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Hansson S, Josefsson E, Lund H, Miranda-Bazargani S, Magnuson A, Lindsten R, Bazargani F. Skeletal effects of posterior crossbite treatment with either quad helix or rapid maxillary expansion: a randomized controlled trial with 1-year follow-up. Angle Orthod 2024; 94:512-521. [PMID: 39230018 PMCID: PMC11363985 DOI: 10.2319/010424-9.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/01/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVES To assess skeletal and dental effects and evaluate possible side effects of maxillary expansion with two different appliances, directly after expansion and 1 year postexpansion. MATERIALS AND METHODS Forty-two patients with unilateral posterior crossbite (mean 9.5 ± 0.9 years) were randomized to either rapid maxillary expansion (RME) banded on the deciduous second molars and bonded to the primary canines or slow expansion with quad helix (QH) on the permanent first molars. Cone-beam computed tomography records were taken at baseline, directly after correction of the posterior crossbite and at follow-up 1 year after expansion. RESULTS All patients were analyzed. RME opened the midpalatal suture more anteriorly and inferiorly (mean 4.1 mm) and less posteriorly and superiorly (mean 1.0 mm). No effect on midpalatal suture could be shown in the QH group after expansion, P < .001. Buccal bone width had significantly decreased (P < .001) in the QH group compared with the RME group. Buccal fenestrations and root resorption on the left first molar had a higher prevalence directly after expansion finished in the QH group (P = .0086, P = .013) but were not significant at 1-year follow-up (P = .11, P = .22). CONCLUSIONS Opening of the suture with RME was more anterior and inferior, and the QH did not open the midpalatal suture at all. More buccal bone loss and fenestrations were seen on the permanent first molar in patients treated with conventional QH than RME anchored to deciduous teeth.
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Affiliation(s)
| | | | | | | | | | | | - Farhan Bazargani
- Corresponding author: Dr Farhan Bazargani, Department of Orthodontics, Sahlgrenska Academy, Gothenburg University, PO Box 450, SE-405 30 Gothenburg, Sweden. (e-mail: )
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Gholampour A, Mollaei M, Ehsani H, Ghobadi F, Hosseinnataj A, Yazdani M. Evaluation of the accuracy of cone beam computed tomography (CBCT) in the detection of peri-implant fenestration. BMC Oral Health 2024; 24:922. [PMID: 39123157 PMCID: PMC11316301 DOI: 10.1186/s12903-024-04674-z] [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: 04/18/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Accurate assessment of the bone supporting the implant is crucial. Early detection of bone defects around the implant can prevent the loss of bone support that ultimately leads to the loss of the implant. Therefore, the purpose of this study is to check the accuracy of CBCT in detecting peri-implant fenestrations around the implant. MATERIALS & METHODS In this laboratory study, healthy beef ribs were used. The ribs were divided into three groups of 12 (control group, 1-2 mm fenestration group, and 2-3 mm fenestration group). The blocks were cut to a length of 20 mm and 36 osteotomies with dimensions of 4 × 12 mm were made by the periodontist in order to place the implant in these bone blocks. Then the titanium implant was placed in the holes and the initial scan was performed with CBCT. In the second group, fenestration-like lesions were created on the same buccal side at a distance of 10 mm from the crest with a diameter of 1-2 mm and in the third group with a diameter of 2-3 mm, and the CBCT scan was performed again with the same parameters. Two radiologists evaluated the images twice for the presence and absence of fenestration. RESULTS There was no statistically significant difference between direct measurements and CBCT in the fenestration group of 1-2 mm (p < 0.05), but there was a significant difference between direct measurements and CBCT in the fenestration group of 2-3 mm and underestimation was observed in CBCT measurements. CONCLUSION The findings of this study showed that CBCT radiography has a higher accuracy in measuring the fenestration around the implant with a smaller diameter and has an acceptable diagnostic value in detecting bone loss around the implant.
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Affiliation(s)
- Atefeh Gholampour
- Department of Oral and Maxillofacial Radiology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Melika Mollaei
- Dental Research Center, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hodis Ehsani
- Department of Periodontology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Ghobadi
- Department of Oral and Maxillofacial Radiology, Dental Research Center, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abolfazl Hosseinnataj
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Yazdani
- Dental Research Center, Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
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Alshomrani F. Cone-Beam Computed Tomography (CBCT)-Based Diagnosis of Dental Bone Defects. Diagnostics (Basel) 2024; 14:1404. [PMID: 39001294 PMCID: PMC11241660 DOI: 10.3390/diagnostics14131404] [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: 05/29/2024] [Revised: 06/15/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024] Open
Abstract
Cone Beam Computed Tomography (CBCT) has completely changed the way that bone disorders are diagnosed and treated, especially in the dental and maxillofacial domains. This article examines the diverse applications of computed tomography (CBCT) in the diagnosis and treatment of facial trauma, including mandibular, dentoalveolar, and other facial fractures, as well as bone abnormalities like dislocations and fractures. CBCT is useful for a wide range of dental conditions and greatly improves diagnostic accuracy in periodontics, orthodontics, endodontics, and dental implantology. Additionally, a comparison between CBCT and conventional imaging methods was conducted, emphasizing the latter's inferior 3D imaging capabilities, allowing for more precise treatment planning and better patient outcomes with CBCT. Although CBCT has many benefits, it also has some drawbacks, such as requiring specific training for accurate interpretation, cost considerations, and a higher radiation exposure than with traditional dental X-rays. In order to optimize benefits and reduce risks, the conclusion highlights CBCT's revolutionary influence on clinical practice while arguing for its prudent and responsible application.
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Affiliation(s)
- Faisal Alshomrani
- Department of Diagnostic Radiology Technology, College of Applied Medical Science, Taibah University, Medinah 41477, Saudi Arabia
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Han S, Fan X, Wang S, Du H, Liu K, Ji M, Xiao D. Dehiscence and fenestration of skeletal Class III malocclusions with different vertical growth patterns in the anterior region: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2024; 165:423-433. [PMID: 38127040 DOI: 10.1016/j.ajodo.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION This study aimed to evaluate the incidence and distribution of alveolar bone dehiscence and fenestration in skeletal Class III malocclusions with different vertical growth patterns in the anterior region using cone-beam computed tomography (CBCT). METHODS In this retrospective study, 84 patients with skeletal Class III malocclusions who underwent CBCT were selected. This study included 28 patients with hypodivergence (mean age, 22.9 ± 3.9 years), 28 with normodivergence (mean age, 21.0 ± 3.0 years), and 28 with hyperdivergence (mean age, 21.0 ± 3.7 years). Teeth in the anterior region were examined using CBCT to detect dehiscence and fenestration. The incidences of dehiscence and fenestration in the anterior teeth region were recorded, and statistical analysis was conducted using SPSS software (version 25.0, IBM, Armonk, NY). RESULTS Among the patients with skeletal Class III malocclusions, dehiscence and fenestration were prone to occur in the mandible. Dehiscence and fenestration were more prevalent in patients with hyperdivergence compared with in patients with hypodivergence and normodivergence. CONCLUSIONS Dehiscence and fenestration are prevalent among patients with skeletal Class III malocclusion. Furthermore, the occurrence of alveolar bone defects is higher in patients with hyperdivergence.
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Affiliation(s)
- Shaobo Han
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Xiangfei Fan
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Song Wang
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Hongyu Du
- Postgraduate of School of Medicine, Nankai University, Tianjin, China
| | - Kexin Liu
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Mengting Ji
- Department of the Graduate School, Tianjin Medical University, Tianjin, China
| | - Danna Xiao
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China.
