1
|
Akbulut S, Bayrak S. Evaluation´ of mandibular alveolar bone in patients with different vertical facial patterns : A cross-sectional CBCT study. J Orofac Orthop 2024; 85:89-97. [PMID: 35788398 DOI: 10.1007/s00056-022-00408-4] [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: 08/26/2021] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The study aimed to investigate the morphological and structural differences of mandibular alveolar bone between different vertical facial patterns (VFP). METHODS In all, 66 CBCT scans of patients were selected for the study: 24 were designated as hyperdivergent, 25 as normodivergent, and 17 as hypodivergent. Fractal values of the interdental alveolus were measured at the incisor, canine, premolar, and molar regions. The minimum trabecular bone width (MTBW) of the alveolus, the buccal and lingual cortical bone thicknesses, and the total alveolar width (AW) at the minimum trabecular bone level were measured. One-way analysis of variance and Tukey test were used to compare the groups. The correlations between FMA (Frankfurt mandibular plane angle) and other measurements were analyzed by Pearson analysis. RESULTS No significant differences were detected in fractal values and buccal and lingual cortical bone thicknesses between the groups. The MTBW and AW of the hypodivergent individuals were found to be higher in the anterior and premolar interdental sites. FMA was found to be significantly correlated with MTBW and AW. CONCLUSIONS The patients with different VFPs did not exhibit significant differences in the trabecular complexity of the mandibular alveolus. Hypodivergent patients tend to have thicker trabecular and alveolar bone widths than normodivergent and hyperdivergent individuals.
Collapse
Affiliation(s)
- Sibel Akbulut
- Faculty of Dentistry, Department of Orthodontics, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Seval Bayrak
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| |
Collapse
|
2
|
Wen C, Zhang Q. Pilot study of fractal dimension analysis of osteogenesis for bone substitute materials of Bio-Oss in lateral sinus augmentation. PLoS One 2023; 18:e0296248. [PMID: 38157335 PMCID: PMC10756558 DOI: 10.1371/journal.pone.0296248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Fractal dimension (FD) analysis has been proposed and validated in osseointegration-related research. The aim of this study was to evaluate the feasibility of FD analysis in the osteogenesis detection of bone substitute materials (BSMs) of Bio-Oss in maxillary lateral sinus augmentation. METHODS Patients who received lateral maxillary sinus augmentation and underwent grafting with BSMs (Bio-Oss) were included in the study. The cross sections of the BSMs under cone-beam computed tomography (CBCT) at mesial, distal, and sagittal directions were obtained immediately after the graft (T0) and 6 months later (T1), and the obtained images were cropped to include only the BSMs. The FD analysis was performed, and the FD value was obtained by the method of box-counting. Paired t-tests and analysis of variance (ANOVA) were used, and p-values <0.05 was considered statistically significant. RESULTS Twelve participants with 22 implants, which were inserted simultaneously after sinus augmentation, were included in this study. A total of 22 mesial, 22 distal, and 14 sagittal images were obtained after FD analysis. The mean FD value and standard deviation at T0 was 1.2860 ± 0.0896, while at T1, it was 1.2508±0.1023; thus, significant differences were detected (p = 0.022). However, the increasing or decreasing trend of FD value was not stable, and no significant difference was detected for FD values of mesial, distal, and sagittal images between T0 and T1. ANOVA indicated that no significant difference was detected among the FD values of mesial, distal, and sagittal images at any timepoint. Differences in FD values between the sexes were not significant either. CONCLUSIONS Since the FD analysis for the osteogenesis detection of BSMs in maxillary sinus augmentation indicated unstable trends of change, its feasibility is not reliable. The initially rough surface, self-degradation, and volume change of the BSMs during osteogenesis may be the reason for the variation in FD values.
Collapse
Affiliation(s)
- Cai Wen
- Department of Oral Implantology, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Department of VIP Dental Service, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
| | - Qing Zhang
- Department of Nosocomial Infection Control, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| |
Collapse
|
3
|
Çoban G, Öztürk T, Bilge S, Canger EM, Demirbaş AE. Evaluation of trabecular changes following advancement genioplasty combined with or without bilateral sagittal split osteotomy by fractal analysis: a retrospective cohort study. BMC Oral Health 2023; 23:160. [PMID: 36934234 PMCID: PMC10024858 DOI: 10.1186/s12903-023-02860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/06/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND It is aimed to investigate whether there was a difference in radiographic changes in the operational areas between genioplasty alone and genioplasty combined with mandibular advancement and to evaluate the fractal dimension (FD) to assess trabecular changes after genioplasty surgery. METHODS Preoperative-(T0) and postoperative-(T1) panoramic radiographs of 26 patients without any complications who underwent genioplasty combined with bilateral sagittal osteotomy and mandibular advancement or genioplasty alone were selected. In the panoramic radiographs of both groups, the genial segment, mandibular angulus, and surgical osteotomy line were examined using FD. The box-counting method was used for FD evaluation. RESULTS It was determined that FD values before and after treatment were similar in both groups for all regions where measurements were made. After surgery, the FD values of the middle region of the genial segment were found to be significantly lower than the other regions. At T1, the FD values at the osteotomy area were found to be significantly higher than those in the middle region of the genial segment. CONCLUSION Trabecular structure does not differ in patients undergoing genioplasty alone or in combination with mandibular advancement osteotomy. The middle region of the genial segment heals later than other regions.
