Cone Beam Computed Tomography Scans Research Articles

Incidence and effect of an extra root on the crown morphometry of the maxillary second molars among Malaysian Mongoloids.

This study aimed to investigate whether the presence of two palatal roots on permanent maxillary second molars (MSMs) can affect the crown size and crown's buccolingual and mesiodistal diameters. A retrospective study was conducted using 592 CBCT scans to investigate 1120 MSMs of Mongoloid Malaysians. 3D models were created to assess the four-rooted MSMs and other related teeth carefully. Crown size and crown's buccolingual and mesiodistal diameters were measured for the four-rooted MSM, the adjacent maxillary first molar (MFM), and their antimeres to investigate the effect of the presence of an extra root on the size and morphological features of the crown of these associated teeth. Only six out of the 1120 MSMs displayed four roots (0.53%). The incidence was 0.67% (2/298) for the Malay males and 0.4% (1/247) for the Malay females, with the Malay male having a bilateral occurrence of four-rooted MSM. The incidence was 0.34% (1/294) for the Chinese males, while 0.71% (2/281) was detected in Chinese females. Interestingly, the four-rooted MSMs showed a wider mesiodistal distance than their three-rooted antimeres in three out of four cases. The presence of two palatal roots may also increase the crown's buccolingual diameter. The presence of anatomical variations and the dramatic change in crown measurements can be good indicators of the presence of extra roots, including in some of their related neighbours. This might help dentists to take precautionary measures when performing tooth extractions and endodontic therapy.

Enhanced alveolar ridge preservation with hyaluronic acid-enriched allografts: a comparative study of granular allografts with and without hyaluronic acid addition

PurposeRidge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition.MethodsIn this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (Allo), 21 received allogeneic bone substitutes with hyaluronic acid (AlloHya). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation.ResultsVertical height loss after 4 months was significantly greater in the Allo group (-0.82 ± 0.95 mm) compared to the AlloHya group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (Allo) and 10.3 ± 7.7% (AlloHya) (p = 0.038). After four months, average bone density was significantly higher in the AlloHya compared to the Allo group (p = 0.004). Nearly all implants (39 out of 40) were classified as “Success” according to the ICOI scheme, with no differences in implant quality between the two study groups.ConclusionsImproved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation.

Investigation of pelvic floor influence on prostate displacement in image-guided radiotherapy.

The uncertainty of target location during prostate cancer radiotherapy plays an important role in accurate dose delivery and radiation toxicity in adjacent organs. This study analyzed displacement correlations between the prostate and pelvic floor. We retrospectively analyzed registration results from 467 daily cone-beam computed tomography (CT) in 12 patients with prostate cancer who received radiation therapy. We analyzed prostate displacement and the pelvic floor relative to the pelvic bone's anatomy in the translational and rotational directions and identified statistical correlations. The systematic (Σ) and random (σ) displacements of the prostate in the three translational directions, anterior-posterior (AP), superior-inferior (SI), and right-left (RL), were 1.49 ± 1.45, 2.10 ± 1.40, and 0.24 ± 0.53 mm, respectively, and in the rotational directions of the pitch, roll, and yaw were 2.10 ± 2.02°, 0.42 ± 0.74°, and 0.42 ± 0.64°, respectively. The pelvic floor displacements were 2.37 ± 1.96, 2.71 ± 2.28, and 0.47 ± 0.84 mm in the AP, SI, and RL directions, respectively, and 0.93 ± 1.49°, 0.98 ± 1.28 °, and 0.87 ± 0.94° in the pitch, roll, and yaw directions, respectively. Additionally, there were statistically significant correlations between the displacement of the prostate and pelvic floor in the AP and SI directions, with correlation coefficients (r) of 0.74 (p < 0.001) and 0.69 (p < 0.001), respectively. The movement of the pelvic floor may be an important factor that causes prostate displacement, affecting the accuracy of radiotherapy. Therefore, it is necessary to take appropriate measures to ensure that the pelvic floor muscle tension is as consistent as possible in the treatment' CT scan and daily treatment.

Incidence of Maxillary Sinus Disorders in Dental Patients Undergoing Cone-Beam Computed Tomography: A Retrospective Cross-Sectional Study.