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Luo N, Chen Y, Li L, Wu Y, Dai H, Zhou J. Multivariate analysis of alveolar bone dehiscence and fenestration in anterior teeth after orthodontic treatment: A retrospective study. Orthod Craniofac Res 2024; 27:287-296. [PMID: 37929647 DOI: 10.1111/ocr.12726] [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] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To compare the prevalence of fenestration and dehiscence between pre- and post-orthodontic treatment and to explore the factors related to fenestration and dehiscence in the anterior teeth after treatment. METHODS This study included 1000 cone-beam computed tomography (CBCT) scans of 500 patients before (T1) and after (T2) orthodontic treatment. These images were imported into Dolphin 11.9 software to detect alveolar fenestration and dehiscence in the anterior teeth area. The chi-square test and Fisher's exact test were performed to compare the prevalence of alveolar bone defects between time points T1 and T2. A total of 499 patients were selected for logistic regression analysis to examine the correlation among age, sex, crowding, sagittal facial type, extraction, miniscrew use and fenestration or dehiscence post-treatment. RESULTS Except for the maxillary lingual fenestration and labial fenestration of mandibular canines, a significant change in the prevalence of fenestration and dehiscence was noted between time points T1 and T2 (P < .025). Multinomial logistic regression showed that age, miniscrew use and extraction highly influenced the prevalence of anterior lingual dehiscence (P < .05). Dehiscence of the mandibular labial side (skeletal Class III vs. I, OR = 2.368, P = .000) and fenestration of the mandibular lingual side (skeletal Class II vs. I, OR = 2.344, P = .044) were strongly correlated with the sagittal facial type. Dehiscence of the maxillary labial side (moderate vs. mild, OR = 1.468, P = .017) was significantly associated with crowding. CONCLUSIONS Older age, maxillary moderate crowding, skeletal Class III, extraction and miniscrew potentially significantly affect the prevalence of anterior teeth dehiscence. Adult females, skeletal Class III patients on the mandibular labial side and skeletal Class II patients on the mandibular lingual side should be monitored for anterior teeth fenestration.
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Affiliation(s)
- Nan Luo
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yanxi Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lingfeng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yan Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hongwei Dai
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Yeom HG, Kim JE, Huh KH, Yi WJ, Heo MS, Lee SS. Development and validation of a clinical phantom reproducing various lesions for oral and maxillofacial radiology research. Imaging Sci Dent 2023; 53:345-353. [PMID: 38174032 PMCID: PMC10761291 DOI: 10.5624/isd.20230129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose The objective of this study was to propose a method for developing a clinical phantom to reproduce various diseases that are clinically prevalent in the field of dentistry. This could facilitate diverse clinical research without unnecessarily exposing patients to radiation. Material and Methods This study utilized a single dry skull, which was visually and radiographically examined to evaluate its condition. Existing lesions on the dry skull were preserved, and other relevant lesions were artificially created as necessary. These lesions were then documented using intraoral radiography and cone-beam computed tomography. Once all pre-existing and reproduced lesions were confirmed by the consensus of 2 oral and maxillofacial radiologists, the skull was embedded in a soft tissue substitute. To validate the process, cone-beam computed tomography scans and panoramic radiographs were obtained of the fabricated phantom. All acquired images were subsequently evaluated. Results Most lesions could be identified on panoramic radiographs, although some sialoliths and cracked teeth were confirmed only through cone-beam computed tomographic images. A small gap was observed between the epoxy resin and the bone structures. However, 2 oral and maxillofacial radiologists agreed that this space did not meaningfully impact the interpretation process. Conclusion The newly developed phantom has potential for use as a standardized phantom within the dental field. It may be utilized for a variety of imaging studies, not only for optimization purposes, but also for addressing other experimental issues related to both 2- and 3-dimensional diagnostic radiography.
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Affiliation(s)
- Han-Gyeol Yeom
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan, Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Patil AB, Patil N, Singh R, Razdan P, Singh S, Mathew RA, Banerjee S. Comparative Assessment of Reliability and Accuracy of Cone-Beam Computed Tomography (CBCT) Over Direct Surgical Measurement for Periodontal Bone Loss: A Prospective, Cross-Sectional Study. Cureus 2023; 15:e44608. [PMID: 37795054 PMCID: PMC10547079 DOI: 10.7759/cureus.44608] [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: 09/03/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION Assessing bone condition holds significant value in the diagnosis, treatment planning, and prognosing the periodontal disease; its importance is undeniable. The main aim of the present study was to evaluate the accuracy of alveolar bone measurements due to periodontal disease using cone-beam computed tomography (CBCT), by comparing with surgical measurements, considered as the gold standard. MATERIALS AND METHODS A prospective cross-sectional study included a sample of 40 individuals diagnosed with chronic periodontitis who required periodontal surgery. A total of 202 sites were assessed for vertical and horizontal bone loss in the anterior (76 sites) and posterior (126 sites) teeth. Bone loss was measured using CBCT and a UNC 15 periodontal probe during the surgical intervention, and then compared. The statistical analysis involved employing a Student's t-test to compare measurements. Unpaired t-tests and correlation analyses were conducted using Pearson's correlation coefficient test. To establish statistical significance, a threshold of p<0.05 was considered appropriate. RESULTS The statistical analysis carried out on the mean values of CBCT and direct surgical measurements for vertical bone loss demonstrated a significant difference (p<0.01). However, the values obtained for horizontal bone loss did not display statistical significance. A strong correlation of 0.94-0.99 existed between surgical and CBCT measurements. A statistically significant distinction was observed between the two methods in measuring bone loss at the distal and palatal sites of the anterior teeth. CONCLUSION Both CBCT and direct surgical measurement exhibit comparable accuracy potential in assessing alveolar bone loss. CBCT provides an accessibility advantage by enhancing visual access to challenging sites during surgical interventions, including palatal and distal areas of the teeth.
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Affiliation(s)
- Anshuman B Patil
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Nileshrao Patil
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Romalpreet Singh
- Department of Conservative Dentistry and Endodontics, Desh Bhagat Dental College, Malout, IND
| | - Priyanka Razdan
- Department of Paediatric and Preventive Dentistry, Yogita Dental College and Hospital, Khed, IND
| | - Sneha Singh
- Department of Conservative Dentistry and Endodontics, Rungta College of Dental Sciences, Bhilai, IND
| | - Rinnu A Mathew
- Department of Periodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
| | - Satyabrat Banerjee
- Department of Conservative Dentistry and Endodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial (JMF's ACPM) Dental College, Dhule, IND
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Li G, Wang T, Zhang J, Zhang C, Zhang M, Ji J. Alveolar bone height changes in the anterior tooth region before and after orthodontic treatment for Angle's Class II division 1 malocclusion and related factors. Minerva Surg 2023; 78:371-377. [PMID: 36940109 DOI: 10.23736/s2724-5691.23.09724-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND The aim of this study was to observe the alveolar bone height changes in the anterior tooth region after orthodontic treatment for Angle's Class II division 1 malocclusion. METHODS Ninety-three patients treated from January 2015 to December 2019 were retrospectively analyzed, of whom 48 received tooth extraction and 45 did not. RESULTS After orthodontic treatment, the alveolar bone heights in the anterior tooth regions of tooth extraction and non-extraction groups decreased by 67.31% and 66.94%, respectively. Except for the maxillary and mandibular canines in the tooth extraction group as well as the labial side of maxillary anterior teeth and the palatal side of maxillary central incisors of the non-extraction group, the alveolar bone heights of other sites significantly reduced (P<0.05). The reduction in the alveolar bone height of the tooth extraction group significantly exceeded that of the non-extraction group on the palatal side of maxillary incisors and the lingual side of mandibular anterior teeth (P<0.05). CONCLUSIONS Alveolar bone height in the anterior tooth region decreases after orthodontic treatment for Angle's Class II division 1 malocclusion, being closely related to tooth position together with movement direction and amplitude.