Collapse
Affiliation(s)
- Gökhan Çoban
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Taner Öztürk
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye.
| | - Süheyb Bilge
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Emin Murat Canger
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| |
Collapse
|
4
|
Muacevic A, Adler JR, Satwalekar P, Nalla S, Basany RB, Sai Krishna S. Reliability of Using Texture Analysis of Periapical Radiographs Obtained Using Radiovisiography for Assessing Bone Quality in Dental Implant Planning: A Cross-Sectional Study. Cureus 2022; 14:e32860. [PMID: 36694502 PMCID: PMC9867846 DOI: 10.7759/cureus.32860] [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: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background Pre-prosthetic implant radiographic imaging helps in the quantitative and qualitative analysis of the bone structure and also enables the evaluation of the relationship between critical structures and potential implant sites. Purpose The aim of the study was to define the reliability of utilizing the analysis of textures from the periapical radiographic images obtained through Radiovisiography (RVG) in order to better plan for dental implantations. Methods A cross-sectional study was conducted using 50 intraoral periapical radiographs which were obtained through RVG performed prior to the placement of implants. The radiographs were segregated based on anatomical locations i.e. 12 for the anterior maxilla, nine for the posterior maxilla, seven for the anterior mandible, and 22 for the posterior mandible. Each of the radiographs was visually assessed by four experienced examiners, namely a Prosthodontist E1, Periodontist E2, Oral surgeon E3, and Oral radiologist E4, which was then compared to an experienced operator's tactile perception during a pilot drill for implant placement. As a reference, the Lekholm and Zarb classification was provided to all the examiners for them to qualitatively assess the bone structure in the radiographs. Results The examiners' results were correlated with the assessment provided by the experienced operator. E1 and E4 successfully assessed 42% of the radiographs while E2 had the least success with only 26%. Of the 12 anterior maxillary radiographs, only eight were accurately assessed by E1. With respect to the posterior maxilla, all examiners correctly assessed four radiographs each. Of the seven anterior mandibular radiographs, except for E2, the rest correctly assessed three radiographs each. Of the 22 posterior mandibular radiographs, only nine were accurately assessed by E4. Conclusion Intraoral periapical radiographs obtained through RVG did not meet the desired parameters for assessing the bone quality during the planning stage for implants.
Collapse
|
5
|
Mishra S, Kumar M, Mishra L, Mohanty R, Nayak R, Das AC, Mishra S, Panda S, Lapinska B. Fractal Dimension as a Tool for Assessment of Dental Implant Stability-A Scoping Review. J Clin Med 2022; 11:4051. [PMID: 35887815 PMCID: PMC9319468 DOI: 10.3390/jcm11144051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/05/2023] Open
Abstract
A lot of modalities for assessing implant stability are available for clinicians, but they fail to assess trabecular changes as they are solely dependent on the operator's skills. The use of Fractal Dimension (FD) has evolved to be used as a measure for trabecular changes depicting implant stability before and after implant placement. The objective of this systematic review was to qualitatively analyse the available scientific literature describing the use of FD as a tool to measure implant stability on the basis of trabecular changes. An electronic search in PubMed, Web of Science and Scopus was carried out using relevant keywords, such as: fractal dimension; fractal analysis; dental implants; implant stability; osseointegration, etc. Studies reporting the use of FD as a tool to measure implant stability were included and subjected to qualitative analysis using ROBINS-I and Cochrane risk of bias assessment criteria. Fourteen studies were included in this review. Results showed that FD was found to be used solely as a measure of implant stability in seven studies, out of which six studies showed an increment in FD values. The majority of studies concluded with a statistical correlation between FD and respective other assessment methods used. FD may not serve as a sole indicator of implant stability; however, it can be used as an adjunct to conventional methods along with additional fractal factors.
Collapse
Affiliation(s)
- Sukanya Mishra
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Manoj Kumar
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India;
| | - Rinkee Mohanty
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Rashmita Nayak
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Abhaya Chandra Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Sambhab Mishra
- Department of General Surgery, SCB Medical College and Hospital, Mangalabagh, Cuttack 753007, Odisha, India;
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.M.); (R.M.); (R.N.); (A.C.D.); (S.P.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
| |
Collapse
|
6
|
Öztürk K, Kış HC. Peri-implant bone microstructural analysis and comparison of resonance frequency analysis before prosthetic placement: a retrospective study. Clin Oral Investig 2022; 26:4967-4975. [PMID: 35314891 PMCID: PMC8938162 DOI: 10.1007/s00784-022-04464-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
Objectives Fractal analysis is a mathematical method used for the calculation of bone trabeculation and lacunarity. This study aims to evaluate the relationship between resonance frequency analysis (RFA) and fractal dimension (FD) of peri-implant bone to determine the preload stability of implants. Materials and methods In this study, the results of the fractal analysis calculated from the resonance frequency analysis results taken in the 3rd month of the patients who underwent 2-stage implant by the same doctor and the radiographs taken in the same session were evaluated. A hundred implants in 20 patients were applied in this study. The implant stability quotient (ISQ) values of the implants and fractal dimension values of the peri-implant bone were calculated. Results The findings showed that the ISQ1 (p = 0.008), ISQ2 (p = 0.038), ROI2 (p = 0.013), and ROI3 (p < 0.001) values were statistically significantly higher in men than women. The ISQ1 (p = 0.003), ISQ2 (p = 0.013), ROI1 (p = 0.011), and ROI3 (p < 0.001) of the mandible were statistically higher than the maxilla. The fractal dimension cut-off value to assess prosthetic loading was found 1.198. Conclusion Fractal analysis is a non-invasive method that can be used in conjunction with clinical examination in the prosthetic loading decision of implants. It is a valuable parameter that can be used without the need for an extra device when it is necessary to reduce the clinical study time. Clinical relevance Calculating the fractal dimension of the peri-implant bone is a practical, economical, and applicable method for clinicians. FD calculated from panoramic radiographs used for diagnosis in routine treatments in clinics where access to the necessary devices for ISQ measurement is not available will contribute to clinical practice. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-022-04464-3.
