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Adames C, Gaêta-Araujo H, Franco A, Soares MQS, Junqueira JLC, Oenning AC. Influence of CBCT-derived panoramic curve variability in the measurements for dental implant planning. Oral Radiol 2024; 40:30-36. [PMID: 37540349 DOI: 10.1007/s11282-023-00703-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. METHODS Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. RESULTS The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68-100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). CONCLUSION Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning.
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Affiliation(s)
- Cyntia Adames
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Hugo Gaêta-Araujo
- Division of Oral Radiology, School of Dentistry, University of São Paulo (FORP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Ademir Franco
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil.
| | - Mariana Quirino Silveira Soares
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, R. Dr. José Rocha Junqueira 13, Ponte Preta, Campinas, Campinas, SP, 13045-755, Brazil
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Gao J, Li X, He J, Jiang L, Zhao B. The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis. Front Bioeng Biotechnol 2022; 10:928656. [PMID: 36105608 PMCID: PMC9465293 DOI: 10.3389/fbioe.2022.928656] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Investigating the biomechanical effects of mandibular flexure (MF) on the design of implant-supported fixed restorations in edentulous jaws of different facial types. Methods: Three-dimensional finite element models were established to analyze mandibular displacement and stress distribution of implant-supported fixed restorations (four or six implants, different implant numbers and sites, and the design of the superstructure across the dental arch in one or two or three pieces, under the loading conditions of maximum opening or right unilateral molar occlusion) in mandibular edentulous patients of three different facial types (brachyfacial, mesofacial, and dolichofacial types). Results: The brachyfacial type presented higher mandibular flexure and stress in the overall restorative system, followed by the mesofacial and dolichofacial types. During jaw opening and occlusal movements, the one-piece framework showed the lowest bone stress values surrounding the anterior implants and gradually increased to the distal position, and the three-piece framework showed the highest stress values for peri-implant bones. Also, the split framework could greatly increase the stress on abutments and frameworks. Moreover, fixed implant prostheses with cantilevers can generate high amounts of biomechanical stress and strain on implants and surrounding bones. The bone surrounding the anterior implant increased in stress values as the most distal implants were more distally located regardless of frameworks. The zirconia framework demonstrated higher stresses than the titanium framework. Conclusion: The design of edentulous fixed implant-supported restorations can be optimized for facial types. For patients of the brachyfacial type or with high masticatory muscle strength, the non-segmented framework without a cantilever provides an optimal biomechanical environment.
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Affiliation(s)
- Jing Gao
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
| | - Xuejing Li
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, School and Hospital of Stomatology, Tongji University, Shanghai, China
| | - Jing He
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
| | - Lulu Jiang
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Lulu Jiang, ; Baohong Zhao,
| | - Baohong Zhao
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Lulu Jiang, ; Baohong Zhao,
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Tavares A, Braga E, Neves FS. Influence of the palatal plane cant and skeletal patterns in the hard palate thickness? Orthod Craniofac Res 2022; 26:224-230. [PMID: 36047667 DOI: 10.1111/ocr.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/27/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of the present study was to evaluate the thickness of the hard palate at the different angles formed by the palatal plane and the Frankfort horizontal line using computed tomography in patients with different facial patterns for planning the installation of MARPE. MATERIALS AND METHODS The measurements were analysed in the hard palate of 106 patients. Four regions were selected passing through the mesial face, tangent at the level of the cemento-enamel junction of the premolars and molars. The bone thickness was measured from the floor of the nasal cavity to the cortical bone of the hard palate, 02 measurements with a distance of 05 mm between them (2.5 mm on each side starting from the midsagittal line) and 2 more with a distance of 7 mm between measurements (3.5 mm on each side starting from the midsagittal line). The palatal plane cant was determined based on the palatal plane and the Frankfort horizontal plane. The sagittal skeletal pattern was determined based on the ANB angle and the vertical skeletal pattern based on the SN.Go.Gn angle. RESULTS Palatal bone thickness was greater in males than in females. Regarding the sagittal skeletal pattern, patients with Class II were found to have a thinner hard palate than Class I and Class III patients. No difference in the vertical skeletal pattern was observed between groups. Regarding the palatal plane cant, bone thickness was greater in patients with clockwise rotation. CONCLUSIONS Careful planning should be considered in the case of female patients; patients with greater angles of the palatal plane cant and Class II patients have a smaller bone thickness.