Background Cone-beam computed tomography (CBCT) was quickly adopted in dentistry settings due to its compact size, low cost, and minimal ionizing radiation dose when compared to medical computed tomography. CBCT generates three-dimensional (3D) images that are useful in a variety of oral and maxillofacial circumstances, including diagnosis and assessment of disease severity, treatment planning and delivery, and follow-up. A significant advantage of CBCT lies in its capability to recognize incidental findings. In the realm of dental CBCT imaging, incidental findings often involve the maxillary sinuses, temporomandibular joints, or other craniofacial structures. Objective To demonstrate the incidental findings of maxillary sinus disorders in dental patients undergoing CBCTfor numerous indications. Methods A retrospective cross-sectional study was carried out using data extracted from the Picture Archiving and Communication System (PACS)of Pure Smile Dental Center and Dental College Teaching Hospitals in the Jazan regionfrom September to December 2022. The study sample included a total of 70 patients who underwent orthodontics CBCT, most of whom were female(76%). Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 27 (IBM Corp., Armonk, USA), along with descriptive statistics. Furthermore, chi-square tests and cross-tabulation were done to assess the relation between the study variables. A p-value <0.01 and <0.05was considered statistically significant. Results The most common dental CBCT findings were root invasion (18.6%), followed by gingivitis (7.14%), and dental caries (4.29%). Of the 70 patients, 42 (60%) had maxillary sinus findings, including opacification (50%), sinusitis (40%), mucosal thickening (34.3%), and polyps (7.1%). Female patients had more frequency of incidental findings related to males (41.43% and 18.57%, respectively). Conclusion A high percentage of dental patients exhibited incidental maxillary sinus findings in CBCT scans, confirming the utility of CBCT as a precise imaging method for detecting paranasal sinus disorders. A holistic documentation of incidental findings is crucial for improving patient outcomes and treatment plans.

Analysis of palatal marginal alveolar exostosis and palatal torus using cone-beam computed tomography.

The aim of the present study was to analyze palatal marginal alveolar exostosis (PMAE) and palatal torus (PT). Cone-beam computed tomography (CBCT) of the maxilla in multiplanar sections and volumetric renderings were used to assess this. PT and PMAE were classified according to location and morphology. Height, width, length, and thickness of the overlying mucosa were determined. The prevalence of PT and PMAE was assessed according to sex and age group. The correlation between the occurrence of PMAE and PT was also evaluated. A total of 385 CBCT scans were examined. PT was found in 38.70% of the sample and located more frequently in the middle third of the maxilla (52.35%) with a flat shape (42.95%). PMAE was found in 54.80% of the sample, bilaterally in 56.40% of the cases, and located more frequently in the molar region (62.42%) in the form of small nodules (36.97%). The mucosa covering PMAE was generally thicker than that over PT. The use of CBCT for the identification of PT and PMAE invivo showed high frequencies of both conditions. The occurrence of PMAE was independent of the presence of PT.

Safe sites in the mandibular buccal shelf for orthodontic mini-screws: Tomographic study in different facial types

Objectives: The objective of this study was to verify safe sites on the mandibular buccal shelf (MBS) for extra-alveolar mini-screw insertion according to facial type. Material and Methods: In this retrospective study, 84 cone-beam computed tomography scans were equally divided into three groups according to the patient’s facial type: Group 1, hyperdivergent; Group 2, neutral; and Group 3, hypodivergent. The total buccal alveolar bone thickness was measured in five zones between the mesial root of the first molar and the distal root of the second molar, 3, 6, and 9 mm apical to the cementoenamel junction (CEJ). Results: MBS areas with adequate thickness for temporary anchorage device (TAD) insertion were as follows: Group 1, second molar distal root 9 mm from the CEJ; Group 2, second molar distal root 6 and 9 mm from the CEJ; and Group 3, second molar mesial root 9 mm from the CEJ and second molar distal root 6 and 9 mm from the CEJ. Conclusion: The safe zones on the MBS for TAD insertion were located on the distal root of the second molar, 9 mm from the CEJ, for all facial types. For neutral and hypodivergent patients, the site located on the second molar distal root, 6 mm from CEJ, was included; for hypodivergent patients, the site located on the second molar mesial root, 9 mm from the CEJ, was included.

