Clinical Radiographic Study Research Articles

Ovoid pontics in the aesthetic management of the upper anterior sector. Case report

Tooth loss in the anterior sector causes not only functional alterations, but also aesthetic ones that alter people's quality of life, which is why its rehabilitation is one of the most common demands of patients in dentistry. One of the techniques used for the aesthetic management of partial edentulism is ovoid pontics. The clinical case of a 46-year-old female patient treated at the dental and aesthetic surgery postgraduate clinic of the San Gregorio de Portoviejo University, for the rehabilitation of the edentulous upper anterior sector, is reported. After the clinical radiographic study, the diagnosis and a comprehensive and interdisciplinary treatment plan were established, which included: oral prophylaxis, removal of dental calculus, endodontics, dental surgery, surgical procedure for modeling the gingival ridge, and creation of ovoid pontics with Zirconium. The ovoid pontic made with zirconium to rehabilitate the anterior areas of the oral cavity is an excellent option that meets the aesthetic and functional expectations of the patient

Treatment of dental fluorosis Level: microabrasion with 6% hydrochloric acid. Case report

Dental fluorosis is a malformation of the dental enamel, which is characterized by an increase in its porosity and permeability, and variations in the clinical presentation in relation to the time and amount of fluoride consumed by the patient. The case of a male patient, 22 years old, with no pathological history or allergy to medications or chemical substances, goes to the dental office reporting dissatisfaction with his dental appearance. After clinical radiographic study, the diagnosis of mild fluorosis was established according to the Dean Index, and microabrasion with 6% hydrochloric acid was chosen as treatment. The procedure followed is described and the different management options for dental fluorosis are discussed. Dental fluorosis is widely present both worldwide and in Ecuador. However, many patients are unaware of their condition and do not receive adequate treatment. Microabrasion was the technique of choice for this case, due to the effectiveness and stability of its results already reported. The management of the patient with dental fluorosis must be individualized, the use of a minimally invasive technique, such as microabrasion with 6% hydrochloric acid, turned out to be a safe and effective method of treatment, which provides the patient with adequate dental aesthetics, and improves your quality of life

Humeral and Glenoid Version in Reverse Total Shoulder Arthroplasty: A Systematic Review.

There is increasing interest in reverse total shoulder arthroplasty (RTSA) as a reliable treatment for arthritic, rotator cuff deficient shoulders. Humeral and glenoid version are controversial parameters that can influence internal and external rotation, muscular forces, and implant stability as outcomes of RTSA. The aim of this study was to obtain an overview of the current knowledge on the effect of both humeral component version and glenoid component version and give recommendations on their most optimal degree for RTSA. A comprehensive quantitative review of the published literature on the effect of humeral version and glenoid version in RTSA was performed, to identify its influence on the range of movement, muscle forces, and intrinsic stability of the reverse prosthesis. Eleven studies were included: nine were biomechanical studies, one was a clinical-radiographic study, and one was an implant design consideration. Anterior stability can be improved by implanting the humeral component in neutral or with some anteversion. Glenoid component retroversion has been proven to reduce the likelihood of subluxation, while increasing ER and ROM at the same time. The study was conducted considering 5° anteversion; neutral; and 5°, 10°, and 20° retroversion of the glenoid component. Although a final opinion has not been yet expressed on the matter, the general consensus tends to agree on restoring 0° to 20° of retroversion of the humeral and glenoid component to yield the best outcomes.

The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Al Kassar M, Heshmeh O. The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. 2023. doi:10.5114/jos.2022.124301. APA Al Kassar, M., & Heshmeh, O. (2023). The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. https://doi.org/10.5114/jos.2022.124301 Chicago Al Kassar, Mohamad, and Omar Heshmeh. 2023. "The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study". Journal of Stomatology. doi:10.5114/jos.2022.124301. Harvard Al Kassar, M., and Heshmeh, O. (2023). The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. https://doi.org/10.5114/jos.2022.124301 MLA Al Kassar, Mohamad et al. "The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study." Journal of Stomatology, 2023. doi:10.5114/jos.2022.124301. Vancouver Al Kassar M, Heshmeh O. The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. 2023. doi:10.5114/jos.2022.124301.

