Cone-beam Computed Tomography Sections Research Articles

Marginal Bone Loss and Clinical Evaluation of Angled Implants: A Retrospective Study

Aim: The volume of the edentulous crest and its proximity to critical anatomical structures are important limiting factors for implant surgery. Surgical procedures with complications can be avoided by placing angled implants. The aim of this clinical study was to evaluate marginal bone loss and the complications of angled implants. Materials and Methods: Fifty-eight dental implants were examined in 32 patients (16 females, 16 males) with cone beam computed tomography (CBCT) images from patients with angled implants and complete edentation. The marginal bone loss in angled implants that were functional for 15 to 30 months was evaluated according to factors such as implant angle, connection type, opposing arch restoration type and planning of superstructure restoration. Marginal bone loss measurements were recorded from CBCT sections. Results: It was determined that 3.44% of the implants placed had an inclination of less than 15°, 75.86% had an inclination between 15° and 30° and 20.68% had an inclination of more than 30°. While there was no marginal bone loss on the mesial and distal surfaces, the average marginal bone loss was 0.66 on the buccal surfaces and 0.93 in the lingual region. Only one of the implants examined failed. No pain or infection was observed in any of the implants examined. Conclusion: According to the results of this retrospective clinical study, further clinical studies with larger sample sizes are needed to evaluate angled implants supported by full arch fixed prostheses as a predictable and valid treatment method in the prosthetic rehabilitation of edentulous jaws.

Efficacy of the Sausage Technique in Rebuilding the Crestal Buccal Bone Thickness: A Retrospective Analysis.

The goal was to evaluate the efficacy of the sausage technique in reconstructing the crestal buccal bone thickness, focusing on the distribution shape of the regenerated volume. Ten implants were placed in five patients with Cawood-Howell class IV defects. A cone beam computed tomography (CBCT) was executed at T0 (before surgery). Guided bone regeneration (GBR) with the sausage technique utilized a resorbable collagen membrane, made of a 50% autologous bone and a 50% anorganic bovine bone matrix (ABBM) mixture. After 6 months, a CBCT (T1) was performed before implant placement. Using CBCT software, a plane parallel to the implant axis intersected perpendicular planes every 1.5 mm from the crest level. T0 and T1 CBCT sections were analyzed, yielding 140 measurements. Statistical analysis via SPSS revealed a significant increase in thickness (average 2.82 ± 1.79 mm). Maximum gains occurred at 4.5 mm from the coronal crest line (3.8 ± 1.51 mm). The GBR sausage technique was effective with minimal post-operative complications, yielding the biggest gain at the mid-ridge sagittal area. Within the analysis limitations, it can be assumed that the sausage technique is effective for horizontal GBR in the maxilla, but a lesser volume might be achieved at the crestal level because it seems to follow a bowed regeneration shape.

An Experimental Anatomic CBCT Study on the Correlations Between MB1 and MB2 of the Mesio-Vestibular Root of the Upper First Molars.

This experimental anatomic study aimed to investigate the correlations between the mesio-vestibular canal (MB1) and the second mesio-vestibular canal (MB2) of the mesio-vestibular root of the upper sexts using cone-beam computed tomography (CBCT) imaging. A total of 24 extracted maxillary first molars were collected and subjected to CBCT imaging. The presence, location, and morphology of MB1 and MB2 canals were evaluated using axial, coronal, and sagittal CBCT sections. The interrelation between MB1 and MB2 canals was assessed, including their separate canals, merging, and division points. Among the 24 maxillary first molars examined, 86.5% demonstrated the presence of an MB2 canal in addition to MB1. The MB2 and MB1 were confluent in 80% of the cases with a confluent height of 4,16mm. The mean distance between MB1 and MB2 canals was 1.85mm. This study provides detailed information on the anatomic correlations between MB1 and MB2 canals of the mesio-vestibular root in the upper sexts using CBCT imaging. The high prevalence of MB2 canals suggests their significance in endodontic procedures and emphasizes the importance of thorough exploration and identification during root canal treatment. The knowledge of the location and morphology of these canals can aid in successful endodontic therapy and enhance treatment outcomes.

