scholarly journals Is there a consensus for CBCT use in Orthodontics?

2014 ◽  
Vol 19 (5) ◽  
pp. 136-149 ◽  
Author(s):  
Daniela G. Garib ◽  
Louise Resti Calil ◽  
Claudia Resende Leal ◽  
Guilherme Janson
Keyword(s):  
Treatment Planning ◽  
Tooth Movement ◽  
Treatment Plan ◽  
Signs And Symptoms ◽  
Cone Beam ◽  
Permanent Teeth ◽  
Current Evidence ◽  
Craniofacial Anomalies ◽  
Conventional Radiograph ◽  
New Information

This article aims to discuss current evidence and recommendations for cone-beam computed tomography (CBCT) in Orthodontics. In comparison to conventional radiograph, CBCT has higher radiation doses and, for this reason, is not a standard method of diagnosis in Orthodontics. Routine use of CBCT in substitution to conventional radiograph is considered an unaccepted practice. CBCT should be indicated with criteria only after clinical examination has been performed and when the benefits for diagnosis and treatment planning exceed the risks of a greater radiation dose. It should be requested only when there is a potential to provide new information not demonstrated by conventional scans, when it modifies treatment plan or favors treatment execution. The most frequent indication of CBCT in Orthodontics, with some evidence on its clinical efficacy, includes retained/impacted permanent teeth; severe craniofacial anomalies; severe facial discrepancies with indication of orthodontic-surgical treatment; and bone irregularities or malformation of TMJ accompanied by signs and symptoms. In exceptional cases of adult patients when critical tooth movement are planned in regions with deficient buccolingual thickness of the alveolar ridge, CBCT can be indicated provided that there is a perspective of changes in orthodontic treatment planning.

scholarly journals Orthodontics in the Era of Digital Innovation – A Review

2021 ◽  
Vol 10 (28) ◽  
pp. 2114-2121
Author(s):  
Mayma Nathasha M ◽  
Sushil Chakravarthi N.C. ◽  
Dilip Srinivasan ◽  
Priya Kalidass ◽  
Davis D. ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Computer Aided Design ◽  
Tooth Movement ◽  
Treatment Plan ◽  
Diagnosis And Treatment ◽  
Orthodontic Appliances ◽  
Three Dimension ◽  
Revolutionary Change ◽  
Good Communication ◽  
Computer Aided

The field of orthodontics in its new era is venturing ahead to more up-to-date technological point of view. Digital technology has a significant effect on our lives ever since the modernization of mobile phones. The advances in technology have remodelled the diagnosis and treatment plan in the field of medicine. Digital workflows are currently increasing in the orthodontic practice and has touched every aspect of orthodontics – with transformations in the documentation, study casts, analysis of a dental malocclusion, smile designing, treatment planning and for fabrication of orthodontic appliances. Three - dimensional imaging of the dentition, skeletal components and the face allows for treatment planning in three dimension and use of computer aided design (CAD) and computer aided manufacturing (CAM) for customization of orthodontic appliances. Software integration of digital models, 3D facial imaging and cone-beam computed tomography (CBCT) makes it possible to simulate the treatment plan and to attain a good communication with the patients. Recent advancement in digital videography has allowed the clinicians to capture patient’s speech, oral and pharyngeal function, and smile at the same time. Effective and optimal tooth movement required for the patient can also be monitored with the digitalization. Moreover, this digital platform has created the advantage of accessing the patient’s information from any location with the help of cloud based computing storage systems. These advancements have improved the efficiency, accuracy, consistency, and predictability of the treatment outcomes and have also led to progress in educational component and communication. The digitalization is bringing about a revolutionary change in the field of diagnosis and treatment planning, posing a challenge to clinical efficiency and knowledge. KEY WORDS Digital Orthodontics, Digital Workflow, Digital Dental Models, Digital Radiography, CAD CAM, Orthodontics, Review

scholarly journals Mind the gap: A novel technique for space closure – a case report

