Cone Beam Computed Tomography Measurements Research Articles

Cone beam computed tomography assessment of maxillary anterior teeth cervix dimensions in healthy adults for optimal anatomic healing abutments.

The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross-sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments. CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento-enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto-palatal (b), palatal (c), mesio-palatal (d), mesial (e), mesio-labial (f), labial (g), and disto-labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored. Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines. CBCT measurements of cervical cross-sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology. The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri-implant soft tissue.

A potential novel technique for measurement of pulp volume on periapical radiography: A pilot study.

Pulp volume can be assessed during dental treatment. Three-dimensional imaging techniques are not routinely used for this purpose because of high radiation doses. This study aimed to develop a novel method to measure pulp volume using periapical radiography. In this study, cone-beam computed tomography (CBCT) was used as a reference method. Periapical radiography and CBCTs obtained from the same patients (n = 32) were recorded. Pulp volume was determined by observing the density differences between the pulp and peripheral structures using ImageJ. A method of graph and volume calculation was developed for each tooth. The Shapiro-Wilk test and Mann-Whitney U test were used to show normality and non-normal distributions. The Bland-Altman plot was used to show the scattering of the mean versus difference values of the measurements of the two methods used to calculate the pulp volume. Normality was evaluated using the Shapiro-Wilk test. CBCT measurements are normally distributed (p = 0.307), while ImageJ is not normally distributed (p = 0.027). Therefore, the mean difference between the two groups was analyzed using the nonparametric Mann-Whitney U test. There was a statistically significant difference between the CBCT and ImageJ measurements (p = 0.01). According to Spearman's correlation analysis, the results obtained from the novel method were moderately correlated with those obtained from the reference method (r = 0.444). The results of this study indicated that a novel method-based Java software can be used to calculate pulp volume using low-dose radiation containing periapical radiography.

Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18-month follow-up prospective cohort study.

The current guidelines recommend that immediate implants be placed in patients with thick (>1 mm) buccal bone due to the inevitable tissue remodeling that follows tooth extraction. The aim of the current study was to investigate the effect of buccal bone thickness on bone resorption in immediate implant placement and compare two measuring techniques of the aforementioned resorption. The present study was designed as a prospective nonrandomized, controlled clinical trial. A total of 30 implants were split between the two study arms, thin buccal bone and thick buccal bone. The primary outcome was to assess vertical bone changes radiographically by cone beam scans preoperatively, at 2 months and 18 months after implant placement in patients with thin and thick buccal plate. Secondary outcomes included the change in the thickness of the buccal bony plate, marginal bone loss, and pink esthetic score. Only 26 implants were statistically analyzed as one early failure was observed in each group. Furthermore, 2 patients of the thick group withdrew from the study. Cone beam computed tomography measurements revealed that at 2 months the vertical bone loss was 1.09 for the thin group and 0.85 for the thick group. The buccal bone plate resorption of the thin group was 0.39 mm while it was 0.52 mm for the thick group. The buccal bone plate was 1.25 mm in the thin group and 1.88 mm in the thick group. The PES did not show any significant difference with very good esthetic results. Within the limitations of the current study, the amount of buccal bone plate resorption and the subsequent thickness obtained after implantation in both groups suggest successful long-term results. The two measuring techniques have proven to be comparable and reliable in the measurement of buccal bony plate changes. https://classic. gov/ct2/results?cond=&term=NCT04731545&cntry=EG&state=&city=&dist=.

Is the assessment of the mandibular molar danger zone affected by field of view and voxel size in cone beam computed tomography examinations?