Collapse
Affiliation(s)
- Kübra Öztürk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
| | - Hatice Cansu Kış
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| |
Collapse
|
7
|
Karadag I, Yilmaz HG. Evaluation of change in trabecular bone structure surrounding dental implants by fractal dimension analysis and comparison with radiomorphometric indicators: a retrospective study. PeerJ 2022; 10:e13145. [PMID: 35341061 PMCID: PMC8953503 DOI: 10.7717/peerj.13145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/01/2022] [Indexed: 01/12/2023] Open
Abstract
Background The trabecular bone surrounding dental implant show some structural changes during healing period. The purpose of this study is to observe the change in trabecular bone with fractal dimensional analysis from baseline to 3rd month of implant placement. It was also aimed to determine the correlation of fractal dimension (FD) change with morphometric indices, mandibular cortical index (MCI) and mandibular cortical width (MCW). Methods Digital panoramic radiographs taken from 14 patients were evaluated in this study. A total of 30 implants which were placed on mandibular premolar or molar region were included. MCI and MCW assessments were made on baseline radiograph and FD were analyzed on baseline and 3rd month radiograph. FD change by time was recorded separately for every ROI. A paired sample t-test was used to evaluate the change between FD-baseline and FD-3rdmonth values. One-way ANOVA was used to determine the relationship between FD change and MCI. FD change and MCW measurements correlation was calculated by Pearson correlation analysis. Results FD value increased in 75 of 90 implant-adjacent regions evaluated in the 3rd month and it was observed that the FD values were statistically significantly increased in the mesial, distal and apical regions at the 3rd month measurements. There was no statistically significant relationship between mean FD change and MCI, and there was no correlation between mean FD change and MCW value. Discussion There are many studies evaluating the resorptive changes in bone. However, there are few studies investigating whether there is a correlation between pre- and post-operative trabecular pattern with MCI and MCW. The results of this study indicate that the implants have an improving effect on bone trabeculation in the region where they are placed.
Collapse
Affiliation(s)
- Ilkim Karadag
- Faculty of Dentistry Department of Periodontology, Ankara University, Ankara, Turkey
| | - Hasan Guney Yilmaz
- Faculty of Dentistry Department of Periodontology, Near East University (Cyprus), Mersin, Turkey
| |
Collapse
|
8
|
Magat G, Oncu E, Ozcan S, Orhan K. Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis. J Korean Assoc Oral Maxillofac Surg 2022; 48:41-49. [PMID: 35221306 PMCID: PMC8890962 DOI: 10.5125/jkaoms.2022.48.1.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative. Materials and Methods In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants. Results There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05). Conclusion The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.
Collapse
Affiliation(s)
- Guldane Magat
- Department of Oral and Maxillofacial Radiology, Konya, Turkey
| | - Elif Oncu
- Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Sevgi Ozcan
- Department of Oral and Maxillofacial Radiology, Konya, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| |
Collapse
|
9
|
Vadiati Saberi B, Khosravifard N, Nooshmand K, Dalili Kajan Z, Ghaffari ME. Fractal analysis of the trabecular bone pattern in the presence/absence of metal artifact-producing objects: Comparison of cone-beam computed tomography with panoramic and periapical radiography. Dentomaxillofac Radiol 2021; 50:20200559. [PMID: 33705225 DOI: 10.1259/dmfr.20200559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The effect of metallic objects on the fractal dimension (FD), bone area fraction (BAF) and gray scale values (GSVs) of cone-beam CT (CBCT) images was assessed. Also, FD, BAF and GSV were compared among CBCT, digital periapical and panoramic radiographies. METHODS Digital periapical and panoramic radiographs were acquired from six blocks of bovine rib. Additionally, different arrangements of titanium implants and intracanal metallic posts were created in the bone blocks and CBCT scans were taken from the different implant-root arrangements. The three radiographical modalities were compared by analysis of variance. Pairwise comparisons between the modalities were performed by the Tukey test (significance level set at 0.05). RESULTS Different root-implant arrangements in the CBCT images revealed no significant differences in the FD (p = 0.920), BAF and GSV values (p = 0.623). FD differed significantly among the three modalities (p < 0.001). Significant differences were found between CBCT and each of the periapical and panoramic techniques (p < 0.001), while no remarkable differences were observed in the FD of the periapical and panoramic images (p = 0.294). BAF and GSV showed significantly different results among the three radiographical techniques (p < 0.001). The difference was remarkable between CBCT and periapical (p < 0.001), CBCT and panoramic (p < 0.001) and periapical and panoramic (p = 0.008). CONCLUSION Presence of titanium implants and intracanal posts does not produce different results in the fractal analysis (FA) of the CBCT images. The trabecular bone pattern is best assessed by FA of the periapical radiographs followed by the panoramic and CBCT techniques, respectively.
