• Title/Summary/Keyword: Dental implantology

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Immediate effect of Nd:YAG laser monotherapy on subgingival periodontal pathogens: a pilot clinical study

  • McCawley, Thomas K.;McCawley, Mark N.;Rams, Thomas E.
    • Journal of Periodontal and Implant Science
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    • v.52 no.1
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    • pp.77-87
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    • 2022
  • Purpose: This pilot study assessed the immediate in vivo effect of high peak pulse power neodymium-doped yttrium aluminum garnet (Nd:YAG) laser monotherapy on selected red/orange complex periodontal pathogens in deep human periodontal pockets. Methods: Twelve adults with severe periodontitis were treated with the Laser-Assisted New Attachment Procedure (LANAP®) surgical protocol, wherein a free-running, digitally pulsed, Nd:YAG dental laser was used as the initial therapeutic step before mechanical root debridement. Using a flexible optical fiber in a handpiece, Nd:YAG laser energy, at a density of 196 J/cm2 and a high peak pulse power of 1,333 W/pulse, was directed parallel to untreated tooth root surfaces in sequential coronal-apical passes to clinical periodontal probing depths, for a total applied energy dose of approximately 8-12 joules per millimeter of periodontal probing depth at each periodontal site. Subgingival biofilm specimens were collected from each patient before and immediately after Nd:YAG laser monotherapy from periodontal pockets exhibiting ≥6 mm probing depths and bleeding on probing. Selected red/orange complex periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Fusobacterium nucleatum, Parvimonas micra, and Campylobacter species) were quantified in the subgingival samples using established anaerobic culture techniques. Results: All immediate post-treatment subgingival biofilm specimens continued to yield microbial growth after Nd:YAG laser monotherapy. The mean levels of total cultivable red/orange complex periodontal pathogens per patient significantly decreased from 12.0% pretreatment to 4.9% (a 59.2% decrease) immediately after Nd:YAG laser monotherapy, with 3 (25%) patients rendered culture-negative for all evaluated red/orange complex periodontal pathogens. Conclusions: High peak pulse power Nd:YAG laser monotherapy, used as the initial step in the LANAP® surgical protocol on mature subgingival biofilms, immediately induced significant reductions of nearly 60% in the mean total cultivable red/orange complex periodontal pathogen proportions per patient prior to mechanical root instrumentation and the rest of the LANAP® surgical protocol.

Automatic Sagittal Plane Detection for the Identification of the Mandibular Canal (치아 신경관 식별을 위한 자동 시상면 검출법)

  • Pak, Hyunji;Kim, Dongjoon;Shin, Yeong-Gil
    • Journal of the Korea Computer Graphics Society
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    • v.26 no.3
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    • pp.31-37
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    • 2020
  • Identification of the mandibular canal path in Computed Tomography (CT) scans is important in dental implantology. Typically, prior to the implant planning, dentists find a sagittal plane where the mandibular canal path is maximally observed, to manually identify the mandibular canal. However, this is time-consuming and requires extensive experience. In this paper, we propose a deep-learning-based framework to detect the desired sagittal plane automatically. This is accomplished by utilizing two main techniques: 1) a modified version of the iterative transformation network (ITN) method for obtaining initial planes, and 2) a fine searching method based on a convolutional neural network (CNN) classifier for detecting the desirable sagittal plane. This combination of techniques facilitates accurate plane detection, which is a limitation of the stand-alone ITN method. We have tested on a number of CT datasets to demonstrate that the proposed method can achieve more satisfactory results compared to the ITN method. This allows dentists to identify the mandibular canal path efficiently, providing a foundation for future research into more efficient, automatic mandibular canal detection methods.

Evaluation of the accuracy of two different surgical guides in dental implantology: stereolithography fabricated vs. positioning device fabricated surgical guides (제작방법에 따른 임플란트 수술 가이드의 정확성비교: stereolithography와 positioning device로 제작한 수술 가이드)

  • Kwon, Chang-Ryeol;Choi, Byung-Ho;Jeong, Seung-Mi;Joo, Sang-Dong
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.271-278
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    • 2012
  • Purpose: Recently implant surgical guides were used for accurate and atraumatic operation. In this study, the accuracy of two different types of surgical guides, positioning device fabricated and stereolithography fabricated surgical guides, were evaluated in four different types of tooth loss models. Materials and methods: Surgical guides were fabricated with stereolithography and positioning device respectively. Implants were placed on 40 models using the two different types of surgical guides. The fitness of the surgical guides was evaluated by measuring the gap between the surgical guide and the model. The accuracy of surgical guide was evaluated on a pre- and post-surgical CT image fusion. Results: The gap between the surgical guide and the model was $1.4{\pm}0.3mm$ and $0.4{\pm}0.3mm$ for the stereolithography and positioning device surgical guide, respectively. The stereolithography showed mesiodistal angular deviation of $3.9{\pm}1.6^{\circ}$, buccolingual angular deviation of $2.7{\pm}1.5^{\circ}$ and vertical deviation of $1.9{\pm}0.9mm$, whereas the positioning device showed mesiodistal angular deviation of $0.7{\pm}0.3^{\circ}$, buccolingual angular deviation of $0.3{\pm}0.2^{\circ}$ and vertical deviation of $0.4{\pm}0.2mm$. The differences were statistically significant between the two groups (P<.05). Conclusion: The laboratory fabricated surgical guides using a positioning device allow implant placement more accurately than the stereolithography surgical guides in dental clinic.

A Radiologic Study of the Relationship of the Maxillary Sinus Floor and Apex of the Maxillary Molar (상악동 아래벽과 상악 대구치 치근사이 위치관계에 관한 방사선학적 연구)

  • Yoon Hae-Rym;Park Chang-Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.111-126
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    • 1998
  • In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA/sup (R)/ in male and female adults in their 20's on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop. and postop. root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied using panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows: 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the actual maxilla specimen were 2.83 mm, 4.51mm, and 4.l5mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography. 3. In cross-sectional view, when the vertical relationship of the maxillary sinus floor and maxillary roots was assessed, in 1st molars, type II (the sinus floor that extends down to the buccolingual furcation area) was predominant, while in 2nd molars, type I (the sinus floor located above the level connecting the buccal and lingual apices) was predominant. In the horizontal relationship, in 1st molars, type II (the lowest floor of the maxillary sinus located in between the buccal and lingual roots) was predominant; in 2nd molars, type I (the lowest floor of the maxillary sinus located on the buccal side of the buccal roots) and type II appeared in similar frequency. In conclusion, the SCANORA/sup (R)/ cross-sectional tomography was more effective than the frequently used panoramic view, in that the relationship of the maxillary molars and maxillary sinus floor can be evaluated more accurately and the buccolingual cross-sectional view can also be observed. And maxillary sinus floor that was close to maxillary 2nd molar had tendency to be located on buccal side than that close to 1st molar. Therefore, cross-sectional tomography is an effective and accurate method to evaluate the position of the teeth in relation to the sinus floor preoperative and can be easily used to diagnose localized periapical lesions. Also, the image quality obtained was quite satisfactory.

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