ObjectiveTo verify if assessment of the danger zone (DZ) in the mesial root of mandibular molars is affected by field of view (FOV) and voxel sizes in cone beam computed tomography (CBCT) scans. Study DesignForty mandibular molars were scanned by micro-computed tomography, creating the reference standard. The teeth were then submitted for CBCT scans with FOVs of 10 × 5.5 cm and 5 × 5.5 cm and voxel sizes of 0.4, 0.2, 0.15, and 0.075 mm3. The smallest dentin thickness in the DZ from the mesiobuccal and mesiolingual canals was measured at 2, 4, and 6 mm apical to the root furcation. Descriptive statistics, paired t-tests, and intraclass correlation coefficients were used for statistical analysis with significance established at P<0.05. ResultsAll CBCT measurements overestimated the DZ dentin thickness (P<0.001) compared to the reference standard. The greatest overestimation occurred in the 5 × 5.5 cm FOV with 0.4 mm3 voxels (P = 0.007). Dentin thickness measured with the 5 × 5.5 cm FOV and 0.075 mm3 voxels was significantly smaller and produced the best ICC value with the reference standard (0.936). ConclusionsCBCT overestimates the dentin thickness of the DZ regardless of FOV and voxel sizes. The 5 × 5.5 cm FOV showed the best performance with the 0.075 mm3 voxel size, but it performed poorly with 0.4 mm3 voxels.

Maxillary sinus in gender determination: a morphometric analysis using cone beam computed tomography.

Gender determination of skeletal remains is an important forensic procedure in the identification process. Maxillary sinus remains intact even when the skull and other bones may be badly disfigured. Cone beam computed tomography (CBCT) can provide precise information about complex anatomical structures, as it is characterized by rapid volumetric image acquisition with high resolution. The present study aimed to assess the accuracy of maxillary sinus measurements using cone beam computed tomography in gender determination and to develop a formula using discriminate function analysis. Bilateral maxillary sinus images (left and right) were acquired for 200 patients (100 females and 100 males) and different parameters (width, length, height, area, perimeter, and volume) were measured and evaluated. Mean and standard deviation of both maxillary sinuses measurements were calculated and compared. The data was subjected to discriminative statistical analysis and analyzed using an unpaired t-test. The difference between all these variables was statistically significant between males and females. Based on discriminant analysis, the most pronounced variable in the differentiation of gender groups was maxillary sinus height. Gender assessment was established correctly with an accuracy of 75% for females and 64% for males with an overall accuracy of 69.5%. Adding other independent variables to the model did not result in an improvement in overall accuracy. Cone beam computed tomography measurement of maxillary sinus can be used as an aid in forensic anthropology for gender determination.

Comparative Assessment of Three Different Alveolar Ridge Dimension Measurement Methods before Implant Placement: An In Vivo Study.

The purpose of this study was to compare the three various techniques for measuring the alveolar ridge's dimensions prior to implant insertion. For this study, a total of 36 participants were chosen. To prepare a surgical stent, a study model was created from an alginate impression. A first point (reference point) was marked on the crest of the ridge in relation to the adjacent teeth. Then, one point (point 1) and another point (point 2) were marked at distances of 3 and 6 mm, respectively, from the reference point. Based on the procedure for measuring the size of the alveolar ridge, the study was divided into the following groups. Group I: Cone-beam computed tomography (CBCT) measurement method; Group II: Ridge mapping measurement method; Group III: Direct caliper measurements method. Descriptive statistics were used to estimate the mean and standard deviation (SD). The Student's unpaired t-test was utilized for the statistical analysis. The 5% level of significance was used. There was no significant difference found between CBCT with ridge mapping and direct caliper measurements. However, on comparison of ridge mapping and direct caliper measurements technique, at point 1, the ridge mapping was 3.88 ± 0.12 and the direct caliper measurement was 3.62 ± 0.08. At point 2, the ridge mapping was 6.58 ± 0.06 and the direct caliper measurement was 6.32 ± 0.04. There was a statistically significant difference found between these two measurement methods. Within the limitation, the current study came to the conclusion that when CBCT and ridge mapping measurements were individually compared with the gold standard-the surgical open method, CBCT-demonstrated to be a highly specific and sensitive method for detecting the residual alveolar ridge width in the treatment planning of dental implants. Evaluation of alveolar bone is necessary during treatment planning for dental implant placement. Using simply panoramic and/or periapical radiographs to evaluate the bone may not be sufficient because it only provides two-dimensional information regarding the implant locations. Therefore, for better implant placement, three-dimensional information of the implant site, such as CBCT and ridge mapping technique, should be assessed.