A novel methodology for analysing dental implant positional changes from virtual planning to placement without CBCT.

Introduction This paper introduces a novel methodology for analysing dental implant positioning in vivo, advancing beyond traditional methods that rely on post-placement cone beam computed tomography (CBCT) scans.Method The core of the methodology is comparing stereolithography (STL) files, representing pre-planned and actual post-placement implant positions. These STL files, exported from guided surgery planning and computer-aided design software, focus on clinically significant key points, like the apical and coronal midpoints. Additionally, the method uses pose detection, differing fundamentally from CBCT scan approximations.Discussion Relying on pose detection instead of scanner resolution, this method aligns with international standards and overcomes CBCT and intra-oral scanner limitations. It allows for a more precise and accurate assessment of implant positions, independent of scanner technology constraints. Further refinements include potential detailed reporting of apical deviations, enhancing implant placement accuracy.Conclusion This research has significant implications for dental implantology, enhancing implant placement precision and overall procedure success. Introducing an automated process for report generation through a batch script improves efficiency and precision, streamlining the analysis process. This innovation sets the stage for future technological advancements, improving both the accuracy and reliability of implant placement assessments.

Predicting the Risk of Maxillary Canine Impaction Based on Maxillary Measurements Using Supervised Machine Learning.

To predict palatally impacted maxillary canines based on maxilla measurements through supervised machine learning techniques. The maxilla images from 138 patients were analysed to investigate intermolar width, interpremolar width, interpterygoid width, maxillary length, maxillary width, nasal cavity width and nostril width, obtained through cone beam computed tomography scans. The predictive models were built using the following machine learning algorithms: Adaboost Classifier, Decision Tree, Gradient Boosting Classifier, K-Nearest Neighbours (KNN), Logistic Regression, Multilayer Perceptron Classifier (MLP), Random Forest Classifier and Support Vector Machine (SVM). A 5-fold cross-validation approach was employed to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision and F1 Score were calculated for each model, and ROC curves were constructed. The predictive model included four variables (two dental and two skeletal measurements). The interpterygoid width and nostril width showed the largest effect sizes. The Gradient Boosting Classifier algorithm exhibited the best metrics, with AUC values ranging from 0.91 [CI95% = 0.74-0.98] for test data to 0.89 [CI95% = 0.86-0.94] for crossvalidation. The nostril width variable demonstrated the highest importance across all tested algorithms. The use of maxillary measurements, through supervised machine learning techniques, is a promising method for predicting palatally impacted maxillary canines. Among the models evaluated, both the Gradient Boosting Classifier and the Random Forest Classifier demonstrated the best performance metrics, with accuracy and AUC values exceeding 0.8, indicating strong predictive capability.

Geometry-Aware Attenuation Learning for Sparse-View CBCT Reconstruction.

Cone Beam Computed Tomography (CBCT) plays a vital role in clinical imaging. Traditional methods typically require hundreds of 2D X-ray projections to reconstruct a high-quality 3D CBCT image, leading to considerable radiation exposure. This has led to a growing interest in sparse-view CBCT reconstruction to reduce radiation doses. While recent advances, including deep learning and neural rendering algorithms, have made strides in this area, these methods either produce unsatisfactory results or suffer from time inefficiency of individual optimization. In this paper, we introduce a novel geometry-aware encoder-decoder framework to solve this problem. Our framework starts by encoding multi-view 2D features from various 2D X-ray projections with a 2D CNN encoder. Leveraging the geometry of CBCT scanning, it then back-projects the multi-view 2D features into the 3D space to formulate a comprehensive volumetric feature map, followed by a 3D CNN decoder to recover 3D CBCT image. Importantly, our approach respects the geometric relationship between 3D CBCT image and its 2D X-ray projections during feature back projection stage, and enjoys the prior knowledge learned from the data population. This ensures its adaptability in dealing with extremely sparse view inputs without individual training, such as scenarios with only 5 or 10 X-ray projections. Extensive evaluations on two simulated datasets and one real-world dataset demonstrate exceptional reconstruction quality and time efficiency of our method.

