Search Results (14)

Background/Objectives: Patients undergoing antiresorptive therapy were evaluated, focusing on clinical and radiological features and their relationship with medication-related osteonecrosis of the jaw (MRONJ). Methods: Patients were allocated to two groups: MRONJ (n = 27) and non-MRONJ (n = 139). Clinical evaluation included decayed, missing, and filled teeth (DMFT), number of teeth, periodontal status, prosthesis use, and preventive/therapeutic measures. Imaging analysis included panoramic radiography (PAN) and cone beam computerized tomography (CBCT) to assess MRONJ-related signs. Results: The sample showed high levels of DMFT and prosthesis use. There was a tendency of higher prevalence of deeper periodontal pockets in the MRONJ group, with greater need for oral hygiene reinforcement and chlorhexidine prescription. PAN showed higher frequency of osteolysis, persistent alveolar socket, bone sequestration, mandibular canal involvement, periosteal reaction, and sinus involvement in the MRONJ group. Still on PAN, all cases in both groups exhibited a sclerotic trabecular bone pattern. CBCT showed higher frequency of a sclerotic trabecular bone pattern, mandibular canal involvement, and bone sequestration in the MRONJ group. Composite radiographic index modified (CRIm) was higher in the MRONJ group for PAN and CBCT, with low-grade cases in the non-MRONJ and medium-/high-grade cases in the MRONJ group. A positive correlation was found between CRIm and MRONJ staging. Conclusions: This study underscores the role of preventive oral care in patients undergoing antiresorptive therapy, highlighting the need for regular periodontal monitoring. Also emphasized is the importance of integrating clinical and radiographic examinations of these patients. Accordingly, CRIm seems to be a reliable tool for MRONJ staging and monitoring. Full article

Lateral cephalometric analysis is commonly used in orthodontics for skeletal classification to ensure an accurate and reliable diagnosis for treatment planning. However, most current research depends on analyzing different type of radiographs, which requires more computational time than 3D analysis. Consequently, this study addresses fully automatic orthodontics tracing based on the usage of artificial intelligence (AI) applied to 2D and 3D images, by designing a cephalometric system that analyzes the significant landmarks and regions of interest (ROI) needed in orthodontics tracing, especially for the mandible and maxilla teeth. In this research, a computerized system is developed to automate the tasks of orthodontics evaluation during 2D and Cone-Beam Computed Tomography (CBCT or 3D) systems measurements. This work was tested on a dataset that contains images of males and females obtained from dental hospitals with patient-informed consent. The dataset consists of 2D lateral cephalometric, panorama and CBCT radiographs. Many scenarios were applied to test the proposed system in landmark prediction and detection. Moreover, this study integrates the Grad-CAM (Gradient-Weighted Class Activation Mapping) technique to generate heat maps, providing transparent visualization of the regions the model focuses on during its decision-making process. By enhancing the interpretability of deep learning predictions, Grad-CAM strengthens clinical confidence in the system’s outputs, ensuring that ROI detection aligns with orthodontic diagnostic standards. This explainability is crucial in medical AI applications, where understanding model behavior is as important as achieving high accuracy. The experimental results achieved an accuracy exceeding 98.9%. This research evaluates and differentiates between the two-dimensional and the three-dimensional tracing analyses applied to measurements based on the practices of the European Board of Orthodontics. The results demonstrate the proposed methodology’s robustness when applied to cephalometric images. Furthermore, the evaluation of 3D analysis usage provides a clear understanding of the significance of integrated deep-learning techniques in orthodontics. Full article

Purpose: The objective of this study was to determine the prevalence of exostosis in the Mississippi population. Methods: The patient archives of the UMMC School of Dentistry between January 2018 and May 2021 were examined. Patients with exostosis were included in the study based on the findings from intraoral photographs, full-moth series (FMS), panoramic radiographs, and cone-beam computerized tomography (CBCT) images of the patients. Patients were excluded from the study if they did not have maxillary or mandibular exostosis. In addition, each patient’s age, gender, and ethnic origins, such as Caucasian, African-American, or Asian, were recorded. All data regarding exostosis were evaluated and categorized according to age, gender, and ethnicity. Multiple logistic regression analysis was performed for more detailed statistical analysis. Results: A total of 1242 patients were examined for the presence of maxillary and mandibular tori. In total, 303 patients were diagnosed with maxillary and/or mandibular tori among the Mississippi population, with a prevalence rate of 24.4%. Exostosis was seen more in females (57.4%) compared to males (42.6%). The highest prevalence of exostosis was seen in Caucasians (71.3%), followed by African-Americans (23.8%) and Asians (5%). Conclusions: High prevalence of exostosis was seen in the Mississippi population. Our findings will help clinicians to be more aware of these bony protuberances and, thus, better at diagnosing them. This may specifically help oral surgeons, periodontists, and prosthodontists in pre-prosthodontic surgery and denture fabrication. Full article