The contribution of image processing in the evaluation of guided bone regeneration

One of the most ambitious goals of modern bone surgery is to predict the shape of the bone defect, monitor the progress of bone regeneration, and assess the quantity and quality of newly formed bone. Calcium phosphate biomaterials such as hydroxyapatite and tricalcium phosphate are commonly used as bone substitutes in maxillofacial and dental surgery. The objective of this work is to use cone-beam computed tomography (CBCT) and image processing to assess the spatial (architectural) layout, rate of bone generation and osseointegration of implanted commercial granules (PAH 40%, β-TCP 60%, size 0.5 to 1 mm) in the bone defect generated after tooth extraction. CBCT measurements were performed at 48 hours and 12 months. The analysis of 3D images and the application of appropriate morphological mathematical operations allowed us to evaluate the volume of the cavity to be filled, the volume occupied by the granules and the volume of porosity generated by the random stacking of the granules. The result shows that the bone generation rate reaches a value of 89% after one year of implantation. This study shows that by using 3D image processing techniques CBCT, the same results as classical anatomical and histological studies can be obtained.

Comparative Assessment of Reliability and Accuracy of Cone-Beam Computed Tomography (CBCT) Over Direct Surgical Measurement for Periodontal Bone Loss: A Prospective, Cross-Sectional Study.

Assessing bone condition holds significant value in the diagnosis, treatment planning, and prognosing the periodontal disease; its importance is undeniable. The main aimof the present study was to evaluate the accuracy of alveolar bone measurements due to periodontal disease using cone-beam computed tomography (CBCT), by comparingwith surgical measurements, considered as the gold standard. A prospective cross-sectional study included a sample of 40 individuals diagnosed with chronic periodontitis who required periodontal surgery. A total of 202 sites were assessed for vertical and horizontal bone loss in the anterior (76 sites) and posterior (126 sites) teeth. Bone loss was measured using CBCT and a UNC 15 periodontal probe during the surgical intervention, and then compared. The statistical analysis involved employing a Student's t-test to compare measurements. Unpaired t-tests and correlation analyses were conducted using Pearson's correlation coefficient test. To establish statistical significance, a threshold of p<0.05 was considered appropriate. The statistical analysis carried out on the mean values of CBCTand direct surgical measurements for vertical bone loss demonstrated a significant difference (p<0.01). However, the values obtained for horizontal bone loss did not display statistical significance. A strong correlation of 0.94-0.99 existed between surgical and CBCT measurements. A statistically significant distinction was observed between the two methods in measuringbone loss at the distal and palatal sites of the anterior teeth. Both CBCTand direct surgical measurement exhibit comparableaccuracy potentialin assessing alveolar bone loss. CBCT provides an accessibility advantage by enhancing visual accessto challenging sites during surgical interventions, including palatal and distal areas of the teeth.

CBCT Compared to Transgingival Probing as a Tool for Estimating Alveolar Bone Crest Level in Patients with Altered Passive Eruption.

Alveolar bone crest level is essential in determining the need for bone removal in subjects with altered passive eruption (APE). This study assessed the validity of Cone Beam Computed Tomography (CBCT) and transgingival probing. Patients presenting with APE were assessed. Transgingival probing was performed to clinically assess the distance between the cementoenamel junction (CEJ) and the crest of the bone at the mid-point of upper anterior teeth. CBCT was used to assess this distance at the same point. Upon reflection of a full mucoperiosteal flap the actual distance was measured. Similar actual and CBCT measurements of the distance between the CEJ and bone crest at upper right 3, upper left 2 and upper left 3 (P>0.05) were recorded. However, in upper right 2, upper right 1 and upper left 1 the distance was significantly greater on CBCT (P<0.05). No significant difference was detected between transgingival probing and the actual distance at all teeth assessed. Careful transgingival probing provides an accurate measure of the distance between the CEJ and crest of the Bone. CBCT gives an accurate estimate, However, it might not be justified for each patient in the presence of safer methods.

