RESUMEN
Weight-bearing computed tomography has multiple advantages in evaluating the hindfoot and ankle. It can assess hindfoot and ankle alignment, pathology in ankle arthritis, and complications related to total ankle replacements. It is an essential tool in ankle osteoarthritis diagnostic, preoperative planning, and total ankle replacement outcomes. It allows for better accuracy and reproducibility of alignment and implant size. In addition, it has the potential to more assertively detect complications related to weight bearing.
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Articulación del Tobillo , Artroplastia de Reemplazo de Tobillo , Tomografía Computarizada de Haz Cónico , Osteoartritis , Soporte de Peso , Humanos , Artroplastia de Reemplazo de Tobillo/efectos adversos , Articulación del Tobillo/diagnóstico por imagen , Articulación del Tobillo/cirugía , Osteoartritis/diagnóstico por imagen , Osteoartritis/cirugíaRESUMEN
Intratumoral injections have the potential for enhanced cancer treatment efficacy while reducing costs and systemic exposure. However, intratumoral drug injections can result in substantial off-target leakage and are invisible under standard imaging modalities like ultrasound (US) and x-ray. A thermosensitive poloxamer-based gel for drug delivery was developed that is visible using x-ray imaging (computed tomography (CT), cone beam CT, fluoroscopy), as well as using US by means of integrating perfluorobutane-filled microbubbles (MBs). MBs content was optimized using tissue mimicking phantoms and ex vivo bovine livers. Gel formulations less than 1% MBs provided gel depositions that were clearly identifiable on US and distinguishable from tissue background and with minimal acoustic artifacts. The cross-sectional areas of gel depositions obtained with US and CT imaging were similar in studies using ex vivo bovine liver and postmortem in situ swine liver. The gel formulation enhanced multimodal image-guided navigation, enabling fusion of ultrasound and x-ray/CT imaging, which may enhance targeting, definition of spatial delivery, and overlap of tumor and gel. Although speculative, such a paradigm for intratumoral drug delivery might streamline clinical workflows, reduce radiation exposure by reliance on US, and boost the precision and accuracy of drug delivery targeting during procedures. Imageable gels may also provide enhanced temporal and spatial control of intratumoral conformal drug delivery.
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Sistemas de Liberación de Medicamentos , Hidrogeles , Hígado , Poloxámero , Ultrasonografía , Poloxámero/química , Animales , Hidrogeles/química , Hígado/diagnóstico por imagen , Hígado/metabolismo , Bovinos , Ultrasonografía/métodos , Sistemas de Liberación de Medicamentos/métodos , Microburbujas , Porcinos , Fantasmas de Imagen , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada de Haz Cónico/métodosRESUMEN
BACKGROUND: Incidental and screen-detected pulmonary nodules are common. The increasing capabilities of advanced diagnostic bronchoscopy will increase bronchoscopists' procedural volume necessitating optimization of procedural scheduling and workflow. OBJECTIVES: The objectives of this study were to determine total time in the procedure room, total bronchoscopy procedure time, and robotic-assisted bronchoscopy procedure time longitudinally and per specific procedure performed. DESIGN: A single-center observational study of all consecutive patients undergoing shape-sensing robotic-assisted bronchoscopy (RAB) biopsy procedures for the evaluation of pulmonary lesions with variable probability for malignancy. METHODS: Chart review to collect patient demographics, lesion characteristics, and procedural specifics. Descriptive and comparative statistics are reported. RESULTS: Actual bronchoscopy procedure time may decrease with increased institutional experience over time, however, there is limited ability to reduce non-bronchoscopy related time within the procedure room. The use of cone beam computed tomography (CBCT), rapid on-site evaluation (ROSE), and performance of staging endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) in a single procedure are each associated with additional time requirements. CONCLUSION: Institutional procedural block times should adapt to the nature of advanced diagnostic bronchoscopy procedures to allow for the accommodation of new modalities such as RAB combined with other technologies including radial endobronchial ultrasound, CBCT, ROSE, and staging linear EBUS. Identifying institutional median procedural times may assist in scheduling and ideal block time utilization.
