zirconia implant and the peri-implant bone structure of the zirconia implants cannot be recognized reliably with any ARA levels, or any imaging parameters used with the Planmeca Viso G7. The need for ARA when imaging the peri-implant bone condition of the titanium and FRC implants may be unnecessary.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, City of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
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16
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Ling C, Shen Y, Zhang X, Ding X. A Cone Beam Computed Tomography Analysis of Bone Volume Variations of Extra-alveolar Region Based on Sex, Age, Vertical and Sagittal Facial Patterns. J Craniofac Surg 2023; 34:e660-e664. [PMID: 37399353 DOI: 10.1097/scs.0000000000009506] [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: 11/26/2022] [Accepted: 05/16/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES The goal of this study is to measure mandibular buccal shelf (MBS) concerning angulation, bone volume, and cortical bone volume as well as bone depth and cortical bone depth of infrazygomatic crest (IZC) via cone beam computed tomography and evaluate the measurements according to sex, age, vertical, and sagittal facial types. MATERIALS AND METHODS This study collected lateral cephalograms and cone beam computed tomography scans from 100 individuals, which were used to observe angulation, bone and cortical bone volume entailing width and depth of MBS as well as the depth of IZC. FH-MP (mandibular plane angle) and A point-Nasion-B point were adopted to determine vertical and sagittal facial patterns respectively. RESULTS Bone widths at 6 mm and 11 mm to cementoenamel junction (CEJ) and cortical bone width at 6 mm to CEJ in MBS showed significant sex differences, while bone depths and cortical bone depths in IZC show significant age difference( P <0.05). Bone width and cortical bone width at 6 mm to CEJ at the mesial root and 11 mm to CEJ at both roots as well as angulations of MBS in the mandibular first molar region, bone depth and cortical bone depth at the maxillary first molar distal buccal root, and the proximity region were all correlated to FH-MP ( P <0.05). CONCLUSIONS Short-faced individuals of Asian ethnicity tend to have greater bone width, greater projection in MBS, and greater bone depth in the posterior region of IZC. The optimal implant sites are 11 mm apical to CEJ at the mandibular second molar distal root and 65° at the maxillary first molar mesial root.
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Affiliation(s)
- Chuanliang Ling
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
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17
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Mihit Mihit FZ, Zubizarreta-Macho Á, Montiel-Company JM, Albaladejo Martínez A. Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques. BMC Oral Health 2023; 23:383. [PMID: 37308848 DOI: 10.1186/s12903-023-03079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The aim of the present systematic review and network meta-analysis (NMA) is to analyze the accuracy of image-guided-based orthodontic mini-implants placement techniques in the inter-radicular space. METHODS The study was conducted under the PRISMA recommendations. Three databases were searched up to July 2022. In vitro randomized experimental trials (RETs) including static computer-aided implant surgery (s-CAIS), mixed reality (MR), soft tissue static computer-aided implant surgery (ST s-CAIS) and conventional free-hand technique (FHT) for the orthodontic mini-implants placement in the inter-radicular space were selected. The risk of bias was assessed using the Current Research Information System scale. A random effects model was used in the NMA. Direct comparisons were combined with a random effects model in a frequentist NMA to estimate indirect comparisons, and the estimated effect size of the comparisons between techniques were analyzed by difference of means. Inconsistency was assessed with the Q test, with a significance level of p < 0.05, and a net heat plot. RESULTS A total of 92 articles was identified, and 8 RETs (8 direct comparisons of 4 techniques) were included in the NMA, which examined 4 orthodontic mini-implants placement techniques: s-CAIS, MR, ST s-CAIS, and FHT. Taking FHT as reference, s-CAIS and ST s-CAIS showed statistically significant coronal and apical deviation. In addition, s-CAIS showed statistically significant angular deviation. However, MR did not show statistically significant differences with respect to FHT, which presented the highest p-score. At the coronal deviation, ST s-CAIS presented the highest P-score (0.862), followed by s-CAIS (0.721). At the apical deviation, s-CAIS presented the highest P-score (0.844), followed by ST s-CAIS (0.791). Finally, at the angular deviation s-CAIS presented again the highest P-score (0.851). CONCLUSIONS Within the limitations of this study, it was found that the image-guided-based orthodontic mini-implants placement techniques showed more accuracy than the free-hand conventional placement technique; specially the computer-aided static navigation techniques for the orthodontic mini-implants placed in the inter-radicular space.
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Affiliation(s)
- Fatima Zahrae Mihit Mihit
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain.
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain.
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010, Valencia, Spain
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18
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Goodarzi Pour D, Emami Meybodi E, Sodagar K, Emami Meybodi ZA, Safari S. Effect of metal artifact removal modes on the accuracy of linear measurement around titanium implants by applying different voltages: an original article. BMC Med Imaging 2023; 23:74. [PMID: 37277737 DOI: 10.1186/s12880-023-01025-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND This study aims to evaluate the effects of the artifact removal algorithm on linear measurements of the buccal cortical plate by altering the voltage. METHODS Ten titanium fixtures were inserted at the site of central, lateral, canine, premolars and molars of dry human mandibles. Vertical height of buccal plate was measured using a digital caliper as a gold standard. Mandibles were scanned with 54 and 58 kVp. Other parameters were constant. Images were reconstructed with none, low, medium and high artifact removal modes. Two Oromaxillofacial radiologists evaluated and measured the buccal plate height using Romexis software. Statistical package for the social sciences (SPSS) version 24 was used for data analysis. RESULTS In medium and high modes, the difference between 54 and 58 kVp was significant (p < 0.001). No significance was noted by using low ARM (artifact removal mode) at the 54 kVp and 58 kVp. CONCLUSION Using artifact removal in low voltage decreases the accuracy of linear measurement and buccal crest visibility. By using high voltage, artifact removal would have no significant effect on accuracy of linear measurements.
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Affiliation(s)
- Daryoush Goodarzi Pour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kosar Sodagar
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sanaz Safari
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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19
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Morgan N, Meeus J, Shujaat S, Cortellini S, Bornstein MM, Jacobs R. CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures. Diagnostics (Basel) 2023; 13:diagnostics13101684. [PMID: 37238169 DOI: 10.3390/diagnostics13101684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.
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Affiliation(s)
- Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt
| | - Jan Meeus
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
| | - Simone Cortellini
- Department of Oral Health Sciences, Section of Periodontology, KU Leuven, 3000 Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafael, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, 141 04 Huddinge, Sweden
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20
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Rabba JA, Suhaimi FM, Mat Jafri MZ, Jaafar HA, Osman ND. Automated measurement for image distortion analysis in 2D panoramic imaging of dental CBCT system: A phantom study. Radiography (Lond) 2023; 29:533-538. [PMID: 36913788 DOI: 10.1016/j.radi.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/15/2023]
Abstract
INTRODUCTION The daily image quality assessment involves large datasets that consume a lot of time and effort. This study aims to evaluate a proposed automated calculator for image distortion analysis in 2-dimensional (2D) panoramic imaging mode for a dental cone beam computed tomography (CBCT) system in comparison with present manual calculations. METHODS A ball phantom was scanned using panoramic mode of the Planmeca ProMax 3D Mid CBCT unit (Planmeca, Helsinki, Finland) with standard exposure settings used in clinical practice (60 kV, 2 mA, and maximum FOV). An automated calculator algorithm was developed in MATLAB platform. Two parameters associated with panoramic image distortion such as balls diameter and distance between middle and tenth balls were measured. These automated measurements were compared with manual measurement using the Planmeca Romexis and ImageJ software. RESULTS The findings showed smaller deviation in distance difference measurements by proposed automated calculator (ranged 3.83 mm) as compared to manual measurements (ranged 5.00 for Romexis and 5.12 mm for ImageJ software). There was a significant difference (p < 0.05) on the mean measured ball diameter between automated and manual measurement. For ball diameter measurement, there is a moderate positive correlation between automated measurement with the manual measurements (r = 0.6024 and r = 0.6358 for Romexis and ImageJ, respectively). However, there is a negative correlation between automated measurement for the distance difference with manual methods (r = -0.3484 and r = -0.3494 for Romexis and ImageJ, respectively). There was a good approximation between automated and ImageJ measurement of ball diameter in comparison to reference value. CONCLUSION In conclusion, the proposed automated calculator provides faster method with an accurate and acceptable results for daily-basis image quality test in dental panoramic mode of a Dental CBCT imaging system in comparison to current manual method. IMPLICATIONS FOR PRACTICE An automated calculator is recommended for image distortion analysis on phantom images in routine image quality assessment for dental panoramic mode of Dental CBCT imaging system that may involve analysis of large image datasets. It offers improvement in routine image quality practice in term of time and accuracy.
