Comparison of hand and semiautomatic tracing methods for creating maxillofacial artificial organs using sequences of computed tomography (CT) and cone beam computed tomography (CBCT) images

Evaluation of the relationship between sphenoid sinus morphology and area and volume by computed tomography

OBJECTIVES

The aim of this study is to investigate the effect of sphenoid sinus pneumatization types, Onodi cell (OC), internal carotid artery (ICA), optic nerve (ON) on sinus volume and area on computed tomography (CT) images.

METHODS

The CT images of 150 patients were evaluated. Sphenoid sinus pneumatization types, OC prevalence, protrusion and dehiscence of ICA and ON, the volume and area were evaluated.

RESULTS

The sinus volume and area were statistically higher in patients with bilateral protrusion of ICA and ON then patients without protrusion of ICA and ON. The mean volume and area of sinus were 9949.4 ± 351.0 mm3 and 4570.9 ± 1604.9 mm2, respectively. The volume and area of sphenoid sinus did not differ significantly between groups with and without OC. The postsellar b type sphenoid sinus had the highest volume, while conchal type has the least volume.

CONCLUSIONS

Bilateral protrusion and dehiscence of ICA and bilateral protrusion of ON caused a significant increase in the sphenoid sinus volume and area. The presence of ICA and ON, the pneumatization of the sinus is an anatomical structure that can affect the sinus volume and area. Before the operation, three-dimensional evaluation should be performed to determine whether these structures are bilateral/unilateral and it should be remembered that the sinus volume and area can change.

Management of Odontogenic Sinusitis: Results with Single-Step FESS and Dentoalveolar Surgery

OBJECTIVE

Odontogenic sinusitis (OS) is a well-known and important border of specialties in otorhinolaryngology and dentoalveolar surgery. Odontogenic sinusitis can develop due to iatrogenic harm or odontogenic infection. The gold standard diagnostic method is clinical and radiological-CBCT (cone beam computed tomography)-examination. The treatment of this condition requires collaboration between ENT and dentoalveolar surgery specialists and can be non-surgical or surgical based on staging. This paper aims to share the results of our clinical study whereby complex therapy was administered by a dentoalveolar surgeon and an otorhinolaryngologist in cooperation.

PATIENTS AND METHODS

We conducted a retrospective study comprising 111 OS patients who underwent complex therapy between 2016 and 2023 at Semmelweis University, Budapest, Hungary. All patients were treated with concurrent FESS (functional endoscopic sinus surgery) and dentoalveolar surgery. Follow-up was based on symptoms, clinical examination and CBCT imaging.

RESULTS

Of the 111 patients, 107 were successfully treated with concurrent FESS and dentoalveolar surgery, and only 4 had further symptoms following the complex therapy and needed retreatment.

CONCLUSIONS

The complex, single-session therapy involving FESS and oral surgery is an effective treatment method, which is less invasive and associated with fewer complications compared to previous interventions, such as the Luc-Caldwell procedure.

Three-dimensional evaluation of the maxillary sinus in patients with different skeletal classes and cranio-maxillary relationships assessed with cone beam computed tomography

