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1.
Ana Márcia Viana Wanzeler Maria Daniela Oliveira Renda Maria Eduarda de Oliveira Pereira Sérgio Melo Alves-Junior Fabricio Mesquita Tuji 《Oral and maxillofacial surgery》2017,21(3):341-346
Introduction
The objective of this study was to establish the anatomical relation between nasal septum deviation (NSD) and oropharynx volume in different facial patterns using cone beam computed tomography (CBCT).Methods
Ninety CBCT examinations were analyzed. InVivoDental software was used to evaluate cephalometric image reconstructions in terms of facial type, determined from cephalometric measurements indicative of growth direction; the presence of NSD was also evaluated. ITK-SNAP software was employed for delimitation of the oropharynx. Intra-examiner error methods were recorded. The results were subjected to parametric and non-parametric tests using Bioestat 5.0.Results
A comparison of facial types revealed a significantly lower prevalence of NSD in the dolichofacial group compared with the brachyfacial and mesofacial groups (P = 0.0101 and 0.0149, respectively). In the total sample, there was a very strong positive relation between the presence of NSD and oropharynx space volume (P = 0.0162). The oropharynx volume was larger in all facial patterns in the presence of NSD.Conclusion
The presence of NSD was not associated with facial type, although the oropharynx volume in patients with NSD increased. Therefore, deviation of the septum influences oropharynx volume.2.
Umut Aksoy Fatma Kermeoğlu Atakan Kalender Hakan Eren Mehmet Eray Kolsuz Kaan Orhan 《Oral Radiology》2017,33(3):193-198
Objectives
The purpose of the present study was to radiographically evaluate the prevalence and characteristics of palatogingival grooves (PGs) in maxillary anterior teeth on cone-beam computed tomography (CBCT) to better understand the nature of these defects.Methods
The CBCT examinations of 993 teeth (330 canines, 315 lateral incisors, 348 central incisors) in 191 patients (87 males, 104 females; age range 16–80 years) were evaluated retrospectively. The diagnosis and radiographic condition of PGs were obtained by consensus among all observers. Verification of PGs was achieved from the patients’ clinical records, which were stored in a database after their clinical evaluation. Differences in age, sex, occurrence, and location were evaluated by the Chi-square test. The level of significance was set at p < 0.05.Results
Among the 993 teeth examined, nine PGs were observed in seven lateral incisors and two central incisors in eight patients (four males and four females). There was one bilateral case in the lateral incisors. The frequencies of PG occurrence and affected patients were 0.90 and 4.18%, respectively, without significance for sex and location (p > 0.05).Conclusions
PGs were a relatively infrequent anomaly of teeth in this population, but when present, clinicians should understand the clinical features of these root variations.3.
Objectives
To determine the prevalence of odontogenic maxillary sinus pathologies and their relationship with periapical pathologies in the maxillary posterior teeth using cone-beam computed tomography (CBCT).Method
Maxillary posterior CBCT scans of consecutive patients aged 20–77 years were evaluated retrospectively. Patients with at least one maxillary posterior tooth were included. Patients with edentulous maxillae or having one or more maxillary implants were excluded. Finally, 461 CBCT images were evaluated. Demographic data, such as age and sex, and pathologic findings of the right and left maxillary sinuses and adjacent teeth were recorded. Statistical analyses were performed using the Chi square test and binary logistic regression.Results
The prevalence of right and left odontogenic maxillary sinusitis was 59.5 and 64 %, respectively. Maxillary sinus pathology was more common in males, and there was no relationship with age. Regarding the maxillary sinus pathology, 64 % had mucosal thickening, 19 % had partial opacification, 5 % had total opacification, and 12 % had polypoidal mucosal thickening. Right and left maxillary sinus pathologies were approximately twice as prevalent in patients with periapical pathology in at least one maxillary posterior tooth. Periapical pathologies in the right maxillary first molar and left maxillary first and second molars significantly increased the risk of maxillary sinus pathology with odds ratios of 2.53, 1.83, and 3.12, respectively.Conclusions
Odontogenic maxillary sinus pathologies were present in >50 % of the study population. Periapical pathologies in the maxillary first and second molar teeth significantly increased maxillary sinus pathologies.4.
