This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.
Purpose: To evaluate whether cone beam computed tomography can depict the distribution, position, frequency, relative vertical dimension, and the diameter of the lingual foramen and direction of lingual bone canal. Materials and Methods : Cone beam computed tomography of mandible was performed on 25 males and 25 females with no history of any orthodontic treatments or any other dental surgeries. A statistical comparison was done on the mean values of males and females. Results: In the location and distribution of lingual foramina, median lingual foramen was found in all subjects and lateral lingual foramen in 58%. In the lateral lingual foramen, bilateral type was found in 28% and unilateral type in 30%. In the number of lingual foramina, median lingual foramen had two foramina and lateral lingual foramen had one foramen, mostly. In the relative mean vertical dimension of lingual foramina, median lingual foramen was 0.03±0.08, and both lateral lingual foramina was 0.20±0.04. The mean diameter of lingual foramina, median lingual foramen was 0.9mm±0.28, right lateral lingual foramen was 0.92mm±0.23, and left lateral lingual foramen was 0.88mm±0.27. The most frequent direction of the lingual bone canals, median lingual bone canal proceeded in anteroinferior direction and lateral lingual bone canal in anterosuperolateral direction. Conclusion : Cone beam computed tomography can be helpful for surgery and implantation on the mandibular area. Radiologist should be aware of this anatomical feature and its possible implications.
Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.
Objective: This study was performed to investigate the changes in alveolar bone after maxillary incisor intrusion and to determine the related factors in deep-bite patients. Methods: Fifty maxillary central incisors of 25 patients were evaluated retrospectively. The maxillary incisors in Group I (12 patients; mean age, $16.51{\pm}1.32years$) were intruded with a base-arch, while those in Group II (13 patients; mean age, $17.47{\pm}2.71years$) were intruded with miniscrews. Changes in the alveolar envelope were assessed using pre-intrusion and post-intrusion cone-beam computed tomography images. Labial, palatal, and total bone thicknesses were evaluated at the crestal (3 mm), midroot (6 mm), and apical (9 mm) levels. Buccal and palatal alveolar crestal height, buccal bone height, and the prevalence of dehiscence were evaluated. Two-way repeated measure ANOVA was used to determine the significance of the changes. Pearson's correlation coefficient analysis was performed to assess the relationship between dental and alveolar bone measurement changes. Results: Upper incisor inclination and intrusion changes were significantly greater in Group II than in Group I. With treatment, the alveolar bone thickness at the labial bone thickness (LBT, 3 and 6 mm) decreased significantly in Group II (p < 0.001) as compared to Group I. The LBT change at 3 mm was strongly and positively correlated with the amount of upper incisor intrusion (r = 0.539; p = 0.005). Conclusions: Change in the labial inclination and the amount of intrusion should be considered during upper incisor intrusion, as these factors increase the risk of alveolar bone loss.
PURPOSE. Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS. Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low5 and High5) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS. Edentulous patients with implants had significantly greater HSD and High5 values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High5 values significantly increased after receiving implants (P < .022). CONCLUSION. The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.
Kim, Jun Ho;Abdala-Junior, Reinaldo;Munhoz, Luciana;Cortes, Arthur Rodriguez Gonzalez;Watanabe, Plauto Christopher Aranha;Costa, Claudio;Arita, Emiko Saito
Imaging Science in Dentistry
/
v.50
no.2
/
pp.133-139
/
2020
Purpose: This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles. Materials and Methods: Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient. Results: High intraobserver and interobserver agreement was found (P<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts. Conclusion: Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.
Purpose: To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibular disorder (TMD) patients. Materials and Methods: 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra- and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Results: Osteophyte (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior and medial surfaces of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78-0.84), but interobserver agreement was fair (k=0.45). Conclusion: CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.
Purpose: This study evaluated and compared interradicular distances and cortical bone thickness in Thai patients with Class I and Class II skeletal patterns, using cone-beam computed tomography (CBCT). Materials and Methods: Pretreatment CBCT images of 24 Thai orthodontic patients with Class I and Class II skeletal patterns were included in the study. Three measurements were chosen for investigation: the mesiodistal distance between the roots, the width of the buccolingual alveolar process, and buccal cortical bone thickness. All distances were recorded at five different levels from the cementoenamel junction (CEJ). Descriptive statistical analysis and t-tests were performed, with the significance level for all tests set at p<0.05. Results: Patients with a Class II skeletal pattern showed significantly greater maxillary mesiodistal distances (between the first and second premolars) and widths of the buccolingual alveolar process (between the first and second molars) than Class I skeletal pattern patients at 10 mm above the CEJ. The maxillary buccal cortical bone thicknesses between the second premolar and first molar at 8 mm above the CEJ in Class II patients were likewise significantly greater than in Class I patients. Patients with a Class I skeletal pattern showed significantly wider mandibular buccolingual alveolar processes than did Class II patients (between the first and second molars) at 4, 6, and 8 mm below the CEJ. Conclusion: In both the maxilla and mandible, the mesiodistal distances, the width of the buccolingual alveolar process, and buccal cortical bone thickness tended to increase from the CEJ to the apex in both Class I and Class II skeletal patterns.
Purpose: This study aimed to evaluate the effect of field-of-view (FOV) size on the gray values derived from cone-beam computed tomography (CBCT) compared with the Hounsfield unit values from multidetector computed tomography (MDCT) scans as the gold standard. Materials and Methods: A radiographic phantom was designed with 4 acrylic cylinders. One cylinder was filled with distilled water, and the other 3 were filled with 3 types of bone substitute: namely, Nanobone, Cenobone, and Cerabone. The phantom was scanned with 2 CBCT systems using 2 different FOV sizes, and 1 MDCT system was used as the gold standard. The mean gray values(MGVs) of each cylinder were calculated in each imaging protocol. Results: In both CBCT systems, significant differences were noted in the MGVs of all materials between the 2 FOV sizes(P<.05) except for Cerabone in the Cranex3D system. Significant differences were found in the MGVs of each material compared with the others in both FOV sizes for each CBCT system. No significant difference was seen between the Cranex3D CBCT system and the MDCT system in the MGVs of bone substitutes on images obtained with a small FOV. Conclusion: The size of the FOV significantly changed the MGVs of all bone substitutes, except for Cerabone in the Cranex3D system. Both CBCT systems had the ability to distinguish the 3 types of bone substitutes based on a comparison of their MGVs. The Cranex3D CBCT system used with a small FOV had a significant correlation with MDCT results.
Objective: To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns. Methods: CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars' distal roots and second molars' mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test. Results: There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns. Conclusions: There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.
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