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Lu J, Ou Y, Zhao W, Chen H, He K, Lin H, Chen J. Cone beam computed tomography assessment of maxillary anterior teeth cervix dimensions in healthy adults for optimal anatomic healing abutments. J ESTHET RESTOR DENT 2024; 36:1199-1207. [PMID: 38605591 DOI: 10.1111/jerd.13236] [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: 10/11/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross-sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments. MATERIALS AND METHODS CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento-enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto-palatal (b), palatal (c), mesio-palatal (d), mesial (e), mesio-labial (f), labial (g), and disto-labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored. RESULTS Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines. CONCLUSIONS CBCT measurements of cervical cross-sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology. CLINICAL SIGNIFICANCE The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri-implant soft tissue.
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Affiliation(s)
- Jie Lu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Yanjing Ou
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Wei Zhao
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Huachen Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Kaixun He
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Hanyu Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Jiang Chen
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
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Paran E, Bouyssou S, King A. Morphological Assessment of the Temporomandibular Joint in Asymptomatic Brachycephalic Dogs Using Computed Tomography. J Vet Dent 2024; 41:137-147. [PMID: 37113019 DOI: 10.1177/08987564231171529] [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: 04/29/2023]
Abstract
Temporomandibular joint (TMJ) incongruity and morphological variations can result in clinical signs but have also been reported in asymptomatic brachycephalic dogs. The purpose of this study was to assess TMJ morphology in a group of brachycephalic dogs using computed tomography (CT). French Bulldogs, English Bulldogs, Boxers, Cavalier King Charles Spaniels (CKCS), Chihuahuas, Lhasa Apsos, Pugs, Shih Tzus, and Staffordshire Bull Terriers were retrospectively enrolled. The severity of the TMJ morphological changes was determined using a modified 5-grade classification system. The intra- and inter-observer agreements were calculated. One hundred fifty-three dogs were included. When evaluating the medial aspect of the TMJ in the sagittal plane, there was a spectrum of variations in the shape of the head of the condylar process of the mandible, the mandibular fossa and the retroarticular process ranging from a rounded concave TMJ with a long retroarticular process to a flattened TMJ with an absent process. Variations in the articular surface of the head of the condyle in the transverse plane ranged from flat, through curved and trapezoid to sigmoid. The prevalence of severe TMJ dysplasia (grades B3 and C) in the CKCS and French Bulldog was high (69.2% and 53.8%, respectively). The intra- and inter-observer agreements were moderate. Variations in TMJ morphology exist in asymptomatic brachycephalic dogs. Marked changes seem to be highly prevalent in the French Bulldog and CKCS and should be considered a breed variation. The TMJ classification described in this study could be used to standardize assessment of canine TMJ morphology. However, further research is needed to determine its clinical application.
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Affiliation(s)
- Emilie Paran
- Imaging Department, Langford Vets, Small Animal Referral Hospital, Bristol, UK
- Imaging Department, The University of Glasgow Small Animal Hospital, Glasgow, UK
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Ryakhovsky AN, Ryakhovsky SA. [Comparative evaluation of the accuracy of 3D TMJ analysis performed by different methods of processing computed tomograms]. STOMATOLOGIIA 2024; 103:56-60. [PMID: 38741536 DOI: 10.17116/stomat202410302156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The aim of this study. Comparison of the accuracy of segmentation of TMJ elements in different ways and assessment of the suitability of the data obtained for the diagnosis of TMJ dysfunction. MATERIALS AND METHODS To study the segmentation of the bone elements of the TMJ (articular fossa, head of the LF), 60 computed tomograms of the maxillofacial region of patients were randomly selected in various ways (archival material). In group 1, the results of CT processing by AI diagnostics algorithms (Russia) were collected; in group 2, the results of CT processing based on the semi-automatic segmentation method in the Avantis3D program. The results of CT processing by Avantis3D AI algorithms (Russia) with different probability modes - 0.4 and 0.9, respectively, were selected for the third and fourth groups. Visually, the coincidence of the contours of the LF heads and articular pits isolated using different methods with their contours on all possible sections of the original CT itself was evaluated. The time spent on TMJ segmentation according to CT data was determined and compared using the methods described above. RESULTS Of the 240 objects, only 7.5% of the cases showed a slight discrepancy between the contours of the original CT in group b1, which was the lowest of all. A slight discrepancy in the TMJ contours to be corrected is characteristic of the semi-automatic method of segmentation by optical density was detected in 50.4% (group 2). The largest percentage of significant errors not subject to correction was noted in the first group, which made it impossible to perform a full 3D analysis of the TMJ, and the smallest in the second and fourth. The magnitude of the error in determining the width of the articular gap in different groups is comparable to the size of one voxel per CT. When segmentation is carried out using AI, the difference between segmented objects is close to zero values. The average time spent on TMJ segmentation in group 1 was 10.2±1.23 seconds, in group 2 - 12.6±1.87 seconds, in groups 3 and 4 - 0.46±0.12 seconds and 0.46±0.13 seconds, respectively. CONCLUSION The developed automated method for segmenting TMJ elements using AI is obviously more suitable for practical work, since it requires minimal time, and is almost as accurate as other methods under consideration.
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Affiliation(s)
- A N Ryakhovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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De Nordenflycht D, Ayala A, Orellana L, Tesch RDS. Intra-articular injections in the TMJ inferior joint space: A scoping review. J Oral Rehabil 2023; 50:1316-1329. [PMID: 37323068 DOI: 10.1111/joor.13542] [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: 02/06/2023] [Revised: 06/04/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To perform a scoping review to identify the available evidence regarding intra-articular injections in the inferior joint space (IJS) of the temporomandibular joint (TMJ). METHODS An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: "Arthrocentesis", "injection", "joint injection", "technique", "Temporomandibular joint", "Temporomandibular joint disorder". Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. Only articles with full-text access were included. RESULTS Thirteen articles were included for analysis-one technical note, three cadavers studies, one animal study, two case reports, five randomised clinical trials and one retrospective study; studies were classified as 'patients-based studies' and 'non-patients-based studies'. Most 'patients-based studies' show moderate or high risk of bias. Techniques were categorised as 'anatomical technique' and 'image-guided technique'. Most 'patients-based studies' show favourable outcomes such as pain reduction, increase in maximum mouth opening, improvement in quality of life and improvement in TMJ dysfunction indexes for the treatment of arthrogenic TMDs. Comparisons between superior and IJS injections are scarce. On the other hand, 'non-patients-based' studies show that image-guided or ultrasound-checked injection techniques achieved a higher effectiveness for needle location than anatomical (or blind) techniques. CONCLUSION The amount of available evidence is scarce, heterogeneous in design, and most 'patients-based studies' show moderate or high risk of bias, which demands the generation of new research to obtain definitive conclusions. The tendency observed suggests that intra-articular injections for the IJS of the TMJ are able to relieve TMJ pain, increase mouth opening and improve TMJ dysfunction, and image-guided injection techniques seem to be more effective than anatomical techniques to locate the needle in the IJS.
