Absence Of Dehiscence Research Articles

Effect of a metal artifact reduction algorithm on dehiscence and fenestration detection around zirconia implants with cone beam computed tomography

ObjectiveTo assess the efficacy of the metal artifact reduction algorithm (MARA) of the Cranex 3D cone beam computed tomography (CBCT) device in the detection of peri-implant dehiscence and fenestration around zirconia implants. Study designIn total, 60 implants were placed in bovine ribs. Dehiscence and fenestration defects were created around the implants, after which 60 CBCT images were obtained with and 60 without activation of MARA. Three radiologists examined the images for the presence of defects. The area under the curve (AUC) from receiver operating characteristic analysis, sensitivity, and specificity were calculated to assess the ability to discriminate the presence vs. absence of bone defects. One-way analysis of variance was employed to analyze outcomes measures. The significance level was established at 5% (α = 0.05). ResultsAUC values indicated excellent discrimination of dehiscence on images with MARA activation and an excellent to outstanding range of discrimination with MARA deactivation. For fenestration, MARA activation and deactivation both led to outstanding discrimination. Sensitivity and specificity values revealed that activation of MARA was helpful in distinguishing the presence vs. absence of dehiscence, while both MARA conditions were helpful for fenestration. However, there were no statistically significant differences between MARA activation and deactivation for any outcome measure (P>0.05). ConclusionCBCT is suitable for detecting peri-implant defects, but MARA application does not significantly affect peri-implant dehiscence and fenestration detection. Statement of Clinical RelevanceEarly diagnosis of defects in cortical bone around zirconia dental implants is important for maintaining function and aesthetics. Cone beam computed tomography is suitable for detecting peri-implant defects, but metal artifact reduction algorithms do not significantly affect diagnostic outcomes.

Pre- and Postoperative Evaluation of Immediate and Early Implant Placement in Esthetic Areas with Pre-Extraction Facial Dehiscence: A Retrospective Clinical Study.

The clinical requirement for a good esthetic result for immediate implant placement is the absence of dehiscence in the anterior facial alveolar bone. In the presence of dehiscence, it is recommended to use a connective tissue graft in addition to immediate implant placement or to change to early implant placement. However, the literature focusing on dehiscence is scarce, and the influence of different placement times and combined use of connective tissue graft on postoperative esthetics in cases with dehiscence is unclear. Therefore, we quantitatively evaluated the pre-extraction dehiscence morphology and postoperative changes in the facial tissue of implants in three groups: immediate implant placement (Group I), immediate implant placement with connective tissue graft (Group IC), and early implant placement (Group E). To this end, 52 implants were obtained (20 in Group I, 16 in Group IC, and 16 in Group E). A wider dehiscence increases the risk of soft tissue regression, which was one reason for choosing early implant placement. A combination of immediate implant placement and connective tissue graft, or early implant placement, tended to result in less soft tissue regression due to the thicker postoperative facial soft tissue volume.

Floral nectary structure, nectar presentation and morpho-anatomical analysis of male‐fertile and male‐sterile anthers in onion (Allium cepa, Amaryllidaceae)

Background and aims: The onion (Allium cepa var. cepa) is an allogamous species in which male-sterile lines have been developed. However, the structure of the flower and floral nectaries have only been briefly described. The objective of this study is to update the floral anatomy data, comparing the gynoecium and androecium of male-fertile and male-sterile lines, and to analyze the three-dimensional structure of the floral nectary. M&M: Conventional optical and scanning electron microscopy techniques were used. Results: Fertile and sterile male flowers have the same structural organization. The septal or gynopleural nectary is organized in three zones: 1) production area formed by the glandular tissue arranged radially in the septa of the ovary, 2) discharge zone: a small channel at the apex connects the nectariferous tissue with the pocket formed between the ovary wall and the overlying ridge, and 3) presentation and harvest zone, where the excreted nectar accumulates, formed between the widened base of the inner staminal filaments opposite the ovary. Conclusions: The only anatomical differences in the flowers sterile male lines are the lack of pollen production and the absence of dehiscence, despite having a normal stomium and anther wall. The floral nectaries of onion are a clear example of secondary presentation of nectar.