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Affiliation(s)
- Guifeng Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tiancong Wang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jianyun Zhang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Caixia Zhang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Min Zhang
- Department of Stomatology, The People's Hospital of Zhangqiu District, Ji'nan, China
| | - Jun Ji
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China -
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Verykokou S, Ioannidis C, Angelopoulos C. CBCT-Based Design of Patient-Specific 3D Bone Grafts for Periodontal Regeneration. J Clin Med 2023; 12:5023. [PMID: 37568425 PMCID: PMC10419991 DOI: 10.3390/jcm12155023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
The purpose of this article is to define and implement a methodology for the 3D design of customized patient-specific scaffolds (bone grafts) for the regeneration of periodontal tissues. The prerequisite of the proposed workflow is the three-dimensional (3D) structure of the periodontal defect, i.e., the 3D model of the hard tissues (alveolar bone and teeth) around the periodontal damage, which is proposed to be generated via a segmentation and 3D editing methodology using cone beam computed tomography (CBCT) data. Two types of methodologies for 3D periodontal scaffold (graft) design are described: (i) The methodology of designing periodontal defect customized block grafts and (ii) the methodology of designing extraction socket preservation customized grafts. The application of the proposed methodology for the generation of a 3D model of the hard tissues around periodontal defects of a patient using a CBCT scan and the 3D design of the two aforementioned types of scaffolds for personalized periodontal regenerative treatment shows promising results. The outputs of this work will be used as the basis for the 3D printing of bioabsorbable scaffolds of personalized treatment against periodontitis, which will simultaneously be used as sustained-release drug carriers.
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Affiliation(s)
- Styliani Verykokou
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece;
| | - Charalabos Ioannidis
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece;
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Kurt Demirsoy K, Türker G, Amuk M, Kurt G. How much should incisors be decompensated? periodontal bone defects during presurgical orthodontic treatment in class III double-jaw orthognathic surgery patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e133-e139. [PMID: 35263684 DOI: 10.1016/j.jormas.2022.03.009] [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: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 05/16/2023]
Abstract
INTRODUCTION The aims of this study were to evaluate periodontal bone defects around the lower and upper incisors and to identify changes in the buccolingual inclination of the incisors during orthodontic decompensation in skeletal Class III orthognathic surgery patients. MATERIALS AND METHODS The sample consisted of 26 adults with skeletal Class III deformity who had undergone presurgical orthodontic treatment and orthognathic surgery. Lateral cephalograms obtained before orthodontic treatment and before surgery were used to determine the inclination and position changes of the incisors. Cephalometric measurements were taken using Dolphin Imaging 11.95. Three-dimensional images were generated from cone-beam computed tomography (CBCT) scans prior to surgery and used to detect periodontal bone defects, including fenestration (F) and dehiscence (D). RESULTS Intraclass correlation coefficients (ICC) were determined and the measurements showed high reproducibility. The cephalometric data showed normal distribution and there were no differences between genders in terms of cephalometric changes, dehiscence, fenestration, or coexistent (D-F/DF) formation. The patients presented maxillary incisor retroclination and mandibular incisor proclination, which was consistent with the tooth decompensation. CBCT assessment was performed for a total of 208 teeth; while 81 upper and 94 lower incisors had D-F/DF formation, 23 upper and 10 lower incisors were healthy. Statistically significant correlations were not found between the inclination degree of the incisors and D-F/DF formation. CONCLUSIONS Decompensation of incisors during presurgical orthodontic treatment increases the risk of periodontal defects. There is no linear relationship between the increase in the inclination degrees of incisors and D-F/DF formation.
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Affiliation(s)
- Kevser Kurt Demirsoy
- Department of Orthodontics, Faculty of Dentistry Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye.
| | - Gökhan Türker
- Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Gökmen Kurt
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Foundation University, İstanbul, Türkiye
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11
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Verykokou S, Ioannidis C, Angelopoulos C. Evaluation of 3D Modeling Workflows Using Dental CBCT Data for Periodontal Regenerative Treatment. J Pers Med 2022; 12:jpm12091355. [PMID: 36143140 PMCID: PMC9503221 DOI: 10.3390/jpm12091355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
The cone beam computed tomography (CBCT) technology is nowadays widely used in the field of dentistry and its use in the treatment of periodontal diseases has already been tackled in the international literature. At the same time, advanced segmentation methods have been introduced in state-of-the-art medical imaging software and well-established automated techniques for 3D mesh cleaning are available in 3D model editing software. However, except for the application of simple thresholding approaches for the purposes of 3D modeling of the oral cavity using CBCT data for dental applications, which does not yield accurate results, the research that has been conducted using more specialized semi-automated thresholding in dental CBCT images using existing software packages is limited. This article aims to fill the gap in the state-of-the-art research concerning the usage of CBCT data for 3D modeling of the hard tissues of the oral cavity of patients with periodontitis using existing software tools, for the needs of designing and printing 3D scaffolds for periodontal regeneration. In this context, segmentation and 3D modeling workflows using dental CBCT data that belong to a patient with periodontitis are evaluated, comparisons between the 3D models of the teeth and the alveolar bone generated through the experiments that yielded the most satisfactory results are made, and an optimal and efficient methodology for creating 3D models of teeth and alveolar bone, especially for being used as the basis for generating bioabsorbable 3D printed scaffolds of personalized treatment against periodontitis, is discussed.
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Affiliation(s)
- Styliani Verykokou
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
- Correspondence:
| | - Charalabos Ioannidis
- Laboratory of Photogrammetry, School of Rural, Surveying and Geoinformatics Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Accuracy and Reliability of CBCT Compared to Clinical Probing in Detection of Trifurcation Defects: An In Vivo Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5805776. [PMID: 35463972 PMCID: PMC9023149 DOI: 10.1155/2022/5805776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/04/2022] [Accepted: 03/17/2022] [Indexed: 11/26/2022]
Abstract
Background Furcation defects are areas of pathological bone resorption in multirooted teeth. The aim of the study was to compare the measurements of trifurcation bone loss, measured using CBCT, versus clinical measurements in order to evaluate the efficacy of CBCT as an adjunctive diagnostic tool. Material and Methods. The included patients had both CBCT scans for maxillary molars and completed periodontal charts. Clinical examination consisted of probing and detection of vertical and horizontal furcation defects. These were measured and recorded. CBCT measurements were then evaluated using the linear measuring tool in Carestream imaging software (Carestream, Rochester, USA) and iCAT (Imaging Sciences, Hatfield, USA). These measurements of the CBCT images were then documented and compared to clinical findings. The two examiners were blinded to each other's measurements. Results The most common tooth with a detected furcation defect was tooth #2 (31.7%), followed by tooth #15 (26.8%) and #3 (21.9%). The least common tooth with a detected furcation defect was #14 (19.5%). The mean values of buccal furcation for clinical and CBCT measurements were 3.01 mm and 2.6 mm, respectively. The measurements of mesial furcation were 2.5 mm and 2.2 mm for CBCT. The distal measurement of clinical examination was 2.7 mm and for CBCT was 2.44 mm. Conclusion CBCT can be used as an adjunct to clinical furcation measurements and adds useful diagnostic information to assess trifurcation defects. In addition, CBCT limited field of view (FOV) can provide relatively high-resolution images at a reduced dose that is comparable to two-dimensional imaging.
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Rincón Rodriguez ML, Martínez-Vega RA, Duarte Monsalve ML, Moreno Monsalve JO. Reproducibilidad y validez de criterio de dos técnicas radiográficas para variaciones de premolares mandibulares comparadas con CBCT. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La existencia de variaciones anatómicas ocasiona fracasos en tratamientos endodónticos, por lo que es importante diagnosticarlas. El objetivo fue determinar la reproducibilidad y la validez de criterio de las radiografías con placa de fósforo y la radiovisografía con sensor para identificar las variaciones anatómicas detectadas por tomografía computarizada de haz cónico (CBCT) en premolares inferiores. Métodos: En 140 premolares se obtuvieron imágenes por CBCT, radiografía y radiovisografía. Se realizó lectura independiente por dos endodocistas, evaluándose la clasificación de Vertucci y las ramificaciones. Se determinó la reproducibilidad intraobservador e interobservador. Se calcularon sensibilidad, especificidad y áreas bajo la curva operador-receptor (AUC) utilizando como estándar de oro la CBCT. Resultados: La reproducibilidad intraobservador e interobservador fue mayor para radiografía. Para la Clase I de Vertucci, la radiografía presentó mayor sensibilidad (94,7%), especificidad (64,9%) y AUC (0,795) que la radiovisiografía (89,3%, 62,2% y 0,757, respectivamente), al igual que para la Clase V (Radiografía 69,2%, 93% y 0,811; Radiovisiografía 50%, 84,2% y 0,671, respectivamente). Ninguna de las técnicas aportó al diagnóstico de la Clase III (AUC <0,5). Las ramificaciones fueron infrecuentes (2,9%) y su detección fue baja (Sensibilidad 25% para radiografía y 0% para radiovisiografía). Discusión: Este es el primer estudio que evalúa la reproducibilidad y validez de estas dos técnicas radiográficas comparadas con la CBCT para la detección de variaciones anatómicas en dientes. Conclusiones: La radiografía con placa de fósforo presentó mayor reproducibilidad y validez para el diagnóstico de las Clase I y V de Vertucci, que fueron las variaciones más frecuentes.