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Elrawdy AM, Amer ME, Algariah AK, Eid MH, Abu-Elsaoud AM, Ghoneim MM. Appraisal of the Accuracy and Reliability of Cone-Beam Computed Tomography and Three-Dimensional Printing for Volumetric Mandibular Condyle Measurements of a Human Condyle. Cureus 2023; 15:e46746. [PMID: 38022326 PMCID: PMC10631571 DOI: 10.7759/cureus.46746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study aims to evaluate the accuracy of volumetric measurements of three-dimensional (3D)-printed human condyles from cone-beam computed tomography (CBCT) in comparison to physical condyles using a water displacement test. Methodology A sample of 22 dry condyles was separated from the mandibular body by disc, mounted on a base made of casting wax, and scanned using the SCANORA (Scanora 3DX, Soredex, Finland) CBCT scanner. Subsequently, the projection data were reconstructed with the machine-dedicated OnDemand 3D (Cybermed Co., Seoul, Korea). The Standard Tessellation Language file was prepared for 3D printing using chitubox slicing software v1.9.1. Frozen water-washable gray resin was used for 3D printing. All condyles were printed using the same parameters and the same resin. The volumetric measurements were then performed using a customized modified pycnometer based on water volume and weight displacement. Volumetric measures were performed for both the physical human condyles and the 3D-printed replicas and the measurements were then compared. Results The volume of dry condyles using the water displacement method showed an average (±SD) of 1.925 ± 0.40 cm3. However, the volume of 3D-printed replicas using the water displacement method showed an average (±SD) of 2.109 ± 0.40 cm3. The differences in measurements were insignificant (p > 0.05), as revealed by an independent t-test. Conclusions Highly precise, accurate, and reliable CBCT for volumetric mandibular condyle was applied for measurements of a human condyle and 3D-printed replica. The modified pycnometer for volumetric measurements presented an excellent volumetric measure based on a simple water displacement device. The tested modified pycnometer can be applied in volumetric measurements in both 3D-printed and mandibular condyle. For best accuracy, the highest scanning resolution possible should be used. As it directly handles irregularly shaped solid objects in a non-destructive manner with a high level of precision and reliability, this 3D scanning approach may be seen as a superior alternative to the current measurement methods.
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Affiliation(s)
- Ahmed M Elrawdy
- Department of Oral Radiology, Suez Canal University, Faculty of Dentistry, Ismailia, EGY
| | - Mohamed E Amer
- Department of Orthodontics, Zagazig University, Faculty of Dentistry, Zagazig, EGY
| | - Ahmed K Algariah
- Department of Orthodontics, Sinai University, Faculty of Dentistry, Ismailia, EGY
| | - Mohamed H Eid
- Department of Oral and Maxillofacial Surgery, Suez Canal University, Faculty of Dentistry, Ismailia, EGY
| | - Abdelghafar M Abu-Elsaoud
- Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
- Faculty of Science, Suez Canal University, Ismailia, EGY
| | - Mohamed M Ghoneim
- Department of Oral and Maxillofacial Surgery, Sinai University, Faculty of Dentistry, El-Arish, EGY
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Occlusal Splint Therapy Combined with Cranio-Temporomandibular Kinesiotherapy in Patients with Temporomandibular Disorders-A CBCT Study. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122143. [PMID: 36556507 PMCID: PMC9787407 DOI: 10.3390/life12122143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD patients is kinesiotherapy, which may be used alone or in conjunction with occlusal splint therapy. The aim of this study was to evaluate the changes in the intra-articular spaces of the temporomandibular joint (TMJ) after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients. Twenty-four patients (N = 24) diagnosed with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included. Cone beam computed tomography (CBCT) images were taken before and after treatment. The anterior, superior, posterior, and medial joint spaces were measured on the CBCT images, and the condylar ratio was calculated using Pullinger and Hollender's formula. Additionally, the thickness of the glenoid fossa (GFT), condylar medio-lateral widths (MLW), and condylar height (HCo) were measured. The condylar ratio was significantly higher after treatment (p = 0.049). The changes in dimensions of the anterior, superior, posterior and medial joint spaces were not statistically significant after treatment. No statistically significant differences were found in the dimensions of the GFT, MLW, and HCo post treatment. The condylar position did not shift anteriorly in a statistically significant way after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients.
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Association between Psychological Status and Condylar Bony Changes in Adults: A Retrospective Survey-Based Study. J Clin Med 2022; 11:jcm11247497. [PMID: 36556113 PMCID: PMC9781577 DOI: 10.3390/jcm11247497] [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: 10/25/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background: This article studies the association between psychological status and condylar bony changes in adults and assesses psychological questionnaires as an indicator of potential condylar bony changes. It is meaningful because condylar bony changes, a severe subtype of TMD and big concern in orthodontic treatment, would likely be ignored in patients with few TMD symptoms, in which case, even with potential psychological problems (depression, somatization and anxiety) being noticed, orthodontists may underestimate the possibility or severity of condylar bony changes and thus may not perform relevant examinations. Methods: A total of 195 adults (145 female and 50 male) who consulted orthodontists and had clinical records were included in this study. Initial CBCT images taken before orthodontic treatment were used for observing their condylar bony changes, and a comprehensive questionnaire conducted by each adult to evaluate psychological status was collected. Age, sex, TMD symptom history, scores on Patient Health Questionnaire-9 (PHQ-9), PHQ-15 and Generalized Anxiety Disorder-7 (GAD-7), and condylar bony changes of these adults were recorded. Odds ratios (OR) and 95% confidence intervals (CIs) for identifying the independent risk factors associated with condylar bony changes were calculated with univariate and multivariate logistic regression analysis. The kappa statistic was used to assess intraobserver reliability of CBCT analysis. Results: The scores of PHQ-15 (OR: 2.088, 95% CI: 1.061−4.108, p < 0.05) and GAD-7 (OR: 2.133, 95% CI: 1.082−4.204, p < 0.05) were correlated with the condylar bony changes on CBCT. Besides, the probability of having condylar bony changes was positively correlated with the number of psychological problems concomitantly present in an adult (OR: 1.440, 95% CI: 1.10−1.867, p < 0.01). The intraobserver agreement value for CBCT analysis was substantial (κ = 0.732). Conclusions: This study found that positive PHQ-15 (somatization) and GAD-7 (anxiety) scores were associated with condylar bony changes in adults. Moreover, the number of psychological problems concomitantly present in an adult was positively associated with the probability of having condylar bony changes.
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Chandran Kana Veettil A, Mariyappa Shantha A, Timmasandra Ashwathappa D, Sailaja Choudary A, Lingaiah U. Assessment of thickness of roof of the glenoid fossa in dentate, edentulous, and partially edentulous subjects using cone beam computed tomography (CBCT) - a retrospective study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e279-e284. [PMID: 35545193 DOI: 10.1016/j.jormas.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/22/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Studies have inferred a direct association between Temporomandibular joint disorders (TMD) and the integrity of the structures associated with it such as the Glenoid fossa thereby necessitating the requirement to measure the thickness of this oft ignored entity. This study was carried out to assess the thickness of the glenoid fossa roof in dentulous, edentulous, and partially edentulous subjects using archival Cone beam computed tomography (CBCT) images. METHOD Analysis of CBCT data of 120 joints from 60 adult subjects without signs and symptoms of TMD was carried out. The scans were grouped based on the dental status as dentulous, edentulous, and partially edentulous and additionally into two sets as those below and above 40 years of age. The distance between the superior and inferior cortices of the glenoid fossa was measured indicating the thickness of the roof of the glenoid fossa in the coronal and sagittal planes, by three independent observers. Analysis of Variance (ANOVA) and Tukey's post hoc test were used to compare the association between the mean thickness of the glenoid fossa and the dentition status. A p ≤ 0.05 was considered to be significant. RESULTS There was no significant association between the mean thickness of the glenoid fossa and the dentition of the study participants of all three groups, when assessed by the three observers, except the mean thickness on the right side in the sagittal section as measured by one observer. A thicker fossa was observed in edentulous subjects when compared to dentulous participants, and the difference was statistically significant (p = 0.035). CONCLUSION The thickness of the roof of the glenoid fossa demonstrated no association with the dental status of the study participants and no age or sex related differences were noted.
