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Mosquera-Barreiro C, Ruíz-Piñón M, Sans FA, Nagendrababu V, Vinothkumar TS, Martín-González J, Martín-Biedma B, Castelo-Baz P. Predictors of periapical bone healing associated with teeth having large periapical lesions following nonsurgical root canal treatment or retreatment: A cone beam computed tomography-based retrospective study. Int Endod J 2024; 57:23-36. [PMID: 37974453 DOI: 10.1111/iej.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
AIM Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evaluate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing. METHODOLOGY Seventy-nine patients were treated during the years 2013-2020 with large periapical lesions of endodontic origin (10-15 mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow-up (IOPAR every 6 months and CBCT every 12 months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi-square test was used for categorical variables, the t-test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of healing time with categorical variables and the correlation index was measured with the quantitative variables. RESULTS Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19 months, of which 60% healed fully between 12 and 18 months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p < .001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p > .05). CONCLUSIONS Clinicians should be aware that periapical lesions in older patients and larger areas of bone loss take longer to heal. CBCT monitoring of large periapical lesions is critical and it can help clinicians in the decision-making process.
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Affiliation(s)
- Carolina Mosquera-Barreiro
- Surgery and medical surgical specialties. International theoretical-practical Master of Endodontics, Dentistry Restorative and Aesthetics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Ruíz-Piñón
- Surgery and medical surgical specialties. International theoretical-practical Master of Endodontics, Dentistry Restorative and Aesthetics, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, University of Sharjah, College of Dental Medicine, Sharjah, United Arab Emirates
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Jenifer Martín-González
- Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Benjamín Martín-Biedma
- Oral Sciences Research Group, Endodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- Oral Sciences Research Group, Endodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Kalla MP, Vagenas TP, Economopoulos TL, Matsopoulos GK. Deep learning-based registration of two-dimensional dental images with edge specific loss. J Med Imaging (Bellingham) 2023; 10:034002. [PMID: 37274759 PMCID: PMC10232841 DOI: 10.1117/1.jmi.10.3.034002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 04/18/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
Purpose Image registration is a very common procedure in dental applications for aligning images. Registration between pairs of images taken from different angles can improve diagnosis. Our study presents an edge-enhanced unsupervised deep learning (DL)-based deformable registration framework for aligning two-dimensional (2D) pairs of dental x-ray images. Approach The proposed neural network is based on the combination of a U-Net like structure, which produces a displacement field, combined with spatial transformer networks, which produce the transformed image. The proposed structure is trained end-to-end by minimizing a weighted loss function consisting of three parts corresponding to image similarity, edge similarity, and registration restrictions. In this regard, the proposed edge specific loss enhances the unsupervised training of the registration framework without the need of supervision through anatomical structures. Results The proposed framework was applied to two datasets, a set of 104 x-ray images of mandibles, arranged in 2600 pairs for training and testing and a set of 17 pairs of pre- and post-operative reconstructed panoramic images. The proposed model outperformed both conventional registration methods and DL-based techniques for both qualitative and quantitative assessment, in most of the compared metrics concerning intensity similarity and edge distances. Conclusions The proposed framework achieved accurate and fast deformable alignment of pairs of 2D dental radiographic images. The edge-based module of the loss function enhances the unsupervised learning by directing the network toward deformations that take into consideration the edges of the depicted objects (teeth, bone, and tissue), which are crucial in diagnosis.