Radiographic texture analysis of the hard tissue changes following socket preservation with allograft and xenograft materials for dental implantation: a randomized clinical trial.

This study aimed to assess the hard tissue changes following socket preservation with allograft and xenograft materials for dental implantation by texture analysis (TA) using cone-beam computed tomography (CBCT). This prospective clinical trial was conducted on 25 patients who required the extraction of carious mandibular posterior teeth and their subsequent replacement with dental implants. The patients were categorized into three groups: (I) no socket preservation, (II) socket preservation with xenograft material, and (III) socket preservation with allograft material. Four months after tooth extraction, the patients were recalled for preoperative assessment before dental implantation, and CBCT scans were obtained (Kvp:110, mA:1.94, S:3.6). MaZda software was used to compare homogeneity, contrast, and texture complexity on axial CBCT sections among the three groups. Significant differences existed among the three groups in all parameters (P < 0.05) except for the mean correlation parameter (P > 0.05). The results showed no significant difference between the no graft and xenograft groups regarding contrast and differential (dif.) entropy (P > 0.05). Also, no significant difference was found between the xenograft and allograft groups regarding the dif. variance and also between the no graft and allograft groups regarding the inverse difference moment(InvDfMom) and dif. variance parameters (P > 0.05). All other pairwise comparisons revealed significant differences (P < 0.05). TA can be used for the quantification of radiographic changes of bone following socket preservation and potentially accelerate the process of decision-making for dental implant treatment.

Morphological Assessment of Nasopalatine Canal Using Cone Beam Computed Tomography: A Retrospective Study of 124 Consecutive Patients.

This study aimed to assess and analyze the morphology and dimensions of the nasopalatine canal (NPC), as well as the adjacent buccal osseous plate (BOP), and to investigate the effect of gender, edentulism, NPC types, absence of maxillary central incisors (ACI) and age on the NPC and BOP, using cone beam computed tomography (CBCT). A total of 124 CBCT examinations (67 female and 57 male patients) were retrospectively included and evaluated. The assessment of the dimensions of the NPC, as well as the dimensions of the adjacent BOP, was performed by three Oral and Maxillofacial Radiologists on reconstructed sagittal and coronal CBCT sections under standardized conditions. Regarding the dimensions of the NPC and the adjacent BOP, the mean values were significantly higher among males than females. Furthermore, edentulous patients showed a significant reduction in BOP dimensions. Additionally, NPC types showed a significant effect on the length of the NPC, and the ACI had a significant effect on reducing BOP dimensions. Age had a significant effect on the diameter of the incisive foramen, with the mean values generally increasing with an increasing age. CBCT imaging of this anatomical structure contributes significantly to its full assessment.

The radioanatomization of the Nasopalatine canal on Cone Beam Computed Tomography – an eloquent study

The Nasopalatine Canal (NPC) was investigated using Cone Beam Computed Tomography (CBCT) to better comprehend its significance and semantic attributes in the diagnosis and treatment of pathologies and reconstructive surgeries involving the premaxilla, as it is more susceptible to progressive resorption and alterations in the morphometrics of the NPC, which increases its clinical significance. Axial, coronal, and sagittal CBCT sections were analysed in a sample of 60 individuals between the ages of 18 and 70. The chi-square test was used to examine differences between categorical variables, while the independent t test and the ANOVA test were used to examine differences between continuous variables. A statistically significant adjudication vis-à-vis the transverse and longitudinal diameters of the Stensen foramen in the axial section, the transverse dimension of the NPC at Level C, and the labial bone length and labial bone width at Level 2 in the sagittal section bequeathed scientific acreage to this study. The Labial bone length and Labial bone width at Level 2, which were not contemplated in other researches, constitute this study as yardstick for imminent inquiries of NPC in these demeanours. This interpretation made an assay of various parameters of NPC, elaborated on the relevance of NPC in the anterior maxilla, and emphasised chartering a protocol to facilitate excellent surgical planning techniques in the placement of dental implants and surgical implants in the premaxillary region, admonishing maxillofacial trauma impacting the aesthetics, and ministration of the various pathologies.