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Affiliation(s)
| | | | | | | | - Upasana Lingaiah
- V S Dental College and Hospital, Rajiv Gandhi University of Health Sciences, Bangalore, India
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Roman R, Almășan O, Hedeșiu M, Băciuț M, Bran S, Popa D, Ban A, Dinu C. Evaluation of the Mandibular Condyle Morphologic Relation before and after Orthognathic Surgery in Class II and III Malocclusion Patients Using Cone Beam Computed Tomography. BIOLOGY 2022; 11:biology11091353. [PMID: 36138832 PMCID: PMC9495726 DOI: 10.3390/biology11091353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022]
Abstract
Simple Summary In individuals with severe malocclusions, orthognathic surgery seeks to rebalance the relationships between the jaws by providing a stable occlusion, a healthy muscle balance, and the functioning of the temporomandibular joint. Cone beam computed tomography may be used to determine the position of the mandibular condyle in the glenoid fossa. This study aimed to assess how the position of the mandibular condyle varies in class II and III malocclusions before and after bimaxillary orthognathic surgery. Before and after orthognathic surgery, 56 TMJs from 28 patients were studied. Following surgery, both class II and class III patients experienced changes in the anterior joint space, posterior joint space, condyle position, and condyle angle. The preliminary findings are promising for determining changes in condyle position and joint spaces that might guide oral and maxillofacial surgeons to address a debilitating clinical affliction. Abstract This study aimed at evaluating the mandibular condyle position changes before and after bimaxillary orthognathic surgery in class II and III malocclusion patients. CBCT scans from patients who underwent bimaxillary orthognathic surgery were analyzed: Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). Both condyles were independently assessed for their largest anterior and posterior joint spaces, smallest medial joint spaces, and condyle angles concerning the transverse line. In the sagittal plane, the minimum size of the anterior and posterior joint spaces was measured. In the coronal plane, the smallest medial joint space was measured. The position of the condyle within the glenoid fossa was determined before and after surgery. A total of 56 TMJs from 28 patients were studied. Following orthognathic surgery, the anterior and posterior space in class II increased. Postoperatively, the anterior joint space in class III decreased. In 42.85% of malocclusion class II patients and 57.14% of malocclusion class III patients, the pre-and post-surgical position of the condyle changed, the condyle was anteriorly positioned (42.85%) in class II patients and centrically positioned (71.4%) in class III patients. Significant changes in the joint space, condylar position, and condyle angle were found in the class II and class III subjects.
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Affiliation(s)
- Raluca Roman
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
- Correspondence:
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Daiana Popa
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Alina Ban
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
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Fricain M, Charavet C, Raoult AG, Oueiss A, Savoldelli C. Condylar repositioning according to digital bite registration method for virtual orthognathic surgery planning: A series of 49 consecutive patients. Am J Orthod Dentofacial Orthop 2022; 162:e133-e140. [PMID: 35835701 DOI: 10.1016/j.ajodo.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The accurate mandibular condylar positioning for orthognathic surgical planning is fundamental in obtaining a planned occlusal result. The differences between the position of condyles seen on computed tomography or cone-beam computed tomography (CBCT) scans and during surgery reduce the accuracy of the result. This study aimed to assess the differences between the condylar position recorded on CBCT and a numerical 3-dimensional (3D) model created after mandibular repositioning for orthognathic surgery planning. METHODS This study retrospectively evaluated 49 patients who underwent virtual orthognathic surgery planning. The procedure involved recording a computed tomography or CBCT of the skull and dental surface using an intraoral digital scanner. The mandible was repositioned on the numerical 3D model according to the superimposed virtual bite registration in centric relation. Linear and angular measurements of the right and left condyles were recorded before and after mandibular repositioning. RESULTS The positions of 98 condyles were compared. Linear measurements of the posterior and superior joint spaces revealed a significant difference. Subgroup analyses displayed statistically significant differences for patients with skeletal Class II malocclusion. CONCLUSION According to the digital bite registration method, the difference between the mandibular position recorded on CBCT and on the numerical 3D model after repositioning may have clinical significance. Further studies are needed to validate this theory and test the accuracy of the clinical results.
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Affiliation(s)
- Margaux Fricain
- Department of Maxillofacial Surgery, University Institute of the Face and Neck, University Hospital of Nice, Nice, France.
| | - Carole Charavet
- Department of Orthodontics, University Hospital of Nice, Nice, France
| | | | - Arlette Oueiss
- Department of Orthodontics, University Hospital of Nice, Nice, France
| | - Charles Savoldelli
- Department of Maxillofacial Surgery, University Institute of the Face and Neck, University Hospital of Nice, Nice, France
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Kustermans L, Van de Casteele E, Asscherickx K, Van Hemelen G, Nadjmi N. Impact of surgically assisted rapid mandibular expansion on the temporomandibular joint. J Craniomaxillofac Surg 2022; 50:590-598. [DOI: 10.1016/j.jcms.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/18/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022] Open
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Postnikov MA, Andriyanov DA, Chigarina SE, Pankratova NV, Postnikova EM, Rodionova AA. [Radiological analysis of size of bone elements of the temporomandibular joint in children and adolescents with class II malocclusion]. STOMATOLOGIIA 2022; 101:35-42. [PMID: 36562365 DOI: 10.17116/stomat202210106135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim of the study was to assess the ratio of bone elements of the temporomandibular joint (TMJ) in children and adolescents with distal occlusion according to cone-beam computed tomography (CBCT). MATERIAL AND METHODS CBCT of the TMJ was analyzed in 121 patients aged 12-18 years, which were divided into two age groups: group I - children aged 12-15 years (62 cases in total, of which 47 patients with distal occlusion and 15 patients with physiological occlusion) and II group - adolescents aged 15-18 years (59 cases, of which 48 patients with distal occlusion and 11 patients with physiological occlusion). CBCT of the temporomandibular joint was performed by the standard method in the position of habitual occlusion and maximally open mouth. The size of the TMJ joint space in the anterior, upper and posterior sections was determined by the method of Rabukhina N.A., the analysis of the ratio of the bone elements of the TMJ was carried out using the Craniometry program. RESULTS The size of the joint space and the angle β of the temporomandibular joint in the anterior section on the right and left in children aged 12-15 with distal occlusion is increased compared to children with physiological occlusion in the position of habitual occlusion. In adolescents 15-18 years old with distal occlusion, the size of the TMJ joint space is increased in the anterior section on the right and left and reduced in the posterior section on the right, angle α is reduced on the right and left, angle β is reduced on the right, angle γ is increased on the right compared to adolescents with physiological occlusion. The revealed deviations indicate the presence of violations in the ratio of the bone elements of the TMJ, which are aggravated with age. CONCLUSION Analysis of the results obtained during CBCT in children and adolescents allows us to correct the plan of orthodontic treatment and predict its results.
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Affiliation(s)
| | | | | | - N V Pankratova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - E M Postnikova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Rodionova
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Cone Beam Computed Tomography Evaluation of the Morphological Variation and Width in Mandibular Condyle. J Craniofac Surg 2021; 32:e479-e481. [PMID: 33496523 DOI: 10.1097/scs.0000000000007465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Classify the normal morphology of mandibular condyle to facilitate the diagnosis of any pathology or abnormal conditions associated with it using cone beam computed tomography (CBCT). MATERIAL AND METHOD A total of 100 joints of 50 subjects with age range of 20 to 50 years were examined prospectively using CBCT images. The mandibular condylar morphology was classified into convex, round, flat, and angled the widest area of the condylar head measured to evaluate the size variation in different age groups for both genders and side. RESULTS Round shape condyle is more frequent than other varieties and angled shape was the less frequent shape. There was no significant difference between gender and condyle shape but the round and angled shape were more obvious in females than males. Convex type was more prevalent to shown bilateral symmetrical shape than other varieties, the condylar head mean of width measuring was 14.85 mm in age group 20 to 29 comparable to 14.45 mm and 14.42 mm in age groups 30 to 39 and 40 to 50 years, respectively. CONCLUSION CBCT facilitates the precise examination of TMJ in 3 planes that play a great role in an accurate visualization of the condyle to provide early diagnosis for any disorder in the region.