Collapse
Affiliation(s)
- Bardia Vadiati Saberi
- Department of Periodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Department of Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Kowsar Nooshmand
- Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Department of Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ebrahim Ghaffari
- Department of Biostatistics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
10
|
Barberá-Millán J, Larrazábal-Morón C, Enciso-Ripoll JJ, Pérez-Pevida E, Chávarri-Prado D, Gómez-Adrián MD. Evaluation of the primary stability in dental implants placed in low density bone with a new drilling technique, Osseodensification: an in vitro study. Med Oral Patol Oral Cir Bucal 2021; 26:e361-e367. [PMID: 33037795 PMCID: PMC8141313 DOI: 10.4317/medoral.24231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/24/2020] [Indexed: 02/03/2023] Open
Abstract
Background Primary stability is an important key determinant of implant osseointegration. We investigated approaches to improve primary implant stability using a new drilling technique termed osseodensification (OD), which was compared with the conventional under-drilling (UD) method utilized for low-density bones.
Material and Methods We placed 55 conical internal connection implants in each group, in 30 low-density sections of pig tibia. The implants were placed using twist drill bits in both groups; groups Under Drilling (UD) and Osseodensification (OD) included bone sections subjected to conventional UD and OD drilling, respectively. Before placing the implants, we randomized the bone sections that were to receive these implants to avoid sample bias. We evaluated various primary stability parameters, such as implant insertion torque and resonance frequency analysis (RFA) measurements.
Results The results showed that compared with implants placed using the UD technique, those placed using the OD technique were associated with significantly higher primary stability. The mean insertion torque of the implants was 8.87±6.17 Ncm in group 1 (UD) and 21.72±17.14 Ncm in group 2 (OD). The mean RFA was 65.16±7.45 ISQ in group 1 (UD) and 69.75±6.79 ISQ in group 2 (OD).
Conclusions The implant insertion torque and RFA values were significantly higher in OD group than in UD. Therefore, compared with UD, OD improves primary stability in low-density bones (based on torque and RFA measurements). Key words:Osseodensification, primary stability, low density bone, RFA.
Collapse
Affiliation(s)
- J Barberá-Millán
- Department of Surgery and Oral Implantology Faculty of Medicine and Health Sciences Catholic University of Valencia Calle Quevedo nº2, 46001, Valencia, Spain
| | | | | | | | | | | |
Collapse
|
11
|
Soylu E, Coşgunarslan A, Çelebi S, Soydan D, Demirbaş AE, Demir O. Fractal analysis as a useful predictor for determining osseointegration of dental implant? A retrospective study. Int J Implant Dent 2021; 7:14. [PMID: 33629210 PMCID: PMC7904985 DOI: 10.1186/s40729-021-00296-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/25/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The present study aimed at evaluating the effectiveness of fractal analysis on determining the osseointegration of dental implants. MATERIAL AND METHODS In a single center, retrospective clinical trial, patients with dental implants in the mandibular premolar/molar region, ASA I-II and < 65-year-old patients were included. Orthopantomograph (OPG) were taken before implant surgery (t0), within a week of surgery (t1), and 1 (t2) and 2 (t3) months after surgery, respectively. Three regions of interest (ROIs) from mesial, distal, and apical sites of the implants were chosen and fractal analysis (FA) was conducted with the box-counting algorithm using White and Rudolph's method. RESULTS A total of 39 patients 19 women and 20 men, with a mean age of 52.2 years (52.3 and 52.1 years, respectively) were included. The mean, minimum and maximum values of mesial (roi1), distal (roi2), and apical (roi3) surfaces were compared. The fractal dimension (FD) values of t1 were significantly lower compared with t0 as they decreased during the first week. FD values gradually increased after the first week although never exceeded the FD values of t0. Also, difference between mean FD values of t0 and t3 were found statistically significant (p < 0.05). DISCUSSION FA is a promising and noninvasive method to predict osseointegration of a dental implant based on dental radiographs, and it can help shorten the total treatment time.
Collapse
Affiliation(s)
- Emrah Soylu
- Faculty of Dentistry Department of Oral and Maxillofacial Surgery, Erciyes University, Kayseri, Turkey
| | - Aykağan Coşgunarslan
- Faculty of Dentistry Department of Oral Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
| | - Selin Çelebi
- Faculty of Dentistry Department of Oral and Maxillofacial Surgery, Erciyes University, Kayseri, Turkey.
| | - Damla Soydan
- Faculty of Dentistry Department of Oral Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
| | - Ahmet Emin Demirbaş
- Faculty of Dentistry Department of Oral and Maxillofacial Surgery, Erciyes University, Kayseri, Turkey
| | - Osman Demir
- Faculty of Medicine Departments of Bioistatistics, Tokat Gaziosmanpaşa University, Tokat, Turkey
| |
Collapse
|
12
|
de Elío Oliveros J, Del Canto Díaz A, Del Canto Díaz M, Orea CJ, Del Canto Pingarrón M, Calvo JS. Alveolar Bone Density and Width Affect Primary Implant Stability. J ORAL IMPLANTOL 2020; 46:389-395. [PMID: 32221558 DOI: 10.1563/aaid-joi-d-19-00028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary implant stability (PIS) depends on surgical technique, implant design, and recipient bone characteristics, among other factors. Bone density (BD) can be determined in Hounsfield units (HUs) using cone beam computerized tomography (CBCT). Reliable prediction of PIS could guide treatment decisions. We assessed whether PIS was associated with recipient bone characteristics, namely, BD and alveolar ridge width (ARW), measured preoperatively by CBCT. We studied a convenience sample of 160 implants placed in 48 patients in 2016 and 2017. All underwent CBCT with a radiologic/surgical guide yielding values for ARW and BD. PIS measures used were the implant stability quotient (ISQ) from resonance frequency analysis and insertion torque (IT). IT was most influenced by the HU value at 0.5 mm outside the implant placement area, followed by the value within this area, and ISQ by the HU value at 0.5 mm outside the placement area, followed by implant placement site and apical ARW. ISQ values were significantly related to ARW in coronal (P < .05), middle (P < .01), and apical (P < .01) thirds. ISQs were higher with larger-diameter implants (P < .01). ISQ and IT were strongly correlated (P < .001). PIS in terms of ISQ and IT is positively correlated with edentulous alveolar ridge BD measured by CBCT, implying that implant stability may be predicted preoperatively. Wide alveolar ridges favored lateral PIS but did not affect rotational PIS. The most significant predictor of lateral and rotational PIS in our patients was the HU value at 0.5 mm outside the implant placement area.