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Affiliation(s)
- J A Rabba
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia; Department of Physics, Federal University Lokoja, PMB 1154 Lokoja, Kogi State, Nigeria
| | - F M Suhaimi
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia
| | - M Z Mat Jafri
- School of Physics, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - H A Jaafar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia
| | - N D Osman
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia.
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Abu-Ta'a MF, Qubain KJ, Beshtawi KR. The mental foramen, anatomical parameters through a radiographic approach to aid in dental implantology: A retrospective analysis in a sample of a Palestinian population. Heliyon 2023; 9:e13886. [PMID: 36895406 PMCID: PMC9988552 DOI: 10.1016/j.heliyon.2023.e13886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Purpose This study aims at analyzing the mental foramen (MF) structure, dimension, position, and emergence profiles among a sample of a Palestinian population. Methods 212 mental foramina (106 patients) were analyzed on two panoramic views (CBCT reformatted (CRP) & conventional (CP)) and CBCT coronal views. The visibility score, position, size, presence of loop & supplementary foramina, distances coronal and apical to the foramen, and the emergence profiles of the mental canals with associated course angles were all noted. Results No statistically significant relationship was found between the type of panoramic radiographic view used (i.e., CP & CRP) and the resultant visibility level and position of MF. The majority of the MF showed an intermediate visibility score on both CP & CRP. The highest percentage of MF's position was under the 2nd mandibular premolar. The emergence profile was shown to be, in most, superior (S) in 47.6% of the sample and posterosuperior (PS) in 28.3%. The MF mean height and width were 4.08 mm & 4.11 mm, respectively. The coronal and axial angles averages were 46.25° and 91.49°, respectively. The distance superior and inferior to the MF showed averages of 12.39 mm and 13.52 mm, respectively. 28.3% of the sample presented with a mental loop, with a mesial extension average of 2 mm. Conclusion On both panoramic views (CBCT & conventional), the majority of the mental foramina displayed an intermediate visibility level, with no significant difference between the two techniques. The MF was found mostly under the second premolar. The majority of the examined mental canals had a superior emergence profile.
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Affiliation(s)
- Mahmoud F Abu-Ta'a
- Department of Dental Sciences, Faculty of Graduate Studies, Arab American University, Palestine
| | - Kamal J Qubain
- Department of Dental Sciences, Faculty of Graduate Studies, Arab American University, Palestine
| | - Khaled R Beshtawi
- Department of Dental Sciences, Faculty of Graduate Studies, Arab American University, Palestine
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22
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Hung KF, Yeung AWK, Bornstein MM, Schwendicke F. Personalized dental medicine, artificial intelligence, and their relevance for dentomaxillofacial imaging. Dentomaxillofac Radiol 2023; 52:20220335. [PMID: 36472627 PMCID: PMC9793453 DOI: 10.1259/dmfr.20220335] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Personalized medicine refers to the tailoring of diagnostics and therapeutics to individuals based on one's biological, social, and behavioral characteristics. While personalized dental medicine is still far from being a reality, advanced artificial intelligence (AI) technologies with improved data analytic approaches are expected to integrate diverse data from the individual, setting, and system levels, which may facilitate a deeper understanding of the interaction of these multilevel data and therefore bring us closer to more personalized, predictive, preventive, and participatory dentistry, also known as P4 dentistry. In the field of dentomaxillofacial imaging, a wide range of AI applications, including several commercially available software options, have been proposed to assist dentists in the diagnosis and treatment planning of various dentomaxillofacial diseases, with performance similar or even superior to that of specialists. Notably, the impact of these dental AI applications on treatment decision, clinical and patient-reported outcomes, and cost-effectiveness has so far been assessed sparsely. Such information should be further investigated in future studies to provide patients, providers, and healthcare organizers a clearer picture of the true usefulness of AI in daily dental practice.
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Affiliation(s)
- Kuo Feng Hung
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Division of Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité–Universitätsmedizin Berlin, Berlin, Germany
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Hamilton A, Singh A, Friedland B, Jamjoom FZ, Griseto N, Gallucci GO. The impact of cone beam computer tomography field of view on the precision of digital intra-oral scan registration for static computer-assisted implant surgery: A CBCT analysis. Clin Oral Implants Res 2022; 33:1273-1281. [PMID: 36239539 PMCID: PMC10091816 DOI: 10.1111/clr.14009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/11/2022] [Accepted: 10/08/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Registration of intra-oral surface scans to cone beam computer tomography (CBCT) is critical in the digital workflow for static computer-aided implant surgery (sCAIS). This study aimed to assess the impact of CBCT field of view (FoV) on the precision of digital intra-oral scan registration. MATERIALS AND METHODS Cone beam computer tomography data and intra-oral scans from 20 patients were included. Small FoV CBCT's were created by digitally segmenting a large FoV into three sextants. Virtual implant planning was performed. Digital intra-oral scans were repeatedly registered onto their corresponding large and small FoV CBCT datasets. The distances and angulations between the matching implant positions of each repeated registration were used to determine the precision of the registration process. Wilcoxon Signed Rank Paired Tests were used to compare the differences between large FoV and small FoV. The threshold for statistical significance was set at p = .05. RESULTS Differences in 3D implant position based on the registration precision between small FoV and large FoV present at both the implant entry point (0.37 ± 0.25 mm vs 0.35 ± 0.23 mm, p = .482) and implant tip (0.49 ± 0.34 mm vs 0.37 ± 0.24 mm, p < .001). Differences in overall angular precision were observed between small FOV and large FoV (1.43 ± 1.36° vs 0.51 ± 0.38°, p < .001). CONCLUSION CBCT with a small FoV is accompanied by greater precision errors in intra-oral scan registration. However, when sufficient well-distributed teeth are visible in small FoV CBCT, the precision of digital intra-oral scan registration appears to be within clinically acceptable limits for sCAIS.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Division of Oral Restorative and Rehabilitative Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Ashi Singh
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Private Practice, Sydney, New South Wales, Australia
| | - Bernard Friedland
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Faris Z Jamjoom
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Neil Griseto
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Zingari F, Francesco G, Alessandro B, Paola B, Simone G, Sergio S. Use of Digital Articulator in Implant Supported Prosthetics. A Case Report. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2208020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
A case report is presented to demonstrate advantages of a new fully digital approach, from planning through to execution to immediate loading implant-prosthetic rehabilitation. Until now, the function of the diagnostic wax-up has not been assessable and the functionalization of the finished product, be it either a provisional or a definitive, has been entrusted entirely to the ability of the technician.