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Kim YH, Shin JY, Lee A, Park S, Han SS, Hwang HJ. Automated cortical thickness measurement of the mandibular condyle head on CBCT images using a deep learning method. Sci Rep 2021; 11:14852. [PMID: 34290333 PMCID: PMC8295413 DOI: 10.1038/s41598-021-94362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
This study proposes a deep learning model for cortical bone segmentation in the mandibular condyle head using cone-beam computed tomography (CBCT) and an automated method for measuring cortical thickness with a color display based on the segmentation results. In total, 12,800 CBCT images from 25 normal subjects, manually labeled by an oral radiologist, served as the gold-standard. The segmentation model combined a modified U-Net and a convolutional neural network for target region classification. Model performance was evaluated using intersection over union (IoU) and the Hausdorff distance in comparison with the gold standard. The second automated model measured the cortical thickness based on a three-dimensional (3D) model rendered from the segmentation results and presented a color visualization of the measurements. The IoU and Hausdorff distance showed high accuracy (0.870 and 0.928 for marrow bone and 0.734 and 1.247 for cortical bone, respectively). A visual comparison of the 3D color maps showed a similar trend to the gold standard. This algorithm for automatic segmentation of the mandibular condyle head and visualization of the measured cortical thickness as a 3D-rendered model with a color map may contribute to the automated quantification of bone thickness changes of the temporomandibular joint complex on CBCT.
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Affiliation(s)
- Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Jin Young Shin
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Seungtae Park
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
| | - Hyung Ju Hwang
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea.
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Sepp H, Vinkka-Puhakka H, Peltomäki T. Mandibular movements in children with deciduous and mixed dentition and in young adults with permanent dentition-the association between movements and occlusal traits. Eur J Orthod 2021; 43:338-345. [PMID: 32524135 DOI: 10.1093/ejo/cjaa033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cross-sectional studies of mandibular movements provide data on developmental trends of dentition and support planning of public health services. OBJECTIVE The aim of this study was to measure mandibular movement capacities in children with deciduous and mixed dentition and in young adults with permanent dentition. The influence of age and gender on mandibular movements and the association between mandibular movements and occlusal traits were analysed. METHOD The sample consisted of 1172 Estonians: group 1: children with deciduous dentition; group 2: children with mixed dentition; and group 3: young adults with permanent dentition. Maximum opening, mandibular laterotrusion, and protrusion were registered. RESULTS Age was correlated with mandibular movements. Young adults had statistically significantly larger mandibular movements as compared to children with deciduous and mixed dentition, and children with mixed dentition had larger mandibular movements as compared to children with deciduous dentition. Young adult males had larger mandibular movements than females of the same age. Associations were found between mandibular movement capacities and some occlusal traits. Mandibular movement capacities were smaller in children with crossbite and open bite as compared with children without corresponding occlusal traits. Mandibular movement capacities were larger in children with deep bite and increased overjet as compared with those without corresponding occlusal traits. CONCLUSION Mandibular movement capacities are age and gender dependent. Maximum mouth opening, mandibular laterotrusion, and protrusion are related, and mandibular movement and some occlusal traits are associated.
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Affiliation(s)
- Hettel Sepp
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Heli Vinkka-Puhakka
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Timo Peltomäki
- Oral and Maxillofacial Unit, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland.,Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Effects of Exposure Parameters and Voxel Size for Cone-Beam Computed Tomography on the Image Matching Accuracy with an Optical Dental Scan Image: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6971828. [PMID: 34222482 PMCID: PMC8213486 DOI: 10.1155/2021/6971828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/02/2021] [Indexed: 11/17/2022]
Abstract
This study is aimed at assessing the effects of exposure parameters and voxel size for cone-beam computed tomography (CBCT) on the image matching accuracy with an optical dental scan image. CBCT and optical scan images of a dry human mandible were obtained. Different CBCT settings were used: tube voltage, 60, 80, and 100 kVp; tube current, 6 and 8 mA; and voxel size, 100, 200, and 300 μm. Image matching between the CBCT and optical scan images was performed using implant planning software by dental professionals (n = 18). The image matching accuracy in each combination of CBCT settings was evaluated by assessing the linear discrepancy between the three-dimensionally reconstructed radiological image and the registered optical scan image using an image analysis software program. The Kruskal-Wallis test and a post hoc Mann–Whitney U test with Bonferroni correction were used to compare the accuracy of image registration between the groups (α = 0.05). Overall, the image matching accuracy was not significantly different between tube voltage and current settings; however, significantly higher image registration errors were found at the combination of 100 kVp tube voltage/8 mA tube current (F = 8.44, P < 0.001). Changes in voxel sizes did not significantly interfere with the image registration results. No interaction was found among voltage, current, and voxel size in terms of image registration accuracy (F = 2.022, P = 0.091). Different exposure parameter settings in tube voltage and tube current did not significantly influence the image matching accuracy between CBCT and optical dental scan images; however, a high radiation dose could be inappropriate. The image matching accuracy was not significantly affected by changing the voxel sizes of CBCT.
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Evaluation of various low-dose cone-beam computed tomography protocols in the diagnosis of specific condylar defects. Am J Orthod Dentofacial Orthop 2021; 159:491-501.e2. [PMID: 33541784 DOI: 10.1016/j.ajodo.2020.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 12/01/2019] [Accepted: 01/01/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This study aimed to determine the identifiability and measurement accuracy of defined bony defects of the temporomandibular joint (TMJ) in cone-beam computed tomographies, depending on different milliampere-second (mAs)-reduced protocols. METHODS Defined artificial defects were prepared on 30 condyles from 15 intact pig heads, with a maximum of surrounding soft tissue preserved. Three-dimensional imaging was performed using ProMax 3D Mid (Planmeca, Helsinki, Finland). The scan protocol with maximum resolution and without mAs-reduction was defined as control. Twenty-six mAs-reduced imaging protocols were analyzed by 1 examiner regarding the protocol-specific measurement accuracy. Defect depth (DD) was divided into 3 categories: I, <2 mm; II, 2-3 mm; and III, >3 mm. The protocol-specific sensitivity and specificity were evaluated in relation to localization and defect size as determined from the results of 3 examiners. RESULTS There was a significant difference from the control protocol in DD measurement in 8 mAs-reduced protocols, P <0.001-0.027. In most protocols, there was no significant difference in measurement accuracy concerning defect size and localization. The mean sensitivity reached values between 93.3% and 98.6% and differed significantly among protocols (P = 0.002). The mean specificity amounted to 97.0%-98.1% and did not differ among protocols (P = 0.462). The specificity of DD III (99.1%) was higher than DD I (97.7%) and DD II (97.1%). There was a significant difference in specificity and sensitivity concerning defect localization (P <0.001). CONCLUSIONS This study showed that mAs-reduced cone-beam computed tomographies protocols are suitable for the analysis of defined osseous TMJ defects. When 3-dimensional TMJ imaging is indicated because of potential erosive defects, validated mAs-reduced scan protocols should be applied instead of high-definition protocols.
