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Moreira-Souza L, Pelai EB, Bigaton DR, Freitas DQ, Oenning ACC, Asprino L. Is there a relationship between the presence of external root resorption in second molars adjacent to impacted mandibular third molars with awake bruxism and masticatory muscle activity? Clin Oral Investig 2024; 28:401. [PMID: 38940883 DOI: 10.1007/s00784-024-05775-3] [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: 08/23/2023] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.
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Affiliation(s)
- Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Elisa Bizetti Pelai
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Delaine Rodrigues Bigaton
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | | | - Luciana Asprino
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
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Alqahtani KA, Jacobs R, Da Costa Senior O, Politis C, Shaheen E. Recommendations to minimize tooth root remodeling in patients undergoing maxillary osteotomies. Sci Rep 2024; 14:13686. [PMID: 38871741 DOI: 10.1038/s41598-024-62059-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
The purpose of this study was to report root remodeling/resorption percentages of maxillary teeth following the different maxillary osteotomies; i.e. one-piece, two-pieces, three-pieces Le Fort I, surgically assisted rapid palatal expansion (SARPE). The possibility of relationships between root remodeling and various patient- and/or treatment-related factors were further investigated. A total of 110 patients (1075 teeth) who underwent combined orthodontic and orthognathic surgery were studied retrospectively. The sample size was divided into: 30 patients in one-piece Le Fort I group, 30 patients in multi-pieces Le Fort I group, 20 patients in SARPE group and 30 patients in orthodontic group. Preoperative and 1 year postoperative cone beam computed tomography (CBCT) scans were obtained. A validated and automated method for evaluating root remodeling and resorption in three dimensions (3D) was applied. SARPE group showed the highest percentage of root remodeling. Spearman correlation coefficient revealed a positive relationship between maxillary advancement and root remodeling, with more advancement contributing to more root remodeling. On the other hand, the orthodontic group showed a negative correlation with age indicating increased root remodeling in younger patients. Based on the reported results of linear, volumetric and morphological changes of the root after 1 year, clinical recommendations were provided in the form of decision tree flowchart and tables. These recommendations can serve as a valuable resource for surgeons in estimating and managing root remodeling and resorption associated with different maxillary surgical techniques.
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Affiliation(s)
- Khalid Ayidh Alqahtani
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Oliver Da Costa Senior
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Pereira SA, Corte-Real A, Melo A, Magalhães L, Lavado N, Santos JM. Diagnostic Accuracy of Cone Beam Computed Tomography and Periapical Radiography for Detecting Apical Root Resorption in Retention Phase of Orthodontic Patients: A Cross-Sectional Study. J Clin Med 2024; 13:1248. [PMID: 38592063 PMCID: PMC10932007 DOI: 10.3390/jcm13051248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Objectives: This clinical study aimed to evaluate and compare the diagnostic accuracy of intraoral periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting external apical root resorption (EARR) in orthodontic patients during the retention phase. Methods: The research involved 41 Caucasian patients who had undergone comprehensive orthodontic treatment, with a total of 328 teeth analyzed. The Kappa values for inter- and intra-examiner agreement were high for both PR and CBCT, indicating a robust level of agreement among examiners. The study used a four-point scale for classifying EARR. Results: This study showed comparable accuracy, sensitivity, and specificity between PR and CBCT when using the most stringent criterion of "Definitely present". The data suggested that CBCT outperformed PR when using a less stringent criterion ("Definitely present" or "Probably present"), particularly for maxillary incisors. However, overall diagnostic performance, as measured by the area under the ROC curve, showed only a slight advantage for CBCT over PR. Areas under the ROC curve range between 0.85 and 0.90 for PR and between 0.89 and 0.92 for CBCT. According to DeLong's test, there is no evidence to conclude that the area under the ROC curve is different for PR and CBCT. Conclusions: Both PR and CBCT are accurate diagnostic tools for identifying EARR, with PR being deemed more suitable for routine clinical use due to its cost-effectiveness and lower radiation exposure. The findings emphasize the importance of considering the risk-benefit ratio when deciding on imaging modalities for monitoring EARR in orthodontic patients.
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Affiliation(s)
- Sónia A. Pereira
- Institute of Orthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
| | - Ana Corte-Real
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
- Forensic Dentistry Laboratory, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Ana Melo
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (A.M.); (L.M.)
| | - Linda Magalhães
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (A.M.); (L.M.)
| | - Nuno Lavado
- Coimbra Institute of Engineering, Polytechnic Institute of Coimbra, 3030-199 Coimbra, Portugal;
- Research Centre in Asset Management and System Engineering (RCM2+), Polytechnic Institute of Coimbra, 3030-199 Coimbra, Portugal
| | - João Miguel Santos
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Hermann L, Nørholt SE, Wenzel A, Taneja P, Matzen LH. Does cone beam CT change the treatment decision for maxillary second and third molars? A prospective study. Dentomaxillofac Radiol 2023; 52:20230128. [PMID: 37641963 PMCID: PMC10552123 DOI: 10.1259/dmfr.20230128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES To evaluate whether information from CBCT changes the treatment plan for maxillary second and third molars and to examine clinical and radiographic parameters with an impact on treatment decision. METHODS This prospective study included 260 maxillary third molars with superimposition onto the second molar in panoramic images (170 patients; mean age 28 years, range 16-63). An initial treatment plan was based on clinical findings and panoramic images. After CBCT, a final treatment plan was decided. Treatment was undertaken based on the final treatment plan. Through logistic regression analyses, impact of clinical and radiographic parameters on change in treatment plan, removal of the third molar vs no treatment, and removal of the second vs third molar were evaluated. RESULTS The treatment plan changed in 82 cases (32%). Sixteen cases (6%) changed from removal of the third molar to removal of the second molar. Regression analyses showed that severe resorption in the second molar was significantly related to a change in treatment plan. Removal of a third molar was decided in 180 cases and regression analyses identified that mesioangulation of the third molar, marginal bone loss, superficial resorption, and age were significantly related to removal of the third molar vs no treatment. Thirty second molars were removed, and regression analyses showed that severe resorption was significantly related to removal of the second molar instead of the third molar. CONCLUSIONS Parameters such as resorption evaluated in CBCT can modify the treatment decision, resulting in removal of the second and/or the third molar.