2019 ◽  
Vol 46 (1) ◽  
pp. 56-62
Author(s):  
Rupal Shah ◽  
Mohammad O Sharif ◽  
Daljit S Gill
Keyword(s):  
Stainless Steel ◽  
Case Report ◽  
Tooth Movement ◽  
Treatment Plan ◽  
Permanent Teeth ◽  
Partial Denture ◽  
Novel Technique ◽  
Space Closure ◽  
Fixed Orthodontic Appliance ◽  
Labial Surface

Patients presenting with severe hypodontia can be challenging to manage. They often present with significant spaces within the dental arches and the lack of permanent teeth can make anchorage control difficult. This case report demonstrates a novel technique for diastema closure in a 14-year-old with severe hypodontia. The technique allows maintenance of root parallelism during space closure in cases with reduced anchorage support. The treatment plan was agreed on a multidisciplinary hypodontia clinic and involved an upper sectional fixed orthodontic appliance to close a 7-mm midline diastema aiding subsequent partial denture provision. Treatment commenced by bonding upper primary canines and central incisors. However, attempting space closure on a 0.019 × 0.025-inch stainless-steel working archwire resulted in tipping of the incisor crowns. Two brackets were therefore placed on the labial surface of each central incisor (one incisal and one gingival). Subsequently two stainless steel working archwires and elastomeric chain were used for diastema closure. This four-bracket system provided superior control allowing space closure by bodily tooth movement. Excellent root parallelism was achieved with this innovative technique.

scholarly journals Orthodontic movement of a contralateral maxillary central incisor across the midpalatal suture

2020 ◽  
Vol 10 ◽  
pp. 50-59
Author(s):  
Chiho Kato ◽  
Satoshi Kokai ◽  
Takashi Ono
Keyword(s):  
Orthodontic Treatment ◽  
Tooth Movement ◽  
Treatment Plan ◽  
Treatment Options ◽  
Cone Beam ◽  
Central Incisor ◽  
Midpalatal Suture ◽  
Maxillary Central Incisor ◽  
Orthodontic Movement ◽  
Morphological Modification

There are several options for replacing a missing maxillary central incisor in orthodontic treatment. Substituting a missing central incisor with the contralateral one can be a useful approach to reduce the number of teeth that require extraction during the treatment. Normal tooth movement across an ossified midpalatal suture (MPS) has only been observed in an animal experiment. Herein, we describe the treatment of a 26-year-old woman who had lost multiple teeth on one side, including the maxillary right central incisor, which required extraction due to endodontic failure. The maxillary left central incisor was moved into the position of the maxillary right central incisor. All other left maxillary teeth were moved mesially to close the space. After completion of orthodontic treatment, acrylic build-up was performed on the maxillary left lateral incisor, which underwent morphological modification to replicate the morphology of a maxillary right incisor. The patient was pleased with the treatment outcome. Cone-beam computed tomography provided evidence of tooth movement across the MPS. Although the movement of the tooth across the MPS is feasible, the treatment plan should also take other treatment options into consideration.

scholarly journals The impact of cone beam computed tomography in diagnosis and endodontic treatment planning decisions - case reports

2021 ◽  
Vol 10 (2) ◽  
pp. e44910212726
Author(s):  
Key Fabiano Souza Pereira ◽  
Thais Helena Turatto ◽  
Lia Beatriz Junqueira-Verardo ◽  
Ana Grasiela da Silva Limoeiro ◽  
Ellen Cristina Gaetti-Jardim
Keyword(s):  
Computed Tomography ◽  
Treatment Planning ◽  
Cone Beam Computed Tomography ◽  
Case Reports ◽  
Treatment Plan ◽  
Root Anatomy ◽  
Diagnosis And Treatment ◽  
Cone Beam ◽  
The Impact ◽  
Clinical Cases