The objective was to evaluate the relationship between the dimensions of the maxillary sinuses (MSs) and various cephalometric parameters. MS volume (MSV), MS surface (MSS), linear maximum depth (LMD), linear maximum width (LMW), and linear maximum height (LMH) were calculated on CBCT scans of 99 adults. Two sets of two-way (ANOVA) assessed the influence respectively of ANB and SNA angles and of the gender on MS dimensions. Pearson's correlation was calculated between MS dimensions and different cephalometric variables. Reliability and accuracy of the proposed method was tested with intra-operator and inter-operator intraclass correlation coefficient (ICC). Two-way ANOVA showed no statistically significant difference in MSV, MSS and LMH between ANB groups, whilst males were associated with bigger sinuses. LMW showed statistically significant difference in both ANB and gender groups. LMD showed no statistically significant difference. The second Two-way ANOVA showed significantly larger MSV, MSS and LMD in patients with increased or reduced SNA angle but not between genders. LMW and LMH also showed a significant difference between genders. All linear measurements showed a significant interaction of the two factors. The intra-observer and inter-observer ICC scored high for all the tested measurements. MSV and MSS showed a positive correlation with S-N, PNS-A, S-Go, N-Me, N-Ans and the distance between Mx points. LMW had a negative correlation with Ba-S-N angle and N-Me, LMH with Ba-S-N angle, S-Go and Mx r-Mx l and LMD with N-Me and N-ANS. LMW had a positive correlation with Mx r-Mx l, LMH with S-N, S-N^Ans-Pns, N-Me, N-Ans and LMD with S-N, Ba-S-N, PNS-A, S-Go and distance between Mx points. In conclusion, MSV and MSS did not differ between the three skeletal classes, males showed significantly larger MS than in females. Concerning the influence of the cranio-maxillary relationship (SNA) and gender on MS dimension, subjects with a retrusion (SNA < 80°) or protusion (SNA > 84°) of the maxillary alveolar bone had larger MSV, MSS, LMW, LMH and LMD than subjects with a normal cranio-maxillary relationship (SNA 82 ± 2°). A statistically significant high positive correlation was observed between S-N, Pns-A, S-Go, Mx-R/Mx-r and MS dimension. Further studies that evaluate similar outcomes in different races may be able to enrich our knowledge on this topic.

Assessment of the relationship between the maxillary sinus and the canine root tip using cone beam computed tomography

BACKGROUND

The purpose of the present study is to investigate the relationship between the maxillary sinus and the canine root apices in cone beam computed tomographic images (CBCT) and to assess the amount of extension of the maxillary sinus to the anterior region of the jaw in different sexes and age groups.

METHODS

CBCT of 300 individuals (154 males and 146 females) over 20 years (with a mean age of 35.12 ± 8.40 years) were evaluated. The subjects were categorized into three age groups (20-30, 30-40, and 40-50 years). When the maxillary sinus extended to the canine area, the vertical distance between them was measured, and their relationship was classified into three types: I (more than 2 mm distance), II (less than 2 mm distance or in-contact), and III (interlock).

RESULTS

413 out of 600 maxillary sinuses (68.8%) were extended into the canine area or beyond. Among them, 15 maxillary sinuses pneumatized into the incisor area (2.5%). The prevalence of the maxillary sinuses extended to the anterior region of the jaw was not significantly different between genders. However, it was significantly less frequent in the older age group and more frequent on the left side. In addition, the mean amount of anterior extension of the maxillary sinus (mm) was significantly lower in the older age group. Type I was the most frequent vertical relationship between the maxillary sinuses and canine apices with no significant difference in gender, side, and age groups.

CONCLUSIONS

In most cases, the maxillary sinus extended to the canine area and sometimes reached the incisor region. This necessitates paying more attention to the maxillary anterior sextant during surgical procedures.

Craniofacial Fibrous Dysplasia Involvements of Mccune-Albright Syndrome: A Review with an Additional Case

BACKGROUND

McCune-Albright Syndrome (MAS) is a genetic disorder with a triad of endocrine diseases, café-au-lait macules and fibrous dysplasias. Craniofacial fibrous dysplasia is a term that is used to describe the fibrous dysplasia, which was localized at the craniofacial skeleton and is common in MAS patients.

OBJECTIVE

The objective of this review is to determine the involvement frequency of cranial and facial bones in patients with MAS and CFD.

METHODS

Articles in PubMed was searched with the following details "(mccune[Title/Abstract] OR albright[Title/Abstract]) OR ("craniofacial fibrous dysplasia"[MeSH Terms] OR ("craniofacial"[ All Fields] AND "fibrous"[All Fields] AND "dysplasia"[All Fields]) OR "craniofacial fibrous dysplasia"[All Fields])". The articles in which the authors did not state the involved bones or did not add any radiographic images were excluded from the study.