Comparison of linear and angular measurements in mandibular symphyseal region using lateral cephalometric and cone beam CT images

AbstractAimTo compare the linear and angular measurements of the mandibular symphyseal region using lateral cephalometric (LC) and cone beam computed tomography (CBCT) images.Materials and MethodsOne hundred patients justifying both LC and CBCT exposures were included. Both lateral cephalometric and CBCT images of the patients were used for angular and linear measurements. Angular measurements included vestibular concavity and lingual and tooth inclination angles. Vestibular and lingual cortical bone and total bone thickness measurements were obtained for the comparison of linear measurements. Three radiologists performed the measurements on 200 images. Comparison of the measurements and the imaging methods were done using paired‐ and Wilcoxon t‐tests. Inter‐observer reliability was evaluated with the intra‐class correlation coefficient (ICC).ResultsA significant difference was observed between measurements of two imaging methods for tooth inclination and vestibular concavity angles; however, no difference was found between LC and CBCT measurements for lingual inclination angle (p &gt; 0.05). Vestibular cortical bone and total bone thickness measurements showed a significant difference (p &lt; 0.05), whereas no difference was obtained in lingual bone thickness measurements of two imaging methods (p &gt; 0.05).ConclusionCBCT imaging is recommended in selected patients where recipient bone or bone augmentation site(s) reveal suspect in clinical examination and lateral cephalometric imaging may not reveal the true anatomic structure and relationships.

Novel biomaterial advanced platelet rich fibrin plus block for multiple gingival recession.

The study was aimed to assess and compare hard and soft tissue augmentation clinicoradiographically with and without advanced platelet rich fibrin + (A-PRF+) block for the treatment of multiple gingival recession using vestibular incision subperiosteal tunnel access (VISTA). A total of 24 patients, exhibiting multiple Miller's Class I or II recession in maxillary esthetic zone were included. Participants were divided into 2 groups, Group 1 treated with VISTA & A-PRF+ block whereas Group 2 with VISTA technique alone. Clinical parameters Probing Depth (PD), Width of Keratinized Gingiva (WKG), Gingival Biotype (GB), Recession Depth (RD) and Clinical Attachment Level (CAL) were recorded at baseline and at the end of 6 months. The radiographic CBCT measurements of labial plate thickness was taken at baseline and 6 months postoperatively. From baseline to 6 months both the groups showed a clinical and statistical improvement in the parameters. However, a statistically significant difference between both the treatment modalities was not observed. In the inter group comparison radiographically, labial plate thickness was statistically significant at the end of 6 months when compared to the baseline. A-PRF+ block along with VISTA technique can be an alternative effective root coverage procedure for the management of multiple gingival recession in the maxillary esthetic zone. This article is protected by copyright. All rights reserved.

Clinical and cone beam computed tomography outcomes of maxillary anterior implant restorations after immediate implant placement with interim restorations: A 1- to 14-year retrospective analysis

Statement of ProblemAchieving and maintaining optimal tissue health and esthetics when immediately placing maxillary anterior implants with interim restorations has been challenging and the clinical outcomes heterogenous. PurposeThe purpose of this retrospective study was to evaluate the clinical outcomes of immediate placement of maxillary anterior implants with interim restorations and compare the tomographic and clinical results before and after implant placement in participants followed for 1 to 14 years. Material and methodsTwenty participants receiving 25 postextraction single implants in the anterior maxilla were studied. Clinical parameters included pink esthetic score (PES) and white esthetic score (WES), peri-implant phenotype, implant probing, plaque index, and cone beam computed tomography (CBCT) to compare initial and at least 1 year after crown placement (postoperative). For qualitative variables, a descriptive analysis was carried out. The PES and WES results were analyzed by using nonparametric statistics, the median (ME) and the interquartile range (IQR) were used as summary measures, and the Wilcoxon sum of signs test was used to compare the total scores between the intervention area and the contralateral tooth. To compare pre- and postoperative data points, the paired t test was used (α=.05). ResultsMean ±standard deviation (SD) time of follow-up was 7.6 ±4.2 years. Twenty participants with a mean ±SD age of 62.4 ±11.0 years old received 25 implants. Mean ±SD initial torque value at implant placement was 38.6 ±9.63 Ncm. Bone height at the top of the alveolar ridge (BH) and bone width at the middle of the alveolar ridge (BW2) showed a statistically significant decrease between the initial and subsequent CBCT measurements (both P<.001). Likewise, the bone width at the alveolar crest (BW1) showed a statistically significant decrease between the initial and post-CBCT measurements (P=.006). Facial bone integrity (FBI) revealed a statistically significant increase between the initial and postoperative time periods (P<.001). The PES index showed a median of 9.0 IQR (8-10), statistically lower than the contralateral tooth (P=.032). No significant differences were found for the WES index or for FBI, regardless of the peri-implant phenotype. ConclusionsImmediate implant placement in the maxillary anterior sextant was found to be a predictable procedure with good esthetic results when the protocol described was used. Labial bone loss is inevitable after tooth extraction but can be compensated for by filling the space with a xenograft material. Long-term gingival tissue integrity was maintained, regardless of phenotype, in periodontally healthy participants.