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Onimaru M, Takahashi M, Shimazaki A, Kimura H, Inou N, Maki K. Verification of mechanical load generated by functional orthodontic appliances. J Biomech 2020; 113:110079. [PMID: 33254058 DOI: 10.1016/j.jbiomech.2020.110079] [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: 01/27/2020] [Revised: 10/04/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
Functional appliances are widely used for promoting mandibular growth by utilizing a construction bite position. We aimed to measure the mechanical load generated by movement of functional appliances and determine the factors influencing this load. Thirteen patients aged 8-12 years were selected for the study, and the load was measured using a previously developed measurement device. To investigate the factors affecting the load, the temporomandibular joint morphology and muscles related to the mandible were examined using cone-beam computed tomography. The standard regression coefficients of the factors affecting the load per millimeter of movement distance were 0.64 and 0.66 for (a) the inclination of the articular eminence and (b) the angle between occlusal plane and posterior temporalis, respectively. Measurement of the occlusal plane to the posterior temporalis and the inclination of the articular eminence were significantly different (p < 0.05). The angle of inclination of the articular eminence emerged as a strong influencing factor. Similarly, the influence of measurements from the occlusal plane to the posterior temporalis was considerable since the posterior temporalis muscle is the most active when the mandible is extended forward. We also found a possible relationship between the occlusal force and load at the construction bite position. To our knowledge, this is the first study to determine the actual load associated with the angle of the temporalis muscle to the occlusal plane, inclination angle of the articular eminence, angle between the occlusal plane and the Frankfort plane, and the angle between the geniohyoid muscle and the occlusal plane. Therefore, mechanical considerations need to be more accurate to facilitate safe orthodontic treatment.
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Affiliation(s)
- Minako Onimaru
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan.
| | - Masahiro Takahashi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Aya Shimazaki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hitoshi Kimura
- Department of Engineering Design, Tamagawa University, Tokyo, Japan
| | - Norio Inou
- Organization for Fundamental Research Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
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Length of the ramus of the mandible as an indicator of chronological age and sex: A study in a group of Egyptians. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2020. [DOI: 10.1016/j.fsir.2020.100066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Hameed Mohamed MA, Abdallah KF, Hussein FA. Three-Dimensional Assessment of Mandibular Condylar Volume and Position Subsequent to Twin Block Functional Therapy of Skeletal Class II Malocclusion Accompanied by Low-Level Laser Therapy. Dent J (Basel) 2020; 8:dj8040115. [PMID: 33050123 PMCID: PMC7712278 DOI: 10.3390/dj8040115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/01/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) on mandibular condylar volume and position following treatment of a Class II malocclusion with a twin block (TB) appliance employing cone beam computed tomography (CBCT). Twenty-four growing patients, aged 9–12 years, were randomly allocated into control and laser groups. All patients were treated with a TB appliance. The patients in the laser group were treated weekly with a gallium–aluminum–arsenide (GaAlAs) diode laser around the temporomandibular joint (TMJ) region for three months. CBCT images were obtained before and after TB therapy and the changes in TMJ and skeletal variables were evaluated and compared among and between the groups. In the laser group, the condylar volume of the right and left sides significantly increased by 213.3 mm3 and 231.2 mm3, respectively (p < 0.05), whereas in the control group it significantly increased by 225.2 mm3, and 244.2 mm3, respectively (p < 0.05), with forward and lateral positioning of both sides. Furthermore, effective mandibular, ramus, and corpus lengths were increased, which were not significant between the groups. Low-Level Laser therapy accomplished no considerable effect on mandibular condylar volume and position following the functional orthopedic treatment of skeletal Class II malocclusions using a TB appliance.
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Kim JJ, Lagravere MO, Kaipatur NR, Major PW, Romanyk DL. Reliability and accuracy of a method for measuring temporomandibular joint condylar volume. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:485-493. [PMID: 32950426 DOI: 10.1016/j.oooo.2020.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/29/2020] [Accepted: 08/14/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of this study was to develop and validate a technique for mandibular condyle segmentation and volume determination by using cone beam computed tomography (CBCT). STUDY DESIGN A dry skull was used to generate 3 dimensional (3-D)-printed mandible models that were then imaged by using CBCT. Semiautomatic segmentation of condyles was completed. The Frankfurt plane was established and translated to the most inferior point of the sigmoid notch, and the condylar volume superior to the plane was determined. This procedure was repeated on 3-D-printed mandibles by using physical landmarks and the water displacement method to obtain the physical volume. This was repeated 3 times to evaluate reliability. Sensitivity analysis was performed to demonstrate the effect of discrepancies in locating landmarks in the Frankfurt plane. Condylar volume measurements obtained from CBCT were compared with physical measurements through repeated-measures analysis of variance (ANOVA) to determine accuracy. RESULTS Condylar volume obtained from CBCT and physical measurements resulted in an intraclass correlation coefficient of 0.988 (0.918, 0.998) (P < .01) with both modalities, demonstrating excellent intrarater reliability. The mean difference of volume measurements between the modalities was not statistically significant (P = .365). Potential discrepancies in porion coordinates had minimal impact on condylar volume change. CONCLUSIONS The condylar segmentation technique proved to be a reliable and accurate method for evaluating condylar volume.
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Affiliation(s)
- Justin J Kim
- Orthodontics Student, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Manuel O Lagravere
- Associate Professor, Division of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton, Canada
| | - Neelambar R Kaipatur
- Clinical Assistant Professor, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Paul W Major
- Professor and Department Chair, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dan L Romanyk
- Professor and Department Chair, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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De Stefano AA, Guercio‐Monaco E, Hernández‐Andara A, Galluccio G. Association between temporomandibular joint disc position evaluated by magnetic resonance imaging and mandibular condyle inclination evaluated by computed tomography. J Oral Rehabil 2020; 47:743-749. [DOI: 10.1111/joor.12962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Adriana A. De Stefano
- Department of Orthodontics Faculty of Dentistry University Central of Venezuela Caracas Venezuela
| | | | | | - Gabriella Galluccio
- Department of Orthodontics Faculty of Dentistry University of Rome Sapienza Rome Italy
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Morphology of the Temporomandibular Joints Regarding the Presence of Osteoarthritic Changes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082923. [PMID: 32340336 PMCID: PMC7215313 DOI: 10.3390/ijerph17082923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022]
Abstract
(1) Osteoarthritis, the most common disease of the temporomandibular joints (TMJs), is diagnosed by clinical and radiographic examination. Cone beam computed tomography (CBCT) is a method of choice for the imaging of osteoarthritic changes. The objective was to compare the morphology of the TMJs in CBCT images regarding the number of the osteoarthritic changes diagnosed in the area of the condyle. (2) A total of 105 patients participated in the study; their 210 TMJs were allocated into one of three groups regarding the number of diagnosed osteoarthritic changes: 1 (none or 1 type), 2 (2 types), 3 (3 or more types). The morphology of the TMJ was examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The statistical significance level was p = 0.05 for all the measurements included. (3) The articular surface flattening was the most common type of the osteoarthritic changes (90%). The condylar A-P dimension differed significantly among the groups (p = 0.0001). The bigger the number of osteoarthritic changes diagnosed in one joint, the smaller the condylar A-P dimension that was observed. (4) The temporomandibular joints’ osteoarthritic changes occur very often, even among asymptomatic patients. The increased number of osteoarthritic changes seems to have an impact on the condylar anteroposterior dimension.
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Kim JJ, Nam H, Kaipatur NR, Major PW, Flores-Mir C, Lagravere MO, Romanyk DL. Reliability and accuracy of segmentation of mandibular condyles from different three-dimensional imaging modalities: a systematic review. Dentomaxillofac Radiol 2019; 49:20190150. [PMID: 31778321 DOI: 10.1259/dmfr.20190150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the reliability and accuracy of methods used for three-dimensional condyle segmentation. METHODS Three electronic databases were searched for studies reporting the reliability and accuracy of various methods used to segment mandibular condyles from three-dimensional imaging modalities. Two authors independently reviewed articles for eligibility and data extraction. RESULTS Nine studies fulfilled the inclusion criteria. Eight studies assessed the condylar segmentation from CBCT images and limited studies were available on non-CBCT three-dimensional imaging modalities. Threshold-based volume segmentation, manual segmentation, and semi-automatic segmentation techniques were presented. Threshold-based volume segmentation reported higher accuracy when completed by an experienced technician compared to clinicians. Adequate reliability and accuracy were observed in manual segmentation. Although adequate reliability was reported in semi-automatic segmentation, data on its accuracy were lacking. CONCLUSION A definitive conclusion with regards to which current technique is most reliable and accurate to efficiently segment the mandibular condyle cannot be made with the currently available evidence. This is especially true in terms of non-CBCT imaging modalities with very limited literature available.