Outcome of using plat eletrich plasma in postextractional wound treatment

Background. Platelet-enriched plasma (PRP) is a revolutionary autologous biomaterial that stimulates bone regeneration, enhances regenerative processes and postoperative wound healing, thus simplifying future implant-prosthetic rehabilitation. Objective of the study. Evaluation of PRP regeneration properties in postextractional wound regeneration. Material and Methods. The clinical examination was used as research methods: inspection, palpation, paraclinical examination: panoramic radiography / CBCT and VAS test were performed. The diagnosis and treatment plan were established, as follows: extraction associated with PRP injection. Results. At the postoperative evaluation of the patient after 7 days of treatment, the intensity of pain according to the modified VAS method showed decreased values- from 4 to 1, the postextractional wound was completely healed, the level of regeneration was attested by the absence of dehiscence, presence of the pale pink epithelium, absence of the postoperative facial edema according to the craniometric points, the Celsius signs also were absent. Conclusion. The use of PRP biomaterial in wisdom tooth extraction is a minimally invasive method of tissue regeneration that reduces the rehabilitation period and prevents the occurrence of post-extraction complications.

An In Vivo and Cone Beam Computed Tomography Investigation of the Accuracy in Measuring Alveolar Bone Height and Detecting Dehiscence and Fenestration Defects.

To investigate cone beam computed tomography (CBCT) accuracy in measuring facial bone height and detecting dehiscence and fenestration defects around teeth. Patients who were treatment planned for periodontal flap or dental implant surgeries were enrolled (n = 25). CBCT imaging (Carestream CS 9300) was obtained at 0.09-mm voxels (n = 10 patients, 23 teeth) and at 0.18-mm voxels (n = 15 patients, 33 teeth). Facial bone height measurements, from cusp tip to crest of bone height along the long axis of the tooth, and presence or absence of dehiscence or fenestration defects were recorded from CBCT images in triplicates independently by two examiners. The corresponding clinical measurements were made at the time of surgery. Comparisons of CBCT and clinical measurements were made using paired t tests for teeth: anterior and posterior, maxillary and mandibular, with or without restorations, or root canal therapy. Level of agreement between investigators was assessed by concordance correlation coefficients (CCC), Pearson's correlation coefficient (PCC), and Cohen's Kappa. Comparing mean CBCT and clinical measurements, statistically significant differences were noted for 0.09-mm and 0.18-mm voxel sizes, for anterior and posterior teeth, for maxillary and mandibular teeth, for teeth with or without restorations, and for teeth without root canal therapy (P < .05). Clinical and CBCT measurements were similar for teeth with crowns and with root canal therapy (P > .05). CBCT measurements underestimated mean facial bone height from 0.33 ± 0.78 to 0.88 ± 1.14 mm (mean ± SD) and absolute facial bone height values from 0.56 ± 0.35 to 1.08 ± 0.92 mm. Intraexaminer and interexaminer reliability for measuring facial bone height ranged from poor to substantial (PCC = 0.78 to 0.97 and CCC = 0.63 to 0.96, respectively). Interexaminer reliability for detection of dehiscence and fenestration defects ranged from poor to moderate (Cohen's Kappa = -0.09 to 0.66). CBCT imaging underestimated facial bone height and overestimated the presence of dehiscence and fenestration defects.

Short-term outcomes of the multi-institutional bladder exstrophy consortium: Successes and complications in the first two years of collaboration

Bladder exstrophy is a rare diagnosis that presents major reconstructive challenges. To increase experience and proficiency in the care of bladder exstrophy (BE), the Multi-Institutional BE Consortium (MIBEC) was formed, with a focus on refining technical aspects of complete primary repair of bladder exstrophy (CPRE) and subsequent care. Outcome measures included successful CPRE (absence of dehiscence), complications, and integrated points of technique and care over the short-term. Boston Children's Hospital, Children's Hospital of Philadelphia and Children's Hospital of Wisconsin alternately served as the host, with observation, commentary and critique by visiting collaborating surgeons. CPRE with bilateral iliac osteotomy was performed at 1-3 months of age. High-definition video capture of the surgery allowed local and distant broadcast to facilitate real-time observation and teaching, and recording of all procedures. From February 2013 to February 2015, MIBEC participating surgeons performed CPRE on 27 consecutive patients (22 classic BE, five epispadias). There were no dehiscences in 27 patients (0%, 95% CI 0-12.5%). Thirteen girls and 14 boys underwent CPRE at a median age of 2.3 months (range 0.1-51.6). One boy had a hypospadiac urethral meatus at CPRE completion. Hydronephrosis of mild or moderate grade was present postoperatively in eight girls and two boys. Additional results, per gender, are presented in the Summary table below. Absence of dehiscence in this cohort was comparable or compared favorably with the literature. However, several girls had significant obstructive complications following CPRE. The rate of bladder outlet obstruction (BOO) in girls was increased compared with published reports. A low complication rate was noted in the boys following CPRE, which was comparable to reports in the literature, and early signs of continence and spontaneous voiding were noted in some boys and girls. Limitations included variation in patient age at presentation, thereby introducing a wide age range at CPRE. Outcome data were limited by short follow-up regarding voiding with continence. This collaborative effort proved beneficial regarding significantly increased surgeon exposure to CPRE, refinement of CPRE technique, surgeon learning and expertise. Technical refinement of CPRE is ongoing.