A cadaveric study of induced isolated orbital floor fractures and implications for surgical decision-making: comparison of two preoperative imaging modalities

Computed tomography (CT) is the gold standard for the diagnosis of isolated orbital floor fractures, while cone beam computed tomography (CBCT) is an alternative. The aim of this study was to compare the diagnostic accuracy of CT and CBCT for isolated orbital floor fractures. Forty-eight isolated orbital floor fractures were systematically induced in cadaver orbits. CBCT and CT scans of each cadaver head were performed and the image data imported into ProPlan CMF for analysis. The orbital floor area (OFA), orbital defect area (ODA), and peri-orbital tissue herniation were evaluated. Surgical decision-making differed significantly according to the imaging modality (P = 0.031). The odds of decision discrepancy between CBCT and CT were higher with increasing ODA/OFA ratios, when adjusted for peri-orbital tissue herniation and fracture localization (P = 0.026). An ODA/OFA ratio cut-off value of >36.25% had a sensitivity of 100% and specificity of 71% (area under the curve 0.83, P = 0.011) for predicting discrepancies between CBCT and CT in surgical decision-making. In this cadaveric study, CT and CBCT were diagnostically equivalent for isolated orbital floor fractures with an ODA/OFA ratio ≤36.25%. However, fractures exceeding this threshold may be better evaluated by CT to avoid discrepancies in surgical decision-making.

Analysing the informative content of the upper jaw pathology visual examination

Objective. To conduct a comparative analysis of the informative content of cone beam computed tomography (CBCT), multispiral computed tomography (MSCT) and paranasal sinuses half-axial X-ray images in the upper jaw pathology diagnosis. Materials and methods. 96 CBCT and MSCT scans of the upper jaw and the similar number of X-ray images of the same patients were analyzed. Results. The analysis of a three-dimensional image and native slice reading in the Planmeca programme makes it possible to determine metric parameters, localization, prevalence of the pathological process and involvement of the upper jaw structures validly. Software features of the Radiant and OneDemand3D had error interval of р ≥ 0,2 mm while analyzing the same criteria. Half-axial X-ray examination demonstrated the lowest informative content. Conclusion. The most informative method of visualization of the upper jaw connective tissue structures, pathological processes, their borders and mutual involvement is CBCT. This is predetermined by the interface functionalities.

A Case of Simultaneous Sinus Augmentation and Oroantral Fistula Closure for Implant Preparation.

An oroantral communication (OAC) may form in the upper molar region after tooth extraction. The patient is a 59-year-old female, who is a non-smoker. At the initial visit, teeth #14, #15, and #17 were missing. After tooth #16 was extracted due to apical periodontitis, a bone defect with a diameter of approximately 4 mm was observed, leading to the formation of an oroantral fistula (OAF). Another window was created in the lateral wall adjacent to the superior part of the bone defect at the fistula site to achieve closure of the OAF through bone formation and simultaneously perform sinus floor elevation (lateral approach) for implant placement. Through this lateral window, instruments were inserted into the maxillary sinus towards the bone defect at the fistula site. During this process, the remaining bone between the lateral window and the bone defect at the fistula site was carefully removed with instruments, connecting the two bone defects to facilitate the manipulation of the instruments. The Schneiderian membrane was elevated without enlarging the tear. Six months after these surgeries, a CBCT scan confirmed the closure of the fistula with hard tissue and the elevation of the sinus floor. Subsequently, three implants were placed, and prosthetic treatment was completed. Follow-up data is provided, including periapical X-ray and CBCT images taken two years and three months after surgery (one year and three months after the placement of the final prosthetic structure). The progress so far has been favorable.