Times necessary to perform robotic assisted bronchoscopy biopsy procedures at a single hospitalBackground: Lung lesions and nodules are commonly seen on computed tomography (CT) scans. With advances in technology, more of these lesions are being biopsied with robotic assisted bronchoscopy (RAB) procedures, leading to increased demand. Health care providers who perform these procedures have finite available time in which they must accommodate all their procedures. Understanding procedure times is necessary to fully utilize schedules. Methods and aims overview: We describe our experience of 5 pulmonologists performing 700 robotic assisted bronchoscopies at a single hospital. Our aim is to describe the time needed for the robotic bronchoscopies over time and with specific procedures. Results and conclusion: We find that as more robotic assisted bronchoscopies are performed, the overall procedure time may decrease. Using cone beam computed tomography during the procedure, having on- site pathology review of biopsies, and obtaining biopsies of lymph nodes may lengthen the procedure time. The time spent preparing the patient for the procedure excluding the bronchoscopy remained stable. Understanding the time necessary based on what is performed during the procedure will allow it to be scheduled for the appropriate amount of time. As a result, procedure days can be fully optimized, minimizing scheduling impacts on patients and health care workers.
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Broncoscopía , Neoplasias Pulmonares , Procedimientos Quirúrgicos Robotizados , Humanos , Broncoscopía/métodos , Femenino , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Robotizados/métodos , Anciano , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/diagnóstico , Factores de Tiempo , Tempo Operativo , Tomografía Computarizada de Haz Cónico , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Flujo de Trabajo , Estudios Retrospectivos , AdultoRESUMEN
BACKGROUND: Artificial intelligence (AI) models are being increasingly studied for the detection of variations and pathologies in different imaging modalities. Nasal septal deviation (NSD) is an important anatomical structure with clinical implications. However, AI-based radiographic detection of NSD has not yet been studied. OBJECTIVE: This research aimed to develop and evaluate a real-time model that can detect probable NSD using cone beam computed tomography (CBCT) images. METHODS: Coronal section images were obtained from 204 full-volume CBCT scans. The scans were classified as normal and deviated by 2 maxillofacial radiologists. The images were then used to train and test the AI model. Mask region-based convolutional neural networks (Mask R-CNNs) comprising 3 different backbones-ResNet50, ResNet101, and MobileNet-were used to detect deviated nasal septum in 204 CBCT images. To further improve the detection, an image preprocessing technique (contrast enhancement [CEH]) was added. RESULTS: The best-performing model-CEH-ResNet101-achieved a mean average precision of 0.911, with an area under the curve of 0.921. CONCLUSIONS: The performance of the model shows that the model is capable of detecting nasal septal deviation. Future research in this field should focus on additional preprocessing of images and detection of NSD based on multiple planes using 3D images.
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Tomografía Computarizada de Haz Cónico , Tabique Nasal , Redes Neurales de la Computación , Prueba de Estudio Conceptual , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Tabique Nasal/diagnóstico por imagen , Femenino , Masculino , Adulto , Persona de Mediana EdadRESUMEN
The follow-up of teeth that have undergone regenerative endodontic procedures through radiographic imaging is crucial for evaluating their success and determining their future prognosis. The periapical radiographs stand out as the primary tool for this task and are also recommended by the existing guidelines. However, two-dimensional (2D) imaging may not reveal the findings accurately, mimicking the root formation success which may not be true otherwise when assessed using cone beam CT (CBCT) imaging. This case series featuring two instances underscores the significance of CBCT in identifying such signs of failure, particularly when they might be obscured in 2D imaging.
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Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional , Endodoncia Regenerativa , Raíz del Diente , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Raíz del Diente/diagnóstico por imagen , Endodoncia Regenerativa/métodos , Masculino , Femenino , Adulto , Tratamiento del Conducto Radicular/métodosRESUMEN
OBJECTIVE: This study aimed to develop a deep learning model to predict skeletal malocclusions with an acceptable level of accuracy using airway and cephalometric landmark values obtained from analyzing different CBCT images. BACKGROUND: In orthodontics, multitudinous studies have reported the correlation between orthodontic treatment and changes in the anatomy as well as the functioning of the airway. Typically, the values obtained from various measurements of cephalometric landmarks are used to determine skeletal class based on the interpretation an orthodontist experiences, which sometimes may not be accurate. METHODS: Samples of skeletal anatomical data were retrospectively obtained and recorded in Digital Imaging and Communications in Medicine (DICOM) file format. The DICOM files were used to reconstruct 3D models using 3DSlicer (slicer.org) by thresholding airway regions to build up 3D polygon models of airway regions for each sample. The 3D models were measured for different landmarks that included measurements across the nasopharynx, the oropharynx, and the hypopharynx. Male and female subjects were combined as one data set to develop supervised learning models. These measurements were utilized to build 7 artificial intelligence-based supervised learning models. RESULTS: The supervised learning model with the best accuracy was Random Forest, with a value of 0.74. All the other models were lower in terms of their accuracy. The recall scores for Class I, II, and III malocclusions were 0.71, 0.69, and 0.77, respectively, which represented the total number of actual positive cases predicted correctly, making the sensitivity of the model high. CONCLUSION: In this study, it is observed that the Random Forest model was the most accurate model for predicting the skeletal malocclusion based on various airway and cephalometric landmarks.
