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Aug 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1167
Context: The present study was undertaken to do a comparative evaluation of the role of Cone Beam Computed Tomography (CBCT) imaging and Orthopantomography (OPG) for pre-operative implant planning in combination with sinus grafting procedures in order to assess sinus anatomy and morphology and the existing bone height in three dimensions. Aims: To assess sinus anatomy and morphology and the existing bone height in three dimensions. Materials and Methods: Pre-operative assessment of maxillary sinuses for implant planning using CBCT imaging was performed on 20 sinuses (17 patients). These patients were subjected to orthopantomographs and CBCT imaging both pre-operatively and post-operatively. CBCT imaging helped to decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication and comparative analysis between pre-and post-procedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis: The results were tabulated and statistically analyzed using Paired and Unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment type based on pre-operative and post-operative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of abberations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A pre-operative planning based on CBCT imaging seems to improve sinus diagnostics and helps to execute a better treatment plan. Also, it is a good tool for the comparison of vertical alveolar bone height pre-and post-operatively following sinus augmentation procedures using various graft materials.
Feb 2026 DOI 10.14302/issn.2576-6694.jbbs-26-5964
The combination of ultrasonography (US) and cone beam computed tomography (CBCT) has been proposed as a multimodal imaging strategy capable of uniting realtime softtissue assessment with highresolution threedimensional visualization of osseous structures. This study critically evaluated whether such integration provides measurable diagnostic or workflow advantages in mandibular imaging. Despite strong theoretical justification, the combined use of US and CBCT failed to demonstrate clinically meaningful improvements in diagnostic accuracy, confidence, or efficiency when compared with CBCT alone. Fundamental physical mismatches, hardware incompatibilities, geometric constraints, and operatordependent variability limited the anticipated synergistic benefits. These negative findings underscore the importance of reporting unsuccessful integration attempts to guide future research and prevent premature clinical adoption of technically incompatible imaging paradigms.
Feb 2022 DOI 10.14302/issn.2577-2279.ijha-22-4094
Objectives To analyze the occurrence rate of bifurcated mandibular canal (BMC) by cone beam CT(CBCT) and summarise a new classification for further clinical work and academic communication. Method Randomly collected the CBCT images of 350 adult patients. Firstly, we analysed and summarized the BMCs into four types by the position of bifurcation point in the mandible. Second, we did statistics about occurrence. Then we have measured three kinds of distance of Type I and Type II. At last, we compared the advantages and disadvantages about different classifications. Results Among these 350 patients, we found 110 adult people with BMC which indicated the occurrence rate of BMC was 31.43%. The most common type was Type I, especially Type IB, and the least was Type III. Vertical distance between the apex of the second molar, the third molar and mandibular canal are 4.36±2.51 mm and 2.45±2.23 mm. Distance from the apex of two molars to the bifurcated spot are 15.87±6.82mm and 9.32±5.37mm. And the distance between the apex and retromolar foramen in Type I are 22.19±5.97mm and 15.82±4.68mm. Conclusion Comparing with former typing theory, we summarized a new classification which is simpler and more convenient, which should attach scholars’ attention to BMC during clinical work.
Dec 2020 DOI 10.14302/issn.2473-1005.jdoi-20-3659
Open bite malocclusion, due to it’s multifactorial etiology, has always been considered a difficult problem to treat. Often associated with transverse maxillary deficiency, this is a real challenge in the field of orthodontics. The traditional approach, for this type of anomaly, in adult patients, is orthognathic surgery and RME (rapid maxillary expansion). There are several approaches to the treatment of adult patients using digital technology. Mini-implant supported palatal expander limits the side effects of the conventional RME and is less invasive compared to orthognathic surgery. Precise and predictable mini-implant insertion, using a customized surgical guide, provides a safe therapeutic approach. This case report combines Cone-beam computed tomography (CBCT), laser scan superimposition, computer-aided design (CAD) and 3D printing in order to design and print a customized surgical guide for orthodontic mini-implant insertion. A CBCT scan was performed to determine the optimal site for mini-implants’ placement. Using the 3Shape Trios Intraoral Scanner the maxilla and the mandible were laser-scanned. Blue Sky Plan 4 software was used to design the surgical guide, and RayWare software was used for printing it. 4 mini-implants were inserted using a safe and predictable technique. The 3D technology represents the future of orthodontics, reducing the risks, chair-side time while providing the best treatment plan for the patient.
