scholarly journals Feasibility of three-dimensional CT reconstruction in assessing mandibular fractures

2021 ◽  
Vol 20 ◽  
pp. e219912
Author(s):  
Victor Nogueira Moura ◽  
Emerson Nogueira ◽  
Ewerton Daniel Rocha Rodrigues ◽  
Caio Gonçalves Silva ◽  
Ricardo José De Holanda Vasconcellos
Keyword(s):  
Computed Tomography ◽  
Correct Diagnosis ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
3D Ct ◽  
Ct Reconstruction ◽  
Cross Sectional ◽  
3D Computed Tomography

Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections.

Fluoroscopy-guided sacroplasty: special focus on preoperative planning from three-dimensional computed tomography

2008 ◽  
Vol 49 (9) ◽  
pp. 1042-1048 ◽  
Author(s):  
Ø. Gjertsen ◽  
T. Schellhorn ◽  
P. H. Nakstad
Keyword(s):  
Computed Tomography ◽  
Pain Relief ◽  
Correct Diagnosis ◽  
Three Dimensional ◽  
The Elderly ◽  
Special Focus ◽  
3D Ct ◽  
Insufficiency Fractures ◽  
Multiplanar Reconstructions ◽  
Sacral Insufficiency Fractures

Background: Osteoporotic sacral insufficiency fractures are usually spontaneous or caused by discrete traumas. The fluoroscopic anatomy of the sacrum can be difficult to understand, and this is why sacroplasty is considered more challenging than ordinary vertebroplasties. Purpose: To demonstrate the planning of the procedure and the effectiveness of treatment with sacroplasty by means of three-dimensional computed tomography (3D CT) by combining multiplanar reconstructions (MPR) and volume-rendering technique (VRT). Material and Methods: Five elderly, osteoporotic patients with intense pelvic and hip pain underwent weeks of inconclusive clinical and radiological diagnostic efforts. Correct diagnosis was finally attained with magnetic resonance imaging (MRI) and CT. Plain radiographs rarely show fractures, and MR or CT examinations are necessary to demonstrate longitudinal fractures. The procedures were performed with digital biplane equipment using preoperative 3D CT planning procedures. Polymethyl methacrylate (PMMA) was injected to fill the fracture sites. Results: The fractures were successfully treated with sacroplasty using PMMA. A new technique, which involves placing the needles along the long axis of the sacrum, was optimized to the individual patients’ fractures and sacral anatomy by meticulous planning on a workstation with 3D CT data sets. It was technically successful in all five cases. Four of the five patients had sustained pain relief. Conclusion: Sacral insufficiency fractures are not uncommon and should be considered in the elderly population with low back pain. Sacroplasty using the optimized “long-axis technique” gave almost immediate pain relief for all five patients in our study material. No complications were observed.

scholarly journals Adequacy of Three Dimensional Miniplate In Treatment Of Mandibular Fracture In Interforaminal Region

2019 ◽  
Vol 9 (2) ◽  
pp. 97-102
Author(s):  
Vivek Singh ◽  
Ritesh Giri
Keyword(s):  
Road Traffic ◽  
Dynamic Compression ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Wound Dehiscence ◽  
Mandibular Fracture ◽  
Oral And Maxillofacial Surgery ◽  
Prospective Clinical Study ◽  
Mandibular Fractures ◽  
Intermaxillary Fixation

Background: Mandible is one of the commonly fractured bone due to trauma, assault and falls. Treatment includes closed and open methods. Methods of open reduction and internal fixation have changed and di­versified enormously in the past few years. Champy’s miniplate fixation, dynamic compression plating has become a standard approach. More recently, three dimensional miniplates have been developed by Farmand which may be effectively used in mandibular fractures. The aim of this study was to check the adequacy of three dimensional miniplate in man­agement of mandibular fracture occurring in the interforaminal region. Methods: A prospective clinical study was carried out in patients attend­ing Emergency Department and Department of Oral and Maxillofacial Surgery, Nobel Medical College and Teaching Hospital (NMCTH) suffer­ing from mandibular fractures in interforaminal region from May 2018 to January 2019. Results: A total of 17 patients with 18 fracture in interforaminal region, all male were included in the study. The age ranged from 16 to 50 years with a mean of 29.17 ± 9.48. Road traffic accident was the leading cause of injury with 15 out of 17 patients (88.23%). There was no incidence of wound infection, wound dehiscence, malunion, nonunion, plate fracture within the follow up period of 3 months. One fracture was unstable on 1st postoperative day and also had mildly deranged occlusion which was man­aged with intermaxillary fixation for two weeks. Conclusions: Three dimensional plates fulfills the treatment goals of ad­equate stabilization and fixation of mandibular interforaminal fractures.