Objectives
Cone-beam computed tomography (CBCT) has been widely used in many fields of dentistry. However, little is known about the accuracy of CBCT for evaluation of periodontal status. The objective of this study was to compare and correlate periodontal assessments among CBCT, clinical attachment loss (CAL) measurement, and periapical (PA)/bitewing (BW) radiography.Methods
Eighty patients (28 males, 52 females; age range, 19–84 years) from the University of Texas School of Dentistry at Houston were evaluated retrospectively. Measurements were taken on the central incisors, canines, and first molars of the right maxilla and left mandible. CAL was extracted from periodontal charts. The radiographic distance from the cementum–enamel junction (CEJ) to the alveolar crest was measured for tooth mesial and distal sites on PA/BW and CBCT images using MiPacs software and Anatomage Invivo software, respectively. One-way ANOVA and Pearson analysis were performed for statistical analyses.Results
The CEJ–crest distances for CBCT, PA/BW, and CAL were 2.56 ± 0.12, 2.04 ± 0.12, and 2.08 ± 0.17 mm (mean ± SD), respectively. CBCT exhibited larger values than the other two methods (p < 0.05). There were highly significant positive correlations among CBCT, PA/BW, and CAL measurements at all examined sites (p < 0.001). The Pearson correlation coefficient was higher for CBCT with CAL relative to PA/BW with CAL, but the difference was not significant (r = 0.64 and r = 0.55, respectively, p > 0.05).Conclusions
This study validates the suitability of CBCT for periodontal assessment. Further studies are necessary to optimize the measurement methodology with CBCT.5.
Luiz Felipe Palma Ariane Fraga Buck Flávio de Ávila Kfouri Isaac Tobias Blachman Leonardo Augusto Lombardi Marcelo Arthur Cavalli 《Oral and maxillofacial surgery》2017,21(3):307-312
Purpose
The purpose of this study was to carry out morphologic and topographic analyses of retromolar canals on cone beam computerized tomography (CBCT) scans, comparing findings to others obtained from the corresponding digital panoramic radiographs.Methods
Sixty-one CBCT scans were analysed digitally, as well as their corresponding digital panoramic radiographs. The prevalence and distribution of these canals, foramen diameters, and intraosseous communications were also evaluated.Results
On CBCT scans, we found that 24.6% of individuals had at least one retromolar canal. The mean foramen diameter was slightly higher than 1 mm and we could not determine the intraosseous anatomical connections in most cases. The morphology and topography of the retromolar canals were not affected by gender and antimere. In addition, only 22.2% of all tomographically identified canals could be confirmed on digital panoramic radiographs (26.7% of such patients). Regarding all sample, 6.6% of individuals showed retromolar canals on digital panoramic radiographs.Conclusion
We may consider that these structures are clinically relevant findings and, due to the low accuracy of the panoramic radiographs, high-quality tomographic exams should always be asked for presurgical treatment planning.6.
Sedat Aydın Mehmet Gökhan Demir Necdet Demir Sefer Şahin Şükran Sarıkaya Kayıpmaz 《Journal of maxillofacial and oral surgery》2016,15(2):277-280
Objective
Dermoid and epidermoid cysts are rare cysts of the head and neck region, which should be considered in differential diagnosis of sublingual mass, constituting 0.01 % of all oral cavity cysts. There are suspected theories regarding the basis of the pathology.Case Report
30-year-old male referred to our clinic with a chief complaint of sublingual mass which had been present for many years but the lesion enlarged over the past 3 years. MRI examination revealed a giant cystic mass which was 3.6 × 3.9 mm in diameter and medially located at sublingual region.Treatment and Prognosis
Intraoral approach was preferred for surgery and no recurrence or complaints were detected during follow-up period.Conclusion
When a cystic mass is detected on the floor of oral cavity, we must consider dermoid cysts for differential diagnosis. Surgery is the only treatment. If possible, intraoral approach should be preferred because of its perfect cosmetic results.7.