Collapse
Affiliation(s)
| | | | | | - Clara Jacobo Orea
- Oral Surgery, Implantology and Periodontics, University of León, León, Spain
| | | | - Jesús Seco Calvo
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| |
Collapse
|
13
|
Ünlü Kurşun B, Akan E. Radiographic determination of trabecular bone change in 2- and 4-implant-supported overdenture prostheses. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:364-370. [PMID: 32859563 DOI: 10.1016/j.oooo.2020.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/18/2020] [Accepted: 08/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to compare the fractal dimensions (FDs) of peri-implant trabecular bone around 2-implant-supported overdentures with the FDs around 4-implant-supported overdentures at the time of implant placement (T0) and 1 year after placement (T1). STUDY DESIGN Standardized regions of interest were chosen at sites mesial and distal to 60 mandibular implants: 20 in 2-implant-supported prostheses (group 1) and 40 in 4-implant-supported prostheses (group 2), for a total of 120 measurements. FD values were calculated by using ImageJ software with the box-counting method. RESULTS The mean FD values of peri-implant bone were significantly lower at T1 than at T0 in both groups (P ≤ .001). Differences between the groups in the decrease in FD between T0 and T1 were mostly insignificant. CONCLUSIONS Within the limitations of this study, 2-implant and 4-implant-supported overdentures exhibited the same degree of reduction in peri-implant FD over time, suggesting similar risk of failure because FD is related to implant stability. Depending on the patient's residual ridge status and other factors, the 2-implant-supported overdenture may be preferred because it requires less surgery and is less costly.
Collapse
Affiliation(s)
- Begüm Ünlü Kurşun
- Research Assistant, Department of Prosthetic Dentistry, University of Katip Çelebi, Izmir, Turkey.
| | - Ender Akan
- Associate Professor, Department of Prosthetic Dentistry, University of Katip Çelebi, Izmir, Turkey
| |
Collapse
|
14
|
Lang MS, Miyamoto T, Nunn ME. Validity of fractal analysis of implants in individuals with healthy and diseased peri-implant mucosa. Clin Oral Implants Res 2020; 31:1039-1046. [PMID: 32790884 DOI: 10.1111/clr.13650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/14/2020] [Accepted: 07/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether fractal analysis could discriminate the peri-implant trabecular bone between individuals with healthy peri-implant mucosa and peri-implant disease using digital periapical radiographs. MATERIAL AND METHODS The electronic health records of patients with a dental implant were reviewed to determine their eligibility. One hundred four patients (aged 27-89 years) were included and divided into three groups. Group 1) Individuals with healthy peri-implant mucosa; Group 2) Individuals with peri-implant mucositis; or Group 3) Individuals with peri-implantitis. The following clinical measurements for each dental implant were extracted: probing depth (PD), clinical attachment level (CAL), and the presence or absence of bleeding on probing (BOP). Digital periapical images of the implant were used to calculate the fractal dimension (FD) for each implant at two regions of interest (ROI). Summary statistics were calculated for mean PD, mean CAL, mean percent BOP, and mean FD by group. Differences among groups were tested using one-way analysis of variance (ANOVA). Spearman nonparametric correlations were tabulated for mean PD, mean CAL, mean percent BOP, and mean FD. RESULTS The only measure that did not demonstrate significant differences among groups was FD (p = .559) with all other measures demonstrating a significant difference (p < .001). CONCLUSIONS Based on this study, FD of the peri-implant bone calculated from a periapical radiograph does not appear to be a valid method to distinguish between healthy and diseased implants, while clinical measures of PD, CAL, and BOP are useful for the diagnosis of peri-implant health, peri-implant mucositis, and peri-implantitis.