Bir Türk Alt Popülasyonunda Kalıcı Üst Azı Dişlerinin Kök Kanal Konfigürasyonunun Değerlendirilmesi: Konik Işınlı Bilgisayarlı Tomografi Çalışması

Objective: Maxillary molars may be challenging for root canal treatment due to their complex canal anatomy and additional root canals, especially in the mesiobuccal root. The current study aimed to investigate the prevalence of root and root canal numbers of maxillary molar in a selected Turkish population. Materials and Methods: A total of 905 first and second maxillary molars were evaluated using cone-beam computed tomography (CBCT) images. The number of roots and canals was recorded and the mesiobuccal canal was further evaluated with the Vertucci classification. Results: A total of 394 teeth had a second mesiobuccal (MB2) canal (43.5%). While 90.4% of all maxillary molars had three roots, 44% had four root canals. The most common root canal anatomy of mesiobuccal root canals was Type II (42.6%) followed by Type IV (31.5%) and Type III (22.1%). Conclusions: It is clear that the second mesial root canal in permanent maxillary molars should be carefully searched for the long-term success of root canal treatments. It is seen that CBCT sections will be beneficial in diagnosis and treatment in better understanding the anatomical structure of the teeth and determining possible anatomical deviations.

Investigation of Frequency of Heterotopic Teeth: A Cone Beam CT Study

Aim: Teeth that occur in distant places from the alveolar arch (maxillary sinus, orbit, infratemporal fossa, condylar region, etc.) because of various local or systemic factors are named heterotopic teeth. The heterotopic tooth is a rare phenomenon. Although the etiology is still unknown, it is known that it may be seen due to pathologies caused by cystic lesions, cleft lip-palate, trauma history, and infectious conditions. They are usually asymptomatic, so they are detected by chance in routine clinical and radiological examinations. This study aims to determine the frequency of heterotopic permanent teeth and their anatomical localization with the help of cone-beam computed tomography (CBCT).&#x0D; Methods: This study was retrospectively performed with CBCT slices. CBCT sections of 2590 individuals (1432 females, 1158 males) between the ages of 10-89 (mean: 44 ± 17 years) were evaluated in the study. Heterotopic teeth were investigated using coronal, axial, sagittal CBCT sections in regions distant from the maxillary-mandibular arch. SPSS V.21 software (IBM Corp., Armonk, NY, USA) was used for data analysis. &#x0D; Results: Heterotopic teeth were found in 10 of 2590 individuals (0.4%). All of the heterotopic teeth detected are molar teeth; 4 are mandibular third molar teeth, 5 are maxillary third molar teeth and 1 is maxillary second molar tooth. The frequency of heterotopic teeth according to gender did not show a statistically significant difference (4 females, 6 males) p&gt; 0.05. The average age of individuals with heterotopic teeth is 35.3 (17-65 years). 4 of the heterotopic impacted teeth are located in the ramus and 6 in the maxillary sinus.&#x0D; Conclusions: The prevalence of heterotopic teeth is very rare (0.4%). The teeth with the highest frequency of heterotopia are the third molars. Heterotopic teeth do not have an anatomical location and gender that they prefer predominantly.

The Charisma of 3D Imaging in Managing Endodontic Mishaps in Calcified Canal: A Case Report

