scholarly journals Geometry of anchoring miniscrew in the lateral palate that support a tissue bone borne maxillary expander affects neighboring root damage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Song Hee Oh ◽  
Sae Rom Lee ◽  
Jin-Young Choi ◽  
Hyo-Won Ahn ◽  
Seong-Hun Kim ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cone Beam ◽  
Palatal Expansion ◽  
Computed Tomography Images ◽  
Tooth Roots ◽  
Geometric Factors ◽  
Sufficient Stability ◽  
Root Proximity ◽  
The Right ◽  
Placement Depth

AbstractAnchoring miniscrews used for a tissue bone borne maxillary expander (C-expander) can fail if they contact tooth roots or perforate the maxillary sinus. Cone beam computed tomography images were reviewed retrospectively to evaluate the geometric factors of miniscrew placement in the palate that contribute to root proximity (RP) and sinus perforation (SP), and to investigate the differences of miniscrew placement depth (PD) and placement angle (PA) among the groups in each variable from 340 anchoring miniscrews on 70 patients whose C-expanders showed sufficient stability after palatal expansion for orthodontic treatment. Two types of miniscrews were used: a self-tapping miniscrew with 1.8 mm-in-diameter, and a self-drilling miniscrew with 1.6 mm-in-diameter. While the self-tapping larger diameter miniscrew influenced root proximity significantly, the screw location and PD affected the rate of sinus perforation. PA was significantly different between the right and left sides of the palate. The results of this study confirmed that root proximity and sinus perforation of anchoring miniscrews in a tissue bone borne palatal expander occurred due to certain risk factors, even when the palates were expanded successfully. Knowledge of these factors can help the clinician place miniscrews with less risk of root proximity or sinus perforation.

Expansão Maxilar Apoiada em Mini-implantes (MARPE) – guia prático para planejamento e instalação

2020 ◽  
Vol 13 (52) ◽  
pp. 10-24
Author(s):  
Luciana Quintanilha Pires Fernandes ◽  
Jonas Capelli Junior ◽  
José Augusto Mendes Miguel
Keyword(s):  
Cone Beam ◽  
Growth Spurt ◽  
Maxillary Expansion ◽  
Pubertal Growth Spurt ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Pubertal Growth ◽  
Division 1 ◽  
The Right

Rapid maxillary expansion (RME) is an orthodontic treatment alternative that aims to increase the transverse direction of the maxilla by separating the median palatine suture (MPS). miniscrew-assisted rapid palatal expansion (MARPE) aims to enhance the orthopedic effects of RME through skeletal anchorage. Thus, the aim of this article is to provide a guide for MARPE planning in cone beam computed tomography (CBCT) and for installation of the expander device with this technique. In addition, a case report of a Caucasian male patient, 16 years and 3 months old with Class II malocclusion, division 1 right subdivision, posterior crossbite of the right side and atresic upper arch in the post-pubertal growth spurt phase will be presented. The patient was treated with MARPE for a period of 5 weeks, when overcorrection of crossbite, correction of maxillary atresia, opening of MPS and creation of a transient diastema between the upper incisors were achieved, evidencing the success of the MARPE technique in a post-pubertal growth spurt patient.

Improved Visualization and Assessment of Condylar Position in the Glenoid Fossa for Different Occlusions: A CBCT Study

2016 ◽  
Vol 17 (8) ◽  
pp. 679-686 ◽  
Author(s):  
Amandeep Kaur ◽  
Amanpreet S Natt ◽  
Simranjeet K Mehra ◽  
Karan Maheshwari ◽  
Amanjot Kaur
Keyword(s):  
Orthodontic Treatment ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Cone Beam ◽  
Glenoid Fossa ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Condylar Position ◽  
The Stability ◽  
The Right