Collapse
Affiliation(s)
- Melissa S Lang
- Department of Periodontics, School of Dentistry, Creighton University, Omaha, NE, USA.,Private Practice, La Vista, NE, USA
| | - Takanari Miyamoto
- Department of Periodontics, School of Dentistry, Creighton University, Omaha, NE, USA.,Private Practice, La Vista, NE, USA
| | - Martha E Nunn
- Department of Periodontics, School of Dentistry, Creighton University, Omaha, NE, USA
| |
Collapse
|
15
|
Kato CN, Barra SG, Tavares NP, Amaral TM, Brasileiro CB, Mesquita RA, Abreu LG. Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol 2019; 49:20180457. [PMID: 31429597 DOI: 10.1259/dmfr.20180457] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study reviewed the use of fractal analysis (FA) in dental images. METHODS A search was performed using PubMed, MEDLINE, LILACS, Web of Science and SCOPUS databases. The inclusion criteria were human studies in the English language, with no date restriction. RESULTS 78 articles were found in which FA was applied to panoramic radiographs (34), periapical radiographs (21), bitewing radiographs (4), cephalometric radiograph (1), cone beam CT (15), micro-CT (3), sialography (2), and ultrasound (2). Low bone mineral density (21) and systemic or local diseases (22) around the bone of dental implants were the main subjects of the study of FA. Various sizes and sites of the regions of interest were used to evaluate the bone structure. Different ways were used to treat the image and to calculate FA. FA of 43 articles showed significant differences in the comparison of groups, mainly between healthy and sick patients. CONCLUSIONS FA in Dentistry has been widely applied to the study of images. Panoramic and periapical radiographs were those most frequently used. The Image J software and the box-counting method were extensively adopted in the studies reviewed herein. Further studies are encouraged to improve clarification of the parameters that directly influence FA.
Collapse
Affiliation(s)
- Camila Nao Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sâmila G Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Núbia Pk Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Tânia Mp Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia B Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
16
|
Gomes NR, Albergaria JDS, Henriques JADS, Amaral TMP, Abdo EN, Silva GAB, Brasileiro CB. Comparison between fractal analysis and radiopacity evaluation as a tool for studying repair of an osseous defect in an animal model using biomaterials. Dentomaxillofac Radiol 2019; 48:20180466. [PMID: 31295019 DOI: 10.1259/dmfr.20180466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate bone repair of an osseous defect in a rat animal model through fractal analysis and radiopacity analysis in radiographic images. METHODS 120 rats were subjected to extraction of their first molar and divided into four groups (n = 6/group) according to the material used for bone grafting: mineralized bovine bone, demineralized bovine bone (DBB), blood clot (BC - control) or Bio-Oss® (BO). The animals were sacrificed after 1, 7, 14, 21 and 49 days and subjected to radiographic evaluation. For fractal analysis (FA), a square regionof interest of 30 × 30 pixels was used, and radiopacity was measured as the mean gray scale (MGS) value for three points of 5 × 5 pixels in the apical, medial and coronal regions of the defect. Histomorphometric evaluation was realized as the gold standard for bone neo-formation and maturation of the new osseous matrix. RESULTS Histomorphometric evaluation suggested that DBB showed faster mineralized deposition and resulted in more mature bone at the final time point of evaluation. Mineralized bovine bone and Bio-Oss presented similar results. The mineralized groups did not show significant differences in bone maturation. The radiopacity analysis revealed a significant difference (p < 0.05) between the DBB and blood clot groups at the final time point. FA did not show any significant differences at the final time point. CONCLUSIONS Mean gray scale seemed to be more effective for the quantification of bone repair than FA in the demineralized group in this animal model. Results for the mineralized groups did not reveal a significant difference, leading to the conclusion that both methods are effective.
Collapse
Affiliation(s)
- Nathália R Gomes
- School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Juliano D S Albergaria
- Department of Morphology, Institute of Biological Science, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Jonathas A de S Henriques
- School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Tânia M P Amaral
- Department of Clinical, Pathology and Dental Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Evandro N Abdo
- Department of Clinical, Pathology and Dental Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Gerluza A B Silva
- Department of Morphology, Institute of Biological Science, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Cláudia Borges Brasileiro
- Department of Clinical, Pathology and Dental Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
17
|
A Comparison between the Implant Stability Quotient and the Fractal Dimension of Alveolar Bone at the Implant Site. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4357627. [PMID: 30410933 PMCID: PMC6205094 DOI: 10.1155/2018/4357627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/02/2018] [Indexed: 11/29/2022]
Abstract
Objectives Fractal analysis of the radiographic pattern of bone has been used to evaluate its quantitative properties. However, the relation between initial implant stability and quality of bone remains unclear. The objective of this study was to evaluate RFA values in relation to the fractal dimension of bone where the implant was inserted. Material and Methods A total of 50 two-stage dental implants were placed in the maxilla and mandible of 32 patients. After implant placement, an implant stability quotient (ISQ) was measured in two perpendicular planes. On intraoral digital periapical radiographs, three 35x35 pixels' regions of interest (ROIs) were chosen covering the bone adjacent to the neck (ROI 1), middle (ROI 2), and apical (ROI 3) part of the implant, respectively. For every ROI, a fractal dimension (FD) was calculated. A linear correlation, as well as a logistic regression analysis, was used to identify a possible relation between the ISQ and FD values for every ROI in the maxilla and mandible. Results The ISQ and FD values were found to be correlated at ROI 1 for the maxilla. There was no linear correlation between ISQ and FD values in any of the three ROIs in the mandible. However, logistic regression analysis showed that in ROI 1 and ROI 3 the values of FD and ISQ are statistically important and may be used to express the difference between maxilla and mandible. Conclusion The fractal dimension of alveolar bone measured from intraoral digital radiographs alone may be an insufficient parameter to determine initial implant stability.