Management of calcified canals is always challenging and is much more prone to mishaps such as perforations and ledge formations. The Two-dimensional (2D) imaging has a limitation, the 2D image of a Three-dimensional (3D) structure overlaps adjacent structures even over the root canals. This can create large confusion during treatment. Here, we are reporting a case where 2D imaging misled the treatment and 3D imaging evolved as a magical tool. A 32-year-old female, presented with complaints of pain, blackish discolouration and repeated sinus tract formation after her initial sitting of previous root canal treatment with upper right front tooth #11. On the radiograph, improper obturation and periapical radiolucency were evident. Hence, re-root canal treatment was advised and initiated. Gutta-percha was removed and radiographs were taken to ensure the removal of gutta-percha followed by working length estimation, which was satisfactory. After following all irrigation protocols, calcium hydroxide was placed as intracanal medicament but the patient came after 2 days with a draining pus sinus. The same happened with double antibiotic paste. Hence, Cone-beam Computed Tomography (CBCT) was advised. A buccal perforation and calcified unnegotiated canal were evident in all sections of CBCT. With the consent of the patient, the canal was again negotiated and guided with multiple angled radiographs. Intraoperative CBCT was advised with a master gutta-percha cone to verify the correct position of the canal. After verification, perforation was sealed with biodentine followed by obturation with crown placement in subsequent visits. Thus, 2D imaging can be misleading and 3D imaging is a guiding tool.

Evaluation of the accuracy of buccal bone thickness measurement from cone beam computed tomography compared with histologic analysis

Statement of problemThree-dimensional radiographic assessment of buccal bone thickness and its integrity from cone beam computed tomography (CBCT) plays an essential role in immediate implant placement. However, the accuracy of CBCT measurements for the assessment of buccal bone thickness adjacent to maxillary anterior teeth is not well understood. PurposeThe purpose of this observational study was to evaluate the accuracy of measuring the buccal bone thickness of maxillary anterior teeth from CBCT compared with direct measurement from histologic sections. A secondary objective was to analyze whether a minimal level of buccal bone thickness of maxillary anterior teeth can be detected from the CBCT scan. Material and methodsFive embalmed human cadavers with a complete anterior dentition were included in this study, providing 30 teeth for evaluation. After preparing reference notches at the gingival margin of each tooth, the anterior segments were scanned. The buccal bone thickness at 3, 5, and 7 mm from the notches was measured on the cross-sections obtained from the CBCT and histomorphometric images for a total of 90 sites. The CBCT measurements were compared with the histomorphometric measurements, and their agreement was assessed by using the Bland-Altman plots and intraclass correlation coefficients. The sensitivity and specificity of buccal bone detection were calculated from the CBCT scan. ResultsHistologic examination showed absence of the buccal bone in 29 sites (32%). The mean ±standard deviation thickness of the buccal bone was 0.52 ±0.05 mm (range: 0 to 1.97 mm) from the CBCT analysis and 0.40 ±0.05 mm (range: 0 to 1.67 mm) from histology. Measurements obtained from the CBCT sections significantly overestimated the buccal bone thickness when compared with the histologic evaluation (P=.001). The intraclass correlation coefficient of buccal bone thickness between the CBCT and histology was ≤0.53, an agreement considered as poor. The sensitivity of the CBCT as a diagnostic tool to detect the presence or absence of the buccal bone was 75.4%, and the specificity was 65.5%. ConclusionsThe buccal bone thickness of maxillary anterior teeth was less than 2 mm at all sites as measured with both CBCT and histology evaluations. CBCT measurements had relatively low accuracy and reliability for the measurement of buccal bone thickness. These findings should be considered when using CBCT as a measuring tool for thin bone structures.

Texture analysis of cone-beam computed tomography images assists the detection of furcal lesion.

The aim of this study was to apply texture analysis (TA) to cone-beam computed tomography (CBCT) scans of patients with grade C periodontitis for detection of non-visible changes in the image. TA was performed on CBCT scans of 34 patients with grade C periodontitis. Axial sections of CBCT were divided into three groups as follows: Group L (lesion) in which there is a furcal lesion with periodontal bone loss; Group I (intermediate) in which the border of the furcal lesion has normal characteristics; and Group C (control) in which the area is healthy. Eleven texture parameters were extracted from the region of interest. Mann-Whitney U test was used to assess the differences in the texture between the three groups as follows: L versus I; L versus C, and I versus C. Statistically significant differences (P<0.05) were observed in almost all parameters in the intergroup analyses (i.e., L versus I and L versus C). However, statistical differences were smaller in groups I versus C in which only entropy of sum, entropy of difference, mean of sum, and variance of difference were statistically different (P<0.05). TA can potentially provide prognostic information to improve the diagnostic accuracy in the grading of the tissue around the furcal lesion, thus potentially accelerating the treatment decision-making process.