ABSTRACT Introduction The position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment. Cone beam computed tomography (CBCT) provides an optimal imaging of the osseous components of the temporomandibular joint (TMJ) and give a full size truly threedimensional (3D) description in real anatomical size. The present study aimed to visualize and compare the position of condyle in the glenoid fossa for different occlusions by using CBCT. Materials and methods Cone beam computed tomographic images of 45 subjects, aged 18 to 42 years, were evaluated. Subjects were equally divided into three groups according to the A point, nasion, B point (ANB) angle. Results In the sagittal plane, condyle is positioned nonconcentrically; positioned anteriosuperiorly in class I and III occlusions and lies posteriosuperiorly in class II occlusion. In the frontal plane, condyle is positioned centrally (mediolaterally) in all the three types of occlusions. In the axial plane, the parameters showed significant difference between the different occlusions. No statistical significant distinction could be made in the position of the condyle when comparing the right and left joints. Conclusion The position of condyle in glenoid fossa influences sagittal, transverse, and vertical relationships of the jaws which eventually contribute to development of various malocclusions. Nonconcentricity is the feature of the condyle in the sagittal plane in different malocclusions. Clinical significance An important consideration in orthodontic treatment is the recognition of the importance that the dentition should be in harmony with the related musculoskeletal structures. Therefore, the condylar position is an important concern in maintaining or restoring temporomandibular harmony with the dentition and the position of the condyle in the glenoid fossa plays an important role in the stability of occlusion after orthodontic treatment. How to cite this article Kaur A, Natt AS, Mehra SK, Maheshwari K, Singh G, Kaur A. Improved Visualization and Assessment of Condylar Position in the Glenoid Fossa for Different Occlusions: A CBCT Study. J Contemp Dent Pract 2016;17(8):679-686.

scholarly journals Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3428
Author(s):  
Marcin Derwich ◽  
Maria Mitus-Kenig ◽  
Elzbieta Pawlowska
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Orthodontic Treatment ◽  
Statistical Significance ◽  
Cone Beam ◽  
Glenoid Fossa ◽  
Computed Tomography Images ◽  
Temporomandibular Joints ◽  
Condylar Head ◽  
Reciprocal Clicking

Background: Patients referred for orthodontic treatment often present symptoms of temporomandibular joints’ disorders (TMD), predominantly clicking. The objective was to analyze the morphology of the temporomandibular joints in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment. Methods: 105 participants took part in the study. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The following tests were performed: U-Mann Whitney, Kruskal-Wallis, t-Student, and chi-square. The statistical significance level was p = 0.05 for all the measurements included. Results: Significantly smaller condylar A-P dimension (p = 0.040) characterized temporomandibular joints with reciprocal clicking. Condyles were substantially more often positioned posteriorly (p = 0.043) and were significantly more often accompanied by subcortical cysts and pathologic osteoarthritic bone changes (p < 0.001). Conclusions: The early stages of internal derangements stay with alterations in morphology and position of TMJs as well as with the presence of osteoarthritic changes.

scholarly journals Root proximity of miniscrews at a variety of maxillary and mandibular buccal sites: Reliability of panoramic radiography

2019 ◽  
Vol 89 (4) ◽  
pp. 611-616 ◽  
Author(s):  
Jae-Hwa An ◽  
Yong-Il Kim ◽  
Seong-Sik Kim ◽  
Soo-Byung Park ◽  
Woo-Sung Son ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Orthognathic Surgery ◽  
Panoramic Radiography ◽  
Cone Beam ◽  
Central Incisor ◽  
Intermaxillary Fixation ◽  
Extreme Caution ◽  
The Mean ◽  
Root Proximity ◽  
The Right

ABSTRACT Objectives: To assess the root proximity and the insertion angles of miniscrews after miniscrew placement at a variety of maxillary and mandibular buccal sites using cone-beam computed tomography (CBCT) and to determine the differences in root proximity between CBCT and panoramic radiography (PR). Materials and Methods: This retrospective study included 50 patients (mean age, 22.0 ± 4.5 years) who underwent postoperative CBCT and PR after miniscrew placements for intermaxillary fixation in orthognathic surgery. Twelve miniscrews were placed in the buccal bone of each patient: at sites between the central incisor and lateral incisor (SII), sites between the canine and first premolar (SCP), and sites between the second premolar and first molar (SPM) on the right and left sides of the mandible and maxilla. The insertion angles were measured on CBCT, and the root proximity was assessed on CBCT and PR. Results: The mean vertical placement angles ranged from 84.27° to 95.12°, and the mean horizontal placement angles ranged from 90.93° to 101.1°. The rates of no contact between the root and the miniscrew were 68.0% in the SII, 50.5% in the SCP, and 57.8% in the SPM, which were significantly different (P = .000). The total concordance rate between PR and CBCT was 41.3%. Conclusions: Clinicians should use extreme caution during placement of miniscrews in the SCP. There are limitations on the use of PR for evaluating the root proximity of miniscrews.