Comparison Between Two Different Design Concepts of 4- Implant Assisted Mandibular Complete Overdenture:- periimplant bone height changes

Abstract:
 Purpose: This study was accomplished to evaluate the bone height changes radiographically and the reliability of use either two posterior short or inclined implants with two conventional anterior implants retaining mandibular overdenture.
 
 Materials and methods: Ten male mandibular completely edentulous patients were divided in two equal groups after delivered complete dentures. For the first group (short implant design- group A) two vertical implants were inserted in the canine areas and two short vertical implants were inserted in the 1st molar area. For the second group (inclined implant design- group B) two vertical implants were inserted in the canine areas and two 30o distally inclined implants were inserted in the second premolar area. Digital standardized periapical radiographic assessment for horizontal and vertical alveolar bone height changes was carried out at T0 (immediately), T6 (6 months), T12 (12 months) and after mandibular complete overdenture insertion.
 Result: 1. VBL decrease significantly with advance of time in both groups during the time intervals. The highest VBL around the implants was noted in the 1st six months followed by the 2nd six months, the highest amount of total VBL observed with the interval T0-T12, followed by the interval (T0-T6) and the inclined implant group showed significant higher total VBL than short implant group at the intervals T0-T6 and T0-12.
 2- HBL decreased significantly with advance of time in both groups. For short and inclined implant group, the highest amount of total HBL observed with the interval T0-T12, followed by the interval (T0-T6). Short implant group showed significant higher total HBL than inclined group at the interval T0-T6 and T0-T12.
 
 Conclusion: Within the limitations of this clinical radiographic study it can be concluded that (1) The 30o distally inclined implants inserted in the posterior areas for assisting mandibular complete overdenture induce vertical bone loss more than the axially inserted implants (short or conventional implants). (2) The short implants inserted in the posterior areas for assisting mandibular complete overdenture induce horizontal bone loss more than the axially inserted implants.
 Keywords: Short implants, O-ring ball attachment, VBL, HBL.

Assessment of supracrestal tissue attachment variation in patients with chronic periodontitis before and after treatment: A clinical-radiographic study

Background/Aim. Healthy periodontium comprises the dento-gingival junction. Periodontal disease starts to appear when the integrity of the junctional epithelium is disturbed. Assessment of the supracrestal tissue attachment (SCTA) is essential because there is a frequent need for restoration or prosthesis after periodontal surgical and non-surgical therapy. The aim of the present study was to evaluate the SCTA variations in a patients with chronic periodontitis before and after treatment. Methods. Thirty systemically healthy patients with periodontitis were enrolled in the study. Fifteen patients were subjected to scaling and root planing and 15 to open flap debridement. Radiographic and clinical findings of the SCTA were assessed before and after treatment at 3-month and 6-month intervals. Results. Comparison between clinical and radiographic findings of the SCTA showed a significant difference in patients with periodontitis (p < 0.05). This difference was not significant after treatment of patients with shallow pockets with scaling and root planing (p > 0.05), but showed a significant difference in patients with moderate pockets treated by open flap debridement (p < 0.05). Conclusion. Progression in periodontal disease causes a reduction in the SCTA dimension, which regains its original dimensions after periodontal therapy. It takes around 3 months for the shallow pockets to regain the supracrestal tissue attachment to the original dimension when treated by scaling and root planing, whereas moderate pockets regain it after 6 months when treated with open flap debridement.

Comparative evaluation of platelet rich fibrin and advanced platelet rich fibrin in management of periodontal infrabony defect: A clinical radiographic study

Comparative evaluation of platelet rich fibrin and advanced platelet rich fibrin in management of periodontal infrabony defect: A clinical radiographic study