Fully automated method for three-dimensional segmentation and fine classification of mixed dentition in cone-beam computed tomography using deep learning

ObjectiveTo establish a high-precision, automated model using deep learning for the fine classification and three-dimensional (3D) segmentation of mixed dentition in cone-beam computed tomography (CBCT) images. MethodsA high-precision, automated deep learning model was built based on modified nnU-Net and U-Net networks and was used to classify and segment mixed dentition. It was trained on a series of 336 CBCT scans and tested using 120 mixed dentition CBCT scans from three centers and 143 permanent dentition CBCT scans from a public dataset. The diagnostic performance of the model was assessed and compared with those of two observers with different seniority levels. ResultsThe model achieved accurate classification and segmentation of specific tooth positions in the internal and external mixed dentition datasets (Dice similarity coefficient: 0.964 vs. 0.951; Jaccard coefficient: 0.931 vs. 0.921; precision: 0.963 vs. 0.945; recall: 0.945 vs. 0.941; F-1 score: 0.954 vs. 0.943). These indices consistently exceeded 0.9 across multiple conditions, including fillings, malocclusion, and supernumerary tooth, with an average symmetric surface distance of 0.091 ± 0.029 mm. For permanent dentition, the Dice similarity and Jaccard coefficients exceeded 0.90, the average symmetric surface distance was 0.190 ± 0.092 mm, and precision and recall exceeded 0.94. With the aid of the model, the performance of junior dentists in mixed dentition classification and segmentation improved significantly; in contrast, there was no significant improvement in the performance of senior dentists. The speed of segmentation conducted by the dentists increased by 20.9–22.8 times. ConclusionThe artificial intelligence model has strong clinical applicability, robustness, and generalizability for mixed and permanent dentition. Clinical SignificanceThe precise classification and 3D segmentation of mixed dentition in dentofacial deformities, supernumerary teeth, and metal artifacts present challenges. This study developed a deep learning approach to analyze CBCT scans, enhancing diagnostic accuracy and efficacy. It facilitates detailed measurements of tooth morphology and movement as well as informed orthodontic planning and orthotic design. Additionally, this method supports dental education by assisting doctors in explaining CBCT images to the families of pediatric patients.

Comparative evaluation of alveolar bone remodeling and root length changes in fixed appliances versus clear aligners: A retrospective cohort study on skeletal Class III malocclusion treatment

The retrospective study examined changes in the root length and alveolar bone surrounding maxillary incisors in patients with skeletal Class III malocclusion treated by surgical orthodontic treatment with either fixed appliances (FAs) or clear aligners (CAs). A total of 60 subjects were divided based on appliance type used. Cone beam computed tomography scans were taken at three stages: before treatment, after presurgical orthodontic treatment, and post-treatment for both groups. Vertical alveolar bone level and horizontal alveolar bone thickness (ABT) were measured at four heights (3, 6, and 9 mm from the cementoenamel junction, and the root apex), along with root length, at these time points. Both groups showed a decrease in root length, with the CA group experiencing a significantly smaller reduction (0.4 ± 0.79 mm) compared with the FA group (0.64 ± 0.8 mm; P = 0.02). The FA group demonstrated more significant reduction in palatal ABT (P < 0.05) and greater root resorption, whereas the CA group exhibited considerable labial marginal bone resorption (P = 0.007) and a notable decrease in labiolingual inclination (P = 0.042). The findings suggest that FA and CA might lead to decreased ABT and significant root resorption, with FA therapy likely resulting in more pronounced effects. Both modalities led to notable vertical bone loss, particularly, on the labial side of the maxillary incisors in the CA group during postsurgical orthodontic treatment. Preventing iatrogenic deterioration of periodontal support surrounding the incisors is crucial during presurgical and postsurgical phases.

Three-dimensional assessment of alveolar bone changes and root resorption in extraction patients after fixed orthodontic treatment: A prospective study

The aim of this study was to evaluate the alveolar crestal bone height, alveolar bone thickness, and root resorption in mandibular incisors after fixed orthodontic treatment. A total of 35 patients (mean age 17.02 ± 3.24 years) with moderate to severe mandibular anterior crowding requiring first premolar extraction were included. Cone beam computed tomography scans of the mandibular anterior region were obtained from the patients before and after orthodontic treatment. The alveolar crestal bone height, cortical bone thickness (CBT) (at apex and midroot level), labial and lingual alveolar bone thickness, and root resorption were assessed for all mandibular incisors. Paired Student's t test was used to compare pretreatment and post-treatment alveolar bone changes and root resorption. A significant decrease in lingual crestal bone height was observed in all mandibular incisors after orthodontic treatment (P < 0.001). Lingual CBT decreased at the midroot level significantly for all mandibular incisors after completion of orthodontic treatment (P < 0.001). A significant decrease in total lingual bone thickness was observed in all mandibular incisors (P < 0.001). Root lengths of mandibular incisors decreased significantly in the sagittal and coronal sections after orthodontic treatment (P < 0.001). Fixed orthodontic treatment with premolar extraction results in a significant reduction of alveolar crestal bone height, CBT (at midroot level), and alveolar bone thickness on the lingual aspect of mandibular incisors. Significant orthodontically induced inflammatory root resorption was observed in all mandibular incisors after orthodontic treatment.