Kist Enükleasyonu Sonrası Oluşan Kemik Rejenerasyonunun Radyolojik Değerlendirmesinde Konik Işınlı Bilgisayarlı Tomografi ile Panoramik Radyografinin Karşılaştırmalı Olarak İncelenmesi

Objective: The aim of this study is to compare the panoramic radiography and cone-beam computed tomography (CBCT) in the evaluation of bone healing after the enucleation of odontogenic cysts. Methods: Pre-operative and post-operative clinical and radiological data of patients who were successfully treated with enucleation between 01/01/2013 and 01/03/2017 with 1-year follow-up were retrieved from the archives and evaluated retrospectively. The panoramic radiographs and CBCT sections were transferred into a computer program and pre-operative and post-operative measurements were performed on the computer program. The manual segmentation method was used in the volume measurement in CBCT sections. An area index was calculated by multiplying the highest vertical and widest horizontal dimension of the cystic lesion on the panoramic radiography. Results: Twelve patients included in the study. Eight patients were male and 4 of them were female. The mean age was 45. The volume of the defect at post-operative 1-year control decreased by 83.05% on average. The area measurement showed a decrease of 38.79% at postoperative 1-year control. The volume of the cystic cavities in tomographic sections and cystic area on panoramic radiographs were significantly reduced at the end of 1-year follow-up (p&amp;lt;0.05). There was a significant and moderate positive relationship between the post-operative measurement values of CBCT and OPG (p=0.021, r=0.655). Conclusion: Panoramic radiography can be used as effective as CBCT to monitor spontaneous bone regeneration after the enucleation of jaw cysts.

The effects of posterior alveolar bone height on the height of maxillary sinus septa.

The purpose of this study was to evaluate whether posterior alveolar bone height affects maxillary sinus septa (MSS) height in dentate and edentulous patients, as determined by cone-beam computed tomography (CBCT). This retrospective analysis enrolled 166 patients (91 men and 75 women) with a mean age of 43.12 ± 15.26years (range 18-74years), who had at least one MSS on CBCT images. MSS were categorized into three regions: anterior, middle, and posterior. Patients were categorized as complete or partial posterior edentulous or fully posterior dentate. The maximum vertical diameter of the sinus septa and alveolar bone height was analyzed in sagittal CBCT sections; P < 0.05 was regarded as statistically significant. We found 210 MSS among the patients in this study. Of the 166 patients, 36 had bilateral septa and 4 had three septa. The septa were mainly located in the middle region in the dentate (n = 70; 33.3%) and edentulous (n = 59; 28.1%) patients. The mean septal height was significantly higher in men than in women (P = 0.024). In dentate patients, the mean MSS height was similar among the three regions. In edentulous patients, the anterior mean MSS height (4.96 ± 2.77mm) was lower than that of the other two regions. There was no statistically significant association between septa and alveolar bone height in any anatomic region, in either group (r = 0.022; P = 0.748). These results suggest that MSS height is not influenced by alveolar bone height.

Proposed classification for interproximal contacts of primary molars using CBCT: a pilot study.

Background: Interproximal contact areas in primary teeth are known to be broader, flatter, and situated more gingivally than in permanent teeth. The objective of the present study was to evaluate the different types of intact interproximal contact areas in primary teeth using cone beam computed tomography (CBCT) among children. Methods: A cross-sectional study was designed with 74 contacts from 28 existing CBCT images of children aged between 3 and 14 years, obtained from the Indian Dental Education Academy, Chennai, India. The shape of the contact area was observed at three levels, the coronal, middle, and apical thirds, in three different sections of CBCT. Prevalence of the types of contact areas was expressed in the form of numbers and percentages. Results: The weighted Cohen's kappa values for inter-examiner reliability was 0.893 at baseline. Results exhibited four different types of contact areas between the primary molars, namely, O type, X type, I type, and S type, based on the shapes observed; hence, the proposed classification is referred to as OXIS. The most common pattern seen was I (66.2%), followed by X (21.6%), O (9.4%) and the least common was S (2.7%). Conclusion: The three-dimensional evaluation of intact interproximal contact areas between primary molars are of four types, O,X, I and S.