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Puntos Anatómicos de Referencia , Cefalometría , Tomografía Computarizada de Haz Cónico , Maloclusión , Humanos , Cefalometría/métodos , Masculino , Puntos Anatómicos de Referencia/diagnóstico por imagen , Femenino , Tomografía Computarizada de Haz Cónico/métodos , Estudios Retrospectivos , Maloclusión/clasificación , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Imagenología Tridimensional/métodos , Orofaringe/diagnóstico por imagen , Orofaringe/patología , Orofaringe/anatomía & histología , Aprendizaje Profundo , Adolescente , Nasofaringe/diagnóstico por imagen , Nasofaringe/patología , Nasofaringe/anatomía & histología , Hipofaringe/diagnóstico por imagen , Hipofaringe/patologíaRESUMEN
AIM: To investigate the root number and morphology of the maxillary second molars in the Syrian population besides bilateral symmetry, and the effect of gender. METHODS: 250 Cone Beam Computed Tomography (CBCT) images (140 females, 110 males) were examined by two endodontists. The detailed analysis included the number of roots, the number of canals and their configurations, bilateral symmetry, and relation to gender. The evaluation was made according to Vertucci classification by analyzing the CBCT images at all levels (Axial, Coronal, Sagittal, Oblique, and 3D). The Chi-square statistical analysis was performed to compare the canals' morphologies and bilateral symmetry in both genders via SPSS. RESULT: The most common shape of the upper second molars is three roots (90.4%). There were significant differences between males and females regarding the symmetry of the number of roots (P < 0.05). The root canal configuration was mainly Vertucci type I classification in the Distobuccally (93.4%) and palatal root (99.6%). The most common type in the mesial root was type I (29.5%), showing all varieties of Vertucci classifications (except VII, and VIII) percentage of MB2 of 70.5%. The ratio of symmetry was (59.6%) with no significant statistical difference between the genders (P = 0.708). CONCLUSION: Most maxillary second molars in the examined Syrian population were types (II) (associated with MB2 cases with three roots and four canals). In terms of symmetry, the number of roots surpassed the canal configuration. Males had a greater symmetrical tendency in the number of roots than females.
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Tomografía Computarizada de Haz Cónico , Cavidad Pulpar , Maxilar , Diente Molar , Raíz del Diente , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Masculino , Femenino , Siria , Diente Molar/diagnóstico por imagen , Diente Molar/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Maxilar/diagnóstico por imagen , Maxilar/anatomía & histología , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/anatomía & histología , Adulto , Factores Sexuales , Adulto Joven , Adolescente , Persona de Mediana EdadRESUMEN
BACKGROUND: The use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA's recommendations. METHODS: For each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading "other". RESULTS: The most common indication was the "other" category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was "orofacial cleft" (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed. CONCLUSIONS: Although the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed.
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Tomografía Computarizada de Haz Cónico , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Adolescente , Niño , Estudios Transversales , Femenino , Masculino , Preescolar , Dosis de Radiación , Diente Impactado/diagnóstico por imagen , Anomalías Dentarias/diagnóstico por imagenRESUMEN
Background: The precision of postoperative prostate cancer radiotherapy is significantly influenced by setup errors and alterations in bladder morphology. Utilizing daily cone beam computed tomography (CBCT) imaging allows for the correction of setup errors. However, this naturally leads to the question of the issue of peripheral dose and workload. Thus, a zero-dose, noninvasive technique to reproduce the bladder volume and improve patient setup accuracy was needed. Purpose: The aim of this study is to investigate if the setup method by combining Optical Surface Management System (OSMS) and BladderScan can improve the accuracy of setup and accurately reproduce the bladder volume during radiotherapy of postoperative prostate cancer and to guide CTV-PTV margins for clinic. Method: The experimental group consisted of 15 postoperative prostate cancer patients who utilized a setup method that combined OSMS and BladderScan. This group recorded 103 setup errors, verified by CBCT. The control group comprised 25 patients, among whom 114 setup errors were recorded using the conventional setup method involving skin markers; additionally, patients in this group also exhibited spontaneous urinary suppression. The errors including lateral (Lat), longitudinal (Lng), vertical directions (Vrt), Pitch, Yaw, and Roll were analyzed between the two methods. The Dice similarity coefficient (DSC) and volume differences of the bladder between CBCT and planning CT were compared as the bladder concordance indicators. Results: The errors in the experimental group at Vrt, Lat, and Lng were 0.17 ± 0.12, 0.22 ± 0.17, and 0.18 ± 0.12 cm, and the control group were 0.25 ± 0.15, 0.31 ± 0.21, 0.34 ± 0.22 cm. The rotation errors of Pitch, Roll, and Yaw in the experimental group were 0.18 ± 0.12°, 0.11 ± 0.1°, and 0.18 ± 0.13°, and in the control group, they were 0.96 ± 0.89°, 1.01 ± 0.86°, and 1.02 ± 0.84°. The DSC and volume differences were 92.52 ± 1.65% and 39.99 ± 28.75 cm3 in the patients with BladderScan, and in the control group, they were 62.98 ± 22.33%, 273.89 ± 190.62 cm3. The P < 0.01 of the above performance indicators indicates that the difference is statistically significant. Conclusion: The accuracy of the setup method by combining OSMS and BladderScan was validated by CBCT in our study. The method in our study can improve the setup accuracy during radiotherapy of postoperative prostate cancer compared to the conventional setup method.