scholarly journals A volumetric study of mandibular condyles in orthognathic patients by semiautomatic segmentation

2021 ◽  
Author(s):  
Max-Philipp Lentzen ◽  
Maximilian Riekert ◽  
Johannes Buller ◽  
Andrea Grandoch ◽  
Matthias Zirk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Volumetric Analysis ◽  
Cone Beam ◽  
Bivariate Analysis ◽  
Semiautomatic Segmentation ◽  
Computed Tomography Images ◽  
Precise Knowledge ◽  
The Mean ◽  
The Right

Abstract Purpose This study was conducted to elucidate volumetric data of mandibular condyles of orthognathic patients by analyzing cone beam computed tomography images based upon semiautomatic segmentation. Methods Cone beam computed tomography images of 87 patients with malocclusions were analyzed in this retrospective study. Patients were between 17 and 53 years old and diagnosed with Angle class I, II, or III malocclusion. By using the validated open-source software “ITK-SNAP,” the volumetric measurements of 174 mandibular condyles were performed. Volumetric analysis was performed according to intra-subject side differences by paired Student t test. In accordance to inter-subject side, gender, age and type of malocclusion differences bivariate analysis and ANOVA were applied. Results The mean volume for the right condyle was 1.378 ± 0.447 cm3, with a maximum of 2.379 cm3 and a minimum of 0.121 cm3. The mean volume for the left side was 1.435 ± 0.474 cm3, with a maximum of 3.264 cm3 and a minimum of 0.109 cm3. Bivariate analysis indicated a highly significant inter-subject difference between the volume of the left and right mandibular condyles (p < 0.01). Females had a significantly smaller condyle volume than males (p < 0.05 left condyle; p < 0.01 right condyle). Conclusion The fact that shape and volume of mandibular condyles show a high susceptibility to pathological alterations and particularly malocclusions makes a precise knowledge about volumetric changes indispensable. Our results show that significant inter-subject differences in condyle volume could be found with respect to the side and gender. Larger volumes could be assessed for the left condyle and for male patients.

scholarly journals Planning orthodontic frontal teeth inclination and estimating bone thickness from cone-beam computed tomography images

2021 ◽  
Author(s):  
IS Kopetskiy ◽  
NG Meskhiya ◽  
AI Kopetskaya ◽  
DA Eremin ◽  
DD Orekhova
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Cone Beam ◽  
Bone Thickness ◽  
Computed Tomography Images ◽  
Positive Treatment ◽  
Tooth Inclination ◽  
Different Levels

Changing the vestibulo-oral inclination (torque) of the frontal teeth is an important component of orthodontic treatment. Cone-beam computed tomography is recommended as an accurate diagnostic tool allowing the orthodontist to estimate the safety of frontal tooth movement and inclination. This tool is helpful in measuring bone thickness at different levels of the tooth root and estimating incisal inclination and position. The aim of our study was to analyze bone thickness in patients with pathologically and normally inclined teeth using CT images and to create a universal table that will provide useful information about the thickness of the bone around different segment of the root required for a safe change in tooth inclination. Using the proposed table, the orthodontist can assess the feasibility of the planned tooth movement in the setting of changed tooth inclination, with due account of critical bone deficit regions. This will ensure the safety of tooth movement, stable retention and a positive treatment outcome.

scholarly journals A CBCT Based Three-Dimensional Assessment of Mandibular Posterior Region for Evaluating the Possibility of Bypassing the Inferior Alveolar Nerve While Placing Dental Implants

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 406 ◽  
Author(s):  
Mohammed G. Sghaireen ◽  
Kumar Chandan Srivastava ◽  
Deepti Shrivastava ◽  
Kiran Kumar Ganji ◽  
Santosh R. Patil ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Age Groups ◽  
Inferior Alveolar Nerve ◽  
Three Dimensions ◽  
High Rate ◽  
Cortical Plate ◽  
Computed Tomography Images ◽  
Group I ◽  
Linear Distance ◽  
The Right