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Affiliation(s)
- Maria-Pavlina Kalla
- National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Theodoros P. Vagenas
- National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - Theodore L. Economopoulos
- National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
| | - George K. Matsopoulos
- National Technical University of Athens, School of Electrical and Computer Engineering, Athens, Greece
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Palkovics D, Solyom E, Somodi K, Pinter C, Windisch P, Bartha F, Molnar B. Three-dimensional volumetric assessment of hard tissue alterations following horizontal guided bone regeneration using a split-thickness flap design: A case series. BMC Oral Health 2023; 23:118. [PMID: 36810076 PMCID: PMC9945662 DOI: 10.1186/s12903-023-02797-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES To analyze morphological, volumetric, and linear hard tissue changes following horizontal ridge augmentation using a three-dimensional radiographic method. METHODS As part of a larger ongoing prospective study, 10 lower lateral surgical sites were selected for evaluation. Horizontal ridge deficiencies were treated with guided bone regeneration (GBR) using a split-thickness flap design and a resorbable collagen barrier membrane. Following the segmentation of baseline and 6-month follow-up cone-beam computed tomography scans, volumetric, linear, and morphological hard tissue changes and the efficacy of the augmentation were assessed (expressed by the volume-to-surface ratio). RESULTS Volumetric hard tissue gain averaged 605.32 ± 380.68 mm3. An average of 238.48 ± 127.82 mm3 hard tissue loss was also detected at the lingual aspect of the surgical area. Horizontal hard tissue gain averaged 3.00 ± 1.45 mm. Midcrestal vertical hard tissue loss averaged 1.18 ± 0.81 mm. The volume-to-surface ratio averaged 1.19 ± 0.52 mm3/mm2. The three-dimensional analysis showed slight lingual or crestal hard tissue resorption in all cases. In certain instances, the greatest extent of hard tissue gain was observed 2-3 mm apical to the initial level of the marginal crest. CONCLUSIONS With the applied method, previously unreported aspects of hard tissue changes following horizontal GBR could be examined. Midcrestal bone resorption was demonstrated, most likely caused by increased osteoclast activity following the elevation of the periosteum. The volume-to-surface ratio expressed the efficacy of the procedure independent of the size of the surgical area.
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Affiliation(s)
- Daniel Palkovics
- Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088, Hungary.
| | - Eleonora Solyom
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Kristof Somodi
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Csaba Pinter
- Empresa de Base Technológica Internacional de Canarias, S.L., Alcalde Jose Ramirez Bethencourt Avenue 17 Las Palmas De Gran Canaria, 35004 Las Palmas De Gran Canaria, Spain
| | - Peter Windisch
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Ferenc Bartha
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
| | - Balint Molnar
- grid.11804.3c0000 0001 0942 9821Department of Periodontology, Semmelweis University, Szentkirályi Street 47, Budapest, 1088 Hungary
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Zhou Y, Li JP, Lv WC, Ma RH, Li G. Three-dimensional CBCT images registration method for TMJ based on reconstructed condyle and skull base. Dentomaxillofac Radiol 2018; 47:20170421. [PMID: 29595332 DOI: 10.1259/dmfr.20170421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A method was introduced for three-dimensional (3D) cone-beamCT (CBCT) images registration of temporomandibular joint (TMJ). This study aimed to provide quantitative and qualitative analysis of TMJ bone changes in two-dimensional (2D) and 3D and to provide the technique for computer-aided diagnosis of temporomandibular joint disorders in the future. METHODS 10 TMJ samples of six patients were obtained from Peking University Hospital of Stomatology. Four of the six patients imaged bilateral TMJs and the other two patients only imaged unilateral TMJ. Each sample consisted of two images from the same TMJ taken at different times. First, condyle and skull base were segmented semi-automatically for 3D model reconstruction. Then the segmented condyle and skull base were registered separately. Registration process can be divided into two processes of rough registration and fine registration. Rough registration step was achieved by selecting corresponding points manually and initialized fine registration. Condyle and skull base were fine registered by minimizing mean square error of condyle (MSEcondyle) and skull base (MSEskull) respectively. Qualitative assessment of osseous component changes utilized 2D color-fused model and 3D surface-fused model and quantitative analyses the convergence of this method used the mean square error of the model (MSEmodel). Independent repeated experiments were carried out to test the stability of our 3D registration method. RESULTS Sufficiently alignment was achieved. Osseous abnormality and morphology changes were displayed using fusion model. MSEmodel of condylar registration and skull base registration declined 51.80% and 64.58% compared with that before registration. Quantitative analysis verified the stability of the method. CONCLUSIONS The proposed method completed 3D TMJ registration for different physiological structure. The result of this method was accurate, reproducible and not relied on the experience of operators.