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Tomografía Computarizada de Haz Cónico , Neoplasias de la Próstata , Vejiga Urinaria , Humanos , Masculino , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/métodos , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/efectos de la radiación , Anciano , Planificación de la Radioterapia Asistida por Computador/métodos , Periodo Posoperatorio , Persona de Mediana Edad , Radioterapia Guiada por Imagen/métodosRESUMEN
OBJECTIVE: The review involves the assessment of morphological variations in the temporomandibular joint (TMJ) and its associated structures in patients with temporomandibular disorder. INTRODUCTION: Temporomandibular disorders (TMD) are debilitating conditions that affect the TMJ complex, surrounding musculature and osseous components. Studies have reported that TMD result from morphological alterations in TMJ. These alterations can be efficiently studied using three-dimensional imaging. This review will summarise the morphological changes in TMJ and associated structures based on studies with three-dimensional imaging in patients with TMD. INCLUSION CRITERIA: The systematic review will include studies with adult subjects with any one symptom of TMD and those studies that assessed TMJ morphology using three-dimensional imaging like CT, cone beam CT, MRI or arthrography. METHODS: Systematic searches for relevant studies will be carried out in multiple databases. Sources will include MEDLINE, Scopus, Dentistry and Oral Sciences Source, Cochrane CENTRAL, CINAHL, Web of Science, ProQuest Dissertation and Thesis and Google Scholar. The databases will be searched from inception to November 2023. Analytical observational studies comprising retrospective and prospective cohort studies, case-control studies and analytical cross-sectional studies will be selected and critical appraisal will be performed. No restrictions will be imposed on the date and country of publication. Joanna Briggs Institute (JBI) guidelines for systematic effectiveness reviews will be followed for data appraisal, extraction and synthesis. The strength of evidence will be graded using the Grading of Recommendations, Assessment, Development and Evaluation method and the summary of findings will be created using GRADEpro software. ETHICS AND DISSEMINATION: Ethical approval is not applicable for this study since this involves analysis of secondary data. Results will be disseminated through peer-reviewed publications and cnference presentations. A comprehensive summary of morphological alterations in TMJ is essential for assessing risk factors, accurate diagnosis, treatment planning and will collectively contribute to enhanced clinical care and overall patient well-being. PROSPERO REGISTRATION NUMBER: The protocol is registered in PROSPERO: CRD42023448882.