Proposed classification for interproximal contacts of primary molars using CBCT: a pilot study

Background: Interproximal contact areas in primary teeth are known to be broader, flatter, and situated more gingivally than in permanent teeth. The objective of the present study was to evaluate the different types of intact interproximal contact areas in primary teeth using cone beam computed tomography (CBCT) among children. Methods: A cross-sectional study was designed with 74 contacts from 28 existing CBCT images of children aged between 3 and 14 years, obtained from the Indian Dental Education Academy, Chennai, India. The shape of the contact area was observed at three levels, the coronal, middle, and apical thirds, in three different sections of CBCT. Prevalence of the types of contact areas was expressed in the form of numbers and percentages. Results: The weighted Cohen’s kappa values for inter-examiner reliability was 0.893 at baseline. Results exhibited four different types of contact areas between the primary molars, namely, O type, X type, I type, and S type, based on the shapes observed; hence, the proposed classification is referred to as OXIS. The most common pattern seen was I (66.2%), followed by X (21.6%), O (9.4%) and the least common was S (2.7%). Conclusion: The three-dimensional evaluation of intact interproximal contact areas between primary molars are of four types, O,X, I and S.

Proposed classification for interproximal contacts of primary molars using CBCT: a pilot study.

Background: Contact areas in primary teeth are known to be broader, flatter, and situated more gingivally than in permanent teeth. The objective of the present study was to evaluate the different types of intact contact areas in primary teeth using cone beam computed tomography (CBCT) among children. Methods: A cross-sectional study was designed with 74 contacts from 28 existing CBCT images of patients aged between 3 and 14 years, obtained from the Indian Dental Education Academy, Chennai, India. The shape of the contact area was observed at three levels, the coronal, middle, and apical thirds, in three different sections of CBCT. The weighted Cohen's kappa values for inter-examiner reliability was 0.893 at baseline. Prevalence of the types of contact areas was expressed in the form of numbers and percentages. Results: Results exhibited four different types of contact areas between the primary molars, namely, O type, X type, I type, and S type, based on the shapes observed; hence, the proposed classification is referred to as OXIS. The most common pattern seen was I (66.2%), followed by X (21.6%), O (9.4%) and the least common was S (2.7%). Conclusion: The three-dimensional evaluation of intact interproximal contact areas between primary molars are of four types.

Changes in dimension of neurovascular canals in the mandible and maxilla: A radiographic finding in patients diagnosed with MRONJ.

BackgroundThe aim of this retrospective study was to compare the morphological features of neurovascular canals and foramina of patients with medication-related osteonecrosis of the jaws (MRONJ) and healthy individuals by using cone beam computed tomography (CBCT).Material and MethodsThe CBCT images of 58 patients under bisphosphonate therapy diagnosed with MRONJ and age gender- matched controls were retrospectively evaluated. The diameter of mandibular and nasopalatine canal and mandibular, mental and lingual foramina were measured on several sections of CBCT. The value of mental index (MI) and panoramic mandibular index (PMI) were also assessed.ResultsThe mean value of diametric measurements for all neurovascular canals and foramina in MRONJ patients were narrower than controls. Left mandibular foramen was the most affected area (p<0.001). There were significantly difference in all measurements of mental foramen, lingual foramen and mandibular incisive canal between two groups (p<0.05). PMI of MRONJ subjects were also significantly differences in both sides (p<0.05).ConclusionsIn MRONJ patient, neurovascular canals and foramina are affected due to the alterations in bone remodeling. Therefore, the diametric measurement of neurovascular canals and assessment of MI and PMI on CBCT, is a potentially useful method for detection of early changes associated with bisphosphonate therapy and for predict areas where new necrosis may occur. Key words:Bisphosphonate, MRONJ, CBCT, neurovascular canals, PMI.

