Supernumerary teeth in premolar and molar area on CBCT: a pictorial review.

Objective: to build a descriptive classification of premolar and molar supernumerary teeth (ST) when preparing the cone beam computed tomography (CBCT) report. The aim is also to share wide range of CBCT images in the open access publishing model. Material and methods: For our review we systematically searched for articles from PubMed with 1) free full texts on ST in molar and premolar area and using CBCT, and 2) articles providing with information on complications related with the presence of ST in molar and premolar area. We also added to our review studies providing with classic ST classifications in premolar and molar area. Results: We found 29 cases of ST, and we freely illustrated them with 84 figures. We separated our pictorial review in: 1) unilateral ST in the mandible, 2) unilateral ST in the maxilla, 3) unilateral undersized ST, 4) bilateral ST, 5) ST with additional features, and 6) cases with major hyperdontia. Conclusions: we build up the classification matrix for premolar and molar ST with 11 descriptors and 50 boxes. The descriptors were: 1) location if the ST crown in axial view, 2) vertical location of the cusp tip in relation with closest erupted tooth in coronal view, 3) shape, 4) distribution, 5) Position (in relation to normal tooth eruption) in sagittal view, 6) State of eruption of the ST in the sagittal view, 7) Follicle size measurement in sagittal view, 8) External root resorption of adjacent teeth by ST and its location in relation to the long axis of the involved tooth, 9) Internal resorption of ST, 10) Adjacent tooth complication, and 11) Damage to surrounding structures if ST removal. The open access figures from the literature illustrated 11 boxes. With our pictorial review we were able to illustrate 45 out of 50 boxes, and freely provide the readership with the most complete description of ST in premolar and molar area on CBCT than in previously published studies.

Dental use of cone beam computed tomography in pediatric embolized arteriovenous maxillofacial malformation

Objective: Pediatric facial arteriovenous malformations (AVMs) are rare but can cause potentially fatal hemorrhages during dental procedures and oral surgery. In this article we present a systematic review of the medical open access literature on pediatric facial AVM. Case report: We illustrate our purpose with clinical dental use of cone beam computed tomography (CBCT) in pediatric embolized facial AVM to define the presence and the position of the right upper impacted canine. Conclusions: We advocate the use of CBCT as additional imaging tool in the follow-up of pediatric dentomaxillofacial AVM, and for depiction of dentoalveolar structures that are inaccessible by conventional dental radiography.

Mucosal necrosis of the palate after embolization for labial arterioveinous malformation

Objective: Cervico-facial arteriovenous malformations (AVMs) are complex and rare vascular lesions, and present in 0.1% of the population. Of traumatic or congenital origin, they are characterized by variable growth, and their complications can be disfiguring and potentially fatal. The treatment of choice is embolization followed by surgery if necessary. The main complications are recurrence and postoperative bleeding. Case report: We report the rare case of a 59-year-old female patient who underwent embolization of a right upper labial and jugal AVM, followed by complete necrosis of the right hemi-palatal mucosa associated with dental mobility and pain. Follow-up at 6 months showed complete reepithelialisation of the palate. Conclusions: Soft tissue necrosis after AVM embolization is a rare event and is more commonly described after embolization for epistaxis. The evolution is generally favourable within a few weeks.

Cone beam computed tomography in the diagnosis of Stafne bone cavity: Report of seven cases and review of the open-access literature.

Stafne bone cavity (SBC) is a rare entity to find on panoramic radiography and on cone beam computed tomography. We reviewed in a systematic way the open-access literature from PubMed and DOAJ. We also proposed a new methodology consisting of collaboration with private practitioners, application of participative science approach, and open science practices, and using social media tool to obtain and describe seven different cases of SBC. We finally propose a new matrix table for classification of anatomical types of SBC already described and those yet to be described in open-access literature.

Medical and dental hidden treasures and secrets of 2700-year-old Egyptian mummy: Osirmose - the doorkeeper of the Temple of Re.

Objective: To perform a ‘virtual autopsy’ on the Egyptian mummy and to study, understand, and interpret three-dimensional (3D) high-resolution computed tomography (CT) scan images of Osirmose’s mummy with a multidisciplinary team composed of radiologists, archaeologists, and oral and maxillofacial surgeon. Material and methods: We studied the Osirmose’s mummy, the doorkeeper of the Temple of Re, who lived during the XXVth dynasty. His mummy belongs to the Royal Museum of Art and History (Inv. E.5889). We performed a high resolution CT scanning of Osirmose’s mummy. We also 3D printed the upper maxilla of the mummy and a tooth found in the oesophagus with a clinically validated low-cost 3D printer. Results: We confirmed the male sex of the mummy. We found the heart, aorta, and kidneys inside the mummy’s body. Brain excerebration was performed through the right ethmoid bone pathway. A wood stick embedded in the dura mater tissue was found inside the skull. The orbicularis oculi muscle, internal canthus, optical nerves, and calcified eye were still present. Artificial eyes were added above the stuffing of eye globes. The skull and face were embalmed with multiple layers of inner bandages in a sophisticated manner. The wear of maxillary teeth was asymmetrical and more pronounced on the maxilla. We discovered three anomalies of the upper maxilla: 1) a rectangular hole on the palatine side of tooth n°26 (the palatine root of tooth n°26 was missing), 2) an indentation at a right angle palatine to tooth n°27, and 3) a semilunar shape of edges around the osteolytic lesion distal and palatine to tooth n°28. Conclusions: The present study provides the first evidence of a tooth removal site, and of oral surgery procedures previously conducted in a 2700-year-old Egyptian embalmed mummy. We found traces of dental root removal, and the opening of a tooth-related osteolytic lesion before the person’s death. The multidisciplinary team, the use of a high resolution 3D CT scan and a 3D-printed model of the upper maxilla helped in this discovery.