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Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Trastornos de la Articulación Temporomandibular , Articulación Temporomandibular , Humanos , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patología , Imagenología Tridimensional , Imagen por Resonancia Magnética , Tomografía Computarizada de Haz CónicoRESUMEN
BACKGROUND: Accurate assessment of basal bone width is essential for distinguishing individuals with normal occlusion from patients with maxillary transverse deficiency who may require maxillary expansion. Herein, we evaluated the effectiveness of a deep learning (DL) model in measuring landmarks of basal bone width and assessed the consistency of automated measurements compared to manual measurements. METHODS: Based on the U-Net algorithm, a coarse-to-fine DL model was developed and trained using 80 cone-beam computed tomography (CBCT) images. The model's prediction capabilities were validated on 10 CBCT scans and tested on an additional 34. To evaluate the performance of the DL model, its measurements were compared with those taken manually by one junior orthodontist using the concordance correlation coefficient (CCC). RESULTS: It took approximately 1.5 s for the DL model to perform the measurement task in only CBCT images. This framework showed a mean radial error of 1.22 ± 1.93 mm and achieved successful detection rates of 71.34%, 81.37%, 86.77%, and 91.18% in the 2.0-, 2.5-, 3.0-, and 4.0-mm ranges, respectively. The CCCs (95% confidence interval) of the maxillary basal bone width and mandibular basal bone width distance between the DL model and manual measurement for the 34 cases were 0.96 (0.94-0.97) and 0.98 (0.97-0.99), respectively. CONCLUSION: The novel DL framework developed in this study improved the diagnostic accuracy of the individual assessment of maxillary width. These results emphasize the potential applicability of this framework as a computer-aided diagnostic tool in orthodontic practice.
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Puntos Anatómicos de Referencia , Tomografía Computarizada de Haz Cónico , Maxilar , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Estudios Retrospectivos , Puntos Anatómicos de Referencia/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Femenino , Masculino , Aprendizaje Profundo , Adolescente , Algoritmos , Adulto , Adulto JovenRESUMEN
Objectives: To analyse and document internal root morphological variations in permanent anterior teeth using conebeam computed tomography. METHODS: The cross-sectional, retrospective study was conducted from January 21 to June 19, 2021, at Jinnah Magnetic Resonance Imaging and Body Scan, and comprised data from July to December 2020 related to all the patients who had been referred to the centre for dental cone-beam computed tomography scan. The scans were evaluated at the Radiology Department of the School of Dentistry at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. The morphology of the roots and root canals in all permanent anterior teeth was examined. Root canal configuration was categorised using Vertucci's classification. Data was analysed using SPSS 20. RESULTS: Of the 211 patients, 116(55%) were females and 95(45%) were males. The overall mean age was 39.9±1.02 years (range: 15-65 years). All the permanent anterior teeth exhibited a single root, with the exception 2(0.9%) mandibular right and 4(1.9%) left canines which had double roots. Type I root canals were observed in all 211 (100%) maxillary right central incisors, maxillary left central incisors and maxillary left canines. Among maxillary right canines, 208(98.6%) had type-I root canals, and the corresponding value for maxillary right lateral incisors was 209(99.1%), and for maxillary left lateral incisors, the value was 210(99.5%). Root canal polymorphism had no significant association with gender (p>0.05). CONCLUSIONS: The presence of type-I root canal was common in permanent anterior teeth, and there was significant association of root canal polymorphism with gender.
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Tomografía Computarizada de Haz Cónico , Cavidad Pulpar , Humanos , Masculino , Femenino , Tomografía Computarizada de Haz Cónico/métodos , Estudios Transversales , Pakistán , Adulto , Adolescente , Persona de Mediana Edad , Adulto Joven , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/anatomía & histología , Estudios Retrospectivos , Anciano , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Incisivo/diagnóstico por imagen , Incisivo/anatomía & histología , Diente Canino/diagnóstico por imagen , Diente Canino/anatomía & histología , Dentición PermanenteRESUMEN
OBJECTIVES: The aim of our study is to determine the relationship between MPS maturation and CVM stage determined from CBCTs. MATERIALS AND METHODS: CBCT images of 130 individuals (75 females, 55 males) with a mean age of 15.04 ± 3.11 (9.56-25.05 years) were analyzed. Images were analyzed using the i-CAT Vision software program. The cephalometric images to be examined were also obtained from the same CBCT images with the ImageJ program. The correlation between MPS and CVM stages was evaluated using the Spearman correlation test. The relationship between the skeletal developmental stage and MPS maturation, as assessed by the CVM method, was evaluated with the positive likelihood ratio. RESULTS: Significant correlations were found between CVM and MPS maturation stages. Positive LHR values of cervical vertebral stages were obtained to define the maturation stages of the midpalatal suture. LHR values greater than ten were found between CS2, CS5, and CS6 and maturation stages B, D, and E, respectively. A 15-30% correlation was observed between CS3 and CS4 maturation stages B and C, respectively. A positive correlation of 15% was found between CS3 and stage C. CONCLUSION: MPS fusion is more likely to occur after CS4. The correlation between the CVM and MPS maturation stages is significant (r = 0.858). CVM stages CS2, CS4, and CS6 can be a preliminary indicator for MPS stages B, D, and E, respectively. CS5 shows that MPS fusion has occurred partially or completely. CLINICAL RELEVANCE: A significant relationship exists between skeletal developmental stages and suture maturation.