Role of three-dimensional computed tomography reconstruction in the management of elongated styloid process: a preliminary study

2007 ◽  
Vol 121 (4) ◽  
pp. 349-353 ◽  
Author(s):  
D R Nayak ◽  
K Pujary ◽  
M Aggarwal ◽  
S E Punnoose ◽  
V A Chaly
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Styloid Process ◽  
3D Ct ◽  
Ct Reconstruction ◽  
Elongated Styloid Process ◽  
Tomography Reconstruction ◽  
Preliminary Study ◽  
3D Ct Reconstruction

Elongated styloid process is a relatively common cause of facial and neck pain, but it is often misdiagnosed due to its varied clinical presentation. Since an elongated styloid process is often confirmed by radiological means, it would be helpful to find a more accurate mode of depicting the styloid process.In this prospective study, 39 cases were evaluated. A three-dimensional computed tomography (3D CT) reconstruction of the styloid process was performed in 18 cases. In these patients, we compared the length and medial angulation of the symptomatic styloid process as viewed on an orthopantomogram and a 3D CT reconstruction.It was noted that a 3D CT reconstruction was more accurate in depicting the styloid process. This investigation can be considered as the ‘gold standard’ in the radiological diagnosis of an elongated styloid process.

scholarly journals Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

2021 ◽  
Author(s):  
Johanna Nilsson ◽  
Fredrik Nysjö ◽  
Ingela Nyström ◽  
Johan Kämpe ◽  
Andreas Thor
Keyword(s):  
Computed Tomography ◽  
Surgical Planning ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Planning System ◽  
Virtual Surgery ◽  
Mandibular Fractures ◽  
Surgery Planning ◽  
Anatomic Reduction ◽  
Mandible Fractures

Abstract Purpose The management of complex mandible fractures, i.e. severely comminuted or fractures of edentulous/atrophic mandibles, can be challenging. This is due to the three-dimensional loss of bone, which limits the possibility for accurate anatomic reduction. Virtual surgery planning (VSP) can provide improved accuracy and shorter operating times, but is often not employed for trauma cases because of time constraints and complex user interfaces limited to two-dimensional interaction with three-dimensional data. Methods In this study, we evaluate the accuracy, precision, and time efficiency of the haptic assisted surgery planning system (HASP), an in-house VSP system that supports stereo graphics, six degrees-of-freedom input, and haptics to improve the surgical planning. Three operators performed planning in HASP on computed tomography (CT) and cone beam computed tomography (CBCT) images of a plastic skull model and on twelve retrospective cases with complex mandible fractures. Results The results show an accuracy and reproducibility of less than 2 mm when using HASP for virtual fracture reduction, with an average planning time of 15 min including time for segmentation in the software BoneSplit. Conclusion This study presents an in-house haptic assisted planning tool for cranio-maxillofacial surgery with high usability that can be used for preoperative planning and evaluation of complex mandible fractures.

scholarly journals Treatment of Mandible Fractures Using a Miniplate System: A Retrospective Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 2922
Author(s):  
Lauren Bohner ◽  
Fabian Beiglböck ◽  
Stephanie Schwipper ◽  
Rômulo Maciel Lustosa ◽  
Carla Pieirna Marino Segura ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Fracture Site ◽  
University Hospital ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Biomechanical Behavior ◽  
Initial Stability ◽  
Tension And Compression ◽  
Mandible Fractures

Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the stabilization of tension and compression areas, improved initial stability, and biomechanical behavior. The aim of this retrospective study was to evaluate the use of a 3D miniplate system for the treatment of patients with mandibular fractures. Patients with mandibular fractures treated with a 3D plate system at the Department of Oral and Maxillofacial Surgery, University Hospital Münster, during a period of 5 years, were included in this study. Mandibular fracture conditions and minor and major post-operative complications were reported. In total, 336 patients and 391 mandibular fractures were assessed. The most common fracture site was anterior mandible, and 155 cases involved a tooth-bearing area. Minor complications were seen in 8.03% of cases, whereas only 1.49% of patients suffered from major complications. The treatment of mandible fractures using 3D miniplates resulted in fracture reduction with a low complication rate.