Feb 2020 DOI 10.14302/issn.2768-0207.jbr-20-3194
Rhinosinusitis is one of widely spread diseases in the region and the role of the anatomical variations in its pathogenesis remains unresolved. A retrospective study using CBCT scan was employed to locate and measure the diameter of 320 primary maxillary ostium (PMO) (n = 160 subjects) among the Malay and Chinese populations (Mongoloid race) in Malaysia. Image analysis was performed using the i-CAT Vision Software, employing the multiplanar reconstruction window in which axial, coronal and sagittal planes were visualized in 0.3 mm intervals. The mean diameter of the PMO was significantly larger in the Chinese than the Malay. Females had larger size than the male and bilateral asymmetry was noticed, where the right side PMO was larger than the left side (p < 0.05). In addition, PMO opened more in the posterior third position of the hiatus semilunaris (61.9%) than anterior and middle third. The PMO showed a statistically significant posteriorly placed position in the Chinese than the Malays and this was more evident in the right side PMO (p < 0.01). In conclusion, the PMO commonly opens in the posterior third of the hiatus semilunaris and its diameter is significantly greater in the Chinese female with evidence of bilateral asymmetry. Awareness the anatomical variation of the Ostium diameter and location among the Malay and Chinese populations potentially has important clinical effects during surgical procedures.
Jan 2018 DOI 10.14302/issn.2577-2279.ijha-17-1903
The aim of the present study was to compare mandibular neurovascular canal anatomy in human and great apes by using cone beam computed tomography (CBCT). The anatomical variability of mandibular neurovascular canals (mandibular, incisive and lingual canals) of 129 modern humans and great apes (Homo, Pan and Gorilla) were analyzed by linear measurements on CBCT images. The Kruskal-Wallis non-parametric test and Dunn’s all pairs for joint ranks were applied to compare the variability of mandibular canals among these groups. Human, Chimpanzee and Gorilla groups showed significant differences in the dimensions of the mandibular canal, mental foramen, incisive canal, lingual canal and anterior mandibular bone width. Bifid mandibular canals and anterior loops were the anatomical variations most frequently observed in the Gorilla. Humans had a larger mental foramen and a distinctive incisive canal. The latter could not be identified in the Gorilla group. The variability in the anatomy within mandibles of human and non-human primates, shows different forms in the neurovascular structures. In comparison to the mandible of great apes, the incisive canal is suggested to be a feature unique to the human mandible.