Objectives
The aim of this study was to evaluate the localization, angulation, and resorption features of maxillary impacted canines on cone-beam computed tomography (CBCT).Methods
This retrospective study examined the CBCT scans of 140 maxillary impacted canines in 102 patients (43 males, 59 females; mean age: 16.25 ± 6.31 years). The following impacted canine-related parameters were analyzed on the CBCT images: impaction side; location; root resorption levels of adjacent teeth; occlusal plane and midline distances of impacted canines; and angulations of impacted canines to midline, lateral incisor, and occlusal plane.Results
Bilateral canine impaction was found in 38 subjects, and unilateral canine impaction was present in 64 subjects. Severe resorption was found in 14 canines. There were no significant differences between the occlusal plane and midline distances to the impacted canine cusp tip and root apex (p > 0.05). The midline angulation of right maxillary impacted canines was significantly higher than that of left maxillary impacted canines (p < 0.05), while the occlusal plane angulation of left maxillary impacted canines was significantly higher than that of right maxillary impacted canines (p < 0.05).Conclusions
Maxillary canine impaction was more frequently seen in female subjects than in male subjects. Lateral incisors were more frequently affected than first premolars, and slight resorption was more frequently seen in adjacent teeth. CBCT assessment of maxillary impacted canines can provide accurate measurements of angular, linear, and resorption parameters.8.
Hong-Soon Kim Gyu-Tae Kim Sun Kim Jung-Woo Lee Eun-Cheol Kim Yong-Dae Kwon 《Clinical oral investigations》2016,20(5):915-922
Objective
The study aims to evaluate the pharyngeal airway space (PAS) following bimaxillary surgery in skeletal class III patients and to compare the changes in PAS between genders using cone-beam computed tomography (CBCT).Materials and methods
In all, 38 patients (16 male and 22 female) with skeletal class III malocclusion underwent bimaxillary surgery. CBCT scans were acquired approximately 1 month before surgery, 3 months after surgery, and 6 months after surgery. The oropharyngeal volume and the minimum cross-sectional area (CSA) were characterized using the InVivoDental imaging software package at each time point.Results
The volume and minimum CSA decreased significantly postoperatively, which was maintained until 6 months postoperatively (p < 0.01). The location of the minimum CSA tended to move into the retropalatal and retroglossal areas postoperatively. A strong correlation between volume and minimum CSA was found. The amount of mandibular setback was not correlated with the change in the airway. By gender, significant decreases in both the volume and minimum CSA were found in females (p < 0.05) but not in males.Conclusion
Bimaxillary surgery significantly affects PAS. Gender differences should also be considered when considering changes in PAS.Clinical relevance
An awareness of the effects of bimaxillary setback surgery on the airway should be considered when implementing an orthognathic treatment plan.9.
Farshid Bastami Shahriar Shahab Azin Parsa Fatemeh Mashhadi Abbas Mohammad Hadi Noori Kooshki Mahshid Namdari Hamidreza Azimi Lisar Tohid Rafiei Farahnaz Fahimipour Majid Salehi Maissa Jafari 《Oral and maxillofacial surgery》2018,22(1):13-20
Objectives
The main aim of this study was to investigate whether Hounsfield unit derived from computed tomography (HU/CT) and gray value derived from cone beam computed tomography (GV/CBCT) can predict the amount of new bone formation (NBF) in the defects after bone reconstruction surgeries.Materials and methods
Thirty calvaria defects created in 5 rabbits and grafted with both radiolucent (RL, n = 15) and radiopaque (RO, n = 15) bone substitute materials were evaluated, 8 weeks postoperatively. The defects were scanned by multislice computed tomography (Somatom®, Siemens Healthineers, Erlangen, Germany) and CBCT (NewTom VG®, Qualitative Radiology, Verona, Italy). MSCT and CBCT scans were matched to select the exact region of interest (ROI, diameter = 5 mm and height = 1 mm). HU/CT and GV/CBCT of each ROI were obtained. Mean amount of NBF in whole of the defects was measured using serial histomorphometric assessment. We investigated the correlation between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF generally, and separately among the RL or RO grafted defects, by linear generalized estimating equation modeling. Receiver operation characteristic analysis was performed to check the accuracy of HU/CT and GV/CBCT in diagnosing more than 10% NBF in the samples.Results
There were linear correlations between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF.Conclusion
According to the results, both HU/CT and GV/CBCT can be considered as fairly good predictors for assessment of the amount of NBF following bone reconstruction surgeries.10.