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Affiliation(s)
- Justin J Kim
- 1Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Hyejin Nam
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Neelambar R Kaipatur
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Paul W Major
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Manuel O Lagravere
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Daniel L Romanyk
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
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Youssef Mohamed MM, Dahaba MM, Farid MM, Ali Elsayed AM. Radiographic changes in TMJ in relation to serology and disease activity in RA patients. Dentomaxillofac Radiol 2019; 49:20190186. [PMID: 31530023 DOI: 10.1259/dmfr.20190186] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This study was undertaken as an attempt to assess radiographic temporomandibular joint (TMJ) changes in relation to rheumatoid factor (RF), anticitrullinated protein (ACCP) antibodies and disease activity score 28 (DAS28) in rheumatoid arthritis (RA) patients to find the best predictor of rheumatoid affection of the TMJ with the ultimate goal of maintaining TMJ function and preventing joint damage. METHODS 20 Rheumatoid Arthritis patients as well as 20 volunteers were included in this study. RA group were assessed for RF, ACCP, DAS28. Both groups were assessed by CBCT for TMJ dimensions and radiographic osteoarthritic changes. All data were statistically analyzed. RESULTS Rheumatoid Arthritis group showed significantly less condylar height and more radiographic osteoarthritic changes than the control group. RF showed no significant correlation with either TMJ measurements or TMJ radiographic osteoarthritic changes. ACCP showed significant inverse correlation with condylar height and anteroposterior (AP) dimensions, but non-significant relation with mediolateral dimension and radiographic osteoarthritic changes. DAS28 showed significant inverse correlation with condylar AP and mediolateral dimensions. It also showed significant correlation with flattening of the TMJ condylar head and flattening of the articular fossa. Patients with high and moderate disease activity showed significantly smaller AP TMJ dimension than patients with low disease activity. Disease activity showed statistically significant direct correlation with all osteoarthritic changes except for erosions of the glenoid fossa and condyle. CONCLUSION Disease Activity Score28 score and disease activity are strong indicators of TMJ affection in RA patients when compared to RF and ACCP. ACCP is a better indicator of changes in condylar measurements than TMJ osteoarthritic changes. While RF is the least efficient indicator of TMJ involvement in RA patients.
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Affiliation(s)
| | - Mushira M Dahaba
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mary Medhat Farid
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Song J, Cheng M, Qian Y, Chu F. Cone-beam CT evaluation of temporomandibular joint in permanent dentition according to Angle's classification. Oral Radiol 2019; 36:261-266. [PMID: 31385140 DOI: 10.1007/s11282-019-00403-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/20/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare characteristics of temporomandibular joint (TMJ) and related structures according to Angle class I, II1, II2, and III. METHODS 123 Chinese patients (13-36 years old, 60 males, and 63 females) were classified in four groups according to Angle's classification: skeletal class I (31 patients), skeletal class II division 1 (30 patients), skeletal class II division 2 (30 patients), and skeletal class III (32 patients). Left and right TMJs of each subject were evaluated independently with cone-beam computed tomography (CBCT). The position of condyle in the joint fossa was analyzed according to Pullinger. RESULTS There were significant differences between class III subjects and class I, II1, II2 in the superior joint space (p < 0.05). Compared with class II1, II2, and III subjects, the height and diameter of condyle in class I was significantly larger (p < 0.05). The width of joint fossa was significantly larger in Angle class III than in Angle class I, II1, and II2, while the depth was significantly smaller. The condyle position in class III subjects was more anteriorly displaced compared with that in class I subjects. In class II2 patients, the condyle position was mainly concentric and posterior. CONCLUSIONS There are significant differences in condylar morphology, joint space, joint fossa morphology, and condylar position between different Angle classifications.
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Affiliation(s)
- Jungyul Song
- Department of Orthodontics, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China
| | - Mingjia Cheng
- Department of Orthodontics, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China
- Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Yufen Qian
- Department of Orthodontics, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Fengting Chu
- Department of Orthodontics, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
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Weiss R, Read-Fuller A. Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review. Dent J (Basel) 2019; 7:dj7020052. [PMID: 31052495 PMCID: PMC6631689 DOI: 10.3390/dj7020052] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022] Open
Abstract
Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.
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Affiliation(s)
- Robert Weiss
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
| | - Andrew Read-Fuller
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Attending Physician, Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
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Postnikov MA, Slesarev OV, Trunin DA, Andriyanov DA, Ispanova SN. Automated Analysis of X-Ray Images of the Temporomandibular Joint in Patients with Orthognathic Bite and Physiological Occlusion. ACTA ACUST UNITED AC 2019. [DOI: 10.20862/0042-4676-2019-100-1-6-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: to propose a procedure for analyzing the X-ray image of the temporomandibular joint (TMJ) through the automated calculation of linear and angular measurements from craniometry points in comparison with the reference values.Material and methods. Fifty TMJ cone beam computed tomography images were analyzed in 25 volunteers aged 18-25 years with orthognathic bite and physiological occlusion. All the tomography images were analyzed from craniometric points, by using a section corresponding to the midsagittal plane of the TMJ. Angular and linear measurements characterizing the functional capacities of the TMJ were determined. A statistical analysis involved descriptive methods and was carried out by the IBM SPSS 21 statistics.Results. The introduction of automated estimation of TMJ functional capacities from angular and linear measurements made it possible to obtain the following data: the α-angle was 11.99±2.44° for the right TMJ and 12.12±2.78° for the left one; the β-angle was 11.58±2.31° for the right TMJ and 12.42±2.81° for the left one; the γ-angle was 156.41±4.57° for the right TMJ and 155.46±5.50° for the left one. A descriptive statistics checking revealed no gross errors.Conclusion. It is expedient to take into account the findings as reference values to characterize the anatomical and functional state of the TMJ on the x-ray image.
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Affiliation(s)
- M. A. Postnikov
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - O. V. Slesarev
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - D. A. Trunin
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - D. A. Andriyanov
- Samara State Medical University, Ministry of Health of the Russian Federation
| | - S. N. Ispanova
- Samara State Medical University, Ministry of Health of the Russian Federation
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Abstract
In the last several decades, the need for 3D images in dentistry have developed. Computerized tomography was first introduced mainly with the advent of implantology, but its use remained limited to a small number of specialists, due to its indications, access and dose radiation. In the late 90's, a new technology using a cone-shaped beam and a reciprocating detector, which rotates around the patient 360 degrees and acquires projected data in a single rotation, namely the cone beam computerized tomography (CBCT), invaded dentistry, making the perception of 3D easily acceptable to dentists and their patients.
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Affiliation(s)
- Ibrahim Nasseh
- Department of Oral and Maxillofacial Radiology, Lebanese University, School of Dentistry, PO Box 166598, Beirut, Lebanon.
| | - Wisam Al-Rawi
- Private Practice, Horizon Dental, 742 Broadway, El Cajon, CA 92021, USA
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
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Akbulut A, Kılınç DD. Evaluation of condyle position in patients with Angle Class I, II, and III malocclusion using cone-beam computed tomography panoramic reconstructions. Oral Radiol 2018; 35:43-50. [PMID: 30484184 DOI: 10.1007/s11282-018-0326-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study was performed to compare the positions of the right and left condyles between male and female patients with different Angle malocclusions using cone-beam computed tomography (CBCT) panoramic reconstructions. METHODS The CBCT images of 60 patients (age of 18-37 years) were retrospectively evaluated. The patients were divided according to their Angle malocclusion classifications (Angle Classes I, II, and III). The condyle-to-eminence, condyle-to-fossa, and condyle-to-meatus distances were measured digitally using i-CAT software. RESULTS The left and right condyle-to-fossa distances were the most variable parameters among the Angle classes. The right condyle-to-eminence and right condyle-to-fossa distances were significantly different among the classes. Male patients seemed to have a greater condyle-to-fossa distance on the right side in both the Class I and III groups. The mean distance from the condyle to eminence, condyle to fossa, and condyle to meatus on the right side was the greatest in the Angle Class II group. CONCLUSIONS In all three types of malocclusion (Angle Classes I, II, and III), the condyles on both the right and left sides were not exactly symmetric or centrally located within the glenoid fossa. This work emphasizes the differences in the condyle position between male and female patients. Furthermore, the symmetry and centricity of the condyles are not dependent on the patient's sex or type of malocclusion.
