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Brockmeyer P, Wiechens B, Sevinc T, Schliephake H, Hahn W. Informational content of two-dimensional panoramic radiographs and lateral cephalometric radiographs with respect to the bone volume of intraoral donor regions considering CBCT imaging. BMC Oral Health 2022; 22:318. [PMID: 35907826 PMCID: PMC9339174 DOI: 10.1186/s12903-022-02344-6] [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: 02/21/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To test the hypothesis that cephalometric parameters in two-dimensional routine dental radiographs correlate with the bone volume of intraoral bone donor sites. METHODS One-hundred and eight radiographs [36 panoramic radiographs (PRs), 36 lateral cephalometric radiographs (LCRs), and 36 cone-beam computed tomography scans (CBCT)] of 36 patients (all three imaging techniques applied according to the needs of treatment planning), were analyzed individually. Cephalometric parameters (PR and LCR) were correlated with the bone volume measurement in three-dimensional CBCT scans in three intraoral donor sites (chin, mandibular retromolar region, and zygomatic alveolar crest). RESULTS The mean bone volumes measured for the chin were (3.10 ± 1.11 cm³ SD), the mandibular retromolar region (1.66 ± 0.54 cm³ SD), and the zygomatic alveolar crest (0.17 ± 0.04 cm³ SD). Cephalometric parameters were significantly correlated (all p-values < 0.05) with the bone volume in the chin and the mandibular retromolar region. The bone volume of the zygomatic alveolar crest exhibited no correlations (p > 0.05) with cephalometric parameters. However, it was significantly correlated (p < 0.01) with the mandibular retromolar bone volume. No gender-specific differences (p > 0.05) were observed concerning bone volumes in all bone harvesting regions. Nevertheless, the male population's interforaminal distance in the chin region was significantly higher (p = 0.001). CONCLUSIONS PRs and LCRs can be used at the initial stage of peri-implant augmentation planning to deduce conclusions about the bone volume in different intraoral bone donor sites. It can help describe indications and justify additional diagnostic options, such as three-dimensional radiologic techniques.
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Affiliation(s)
- Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Robert-Koch Str. 40, D-37075, Goettingen, Germany.
| | - Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, Goettingen, Germany
| | | | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Robert-Koch Str. 40, D-37075, Goettingen, Germany
| | - Wolfram Hahn
- Department of Orthodontics, University Medical Center Goettingen, Goettingen, Germany.,Private Office, Goettingen, Germany
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Safi Y, Amid R, Kadkhodazadeh M, Mortazavi H, Sharifi MP, Gandomi S. Bone quality and quantity of the mandibular symphyseal region in autogenous bone grafting using cone-beam computed tomography: a cross-sectional study. Head Face Med 2021; 17:26. [PMID: 34253223 PMCID: PMC8273950 DOI: 10.1186/s13005-021-00282-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bone volume plays a pivotal role in the success of dental implant treatment. Autogenous bone grafts should be harvested from reliable sites in the maxillofacial region. This study sought to assess the quantity and quality of bone in the mandibular symphysis for autogenous bone graft harvesting using cone-beam computed tomography (CBCT). METHODS This cross-sectional study evaluated the CBCT scans of 78 adults presenting to three oral and maxillofacial radiology centers. The vertical (VD) and horizontal (HD) alveolar bone dimensions, cortical thickness (CT), and cancellous to cortical bone ratio (C/C) were measured in the interforaminal region of the mandible at the sites of central incisor to first premolar teeth. The interforaminal distance (ID) and the anterior loop length were also measured. Nonparametric statistical tests were used to analyze the data with respect to sex, age, and tooth position. RESULTS The median VD, HD, and CT of the symphysis were 20.21 (3.26), 4.13 (0.37), and 2.25 (0.23) mm, respectively. The median C/C was 1.51 (0.11). The median ID was 52.24 (8.24) mm, and the median anterior loop length was 1.82 (1.06) mm. Significant differences were observed in all parameters among different teeth. Most of the measured parameters were greater in males compared with females. There were significant differences in ID, VD, and CT between different age groups. CONCLUSIONS The quantity and quality of the available bone in the mandibular symphysis for bone graft harvesting vary by gender, age, and harvesting site, necessitating careful preoperative evaluation.
