Cone Beam Computed Tomography (CBCT) is Superior to Orthopantomogram (OPG) in Interpreting the Imaging Characteristics of Medication-Related Osteonecrosis of the Jaw (MRONJ and More Stage-Sensitive: A Prospective Assessment in 98 Cancer Patients

Objectives: To prospectively evaluate the imaging characteristics of Medication-Related Osteonecrosis of the Jaw (MRONJ), observed in the Orthopantomogram (OPG) and in Cone Beam Computed Tomography (CBCT), in patients with cancer. Materials and Methods: Cancer patients, who received Bone Targeting Agents (BTAs) and developed MRONJ, were prospectively included in the study. MRONJ was staged following the American Association of Oral and Maxillofacial Surgery (AAOMS) 2014 criteria. Four predefined radiological findings, osteolytic changes, sclerosis, periosteal reaction, and sequestration were assessed and were scored as “absent”, “localized”, “extensive” and “beyond the alveolar bone”. Results: Ninety-eight cancer patients were enrolled. Eighty patients (81.6%) received BTAs for over a year; 19 (19.4%) received BTAs between 13 to 24 months and 61 patients (62.2%) received BTAs for over 24 months. The majority of the patients (n=58, 59.2%) had stage 2 MRONJ and 35 (35.7%) were at MRONJ stage 3.Fifty-two (53.06%) patients were assessed with OPG and 89 (90.81%) with CBCT and CBCT was found more effective in detecting sclerosis and sequestration than OPG.Forty-three (43.87%) patients were assessed with both OPG and CBCT and were available for comparisons between OPG and CBCT. CBCT was significantly more accurate than OPG in interpreting the “beyond the alveolar bone” osteolytic changes, sclerosis, periosteal reaction and sequestration, in all MRONJ stages. P-value was 0.0002, <0.0001, 0.0027 and 0.0009 respectively.Furthermore, CBCT was significantly more accurate than OPG in interpreting the “extensive” and “beyond the alveolar bone” imaging characteristics, when comparisons included the patients with early stages of MRONJ, 1 and 2 and the patients with stage 3 of MRONJ. Conclusion: CBCT is superior and more stage-sensitive to OPG in interpreting and staging MRONJ and can be particularly useful to achieve an early diagnosis of MRONJ.

Download Full-text

Using Cone-Beam Computed Tomography to Assess Changes in Alveolar Bone Width around Dental Implants at Native and Reconstructed Bone Sites: A Retrospective Cohort Study

Journal of Personalized Medicine ◽

10.3390/jpm11101011 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1011

Author(s):

Kai-Fang Hu ◽

Szu-Wei Lin ◽

Ying-Chu Lin ◽

Jiiang-Huei Jeng ◽

Yu-Ting Huang ◽

...

Keyword(s):

Computed Tomography ◽

Dental Implants ◽

Cone Beam Computed Tomography ◽

Alveolar Bone ◽

Cone Beam ◽

P Value ◽

Implant Surgery ◽

Native Bone ◽

Bone Width ◽

Before And After

The aim of this study was to use a cone-beam computed tomography (CBCT) to assess changes in alveolar bone width around dental implants at native and reconstructed bone sites before and after implant surgery. A total of 99 implant sites from 54 patients with at least two CBCT scans before and after implant surgery during 2010–2019 were assessed in this study. Demographic data, dental treatments and CBCT scans were collected. Horizontal alveolar bone widths around implants at three levels (subcrestal width 1 mm (CW1), subcrestal width 4 mm (CW4), and subcrestal width 7 mm (CW7)) were measured. A p-value of < 0.05 indicated statistically significant differences. The initial bone widths (mean ± standard deviation (SD)) at CW1, CW4, and CW7 were 6.98 ± 2.24, 9.97 ± 2.64, and 11.33 ± 3.00 mm, respectively, and the postsurgery widths were 6.83 ± 2.02, 9.58 ± 2.55, and 11.19 ± 2.90 mm, respectively. The change in bone width was 0.15 ± 1.74 mm at CW1, 0.39 ± 1.12 mm at CW4 (p = 0.0008), and 0.14 ± 1.05 mm at CW7. A statistically significant change in bone width was observed at only the CW4 level. Compared with those at the native bone sites, the changes in bone width around implants at reconstructed sites did not differ significantly. A significant alveolar bone width resorption was found only at the middle third on CBCT scans. No significant changes in bone width around implants were detected between native and reconstructed bone sites.