Case Description:
A female patient, unaffected by systemic disease and cranio-cervico-mandibular muscular pain, required removal of hopeless residual teeth of the upper arch and substitution with immediately loaded implants using guided surgery. A fully digital technique was performed using specific software to record individual condylar (axiography) movements and mastication cycles and to correlate these with initial intra-oral scans in order to create a virtual 3D individual value articulator. Seven implants were placed using guided surgery and the prosthetic rehabilitation was successfully performed as planned.
Conclusion:
The use of guided surgery guarantees atraumaticity and procedure predictability as documented in recent literature. However, in this case, for the first time, using the digital axiograph and digital articulator, it was possible to record the axiography of condylar movements in order to 'functionalize' the diagnostic wax-up prior to its insertion into guided surgery software. This clinical case suggests how the software's compatibility with intra-oral scan files, diagnostic wax-up, facial scans, CBCT and, in the near future, electromyography of mastication muscles permits the clinician to work on a virtual patient and analyze all critical aesthetic and functional parameters prior to guided surgery.
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A Fast Automatic Reconstruction Method for Panoramic Images Based on Cone Beam Computed Tomography. ELECTRONICS 2022. [DOI: 10.3390/electronics11152404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Panoramic images have been widely used in the diagnosis of dental diseases. In the process of panoramic image reconstruction, the position of the dental arch curve usually affects the quality of display content, especially the completion level of the panoramic image. In addition, the metal implants in the patient’s mouth often lead the contrast of the panoramic image to decrease. This paper describes a method to automatically synthesize panoramic images from dental cone beam computed tomography (CBCT) data. The proposed method has two essential features: the first feature is that the method can detect the dental arch curve through axial maximum intensity projection images over different ranges, and the second feature is that our method is able to adjust the intensity distribution of the implant in critical areas, to reduce the impact of the implant on the contrast of the panoramic image. The proposed method was tested on 50 CBCT datasets; the panoramic images generated by this method were compared with images attained from three other commonly used approaches and then subjectively scored by three experienced dentists. In the comprehensive image contrast score, the method in this paper has the highest score of 11.16 ± 2.64 points. The results show that the panoramic images generated by this method have better image contrast.
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Lee KH, Park W, Cheong J, Park KM, Kim JW, Kim KD. Identifying the course of the greater palatine artery using intraoral ultrasonography: cohort study. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1139-1146. [PMID: 35913512 DOI: 10.1007/s00276-022-02967-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/20/2022] [Indexed: 10/16/2022]
Abstract
AIMS The greater palatine artery (GPA) is one of the most important anatomical structure for free gingival grafts or connective-tissue grafts during soft tissue surgery for dental implants. Several studies have identified the approximate location of the GPA, but it is impossible to detect its exact location during surgery due to large variability between individuals. The authors, therefore, investigated the course of the GPA using intraoral ultrasonography to determine the feasibility of using real-time nonionizing ultrasonography for implant surgery. MATERIALS AND METHODS This study included 40 healthy young participants. The courses of the GPA were identified using intraoral ultrasound probes from the first premolar to the second molar. The distance from the gingival margin to the GPA (GM-GPA) and the depth of the palatal gingiva from the GPA (PG-GPA) were measured by two independent examiners. Measurements were analyzed statistically, and interexaminer reliability was determined. RESULTS The distance of the GM-GPA and the mean depth of the PG-GPA were 14.8 ± 1.6 mm and 4.10 ± 0.51 mm (mean ± SD), respectively. GM-GPA decreased when the GPA ran from the second molar to the first molar, and GM-GPA was significantly shorter in females (P < 0.05). PG-GPA increased when the GPA ran to the posterior teeth. Interexaminer measurement agreements were excellent, with intraclass correlation coefficient values of 0.983 and 0.918 for GM-GPA and PG-GPA, respectively. CONCLUSIONS Using an intraoral ultrasound probe, real-time GPA tracking is possible, which is expected to help reduce the possibility of bleeding during surgery.
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Affiliation(s)
- Kang-Hee Lee
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Jieun Cheong
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Kyeong-Mee Park
- Department of Advanced General Dentistry, College of Dentistry, Human Identification Research Institute, Yonsei University, Seoul, South Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea.
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Martins VB, Oenning ACC, Guimarães LC, Junqueira JLC, Franco A. CBCT study on the prevalence, morphology and position of the mandibular incisive canal in a North-Brazilian population. J Clin Exp Dent 2022; 14:e534-e540. [PMID: 35912024 PMCID: PMC9328487 DOI: 10.4317/jced.59487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background The mandibular incisive canal (MIC) is an anatomic structure to be considered in treatment planning for surgeries in the anterior region of the mandible. Awareness of the MIC increased with the use of 3D imaging for treatment planning, such as cone beam computed tomography (CBCT). This study aimed to use CBCT to assess the prevalence, morphology and position of the MIC among North-Brazilians.
Material and Methods The sample consisted of CBCT scans of 100 hemi-mandibles (50 individuals) that were assessed for the absolute (n) and relative frequency of the MIC. The morphological component of this study was the diameter (mm) of the detected MIC in five anatomic sites between the mental foramen and the midline. Within the interformainal region, the position of the MIC was assessed by measuring (mm) the distances between the MIC and the basal, vestibular and lingual cortical bone surfaces.
Results The prevalence of the MIC was >76% considering the different anatomic regions screened in CBCT. The mean diameter of the MIC progressively reduced from 1.29 mm to 0.86 throughout the five anatomic regions measured. The position of the MIC showed a downward trajectory away from the lingual cortical bone surface.
Conclusions MIC was a highly prevalent anatomic structure in the studied sample. The funnel-shaped outline of the MIC and its trajectory into the interforaminal region highlighted a major risk of damage to the neurovascular bundle in surgeries (e.g. implant placement) that are close to the mental foramen and the vestibular cortical bone. Key words:Anatomy, cone beam computed tomography, imaging, mandibular incisive canal, oral radiology.
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Affiliation(s)
| | | | | | | | - Ademir Franco
- Division of Forensic Dentistry, Faculdade Sao Leopoldo Mandic, Brazil.,Centre of Forensic and Legal Medicine and Dentistry, University of Dundee, UK
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Distribution of implant failure caused by positioning in a certain part of Turkish society on CBCT. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1032929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: The aim of this report was to evaluate the prevalence of implant failure rates due to implant positioning on Cone beam Computerized Tomography.
Methods: Study sample (n= 333) consisted of CBCT(Cone-beam computerized tomography) scans of patients who were referred to the Department of Dentomaxillofacial Radiology, University of Health Sciences Turkey, Gülhane Faculty of Dentistry, Ankara, Turkey. Obtained data such as age, gender, number of implants and locations from CBCT images gathered and recorded.
Results: The data consists of 333 patients and so the total data evaluated was 844. The implant survival rate of the patients between 20-40 years old (49.4%) was lower significantly than that of the patients ≥ 40 years old (P=0.001). In the R4 (right mandibular region), implant failure rate is 17.5% shows quite low rate compared to other regions. At the R1 (right maxillar region) (39%) and R2 (45%) the most common reason of failure was maxillary sinus perforation, the least common reason was palatinal bone perforation, respectively 4% and 1%.
Conclusion: Preventing misinterpretations of clinicians is only possible by correct evaluation of incidental findings and better knowledge of head and neck anatomy.