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Kalaitzoglou ME, Angelopoulos C, Lyroudia K, Lambrianidis T. Frequency of root fenestration in a Greek subpopulation: A cone beam computed tomography clinical study. AUST ENDOD J 2021; 47:580-591. [PMID: 34190384 DOI: 10.1111/aej.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/28/2021] [Accepted: 04/13/2021] [Indexed: 12/29/2022]
Abstract
This cone beam computed tomography (CBCT) study aimed to assess the root fenestration (RF) frequency in healthy, intact teeth and analyse their features in a Greek subpopulation. 432 CBCT scans were examined. 5486 teeth were evaluated for RF prevalence. RF prevalence and distribution were recorded for each jaw, tooth group, as well as patient age and sex. RF symmetry, distribution to the affected root surface and the effects of age and sex were evaluated. The prevalence of RF ranged from 0.57% (central incisors) to 7.18% (first premolars) and from 0.48% (second premolars) to 10.79% (lateral incisors) for the maxilla and the mandible, respectively. No symmetrical occurrence of RF was detected. Most RF patients presented one or two defects in both jaws. Types I and IV were the most prevalent in the maxilla, while Types III, II and V were the most prevalent in the mandible. No statistical difference was detected between different sexes and age groups (P > 0.05).
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Affiliation(s)
- Maria-Elpida Kalaitzoglou
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis & Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Kleoniki Lyroudia
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Lambrianidis
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Bagis N, Kurt MH, Evli C, Camgoz M, Atakan C, Peker Ozturk H, Orhan K. Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study. Oral Radiol 2021; 38:325-335. [PMID: 34387842 DOI: 10.1007/s11282-021-00561-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw. METHODS Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm3) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced. RESULTS For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p ≤ 0.05). Titanium implants were found to have higher AUC values than zirconium (p ≤ 0.05). CONCLUSION Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.
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Affiliation(s)
- Nilsun Bagis
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mehmet Hakan Kurt
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Cengiz Evli
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Melike Camgoz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Cemal Atakan
- Department of Statistics, Faculty of Science, Ankara University, Ankara, Turkey
| | - Hilal Peker Ozturk
- Department of Dentomaxillofacial Radiology, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentoaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Palkovics D, Mangano FG, Nagy K, Windisch P. Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning. BMC Oral Health 2020; 20:351. [PMID: 33261592 PMCID: PMC7709443 DOI: 10.1186/s12903-020-01342-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background In the regenerative treatment of intrabony periodontal defects, surgical strategies are primarily determined by defect morphologies. In certain cases, however, direct clinical measurements and intraoral radiographs do not provide sufficient information on defect morphologies. Therefore, the application of cone-beam computed tomography (CBCT) has been proposed in specific cases. 3D virtual models reconstructed with automatic thresholding algorithms have already been used for diagnostic purposes. The aim of this study was to utilize 3D virtual models, generated with a semi-automatic segmentation method, for the treatment planning of minimally invasive periodontal surgeries and to evaluate the accuracy of the virtual models, by comparing digital measurements to direct intrasurgical measurements. Methods Four patients with a total of six intrabony periodontal defects were enrolled in the present study. Two months following initial periodontal treatment, a CBCT scan was taken. The novel semi-automatic segmentation method was performed in an open-source medical image processing software (3D Slicer) to acquire virtual 3D models of alveolar and dental structures. Intrasurgical and digital measurements were taken, and results were compared to validate the accuracy of the digital models. Defect characteristics were determined prior to surgery with conventional diagnostic methods and 3D virtual models. Diagnostic assessments were compared to the actual defect morphology during surgery. Results Differences between intrasurgical and digital measurements in depth and width of intrabony components of periodontal defects averaged 0.31 ± 0.21 mm and 0.41 ± 0.44 mm, respectively. In five out of six cases, defect characteristics could not be assessed precisely with direct clinical measurements and intraoral radiographs. 3D models generated with the presented semi-automatic segmentation method depicted the defect characteristics correctly in all six cases. Conclusion It can be concluded that 3D virtual models acquired with the described semi-automatic segmentation method provide accurate information on intrabony periodontal defect morphologies, thus influencing the treatment strategy. Within the limitations of this study, models were found to be accurate; however, further investigation with a standardized validation process on a large number of participants has to be conducted.
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Affiliation(s)
- Daniel Palkovics
- Department of Periodontology, Semmelweis University, 1088 Szentkirályi Str. 47. 4th Floor, Budapest, Hungary.
| | - Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Bol'shaya Pirogovskaya Ulitsa, 19c1, Moscow, Russia
| | - Katalin Nagy
- Department of Oral Surgery, University of Szeged, Tisza L. Str. 64, Szeged, Hungary
| | - Peter Windisch
- Department of Periodontology, Semmelweis University, 1088 Szentkirályi Str. 47. 4th Floor, Budapest, Hungary
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V A, A E, S S, M R J, Gholi Mezerji N M. Efficacy of Periapical Radiography and Three Cone-Beam Computed Tomography Systems for Detection of Peri-Implant Dehiscence Defects: An in- Vitro Study. J Biomed Phys Eng 2020; 10:751-760. [PMID: 33364213 PMCID: PMC7753257 DOI: 10.31661/jbpe.v0i0.2008-1162] [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: 08/17/2020] [Accepted: 09/14/2020] [Indexed: 12/03/2022]
Abstract
Background: Early detection of peri-implant bone defects is highly important because these defects eventually lead to gingival recession, bone loss and implant failure. Objective: This study aimed to assess and compare the efficacy of periapical radiography and three CBCT systems for the detection of peri-implant dehiscence defects. Material and Methods: In this vitro study, 124 titanium implants were placed in bovine ribs. The bone pieces were then mounted in boxes in the form of mandible and red dental wax was used to simulate the soft tissue. Crestal bone defects with 2, 3, and 4 mm depth were created in the ribs using a round bur. Periapical and CBCT images were then obtained. Images were investigated by two oral and maxillofacial radiologists twice with a two-week interval. The results were analyzed using chi-square, Kappa coefficient, Cochrane’s Q and McNemar tests as well as the receiver operating characteristic (ROC) curve. Results: The two observers showed good agreement in detection of sound and defective samples on periapical radiographs and CBCT scans. The level of agreement was low in detection of two samples with 2 mm defects on CBCT scans taken with Planmeca and NewTom 3G systems at the time of second assessment. NewTom 3G had the highest sensitivity (68.9%, 74.2% and 86.3%, respectively) and specificity (100% for all three) compared to other systems for detection of 2, 3 and 4 mm crestal bone defects. Conclusion: The inter-observer agreement increased with increase in depth of defects. NewTom 3G had the highest accuracy for detection of crestal bone defects.