Conventional radiographic techniques have limitations, showing a two-dimensional image of a three-dimensional object, making it difficult to recognize the internal root anatomy in endo-dontic therapy. Cone-beam computed tomography (CBCT) is a diagnostic method that allows the visualization of all structures three-dimensionally, showing promising results compared to periapical radiographs. The objective of this study was to report two clinical cases where CBCT was fundamental to the diagnosis and a better treatment planning of the steps that were taken during the endodontic intervention. The CBCT were performed prior to the treat-ments, the volume of the exams were dynamically analyzed in specific software. The data were interpreted and together with the radiographic image and clinical examination data, the diagnosis and treatment planning were carried out. Given the report and discussion of the two clinical cases, it can be concluded that CBCT proved to be an impacting resource to support diagnosis and decision-making in the treatment of complex endodontic cases. CBCT ensured greater reliability in the diagnosis and treatment plan adopted, increasing the predictability of the endodontic therapy.

scholarly journals Long-term stability of the Hounsfield unit to electron density calibration curve in cone-beam computed tomography images for adaptive radiotherapy treatment planning

2015 ◽  
Vol 14 (4) ◽  
pp. 410-417 ◽  
Author(s):  
Akihiro Takemura ◽  
Shogo Tanabe ◽  
Mei Tokai ◽  
Shinichi Ueda ◽  
Kimiya Noto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Treatment Planning ◽  
Electron Density ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Dose Calculation ◽  
Hounsfield Unit ◽  
Cone Beam ◽  
Computed Tomography Images ◽  
Calibration Curves

AbstractAimTo use cone-beam computed tomography (CBCT) images for treatment planning, the Hounsfield unit (HU)-electron density (ED) calibration table for CBCT should be stable. The purpose of this study was to verify the stability of the HU values for the CBCT system over 1 year and to evaluate the effects of variation in HU-ED calibration curves on dose calculation.Materials and MethodsA tissue characterisation phantom was scanned with the field of view (FOV) of size S (FOV-S) and FOV of size M (FOV-M) using the CBCT system once a month for 1 year. A single field treatment plan was constructed on digital phantom images to validate the dose distribution using mean HU-ED calibration curves and possible variations.ResultsHU values for each material rod over the observation period varied with trend. The HU value of the cortical bone rod decreased by about 100 HU for the FOV-S and by about 300 HU for the FOV-M. Possible variation in the HU-ED calibration curves produced a ≤17·9% dose difference in the dose maximum in the treatment plan.ConclusionsThe CBCT system should be calibrated periodically for consistent dose calculation.

Managing the Transition to Edentulousness Using Partial Transitional Dentures for First Time Prosthodontic Patients: Addressing Unrealistic Expectations – A Case Report

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Case Report ◽  
Treatment Outcomes ◽  
Treatment Planning ◽  
Clinical Relevance ◽  
Treatment Plan ◽  
Sequential Treatment ◽  
Aesthetic Result ◽  
Abutment Teeth ◽  
First Time ◽  
Unrealistic Expectations

Aim: The aim of this report is to describe the management of a prosthodontic patient expressing unrealistic expectations with respect to the transition to edentulousness. Objectives: To outline (1) the diagnosis and explicit expectations of the patient on presentation (2) considerations made during treatment planning to address the wishes of the first time prosthodontic patient (3) a sequential treatment plan utilizing transitional partial removable dentures to manage the change to edentulousness (4) functional and aesthetic result achieved. Results: Delivery of immediate removable partial dentures retaining key abutment teeth in upper and lower arches was a viable prosthodontic solution in the transition to edentulousness of a patient expecting unrealistic treatment outcomes. Conclusions: Addressing impractical expectations and devising a treatment plan amenable to both clinician and patient is difficult. Strategies to manage these wishes in prosthodontic dentistry can include transitional partial dentures. Clinical relevance: Practitioners who encounter similar situations may consider this report valuable.