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Li-Rodríguez JK, Díaz-Durany M, Romeo-Rubio M, Paz Salido M, Pradíes G. Accuracy of a guided implant system with milled surgical templates. J Oral Sci 2022; 64:145-150. [PMID: 35321962 DOI: 10.2334/josnusd.21-0361] [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: 11/01/2022]
Abstract
PURPOSE This in vitro study analyzed the accuracy of a computer-assisted design (CAD)/computer-assisted manufacturing (CAM) guided implant surgery system by comparing linear, angular, and coronal deviations between the planned and final implant placement. METHODS By using a fully guided surgery workflow, 32 dental implants were placed in 16 partially edentulous models. After virtual design of the restorations, radiological and CAD files were matched and implant positions were planned by using dedicated implant planning software (Galileo Implant version 1.9.2.). Templates were designed (Cerec Omnicam) and milled (Cerec MC XL) by using chairside workflow. Galileo Implant version 1.9.2. was used to evaluate accuracy. RESULTS Mean horizontal and angular-coronal total deviation values were 0.2 mm (SD = 0.126) and 1.1º (SD = 0.834) respectively. Multivariate analysis of variance showed significant differences in horizontal and angular-coronal total deviation in the 32 implants (P = 0.0001). Multivariate analysis with one-factor interaction showed no statistical difference in implant position or implant type (P = 0.139) between eight maxilla models and eight jaw models. CONCLUSION Horizontal and angular-coronal deviations of implants placed with chairside digital workflow were within the recommended safety margin for fully guided surgery.
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Affiliation(s)
- Jeanette K Li-Rodríguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | | | - Marta Romeo-Rubio
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | - María Paz Salido
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
| | - Guillermo Pradíes
- Department of Conservative Dentistry and Buccofacial Prostheses, Complutense of Madrid University
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Chang CC, Kim SK, Lee CT. A novel approach to assess volumetric bone loss at immediate implant sites and comparison to linear measurements: a pilot study and measurement workflow. J Dent 2022; 120:104083. [PMID: 35247470 DOI: 10.1016/j.jdent.2022.104083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Studies have evaluated changes in hard tissue following immediate implant placement (IIP) through cone beam computed tomography (CBCT) imaging, typically examining the amount of two-dimensional (2D) linear, rather than three-dimensional (3D) volumetric bone loss. This study compared the 3D volumetric changes of the alveolar bone at immediate implant sites with 2D linear measurement outcomes by using a novel image analysis workflow. METHODS Preoperative and 6-month postoperative CBCT images of patients who underwent IIP and bone grafting in the maxillary esthetic area were acquired. Linear and volumetric measurements of buccal bone dimensions were taken using a specially designed workflow. The 2D and 3D measurements were compared, and their correlations were determined. RESULTS Images from 13 patients (13 implants) were analyzed. Linear measurements revealed that the general linear buccal bone loss was less than 1mm in all segments. The 3D volumetric bone reduction (reported as median [first quantile, third quantile]) in the vertical, cervical, middle, and apical segments was 14.27 [11.33, 30.66] mm3 (51.30 [42.78, 66.91]%), 16.20 [10.35, 30.52] mm3 (18.20 [9.88, 24.74]%), 17.48 [8.42, 21.17] mm3 (24.05 [12.39, 28.22]%), and 6.87 [3.88, 9.45] mm3 (11.34 [5.14, 22.54]%), respectively. Significant positive correlations between 2D and 3D measurements were consistently identified in the cervical and middle segments, but no significant correlation was noted in the vertical segment. CONCLUSIONS The results revealed that linear measurements could not fully represent volumetric bone dimensional changes. Performing volumetric measurements and 3D rendering could be valuable in presenting the actual amount and topography of peri-implant bone remodeling. CLINICAL SIGNIFICANCE Linear measurements only partially represent the real-life event of 3D bone changes at immediate implant sites. Factors affecting hard tissue alterations following IIP should be reassessed using 3D volumetric measurement outcomes.
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Affiliation(s)
- Chi-Ching Chang
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054; Department of Periodontics, Chang Gung Memorial Hospital, No.199, Dun-Hua North Rd., Taipei, Taiwan, 105406; Chang Gung University, No.259, Wenhua 1st Rd., Taoyuan City, Taiwan, 333323
| | - Sung K Kim
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054.
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Automatic detection and segmentation of morphological changes of the maxillary sinus mucosa on cone-beam computed tomography images using a three-dimensional convolutional neural network. Clin Oral Investig 2022; 26:3987-3998. [DOI: 10.1007/s00784-021-04365-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023]
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Velasco-Ortega E, Jiménez-Guerra A, Ortiz-Garcia I, Garrido NM, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero JL, Cabanillas-Balsera D, López-López J, Monsalve-Guil L. Implant Treatment by Guided Surgery Supporting Overdentures in Edentulous Mandible Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211836. [PMID: 34831594 PMCID: PMC8622873 DOI: 10.3390/ijerph182211836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to show the clinical outcomes of implants inserted by guided surgery supporting mandibular overdentures in edentulous patients. PATIENTS AND METHODS Mandibular edentulous patients were diagnosed with an oral examination, cone-beam computerized tomography, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants by guided surgery. After flapless surgery, implants were early loaded with an overdenture at 6 weeks. RESULTS AND DISCUSSION Fourteen patients (nine females and five males) were treated with 28 implants. Four patients (28.6%) had a previous history of periodontitis. Five patients (35.7%) were smokers. Nine patients (64.3%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 44.7 ± 31.4 months. Clinical outcomes showed a global success of 100% of implants. Fourteen overdentures were placed in the patients over the implants. Mean marginal bone loss was 1.25 mm ± 0.95 mm. Four patients (28.6%) showed some kind of mechanical prosthodontic complications. Six implants (21.4%) were associated with peri-implantitis. CONCLUSIONS This study indicates that treatment of mandibular edentulous patients with overdentures by guided surgery and early loading of implants placed appears to be a successful implant protocol.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Alvaro Jiménez-Guerra
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Ivan Ortiz-Garcia
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Nuno Matos Garrido
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Jesús Moreno-Muñoz
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Enrique Núñez-Márquez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - José Luis Rondón-Romero
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - José López-López
- Department of Odontostomatoly, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, C/ Feixa LLarga s/n, 08907 Hospitalet de LLobregat, Spain
- Correspondence:
| | - Loreto Monsalve-Guil
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
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Presurgical Assessment of Anatomical Landmark Position Using Two Views of Cone Beam Computed Tomography: A Comparative Radiological Study. J Craniofac Surg 2021; 33:e165-e168. [PMID: 34545052 DOI: 10.1097/scs.0000000000008182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cone beam computerized computed tomography (CBCT) has been widely indicated in dental implant procedure. The first step that the doctors should perform in local hospitals is to use orthopantomography for surgical planning to avoid and limit the risk of complications. As a result, determining the magnification amount of orthopantomography to achieve a precise diagnosis is clinically important. This study investigated the difference in measurement of the mental foramen (MF) position before dental surgery using 2 views of CBCT. MATERIALS AND METHODS Cone beam computed tomography scan was performed for 100 patients who required implant placement. In the panoramic and three-dimensional views of CBCT, the vertical distance between the margin of the mandible and the lower border of MF, and the horizontal distance between the mandibular symphysis and the mesial anterior border of MF were calculated. The differences between the 2 views were compared using Wilcoxon-rank U test with P value ≤ 0.05 considered statistically significant. RESULTS The findings of this study showed a substantial statistical difference in the horizontal distance for the dentate patients in panoramic and three-dimensional views (22.7 ± 3.04 versus 21.1 ± 1.6), (22.5 ± 2.4 versus 20.9 ± 1.5) and left side (22.4 ± 2.8 versus 21.2 ± 1.6), (22.4 ± 2.8 versus 20.6 ± 1.4) of both genders. Concerning the vertical distance, a significant difference was also observed in the dentate (12.1 ± 2.1 versus 11.1 ± 1.4), (10.6 ± 1.4 versus 9.6 ± 1.3) and left side of the jaw (11.6 ± 1.95 versus 10.9 ± 1.2), (10.5 ± 1.2 versus 9.96 ± 1.4) for both genders in both views. In the edentulous and right side of the jaw, however no statistical difference was observed between male and female patients in terms of horizontal and vertical measurements.