Daekeun Kang Kyoung-Ho Kwak Seong-Sik Kim Soo-Byung Park Woo-Sung Son Yong-Il Kim 《Oral Radiology》2017,33(3):199-203
Objective
To evaluate the potential clinical application of fractal analysis of midpalatal suture fusion for prediction of pubertal growth spurts.Methods
Cone-beam computed tomography (CBCT) scans and hand-wrist radiographs were obtained for 165 subjects (81 males, 84 females; mean age 15.5 ± 7.6 years). From the CBCT image of the midpalatal suture, the region of interest was obtained according to a previously described protocol. The fractal dimension (FD) of the midpalatal suture was calculated. Spearman’s correlation coefficients were estimated to investigate the associations among age, skeletal maturation index (SMI), and FD of the midpalatal suture. Receiver-operating characteristic curves were used to determine the cutoff values for identification of pubertal growth spurts.Results
Significant correlations were observed among age, SMI, and FD of the midpalatal suture (P < 0.05). The optimal cutoff value of the FD for evaluation of a pubertal growth spurt was 0.9484 in males and 1.1205 in females. Fractal analysis of the midpalatal suture on CBCT images might be a clinically meaningful, objective, and quantitative method for evaluating pubertal growth spurts.Conclusions
The present results suggest that fractal analysis of the midpalatal suture could be useful for decision-making on treatments involving growth modification in growing children with a skeletal discrepancy.11.
Objectives
The present study investigated the position and relationship of the maxillary third molars to the maxillary sinus. These molars were detected to have a close relationship with the maxillary sinus based on panoramic images, using cone-beam computed tomography (CBCT).Methods
This retrospective study evaluated 162 impacted third molars from 100 patients that showed a superimposed relationship between the maxillary sinus and third molars on panoramic images obtained from CBCT. CBCT images were used to assess the horizontal (buccopalatal) and vertical positions of the maxillary sinus relative to the maxillary third molars, proximity of the roots to the sinus, and angulation and depth of the third molars. The associations among the angulation, depth of third molars, and horizontal and vertical positions of the maxillary sinus relative to the third molar findings were examined using Chi square tests.Results
Based on the winter classification, the most frequent tooth position was vertical (59.9 %), followed by mesioangular (14.2 %), distoangular (9.9 %), and others. Most impacted teeth were at the level between the occlusal and cervical levels of the adjacent second molar. Regarding the relationships of the maxillary third molars with the maxillary sinus examined on CBCT, vertical type III (buccal root related with maxillary sinus) (34 %) and horizontal type 2 (maxillary sinus located between roots) (64.8 %) were seen most frequently.Conclusions
The relationship between the maxillary sinus and third molar roots should be considered during extraction. When a risk of sinus perforation is predicted in an extraction, a presurgical CBCT examination could be valuable.12.
Ling Gao Wenhao Ren Shaoming Li Jingjing Zheng Lingfa Xue Yaoxiang Xu Qibo Wang Jianzhong Song Zhichao Dou Minzhan Zhou Wenlin Xiao Keqian Zhi 《Oral Radiology》2018,34(3):251-256
Objectives
Bone quality comprises bone mineral density and trabecular microstructure. The aim of this study was to explore the effectiveness of cone-beam computed tomography (CBCT) in evaluating bone quality of large odontogenic cystic lesions after decompression using CBCT and BoneJ software, and to determine whether secondary definitive surgery can be guided using CBCT data.Methods
Twenty-seven patients with large odontogenic cystic lesions treated by decompression were evaluated by CBCT. Medical history and perioperative details were analyzed.Results
The \(\Delta\)CT values for all patients with cystic lesions decreased after decompression, with no differences for age, sex, and histology (p?>?0.05). Bone volume fraction and trabecular number of new cancellous bone (0.012%, 0.17/mm3) were lower than those of normal cancellous bone (0.189%, 0.47/mm3) (p?<?0.05), while new cancellous bone trabecular separation (11.344?±?2.556 mm) was stronger than normal cancellous bone trabecular separation (4.833?±?2.232 mm) (p?<?0.05). There were no differences in trabecular thickness between new cancellous bone (3.812?±?1.593 mm) and normal cancellous bone (4.598?±?3.573 mm) (p?=?0.746). The \(\Delta\)CT values of five patients with favorable osteogenesis were ??72, ?86, ??86, ?47, and ??55, those of three patients with moderate osteogenesis were ??107, ?120, and ??71, and those of two patients with poor osteogenesis were ??165 and ??127 during secondary definitive surgery.Conclusions
CBCT is considered beneficial for evaluating bone quality of large odontogenic cystic lesions after decompression, while providing potentially useful information for referral to secondary definitive surgery.13.