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Affiliation(s)
- Akheshteh V
- MSD, Department of Oral and Maxillofacial Radiology, Alborz University of Medical Sciences, Tehran, Iran
| | - Eskandarloo A
- MSD, Department of Oral and Maxillofacial Radiology, School of Dentistry, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Saati S
- MSD, Department of Oral and Maxillofacial Radiology, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Jamalpour M R
- MSD, Department of Oral and Maxillofacial Surgery, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Mohammad Gholi Mezerji N
- PhD, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamedan, Iran
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Kurt MH, Bağış N, Evli C, Atakan C, Orhan K. Comparison of the different voxel sizes in the estimation of peri-implant fenestration defects using cone beam computed tomography: an ex vivo study. Int J Implant Dent 2020; 6:58. [PMID: 33006000 PMCID: PMC7530157 DOI: 10.1186/s40729-020-00254-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background To examine the influence of voxel sizes to detect of peri-implant fenestration defects on cone beam computed tomography (CBCT) images. Materials and methods This study performed with three sheep heads both maxilla and mandible and two types of dental implant type 1 zirconium implant (Zr40) (n = 6) and type 2 titanium implant (Ti22) (n = 10). A total of 14 peri-implant fenestrations (8 buccal surfaces, 6 palatal/lingual surface) were created while 18 surfaces (8 buccal, 10 palatal/lingual) were free of fenestrations. Three observers have evaluated the images of fenestration at each site. Images obtained with 0.75 mm3, 0.100 mm3, 0.150 mm3, 0.200 mm3, and 0.400 mm3 voxel sizes. For intra- and inter-observer agreements for each voxel size, Kappa coefficients were calculated. Results Intra- and inter-observer kappa values were the highest for 0.150 mm3, and the lowest in 0.75 mm3 and 0.400 mm3 voxel sizes for all types of implants. The highest area under the curve (AUC) values were found higher for the scan mode of 0.150 mm3, whereas lower AUC values were found for the voxel size for 0.400 mm3. Titanium implants had higher AUC values than zirconium with the statistical significance for all voxel sizes (p ≤ 0.05). Conclusion A voxel size of 0.150 mm3 can be used to detect peri-implant fenestration bone defects. CBCT is the most reliable diagnostic tool for peri-implant fenestration bone defects.
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Affiliation(s)
- Mehmet Hakan Kurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| | - Nilsun Bağış
- Dentistry Department of Periodontology, Ankara University, Ankara, Turkey
| | - Cengiz Evli
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Cemal Atakan
- Faculty of Science Department of Statistics, Ankara University, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
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Fenestration and dehiscence in the alveolar bone of anterior maxillary and mandibular teeth in cone-beam computed tomography of an Iranian population. Dent Res J (Isfahan) 2020; 17:380-387. [PMID: 33343847 PMCID: PMC7737820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The presence of dentoalveolar lesions such as fenestration and dehiscence has great clinical importance. This study was designed to determine the incidence of bony fenestrations and dehiscences associated with the anterior teeth by using cone-beam computed tomography images. MATERIALS AND METHODS A total of 216 images (1189 teeth) were included in this cross-sectional study. The presence of fenestration and dehiscence at the buccal and lingual/palatal surfaces and also their relative levels on the roots of the teeth were determined. McNemar's, Chi-square, and Cochran's Q tests were used for data analysis. A value of P < 0.05 was considered to be statistically significant. RESULTS The incidence of fenestration and dehiscence was 17.6% and 3.9%, respectively with the maxillary fenestrations being more prevalent (P < 0.0001). No significant differences were observed in the incidence of dehiscences between the jaws (P = 0.824) and among the tooth types (P = 0.689). The lesions were more frequent at the buccal surfaces (80%-92.5%). About 85.9% of the fenestrations occurred in the apical root thirds, whereas dehiscences had the highest prevalence in the cervical thirds. Fenestration and dehiscence incidences were significantly higher in females (P < 0.05). There was no significant difference among the age groups regarding these lesions. CONCLUSION Fenestration and dehiscence were observed more on the buccal surfaces and also in the apical and cervical root thirds, respectively. Age had no significant influence on the occurrence of these lesions in contrast to the sex.
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20
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Assiri H, Dawasaz AA, Alahmari A, Asiri Z. Cone beam computed tomography (CBCT) in periodontal diseases: a Systematic review based on the efficacy model. BMC Oral Health 2020; 20:191. [PMID: 32641102 PMCID: PMC7341656 DOI: 10.1186/s12903-020-01106-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Periodontal diseases are prevalent among adult populations. Its diagnosis depends mainly on clinical findings supported by radiographic examinations. In previous decades, cone beam computed tomography has been introduced to the dental field. The aim of this study was to address the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. METHODS A systematic search of electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted in February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on diagnostic imaging modality. Four examiners performed the eligibility and quality assessment of relevant studies and consensus was reached in cases where disagreement occurred. RESULTS The search resulted in 64 studies. Of these, 34 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy of the included studies showed a low or moderate risk of bias and applicability concerns in the use of CBCT. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of outcomes after the treatment of periodontal defects. CONCLUSION CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
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Affiliation(s)
- Hassan Assiri
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ali Azhar Dawasaz
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ahmad Alahmari
- Department of Periodontology, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Zuhair Asiri
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Kim JH, Abdala-Júnior R, Munhoz L, Cortes ARG, Watanabe PCA, Costa C, Arita ES. Comparison between different cone-beam computed tomography devices in the detection of mechanically simulated peri-implant bone defects. Imaging Sci Dent 2020; 50:133-139. [PMID: 32601588 PMCID: PMC7314605 DOI: 10.5624/isd.2020.50.2.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/12/2020] [Accepted: 04/24/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles. Materials and Methods Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient. Results High intraobserver and interobserver agreement was found (P<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts. Conclusion Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.
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Affiliation(s)
- Jun Ho Kim
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinaldo Abdala-Júnior
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Arthur Rodriguez Gonzalez Cortes
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Mater Dei Hospital, Msida, Malta
| | - Plauto Christopher Aranha Watanabe
- Department of Stomatology, Field of Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Lim YW, Lim YJ, Kim B, Lee SP. A New Method of Measuring the Volumetric Change of Alveolar Bone Around Dental Implants Using Computed Tomography. J Clin Med 2020; 9:jcm9041238. [PMID: 32344680 PMCID: PMC7230185 DOI: 10.3390/jcm9041238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/16/2022] Open
Abstract
This study proposes a method for measuring the volumetric change of alveolar bone after dental implant surgery using computed tomography (CT). A total of 40 implants in 20 patients (15 males and 5 females) were selected. The types of implants used were group 1: 24 CMI IS-II Active implants (Neobiotech Co., Seoul, Republic of Korea) and group 2: 16 SLActive Bone Level implants (Institut Straumann AG, Basel, Switzerland). The OnDemand3D software (CyberMed, Seoul, Korea) was used for analysis. The volumetric change of the alveolar bone around an implant fixture is measured as follows: (1) Establish two cylinders: the main cylinder with the implant axis as the central axis (radius of implant + 3 mm) and the error correction cylinder (radius of implant + 1 mm). (2) The height of the cylinder extended from the top of the fixture to a 3 mm coronal portion. (3) Calculate the volumetric change of the alveolar bone (Vd) by subtracting the volume of the error correction cylinder from the main cylinder between CT images taken immediately after the implant placement and 12 months later. After a one-year installation, the volumetric change of alveolar bone, ΔV (cc) had increased in both groups (group 1: −0.011 ± 0.015 cc, group 2: −0.012 ± 0.017 cc) with statistical significance (p < 0.05), and the difference between the groups was not statistically significant (p > 0.05). This three-dimensional assessment method would be a useful clinical reference for the assessment of marginal bone change after implant surgery.
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Affiliation(s)
- Young-Wook Lim
- Department of Dentistry, School of Dentistry, Seoul National University, Seoul 03080, Korea;
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-02-2072-2040
| | - Bongju Kim
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Seung-Pyo Lee
- Department of Oral Anatomy and Dental Research Institute, Seoul National University, Seoul 03080, Korea;
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Kajan Z, Seyed Monir S, Khosravifard N, Jahri D. Fenestration and dehiscence in the alveolar bone of anterior maxillary and mandibular teeth in cone-beam computed tomography of an Iranian population. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.294327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vadiati Saberi B, Khosravifard N, Ghandari F, Hadinezhad A. Detection of peri-implant bone defects using cone-beam computed tomography and digital periapical radiography with parallel and oblique projection. Imaging Sci Dent 2019; 49:265-272. [PMID: 31915611 PMCID: PMC6941830 DOI: 10.5624/isd.2019.49.4.265] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/03/2019] [Accepted: 09/18/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) with that of parallel (PPA) and oblique projected periapical (OPA) radiography for the detection of different types of peri-implant bone defects. Materials and Methods Forty implants inserted into bovine rib blocks were used. Thirty had standardized bone defects (10 each of angular, fenestration, and dehiscence defects), and 10 were defect-free controls. CBCT, PPA, and OPA images of the samples were acquired. The images were evaluated twice by each of 2 blinded observers regarding the presence or absence and the type of the defects. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were determined for each radiographic technique. The 3 modalities were compared using the Fisher exact and chi-square tests, with P<0.05 considered as statistical significance. Results High inter-examiner reliability was observed for the 3 techniques. Angular defects were detected with high sensitivity and specificity by all 3 modalities. CBCT and OPA showed similar AUC and sensitivity in the detection of fenestration defects. In the identification of dehiscence defects, CBCT showed the highest sensitivity, followed by OPA and PPA, respectively. CBCT and OPA had a significantly greater ability than PPA to detect fenestration and dehiscence defects (P<0.05). Conclusion The application of OPA radiography in addition to routine PPA imaging as a radiographic follow-up method for dental implantation greatly enhances the visualization of fenestration and dehiscence defects. CBCT properly depicted all defect types studied, but it involves a relatively high dose of radiation and cost.