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Schwindling FS, Juerchott A, Boehm S, Rues S, Kronsteiner D, Heiland S, Bendszus M, Rammelsberg P, Hilgenfeld T. Three-dimensional accuracy of partially guided implant surgery based on dental magnetic resonance imaging. Clin Oral Implants Res 2021; 32:1218-1227. [PMID: 34352147 DOI: 10.1111/clr.13819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To measure in vivo 3D accuracy of backward-planned partially guided implant surgery (PGIS) based on dental magnetic resonance imaging (dMRI). MATERIAL AND METHODS Thirty-four patients underwent dMRI examinations. Tooth-supported templates were backward planned using standard dental software, 3D-printed, and placed intraorally during a cone beam computed tomography (CBCT) scan. Treatment plans were verified for surgical viability in CBCT, and implants were placed with guiding of the pilot drill. High-precision impressions were taken after healing. The 3D accuracy of 41 implants was evaluated by comparing the virtually planned and definitive implant positions with respect to implant entry point, apex, and axis. Deviations from the dMRI-based implant plans were compared with the maximum deviations calculated for a typical single implant. RESULTS Twenty-eight implants were placed as planned in dMRI. Evaluation of 3D accuracy revealed mean deviations (99% confidence intervals) of 1.7 ± 0.9mm (1.2-2.1mm) / 2.3 ± 1.1mm (1.8-2.9 mm) / 7.1 ± 4.8° (4.6-9.6°) for entry point / apex / axis. The maximum deviations calculated for the typical single implant surpassed the upper bounds of the 99% CIs for the apex and axis, but not for the entry point. In the 13 other implants, dMRI-based implant plans were optimized after CBCT. Here, deviations between the initial dMRI plan and definitive implant position were only in part higher than in the unaltered group (1.9 ± 1.7 mm [0.5-3.4 mm] / 2.5 ± 1.5 mm [1.2-3.8 mm] / 6.8 ± 3.8° [3.6-10.1°] for entry point / apex / axis). CONCLUSIONS The 3D accuracy of dMRI-based PGIS was lower than that previously reported for CBCT-based PGIS. Nonetheless, the values seem promising to facilitate backward planning without ionizing radiation.
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Affiliation(s)
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sophia Boehm
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Dorothea Kronsteiner
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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Sugawara S, Ishikawa T, Sato S, Kihara H, Taira M, Sasaki M, Kondo H. Uptake of Nanotitania by Gingival Epithelial Cells Promotes Inflammatory Response and Is Accelerated by Porphyromonas gingivalis Lipopolysaccharide: An In Vitro Study. Int J Mol Sci 2021; 22:ijms22158084. [PMID: 34360848 PMCID: PMC8348964 DOI: 10.3390/ijms22158084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022] Open
Abstract
Titanium is often used in the medical field and in dental implants due to its biocompatibility, but it has a high rate of leading to peri-implantitis, which progresses faster than periodontitis. Therefore, in the present study, the expression of cytokines from gingival epithelial cells by nanotitania was investigated, which is derived from titanium in the oral cavity, and the additional effect of Porphyromonasgingivalis (periodontopathic bacteria) lipopolysaccharide (PgLPS) was investigated. Ca9-22 cells were used as a gingival epithelial cell model and were cultured with nanotitania alone or with PgLPS. Cytokine expression was examined by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, cellular uptake of nanotitania was observed in scanning electron microscopy images. The expression of interleukin (IL)-6 and IL-8 significantly increased in Ca9-22 cells by nanotitania treatment alone, and the expression was further increased by the presence of PgLPS. Nanotitania was observed to phagocytose Ca9-22 cells in a dose- and time-dependent manner. Furthermore, when the expression of IL-11, related to bone resorption, was investigated, a significant increase was confirmed by stimulation with nanotitania alone. Therefore, nanotitania could be associated with the onset and exacerbation of peri-implantitis, and the presence of periodontal pathogens may worsen the condition. Further clinical reports are needed to confirm these preliminary results.
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Affiliation(s)
- Shiho Sugawara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 1-3-27 Chuo-dori, Morioka 020-8505, Iwate, Japan; (S.S.); (H.K.); (H.K.)
| | - Taichi Ishikawa
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University, 1-1-1 Idai-dori, Morioka 028-3694, Iwate, Japan;
- Correspondence: ; Fax: +81-19-908-8011
| | - Shu Sato
- Division of Dental Anesthesiology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 1-3-27 Chuo-dori, Morioka 020-8505, Iwate, Japan;
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 1-3-27 Chuo-dori, Morioka 020-8505, Iwate, Japan; (S.S.); (H.K.); (H.K.)
| | - Masayuki Taira
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idai-dori, Morioka 028-3694, Iwate, Japan;
| | - Minoru Sasaki
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University, 1-1-1 Idai-dori, Morioka 028-3694, Iwate, Japan;
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, 1-3-27 Chuo-dori, Morioka 020-8505, Iwate, Japan; (S.S.); (H.K.); (H.K.)
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Ramis-Alario A, Soto-Peñaloza D, Tarazona-Alvarez B, Peñarrocha-Diago M, Peñarrocha-Oltra D. Comparison of the diagnostic efficacy of 2D radiography and cone beam computed tomography in persistent apical periodontal disease: A PRISMA-DTA systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e153-e168. [PMID: 34376356 DOI: 10.1016/j.oooo.2021.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/27/2021] [Accepted: 07/04/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this study was to answer the question: Do conventional radiographs (periapical/panoramic) afford better diagnostic outcomes than cone beam computed tomography (CBCT) as a complement for clinical diagnosis of apical lesions with persistent apical periodontitis or disease after root canal treatment? STUDY DESIGN Five electronic databases were searched and provided information to enable construction of a table to determine primary diagnostic measures and secondary parameters. The evidence was appraised with the Quality Assessment of Diagnostic Accuracy Studies tool and GRADEpro software. RESULTS Twenty-seven articles (9903 diagnostic images) were included. The pooled sensitivity, specificity, area under the receiver operating characteristic curve (AUCROC), positive predictive value, negative predictive value, negative likelihood ratio, and accuracy were 0.58, 1, 0.77, 1, 0.68, 0.45, and 0.79, respectively. CONCLUSIONS Moderate certainty evidence suggested that conventional radiographs showed poor sensitivity and excellent specificity but good diagnostic performance in terms of AUCROC and accuracy. Sensitivity, AUCROC, and negative likelihood ratio values could be reduced if the time elapsed to diagnosis after root canal treatment exceeded 5 years. The use of CBCT with a reduced field of view or a 2D radiographic technique should be weighed considering patient-specific and indication-oriented criteria as taking precedence over the therapeutic goal.