Collapse
|
18
|
Bone Texture Fractal Dimension Analysis of Ultrasound-Treated Bone around Implant Site: A Double-Blind Clinical Trial. Int J Dent 2018; 2018:2672659. [PMID: 29849635 PMCID: PMC5925011 DOI: 10.1155/2018/2672659] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/17/2018] [Accepted: 03/19/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the efficacy of bone texture fractal dimension (FD) analysis method in predicting implant stability from intraoral periapical radiographs using two implant protocols. Materials and Methods A double-blind clinical trial was conducted on 22 subjects who needed dental implants. The participants were randomized into two groups, the control group with standard implant protocol treatment and the intervention group with added low-intensity power ultrasound treatment (LIPUS) besides the standard implant protocol. The FD values of bone density were carried out on the mesial and distal sides of the implant on digital intraoral radiographs using the box-counting method. Both resonance frequency (RF) and fractal dimension (FD) were assessed in three time intervals: after surgery and before and after loading. Results FD on both the mesial and distal sides serve as very good-to-excellent tests with high validity (ROC area exceeding 0.8) in predicting high implant stability (ISQ ≥ 70). The mesial side measurements were consistently better than the distal side among the intervention groups. The optimum cutoff value for the FD-mesial side that predicts a highly stable implant (ISQ ≥ 70) is ≥1.505. At this optimum cutoff value, the mesial side FD is associated with a perfect sensitivity (100%) and fairly high specificity (86.5%). Conclusion The FD analysis could be recommended as an adjunctive quantitative method in prediction of the implant stability with very high sensitivity and specificity. This trial is registered with ISRCTN72648040.
Collapse
|
19
|
Magat G, Ozcan Sener S. Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of cone-beam computed tomography and panoramic radiography. Oral Radiol 2018; 35:35-42. [PMID: 30484179 DOI: 10.1007/s11282-018-0316-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/30/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study was performed to compare the fractal dimension (FD), bone area fraction (BAF), and gray scale value (GSV) on digital panoramic radiography (DPR) and cross-sectional cone-beam computed tomography (CBCT) using image analysis and to determine whether a relationship exists among parameters associated with bone quality. METHODS Thirty edentulous human hemimandibles were scanned by DPR and CBCT. Ninety regions of interest (ROIs) were evaluated on DPR and CBCT images to calculate the FD and BAF. The GSV of the ROI on CBCT was also calculated. RESULTS Statistically significant differences were observed in the FD values of the ROIs between DPR and CBCT (p = 0.002) and in the BAF values of ROIs between DPR and CBCT (p = 0.017). The Spearman's correlation test revealed a statistically significant high correlation between the FD and BAF values of the ROIs on DPR and between the FD and BAF values of the ROIs on CBCT (p < 0.01). No significant correlations were observed between the GSVs of ROIs on CBCT and the FD values of ROIs on DPR, the BAF values of ROIs on DPR, the FD values of ROIs on CBCT, and the BAF values of ROIs on CBCT (p > 0.05). CONCLUSIONS The GSV did not support the FD and BAF. Additionally, DPR and CBCT did not have similar image quality for assessing the FD, BAF, and GSV. In evaluating the trabecular structure, the use of panoramic radiographs should be continued because the image resolution of CBCT is lower and its generalized dose is higher than that of panoramic radiography. These results may serve as a reference for clinical practitioners using dental CBCT to analyze the trabecular structures of alveolar bones.
Collapse
Affiliation(s)
- Guldane Magat
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Karaciğan Mahallesi, No:A, Ankara Cd., No:74, 42050, Karatay/Konya, Turkey.
| | - Sevgi Ozcan Sener
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Karaciğan Mahallesi, No:A, Ankara Cd., No:74, 42050, Karatay/Konya, Turkey
| |
Collapse
|
20
|
Radiographic Fractal and Clinical Resonance Frequency Analyses of Posterior Mandibular Dental Implants: Their Possible Association With Mandibular Cortical Index With 12-Month Follow-up. IMPLANT DENT 2017; 25:789-795. [PMID: 27824719 DOI: 10.1097/id.0000000000000496] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of the present study was to investigate whether the mandibular cortical index (MCI) has a relationship with fractal dimension of bone and/or implant stability, and to justify the possible association between MCI, fractal dimension, and stability. MATERIALS AND METHODS Eighty-two subjects who received dental implants to replace missing mandibular premolar/molar sites were selected. Three months after surgical placement, implants were restored with fixed ceramic fused metal crowns. MCI was evaluated at baseline; fractal dimensions were measured with fractal analysis (FA) and implant stability quotient (ISQ) with resonance frequency analysis immediately after surgery and 12-month follow-up. RESULTS FA at mesial and distal regions for Class 1, Class 2, and Class 3 MCI resulted with significant increases at 12-month follow-up compared to baseline. The ISQ in patients with Class 2 and Class 3 MCI resulted with a significant decrease compared to Class 1 MCI at baseline and at 12 months. All MCI classes evaluated with ISQ and FA at baseline values resulted with significant increases at 12 months. Significant correlations were considered for all mandibular posterior implants between baseline and 12-month measurements for ISQ and FA evaluations. CONCLUSIONS Fractal analysis may be a useful method for understanding the healing process around implants and implant stability quotient values. Mandibular cortical index evaluations should be considered before implant procedures, which may provide a presurgical treatment plan and may provide information about the mandibular bone quality.
Collapse
|
21
|
Akoğlan M, Tatli U, Kurtoğlu C, Salimov F, Kürkçü M. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res 2017; 19:624-631. [PMID: 28493347 DOI: 10.1111/cid.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.