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Tomografía Computarizada de Haz Cónico , Humanos , Femenino , Masculino , Adulto , Adolescente , Niño , Adulto Joven , Tomografía Computarizada de Haz Cónico/métodos , Suturas Craneales/crecimiento & desarrollo , Suturas Craneales/diagnóstico por imagen , Desarrollo Óseo/fisiología , Cefalometría/métodosRESUMEN
STATEMENT OF PROBLEM: The demand for immediate implant placement (IIP) in the esthetic zone is rapidly increasing. Despite the treatment's benefits, the sagittal root position often dictates implant angulation, commonly necessitating the use of cement-retained restorations. This study investigates the impact of angulated screw channel on IIP in the esthetic zone. PURPOSE: The purpose of this cone-beam computed tomography (CBCT) study was to determine the probability of IIP in the esthetic zone, using four different implant angulations. MATERIALS AND METHODS: A retrospective review of CBCT images was conducted and accessed on 9 June 2021. The midsagittal images of maxillary anterior teeth were input into an implant planning software (Implant Studio®). Bone Level X Straumann® implant (BLX 3.5, 3.75, 4.0, 4.5, 5.0 mm) and Bone Level Tapered implant (BLT 2.9, 3.3 mm) were selected for 3D implant planning of IIP in the esthetic zone. The frequency distribution and probability of IIP were recorded and compared among all maxillary anterior teeth. RESULTS: CBCT images from 720 teeth (120 patient) were evaluated, revealing an overall probability of IIP in the esthetic zone is 76.11% (548/720). Different implant restoration type was evaluated in this study, with the following results; straight screw-retained prosthesis at 3.47% (19/548), cement-retained prosthesis at 14.59% (80/548) and angle screw-retained prosthesis at 85.40% (468/548). CONCLUSION: IIP with traditional straight screw-retained prosthesis demonstrated the lowest probability. Nevertheless, the use of angulated screw channels enhances the probability of achieving straight screw-retained prostheses. CLINICAL IMPLICATIONS: The angulated screw channel is essential for increasing the probability of screw-retained prosthesis in IIP in the esthetic zone. However, limitation in screw angle correction still necessitate the use of cement-retained prostheses for numbers of patients undergoing IIP.
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Tornillos Óseos , Tomografía Computarizada de Haz Cónico , Carga Inmediata del Implante Dental , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Estudios Retrospectivos , Femenino , Masculino , Carga Inmediata del Implante Dental/métodos , Persona de Mediana Edad , Adulto , Maxilar/cirugía , Maxilar/diagnóstico por imagen , Estética Dental , Implantes Dentales , AncianoRESUMEN
OBJECTIVES: To detect any association between palatally displaced canine (PDC) and nasal septal deviation (NSD), palatal bone thickness and volume, and nasal airway dimensions and volume. MATERIALS AND METHODS: A total of 92 patients were included and subdivided into two groups: group 1, unilateral PDCs (44 patients), and group 2, normally erupted canines (NDCs) (48 subjects). The following variables were measured using cone-beam computed tomography: presence and type of NSD, nasal width, inferior conchae, hard palate and nasal septum thickness, maxillary bone and nasal airway volumes. RESULTS: NSD was detected in 77% and 50% of PDC and NDC subjects, respectively. Within the PDC subjects, significant differences between the displaced and nondisplaced sides were detected. Palate thickness was increased in the canine region and reduced in the molar region. Compared with the control group, PDC subjects had reduced palate thickness and lower nasal airway volume. Two predictors were significant for predicting the odds of PDC occurrence: NSD and maxillary bone volume. CONCLUSIONS: NSD is more frequent in PDC subjects. PDC subjects have reduced palate thickness and decreased nasal airway volume. In the presence of NSD, the odds of developing PDC increase by 3.35 times, and for each one-unit increase in the maxillary bone volume, the odds of developing PDC decrease by 20%.