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Affiliation(s)
- Amparo Ramis-Alario
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - David Soto-Peñaloza
- Master in Oral Surgery and Implantology, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Beatriz Tarazona-Alvarez
- Assistant Professor, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
| | - Miguel Peñarrocha-Diago
- Chairman of Oral Surgery and Director of the Master in Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain
| | - David Peñarrocha-Oltra
- Full Professor of Oral Surgery, Department of Stomatology, Valencia University Medical and Dental School, Valencia, Spain
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Komuro A, Yamada Y, Uesugi S, Terashima H, Kimura M, Kishimoto H, Iida T, Sakamoto K, Okuda K, Kusano K, Baba S, Sakamoto T. Accuracy and dimensional reproducibility by model scanning, intraoral scanning, and CBCT imaging for digital implant dentistry. Int J Implant Dent 2021; 7:63. [PMID: 34189641 PMCID: PMC8241962 DOI: 10.1186/s40729-021-00343-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Recently, it has become possible to analyze implant placement position using the digital matching data of optical impression data of the oral cavity or plaster models with cone beam computed tomography (CBCT) data, and create a highly accurate surgical guide. It has been reported that CBCT measurements were smaller than the actual values, termed shrinkage. Matching of digital data is reliable when the plaster model or intraoral impression values show shrinkage at the same rate as the CBCT data. However, if the shrinkage rate is significantly different, the obtained digital data become unreliable. To clarify digital matching reliability, we examined dimensional reproducibility and shrinkage in measurements obtained with a model scanner, intra-oral scanner (iOS), and CBCT. Materials and methods Three implants that were arranged in a triangle were fixed in an acrylic plate. The distance between each implants were measured using model scanner, iOS, and CBCT. The actual size measured by electronic caliper was regarded as control. Results All values measured with CBCT were significantly smaller than that of model scanner, iOS, and control (p<0.001). The model scanner shrinkage was 0.37-0.39%, iOS shrinkage was 0.9-1.4%, and CBCT shrinkage was 1.8-6.9%. There were statistically significant differences among the shrinkage with iOS, CBCT, and model scanner (p<0.001). Conclusion Our findings showed that all measurements obtained with those modalities showed shrinkage as compared to the actual values. In addition, CBCT shrinkage was largest among three different measuring methods. They indicated that data matching between CBCT and scanner measurements requires attention in regard to the reliability of values obtained with those devices.
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Affiliation(s)
- Akira Komuro
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan.
| | - Yoichi Yamada
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Satoshi Uesugi
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Hiroaki Terashima
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Masashi Kimura
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Hiroto Kishimoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Tsutomu Iida
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Katsuya Sakamoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Kenichi Okuda
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
| | - Kaoru Kusano
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 1-5-17 Otemae Chuo-ku, Osaka, 540-0008, Japan
| | - Takashi Sakamoto
- Osaka Academy of Oral Implantology, 1-1-43 Abenosuji, Abenoku, Osaka, 545-6008, Japan
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Maret D, Vergnes JN, Peters OA, Peters C, Nasr K, Monsarrat P. Recent Advances in Cone-beam CT in Oral Medicine. Curr Med Imaging 2021; 16:553-564. [PMID: 32484089 DOI: 10.2174/1573405615666190114152003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Affiliation(s)
- Delphine Maret
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,AMIS Laboratory - Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean-Noel Vergnes
- Epidemiology and Public Health Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Christine Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States
| | - Karim Nasr
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France
| | - Paul Monsarrat
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA, Tareen SUK, Awinashe V. Influence of Inter-Radicular Septal Bone Quantity in Primary Stability of Immediate Molar Implants with Different Length and Diameter Placed in Mandibular Region. A Cone-Beam Computed Tomography-Based Simulated Implant Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S484-S491. [PMID: 34447139 PMCID: PMC8375907 DOI: 10.4103/jpbs.jpbs_818_20] [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] [Received: 12/09/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/04/2022] Open
Abstract
AIM The purpose of this in vitro study was to investigate the influence of length and width of implant on primary stability in immediate implants in mandibular first molar. MATERIALS AND METHODS The study was carried out on 40 cone-beam computed tomography scans selected with defined inclusion and exclusion criteria. According to the diameter and length of implants, they were divided into nine groups (G1 to G9). The virtual implants of different diameters and length were placed in mandibular first molar and measurements were done for peri-implant horizontal and vertical gap defect, peri-implant interradicular bone support and apical bone support for all the groups. RESULTS The study groups Diameter, (D-7 mm) showed least horizontal gap defect (Buccal-1.30 ± 0.56 mm, lingual-1.30 ± 0.56 mm, mesial-1.20 ± 0.51 mm, and distal-1.05 ± 0.59 mm) as compared to regular implant diameter (D-4.7) groups (Buccal-2.35 ± 0.483 mm, lingual-2.10 mm ± 0.44 mm, mesial-2.30 ± 0.64 mm, and distal-2.25 ± 0.43 mm). The unsupported Vertical implant gap defect at the coronal part of the socket was 2.80 mm ± 0.83 mm for all groups in both horizontal and vertical direction. The vertical peri-implant interradicular bone support showed increased bone support with increase in implant length (L). The buccal and lingual inter-radicular bone-support was least for Length (L-8.5 mm), moderate for L-11.5 mm, and highest for L-13.5 mm groups, respectively. The mesial inter-radicular bone support was least for G4G7, moderate for G1G2G5G8, and maximum for G3G6G9 groups. Similarly, the distal inter-radicular bone support was least for G4G7, moderate for G1G5G8, and maximum for G2G3G6G9 groups, respectively. There was no apical bone support in L-8.5 mm group as the tip of implant was 3.5-4 mm within the socket tip. Whereas, L-11.5 mm had decent (0.9-1 mm) and L-13.5 mm had Good (1.35-1.95 mm) apical bone support as the implant tip was beyond the socket tip. CONCLUSION All the groups showed good interradicular bone support on buccal and lingual surfaces. Regular width implants with longer length showed satisfactory interradicular bone support on mesial and distal surfaces. Longer implants showed good apical bone support in all the four surfaces and hence good apical primary stability expected.
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Affiliation(s)
- Arshad Jamal Sayed
- Department of Preventive Dentistry, College of Dentistry in Alrass, Qassim University, Saudi Arabia
| | - Safia Shoeb Shaikh
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudi Arabia
| | - Shoeb Yakub Shaikh
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Saudi Arabia
| | | | | | - Vaibhav Awinashe
- Department of Prosthodontics. College of Dentistry in Alrass, Qassim University, Saudi Arabia
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Cone-Beam Computed Tomography: A User-Friendly, Practical Roadmap to the Planning and Execution of Every Rhinoplasty-A 5-Year Review. Plast Reconstr Surg 2021; 147:749e-762e. [PMID: 33835107 DOI: 10.1097/prs.0000000000007900] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cone-beam computed tomography has recently rapidly developed worldwide as a versatile and convenient alternative to traditional computed tomography for imaging of the maxillofacial region. However, most surgeons performing rhinoplasty are surprisingly unfamiliar with it, in both the plastic surgery and ear, nose, and throat communities. METHODS The broad clinical experience of a single center over the past 5 years is reviewed. The many applications of cone-beam computed tomography to primary and secondary rhinoplasty are analyzed regarding septum, turbinates, nasal bones, skin thickness, and other issues. The importance of a paradigm shift from a two-dimensional to a three-dimensional approach in image reconstruction is demonstrated, together with the value of surface contour enhancement. RESULTS Cone-beam computed tomography has a multitude of practical applications highly relevant to rhinoplasty. The surface image will strengthen aesthetic analysis, and the detailed preview of bony and functional anatomy will facilitate surgical planning. Cone-beam computed tomography serves as a roadmap to plan and execute rhinoplasties more predictably and efficiently. The availability of spatial views and accurate detail, together with the possibility of easy, accurate measuring, offers a plenitude of potential applications. CONCLUSIONS Cone-beam computed tomography is a user-friendly, quick technique with abundant advantages in planning any rhinoplasty. It causes the patient no inconvenience and has very few, if any, drawbacks, with these being limited to radiation exposure and limited cost.