Forearm post-traumatic deformities: Classification and treatment

IntroductionThere is no classification for acquired forearm deformities. A clinical-radiographic study was conducted to classify these deformities and evaluate the results. Materials and methodsThirteen patients with forearm deformities following traumas or their treatment were included (11 men and two women, from 2000 to 2010). Mean age was 31 years (range 10–75 years). Initial treatment was conservative in five patients and surgical in eight patients. One segment was affected in seven patients (the radius in four patients, the ulna in three), and both segments were affected in six patients. Location assessment: 2 projections X-rays, including wrist and elbow. Deformity location: proximal, diaphisary, distal, defined with the abbreviation, in distal sense, R1, R2, R3 for the radius, and U1, U2, U3 for the ulna. Primary and secondary deformities were distinguished: secondary deformities occurred later in a different location than the primary one. Six patients were treated with plate and screws. An external fixator was used in six patients. One patient was treated with bone resection. Iliac crest bone graft was used in 10 patients, and vascularised fibula graft in one patient. ResultsThe primary deformity affecting the radial diaphysis (R2) determined a secondary deformity in four patients: in the distal ulna (U3) with ulnocarpal dislocation in three patients and in the distal radius (R3) in one patient. Results of osteosynthesis treatment were excellent in one patient, satisfactory in four and unsatisfactory in one. External fixation was excellent in one patient and satisfactory in five. Bone resection was satisfactory in one patient. DiscussionSurgical treatments with osteosynthesis are the major cause of acquired forearm deformities in adults. Location and aetiology of the deformities are essential for the surgical indication and the result. It is important to restore the length of the deformed segment, realigning the anatomical axis. X-rays enable clinicians to distinguish between primary and secondary forearm deformities. ConclusionCharacteristics and locations of post-traumatic deformities were identified. The major location is diaphisary and distal, the elbow is rarely affected. The functional consequence is a limitation in the range of motion of the hand. The best results are achieved with short-term treatment.

Coupling Between Sagittal and Frontal Plane Deformity Correction in Idiopathic Thoracic Scoliosis and Its Relationship With Postoperative Sagittal Alignment

Prospective clinical-radiographic study. To investigate the natural coupling behavior between frontal deformity correction and the simultaneous changes in thoracic kyphosis, and to examine how the postoperative thoracic sagittal realignment relates to this natural coupling behavior. Restoration of the sagittal alignment is one of the fundamental goals in scoliosis correction surgery. It is generally achieved by rod precontouring intraoperatively. However, clinical studies suggested that postoperative sagittal realignment seems to be more affected by the inherent properties of the spine rather than the instrumentation or the surgical maneuver. Ninety-eight idiopathic scoliosis patients with thoracic curves treated with one-stage posterior spinal fusion, using corrective segmental spinal instrumentation (hook-rod or pedicle screw-rod constructs) were investigated. Pre- and postoperative frontal and sagittal alignments were measured by standing anteroposterior and lateral radiographs. Preoperative frontal plane flexibility was assessed by the fulcrum bending radiograph in the standard manner, an additional radiograph was taken in the lateral plane, to assess how this frontal correction force affects sagittal plane alignment (lateral fulcrum bending radiograph). When thoracic frontal deformity was corrected under fulcrum bending, coupled changes in the thoracic kyphosis demonstrated 3 different patterns: thoracic kyphosis increased in 25 patients with a mean kyphosis of 9 degrees to 19 degrees, decreased in 45 with a mean of 34 degrees to 21 degrees and remained unchanged (within 3 degrees ) in 28 with a mean of 19 degrees to 18 degrees. After surgery, the direction of correction of thoracic kyphosis significantly correlated with the coupling patterns demonstrated on fulcrum bending radiographs (r = 0.579, P < 0.001). However, the actual postoperative thoracic kyphosis angle cannot be predicted by the preoperative lateral fulcrum bending radiograph. There was no statistically significant difference (P = 0.263) between using pedicle screws and hooks in achieving the additional correction beyond what was demonstrated on the lateral fulcrum bending radiographs. Changes in thoracic kyphosis on fulcrum bending due to natural coupling of deformities are directed towards "self-normalization." There is no difference in the sagittal plane deformity correction with the use of hook-rod system or pedicle screw-rod constructs. This can be used as a guideline for exact preoperative rod contouring to reduce the stress on the bone-implant interface and the rate of postoperative failures. The findings also suggest that it is not how big or strong the implants are, but rather the natural curve behavior will at least partially determine the final sagittal outcome.