Measurements of tooth size for estimating inter-arch tooth size discrepancies and inter-tooth distances, essential for orthodontic diagnosis and treatment, are primarily done using traditional methods involving plaster models and calipers. These methods are time-consuming and labor-intensive, requiring multiple steps. With advances in cone-beam computerized tomography (CBCT) and intraoral scanning technology, these processes can now be automated through computer analyses. This study proposes a multi-step computational method for measuring mesiodistal tooth widths and inter-tooth distances, applicable to both CBCT and scan images of plaster models. The first step involves 3D segmentation of the upper and lower teeth using CBCT, combining results from sagittal and panoramic views. For intraoral scans, teeth are segmented from the gums. The second step identifies the teeth based on an adaptively estimated jaw midline using maximum intensity projection. The third step uses a decentralized convolutional neural network to calculate key points representing the parameters. The proposed method was validated against manual measurements by orthodontists using plaster models, achieving an intraclass correlation coefficient of 0.967 and a mean absolute error of less than 1 mm for all tooth types. An analysis of variance test confirmed the statistical consistency between the method’s measurements and those of human experts. Full article

Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (−0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients’ rehabilitation and soft tissue preservation to replace a hopeless tooth. Full article

Sialography is used for diagnosis of obstructive salivary gland diseases and prior to sialendoscopy. Three-dimensional cone beam computerized tomography (CBCT) sialography allows imaging and measurement of salivary duct structures. Salivary gland endoscopy has a long learning curve. The aim of this retrospective study is to create an anatomical quantitative guide of different distances and angles significant for endoscopy. Twenty-six CBCT sialographies of healthy parotid ducts were included. Outcome parameters included diameters, distances, angles and number of minor tributaries. Results show the average distance from the papilla to the curvature of the gland was 41.5 mm (Q1 36.97 mm–Q3 45.32 mm), with an angle of 126.9° (Q1 107.58°–Q3 135.6°) of the curvature and a distance of 35.25 mm (±7.81 mm) between the curvature and the hilus. The mean width of the duct was 0.8 mm (Q1 0.7 mm–Q3 1.15 mm) at its narrowest and 2 mm (Q1 1.4 mm–Q3 2.2 mm) at its widest. This is the first anatomical quantitative study of the parotid duct in relation to sialendoscopy. Full article

Background: The collum angle (CA) is an extremely significant for patients who are undergoing orthodontic, dental implant restoration, prosthodontic and periodontic treatments. Aim and Objectives: To determine and compare the mean CA for maxillary central incisor in different types of malocclusion utilizing 3D Cone Beam Computerized Tomography (CBCT) images. The additional objectives were to determine and compare the mean CA for maxillary central incisor based upon the demographic characteristics among Saudi, Jordan and Egypt subpopulation and to test for significant differences in the CA of maxillary central incisor with different molar malocclusions. Methodology: A total of 400 CBCT images were included from the radiology archive at the College of Dentistry, Jouf University (Sakaka, Saudi Arabia). The CBCT images were divided into four groups based upon molar classifications. The selected records were used for the measurement of CA of maxillary central incisor using the measurement tool built into 3D:OnDemand software. Statistical analysis was done using independent t test and ANOVA to examine the differences between gender and races. Results: The mean CA for Class II div 2 exhibited significantly higher crown-root variation as compared other groups (p < 0.0001). Males sample showed greater value of CA for each group as compared to the females and this difference was statistically significant for all the groups other than for Class I (p < 0.05). The post hoc pairwise comparisons between the races showed statistically insignificant findings (p > 0.05). Significant difference was found on pairwise comparisons among different malocclusion groups other than for group Class I/Class II div 1 (p < 0.05). Conclusion: The CA of Class II div 2 group was the greatest as compared to other malocclusion groups. Males sample showed greater value of CA for each group as compared to the females and this difference was statistically significant for all the groups other than for Class I. Statistically insignificant difference was noted for the mean CA among different races whereas significant difference was found on pairwise comparisons among different malocclusion groups other than for group Class I/Class II div 1. Full article

The purpose of this study was to develop a technique to record the natural head position (NHP) of a subject using the scout images of cone beam computerized tomography (CBCT) scans. The first step was to align a hanging mirror with the vertical (XY) plane of the CBCT field-of-view (FOV) volume. Then, two scout CBCT images, at frontal and at sagittal planes, were taken when the subject exhibited a NHP. A normal CBCT scan on the subject was then taken separately. These scout images were used to correct the orientation of the normal CBCT scan. A phantom head was used for validation and performance analysis of the proposed method. It was found that the orientation detection error was within 0.88°. This enables easy and economic NHP recording for CBCT without additional hardware. Full article

