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Wang SH, Fuh LJ, Chen MYC, Tsai MT, Huang HL, Peng SL, Hsu JT. Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods. Head Face Med 2024; 20:33. [PMID: 38760840 PMCID: PMC11100211 DOI: 10.1186/s13005-024-00434-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Michael Y C Chen
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
| | - Heng-Li Huang
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
| | - Jui-Ting Hsu
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
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Cheng NM, Lin CY, Liao CT, Tsan DL, Ng SH, Yen TC. The added values of 18F-FDG PET/CT in differentiating cancer recurrence and osteoradionecrosis of mandible in patients with treated oral squamous cell carcinoma. EJNMMI Res 2023; 13:25. [PMID: 37010632 PMCID: PMC10070584 DOI: 10.1186/s13550-023-00965-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/07/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Osteoradionecrosis (ORN) of the jaw requires a differential diagnosis to exclude cancer recurrence. Here, we sought to develop a scoring system comprising 18F-FDG PET/CT parameters for distinguishing between the two conditions in patients with oral squamous cell carcinoma (OSCC). METHODS The study consisted of 103 OSCC patients with suspected ORN of the jaw. All participants underwent 18F-FDG PET/CT imaging within 6 months of diagnostic histopathology. Following extraction of PET parameters, we identified clinical and imaging predictors of mandibular recurrence-free survival (MRFS) using receiver operating characteristic curve analysis and multivariate Cox regression models. RESULTS The results of histopathology revealed mandibular cancer recurrence in 24 patients (23.3%). Multivariate Cox regression analyses identified an age at diagnosis ≤ 52 years (P = 0.013), a location of the SUVmax voxel with soft tissue predominance (P = 0.019), and mandibular total lesion glycolysis (TLG) > 62.68 g (P < 0.001) as independent risk factors for MRFS. A scoring system was devised with scores from 0 (no risk factor) to 3 (presence of all three risk factors). High-risk patients with a score of 2-3 compared with score of 0-1 had a significantly higher likelihood of mandibular cancer recurrence (hazard ratio: 32.50, 95% confidence interval: 8.51-124.18, P < 0.001). The scoring system had a sensitivity of 87.50%, a specificity of 82.28%, and an accuracy of 83.50% for identifying mandibular cancer recurrence. CONCLUSIONS The scoring system of our study is clinically useful for identifying mandibular cancer recurrence in patients with suspected ORN of the jaw.
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Affiliation(s)
- Nai-Ming Cheng
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, No. 5, Fu-Shin St., Kueishan District, Taoyuan City, 333, Taiwan
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Ta Liao
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Din-Li Tsan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shu-Hang Ng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, No. 5, Fu-Shin St., Kueishan District, Taoyuan City, 333, Taiwan.
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Singh N, Tripathi T, Mohanty S, Rai P, Bhutiani N. Closure of large alveolar defect by maxillary alveolar distraction using a vector-controlled distractor appliance in cleft patients: A pilot study. J Oral Biol Craniofac Res 2021; 11:277-283. [PMID: 33680751 DOI: 10.1016/j.jobcr.2021.02.008] [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: 12/09/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/27/2022] Open
Abstract
Objective To assess the treatment outcome of custom made maxillary transport distractor appliance for closure of large alveolar clefts. Method A pilot study was conducted on 12 large alveolar cleft defects present in 11 non-syndromic cleft lip and palate patients (1 bilateral and 10 unilateral) in the age group of 16-25 years. All the subjects underwent pre-surgical orthodontics followed by alveolar distraction using custom-made distractor appliance. Study models, lateral cephalogram, panoramic radiograph and cone beam computed tomograms were obtained pre-surgically (T0) and after distractor removal (T1). The reduction in the width and volume of the alveolar cleft defect and change in the mesiodistal axial inclination of the teeth in transport segment following distraction were recorded. P value < 0.05 was considered statistically significant. Results Significant reduction in cleft width (9.18 mm), volume (89.82 mm3) and the change in the mesiodistal axial inclination of the teeth in the transport segment (3.05°) (P < 0.05) were observed. SNA (1.75°), ANB (1.58°), maxillary length (1.58 mm), upper incisor inclination (3°) and distal movement of anchorage teeth (0.95 mm) also showed significant change (P < 0.05). Conclusion The custom-made tooth borne distraction appliance successfully closed the large alveolar cleft defect with minimal or no inadvertent effects on the oral tissues.