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Affiliation(s)
- Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Shiva Gandomi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Husseini B, Khoury G, Riachi F, Ghosn N, Khoury N, Jerbaka F, Bouserhal J, Younes R. Three-dimensional radiographic assessment of the mandibular interforaminal donor site in different vertical facial growth types. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:9-15. [PMID: 33609788 DOI: 10.1016/j.jormas.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/17/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess volumetrically, the impact of vertical facial growth types (VFGT) on the mandibular interforaminal region as a potential bone donor site. MATERIAL AND METHODS 60 cone beam computed tomography (CBCT) scans of adult individuals were classified in three groups according to their SN-GoGn angle: hypodivergent group (hG) (N=20), normodivergent group (NG) (N=19) and hyperdivergent group (HG) (N=21). Total harvestable bone volume (TBV), cortico-cancellous bone volume (CBV-cBV), and cortical bone surface (CBS) were evaluated. ANOVA test followed by Tukey post hoc tests were used to compare the mean continuous outcomes according to their VFGT. RESULTS The whole sample showed a mean TBV of 1376.32±541.01mm3, CBV of 468.52±121.54mm3 and cBV of 908.73±474.71mm3. The mean CBS amounted to 782.58±146.80mm2. The comparison between the groups stated a significantly different mean TBV and cBV (-p-value<0.001). The mean CBS was significantly different (-p-value=0.015): the smallest for the NG, but not significantly different (-p-value<0.001): the highest for the HG, intermediate for the NG and the smallest for the hG. CONCLUSION Hypodivergent individuals have the thickest cancellous bone suitable for an onlay bone graft, while hyperdivergent individuals have the thinnest bone ideal for a 3D grafting approach.
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Affiliation(s)
- B Husseini
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon..
| | - G Khoury
- Department of Advanced Surgical Implantology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, University Denis Diderot, Paris, France.
| | - F Riachi
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - N Ghosn
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon..
| | - N Khoury
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
| | | | - J Bouserhal
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.; Department of Orthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Department of orthodontics, Henry M. Goldman School of Dental Medicine, Boston, USA
| | - R Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon..
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Gandhi V, Lowney A, Cardarelli L, Yadav S, Tadinada A. Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography. Imaging Sci Dent 2020; 50:217-226. [PMID: 33005579 PMCID: PMC7506094 DOI: 10.5624/isd.2020.50.3.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/01/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.
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Affiliation(s)
- Vaibhav Gandhi
- Division of Orthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Arianna Lowney
- School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Lauren Cardarelli
- School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
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Truong MK, He P, Adeeb N, Oskouian RJ, Tubbs RS, Iwanaga J. Clinical Anatomy and Significance of the Retromolar Foramina and Their Canals: A Literature Review. Cureus 2017; 9:e1781. [PMID: 29255660 PMCID: PMC5732010 DOI: 10.7759/cureus.1781] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The retromolar foramina (RMF) and the retromolar canal (RMC) are anatomic variants in the mandible located distally to the last molar. The retromolar nerve, which runs through the RMC, is a type 1 bifidity of the mandibular canal. The investigations of the RMF and RMC have been performed by dry mandible studies, the panoramic radiograph (PAN), computed tomography (CT), and the cone beam computed tomography (CBCT) studies. The CBCT has been shown to be the superior method for visualizing the RMF and RMC. There is wide variation in the frequency, location, diameter, and distance of the canal in different individuals. Overall, there is no significant difference in the frequency of the canal in the mandible between sexes or sides of the mandible. The peak incidence of the RMF may occur in adolescence. The RMC is significant due to the neurovascular bundle which runs through it. Injury to this neurovascular bundle during surgical procedures, such as third molar extraction, implant placement, or split sagittal osteotomy, may lead to paresthesia, excessive bleeding, or traumatic neuroma. The presence of RMC may also lead to insufficient anesthesia in the mandible which may be overcome with alternative anesthetic techniques.