Lutfi Mohamed Mohamed Elhamruni Hamdy Abdelmegeed Mohamed Marzook Wael Mohamed Said Ahmed Mohamed Abdul-Rahman 《Oral and maxillofacial surgery》2016,20(3):281-287
Objective
The purpose of this study was to investigate the effect of the dental implant penetration into the maxillary sinus cavity in different depths on implant and sinus health in a dog model.Materials and methods
The study sample included eight titanium dental implant placed in four female dogs immediately after extraction of the first maxillary molar in the palatal socket and assigned into four groups according to the protruding of implant tips (control group A?=?0 mm, and study groups B, C, and D with protrusion of 1, 2, and 3 mm, respectively). The bone blocks of the implants were harvested 5 months postoperatively and evaluated by cone beam computed tomography (CBCT) and histological analysis.Results
The whole groups showed no signs of inflammation during the 5-month period of the study. The tips of the implants in group B with penetrating depths of 1 mm were found to be fully covered with newly formed bone. The tips of the implants in group C with penetrating depths of 2 mm were exposed in the sinus cavity and showed partially new bone coverage, while depths of 3 mm in group D were found to have no bone formation and the dental implant fixture sites were communicated with the sinus cavity. No significant differences were found among the groups regarding implant stability.Conclusion
Despite the protrusion extents, penetration of dental implant into the maxillary sinus with membrane perforation does not compromise the sinus health and the implant in canine.14.
Valerie G. A. Suter Reinhilde Jacobs Marcia R. Brücker Alberto Furher Jim Frank Thomas von Arx Michael M. Bornstein 《Clinical oral investigations》2016,20(3):553-561
Objectives
Maxillary incisors (MI) are often affected by dentoalveolar injury resulting in tooth devitalization and apical periodontitis. The aim of the present study was to analyze any association between a history of dentoalveolar injury and the shape and size of the nasopalatine canal (NC) using cone beam computed tomography (CBCT).Material and methods
Patients were allocated to the trauma group if they had a history of dentoalveolar injury and a root filling in at least one MI and/or one missing MI. As controls, 100 matched-controlled (age and gender) patients were selected. NC dimensions including length, width at midway, and diameter of incisal and nasal foramen were measured in sagittal and axial CBCT planes. Furthermore, an evaluation of NC bulging signs, apical osteolysis of MI, and its fusion with NC was performed.Results
In the trauma group (n?=?96), 31.3 % had at least one missing MI, and 95.8 % had a root filling in a MI. The antero-posterior dimension of the incisive foramen (p?=?0.02) and of the NC at midway (p?= 0.04) was significantly larger in the trauma group. Significantly more cases with a bulging sign were found in the trauma (n?=?19) than in the control group (n?=?3, p?= 0.001). An apical osteolysis was identified in 5.1 % of MI, and 12/38 did show a fusion with the NC.Conclusion
Wider dimensions of the NC and a bulging sign may suggest a former dentoalveolar injury to the anterior maxilla. Periapical osteolysis of central MI over 5 mm in diameter tends to fuse with the NC.Clinical relevance
In patients with a history of dentoalveolar injury and/or apical periodontitis, the NC should be evaluated on available CBCT images. Any inflammatory processes in the neighboring teeth should be recognized and eliminated as they may initiate bulging of the NC and/or the formation of a nasopalatine duct cyst (NPDC). NC with bulging signs should be monitored clinically and radiographically to diagnose a NPDC in an early stage.15.