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Affiliation(s)
- Yue Zhou
- 1 Signal and image processing laboratory, School of Electronic Information Engineering, Beijing Jiao tong University , Beijing , China
| | - Ju-Peng Li
- 1 Signal and image processing laboratory, School of Electronic Information Engineering, Beijing Jiao tong University , Beijing , China
| | - Wen-Chao Lv
- 1 Signal and image processing laboratory, School of Electronic Information Engineering, Beijing Jiao tong University , Beijing , China
| | - Ruo-Han Ma
- 2 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology , Beijing , China
| | - Gang Li
- 2 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology , Beijing , China
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Kalla MP, Economopoulos TL, Matsopoulos GK. 3D dental image registration using exhaustive deformable models: a comparative study. Dentomaxillofac Radiol 2017; 46:20160390. [PMID: 28402714 PMCID: PMC5988184 DOI: 10.1259/dmfr.20160390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Image registration is commonly used in dental applications for aligning imaging data sets, which is particularly useful when assessing the progression or regression of particular pathomorphic conditions. However, due to the nature of the processed data or the data acquisition process itself, rigid body registration may be insufficient to accurately align the processed data sets. In such cases, deformable models are employed. This study presents a comparison of four well-established deformable models for aligning CBCT volumes. METHODS The compared models include the original Demons algorithm, symmetric forces Demons, diffeomorphic Demons and level-set motion. The compared techniques are incorporated into a general image registration scheme featuring two distinct stages: a common, fast, rigid-based alignment for pre-registering the data and a finer elastic registration phase, based on the four compared deformation models. RESULTS The proposed framework was applied to a total of 40 CBCT volume pairs with known and unknown initial differences. CONCLUSIONS After both qualitative and quantitative assessment of the produced aligned data, it was concluded that the level-set motion method outperformed all other techniques for data pairs with both unknown initial differences, as well as with known elastic deviations based on fixed sinusoidal models and B-splines.
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Affiliation(s)
- Maria-Pavlina Kalla
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Theodore L Economopoulos
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - George K Matsopoulos
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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Papakosta TK, Savva AD, Economopoulos TL, Matsopoulos GK, Gröhndal HG. An automatic panoramic image reconstruction scheme from dental computed tomography images. Dentomaxillofac Radiol 2017; 46:20160225. [PMID: 28112548 DOI: 10.1259/dmfr.20160225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Panoramic images of the jaws are extensively used for dental examinations and/or surgical planning because they provide a general overview of the patient's maxillary and mandibular regions. Panoramic images are two-dimensional projections of three-dimensional (3D) objects. Therefore, it should be possible to reconstruct them from 3D radiographic representations of the jaws, produced by CBCT scanning, obviating the need for additional exposure to X-rays, should there be a need of panoramic views. The aim of this article is to present an automated method for reconstructing panoramic dental images from CBCT data. METHODS The proposed methodology consists of a series of sequential processing stages for detecting a fitting dental arch which is used for projecting the 3D information of the CBCT data to the two-dimensional plane of the panoramic image. The detection is based on a template polynomial which is constructed from a training data set. RESULTS A total of 42 CBCT data sets of real clinical pre-operative and post-operative representations from 21 patients were used. Eight data sets were used for training the system and the rest for testing. CONCLUSIONS The proposed methodology was successfully applied to CBCT data sets, producing corresponding panoramic images, suitable for examining pre-operatively and post-operatively the patients' maxillary and mandibular regions.
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Affiliation(s)
- Thekla K Papakosta
- 1 School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Antonis D Savva
- 1 School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Theodore L Economopoulos
- 1 School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - George K Matsopoulos
- 1 School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - H G Gröhndal
- 2 Department of Oral and Maxillofacial Radiology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
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Three-dimensional maxillary and mandibular regional superimposition using cone beam computed tomography: a validation study. Int J Oral Maxillofac Surg 2016; 45:662-9. [DOI: 10.1016/j.ijom.2015.12.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 10/27/2015] [Accepted: 12/08/2015] [Indexed: 11/21/2022]
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Savva AD, Economopoulos TL, Matsopoulos GK. Geometry-based vs. intensity-based medical image registration: A comparative study on 3D CT data. Comput Biol Med 2016; 69:120-33. [DOI: 10.1016/j.compbiomed.2015.12.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/16/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
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Xia Y, Xie L, Zhou Y, Song T, Zhang F, Gu N. A new method to standardize CBCT for quantitative evaluation of alveolar ridge preservation in the mandible: a case report and review of the literature. Regen Biomater 2016; 2:251-60. [PMID: 26816648 PMCID: PMC4676331 DOI: 10.1093/rb/rbv017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/21/2015] [Accepted: 08/30/2015] [Indexed: 11/29/2022] Open
Abstract
Cone-beam computerized tomography (CBCT) is an effective technique for assessment of changes to the alveolar ridge (AR). However, its accuracy and reliability could be improved by standardization of imaging positions to remain unchanged during measurements. In this study, an alveolar ridge preservation procedure was performed on a left third molar (38) socket by filling it with a radiotransparent synthetic bone graft, mineralized collagen (MC). Photographic, X-ray and CBCT images were captured before and 3, 6 and 12 months after surgery. A new method was developed to standardize CBCT for quantitative evaluation. Obtained CBCT images showed good comparability. The post-extraction alveolar width and height were both over 95% of the original values, but some resorption of the lingual bone wall (>50%) and inter-crestal bone (>30%). It is concluded that an effective positional standardization method was developed for CBCT assessment of AR dimensional changes in the posterior mandible. The use of MC in combination with a collagen membrane improved dimensional preservation of the AR.