scholarly journals Accuracy and Reproducibility of Facial Measurements of Digital Photographs and Wrapped Cone Beam Computed Tomography (CBCT) Photographs

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 757
Author(s):  
Maged Sultan Alhammadi ◽  
Abeer Abdulkareem Al-mashraqi ◽  
Rayid Hussain Alnami ◽  
Nawaf Mohammad Ashqar ◽  
Omar Hassan Alamir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Cone Beam Computed Tomography ◽  
High Reliability ◽  
Three Dimensional ◽  
Cone Beam ◽  
Cross Sectional ◽  
Facial Profile ◽  
Digital Photographs ◽  
Gonial Angle

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.

scholarly journals Effectiveness of endoscopic intranasal incision reduction for nasal fractures

2021 ◽  
Author(s):  
Shu Yan ◽  
Yan Jiang ◽  
Yan Wang ◽  
Kaixuan Chen ◽  
Xudong Yan ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Three Dimensional ◽  
Junior Doctors ◽  
3D Ct ◽  
Nasal Airflow ◽  
Temporal Window ◽  
Cross Sectional ◽  
Frontal Process ◽  
Bone Fragments ◽  
Nasal Fractures

Abstract Purpose To report our experience using endoscopic intranasal incision reduction (EIIR) for nasal fractures and to assess effectiveness of the method. Methods 30 patients who underwent EIIR were retrospectively analysed. All the patients were examined by three-dimensional computed tomography (3D CT), acoustic rhinometry and rhinomanometry, preoperatively and postoperatively at 1 month. The visual analogue scale (VAS) was used to assess the preoperative aesthetics and nasal airflow satisfaction and at 1, 3 and 6 months postoperatively. VAS aesthetic satisfaction was also scored by two junior doctors. Results 3D CT showed that the fracture fragments fitted well in 30 patients postoperatively at 1 month. VAS aesthetics and nasal airflow scores were significantly improved postoperatively at 1, 3 and 6 months compared with preoperative scores (P < 0.01). The VAS aesthetic scores from the two surgeons were also significantly improved (P < 0.01). The minimal cross-sectional area increased from 0.39 ± 0.13 to 0.64 ± 0.13 (P < 0.001), the nasal volume increased from 4.65 ± 0.86 to 6.37 ± 0.94 (P < 0.001) and the total inspiratory airway resistance of the bilateral nasal cavity median decreased from 0.467 Pa/mL/s to 0.193 Pa/mL/s (P < 0.001). There were no technique-related intraoperative complications. Conclusion EIIR was a practical choice, and the aesthetics and nasal airflow were significantly improved in patients with overlapped and displaced bone fragments, patients with fractures of the frontal process of the maxilla (FFPM), patients who underwent failed CR and patients beyond the optimal temporal window.

scholarly journals Research on the Computed Tomography Pebble Flow Detecting System for HTR-PM

2017 ◽  
Vol 2017 ◽  
pp. 1-13
Author(s):  
Xin Wan ◽  
Ximing Liu ◽  
Jichen Miao ◽  
Peng Cong ◽  
Yuai Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Three Dimensional ◽  
Helical Ct ◽  
Design Parameters ◽  
Three Dimensional Model ◽  
Safe Operation ◽  
Cross Sectional ◽  
Ct System ◽  
Near Future ◽  
Pebble Flow

Pebble dynamics is important for the safe operation of pebble-bed high temperature gas-cooled reactors and is a complicated problem of great concern. To investigate it more authentically, a computed tomography pebble flow detecting (CT-PFD) system has been constructed, in which a three-dimensional model is simulated according to the ratio of 1 : 5 with the core of HTR-PM. A multislice helical CT is utilized to acquire the reconstructed cross-sectional images of simulated pebbles, among which special tracer pebbles are designed to indicate pebble flow. Tracer pebbles can be recognized from many other background pebbles because of their heavy kernels that can be resolved in CT images. The detecting principle and design parameters of the system were demonstrated by a verification experiment on an existing CT system in this paper. Algorithms to automatically locate the three-dimensional coordinates of tracer pebbles and to rebuild the trajectory of each tracer pebble were presented and verified. The proposed pebble-detecting and tracking technique described in this paper will be implemented in the near future.

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