Modern dentistry commonly uses a variety of imaging methods to support diagnosis and treatment. Among them, cone beam computed tomography (CBCT) is particularly useful in presenting head structures, such as the temporomandibular joint (TMJ). The determination of the morphology of the joint is an important part of the diagnosis as well as the monitoring of the treatment results. It can be accomplished by measurement of the TMJ gap width at three selected places, taken at a specific cross-section. This study presents a new approach to these measurements. First, the CBCT images are denoised using curvilinear methods, and the volume of interest is determined. Then, the orientation of the vertical cross-section plane is computed based on segmented axial sections of the TMJ head. Finally, the cross-section plane is used to determine the standardized locations, at which the width of the gap between condyle and fossa is measured. The elaborated method was tested on selected TMJ CBCT scans with satisfactory results. The proposed solution lays the basis for the development of an autonomous method of TMJ index identification. Full article

The aim of this study is to propose a 3D skeletal classification and relative normal values of reference. Method: from a pool of 271 cone-beam computerized tomography images 108 chin-summit examinations of the skull were selected and divided into 3 traditional skeletal classes. The same Cone-beam Computerized Tomography (CBCT) images were then assessed using the cephalometric multiplanar analysis following the total face approach protocol. Results: the results of this study indicate standard 3D cephalometric norms for the vertical and sagittal evaluation of the skull. Conclusions: data obtained from our measurements allowed the creation of intervals supplying nosological classification that could be used in orthodontics, orthognatic surgery and implant surgery in fully edentulous patients. Full article

This study aimed to evaluate the impact of surface-modified biomedical titanium (Ti) dental implant on osseointegration. The surfaces were modified using an innovative dip-coating technique (IDCT; sandblasted, large-grit, and acid-etched, then followed by coating with the modified pluronic F127 biodegradable polymer). The surface morphology and hemocompatibility evaluations were investigated by field-emission scanning electron microscopy, while the contact analysis was observed by goniometer. The IDCT-modified Ti implant was also implanted in patients with missing teeth by single-stage surgical procedure then observed immediately and again four months after placement by cone-beam computerized tomography (CBCT) imaging. It was found that the IDCT-modified Ti implant was rougher than the dental implant without surface modification. Contact angle analysis showed the IDCT-modified Ti implant was lower than the dental implant without surface modification. The hemocompatibility evaluations showed greater red blood cell aggregation and fibrin filament formation on the IDCT-modified Ti implant. The radiographic and CBCT image displayed new bone formation at four months after the IDCT-modified Ti implant placement. Therefore, this study suggests that the IDCT-modified Ti dental implant has great potential to accelerate osseointegration. Full article

Background: To investigate the middle-term effect on bone remodeling of different timings for different implant placement (immediate versus delayed). Methods: Patients with an anterior maxillary failing tooth were treated by single-crown supported by dental implant. Subjects were retrospectively analyzed for 3 years and assigned to one of two predictor groups: nine immediate versus 10 delayed implant placement (1–2 months after tooth extraction). The crestal bone loss around dental implants was measured with the cone beam computerized tomography by fusing pre-operative and post-operative data. Results: The percentage of volume loss registered at 1-year follow-up (%ΔV) was of 7.5% for the immediate group, which was significantly lower (p-values ≤ 0.0002) than the loss of 24.2% for the delayed group. At 3 years, there was a significant difference (p-values = 0.0291) between the two groups, respectively, with a volume loss of 14.6% and 27.1%. When different times were compared, the percentage of the volume loss for the immediate group was different (p-value = 0.0366) between the first and third year (7.5% and 14.6%, respectively). For the delayed group, no significant difference was registered between the 1- and 3-year follow-up. Conclusions: The bone loss around dental implant-supported single-crown with different timing of insertion appeared higher for the delayed group than the immediate group. Full article

The aim of this study was to compare the accuracy of implant placement by using the conventional freehand method, the surgical guide alone, the dental navigation system alone, and the dental navigation system with a surgical guide. The participants were aged 20 years or older and were requiring dental implant surgery according to an assessment made by a dentist between July 2014 and December 2017. A total of 128 dental implants were inserted, 32 dental implants in each group, and participants with similar or identical age (i.e., 20–50 years or 50 years or above) and missing tooth locations were paired for comparison. Accuracy was measured by overlaying the real position in the postoperative Cone Beam Computerized Tomography (CBCT) on the virtual presurgical placement of the implant in a CBCT image. Using the dental navigation system with a surgical guide could help dentists to position implants more accurately. Total, longitudinal, and angular error deviation were significantly different (p < 0.0001). The same level of accuracy could be obtained for the different jaws and tooth positions. The one-way analysis of variance (ANOVA) showed that the total, longitudinal, and angular errors differed significantly (p < 0.0001). A comparison of the four dental implant surgical methods indicated that the combination of a dental implant navigation system and a surgical guide kit achieved the highest accuracy in terms of the different tooth positions and jaws. Full article

This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus. Full article