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Affiliation(s)
- Yang Xia
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China, ; Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing, 210009, China
| | - Lizhe Xie
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China
| | - Yi Zhou
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China
| | - Tianxi Song
- Beijing Allgens Medical Science & Technology Co., Ltd, Beijing, 100176, China
| | - Feimin Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China, ; Suzhou Key Laboratory of Biomaterials and Technologies & Collaborative Innovation Center of Suzhou Nano Science and Technology, Suzhou, 215123, China
| | - Ning Gu
- Suzhou Key Laboratory of Biomaterials and Technologies & Collaborative Innovation Center of Suzhou Nano Science and Technology, Suzhou, 215123, China
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Adisen MZ, Yilmaz S, Misirlioglu M, Atil F. Evaluation of volumetric measurements on CBCT images using stafne bone cavities as an example. Med Oral Patol Oral Cir Bucal 2015; 20:e580-6. [PMID: 26116844 PMCID: PMC4598927 DOI: 10.4317/medoral.20633] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 04/24/2015] [Indexed: 11/29/2022] Open
Abstract
Background The aim of the present study is to evaluate the efficacy of CBCT in volume measuring using Stafne Bone Cavities (SBC) as an example. Material and Methods The study was conducted with 14 subjects with SBC detected on panoramic radiographs. In order to evaluate lesions volumetric dimensions, CBCT images for each patient were captured. Files in Digital Imaging and Communications in Medicine (DICOM) format were transferred into a medical image processing program (ITK-SNAP 2.4.0) and volume in mm3 of the cavities were measured using semi-automatic segmentation procedure by 2 observers blinded to each other over a one-month period. Inter-reliability of volumetric measurements between observers was compared. SBCs relation to mandibular canal was also examined and three types of relation were observed; type 1: mandibular canal is separated from the SBC, type 2: mandibular canal is in contact with SBC, type 3: mandibular canal goes through the SBC. Results There were 12 males and 2 females who had SBC in this study (age range: 37-73, mean age: 55.3 years). The total volume of SBC in patients ranged from 160 mm3 to 520 mm3 (mean: 361.7 mm3). There was no significant difference between observers for volume measurements (p>0.05). According to relationship of SBC with mandibular canal, most SBCs were Type 1 (64.3 %) followed by type 3 (21.4 %) and type 2 (14.3 %). Pearson correlation coefficient shows a positive correlation between lesions volumetric size and relation with mandibular canal (pearson correlation = 0.54, sig < 0.05). Conclusions Based on the results of this preliminary study, CBCT was considered to be an effective radiographic technic for measuring volumetric sizes of SBCs. However further studies with larger sample sizes are needed to prove the usefulness of CBCT in volume measurements. Key words:Stafne bone cavity, CBCT, volumetric measurements, image segmentation.