A three-dimensional retrospective analysis of the evolution of spinal instrumentation for the correction of adolescent idiopathic scoliosis

This is a clinical radiographic study, spanning over three decades, analyzing the three-dimensional (3-D) changes in spine geometry after corrective surgery for adolescent idiopathic scoliosis (AIS) using four generations of instrumentation systems. The objective of this study was to retrospectively evaluate the evolution of spinal instrumentation over time by measuring the 3-D changes of spinal shape before and after surgical correction of subjects with AIS using Harrington/Harrington-Luque (H/HL) instrumentation, original and recent generations of Cotrel-Dubousset Instrumentation (CDI) with rod rotation maneuvers, as well as third generation systems using thoracic pedicle screws and direct vertebral derotation (DVD) manoeuver in order to determine if the claims for improved 3-D correction from generation to next generation could be substantiated. The 3-D shape of the thoracic and lumbar spine was recorded from a pair of standing radiographs using a novel 3-D reconstruction technique from uncalibrated radiographs in 128 adolescents with AIS undergoing surgery by a posterior approach. Changes in coronal Cobb angles, kyphosis, lordosis, as well as in a series of 3-D parameters computed from the spine reconstructions before and after surgery were used to compare the four groups. Results demonstrate statistically significant differences (P = 0.05) between generations with regards to the correction of the coronal Cobb angle, and different loss of physiological lordosis. More importantly, significant differences in the 3-D correction of the spine based on the orientation of the planes of maximal curvature were observed (20/-6% H/HL vs. 39/39% CDI vs. 42/18% DVD for the thoracic/lumbar regions, respectively), confirming that recent CDI and third generation instrumentations coupled with DVD can bring the deformity significantly closer to the sagittal plane. An increased correction in apical vertebra axial rotation was observed with the DVD manoeuver (74%), while fewer notable differences were found between DVD and recent CDI systems in terms of 3-D correction. This is the first quantitative study to clearly demonstrate that the rod derotation and DVD maneuvers can significantly improve 3-D correction of scoliotic deformities, thereby supporting the transition towards these more elaborate and costly instrumentation technologies in terms of 3-D assessment.

Influence of Interimplant Distance on Papilla Formation and Bone Resorption: A Clinical-radiographic Study in Dogs

Implant esthetics has been the focus of attention for the past decade, and one vital issue is the effect of interimplant distance on interimplant papilla formation and crestal bone loss. The aim of this study was to evaluate the effect of 1, 2, and 3 mm of interimplant distance on papilla formation and crestal resorption in submerged and nonsubmerged Ankylos implants after prosthetic restoration. Bilateral mandibular premolars of 7 dogs were extracted, and after 12 weeks each dog received 8 implants. Implants were placed so that 3 interimplant distances were created at 1 mm (group 1), 2 mm (group 2), and 3 mm (group 3). The sides and the position of the groups were randomly selected. Twelve weeks after placement, the implants received metallic prostheses that allowed 5 mm of space between the prosthetic contact point (CP) and the crestal bone (CB). After 8 weeks, the distance between the CP and the papilla (CP-P) and the gingival height at the distal proximal aspect of the prosthesis (CP-DE) was clinically measured. Radiographic images were obtained to measure the distance of the CP to the CB within the interimplant surfaces (CP-IP) and adjacent to the edentulous surfaces (CP-ED). The clinical measurement of CP-P for submerged and nonsubmerged implants was 3.57+/-1.17 mm and 3.10+/-0.82 mm for group 1, 3.57+/-0.78 mm and 3.16+/- 0.87 mm for group 2, and 3.35+/- 0.55 mm and 3.07+/-0.93 mm for group 3. The CP-DE was 3.25+/-0.77 mm for submerged and 2.78+/- 0.64 mm for nonsubmerged implants. The CP-IP for the submerged and nonsubmerged implants was 6.91+/-0.95 mm and 7.68+/-2.73 mm for group 1, 7.46+/-1.43 mm and 5.87+/-1.71 mm for group 2, and 7.72+/-0.81 mm and 7.59+/-1.33 mm for group 3. The CP-ED was 6.77+/-1.33 mm for submerged implants and 6.03+/-1.58 mm for nonsubmerged implants. There were no statistical significant differences for any of the measured parameters. We conclude that when the distance from the CP to the CB was 5 mm, interimplant distances of 1 to 3 mm did not affect papilla formation or crestal resorption of submerged or nonsubmerged implants in the dog model.