Evaluation of the validity of mental foramen USG measurements by comparison with CBCT and determination of blood flow.

To examine mental foramen (MF) morphology and morphometry in comparison with ultrasonography (USG) and cone-beam computed tomography (CBCT), and to determine the relationship between mental artery blood flow parameters and age, gender, dental status, alveolar crest height, mandibular cortical index (MCI) with USG. A total of 120 MF and mental arteries of 60 patients (21 males and 39 females), including 20 patients in each group, aged 18-39, 40-59, and 60years and above, were evaluated. The horizontal and vertical diameter of the MF and the distance between it and the alveolar crest were evaluated with USG and CBCT. In addition, mental artery blood flow parameters were examined by USG. When the horizontal diameter values of MF were compared in USG and CBCT measurements; the diameter was significantly lower in the measurements obtained by USG (p < 0.05). It was observed that there were no mental arteries whose blood flow could not be recorded, 31 (25.8%) had strong blood flow and 89 (74.2%) had weak blood flow. No significant correlation was observed between gender and blood flow parameters (p > 0.05). Considering that CBCT images are used as gold standard in our study, it may be said that USG is not as reliable as CBCT in evaluating the MF dimensions in the maxillofacial region. Nevertheless, USG is a suitable technique for determining the visualizing and blood flow of the MF.

Modeling the effect of bilateral sagittal split osteotomy on posterior, superior and medial space dimensions of the temporomandibular joint: a retrospective controlled cohort study

BackgroundTo model the effect of isolated bilateral sagittal split osteotomy (BSSO) on changes in posterior (PSD), superior (SSD), and medial space dimensions (MSD) of the temporomandibular joint.MethodsUsing a retrospective cohort study design, pre- and postoperative (immediately after surgery; 1 year follow-up) cone-beam computed tomography measurements of 36 patients who had undergone BSSO for mandibular advancement were compared with a control group of 25 subjects from whom a mandibular odontogenic cyst was removed under general anesthesia. Generalized estimation equation (GEE) models were used to examine the independent effects of study group, preoperative condylar position, and time points on PSD, SSD, and MSD adjusting for covariates (age, sex, and mandibular advancement).ResultsNo significant differences were found regarding changes in PSD (p = 0.144), SSD (p = 0.607), or MSD (p = 0.565) between the BSSO and control groups. However, the preoperative posterior condylar position showed significant effects on PSD (p < 0.001) and MSD (p = 0.043), while the preoperative central condylar position demonstrated a significant effect on PSD (p < 0.001).ConclusionThe data suggest that preoperative posterior condylar position is a significant effect modifier of PSD and MSD over time in this cohort.

Inclination of mandibular incisors and symphysis in severe skeletal class III malocclusion

ObjectiveThe aim of this study was to systematically explore the inclination of the lower central incisor and symphysis in alveolar bone in severe skeletal class III patients.Materials and methodsA total of 198 severe skeletal class III patients (ANB ≤ -4°) who underwent combined orthodontic and orthognathic treatment were divided into three groups based on the mandibular plane angle (MP-SN). Pretreatment lateral cephalograms were analysed and compared among the three groups. We also assessed cone-beam computed tomography (CBCT) images of 11 samples to investigate the reliability of the cephalometric analysis.ResultsANOVA showed no statistically significant differences in the angle between the long axis of the mandibular symphysis and the long axis of the lower central incisor (MIA) among the low-angle, normal-angle and high-angle groups (P > 0.05), while significant differences were found in the angle between the axis of the lower incisor and the mandibular plane (IMPA) among the three groups (P < 0.001). The mean IMPA decreased with increasing MP-SN in the 198 patients. The mean MIA in the low-angle and normal-angle groups was 3.70° and 3.52°, respectively, while the value (2.33°) was smaller in the high-angle group. Paired-samples t test showed no statistically significant differences between the cephalometric and CBCT measurements of the MP-SN, the angle between the mandibular plane and the Frankfort plane (FH-MP) and the MIA (P > 0.05).ConclusionsIn severe skeletal class III patients, the long axis of the lower central incisor was highly consistent with the long axis of the mandibular symphysis, which was more obvious in the high-angle subjects. The MIA reflects the physiological inclination of the lower central incisor better than the IMPA.