RESULTS

26 cases in 25 articles met the inclusion criteria. Among the 26 cases and our case, sphenoid and frontal bones were involved in 17 cases, parietal and occipital bones were involved in 15 cases, mandible and ethmoid bone were involved in 14 cases, maxilla-zygoma-temporal and palate was involved in 13, 11, 6 and 3 cases, respectively. Palate was involved in cases where maxilla was also involved. Our case was the only case that was evaluated with CBCT.

CONCLUSION

Routine follow-ups are important since new CFDs can occur in different cranial or facial bones. 2D imaging techniques may not be able to demonstrate early CFDs; thus, an advanced imaging technique should be used after MAS diagnosis.

Three-Dimensional Evaluation of Maxillary Sinus Changes in Growing Subjects: A Retrospective Cross-Sectional Study

This study aims to evaluate changes of maxillary sinuses in growing subjects. Cone Beam Computed Tomography (CBCT) scans of 146 patients were divided according to gender and age (6–8, 9–11, 12–14 years old). Left, right and total maxillary sinus volume (MSV-R, MSV-L, MSV-Tot) and surface (MSS-R, MSS-L, MSS-Tot), left and right linear maximum width (LMW-L, LMW-R), depth (LMD-R, LMD-L) and height (LMH-R, LMH-R) were calculated using Mimics Research 22. Kruskal–Wallis Test and showed a statistically significant increase in both genders for all variables. Pairwise comparisons in females are always statistically significant in: LMH-R, LMH-R, MSS-Tot, MSV-Tot. All other variables showed a statistical significant increase between 9–11 and 12–14, and between 6–8 and 12–14 age groups, apart from LMSW-R, LMSW-L, LMSD-R, LMSD-L between 6–8 and 12–14 age groups. Pairwise comparisons in males are always and only statistically significant between 9–11 and 12–14, and between 6–8 and 12–14 groups. Symmetrical measurements (right and left) evaluated using Wilcoxon test retrieved no statistical significant difference. Comparisons between measurements on male and female subjects using Mann–Whitney test showed a statistical significant difference in 6–8 years group in MSV-R, MSV-L and MSV-Tot, and in 12–14 age group in MSV-R, MSV-L, MSV-Tot, MSS-r, MSS-l, MSS-Tot, MSW-R, MSW-L, MSD-R, MSD-L. Intraclass Correlation Coefficient (ICC) assessing inter-operator and intra-operator concordance retrieved excellent results for all variables. It appears that maxillary sinus growth resembles the differential peak of growth in male and female subjects. Sinuses starts to develop early in female subjects. However, in the first and last age group female sinuses are statistically significantly smaller compared to male ones. In male subjects, sinus growth occurs mainly between the second and third age group whilst in female subjects it starts between the first and second age group and continues between the second and the last. Sinus has a vertical development during the peak of growth, which is the main reason for its increase in volume.

Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT

AIM

Sinus maxillaris is an important anatomical formation in many branches of dentistry due to its proximity to the field of work. Various methods have been used in literature to measure the maxillary sinus volume (MSV) such as cadavers, stereology, two-dimensional conventional radiographs, computed tomography (CT), magnetic resonance imaging (MRI). The aim of this study is to evaluate the change of maxillary sinus volume according to age and gender with MIMICS 19.0 (Materialise HQ Technologielaan, Leuven, Belgium) which is one of three-dimensional modeling software.

MATERIALS AND METHODS

This study was performed in 200 patients selected by a retrospective review of the archives of the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology. Patients were divided into five age groups (18-24 years, 25-34 years, 35-44 years, 45-54 years, and ≥ 55 years) and by sex. Cone-beam computed tomography (CBCT) images of the patients were transferred to the MIMICS software and the MSV was measured. All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software.

RESULTS

There was no statistically significant difference between the right and left maxillary sinus volume according to the findings obtained from our study, and maxillary sinus volume in males was found to be significantly higher than that of females. Another finding of our study is that the maxillary sinus volume decreases with age increase. Especially it was also found that the sinus volume in males in the 18-24 age group was statistically significantly higher than females.

CONCLUSION

Consequently, maxillary sinus volume measurements can be made on CT, CBCT, MRI scans using reconstruction software.