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Affiliation(s)
- Alana Tavares
- Program in Dentistry and Health School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
- Avenida Alphaville, 635, apt 1103, Alphaville Salvador 1 Salvador /Bahia Brazil
| | - Emanuel Braga
- Department of Orthodontics School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
| | - Frederico Sampaio Neves
- Division of Dentomaxillofacial Radiology School of Dentistry, Federal University of Bahia, Ufba Salvador Brazil
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Gu Y, Yan C, Yan Z, Wang X, Yue L, Li L. Evaluation of the clinical efficacy and safety of modified alveolar cleft bone graft with cone-beam CT digital imaging in children. Transl Pediatr 2022; 11:1140-1148. [PMID: 35958001 PMCID: PMC9360813 DOI: 10.21037/tp-22-214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cone-beam computed tomography (CBCT) is used to observe the bone density and bone height in children with modified alveolar bone graft (ABG) at different times after operation. In this study, the changes of labial-palatal bone mass in the stable period of bone union and in the bone graft area were investigated to provide reference for subsequent treatment. METHODS A total of 140 pediatric patients with unilateral complete alveolar cleft were selected and routinely underwent iliac bone grafting. The original data obtained by ProMax 3D (Planmeca) examination were stored in DICOM format at 3 and 6 months postoperatively, and the images were reconstructed by Simplant software (Dentsply Sirona). The bone density of the healthy side was measured at 3 months and 6 months, and the results were expressed as Hounsfield units (HU). The labial and palatal bone height at the bone graft site at 3 and 6 months postoperatively was classified according to the modified Bergland classification method, and was compared with panoramic film classification. RESULTS Mean bone density at 3 months after surgery (385.4800±78.39770 HU) was not significantly different from that at 6 months (356.1875±73.67164 HU; P>0.05). There were significant differences between the classification of lip and palatal bone height 3 months after operation and that of the classification of panorama film in the same month (P<0.05); between the classification of lip and palatal bone height 6 months after surgery compared with that of panorama film of the same month (P<0.05); and between the classification of bone height degree in labial, palatal, and panoramic slices at 3 months after operation and that at 6 months after operation (P<0.05). CONCLUSIONS The labial and palatal classification is different, and the bone height classification 6 months after surgery is lower than that 3 months after surgery, indicating the persistence of bone resorption. CBCT can objectively evaluate the bone quality in the bone graft area, which has clinical application value for surgical evaluation value and posttreatment guidance.
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Affiliation(s)
- Yueguang Gu
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Chaoting Yan
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Zhongyi Yan
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaochen Wang
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Li Yue
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Lei Li
- Department of Stomatology, The First People's Hospital of Lianyungang, Lianyungang, China
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Does the angulation between the maxillary central incisors and the nasopalatine canal differ among sagittal and vertical skeletal patterns? A CBCT study. Int Orthod 2022; 20:100636. [DOI: 10.1016/j.ortho.2022.100636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/20/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2022]
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Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
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The influence of facial types on the morphology and location of the greater palatine foramen: a CBCT study. Oral Radiol 2021; 38:337-343. [PMID: 34409547 DOI: 10.1007/s11282-021-00563-1] [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: 04/03/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to assess the morphology and location of the great palatine foramen (GPF) of different facial types using cone beam computed tomography (CBCT) scans. METHODS Sixty CBCT scans were divided into: brachyfacial (n = 20), dolichofacial (n = 20) and mesofacial (n = 20) using Ricketts' VERT index for the determination of cephalometric facial type and imported into ImageJ software. GPF shape was characterized as: round, elongated in the anteroposterior direction (EAP), or elongated in the latero-medial direction (ELM). The distances between the GPF and the palatine suture (PS), the center of the GPF and the center incisive foramen (IF), the GPF and the palatine alveolar ridge (PAR), right side GPF (GPFr) and left side (GPFl) GPFs; and the angles formed from the intersection of the GPF, IF and PS were assessed. The position of the GPF was evaluated in relation to the molars. RESULTS GPFr and GPFl mean distances from PAR presented higher values for dolichofacial patients (p < 0.05). GPFr and GPFl location distally to the third molar (3 M) was higher for brachyfacial type, while their location distally to the second molar was higher for mesofacial and between the mesial and distal surfaces of the 3 M for dolichofacial (p < 0.05). CONCLUSIONS The GPF was more distant from the PAR in the dolichofacial-type group. The location of the GPF in relation to the molars varied according to the facial type. However, the morphology of the GPF was similar in the three facial types, and the elongated in the anteroposterior direction morphology was more frequent.
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Costa ED, de Oliveira Reis L, Gaêta-Araujo H, Martins LAC, Oliveira-Santos C, Freitas DQ. Comparison of distance of upper central incisor root and incisive canal in different sagittal and vertical skeletal patterns and sex: A retrospective CBCT study. Int Orthod 2021; 19:462-470. [PMID: 34312102 DOI: 10.1016/j.ortho.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION To evaluate the influence of sagittal and vertical skeletal patterns (skeletal classes and facial profiles), and sex on the distance between upper central incisors roots and incisive canal. MATERIAL AND METHODS Cone-beam computed tomography exams of 172 patients were classified into skeletal classes I, II, and III and according to the facial profile into mesofacial, brachyfacial, and dolichofacial. In sagittal reconstructions, linear measurements were done between central incisors roots and incisive canal at three levels: incisive foramen opening, intermediate region, and the region close to the apex of upper central incisors. In axial reconstructions, measurements of incisive canal width and distance between the roots were obtained. Analysis of Variance (three-way ANOVA) was used to evaluate measurement differences in relation to skeletal classes, facial profiles, and sex. RESULTS The distance between upper central incisors roots and incisive canal anterior region was little influenced by sagittal and vertical skeletal patterns and sex. Men had significantly greater incisive canal (mean=2.85mm; SD=1.18) width compared to women (mean=2.40mm; SD=1.04), regardless of skeletal class and facial profile (P<0.05). In general, inter-root distance between medial points of central incisors roots and incisive canal opening was greater in the region close to upper central incisors apex (mean=3.84mm; SD=1.44) than in incisive foramen opening (2.44mm; SD=1.04), (P<0.05). CONCLUSIONS The distance between upper central incisors roots and incisive canal is little influenced by sagittal and vertical skeletal patterns and sex.
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Affiliation(s)
- Eliana Dantas Costa
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil.
| | - Larissa de Oliveira Reis
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Hugo Gaêta-Araujo
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Luciano Augusto Cano Martins
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Christiano Oliveira-Santos
- University of São Paulo, Ribeirão Preto, Public Health and Forensic Dentistry, Department of Stomatology, Division of Oral Radiology, School of Dentistry of Ribeirão Preto, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
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