ESTIMATION OF REMAINING DENTIN THICKNESS UNDER DENTIN CARIES WITH CBCT, RADIOGRAPHS AND DIGITAL CALIPER IN PERMANENT TEETH - AN INVITRO STUDY

Background: In order to avoid damaging the dental pulp from mechanical injury and inammatory agents, operators are recommended to remove just infected dentin while maintaining affected and sound dentin. As a result, maximum dentin tissue must be preserved. This study aims to identify a logistic and accurate link between the amounts of actual remaining dentine thickness and the radiographic remaining dentine thickness before starting caries excavation, thereby lowering the incidences of post-operative sensitivity and direct pulpal exposure. In a three-stage experiment, 24 extracted human teeth were Material and Methodology: evaluated using three different techniques: digital radiography(RVG), cone beam computed tomography(CBCT), and using digital caliper after hand excavation of any remaining caries. The results were compared and statistical analysis was performed for each tooth. The difference among the Statistical analysis: groups was analyzed by post hoc Turkey and analysis of variance tests. A P &lt; 0.05 was considered statistically signicant. The results Results: indicated no signicant difference between actual clinical (digital caliper) and CBCT measurements (P=0.054) but a signicant difference was found between actual clinical and periapical radiographs. It is imprecise to Conclusion: estimate the remaining dentine thickness using routine periapical radiographs; a reliable and affordable method still has to be developed.

Does endodontics influence radiological detection of external root resorption? an in vitro study

BackgroundExternal root resorption (ERR) has a multifactorial etiology and is difficult to diagnose, which means that is continues to be of research interest. This work mainly aims to determine whether external root resorption can be differentially detected in root-filled versus non-endodontically treated teeth using digital periapical radiography (DPR) and cone-beam computed tomography (CBCT).MethodsThe Checklist for Reporting In-vitro Studies (CRIS) guidelines were followed throughout this study. This experiment highlights the preparation and generation of standardized synthetic teeth measured on three-dimensional records converted into Digital Imaging and Communication on Medicine (DICOM) file format. Twelve replicate maxillary incisors were randomized into two groups: (G1) six non-endodontically treated, and (G2) six endodontically treated teeth. In both groups, actual tooth lengths of all specimens were measured and compared with measurements obtained using DPR and CBCT. Simulated ERR lesions [0.12, 0.18, 0.20 mm × 0.5 mm depth in the mesial, distal and palatal apical regions] were created progressively, radiographic images were recorded, and 24 DPRs and 96 CBCTs were obtained in total. Eight blinded, previously calibrated researchers made a total of 1920 measurements (using Horos Software). Data were analyzed using the Shapiro–Wilk, ANOVA, Kruskal–Wallis and Wilcoxon rank post-hoc tests [Bonferroni correction in multiple comparison tests (p < 0.05)].ResultsICC values for intra- and inter-examiner agreement were appropriate. DPR overestimated ERR detection compared to the actual and CBCT measurements [Mean diff = 0.765 and 0.768, respectively]. CBCT diagnosis of ERR lesions in specimens without root canal treatment was significantly more accurate than DPR diagnoses on both non-endodontically and endodontically-treated specimens [p = 0.044; p = 0.037, respectively]. There was an 18.5% reduction in sensitivity in all DPR diagnoses made on endodontic teeth versus those made on non-endodontically treated teeth. For the smallest ERR lesions, this sensitivity was even more marked, with 27.8 and 25% less sensitivity, respectively.ConclusionsThe results of this study highlight that both CBCT and DPR are good diagnostic methods for ERR. Nevertheless, root canal filling material influences diagnostic capability in ERR. The clinical significance was that the presence of intracanal material reduces the detection and diagnosis of ERR by DPR in teeth with root canal treatment.