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Tomografía Computarizada de Haz Cónico , Diente Canino , Maxilar , Tabique Nasal , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Estudios Retrospectivos , Masculino , Femenino , Tabique Nasal/diagnóstico por imagen , Diente Canino/diagnóstico por imagen , Adolescente , Maxilar/diagnóstico por imagen , Niño , Paladar Duro/diagnóstico por imagen , Erupción Ectópica de Dientes/diagnóstico por imagen , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/anatomía & histología , Adulto JovenRESUMEN
OBJECTIVES: To compare the buccal and palatal bone changes of maxillary posterior teeth produced by hybrid hyrax (HH) and conventional hyrax (CH) expanders in growing patients. MATERIAL AND METHODS: A sample of 32 patients with posterior crossbites in the late mixed dentition was recruited and randomly allocated into two groups. Group HH was composed of 18 individuals with a mean age of 10.7 years (six female, 12 male) treated with a hybrid expander with two anterior parasagittal miniscrews. Group CH was composed of 14 individuals with a mean age of 11.4 years (six female, eight male) treated with a conventional Hyrax expander. Cone-beam computed tomography (CBCT) exams were obtained before expansion (T1) and after 11 months when the expander was removed (T2). Buccal and palatal bone plate thickness and height of maxillary posterior teeth were measured. Intergroup comparisons were performed using t or Mann-Whitney tests (P < .05). RESULTS: The CH group showed greater decreases of the buccal bone plate height (mean change: 1.27 mm) at the maxillary first premolars compared to the HH group (mean change: 0.11 mm, P = .001). No intergroup difference was found for changes in the buccal and palatal bone thickness. CONCLUSIONS: Hybrid expanders showed a tendency to cause less negative impact on the buccal bone plate height of first premolars compared to conventional Hyrax expanders. However, the difference was not clinically significant. Both hybrid and conventional Hyrax expanders are safe for the alveolar bone morphology in the late mixed dentition.
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Proceso Alveolar , Tomografía Computarizada de Haz Cónico , Técnica de Expansión Palatina , Humanos , Femenino , Masculino , Técnica de Expansión Palatina/instrumentación , Tomografía Computarizada de Haz Cónico/métodos , Niño , Proceso Alveolar/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Diseño de Aparato Ortodóncico , Maloclusión/terapia , Maloclusión/diagnóstico por imagen , Dentición Mixta , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diente Premolar/diagnóstico por imagenRESUMEN
OBJECTIVES: To evaluate changes of the upper airway and oral cavity volumes in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery, and to analyze the correlation between postoperative upper airway decrease and the amount of jaw movement and oral cavity volume reduction. MATERIALS AND METHODS: Thirty patients (16 males and 14 females) undergoing bimaxillary surgery were included. Three-dimensional reconstruction of the upper airway and oral cavity were performed using preoperative (T0) and postoperative (T1) (6 months) cone-beam computed tomography scans. RESULTS: The volume, sagittal area and minimum cross-sectional area of the upper airway were diminished (P < .001). The decrease in volume and minimum cross-sectional area in the oropharyngeal region of the upper airway were weakly correlated with B-point posterior movement (P < .05). Total oral cavity volume was decreased, with maxillary oral volume increasing and mandibular oral volume decreasing (P < .001). Upper airway decrease was highly correlated with total oral volume reduction and mandibular oral volume reduction, with the most significant correlation being with total oral volume reduction (P < .001). CONCLUSIONS: Class III bimaxillary surgery reduced the volume, sagittal area, and minimum cross-sectional area of the upper airway as well as oral cavity volume. Upper airway changes were weakly correlated with anterior-posterior mandibular movement but significantly correlated with oral cavity volume changes. Thus, oral cavity volume reduction is a crucial factor of upper airway decrease in patients with skeletal Class III malocclusion undergoing bimaxillary orthognathic surgery.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional , Maloclusión de Angle Clase III , Boca , Procedimientos Quirúrgicos Ortognáticos , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase III/diagnóstico por imagen , Femenino , Masculino , Procedimientos Quirúrgicos Ortognáticos/métodos , Adulto , Boca/diagnóstico por imagen , Imagenología Tridimensional/métodos , Adulto Joven , Proyectos Piloto , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Adolescente , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Orofaringe/diagnóstico por imagen , Orofaringe/patología , Faringe/diagnóstico por imagenRESUMEN
OBJECTIVES: To compare upper airway changes following bimaxillary surgery for correction of Class III deformity between patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) and to compare the preoperative and postoperative upper airway among patients with UCLP and BCLP to healthy controls. MATERIALS AND METHODS: Sixty adults with CLP-related skeletal Class III deformity (30 UCLP and 30 BCLP) who consecutively underwent bimaxillary surgery were studied retrospectively. Cone-beam computed tomography (CBCT) was performed before and after surgery to measure upper airway and movements of facial skeletal and surrounding structures. CBCT images from 30 noncleft skeletal Class I adults, matched by age, gender, and body mass index and without surgical intervention, served as controls. RESULTS: After surgery, the volume of the nasopharynx increased in patients with CLP (both P < .001). Patients with CLP did not differ from controls in postoperative volume of the nasopharynx or oropharynx. However, the nasal cavity differed significantly between patients with CLP and controls (P < .001). CONCLUSIONS: After bimaxillary surgery, the nasal cavity of patients with CLP differed significantly compared with the controls. Volumes of the nasopharynx and oropharynx did not differ between patients with CLP after surgery and controls.