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Affiliation(s)
- Bardia Vadiati Saberi
- Dental Sciences Research Center, Department of Periodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Farnaz Ghandari
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Hadinezhad
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Helmi MF, Huang H, Goodson JM, Hasturk H, Tavares M, Natto ZS. Prevalence of periodontitis and alveolar bone loss in a patient population at Harvard School of Dental Medicine. BMC Oral Health 2019; 19:254. [PMID: 31752793 PMCID: PMC6873420 DOI: 10.1186/s12903-019-0925-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/09/2019] [Indexed: 12/24/2022] Open
Abstract
Background Although several studies assessed the prevalence of alveolar bone loss, the association with several risk factors has not been fully investigated. The aim of this article is to measure the prevalence of periodontitis by calculating the mean alveolar bone loss/level of posterior teeth using bitewing radiographs among the patients enrolled in the clinics at Harvard School of Dental Medicine and address risk factors associated with the disease. Methods One thousand one hundred thirty-one patients were selected for radiographic analysis to calculate the mean alveolar bone loss/level by measuring the distance between the cementoenamel junction and the alveolar bone crest on the mesial and distal surfaces of posterior teeth. Linear regression with Multi-level mixed-effect model was used for statistical analysis adjusting for age, sex, race, median household income, and other variables. Results Mean alveolar bone level of the whole sample was 1.30 mm (±0.006). Overall periodontitis prevalence for the sample was 55.5% (±1.4%). Moderate periodontitis prevalence was 20.7% (±1.2%), while 2.8% (±0.5%) of the whole sample had severe periodontitis. Adjusted mean alveolar bone loss was higher in older age groups, males, Asian race group, ever smokers, and patients with low median household income. Conclusion The effect of high household income on the amount of bone loss can be powerful to the degree that high household income can influence outcomes even for individuals who had higher risks of developing the disease. Public health professionals and clinicians need to collaborate with policy makers to achieve and sustain high quality of healthcare for everyone.
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Affiliation(s)
- Mohammad F Helmi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Hui Huang
- Pre-doc student, School of Dental Medicine, Harvard University, Boston, MA, USA
| | - J Max Goodson
- Department of Oral Medicine, Infection, and Immunity, School of Dental Medicine, Harvard University, Boston, MA, USA.,Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Hatice Hasturk
- Department of Applied Oral Sciences, Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA, USA
| | - Mary Tavares
- Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
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Eshraghi VT, Malloy KA, Tahmasbi M. Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease. Dent J (Basel) 2019; 7:dj7020057. [PMID: 31159356 PMCID: PMC6631177 DOI: 10.3390/dj7020057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/20/2022] Open
Abstract
The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.
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Affiliation(s)
- V Thomas Eshraghi
- Private Practice, Tualatin, OR 97062, USA.
- Private Practice, Beaverton, OR 97006, USA.
- Department of Periodontology, Oregon Health & Science University, Portland, OR 97201, USA.
| | | | - Mehrnaz Tahmasbi
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX 75246, USA.
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Detection of alveolar bone defects with three different voxel sizes of cone-beam computed tomography: an in vitro study. Sci Rep 2019; 9:8146. [PMID: 31148581 PMCID: PMC6544761 DOI: 10.1038/s41598-019-44675-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/20/2019] [Indexed: 11/16/2022] Open
Abstract
This study was conducted to assess the accuracy of cone-beam computed tomography (CBCT) of different voxel sizes in the detection of alveolar bone defects, and to select the optimal voxel size for clinical use. 46 in-vitro teeth were placed in bovine ribs in which alveolar bone defects were randomly simulated. In total, 32 alveolar bone defects and 14 teeth without periodontal defects were used. CBCT images were acquired with the use of three different voxel sizes: 0.125-mm, 0.2-mm and 0.4-mm. The scan data were 3D-reconstructed in Mimics software and evaluated by two observers with more than 5 years of experience in CBCT. Receiver operating characteristic (ROC) curves and diagnostic values were obtained. Pairwise comparison of ROC curves was made for evaluation of the diagnostic values of different voxel sizes. Kappa statistics assessed the observer reliability. Results were considered significant at P < 0.05. It showed no statistically significant difference between 0.125-mm group and 0.2-mm group, but 0.4-mm group had lower Az values that differed significantly from 0.125-mm and 0.2-mm groups (P < 0.05). Based on diagnostic value and radiation protection, 0.2-mm voxel size may be a good choice for the detection of bone defects with CBCT.
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Dantas LL, Ferreira PP, Oliveira LSAF, Neves FS, Campos PSF, Scarfe WC, Crusoe‐Rebello I. Cone beam computed tomography devices in the evaluation of buccal bone in anterior teeth. Aust Dent J 2019; 64:161-166. [DOI: 10.1111/adj.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2019] [Indexed: 01/31/2023]
Affiliation(s)
- LL Dantas
- Department of Prosthetics and Integrated Clinics School of Dentistry Federal University of Bahia Bahia Brazil
| | - PP Ferreira
- Department of Prosthetics and Integrated Clinics School of Dentistry Federal University of Bahia Bahia Brazil
| | - LSAF Oliveira
- Academic Department of Technology in Health and Biology Federal Institute of Bahia Bahia Brazil
| | - FS Neves
- Department of Prosthetics and Integrated Clinics School of Dentistry Federal University of Bahia Bahia Brazil
| | - PSF Campos
- Department of Prosthetics and Integrated Clinics School of Dentistry Federal University of Bahia Bahia Brazil
| | - WC Scarfe
- Department of Surgical/Hospital Dentistry University of Louisville School of Dentistry Louisville KY USA
| | - I Crusoe‐Rebello
- Department of Prosthetics and Integrated Clinics School of Dentistry Federal University of Bahia Bahia Brazil
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Orhan K, Jacobs R, Celikten B, Huang Y, de Faria Vasconcelos K, Nicolielo LFP, Buyuksungur A, Van Dessel J. Evaluation of Threshold Values for Root Canal Filling Voids in Micro-CT and Nano-CT Images. SCANNING 2018; 2018:9437569. [PMID: 30116470 PMCID: PMC6079325 DOI: 10.1155/2018/9437569] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
While several materials and techniques have been used to assess the quality of root canal fillings in micro-CT images, the lack of standardization in scanning protocols has produced conflicting results. Hence, the aim of this study was to determine a cutoff voxel size value for the assessment of root canal filling voids in micro-CT and nano-CT images. Twenty freshly extracted mandibular central incisors were used. Root canals were prepared with nickel titanium files to an ISO size 40/0.06 taper and then filled with a single cone (40/0.06 taper) and AH Plus sealer. The teeth were scanned with different voxel sizes with either micro-CT (5.2, 8.1, 11.2, and 16.73 μm) or nano-CT (1.5 and 5.0 μm) equipment. Images were reconstructed and analyzed with the NRecon and CTAn software. Void proportion and void volume were calculated for each tooth in the apical, middle, and coronal thirds of the root canal. Kruskal-Wallis and post hoc Mann-Whitney U tests were performed with a significance level of 5%. In micro-CT images, significantly different results were detected among the tested voxel sizes for void proportion and void volume, whereas no such differences were found in nano-CT images (p > 0.05). Micro-CT images showed higher void numbers over the entire root length, with statistically significant differences between the voxel size of 16.73 μm and the other sizes (p < 0.05). The values of the different nano-CT voxel sizes did not significantly differ from those of the micro-CT (5.2, 8.1, and 11.2 μm), except for the voxel size of 16.73 μm (p < 0.05). All tested voxel sizes enabled the detection of root canal filling voids except for the voxel size of 16.73 μm. Bearing in mind the limitations of this study, it seems that a voxel size of 11.2 μm can be used as a reliable cutoff value for the assessment of root canal filling voids in micro-CT imaging.