Collapse
Affiliation(s)
- Mücahide Akoğlan
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Cem Kurtoğlu
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mehmet Kürkçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| |
Collapse
|
22
|
Sener E, Cinarcik S, Baksi BG. Use of Fractal Analysis for the Discrimination of Trabecular Changes Between Individuals With Healthy Gingiva or Moderate Periodontitis. J Periodontol 2015; 86:1364-9. [DOI: 10.1902/jop.2015.150004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
23
|
Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig 2014; 19:519-24. [PMID: 24802628 DOI: 10.1007/s00784-014-1245-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 04/21/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is no consensus on the relationship between fractal dimension and trabecular bone complexity. Our aims were to examine the changes in fractal dimension (FD) from peri-implant alveolar bone on digital panoramic radiographs 6 and 12 months after prosthodontic loading and to compare these with baseline values calculated just after loading. MATERIAL AND METHODS Three panoramic radiographs taken from 76 implant patients taken (1) after prosthodontic loading (3 months ± 2 weeks after insertion = baseline), (2) 6 months ± 2 weeks after loading, and (3) 12 months ±2 weeks after loading were considered for the study. Panoramic images were obtained using storage phosphor plates of the Digora PCT system and saved into a computer. Three regions of interest from mesial, distal, and apical areas were selected for each implant on three consecutive panoramic images. Statistical analysis of the data was performed using two-way repeated measures ANOVA, independent t test and paired t test, and pairwise comparisons (P < 0.05). RESULTS Mean FD values at baseline were 1.202, 1.224, and 1.199 for apical, mesial, and distal areas. The FD values were calculated as 1.121, 1.113, and 1.128 at the 6th month. The differences between values calculated at baseline and the 6th month were statistically significant for all aspects, indicating a significant decrease in FD 6 months after prosthodontic loading (P < 0.05). FD values calculated at the 12th month were 1.121, 1.110, and 1.121 for apical, mesial, and distal aspects, respectively, with no significant differences from corresponding values obtained at the 6th month (P > 0.05). CONCLUSIONS FD values of trabecular bone around implants 6 months after prosthodontic loading are significantly lower than the baseline values. However, no significant decrease or increase was observed at 12 months, which revealed comparable results with peri-implant alveolar bone at 6 months. CLINICAL RELEVANCE Trabecular bone around successful dental implants exhibits lower fractal dimension values 6 months after prosthodontic loading and displays stable bony microstructure at 12 months of follow-up.
Collapse
Affiliation(s)
- Mert Zeytinoğlu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Bornova, İzmir, Turkey
| | | | | | | |
Collapse
|
24
|
Mu TJ, Lee DW, Park KH, Moon IS. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study. J Periodontal Implant Sci 2013; 43:209-14. [PMID: 24236242 PMCID: PMC3825987 DOI: 10.5051/jpis.2013.43.5.209] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 09/06/2013] [Indexed: 11/27/2022] Open
Abstract
Purpose To assess bony trabecular changes potentially caused by loading stress around dental implants using fractal dimension analysis. Methods Fractal dimensions were measured in 48 subjects by comparing radiographs taken immediately after prosthesis delivery with those taken 1 year after functional loading. Regions of interest were isolated, and fractal analysis was performed using the box-counting method with Image J 1.42 software. Wilcoxon signed-rank test was used to analyze the difference in fractal dimension before and after implant loading. Results The mean fractal dimension before loading (1.4213±0.0525) increased significantly to 1.4329±0.0479 at 12 months after loading (P<0.05). Conclusions Fractal dimension analysis might be helpful in detecting changes in peri-implant alveolar trabecular bone patterns in clinical situations.
Collapse
Affiliation(s)
- Teh-Jing Mu
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | | | | | | |
Collapse
|
25
|
Pixel intensity and fractal dimension of periapical lesions visually indiscernible in radiographs. J Endod 2012; 39:16-9. [PMID: 23228251 DOI: 10.1016/j.joen.2012.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 10/05/2012] [Accepted: 10/08/2012] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The purpose of the study was to analyze pixel intensity (PI) and fractal dimension (FD) values in radiographs of chemically created but visually undetectable periapical lesions. METHODS Artificial lesions were created by applying 70% perchloric acid to the sockets of left and right first premolars in 12 cadaver mandibles. For preparation of relatively small lesions, the acid was applied for 30 and 60 minutes. Before and after each acid application, radiographs were taken (60 kVp, 7 mA, and 1.5 mm Al equivalent filtration for 0.12 second) with storage phosphor plates. An optical bench was used to standardize projection geometry. Image plates were scanned immediately after exposure, and the acquired images were saved uncompressed in TIF format. Six observers evaluated the images by using a 5-grade scale, and the images scored as "definitely absent" by all observers were used for the calculations of PI and FD. Box-counting FDs and differences in mean PI were computed for regions of interest at the apical areas of each premolar. Repeated-measures analysis of variance, Tukey test, and Pearson correlation coefficient test were used for statistical analysis. RESULTS A significant difference was found in FD values after both acid application periods (P < .05), whereas a difference in PI was detected only in images obtained after 60-minute acid application (P < .05). There was a negative correlation between FD and PI values (-0.754, P < .05). CONCLUSIONS Calculation of FD can be a tool for the early detection of periapical lesions given the presence of baseline radiographs.
Collapse
|
26
|
Sansare K, Singh D, Karjodkar F. Changes in the fractal dimension on pre- and post-implant panoramic radiographs. Oral Radiol 2011. [DOI: 10.1007/s11282-011-0075-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Fractals in dentistry. J Dent 2011; 39:273-92. [DOI: 10.1016/j.jdent.2011.01.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 01/28/2011] [Accepted: 01/31/2011] [Indexed: 12/13/2022] Open
|