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Wei SM, Zhu Y, Wei JX, Zhang CN, Shi JY, Lai HC. Accuracy of dynamic navigation in implant surgery: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:383-393. [PMID: 33540465 DOI: 10.1111/clr.13719] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 12/17/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the accuracy of dynamic computer-assisted implant surgery. MATERIALS AND METHODS An electronic search up to March 2020 was conducted using PubMed, Embase, and the Cochrane Central Register of Controlled Trial to identify studies using dynamic navigation in implant surgery, and additional manual search was performed as well. Clinical trials and model studies were selected. The primary outcome was accuracy. A single-arm meta-analysis of continuous data was conducted. Meta-regression was utilized for comparison on study design, guidance method, jaw, and systems. RESULTS Ten studies, four randomized controlled trials (RCT) and six prospective studies, met the inclusion criteria. A total of 1,298 drillings and implants were evaluated. The meta-analysis of the accuracy (five clinical trials and five model studies) revealed average global platform deviation, global apex deviation, and angular deviation were 1.02 mm, 95% CI (0.83, 1.21), 1.33 mm, 95% CI (0.98, 1.67), and 3.59°, 95% CI (2.09, 5.09). Meta-regression shown no difference between model studies and clinical trials (p = .295, 0.336, 0.185), drilling holes and implant (p = .36, 0.279, 0.695), maxilla and mandible (p = .875, 0.632, 0.281), and five different systems (p = .762, 0.342, 0.336). CONCLUSION Accuracy of dynamic computer-aided implant surgery reaches a clinically acceptable range and has potential in clinical usage, but more patient-centered outcomes and socio-economic benefits should be reported.
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Affiliation(s)
- Shi-Min Wei
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yu Zhu
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jian-Xu Wei
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chu-Nan Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Bohner L, Tortamano P, Gremse F, Chilvarquer I, Kleinheinz J, Hanisch M. Assessment of Trabecular Bone During Dental Implant Planning using Cone-beam Computed Tomography with High-resolution Parameters. Open Dent J 2021. [DOI: 10.2174/1874210602115010057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Cone-Beam Computed Tomography (CBCT) with high-resolution parameters may provide an acceptable resolution for bone assessment.
Objectives:
The purpose of this study is to assess trabecular bone using two cone-beam computed tomography (CBCT) devices with high-resolution parameters in comparison to micro-computed tomography (µCT).
Methods:
Bone samples (n=8) were acquired from dry mandibles and scanned by two CBCT devices: 1) VV (Veraview R100, Morita; FOV 4x4, 75kV, 9mA, voxel size 0.125µm); and PR (Prexion 3D, Prexion; FOV 5x5, 90kV, 4mA, 37s, voxel size 108µm). Gold-standard images were acquired using µCT (SkyScan 1272; Bruker; 80kV, 125mA, voxel size 16µm). Morphometric parameters (BvTv- Bone Volume Fraction, BsBv- Trabecular specific surface, TbTh- Trabecular thickness and TbSp- Trabecular separation) were measured. Statistical analysis was performed within ANOVA, Spearman Correlation test and Bland-Altmann plots with a statistical significance level at p=0.05.
Results:
CBCT devices showed similar BvTv values in comparison to µCT. No statistical difference was found for BvTv parameters assessed by CBCT devices and µCT. BsBv values were underestimated by CBCT devices (p<0.01), whereas TbTh and TbSp values were overestimated by them (p<0.01). Positive correlations were found between VV and µCT measurements for BvTv (r2= 0.65, p=0.00), such as between PR and µCT measurements for TbSp (r2= 0.50, p=0.04). For BsBv measurements, PR was negatively correlated with µCT (r2= -0.643, p=0.01).
Conclusion:
The evaluated CBCT device was able to assess trabecular bone. However, bone parameters were under or overestimated in comparison to µCT.
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Stricker A, Jacobs R, Maes F, Fluegge T, Vach K, Fleiner J. Resorption of retromolar bone grafts after alveolar ridge augmentation-volumetric changes after 12 months assessed by CBCT analysis. Int J Implant Dent 2021; 7:7. [PMID: 33474648 PMCID: PMC7817723 DOI: 10.1186/s40729-020-00285-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022] Open
Abstract
In this pilot study, a volumetric analysis of retromolar onlay bone grafts over a period of 12 months was conducted, using repeated CBCT imaging combined with automated image registration. Eleven patients being treated with 16 bone grafts taken from the retromolar area were examined by CBCT scanning prior to bone augmentation (T0), immediately after bone augmentation (T1) and after a healing time of 12 months after augmentation (T2). Graft volumes were measured at each time point after automated image registration of consecutive CBCT scans. The mean volume of the augmented site was 372.2 ± 179.4 mm3. Resorption relative to the original augmented volume was 43.7% ± 19.0% after 12 months. Three-dimensional graft resorption could be precisely depicted by the use of automated image registration for CBCT data over a period of 12 months and demonstrated extensive volumetric changes of bone grafts taken from the ascending ramus of the mandible. Graft resorption and continuous bony remodeling of the grafted site before and after implant insertion have to be carefully considered by the clinician.
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Affiliation(s)
- Andres Stricker
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany. .,Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, Freiburg, Germany. .,Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Frederik Maes
- ESAT/PSI & Medical Imaging Research Center, Faculty of Engineering Sciences, University of Leuven, Leuven, Belgium
| | - Tabea Fluegge
- Department of Oral and Maxillofacial Surgery, Charité University of Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jonathan Fleiner
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium
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Abstract
Aims To investigate the awareness and practice of 2D and 3D diagnostic imaging, including respective equipment, specifications, number of images acquired, indications for CBCT scans, preference between 2D and 3D imaging, and the confidence in acquiring and interpreting radiographic images among dentists in Hong Kong.Materials and methods A citywide survey was performed with an online questionnaire that was sent via the local dental association to registered dentists in Hong Kong. The anonymous survey focused on: their dental background; number, type and age of their intra-oral, panoramic devices; CBCT indications, field-of-view and consideration of low-dose protocols; and their confidence in taking and interpreting these images.Results From the feedback collected, 65% of dentists used digital intra-oral systems. Around 70% of respondents who perform CBCTs utilised low-dose protocols to reduce radiation dose. Age and years of practising dentistry were significant influencing factors in determining dentists' utilisation of low-dose protocols for CBCT devices. Male dentists and dentists with higher qualifications generally reported being more confident in taking and interpreting CBCT images. Dentists who were older and had more years of practising dentistry were generally more confident in interpreting CBCT images.Conclusion Only half of the dentists feel confident in taking and interpreting CBCT images, and there seems to be a limited knowledge of radiation dose-related risks. Therefore, continuous professional education should specifically focus on the potential of digital imaging and training in CBCT modalities, radiation dose protection and image interpretation.
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Contour changes of peri-implant tissues are minimal and similar for a one- and a two-piece implant system over 12 years. Clin Oral Investig 2020; 25:719-727. [PMID: 33063219 PMCID: PMC7819926 DOI: 10.1007/s00784-020-03638-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/07/2020] [Indexed: 01/23/2023]
Abstract
Objectives To assess contour changes of peri-implant tissues comparing a one- and a two-piece dental implant system over 12 years. Materials and methods Patients seeking implant therapy were enrolled and randomly allocated to receive implants (a one-piece (STM) or a two-piece (BRA) system). Impressions were taken at the time of insertion of the final reconstruction (BL), after 1 year (FU-1), 5 years (FU-5), and at 12 years (FU-12). Thirty patients were included in the analysis (STM, 16; BRA, 14). Digital scans of casts were superimposed and analyzed in an image analysis program. Measurements included changes of the crown height, contour changes on the buccal side of the implants and the contralateral teeth (control). Results Contour changes at implant sites revealed a loss of − 0.29 mm (STM) and − 0.46 mm (BRA) during an observation period of 12 years. Contour changes at the corresponding tooth sites amounted to − 0.06 mm (STM) and − 0.12 mm (BRA) during the same time period. The implant crown gained 0.25 mm (STM) and 0.08 mm (BRA) in height due to recession of the marginal mucosa. The corresponding gain in crown height at the contralateral tooth sites amounted to 0.36 mm (STM) and 0.10 mm (BRA). Interproximal marginal bone level changes measured − 0.28 mm (STM) and − 1.11 mm (BRA). The mean BOP amounted to 38.8% (STM) and 48.7% (BRA) at the 12-year follow-up (FU-12). Conclusion Minimal changes of the peri-implant soft tissue contour were observed at implant sites over the period of 12 years irrespective of the use of a one- or a two-piece implant system. The differences between the implant sites and corresponding teeth were clinically negligible. Clinical relevance Peri-implant soft tissue stability is of high clinical relevance when monitoring dental implant sites on the long run. Clinical data on the extent of soft tissue changes around different implant systems are scarce. The present RCTs demonstrate minimal changes of the peri-implant soft tissue contour 12 years after implant insertion independent of the use of a one- or a two-piece implant system.