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Affiliation(s)
- Kaan Orhan
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Oral Facial Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Solna, Sweden
| | - Berkan Celikten
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Faculty of Dentistry, Department of Endodontics, Ankara University, Ankara, Turkey
| | - Yan Huang
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Laura Ferreira Pinheiro Nicolielo
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | - Jeroen Van Dessel
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Elashiry M, Meghil MM, Arce RM, Cutler CW. From manual periodontal probing to digital 3-D imaging to endoscopic capillaroscopy: Recent advances in periodontal disease diagnosis. J Periodontal Res 2018; 54:1-9. [DOI: 10.1111/jre.12585] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 01/07/2023]
Affiliation(s)
- M. Elashiry
- Department of Oral Biology; Augusta University; Augusta GA USA
- Department of Periodontics; The Dental College of Georgia at Augusta University; Augusta GA USA
| | - M. M. Meghil
- Department of Oral Biology; Augusta University; Augusta GA USA
- Department of Periodontics; The Dental College of Georgia at Augusta University; Augusta GA USA
| | - R. M. Arce
- Department of Periodontics; The Dental College of Georgia at Augusta University; Augusta GA USA
| | - C. W. Cutler
- Department of Periodontics; The Dental College of Georgia at Augusta University; Augusta GA USA
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Elashiry M, Meghil MM, Kalathingal S, Buchanan A, Elrefai R, Looney S, Rajendran M, Ochieng M, Young N, Elawady A, Arce RM, Sandhage KH, Cutler CW. Application of radiopaque micro-particle fillers for 3-D imaging of periodontal pocket analogues using cone beam CT. Dent Mater 2018; 34:619-628. [PMID: 29395473 DOI: 10.1016/j.dental.2018.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/07/2017] [Accepted: 01/09/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Periodontitis is an infectious/inflammatory disease most often diagnosed by deepening of the gingival sulcus, which leads to periodontal pockets (PPs) conventional manual periodontal probing does not provide detailed information on the three-dimensional (3-D) nature of PPs. OBJECTIVES To determine whether accurate 3-D analyses of the depths and volumes of calibrated PP analogues (PPAs) can be obtained by conventional cone beam computed tomography (CBCT) coupled with novel radiopaque micro-particle fillers (described in the companion paper) injected into the PPAs. METHODS Two PPA models were employed: (1) a human skull model with artificial gingiva applied to teeth with alveolar bone loss and calibrated PPAs, and (2) a pig jaw model with alveolar bone loss and surgically-induced PPAs The PPAs were filled with controlled amounts of radiopaque micro-particle filler using volumetric pipetting Inter-method and intra-method agreement tests were then used to compare the PPA depths and volumes obtained from CBCT images with values obtained by masked examiners using calibrated manual methods. RESULTS Significant inter-method agreement (0.938-0.991) and intra-method agreement (0.94-0.99) were obtained when comparing analog manual data to digital CBCT measurements enabled by the radiopaque filler. SIGNIFICANCE CBCT imaging with radiopaque micro-particle fillers is a plausible means of visualizing and digitally assessing the depths, volumes, and 3-D shapes of PPs This approach could transform the diagnosis and treatment planning of periodontal disease, with particular initial utility in complex cases Efforts to confirm the clinical practicality of these fillers are currently in progress.
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Affiliation(s)
- M Elashiry
- Department of Oral Biology, Augusta University, Augusta, GA, USA; Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA.
| | - M M Meghil
- Department of Oral Biology, Augusta University, Augusta, GA, USA; Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - S Kalathingal
- Department of Diagnostic Science, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - A Buchanan
- Department of Diagnostic Science, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - R Elrefai
- Department of Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - S Looney
- Department of Biostatistics, Augusta University, Augusta, GA, USA
| | - M Rajendran
- Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - M Ochieng
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA, USA
| | - N Young
- Department of General Dentistry, Augusta University, Augusta, GA, USA
| | - A Elawady
- Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - R M Arce
- Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
| | - K H Sandhage
- School of Materials Engineering, Purdue University, West Lafayette, IN, USA
| | - C W Cutler
- Department of Periodontics, The Dental College of Georgia at Augusta University, Augusta, GA, USA
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:260-267. [PMID: 29273196 DOI: 10.1016/j.oooo.2017.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 10/07/2017] [Accepted: 11/06/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study assessed the use of different voxel resolutions in a cone beam computed tomography (CBCT) unit for the detection of artificially induced periodontal bone defects created using burr, burr and chemicals, and only chemicals. STUDY DESIGN Seven dry skulls were used in this study. In total, 65 dehiscence defects, 43 fenestration defects, and 76 control sites with no periodontal defects were examined. Images were obtained from a CBCT unit (3 D Accuitomo; J Morita Mfg. Corp., Kyoto, Japan), using 3 field-of-view (FOV) sizes (4 × 4 cm; 6 × 6 cm; and 8 × 8 cm) and 4 scan modes (standard, high-definition, high-fidelity, and low-dose). RESULTS Overall, κ coefficients for interobserver agreement on burr-induced periodontal defects ranged from 0.336 to 0.795, with the lowest κ value (indicating a fair degree of agreement) obtained for images acquired in standard mode with a voxel size of 0.160 mm3. κ coefficients for the detection of periodontal defects were highest (indicating moderate to high degrees of interobserver agreement) for smaller voxel sizes and high-resolution images. Statistical comparison among groups (burr, burr + chemicals, and chemicals only) was performed using 1-way analysis of variance with post hoc tests. CONCLUSIONS The CBCT scan mode may affect the diagnosis of periodontal defects. The technique used to create periodontal defects also affected diagnosis. For this kind of experiment, burr-induced or burr + chemical-induced defects should be used, rather than those induced solely using a chemical technique.
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Engineered scaffolds and cell-based therapy for periodontal regeneration. J Appl Biomater Funct Mater 2017; 15:e303-e312. [PMID: 29131300 DOI: 10.5301/jabfm.5000389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The main objective of regenerative periodontal therapy is to completely restore the periodontal tissues lost. This review summarizes the most recent evidence in support of scaffold- and cell-based tissue engineering, which are expected to play a relevant role in next-generation periodontal regenerative therapy. METHODS A literature search (PubMed database) was performed to analyze more recently updated articles regarding periodontal regeneration, scaffolds and cell-based technologies. RESULTS Evidence supports the importance of scaffold physical cues to promote periodontal regeneration, including scaffold multicompartmentalization and micropatterning. The in situ delivery of biological mediators and/or cell populations, both stem cells and already differentiated cells, has shown promising in vivo efficacy. CONCLUSIONS Porous scaffolds are pivotal for clot stabilization, wound compartmentalization, cell homing and cell nutrients delivery. Given the revolutionary introduction of rapid prototyping technique and cell-based therapies, the fabrication of custom-made scaffolds is not far from being achieved.