Effects of Simvastatin-Loaded Nanomicelles on the Early Preservation of Tooth Extraction Sites.

The present study intended to evaluate the effect of simvastatin-loaded nanomicelles (SVNs) on promoting new bone formation and reducing alveolar ridge resorption at the tooth extraction sites at the early healing of the extraction sockets. SVNs were synthesized using a dialysis method. The rabbit tooth extraction model was established, SVNs and simvastatin (SV) were loaded on gelatin sponge and inserted into the extraction socket. CBCT scans were performed at 0, 2, and 4weeks postoperatively to evaluate bone formation and alveolar ridge absorption in the extraction sockets. And all the animals were sacrificed and the mandibles were harvested. And HE staining and Masson staining were used for histological evaluation of the bone formation in the extraction sockets. Radiographic evaluation showed that compared with the blank control group, at 2 and 4weeks after extraction, SVNs increased the new bone density in the extraction sockets by 75.7% and 96.5%, and reduced the absorption rate of alveolar ridge length at the extraction sites by 60.8% and 49.1%, respectively. Histological evaluation showed that SVNs significantly improved the maturation of new bone tissue in the extraction sockets. SVNs can significantly accelerate healing and effectively reduce the absorption of alveolar ridge at the extraction sites in the early stage of tooth extraction socket healing.

Randomized Clinical Trial: Bone Bioactive Liquid Improves Implant Stability and Osseointegration.

Implant stability can be compromised by factors such as inadequate bone quality and infection, leading to potential implant failure. Ensuring implant stability and longevity is crucial for patient satisfaction and quality of life. In this multicenter, randomized, double-blind clinical trial, we assessed the impact of a bone bioactive liquid (BBL) on the Galaxy TS implant's performance, stability, and osseointegration. We evaluated the impact stability, osseointegration, and pain levels using initial stability quotient (ISQ) measurements, CBCT scans, and pain assessment post-surgery. Surface analysis was performed using scanning electron microscopy (SEM) and atomic force microscopy (AFM). In vitro studies examined the BBL's effects on dental pulp pluripotent stem cells' (DPPSCs') osteogenesis and inflammation modulation in human macrophages. All implants successfully osseointegrated, as demonstrated by the results of our clinical and histological studies. The BBL-treated implants showed significantly lower pain scores by day 7 (p < 0.00001) and improved stability by day 30 (ISQ > 62.00 ± 0.59, p < 8 × 10-7). By day 60, CBCT scans revealed an increased bone area ratio in BBL-treated implants. AFM images demonstrated the BBL's softening and wettability effect on implant surfaces. Furthermore, the BBL promoted DPPSCs' osteogenesis and modulated inflammatory markers in human primary macrophages. This study presents compelling clinical and biological evidence that BBL treatment improves Galaxy TS implant stability, reduces pain, and enhances bone formation, possibly through surface tension modulation and immunomodulatory effects. This advancement holds promise for enhancing patient outcomes and implant longevity.

Root Canal Morphology of Premolars in Population of Hyderabad, Pakistan: A Cone Beam Computerised Tomographic Analysis.