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Affiliation(s)
- Aslıhan Akbulut
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Istanbul Medipol University, Atatürk Blv. No. 27, Unkapanı, Fatih, 34083, Istanbul, Turkey
| | - Delal Dara Kılınç
- Department of Orthodontics, Faculty of Dentistry, Istanbul Medipol University, Atatürk Blv. No. 27, Unkapanı, Fatih, 34083, Istanbul, Turkey.
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Nota A, Caruso S, Ehsani S, Baldini A, Tecco S. Three-dimensional volumetric analysis of mandibular condyle changes in growing subjects: A retrospective cross-sectional study. Cranio 2018; 38:320-326. [PMID: 30353788 DOI: 10.1080/08869634.2018.1537088] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The purpose of this study is to analyze the mandibular condylar volumein a sample of subjects 11-26 years old. METHODS CBCT condylescans from 94 patients (mean age 18.2 ± 4.5 y) acquired with areconstructed layer thickness of 0.5 mm and a 512×512 matrix were examined. Data on condylar volume were compared among three groups with different age ranges: 11-16 years, 17-21years, and 22-26 years. Condylar volumetric measurements were performed with Mimics™ software. RESULTS A significant increase in condylar volume from puberty to young adulthood was detected (p < 0.01). Females showed a higher condylar volume in the 17-21 y group compared with the 11-16 y group. Males showed differences among all three groups. CONCLUSION The mandibular condyle growth seems to continue at least until 17-21 years in males but seems to stop before 17 years in females.
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Affiliation(s)
- Alessandro Nota
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital , Milan, Italy.,MeSVA, University of L'Aquila , L'Aquila, Italy
| | | | - Shideh Ehsani
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital , Milan, Italy
| | - Alberto Baldini
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital , Milan, Italy
| | - Simona Tecco
- Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital , Milan, Italy
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Kinzinger GSM, Lisson JA, Booth D, Hourfar J. Are morphologic and topographic alterations of the mandibular fossa after fixed functional treatment detectable on tomograms? Visual classification and morphometric analysis. J Orofac Orthop 2018; 79:427-439. [PMID: 30203326 DOI: 10.1007/s00056-018-0156-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/08/2018] [Indexed: 11/25/2022]
Abstract
AIM The goal was to evaluate if changes in morphology and topography of the mandibular fossa after Functional Mandibular Advancer (FMA) treatment are detectable on tomograms. Furthermore, the suitability of digital tomograms (DT) over magnetic resonance imaging (MRI) for this particular question was investigated. MATERIALS AND METHODS In all, 25 patients (14 female, 11 male) with a skeletal class II malocclusion received treatment with a FMA. DTs were available prior to (T1) and after (T2) FMA treatment. A total of 50 temporomandibular joints were investigated. The mandibular fossae were evaluated metrically and visually regarding treatment-induced alterations. A p < 0.05 was set as the level for statistical significance for all tests. Results were compared to the results of a recent MRI study. RESULTS Visual inspection of all 50 joints in the DT at T1 and T2 revealed no alterations of the fossa shape in the sagittal plane; 24 patients showed identical morphology of right and left joints. The metrical analysis revealed no significant changes regarding width, depth and ratio thereof between T1 and T2. There also were no bilateral differences. Another 18 different distance measurements between porion, mandibular fossa, articular eminence and pterygoid fossa showed no significant changes. There was no detectable proof of a fossa shift. CONCLUSIONS No changes in the sagittal plane, mandibular fossa, the articular tubercle, or a possible fossa shift were found in the DT of class II patients after FMA treatment. DT and MRI measurements and the visual inspection revealed identical findings; thus, DT appears to be a valuable research tool for sagittal analysis of mandibular fossa changes.
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Affiliation(s)
- Gero Stefan Michael Kinzinger
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Toenisvorst, Germany
| | - Jörg Alexander Lisson
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany.
| | - Dania Booth
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Rheinberg, Germany
| | - Jan Hourfar
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Michelstadt, Germany
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Abstract
Imaging of the temporomandibular joint in pediatric patients is a critical component in the evaluation and treatment of children with temporomandibular joint symptoms. MRI can provide detailed joint anatomy and identify inflammation, sometimes before symptom onset. Ultrasound scan is a convenient emerging modality to evaluate the joint and guide therapeutic injections. Radiography and computed tomography offer osseous detail to recognize early morphologic changes of the mandibular condyle and provide operative planning. Imaging promises to direct treatment to prevent future joint destruction and maintain function.
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35
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Talmaceanu D, Lenghel LM, Bolog N, Hedesiu M, Buduru S, Rotar H, Baciut M, Baciut G. Imaging modalities for temporomandibular joint disorders: an update. ACTA ACUST UNITED AC 2018; 91:280-287. [PMID: 30093805 PMCID: PMC6082607 DOI: 10.15386/cjmed-970] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/05/2018] [Accepted: 02/13/2018] [Indexed: 12/20/2022]
Abstract
The diagnosis and management of temporomandibular disorders (TMD) require both clinical and imaging examinations of the temporomandibular joint (TMJ). A variety of modalities can be used to image the TMJ, including magnetic resonance imaging (MRI), computed tomography (CT), cone beam CT, ultrasonography, conventional radiography. The present review outlines the indications of the most frequently used imaging techniques in TMD diagnosis. Because of the anatomic complexity of the TMJ, imaging can be difficult. Choosing the proper imaging technique is essential. Conventional radiography, nowadays, is of limited interest. The use of flat plane films for TMJ pathology is not sufficient, because this joint requires three dimensional imaging views. Osseous changes are better visualized with CT and cone beam CT. Cone beam CT provides high-resolution multiplanar reconstruction of the TMJ, with a low radiation dose, without superimposition of the bony structures. MRI is a noninvasive technique, considered to be the gold standard in imaging the soft tissue components of the TMJ. MRI is used to evaluate the articular disc in terms of location and morphology. Moreover, the early signs of TMD and the presence of joint effusion can be determined. High-resolution ultrasonography is a noninvasive, dynamic, inexpensive imaging technique, which can be useful in diagnosing TMJ disc displacements. The diagnostic value of high-resolution ultrasonography is strictly dependent on the examiner's skills and on the equipment used.
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Affiliation(s)
- Daniel Talmaceanu
- Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lavinia Manuela Lenghel
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Mihaela Hedesiu
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Smaranda Buduru
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotar
- Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Lombardo L, Arreghini A, Guarneri MP, Lauritano D, Nardone M, Siciliani G. Unexpected artefacts and occult pathologies under CBCT. ORAL & IMPLANTOLOGY 2018; 10:97-104. [PMID: 29876034 DOI: 10.11138/orl/2017.10.2.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To present the most frequent occult pathologies unexpectedly encountered via cone-beam computed tomography (CBCT), with particular reference to the diagnostic role of the dentist and that of the radiographer, with a view to clarifying where the diagnostic responsibility lies. Material and methods A narrative literature review on the most diffused occult pathologies under CBCT was conducted, with iconographical guide as an example for each category. Results The most frequent forms of unexpected pathologies encountered are: the presence of foreign bodies, airway anomaly, and the presence of radio-opacity or -transparency in the maxillofacial district. Conclusions The orthodontists must know that they are responsible to recognize these frequent, and potentially serious, pathologies of the head and neck. If the dentist feels unable to take on this responsibility, he or she should, however, be sure to have the scans read by a specialist radiologist.