Immediate dentoskeletal and periodontal effects of miniscrew-assisted rapid palatal expansion: Comparison between young vs middle-aged adults

This study aimed to compare the dentoskeletal and periodontal changes after miniscrew-assisted rapid palatal expansion (MARPE) in patients aged 18-29 and 30-45 years. The sample comprised 28 subjects with transverse maxillary discrepancy successfully treated with MARPE. The young adult (YA) group comprised 14 subjects (mean age, 22.8 years; 3 male, 11 female). The middle adult (MA) group comprised 14 subjects (mean age, 36.8 years; 6 male, 8 female). All patients were treated with a 4-miniscrew MARPE expander. The activation protocol was one quarter turn twice a day until the midline diastema opening, followed by one quarter turn a day until overcorrection. Cone-beam computed tomography (CBCT) scans taken before and immediately after the expansion was analyzed using OnDemand3D Dental software. Using CBCT coronal images, transversal dentoskeletal and periodontal variables were measured in the preexpansion and postexpansion. Intergroup comparisons of expansion changes were performed using t and Mann-Whitney tests (P<0.05). Groups were compatible at preexpansion for most CBCT measurements. A success rate of midpalatal suture opening of 100% and 81% was observed for YA and MA groups, respectively. No intergroup differences were found for the maxillary and dental arch widths increases. The buccal tip of anchorage teeth was observed similarly in both groups. The buccal bone thickness of posterior teeth decreased, and the palatal bone thickness increased after expansion with no difference between groups. After MARPE, the MA group showed similar dentoskeletal and periodontal changes compared to the YA group.

Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients.

The primary aim was to evaluate dentoalveolar expansion with Invisalign clear aligners comparing linear measurements in ClinCheck vs. cone beam computed tomography (CBCT). This would enable an assessment of to what extent expansion gained from Invisalign clear aligners was due to buccal tipping and/or bodily translation of the posterior teeth. The study also evaluated the predictive value of Invisalign ClinCheck® (Align Technology, San Jose, CA, USA) to final outcomes. The orthodontic records of thirty-two (32) subjects comprised the sample to conduct this study. Linear values of the upper arch width were measured for premolars and molars at two different points (occlusal and gingival) utilized for ClinCheck® measurements and three different points for CBCT measurements before (T0 and after treatment (T1). Paired T-tests at a significance level of 0.05 were used for analyses. Expansion was found to be possible with Invisalign clear aligners. However, more expansion was measured at the cusp tips compared to gingival margins (p < 0.0001), indicating more tipping was occurring than bodily translation. ClinCheck® also showed a significant overestimation of the amount of expansion capable, with nearly 70% expression in the first premolar area, and the expression decreased as one moved posteriorly with only 35% expressed at the first molar area (p < 0.0001). Dentoalveolar expansion with Invisalign is achieved through buccal tipping of posterior teeth and bodily translation; and there is a significant overestimation of the amount of expansion achieved between ClinCheck® and clinical results.

Endoscopic visualization of the inferior alveolar nerve associated with somatosensory changes after impacted mandibular third molar extraction.

The aim of this study is to assess the relationship between somatosensory functional changes and inferior alveolar nerve (IAN) exposure after impacted mandibular third molars (M3M) removal. We recruited 35 patients who underwent impacted M3M extraction near the IAN. The M3Ms were extracted by combined endoscopy, piezosurgery, and contra-angle high-speed turbine handpiece. All IAN canal perforations and exposed regions were recorded and measured by endoscopy after extraction and on cone-beam computed tomography (CBCT) images before extraction. The patients were followed up 1, 7, and 35days after surgery. A standardized quantitative sensory testing (QST) battery was performed on the lower lip skin. All of 35 cases had exposed IAN on CBCT images, 5 of which had no exposed IAN under endoscopy. For the other 30 cases, the endoscopy-measured IAN length and width were shorter than the CBCT measurements (P < 0.001). The warm and mechanical detection thresholds (MDT) on the operation side were significantly higher than the contralateral side after surgery (P < 0.05). Thermal sensory limen, MDT, and cold pain threshold were strongly correlated with the exposed IAN length and MDT also with the exposed IAN width one day after surgery. In conclusion, it was found that not all exposed IAN in CBCT images were real exposure after surgery. The intraoperative exposed IAN endoscopic measurements were smaller than by CBCT and strongly correlated with some QST parameters.