Cost efficiency analysis for fine-needle aspiration in the workup of parotid and submandibular gland nodules

The utility and cost effectiveness of salivary gland fine-needle aspiration (FNA) is controversial. Some authorities argue FNA has no added value over clinical-radiographic study because most salivary gland nodules occur in the parotid and the tumor's relationship to the facial nerve determines the operative procedure rather than the histology. Other experts contend FNA is of value by reducing the overall number of operative procedures performed. We studied 306 salivary gland nodules (214 parotid and 92 submandibular gland) undergoing FNA. One hundred and seventy one were subsequently surgically resected and the remaining 135 followed clinically. A 16% error rate was associated with the nonoperative group, necessitating later surgical resection. The cost of the FNAs and surgical resections (when performed) was calculated based on Medicare reimbursement rates. Costs were based on all cases undergoing initial FNA. The expense of initial resection was based on the observed percentage of patients undergoing resection in our series. The costs of resections related to erroneous FNA diagnoses were based on the error rate associated with FNA diagnoses clinically followed (i.e., chronic sialadenitis). Costs of FNAs, initial resections, and subsequent resections related to FNA errors were summed and compared with the cost which would have occurred if all nodules had been primarily resected.FNA reduced the number of operative procedures by approximately 65% for submandibular nodules and 35% for parotid nodules. Diagnoses which resulted in nonsurgical management included chronic radiation-induced sialadenitis, intraparotid lymph node, recurrent lymphoma, and accessory nodules or lobes of the parotid gland. Pure surgical management was associated with a cost of $275,750.00 per 100 patients. FNA management was associated with an expenditure of $206,632.00 per 100 patients, representing a savings of $69,118.00 (33% savings over surgical management alone). Based on these data, FNA appears to be cost effective in addition to supplying preoperative diagnoses helpful in counseling, operative planning, and allaying patient anxiety.

The impact of improved access and searching techniques on detection of the mesiolingual canal in maxillary molars

A clinical radiographic study of endodontically treated maxillary first and second molars was conducted. The study revealed that modifying the access preparation resulted in a definite increase in the number of mesiolingual canals located and obturated.

T2 and T3 sympathetic ganglia in the adult human: a cadaver and clinical-radiographic study and its clinical application.

The technique of percutaneous radiofrequency (RF) upper thoracic sympathectomy mandates an exact knowledge of the anatomical location of the sympathetic ganglia. Because conflicting descriptions are given in anatomy texts, we examined the T2 and T3 sympathetic ganglia in 48 sympathetic chains in adult cadavers to measure the exact location of the ganglia. Measurements were made relative to their distances (a) dorsal to the ventral surface of the vertebral body and (b) rostral or caudal to the midpoint of the vertebral body. Median locations of T2 and T3 ganglia were 17 to 20 mm dorsal to the ventral surface of the vertebral body and 2 mm rostral to the T1-T2 and T2-T3 vertebral bodies. The sympathetic chains lay lateral to and between the heads of the ribs at these levels. A clinical-radiographic correlation study of the sympatholytic effectiveness of various needle electrode placement sites during sympathectomy confirmed these findings. These data have been used to modify the technique of percutaneous RF sympathectomy.

A clinical-radiographic study of allogenic demineralized dentin implants in cystic jaw cavities

Different implantation materials have been used in cystic cavities in the jaws to accentuate and enhance healing following enucleation. No material lias proved to be ideal. In the, present study, allogenic demineralized dentin was used in a group of patients with jaw cysts. The observation period varied from 6 to 66 months. The dentin group (33 cases) appeared to have somewhat more immediate postoperative symptoms than the control group (37 cases), but had a lower incidence of operational defects and higher incidence of complete healing of the cyst cavity on radiographic examination.