Signs and symptoms of craniomandibular dysfunction in a population of Spanish children

2018 ◽  
Vol 16 (1) ◽  
pp. 24
Author(s):  
Maria Esperanza Sánchez-Sánchez
Keyword(s):  
Signs And Symptoms ◽  
Permanent Teeth ◽  
Tooth Sensitivity ◽  
Craniomandibular Dysfunction ◽  
Teeth Grinding ◽  
Specific Questionnaire ◽  
Other Hand ◽  
Opening And Closing

The craniomandibular dysfunction (CMD) is a pathology that can appear at early ages. In a sample of 36 childrenresiding in Madrid (Spain), of both sexes, with ages between 7 and 13 years, the prevalence of signs and symptomsof CMD was analyzed. For that purpose, we did a dental and muscular examination, together with temporomandibularjoints, functional and occlusal examination, and completed with a specific questionnaire. The results revealedthat 100% showed some sign or sympthom of CMD. 77,8% of the pacients presented 3 or more CMD signs.The most prevalent were painful muscle palpation (94,4%), together with sliding anteriorly (91,7%), painful jointpalpation (69,4%), wear facets in permanent teeth (41,7%) and altered opening and closing trayectory (38,9%). Onthe other hand, only 38,9% showed any CMD symptom. The most prevalent symptoms were night teeth grinding(27,8%), followed by tooth sensitivity (19,4%) and fullness in the ears (16,7%). We conclude that in our sample,25% presented mild CMD (less that 3 signs or symptoms), 58,3% presented moderate CMD (from 3 to 6 signs orsymptoms) and 16,7% showed severe CMD (more than 6 symptoms). Nevertheless, it’s important to remark thatnone of these pacients came seeking treatment for his CMD and these symptoms were refered only when beingasked. Hence the importance of a comprehensive clinic history to precociously diagnose this pathology and havethe ability to prevent its progression.

scholarly journals Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Motohiro Munakata ◽  
Koudai Nagata ◽  
Minoru Sanda ◽  
Ryota Kawamata ◽  
Daisuke Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Cone Beam ◽  
Alveolar Ridge ◽  
Marginal Bone Loss ◽  
Mandibular Molar ◽  
Mucosal Thickness ◽  
And Gender ◽  
Edentulous Patients

Abstract Background The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender. Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge. Results The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less. Conclusions Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.

scholarly journals Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods

2021 ◽  
Vol 18 (4) ◽  
pp. 1995
Author(s):  
Valentina Scalise ◽  
Fabrizio Brindisino ◽  
Leonardo Pellicciari ◽  
Silvia Minnucci ◽  
Francesca Bonetti
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Manual Therapy ◽  
Carpal Tunnel ◽  
Signs And Symptoms ◽  
Current Evidence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Therapeutic Exercises ◽  
Chi Squared ◽  
Tunnel Syndrome

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

scholarly journals Application of 3D tooth model for monitoring of implant space and inter-root distance without radiographs: a proof of concept study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyungmin Lee ◽  
Gyu-Hyoung Lee
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Cone Beam Computed Tomography ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Treatment Evaluation ◽  
Cone Beam ◽  
Proof Of Concept ◽  
Cbct Image ◽  
Root Position

Abstract Background Radiographs are integral in evaluating implant space and inter-root distance. The purpose of this report is to introduce a method for evaluating the 3D root position with minimal radiation using a 3D tooth model composed of an intraoral-scanned crown and a cone-beam computed tomography (CBCT)-scanned root. Materials and methods Intraoral scan and CBCT scan of the patient were obtained before treatment. In the CBCT image, tooth segmentation was performed by isolating individual teeth from the maxillary and mandibular alveolar bone using software program. The 3D tooth model was fabricated by combining segmented individual teeth with the intraoral scan. Results A post-treatment intraoral scan was integrated into the tooth model, and the resulting position of the root could be predicted without additional radiographs. It is possible to monitor the root position after a pretreatment CBCT scan using a 3D tooth model without additional radiographs. Conclusion The application of the 3D tooth model benefits the patient by reducing repeated radiation exposure while providing the clinician with a precise treatment evaluation to monitor tooth movement.

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