Noura A. Alsufyani Michelle L. Noga Manisha Witmans Paul W. Major 《Oral Radiology》2017,33(3):161-169
Objective
To review recent use of three-dimensional (3D) imaging, specifically cone-beam computed tomography (CBCT), in the analysis of the upper airway for diagnosis or treatment outcomes in patients with sleep-disordered breathing (SDB).Types of studies reviewed
Literature review of relevant medical and dental studies utilizing 3D imaging to assess the upper airway.Results
Imaging of the upper airway provided insight into potential areas of obstruction. Accessibility of CBCT to dentists is reflected in several applications of upper airway diagnosis, treatment planning, and different treatment outcomes, as well as association with craniofacial development. However, multiple deficiencies in image acquisition, 3D reconstruction, and analysis are evident.Practical implications
The role of CBCT in the analysis of the upper airway is growing; however, critical limitations remain. An understanding of these limitations, clarification of misconceptions, and improvements in analysis methods are required to ensure proper use and development of CBCT.16.
17.
Objectives
There are many developmental variations in the permanent dentition. Dens invaginatus can be recognized on many dental X-rays of affected patients, but not every image allows for assessment of the type of malformation. The aim of the present study was to assess the presence of dens invaginatus with radiological features using cone-beam computed tomography (CBCT).Methods
CBCT images of 33 patients were evaluated. Age, sex, side, lateralization, occurrence in a particular group of teeth, type of invagination, differentiation, and the consequences of these factors were analyzed.Results
Forty-one teeth with dens invaginatus met the inclusion criteria for this evaluation. Females were affected more frequently than males (57.6 vs. 42.4%, respectively). The patients’ age ranged from 7 to 40 years, and the occurrence of dens invaginatus peaked from age 9 to 13 years. In total, 92.7% of affected teeth were present in the maxilla, more often unilaterally (75.8%) than bilaterally (24.2%). The most frequent tooth with dens invaginatus was the maxillary lateral incisor (53.7% of affected teeth). Almost two-thirds (63.4%) of affected teeth were found on the left side and 36.6% were found on the right. The tooth anatomy was distorted within the crown and root. Dens invaginatus sometimes affected other surrounding teeth and reduced their esthetics.Conclusions
The obtained data indicate that CBCT examination is an essential tool in assessing dens invaginatus and can guide dental practitioners in treating patients who exhibit characteristic features of this disorder. CBCT allows the clinician to distinguish the type of anomaly.18.
Sameep Kadakia David Chan Yadranko Ducic Ricardo Cristobal Moustafa Mourad 《Oral and maxillofacial surgery》2017,21(1):7-11
Objective
We analyzed patients with advanced parotid malignancy requiring proximal facial nerve exposure undergoing mastoidectomy versus lateral temporal bone resection to determine differences in local and distant recurrence.Study design
The study design is a case series with chart review.Setting
The setting is in Tertiary care practice in Fort Worth, Texas from January1998 to January 2014.Subjects and methods
The study included 120 patients with advanced parotid malignancy, 82 males between 19 and 87 years, and 38 females between 26 and 83 years. Patients with no overt bone involvement were treated with parotidectomy and mastoidectomy for exposure of the proximal facial nerve, and patients with clinically suspected (radiographic imaging or clinical fixation) bone involvement were treated with parotidectomy and lateral temporal bone resection. Follow up ranged from a minimum of 18 months to 11 years following surgery.Results
Sixty patients were treated with mastoidectomy and 60 were treated with lateral temporal bone resection. In patients treated with mastoidectomy, 13 had local recurrence and 7 had distal recurrence. In patients treated with lateral temporal bone resection, 2 had local recurrence while 9 had distant recurrence. Statistical analysis revealed that patients treated with mastoidectomy developed local recurrence (p = 0.0022) more commonly than those treated with lateral temporal bone resection. There was no significant difference in distant recurrence between both groups (p = 0.5949).Conclusions
Patients with advanced parotid malignancy should be treated aggressively with parotidectomy and lateral temporal bone resection regardless of bone involvement due to increased risk of local recurrence in those treated with mastoidectomy alone.Level of evidence
Level of evidence is a 4 case series.19.
20.
Doğan Dolanmaz Alparslan Esen Ahmet Mihmanlı Kubilay Işık 《Oral and maxillofacial surgery》2016,20(2):203-209