A high rate of nerve injury and related consequences are seen during implant placement in the posterior mandibular arch. An approach has been proposed to avoid nerve injury by dodging the inferior alveolar nerve (IAN) while placing an implant. A prospective study with a total of 240 CBCT (cone beam computed tomography) images of patients with three dentate statuses, namely, edentulous (group I), partially edentulous (group II) and dentate (group III) were included in the study. The nerve path tracing was done on CBCT images with On-demand 3D software. The three dimensions, i.e., the linear distance from the outer buccal cortical plate to the inferior alveolar nerve (BCPN), linear distance from the outer lingual cortical plate to the inferior alveolar nerve (LCPN) and linear distance from the midpoint of the alveolar crest to the inferior alveolar nerve (ACN) were assessed. The data were presented and analyzed between variables using one-way ANOVA and independent t-test in SPSS version 21.LCPN of the right 1st premolar region (p < 0.05) was significantly different among the groups with edentulous subjects recorded with the minimum value (6.50 ± 1.20 mm). Females were found to have significantly (p < 0.05) less available bone (6.03 ± 1.46 mm) on the right side of the mandibular jaw compared to males in edentulous group of patients. On comparing age groups for partially edentulous subjects, LCPN of the right 1st premolar region had significantly (p < 0.05) less available bone (6.03 ± 0.38 mm) in subjects with age ≥54 years. The IAN follows a lingual course in the molar region and later flips to the buccal side in the premolar region. The LCPN dimension in the 1st and 2nd premolar region was found to be more than 6 mm irrespective of age, gender and side of the jaw. Thus, it can be considered as a suitable site for placing implants while bypassing the IAN with CBCT assessment remaining as the mainstay in the pre-surgical phase.

scholarly journals Steering the Mandible in the Right Direction : Forsus Case Series

2021 ◽  
pp. 030157422110054
Author(s):  
Prachi Gohil ◽  
Sonali Mahadevi ◽  
Bhavya Trivedi ◽  
Neha Assudani ◽  
Arth Patel ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Case Series ◽  
Treatment Compliance ◽  
Class Ii ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Technological Advances ◽  
Functional Appliances ◽  
The Right ◽  
Mandibular Retrognathia

We are in the process of discovery of new vistas for technological advances in terms of various appliances with a vision of making orthodontic treatment compliance free as well as successful. Due to improved technology, the enigma of treating the Class II syndrome is palliated. “Out of the box” thinking has become a norm to treat certain situations that were not corrected in noncompliant patients. Fixed functional appliances are valuable tools introduced to assist the correction of skeletal Class II malocclusion with mandibular retrognathia at the deceleration stage of growth for achieving stable results. In this direction a case series is reported of patients having the above conditions and undergoing orthodontic treatment using a Forsus FFA. Joining hands with technology is a win-win situation for both the patient and the orthodontist.

scholarly journals Intrusion of maxillary molar roots into the maxillary sinus in a sample of the Egyptian population using cone beam computed tomography

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Esraa Ahmed Eid ◽  
Fatma Mostafa El-Badawy ◽  
Walaa Mohamed Hamed
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Cone Beam ◽  
Egyptian Population ◽  
Maxillary Molar ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
The Right

Abstract Background The proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The aim of this study is to evaluate the relationship between each maxillary molar root and maxillary sinus floor using cone beam computed tomography. Predicting the probability of protrusion of each root into the sinus will consequently predict the probability of occurrence of the oroantral fistula in a sample of the Egyptian population. Results The total number of roots located outside the sinus was 121 (35.3%), while those contacting the sinus floor were 80 (23.3%) and those intruded the sinus were 141 (41.2%). The percentage of root intrusion into the sinus in males (56.9%) was significantly (p = 0.01) higher than females (42.9%). The probability of root intrusion in the left molars (54.2%) was non-significantly (p = 0.067) higher than that of the right side (44.3%). As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) then the first molars (40.9). According to the type of root, the mesiobuccal root showed the highest probability of intrusion into the sinus (50.9%) followed by the palatal root (49.1%) then the distobuccal root (47.4%). However, the difference in both type of tooth and type of root was statistically non-significant (p = 0.051 and 0.869 respectively). As for the individual root with the highest probability of intrusion, the mesio-buccal root of the right third molar is the most frequent root to intrude the sinus (71.4%) and the mesio-buccal root of the right first molar is the least frequent (22.7%). Conclusions In a sample of the Egyptian population, males exhibit higher probability of root protrusion into the sinus than females. The side and type of tooth are of higher impact on the probability of its intrusion into the sinus compared to the type of root. Left second molars are at a higher risk of oroantral communications on surgical or endodontic procedures compared to other molars due to its highest probability of intrusion into the sinus.

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