Asunto(s)
Labio Leporino , Fisura del Paladar , Tomografía Computarizada de Haz Cónico , Maloclusión de Angle Clase III , Maxilar , Nasofaringe , Humanos , Femenino , Masculino , Tomografía Computarizada de Haz Cónico/métodos , Fisura del Paladar/cirugía , Fisura del Paladar/diagnóstico por imagen , Labio Leporino/cirugía , Labio Leporino/diagnóstico por imagen , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase III/diagnóstico por imagen , Estudios Retrospectivos , Adulto , Nasofaringe/diagnóstico por imagen , Maxilar/cirugía , Maxilar/diagnóstico por imagen , Procedimientos Quirúrgicos Ortognáticos/métodos , Orofaringe/diagnóstico por imagen , Adulto Joven , Cavidad Nasal/diagnóstico por imagen , Estudios de Casos y Controles , Adolescente , Resultado del TratamientoRESUMEN
OBJECTIVES: To assess skeletal and dental effects and evaluate possible side effects of maxillary expansion with two different appliances, directly after expansion and 1 year postexpansion. MATERIALS AND METHODS: Forty-two patients with unilateral posterior crossbite (mean 9.5 ± 0.9 years) were randomized to either rapid maxillary expansion (RME) banded on the deciduous second molars and bonded to the primary canines or slow expansion with quad helix (QH) on the permanent first molars. Cone-beam computed tomography records were taken at baseline, directly after correction of the posterior crossbite and at follow-up 1 year after expansion. RESULTS: All patients were analyzed. RME opened the midpalatal suture more anteriorly and inferiorly (mean 4.1 mm) and less posteriorly and superiorly (mean 1.0 mm). No effect on midpalatal suture could be shown in the QH group after expansion, P < .001. Buccal bone width had significantly decreased (P < .001) in the QH group compared with the RME group. Buccal fenestrations and root resorption on the left first molar had a higher prevalence directly after expansion finished in the QH group (P = .0086, P = .013) but were not significant at 1-year follow-up (P = .11, P = .22). CONCLUSIONS: Opening of the suture with RME was more anterior and inferior, and the QH did not open the midpalatal suture at all. More buccal bone loss and fenestrations were seen on the permanent first molar in patients treated with conventional QH than RME anchored to deciduous teeth.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Maloclusión , Diente Molar , Técnica de Expansión Palatina , Humanos , Niño , Femenino , Masculino , Estudios de Seguimiento , Maloclusión/terapia , Diente Molar/diagnóstico por imagen , Diseño de Aparato Ortodóncico , Maxilar , Resultado del Tratamiento , Resorción Radicular/etiología , Resorción Radicular/diagnóstico por imagenRESUMEN
OBJECTIVES: To determine the prevalence of root resorption of teeth adjacent to permanent maxillary canines on both sides, by cone-beam computed tomography (CBCT), in pretreatment adolescent subjects with unilaterally impacted maxillary canines, and to define predictive factors for the root resorption. MATERIALS AND METHODS: This retrospective sample included 76 adolescents (38 boys, 38 girls, mean age 12.3 ± 2.1 years; range 8-17 years) who had CBCT after detection of a unilateral impacted maxillary canine before any active orthodontic treatment. Both ipsilateral and contralateral sides were examined, and 14 qualitative and quantitative variables were collected. Descriptive statistics were calculated, and multiple logistic regression was used to predict root resorption. RESULTS: On the impaction side, 57.9% of canines resorbed at least one adjacent tooth compared with 13.2% on the contralateral side (P < .001). On the impaction side, resorption was slight in 59.6%, moderate in 5.8%, and severe in 34.6% of the cases. On the contralateral side, resorption was slight in 91.7%, moderate in 0%, and severe in 8.3% of the cases. On both sides, upper lateral incisors were the teeth most frequently resorbed, followed by the upper first premolars and upper central incisors. The presence of contact between the canine and the adjacent roots was the only statistically significant risk factor for resorption for both ipsilateral and contralateral sides. CONCLUSIONS: Orthodontists should look for root resorption on both sides in cases of unilaterally impacted maxillary canines.