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Affiliation(s)
- L Lombardo
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - A Arreghini
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - M P Guarneri
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - D Lauritano
- Department of Translational Medicine and Surgery, Neuroscience Center of Milan, University of Milano Bicocca, Monza, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - G Siciliani
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
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Zadravec D, Badel T, Smoljan M, Čimić S, Katavić N, Savić Pavičin I. Zygomatic Air Cell Defect - Magnetic Resonance Imaging of the Temporomandibular Joint Compared with Panoramic Radiographs. Acta Clin Croat 2018; 57:227-234. [PMID: 30431714 PMCID: PMC6531993 DOI: 10.20471/acc.2018.57.02.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
SUMMARY – The aim of the study was to analyze zygomatic air cell defect (ZACD) incidence using magnetic resonance imaging (MRI) and validity of panoramic radiograph as a comparative method of ZACD diagnostics. The connection between ZACD incidence, age, left/right temporomandibular joint (TMJ) and comorbidity with diagnosis of TMJ disorder was analyzed. Panoramic radiographs and MRIs of 140 TMJs of 70 consecutive patients with previously confirmed TMJ diagnosis were compared in the study. A grading system (4-point scale from ‘0’ for absence to ‘3’ for most extended pneumatization) was used to determine low signal on MRIs as pneumatization of temporal bone. ZACD was diagnosed in 22 joints of 15 patients (incidence, 20.4%), with seven patients having bilateral appearance. In the joints of nine patients, ZACD was identified as extensive according to the grading scale. The validity of ZACD findings on panoramic radiographs compared with MRI findings yielded 0.45 sensitivity and 0.98 specificity. There was no relation (p>0.05) between comorbidity of ZACD and TMJ disorder, either by age or side of the body. More prevalent ZACD in our MRI analysis than in other researches based on panoramic radiographs could be explained by the expected superimposed osseous structures in the area of articular eminence.
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Affiliation(s)
| | - Tomislav Badel
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Mia Smoljan
- Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Center, University of Zagreb, Zagreb, Croatia
| | - Samir Čimić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Nataša Katavić
- Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Center, University of Zagreb, Zagreb, Croatia
| | - Ivana Savić Pavičin
- Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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3D Comparison of Mandibular Response to Functional Appliances: Balters Bionator versus Sander Bite Jumping. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2568235. [PMID: 29854734 PMCID: PMC5941721 DOI: 10.1155/2018/2568235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/18/2018] [Indexed: 11/24/2022]
Abstract
Aim To assess the three-dimensional (3D) maxillomandibular and dental response to Balters Bionator (BB) and the Sander Bite Jumping Appliance (SBJA) in growing patients. Materials and Methods Twenty-seven Class II division 1 patients (13 males, 14 females), consecutively treated with either the BB (9 females, 7 males; 10.1 ± 1.6 years) or SBJA (5 females, 6 males; 11 ± 1.9 years), were collected from a single orthodontic practice. All patients presented overjet ≥5 mm, full Class II or end-to-end molar relationship, mandibular retrusion. CBCT scans were available at T1 and after removal of the functional appliances (T2) with a mean interval of 18 months. The 3D location and direction of skeletal and dental changes with growth and treatment were quantitatively assessed. Statistical analysis was performed by means of Mann–Whitney U test (p < 0.05). Results Patients treated with the SBJA and BB orthopedic appliances presented, respectively, 4.7 mm and 4.5 mm of 3D displacement of the chin, with marked ramus growth of, respectively, 3.7 mm and 2.3 mm. While the mandible and maxilla grew downward and forward, no opening of the mandible plane was observed. Both appliances adequately controlled labial inclination of lower incisors (1.3° and 0.3°, for the SBJA and BB groups, resp.). No significant between-group differences were found for the T2−T1 changes for any of the variables, with the exception of molar displacements (significantly greater in the SBJA group than in the BB group, 1.2 mm and 0.9 mm, resp.). Conclusions The maxillomandibular and dental growth responses to BB and SBJA therapies are characterized by vertical ramus growth and elongation of mandible that improve the maxillomandibular relationship with adequate control of lower incisor position.
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Tecco S, Nota A, Caruso S, Primozic J, Marzo G, Baldini A, Gherlone EF. Temporomandibular clinical exploration in Italian adolescents. Cranio 2017; 37:77-84. [PMID: 29072541 DOI: 10.1080/08869634.2017.1391963] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study investigated the prevalence of the signs and symptoms of temporomandibular disorders (TMD) among Italian adolescents. METHODS The data were recorded from 567 subjects (246 males and 321 females; age range 11-19 years), grouped according to age and molar class relationship. RESULTS Forty-four point one percent of subjects showed at least one sign or symptom of TMD, which were significantly more frequent in the 16-19 year-old group (52.9%) in respect to the 11-15 year-old group (39.8%) (χ 2 = 8.78; p = 0.003). Signs and/or symptoms were about 1.6 times more frequent in subjects with Class II/1 malocclusion (χ 2 = 13.3, p = 0.0003), mostly for TMJ sounds (χ 2 = 1.444; p = 0.036). Myalgia was more frequent in females than in males (χ 2 = 3.882; p = 0.049). CONCLUSION TMD signs and/or symptoms among Italian adolescents seem diffused (44.1%). Therefore, all adolescents should be screened thorough medical history and clinical examination.
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Affiliation(s)
- Simona Tecco
- a Dental School , Vita-Salute San Raffaele University , Milan , Italy
| | - Alessandro Nota
- a Dental School , Vita-Salute San Raffaele University , Milan , Italy.,b Department of Health, Life and Environmental Science , University of L'Aquila , L'Aquila , Italy
| | - Silvia Caruso
- b Department of Health, Life and Environmental Science , University of L'Aquila , L'Aquila , Italy
| | - Jasmina Primozic
- c Department of Orthodontics , University of Ljubljana , Ljubljana , Slovenia
| | - Giuseppe Marzo
- b Department of Health, Life and Environmental Science , University of L'Aquila , L'Aquila , Italy
| | - Alberto Baldini
- a Dental School , Vita-Salute San Raffaele University , Milan , Italy
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LOMBARDO L, VERONESI F, CANDOTTO V, NARDONE M, SICILIANI G. Correlation between coronal and apical arch form and degree of divergence: a volumetric computed tomography analysis. ORAL & IMPLANTOLOGY 2017; 10:424-438. [PMID: 29682260 PMCID: PMC5892657 DOI: 10.11138/orl/2017.10.4.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To determine the existence of any correlation between the degree of divergence and apical and coronal arch form using cone-beam computed tomography (CBCT). MATERIALS AND METHODS A total of 176 (88 coronal and 88 apical) CBCT scans pertaining to a sample of 44 subjects (16 males and 28 females), of which 26 were Class I, 14 Class II and 4 Class III, were analysed. A lateral projection of the skull was obtained from each VCT and cephalometric tracing was performed (according to Ricketts) so as to divide the sample into subgroups based on the degree of divergence (11 short-faced, 18 norm-faced and 15 long-faced subjects). Dahlberg's index values were calculated and Student's t-test for paired data was applied. RESULTS On the whole, the hyperbolic cosine curve was found to be the most representative of the arch forms considered. CONCLUSIONS A correlation between degree of divergence and the arch form of the apical and, especially, coronal portions of both the upper and lower jaws was revealed.
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Affiliation(s)
- L. LOMBARDO
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - F. VERONESI
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - V. CANDOTTO
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | | | - G. SICILIANI
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
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