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Affiliation(s)
- Louise Hermann
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | | | - Ann Wenzel
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Pankaj Taneja
- Section for Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Louise Hauge Matzen
- Section for Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Chen Y, Dai Y, Yan Z, You Y, Wu B, Lu B. Morphological analysis of anterior permanent dentition in a Chinese population using cone-beam computed tomography. Head Face Med 2023; 19:12. [PMID: 36959644 PMCID: PMC10037846 DOI: 10.1186/s13005-023-00357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
PURPOSE Morphological analysis of permanent anterior dentition is essential for achieving an ideal treatment outcome and avoiding unnecessary failure. This study aimed to analyze the morphologies of anterior teeth in the Chinese population in depth. METHODS In this retrospective study, 4309 anterior teeth from 401 Chinese patients were investigated using cone-beam computed tomography (CBCT) from 2019-2021. We summarized the morphological characteristics of the anterior teeth in terms of the root length, cementoenamel junction curvature (CEJ-C), root furcation and canal variations. RESULTS We found that the root lengths of the maxillary anterior incisors were similar (13.3 mm), while the root lengths of the mandibular central (12.2 mm) and lateral incisors (13.4 mm) varied significantly (p < .0001). Both the maxillary (16.6 mm) and mandibular canines (15.5 mm) were found to have greater root lengths than the corresponding incisors (p < .0001). The CEJ-C was significantly greater around incisors (2.5 mm) than around the canines (2.0 mm) in the maxilla (p < .0001), while the curvature remained similar in mandibular anterior teeth (1.8 mm). Root furcation was observed in mandibular canines and lateral incisors. Moreover, all types of Vertucci's classification in anterior dentitions were observed, while two other new types were found. Among them, the maxilla was only observed to exhibit types I, II, III, and ST II, while the mandible was found to exhibit almost all types. However, Type I still accounts for the majority of dentitions. CONCLUSIONS Morphological analysis of permanent anterior dentition revealed diversity in the tooth length, CEJ-C, furcation proportion, and canal variations. In general, mandibular anterior teeth showed a more complex structure than maxillary teeth.
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Affiliation(s)
- Yu Chen
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Yu Dai
- Department of Dentistry, Shenzhen People’s Hospital, Shenzhen, 518020 Guangdong China
| | - Zhengbin Yan
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Yuehua You
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Bin Wu
- Department of Dentistry, People’s Hospital of Longhua, Shenzhen, 518109 Guangdong China
| | - Bingtai Lu
- Medical Research Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong 510080 Guangzhou, China
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Alqahtani KA, Jacobs R, Shujaat S, Politis C, Shaheen E. Automated three-dimensional quantification of external root resorption following combined orthodontic-orthognathic surgical treatment. A validation study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101289. [PMID: 36122841 DOI: 10.1016/j.jormas.2022.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Three-dimensional (3D) quantitative assessment of external root resorption (ERR) following combined orthodontic-orthognathic surgical treatment is vital for ensuring an optimal long-term tooth prognosis. In this era, lack of evidence exists applying automated 3D approaches for assessing ERR. Therefore, this study aimed to validate a protocol for 3D quantification of ERR on cone-beam computed tomography (CBCT) images following combined orthodontic-orthognathic surgical treatment. MATERIAL AND METHODS Twenty patients who underwent combined orthodontic-orthognathic surgical treatment were recruited. Each patient had CBCT scans acquired with NewTom VGi evo (NewTom) at three time-points i.e., 4-weeks prior to surgery (T0), 1-week (T1) and 1-year after surgery (T2). Patients were divided into two groups, group A (surgical Le Fort I osteotomy group: 10 patients) and group B (orthodontic group without maxillary surgical intervention: 10 patients). Root resorption was assessed by measuring length and volumetric changes of maxillary premolar to premolar teeth (central and lateral incisors, canines, 1st and 2nd premolars= 10 teeth) at T0-T1 and T0-T2 time intervals in both groups. The protocol consisted of convolutional neural network based segmentation followed by surface-based superimposition and automated 3D analysis. RESULTS The intra-observer intra-class correlation coefficient (ICC) was found to be excellent (1.0) with an average error of 0 mm and 0 mm3 for assessing root length and volume, respectively. The entire protocol took 56.8 ± 7 s for quantifying ERR. Both group of patients showed negligible changes in length and volumetric ratio at T0-T1 time-interval. Furthermore, group A had lower ERR ratio with decreased root volume and length compared to group B at T0-T2 time-interval. CONCLUSIONS The proposed protocol was found to be time efficient, accurate and reliable for 3D quantification of ERR on CBCT images. It could act as a viable automated option for assessing ERR. CLINICAL SIGNIFICANCE The automated protocol could provide a time efficient method to allow a reliable and accurate 3D follow up root resorption after orthognathic and orthodontic treatment procedures. These new insights could allow clinicians to implement strategies for minimizing the risk of root resorption and to further enhance treatment predictability.
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Affiliation(s)
- Khalid Ayidh Alqahtani
- OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia.
| | - Reinhilde Jacobs
- OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sohaib Shujaat
- OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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