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Affiliation(s)
- Mehmet-Zahit Adisen
- Kirikkale University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Kirikkale, Turkey,
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Volumetric analysis of implanted biphasic calcium phosphate/collagen composite by three-dimensional cone beam computed tomography head model superimposition. J Craniomaxillofac Surg 2015; 43:167-74. [DOI: 10.1016/j.jcms.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/17/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
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Three-dimensional evaluation of the different donor sites of the mandible for autologous bone grafts. Clin Oral Investig 2014; 19:453-8. [DOI: 10.1007/s00784-014-1235-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
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Suomalainen A, Åberg T, Rautio J, Hurmerinta K. Cone beam computed tomography in the assessment of alveolar bone grafting in children with unilateral cleft lip and palate. Eur J Orthod 2014; 36:603-11. [PMID: 24509615 DOI: 10.1093/ejo/cjt105] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To quantify the treatment outcome of secondary alveolar bone grafting (SABG) in individuals with unilateral cleft lip and palate using cone beam computed tomography (CBCT) and to reveal needs for improvement in surgical technique. MATERIAL AND METHODS CBCT images taken 6 months after SABG of 35 patients were analysed. Vertical and horizontal bone supports of the grafted bone at three levels of the roots of the adjacent teeth were classified, the height of the nasal floor was compared with the unaffected side, and the inter- and intraexaminer reproducibility of these evaluations was assessed. RESULTS The grafted bone filled the defect in all three vertical measurement levels in 34 per cent. The labiopalatal thickness of the grafted bone was good in at least one-third of the root length in 66 per cent and fair in 34 per cent. Typically, the bone graft was deficient in the apical and palatal direction. Clear asymmetry in the nasal floor was found in 72 per cent. Kappa values indicated excellent agreement for all but one measured parameter. LIMITATIONS This is a preliminary study involving only a limited number of study subjects. CONCLUSIONS Our results showed mainly a good or fair treatment outcome. Deficiency of the bone graft was observed mostly in the apical and palatal areas of the defect. Asymmetry of the nasal floor was observed frequently. Careful insertion of the bone graft towards the palatal and apical direction of the cleft is recommended.
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Affiliation(s)
- Anni Suomalainen
- *Department of Radiology, Helsinki University Central Hospital and University of Helsinki,
| | - Thomas Åberg
- **Department of Orthodontics, Institute of Dentistry, University of Helsinki
| | - Jorma Rautio
- ***Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Central Hospital, Finland
| | - Kirsti Hurmerinta
- ***Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Central Hospital, Finland
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Metska ME, Parsa A, Adriana Aartman IH, Wesselink PR, Ozok AR. Volumetric Changes in Apical Radiolucencies of Endodontically Treated Teeth Assessed by Cone-beam Computed Tomography 1 Year after Orthograde Retreatment. J Endod 2013; 39:1504-9. [DOI: 10.1016/j.joen.2013.08.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 11/28/2022]
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Comparison of Intraoral Harvest Sites for Corticocancellous Bone Grafts. J Oral Maxillofac Surg 2013; 71:497-504. [DOI: 10.1016/j.joms.2012.10.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 10/16/2012] [Accepted: 10/19/2012] [Indexed: 12/23/2022]
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Alveolar ridge preservation. A systematic review. Clin Oral Investig 2012; 17:341-63. [PMID: 22814758 DOI: 10.1007/s00784-012-0758-5] [Citation(s) in RCA: 154] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 05/14/2012] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The objective of this paper is to examine the effect of alveolar ridge preservation (ARP) compared to unassisted socket healing. METHODS Systematic review with electronic and hand search was performed. Randomised controlled trials (RCT), controlled clinical trials (CCT) and prospective cohort studies were eligible. RESULTS Eight RCTs and six CCTs were identified. Clinical heterogeneity did not allow for meta-analysis. Average change in clinical alveolar ridge (AR) width varied between -1.0 and -3.5 ± 2.7 mm in ARP groups and between -2.5 and -4.6 ± 0.3 mm in the controls, resulting in statistically significantly smaller reduction in the ARP groups in five out of seven studies. Mean change in clinical AR height varied between +1.3 ± 2.0 and -0.7 ± 1.4 mm in the ARP groups and between -0.8 ± 1.6 and -3.6 ± 1.5 mm in the controls. Height reduction in the ARP groups was statistically significantly less in six out of eight studies. Histological analysis indicated various degrees of new bone formation in both groups. Some graft interfered with the healing. Two out of eight studies reported statistically significantly more trabecular bone formation in the ARP group. No superiority of one technique for ARP could be identified; however, in certain cases guided bone regeneration was most effective. Statistically, significantly less augmentation at implant placement was needed in the ARP group in three out of four studies. The strength of evidence was moderate to low. CONCLUSIONS Post-extraction resorption of the AR might be limited, but cannot be eliminated by ARP, which at histological level does not always promote new bone formation. RCTs with unassisted socket healing and implant placement in the ARP studies are needed to support clinical decision making. CLINICAL RELEVANCE This systematic review reports not only on the clinical and radiographic outcomes, but also evaluates the histological appearance of the socket, along with site specific factors, patient-reported outcomes, feasibility of implant placement and strength of evidence, which will facilitate the decision making process in the clinical practice.
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