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Affiliation(s)
| | - Puhan He
- Harvard School of Dental Medicine, Harvard University
| | - Nimer Adeeb
- Department of Neurosurgery, Louisiana State University, Shreveport, LA
| | - Rod J Oskouian
- Neurosurgery, Complex Spine, Swedish Neuroscience Institute
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Kung CY, Wang YM, Chan CP, Ju YR, Pan WL. Evaluation of the Mandibular Lingual Canal and Anterior Loop Length to Minimize Complications Associated With Anterior Mandibular Surgeries: A Cone-Beam Computed Tomography Study. J Oral Maxillofac Surg 2017; 75:2116.e1-2116.e13. [DOI: 10.1016/j.joms.2017.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/17/2017] [Accepted: 06/09/2017] [Indexed: 11/25/2022]
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Shirzadeh A, Rahpeyma A, Khajehahmadi S. A Prospective Study of Chin Bone Graft Harvesting for Unilateral Maxillary Alveolar Cleft During Mixed Dentition. J Oral Maxillofac Surg 2017; 76:180-188. [PMID: 28774851 DOI: 10.1016/j.joms.2017.07.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE The chin is a common donor site for alveolar cleft bone grafting. The amount of bone available at this site can be limited, because conservative harvesting with mixed dentition must consider the incisive nerve, the unerupted mandibular canine, and the integrity of the inferior mandibular border. MATERIALS AND METHODS Patients with nonsyndromic unilateral alveolar cleft in the mixed dentition stage were selected for this study. The volume of bone obtained from the mandibular symphysis (symphysis menti), degree of alteration in lower lip sensation, anterior tooth vitality, remaining bone in the alveolar cleft, and bone defects at the donor site 1 year after surgery were evaluated. RESULTS Eighteen patients were enrolled in this study. The mean volume of bone harvested from the symphysis was 2.1 mL (range, 1.6 to 2.3 mL). For all cases, the bone volume harvested from the symphysis was insufficient to fill the alveolar cleft defect, and allograft had to be added to completely fill the cleft. Allograft was admixed in the range of 0.5 to 1 mL with autogenous bone harvested from the mandible. Lower lip sensation and vitality of the anterior teeth of the mandible were within the normal range 1 year after surgery in all cases. Fourteen of 18 patients (77.8%) had normal bone height or bone height at least three fourths of the expected height in the grafted alveolar cleft after 1 year; only 10% of the defect remained in the mandible. CONCLUSION The amount of bone yielded by conservative monocortical bone harvest from the mandibular symphysis during the mixed dentition stage for unilateral alveolar cleft bone grafting is not sufficient in volume and should be mixed with allograft. However, donor site morbidity is low with this approach.
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Affiliation(s)
- AliReza Shirzadeh
- Undergraduate of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Rahpeyma
- Associate Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Associate Professor of Oral and Maxillofacial Pathology, Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Volumetric Evaluation of Safe Zone for Bone Harvesting From Symphysis Region by Using Cone Beam Computed Tomography. IMPLANT DENT 2017; 25:758-761. [PMID: 27356201 DOI: 10.1097/id.0000000000000450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of the present study was to retrospectively make a volumetric evaluation of symphysis sites of patients by the use of cone beam computed tomography (CBCT). METHODS This retrospective study evaluated dentate symphysis region of the mandibles in CBCT scans taken for different reasons in 90 patients (45 women and 45 men). Three-dimensional (3D) data were obtained using a CBCT device Kodak 9000 3D CMOS sensor with optical fiber. CBCT images were then transferred as digital imaging and communications in medicine files and imported into a volumetric-rendering software 3D DOCTOR (Able Software Corp., Lexington, MA) capable of measurements of vector based-segmentation technology for volumetric measurements. RESULTS The total average bone volume is 2616.45 mm. Significant differences in average bone volume were found between group I and group IV (P < 0.001). Higher bone volume was obtained in the male groups (2903.01 mm) than in the female groups (2329.88 mm). CONCLUSIONS CBCT is a good candidate for 3D assessment of high-contrast structures in the oral region. We suggest that the use of 3D computed tomography in combination with a software program is a dependable means of measuring the volume of the symphysis bone graft.
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