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Bernaerts A, Barbier L, Abeloos J, De Backer T, Bosmans F, Vanhoenacker FM, Casselman J. Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists. Semin Musculoskelet Radiol 2020; 24:499-509. [PMID: 33036038 DOI: 10.1055/s-0040-1701496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.
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Affiliation(s)
- Anja Bernaerts
- Department of Radiology, GZA Hospitals, Antwerp, Belgium
| | - Lieven Barbier
- Training Center for Dental Students of the KU Leuven, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Johan Abeloos
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Tom De Backer
- Department of Maxillo-Facial Surgery, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Frederik Bosmans
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan Casselman
- Department of Radiology, GZA Hospitals, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Radiology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
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Assessing the frequency of deep lingual concavities in 826 posterior mandible sockets. J Craniomaxillofac Surg 2020; 48:1045-1051. [PMID: 33012600 DOI: 10.1016/j.jcms.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/30/2020] [Accepted: 09/07/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the frequency of deep lingual concavities in the lower jaw, which can cause surgical complications while inserting dental implants. METHODS Cross-sections of the mandible alveolar ridge at the edentulous sockets were obtained via cone-beam computed tomography. Measurements were carried out using the freeware 'IC Measure' and based on the basic definitions of a previous study. RESULTS Most (767/826 = 93%) sockets had concavities of various degrees (30-90°), while 59 (7%) sockets had no concavity. However, the majority of the concavities (71%) were mild, with angles > 60°. The other 220 (26%) sockets had deeper concavities of <60°; among these, 12 (1%) had extremely deep concavities of <40°. CONCLUSIONS Only a few cases have deep lingual concavities that pose a high risk for lingual plate perforation during dental implantation.
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Domic D, Bertl K, Ahmad S, Schropp L, Hellén-Halme K, Stavropoulos A. Accuracy of cone-beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study. J Periodontol 2020; 92:592-601. [PMID: 32846005 PMCID: PMC8247288 DOI: 10.1002/jper.20-0222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone-beam computed tomography (CBCT) to determine the buccal bone level at titanium implants. METHODS Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface; thus, resulting in three BBT groups (i.e., >0.5 to 1.0; >1.0 to 1.5; >1.5 to 2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared with the direct measurements at the bone blocks. RESULTS While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤1.0 mm, a dehiscence was often diagnosed although not present, that is, the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm. CONCLUSIONS Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤1 mm thick, detection of the buccal bone level is largely inaccurate.
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Affiliation(s)
- Danijel Domic
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Salman Ahmad
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Lars Schropp
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
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Kernen F, Kramer J, Wanner L, Wismeijer D, Nelson K, Flügge T. A review of virtual planning software for guided implant surgery - data import and visualization, drill guide design and manufacturing. BMC Oral Health 2020; 20:251. [PMID: 32912273 PMCID: PMC7488021 DOI: 10.1186/s12903-020-01208-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background Virtual implant planning systems integrate (cone beam-) computed tomography data to assess bone quantity and virtual models for the design of the implant-retained prosthesis and drill guides. Five commercially available systems for virtual implant planning were examined regarding the modalities of integration of radiographic data, virtual dental models and the design of drill guides for guided implant surgery. The purpose of this review was to describe the limitations of these available systems regarding the import of imaging data and the design and fabrication of a drill guide. Methods The following software systems were examined regarding the import of imaging data and the export of the virtual implant planning for the design and fabrication of a drill guide with the help of two clinical situations requiring dental implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria included data formats and management as well as the workflow for the design and production of drill guides. Results All systems have a DICOM-interface (“Digital Imaging and Communication in Medicine”) for the import of radiographic data. Imaging artefacts could be reduced but not eliminated by manual data processing. The import of virtual dental models in a universal format (STL: Standard Tesselation Language) was possible with three systems; one system could only be used with a proprietary data format. All systems display three-dimensional surface models or two-dimensional cross-sections with varying orientation for virtual implant planning. Computer aided design and manufacturing (CAD/CAM) of drill guides may be performed by the user with the help of default parameters or solely by the provider of the software and thus without the influence of the clinician. Conclusion Data bases of commonly used implant systems are available in all tested software, however not all systems allow to plan and execute fully guided implant placement. An individual design and in-house manufacturing of the drill guide is only available in some software systems. However, at the time of publication most recent software versions showed flexibility in individual design and in-house manufacturing of drill guides.
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Affiliation(s)
- Florian Kernen
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Jaap Kramer
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Laura Wanner
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Daniel Wismeijer
- Department of Oral Implantology, Academisch Centrum Tandheelkunde Amsterdam (ACTA), Amsterdam, Netherlands
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Tabea Flügge
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Berlin, Germany
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da Silva RLB, Duailibi Neto EF, Todescan FF, Ruiz GM, Pannuti CM, Chilvarquer I. Evaluation of cervical peri-implant optical density in longitudinal control of immediate implants in the anterior maxilla region. Dentomaxillofac Radiol 2020; 49:20190396. [PMID: 32364770 DOI: 10.1259/dmfr.20190396] [Citation(s) in RCA: 2] [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
OBJECTIVE This research aimed to longitudinally evaluate the optical density of peri-implant alveolar bone. The data acquired from study participants previously treated with 37 osseointegrated implants were analyzed utilizing the radiographic subtraction technique. METHODS AND MATERIALS The radiographic follow-ups were performed five times: at the implantation of the prostheses and after 15, 90, 180 and 360 days. Intraoral radiographs were obtained by the paralleling technique using individualized Hanshin-type positioners to guarantee the standardization of the images. The obtained digital images were aligned and equalized before they were submitted to the radiographic subtraction procedure. RESULTS A significant difference was found between the distal region of Group I (patients treated with osseointegrated implants who required extraction of the dental element) and the 360 day follow-up and the distal region of Group II (patients with healed alveolar sockets) in all follow-up analyses (p < 0.05). We did not observe a significant difference between the groups analyzed and other follow-ups concerning the subcrestal and middle third regions for both the mesial and distal variables (p > 0.05). There was a statistically significant difference in the distal sites [χ2 = 5,745,, p = 0.03], showing a significant association between time and the presence of bone resorption. This association was not shown on the mesial surface (p = 0.16). CONCLUSION We concluded that there was no statistically significant difference between groups I and II. Using this technique, we were able to quantitatively and qualitatively evaluate the changes in the proximal sites on the digital radiographic images for the analyzed data. Digital subtraction technology to measure peri-implant bone density is an accurate and reproducible technique for quantifying peri-implant bone reactions to different therapeutic modalities.
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Affiliation(s)
| | | | | | - Glaucio Morente Ruiz
- Foundation FUNDECTO, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio Mendes Pannuti
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Israel Chilvarquer
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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