Sep 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1196
Background and Context: Autologous bone grafts require a second surgical exposure to harvest the graft with a significant risk of post-operative complications and donor site morbidity. Employment of allografts potentially eliminates donor site morbidity but carries the potential of causing foreign body immune reactions with a high rate of rejection and failures. Hence, Alloplasts have emerged as novel materials to overcome the drawbacks of autogenous and allogenous bone grafts. Today’s advanced dentistry is enterprising a putty form of calcium phosphosilicate (CPS) into several aspects of reconstructive domain of dentistry including the sinus augmentation procedures, osseous regeneration of periodontal bone defects, cystic cavity defects and alveolar socket preservation. This eccentric multifaceted study was planned as an honest effort on the path of proving the efficiency of CPS as an alloplastic bioactive graft material and aimed at quantitative evaluation of regenerated bone radiographically using Cone Beam Computed Tomography (CBCT) scans following sinus augmentation procedures. Materials and Methods: A total of 20 sinus augmentations were carried-out in 17 patients satisfying the criteria (inclusion and exclusion) requiring placement of implants in atrophic maxilla and in other situations of anatomic constraints. The graft material used was calcium phosphosilicate (CPS) putty (Nova bone dental putty, Novabone products, Alachua, Fla). The residual bone height was recorded using CBCT scans and a computer based software where the measurements were made from the crest of the ridge till the sinus floor lining. The patients were assessed clinically at immediate post-operative, 1 week, 1 month, 3 months and 6 months follow-up recalls post-operatively. Radiographic assessment for bone height was done pre-operatively and at 6 months follow-up recall post-operatively using Cone Beam Computer Tomography scans. Results: The post-treatment bone height (11.76+0.97mm) was found to be significantly higher than the pre-treatment bone height (6.8 +0.70mm) in indirect sinus augmentation procedures (t=14.4, p<0.005). In case of direct sinus augmentation group also, the post-treatment bone height (11.27 +0.71mm) came-out to be significantly higher than the pre-treatment bone height (2.44 +0.81mm) (t=32.17, p<0.005). The post-treatment bone grafted sinus floor measurements (1107.6 + 155.6mm) were also found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (412+ 65.5mm) (t=16.6, p<0.001) in case of indirect sinus augmentation procedures. Similarly, the post-treatment bone grafted sinus floor measurements (1169.6+136.7mm) were found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (416.4+ 0.70mm) (t=17.9, p<0.001) in case of direct sinus augmentation group. Conclusion: Calcium Phosphosilicate (CPS) was accepted well at the recipient sites without any complications demonstrating its efficiency and reliability in sinus augmentation procedures.
Jul 2016 DOI 10.14302/issn.2473-1005.jdoi-16-999
Purpose: The aim of the study was to analyze the spatial relationship between the sinus floor and the alveolar bone of maxillary premolars and molars in order to assess the amount of basal bone available for immediate extraction placement of endosseous implants. Materials and Methods: All the cone-beam computerized tomographic (CBCT) scans taken over a three-year period at four centers were identified. The subsinus bone height (SBH) was evaluated by measuring the distance between the sinus floor and the first and second premolar root apexes. The interradicular septum bone height (ISBH) of all the first and second molars was also measured, and the presence or absence of sinus-floor invagination between the molar roots was recorded. Results: Five hundred twenty-six (526) CBCT scans of fully or partially dentate maxillary arches were examined. The root apex was inside the sinus of 1.8% of all the first premolars. It approximated the sinus floor of 5.3% of them, and the distance between the two points was between 1 and 3mm of 20%, between 3 and 7mm for 34.1%, and more than 7mm for 34.1%. For the second premolars, the findings were 13.5% (inside the sinus), 10.5% (touching the sinus), 32.8% (1-3mm of distance) 28% (3-7 mm), and 15.2% (more than 7mm). Root invagination was noted in 50.2% of the first molars and 43.1% of the second molars, with the ISBHs ranging from 13.4% to 56.9%. Conclusion: Radiological evaluation is essential to determining whether implants should be placed immediately after extraction of maxillary premolars and molars.
Feb 2016 DOI 10.14302/issn.2473-1005.jdoi-15-912
A healthy 55-year-old man was referred to the Department of Endodontics, Oral and Dental Healthy Hospital, Eskişehir suffering from pain and paraesthesia in the left lower lip and chin.A panoramic radiograph revealed the presence of broken endodontic instrument beyond the apex of the mandibular left third molar. A cone beam computed tomography (CBCT) examination was undertaken, which revealed that the broken instrument was inside the mandibular canal. Damage to the inferior alveolar nerve (IAN) secondary to extrusion of a broken endodontic instrument was diagnosed. Extraction of the tooth was decided and the patient was prescribed with 1 mg/kg/day prednisone 2 times/day, once-daily regimen, and 150 mg/day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. One month after the incident, the signs and symptoms were gone. The complete resolution of the paraesthesia and the control of pain achieved in the present case suggest that surgical removal of broken endodontic instrument extruded into the mandibular canal with the use of prednisone and pregabalin is a good option in the management of inferior alveolar nerve injury.