Editor's Comment and Q&A: Dehiscence and fenestration in patients with Class I and Class II Division 1 malocclusion assessed with cone-beam computed tomography

Introduction The aim of this study was to compare the presence of alveolar defects (dehiscence and fenestration) in patients with Class I and Class II Division 1 malocclusions and different facial types. Methods Cone-beam computed tomography records of 79 patients with Class I and 80 patients with Class II Division 1 malocclusions and no previous orthodontic treatment were evaluated. The sample included 4319 teeth. All teeth were analyzed by 2 examiners who evaluated sectional images in axial and cross-sectional views to check for the presence or absence of dehiscence and fenestration on the buccal and lingual surfaces. Results Dehiscence was associated with 51.09% of all teeth, and fenestration with 36.51%. The Class I malocclusion patients had a greater prevalence of dehiscence: 35% higher than those with Class II Division 1 malocclusion ( P Conclusions Alveolar defects are a common finding before orthodontic treatment, especially in Class I patients, but they are not related to the facial types.

Dehiscence and fenestration in patients with Class I and Class II Division 1 malocclusion assessed with cone-beam computed tomography

The aim of this study was to compare the presence of alveolar defects (dehiscence and fenestration) in patients with Class I and Class II Division 1 malocclusions and different facial types. Seventy-nine Class I and 80 Class II patients with no previous orthodontic treatment were evaluated using cone-beam computed tomography. The sample included 4319 teeth. All teeth were analyzed by 2 examiners who evaluated sectional images in axial and cross-sectional views to check for the presence or absence of dehiscence and fenestration on the buccal and lingual surfaces. Dehiscence was associated with 51.09% of all teeth, and fenestration with 36.51%. The Class I malocclusion patients had a greater prevalence of dehiscence: 35% higher than those with Class II Division 1 malocclusion (P <0.01). There was no statistically significant difference between the facial types. Alveolar defects are a common finding before orthodontic treatment, especially in Class I patients, but they are not related to the facial types.

Vestibular-Evoked Myogenic Potentials in the Diagnosis of Superior Canal Dehiscence Syndrome

Patients with superior canal dehiscence (SCD) syndrome have vertigo and oscillopsia induced by loud noises and by stimuli that result in changes in middle ear or intracranial pressure. We recorded vestibular-evoked myogenic potentials (VEMP responses) in 10 patients with SCD syndrome. The diagnosis had been confirmed in each case by evoked eye movements and by high-resolution CT scans of the temporal bones that showed a dehiscence overlying the affected superior canal. For the 8 patients without prior middle ear disease, the VEMP threshold from the dehiscent ears measured 72 - 8 dB NHL (normal hearing level) whereas the threshold from normal control subjects was 96 - 5 dB NHL ( p < 0.0001). The VEMP threshold measured from the contralateral ear in patients with unilateral dehiscence was 98 - 4 dB NHL ( p > 0.9 with respect to normal controls). Two patients with apparent conductive hearing loss from middle ear disease, and SCD, had VEMP responses from the affected ears. In the absence of dehiscence, VEMP responses would not have been expected in the setting of conductive hearing loss. These findings confirm earlier studies demonstrating that patients with SCD syndrome have lowered VEMP thresholds. Conditions other than SCD syndrome may also lead to lowered VEMP thresholds. Rather than being based upon a single test, the diagnosis of SCD syndrome is best established when the characteristic symptoms, signs, VEMP response, and CT imaging all indicate SCD.