To investigate the mean tooth length and root canal configuration of human maxillary and mandibular premolars in the population of Hyderabad, Pakistan, using Cone Beam Computed Tomography (CBCT). Observational study. Place and Duration of the Study: Department of Operative Dentistry and Endodontics, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan, from December 2022 to March 2023. Using retrospective analysis of CBCT scans, tooth length, the number of roots, and root canal configuration of 536 mandibular and maxillary premolars were assessed in the subpopulation of Pakistan. The data were analysed employing descriptive statistics, Chi-square tests, and One-Way ANOVA to determine the association between various factors and root canal morphology. Vertucci Type 1 (one canal) was the most common configuration in maxillary premolars, with frequencies ranging from 46.3 to 52.2%. The mean length of all 8 premolars ranged from 20.56 mm to 21.58 mm. C-shaped canal configurations were observed in a small percentage of maxillary and mandibular premolars, with C1 being the most common. No significant association was found between gender and canal configuration or tooth length, and in tooth lengths among different canal configurations. Vertucci Type 1 was the most common configuration in maxillary premolars, followed by Vertucci Type 4. Single-rooted premolars were more prevalent, while two-root configurations were less common. C-shaped canal configurations were observed in a small percentage of premolars, with higher frequency in mandibular premolars. Cone beam computed tomography, Dental anatomy, Endodontics, Premolars, Root canal morphology.

Evaluation of canalis sinuosus and accessory canal morphology by cone-beam computed tomography.

To evaluate canalis sinuosus (CS) and accessory canalis sinuosus (AC) morphology and their relationship with the impacted canine on cone-beam computed tomography (CBCT) images. The diameter and location of the CS, its distance from the nasal cavity (NC-CS), its distance from the buccal cortical plate (BC-CS), and its distance from the alveolar ridge crest (AR-CS) were evaluated on 1000 CBCT scans. The prevalence and termination of AC and the presence of impacted canines were also evaluated. CS was detected in 89 (8.9%) of 1000 CBCTs. The mean CS diameter was found as 1.34 ± 0.53mm. No statistically significant difference was found between gender, age, direction, and CS presence and diameter. CS was most frequently seen in regions 11 (23.6%) and 13 (23.6%). The average NC-CS, BC-CS, and AR-CS length was 6.14, 6.06 and 4.35mm, respectively. AC was detected in 22 patients (24.71%). There was no statistically significant difference between the presence of AC and gender, age, CS diameter, NC-CS, BC-CS, and AR-CS distance. BC-CS length and AR-CS length were statistically significantly higher in patients with impacted canines. It should be kept in mind that the CS diameter, NC-CS, BC-CS, and AR-CS distance may increase in the presence of an impacted canine and the integrity of the neurovascular structure should be preserved. The fact that the CS is often localized in the palatial region requires a detailed evaluation of the anterior maxillary region with three-dimensional imaging methods.

Demineralized, Freeze-Dried Allogeneic Bone Blocks With Suture Fixation Technique for Reconstruction of Maxillary Alveolar Bone Deficiency: A Case Series.

This study aims to evaluate the clinical outcomes of using demineralized, freeze-dried allogeneic bone blocks (DFDABB) combined with the periosteal vertical mattress suture (PVMS) technique for the reconstruction of severe horizontal alveolar bone deficiencies in the maxilla. In continuous horizontal maxillary defects cases, bone augmentation was performed using DFDABB and deproteinized bovine bone matrix (DBBM) filling the interstice. Subsequently, a resorbable collagen membrane was carefully placed over the graft surface, and both the membrane and bone graft were firmly secured using the PVMS technique. Linear changes were assessed through superimposed cone-beam computerized tomography scans obtained before the operation and after a healing period of 6-10 months. A total of 7 female patients with 10 bone blocks and 13 implants were included in this study. One of the wounds was slightly ruptured postoperatively without infection, and all implants showed successful osseointegration. The average alveolar ridge width at a point 5 mm below the crest was 4.52 ± 2.03 mm before bone graft and 9.79 ± 1.57 mm after implantation with an average increase of 5.26 ± 1.97 mm. Similarly, at a point 10 mm below the crest, the pregraft alveolar ridge width measured 7.23 ± 3.60 mm, and postimplantation, it expanded to 11.81 ± 2.90 mm, showing an average gain of 4.58 ± 2.01 mm. This case series demonstrates the successful application of DFDABB combined with the PVMS technique to achieve adequate bone width for implantation at severe continuous horizontal bone deficiency of the maxilla. DFDABB with the PVMS technique resulted in superior horizontal bone gain during maxillary bone augmentation with horizontal continuity deficiency. However, further studies are necessary to validate these findings.