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Silveira-Neto N, Flores ME, De Carli JP, Costa MD, de Souza Matos F, Paranhos LR, Linden MSS. Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study. Clinics (Sao Paulo) 2017; 72:708-713. [PMID: 29236918 PMCID: PMC5707201 DOI: 10.6061/clinics/2017(11)10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/15/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This research evaluated detail registration in peri-implant bone using two different cone beam computer tomography systems and a digital periapical radiograph. METHODS Three different image acquisition protocols were established for each cone beam computer tomography apparatus, and three clinical situations were simulated in an ex vivo fresh pig mandible: buccal bone defect, peri-implant bone defect, and bone contact. Data were subjected to two analyses: quantitative and qualitative. The quantitative analyses involved a comparison of real specimen measures using a digital caliper in three regions of the preserved buccal bone - A, B and E (control group) - to cone beam computer tomography images obtained with different protocols (kp1, kp2, kp3, ip1, ip2, and ip3). In the qualitative analyses, the ability to register peri-implant details via tomography and digital periapical radiography was verified, as indicated by twelve evaluators. Data were analyzed with ANOVA and Tukey's test (α=0.05). RESULTS The quantitative assessment showed means statistically equal to those of the control group under the following conditions: buccal bone defect B and E with kp1 and ip1, peri-implant bone defect E with kp2 and kp3, and bone contact A with kp1, kp2, kp3, and ip2. Qualitatively, only bone contacts were significantly different among the assessments, and the p3 results differed from the p1 and p2 results. The other results were statistically equivalent. CONCLUSIONS The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography.
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Affiliation(s)
| | | | - João Paulo De Carli
- Departamento de Odontologia, Universidade de Passo Fundo, Passo Fundo, RS, BR
| | - Max Dória Costa
- Departamento de Odontologia, Universidade Tiradentes, Aracaju, SE, BR
| | - Felipe de Souza Matos
- Departamento de Odontologia Restauradora, Instituto de Ciência e Tecnologia, Universidade Estadual Paulista, São José dos Campos, SP, BR
| | - Luiz Renato Paranhos
- Departamento de Odontologia, Universidade Federal de Sergipe, Lagarto, SE, BR
- *Corresponding author. E-mail:
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Haas LF, Zimmermann GS, De Luca Canto G, Flores-Mir C, Corrêa M. Precision of cone beam CT to assess periodontal bone defects: a systematic review and meta-analysis. Dentomaxillofac Radiol 2017; 47:20170084. [PMID: 28869397 DOI: 10.1259/dmfr.20170084] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard (in situ measurement). METHODS Studies in which the main objective was to evaluate the diagnostic validity of CBCT in measuring periodontal bone defects when compared with the reference standard were selected. Four databases were searched. The studies were selected by two independent reviewers. The methodology of selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. The quality of evidence and strength of recommendation was assessed by The Grading of Recommendations Assessment Tool, Development and Evaluation. RESULTS Using a selection process in two phases, 16 studies were identified and, in seven articles meta-analysis was performed. The results from these meta-analyses showed that no difference between the measurements of CBCT and in situ for alveolar bone loss, and demonstrated a concordance of 82.82% between CBCT and in situ for the classification of the degree of furcation involvement. CONCLUSIONS Based on a moderate level of evidence, CBCT could be useful for furcation involvement periodontal cases, but it should only be used in cases where clinical evaluation and conventional radiographic imaging do not provide the information necessary for an adequate diagnosis and proper periodontal treatment planning.
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Affiliation(s)
- Letícia Fernanda Haas
- 1 Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - G De Luca Canto
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil.,3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- 3 Department of Dentistry, Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
| | - Márcio Corrêa
- 2 Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
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Detection of Bone Defects Using CBCT Exam in an Italian Population. Int J Dent 2017; 2017:7523848. [PMID: 29181025 PMCID: PMC5664353 DOI: 10.1155/2017/7523848] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/09/2017] [Accepted: 09/19/2017] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this study was to evaluate the in vivo incidence and the location of fenestrations in a young Italian population by using CBCT. Materials and Methods Fifty patients who had previously performed CBCT for planning third molar extraction or orthodontic therapy were selected for the study. No previous dental treatment had been performed on these patients. Overall, 1,395 teeth were evaluated. Root fenestrations were identified according to the definition of Davies and the American Association of Endodontists. Data was collected and statistically analyzed. Results Fenestrations were observed in 159 teeth out of 1,395 (11% of teeth). In the lower jaw, we found 68 fenestrations (5%) and 91 in the maxilla (6,5%). Incisors were the teeth with the highest incidence of fenestrations. Conclusion The relative common finding (11%) of fenestration supports the need for CBCT exams before any surgical/implant treatment to avoid complications related to the initial presence of fenestrations. CBCT was found to be an effective and convenient tool for diagnosing fenestration.
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Identification of the Procedural Accidents During Root Canal Preparation Using Digital Intraoral Radiography and Cone Beam Computed Tomography. ACTA MEDICA MARISIENSIS 2016. [DOI: 10.1515/amma-2016-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Crown or root perforation, ledge formation, fractured instruments and perforation of the roots are the most important accidents which appear during endodontic therapy. Our objective was to evaluate the value of digital intraoral periapical radiographs compared to cone beam computed tomography images (CBCT) used to diagnose some procedural accidents. Material and methods: Eleven extracted molars were used in this study. A total of 18 perforations and 13 ledges were created artifically and 10 instruments were fractured in the root canals. Digital intraoral periapical radiographs from two angles and CBCT scans were made with the teeth fixed in position. The images were evaluated and the number of detected accidents were stated in percentages. Statistical analysis was performed using the chi square-test. Results: On digital periapical radiographs the evaluators identified 12 (66.66%) perforations, 10 (100 %) separated instruments and 10 (76.9%) created ledges. The CBCT scans made possible the recognition of 17 (94.66 %) perforations, 9 (90 %) separated instruments and 13 (100%) ledges. The totally recognized accidental procedures showed significant differences between the two groups. (p<0.05) Conclusion: Digital periapical radiographs are the most common imaging modalities used during endodontic treatments. Though, the CBCT allows a better identification of the procedural accidents.
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An Intraoral Miniature X-ray Tube Based on Carbon Nanotubes for Dental Radiography. NUCLEAR ENGINEERING AND TECHNOLOGY 2016. [DOI: 10.1016/j.net.2016.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pinheiro LR, Scarfe WC, Augusto de Oliveira Sales M, Gaia BF, Cortes ARG, Cavalcanti MG. Effect of Cone-Beam Computed Tomography Field of View and Acquisition Frame on the Detection of Chemically Simulated Peri-Implant Bone Loss In Vitro. J Periodontol 2015; 86:1159-65. [PMID: 26156676 DOI: 10.1902/jop.2015.150223] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study is to determine the influence of field of view (FOV) and number of acquisition projection images (frames) on the detection of chemically simulated peri-implant defects by cone-beam computed tomography (CBCT) using an in vitro bovine rib bone model. METHODS Eighty implants were placed in bovine ribs in which small and large bone defects were created using 70% perchloric acid. CBCT images were acquired at three acquisition protocols: protocol 1 (FOV 4 × 4 cm, 0.08-mm voxel size, 1,009 frames [high fidelity]; protocol 2 (same as protocol 1 except 512 frames [standard]); and protocol 3 (FOV 14 × 5 cm, 0.25-mm voxel size; high fidelity). Two oral and maxillofacial radiologists (OMRs) and two oral and maxillofacial surgeons (OMSs) rated the presence or absence of bone defects on a five-point scale. κ and area under the curve (AUC) were calculated and compared using analysis of variance with post hoc Tukey test at P ≤ 0.05. RESULTS Intra- and interobserver agreement for OMRs ranged from moderate to good and from slight to moderate for OMSs. For the detection of small lesions, protocol 1 (AUC 0.813 ± 0.045) provided higher detection rates than protocol 2 (AUC 0.703 ± 0.02) and protocol 3 (AUC 0.773 ± 0.55) [F(2,9) = 1.6377]. For larger defects, the trends were similar, with protocol 1 (AUC 0.852 ± 0.108) providing higher detection rates than protocol 2 (AUC 0.730 ± 0.045) and protocol 3 (AUC 0.783 ± 0.058) [F(2,9) = 1.9576]. CONCLUSION Within the limits of this study, optimal detection of chemically simulated pericircumferential implant crestal bone defects is achieved at the least radiation detriment using the smallest FOV, the highest number of acquisition frames, and the smallest voxel.
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Affiliation(s)
- Lucas Rodrigues Pinheiro
- Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, Kentucky.,Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - William C Scarfe
- Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, Kentucky
| | | | - Bruno Felipe Gaia
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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