Download Full-text

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

International Journal of Implant Dentistry ◽

10.1186/s40729-020-00253-3 ◽

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.

Download Full-text

Alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients using cone-beam computed tomography evaluation

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-020-00276-w ◽

2021 ◽

Author(s):

Marcin Stasiak ◽

Anna Wojtaszek-Słomińska ◽

Bogna Racka-Pilszak

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Contralateral Side ◽

Cone Beam ◽

Rank Test ◽

Cross Sectional ◽

Alveolar Bone Grafting

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.

Download Full-text

Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography

The Korean Journal of Orthodontics ◽

10.4041/kjod.2013.43.3.134 ◽

2013 ◽

Vol 43 (3) ◽

pp. 134 ◽

Cited By ~ 17

Author(s):

Asli Baysal ◽

Faruk Izzet Ucar ◽

Suleyman Kutalmis Buyuk ◽

Torun Ozer ◽

Tancan Uysal

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Alveolar Bone ◽

Class Ii ◽

Class I ◽

Cone Beam ◽

Bone Thickness ◽

Lower Incisor ◽

Skeletal Class

Download Full-text

Imaging Characteristics of Odontogenic Cysts and Tumours: a Retrospective Cone Beam Computed Tomography Study

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-021-01102-z ◽

2022 ◽

Vol 4 (1) ◽

Author(s):

Mailon Cury Carneiro ◽

Elen de Souza Tolentino ◽

Lorena Borgognoni Aquaroni ◽

Milenka Gabriela Quenta Huayhua ◽

Bernardo da Fonseca Orcina ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Odontogenic Cysts ◽

Imaging Characteristics

Download Full-text

An In Vivo and Cone Beam Computed Tomography Investigation of the Accuracy in Measuring Alveolar Bone Height and Detecting Dehiscence and Fenestration Defects

The International Journal of Oral & Maxillofacial Implants ◽

10.11607/jomi.6633 ◽

2018 ◽

Vol 33 (6) ◽

pp. 1296-1304 ◽

Cited By ~ 2

Author(s):

Andrew Peterson ◽

Mansen Wang ◽

Shawneen Gonzalez ◽

David Covell ◽

James Katancik ◽

...

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Alveolar Bone ◽

Cone Beam ◽

Bone Height

Download Full-text

Virtual quad zygoma implant placement using cone beam computed tomography: sufficiency of malar bone volume, intraosseous implant length, and relationship to the sinus according to the degree of alveolar bone atrophy

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.07.004 ◽

2018 ◽

Vol 47 (2) ◽

pp. 252-261 ◽

Cited By ~ 3

Author(s):

J. Bertos Quílez ◽

R. Guijarro-Martínez ◽

S. Aboul-Hosn Centenero ◽

F. Hernández-Alfaro

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Alveolar Bone ◽

Bone Volume ◽

Cone Beam ◽

Malar Bone ◽

Implant Placement ◽

Bone Atrophy ◽

Implant Length

Download Full-text

Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review

Dentistry Journal ◽

10.3390/dj7020052 ◽

2019 ◽

Vol 7 (2) ◽

pp. 52 ◽

Cited By ~ 9

Author(s):

Robert Weiss ◽

Andrew Read-Fuller

Keyword(s):

Computed Tomography ◽

Head And Neck ◽

Cone Beam Computed Tomography ◽

Financial Burden ◽

Maxillofacial Surgery ◽

Cone Beam ◽

Future Research ◽

Oral And Maxillofacial Surgery ◽

Evidence Based ◽

3 Dimensional

Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.

Download Full-text