Determination of Proximity of Mandibular Third Molar to Mandibular Canal Using Panoramic Radiography and Cone-beam Computed Tomography

Objectives: Position of inferior alveolar canal with respect to an impacted third molar reveals certain radiographic signs, but three-dimensional relationship to the canal can be provided with cone-beam computed tomography (CBCT). The purpose of this study was to determine which radiographic signs on panoramic radiography indicate a true relationship on CBCT. Materials and Methods: Forty samples with signs or symptoms of impacted mandibular third molar and panoramic radiograph showing signs of a close relationship with the mandibular canal as described by Félez-Gutiérrez et al. were included in the study and subjected to CBCT. Radiographic signs on panoramic radiography were compared with the relationship on CBCT. Statistical analysis was done using Chi-square test. Results: Twenty-one samples (52.5%) showed darkening of the apex, which was the most frequent type of radiographic sign of a close relationship on panoramic radiography. Twenty-three samples (57.5%) revealed a true relationship on CBCT. Darkening of the apex and narrowing of the canal were the signs most frequently associated with a true relationship. On CBCT, coronal and axial sections better predicted a true relationship. Conclusion: This study showed that the presence of any of the radiographic signs cannot definitely predict a true relationship; however, the presence of a close sign on panoramic radiography is often associated with a true relationship to the canal.

A Comparative evaluation of CBCT outcomes of two closed treatment methods in intracapsular condylar fractures

The cone beam computed tomography (CBCT) images of 2 closed treatments are compared for intracapsular condylar fractures (ICFs) to learn whether splint treatment could promote better radiologic outcomes. Fifty-four patients with 60 sides of ICF were divided into 2 groups. In the control group (C-group), patients had a liquid diet for 1month. In the trial group (T-group), patients wore splints with anterior elastic traction. Local CBCT images of the temporomandibular joint were obtained at T0 (mean 8.8days), T1 (mean 37.4days), and T3 (mean 3.3months) after trauma. Six parameters, including 2 horizontal, 1 sagittal, and 3 vertical distances, were calculated using the coordinates of 10 points marked on CBCT sections. Statistical analysis included intragroup comparison at T0, T1, and T3, and intergroup comparison among subgroups classified by age and ICF types. Compared to C-group, vertical distances were significantly changed in T-group, specifically in adults and patients with ICF type B. Significant changes at stage T1 were also observed in T-group. During the natural healing process, ICF healed in the displaced position and the stump tended to move closer to the joint fossa in the vertical dimension. Splint treatment with elastic traction was helpful to increase joint space and promote better radiologic healing shape.

Evaluation of the Reliability of Cone-beam Computed Tomography Scanning and Electronic Apex Locator Measurements in Working Length Determination of Teeth with Large Periapical Lesions

IntroductionThis study evaluates the endodontic working-length measurements in teeth with large periapical lesions and persistent intracanal exudate by using preexisting cone-beam computed tomography (CBCT). It compares the measurements with clinical root canal lengths determined by using 2 electronic apex locators. MethodsAll patients had undergone a CBCT scan independent of the present study and needed root canal treatment of at least 1 tooth visible in the field of view. Seventy-three teeth with single roots and canals were studied. An endodontist measured each root canal length with 2 different electronic apex locators. The measurements were repeated 3 times by using a digital caliper, and the mean was recorded. This mean was compared with the root canal length as measured on CBCT sections by an oral radiologist not involved in the endodontic treatment. The CBCT measurements were taken twice for analysis of intrarater reliability. The data were statistically analyzed. ResultsThere were no significant measurement differences between the methods used (P > .05). ConclusionsIn teeth with large periapical lesions and persistent intracanal exudate, measurement of the root canal length by using CBCT was as reliable as measurements that used apex locators.