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Affiliation(s)
- Navneet Singh
- Department of Orthodontics and Dentofacial Orthopedics, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Tulika Tripathi
- Department of Orthodontics and Dentofacial Orthopedics, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Sujata Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Priyank Rai
- Department of Orthodontics and Dentofacial Orthopedics, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Neha Bhutiani
- Department of Orthodontics and Dentofacial Orthopedics, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
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Schneider S, Gandhi V, Upadhyay M, Allareddy V, Tadinada A, Yadav S. Sex-, growth pattern-, and growth status-related variability in maxillary and mandibular buccal cortical thickness and density. Korean J Orthod 2020; 50:108-119. [PMID: 32257936 PMCID: PMC7093665 DOI: 10.4041/kjod.2020.50.2.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 12/14/2019] [Indexed: 11/15/2022] Open
Abstract
Objective The primary objective of this study was to quantitatively analyze the bone parameters (thickness and density) at four different interdental areas from the distal region of the canine to the mesial region of the second molar in the maxilla and the mandible. The secondary aim was to compare and contrast the bone parameters at these specific locations in terms of sex, growth status, and facial type. Methods This retrospective cone-beam computed tomography (CBCT) study reviewed 290 CBCT images of patients seeking orthodontic treatment. Cortical bone thickness in millimeters (mm) and density in pixel intensity value were measured for the regions (1) between the canine and first premolar, (2) between the first and second premolars, (3) between the second premolar and first molar, and (4) between the first and second molars. At each location, the bone thickness and density were measured at distances of 2, 6, and 10 mm from the alveolar crest. Results The sex comparison (male vs. female) in cortical bone thickness showed no significant difference (p > 0.001). The bone density in growing subjects was significantly (p < 0.001) lower than that in non-growing subjects for most locations. There was no significant difference (p > 0.001) in bone parameters in relation to facial pattern in the maxilla and mandible for most sites. Conclusions There was no significant sex-related difference in cortical bone thickness. The buccal cortical bone density was higher in females than in males. Bone parameters were similar for subjects with hyperdivergent, hypodivergent, and normodivergent facial patterns.
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Affiliation(s)
- Sydney Schneider
- Department of Orthodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Vaibhav Gandhi
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
| | - Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, Brodie Laboratory for Craniofacial Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, University of Connecticut Health, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
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Schnitman PA, Hayashi C, Han RK. Why guided when freehand is easier, quicker, and less costly? J ORAL IMPLANTOL 2015; 40:670-8. [PMID: 25233441 DOI: 10.1563/aaid-joi-d-14-00231] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Computer-assisted implant planning and subsequent production of a surgical template based on this plan has gained attention because it provides restoratively driven esthetics, patient comfort, satisfaction, and the option of flapless surgery and immediate restoration. However, it adds expense and requires more time. Another significant but not so apparent advantage may be improved survival and success over freehand techniques in types III and IV bone. This retrospective analysis was undertaken to examine that possibility. It reports 1-year outcome for 80 implants in 27 consecutively presenting patients treated over a 7-year period using computer-assisted techniques across all bone qualities in commonly encountered treatment indications in private practice. Implants were placed to support single teeth, small bridges, and complete arch restorations in exposed or immediately restored applications, based on primary stability as determined by insertion torque, resonance frequency analysis, and Periotest. For the 80 implants supporting 35 restorations, the median observation period is 2.66 years; 73 implants supporting prostheses in 22 patients had readable radiographs at 1 year. There was a 1-year overall implant survival and a success rate of 100%. Radiographic analysis demonstrated the change in bone level from the platform at 1-year is less than 2 mm. Intra-operative median measurements of primary stability were insertion torque, 40 Ncm; resonance frequency, 76 ISQ; and Periotest, -3. All intra-operative measurements were consistent for acceptable primary stability regardless of bone density. Restoratively driven diagnosis and precision planning and initial fit were possible with computer-assisted techniques resulting in the achievement of high primary stability, even in areas of less dense bone. The ability to plan implant position, drill sequence, and implant design on the basis of predetermined bone density gives the practitioner enhanced pretreatment information which can lead to improved outcome.
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Cobo-Vázquez C, Fernández-Tresguerres I, Ortega-Aranegui R, López-Quiles J. Effects of local melatonin application on post-extraction sockets after third molar surgery. A pilot study. Med Oral Patol Oral Cir Bucal 2014; 19:e628-33. [PMID: 25350595 PMCID: PMC4259382 DOI: 10.4317/medoral.19851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/28/2014] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to assess the anti-inflammatory, analgesic and osteogenic early effects of melatonin on post-extraction sockets ofpatients requiring third molars extraction.
Study Design: A randomized, triple-blind clinical trial was made using a split-mouth design. Both lower third molars of 10 patients were extracted and 3 mg of local melatonin or placebo were applied. Concentrations of interleukin-6 and nitrotyrosine were determined on samples of the clot from the socket by independent ELISA tests. Radiographic bone density was evaluated by measuring Hounsfield Units in panoramic and cross sections obtained by digital scanner. Statistycal analysis by Kolmogorov-Smirnov test was performed for ELISA data. Bone density was analyzed by Shapiro-Wilk test. Subsequently t test was applied. P<0.05 was considered to be significant.
Results: The concentration of interleukin-6 increased with the application of melatonin without statistically significance (361.32 ± 235.22 pg/ml vs 262.58 ± 233.92 pg/ml). Nitrotyrosine concentrations showed values below to the detectability pattern (<0.001 nM) in Optic Density curve. Bone density in panoramic sections at socket after melatonin application showed no significant difference (561.98 ± 105.92 HU vs 598.82 ± 209.03 HU). In cross sections, bone density in the alveolar region showed no significant difference(377.42 ± 125.67 HU vs 347.56 ± 97.02 HU).
Conclusions: Within the limitations of this pilot study, no differences with the application of melatonin were found in terms of the concentration of interleukin-6 and bone density in post-extraction socket of retained mandibular third molars.
Key words:Melatonin, inflammation, pain, bone density, third molar surgery.
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Affiliation(s)
- Carlos Cobo-Vázquez
- Department of Medicine and Oral Surgery, Faculty of Odontology, Complutense University of Madrid, Plaza de Ramón y Cajal, 3, 28040, Madrid, Spain,
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