Déplacement accidentel de la dent de sagesse maxillaire dans le vestibule jugal antérieur

Les déplacements accidentels des dents de sagesse du maxillaire supérieur dans divers régions anatomiques sont rares. Nous avons effectué la recherche de littérature sur ce sujet de manière systématique en utilisant PubMed et DOAJ. Il n’existe pas d’illustration accessible gratuitement pour les voies de déplacements accidentels des dents de sagesse supérieurs imagées par le CT scan ou par le CBCT à part le déplacement vers la fosse infra-temporale et vers la fosse ptérygopalatine. Nous décrivons et illustrons par CBCT un cas unique dans la littérature médicale de déplacement accidentel du germe de la dent de sagesse du maxillaire supérieur dans l’espace jugal antérieur. Les raisons potentielles, les conséquences ainsi que les moyens de prévention de cette rare complication d’extraction de dents de sagesse sont aussi expliquées.

Open access resources on motion artifact in adult dentomaxillofacial CBCT: illustrated pictorial review of medical literature

Objective: to know how much open access/open knowledge reference figures were available on motion artifacts in CBCT dentomaxillofacial imaging, and to describe and to categorize clinical variation of motion artifacts related to diverse types of head motion retrospectively observed during CBCT scanning time. Material and methods: a search equation was performed on Pubmed database. We found 56 articles. The 45 articles were out of scope, and 7 articles were excluded after applying exclusion and inclusion criteria. Only 4 articles were finally freely accessible and selected for this review. Moreover, we retrospectively used our department CBCT database to search examinations with motion artifacts. We also checked retrospectively for radiological protocols as the type of motion artifact was described when occurred during the CBCT scanning time by the main observer. We had obtained the approval from the Ethical committee for this study. Results: The accessibility of free figures on motion artifact in dentomaxillofacial CBCT is limited to 13 figures not annotated, and to one annotated figure presenting a double contour around cortex of bony orbits. We proposed to categorize the motion artifacts into three levels: low, intermediary, and major. Each level was related to: 1) progressive image quality degradation, 2) distortion of anatomy, and 3) potential possibility of performing clinical diagnosis. All 45 figures were annotated. Conclusions: There exists a scarce open access literature on motion artifacts in CBCT. In our pictorial review we found that low level motion artifacts were more related to head rotation in axial plane (rolling). Rolling and lateral translation were responsible of intermediary level motion artifacts. Major level motion artifacts were created by complex motion with multiple rotation axes, multiple translation directions, and by anteroposterior translation. The main limitation of this study is related to retrospectively report empirical observation of patient motion during CBCT scanning and to compare these observations with motion artifacts found on clinical images. More robust methodology should be further developed using a virtual simulation of various types of head movements and associated parameters to consolidate the open knowledge on motion artifacts in dentomaxillofacial CBCT.

Contribution of dental private practitioners to publications on anatomical variations using cone beam computed tomography

Objective: To investigate the participation of citizens-dental private practitioner in scientific articles about anatomical variations on dentomaxillofacial CBCT. Our null hypothesis was that private practice practitioners are not involved in publications on anatomical variations using cone beam computed tomography. Material and methods: This study was performed from home without access to our university library. Only PubMed database was used to perform our study. We found 384 articles published among 1830 articles corresponding to our inclusion/exclusion criteria. For each selected article we searched for affiliation of all of the authors (university, private dental practice, students, other). We applied a co-creation approach to involve colleagues from private practice in analyzing results of this study. Results: A large majority of authors have university affiliation (96.5%). Only 3% of authors come from private practice. Most of articles belong to the group of 7 emergent economies (E7), and from Asia. 47.9% of 96 journals published only one article on anatomical variations discovered on CBCT. The higher number of articles (18.75%) were published by journals related to endodontics. The 84% of articles were dispersed among a vast span of general and specific dental, and maxillofacial journals. The 68.4% of articles on variations in CBCT were available in closed access and 31.6% of articles were available in open access. Only 6.7% of articles were published in open access without author publication charges (APC). The 31.6% of authors with university affiliation choose open access for their article. 7.8% of authors from private practice were involved in publishing in closed access journals and 2.34% in open access journals. Only 3 articles (0.78%) were published by authors affiliated to private practice without involvement of university authors. 2.6% of articles involved students as co-authors. Authors with other affiliation were involved only in one closed access publication. For the step of co-creation none of 183 private practitioners, and 3/33 (9%) university-affiliated members of Nemesis Facebook group actively participated in analyzing the results of this study. Conclusions: the null hypothesis was accepted: dentists from private practice are exceptionally involved in publications on anatomical variations using CBCT in dentomaxillofacial area.

Imprimantes tridimensionnelles grand public compatibles avec la dentisterie ?

L’objectif de ce travail est de définir les différents critères qu’un dentiste généraliste doit prendre en compte pour s’équiper d’une imprimante tridimensionnelle (3D) à usage dentaire. Nous avons recensé au total 1037 imprimantes 3D produites par 342 entreprises et 211 imprimantes 3D de 88 entreprises pouvant imprimer avec des couches de 25µm. Pour pouvoir les comparer nous avons évalué 16 caractéristiques différentes: 1) famille de procédé d’impression 3D, 2) épaisseur de couche minimale, 3) présence ou non d’étude scientifique de validation de l’épaisseur de couche minimale, 4) résolution XY minimale, 5) type de calibrage, 6) environnement d’impression, 7) présence d’un plateau d’impression chauffant, 8) vitesse d’impression maximale (en mm/s) avec un lien donnant le détail de l’épaisseur de couche utilisée, de la résolution XY utilisée et du matériau utilisé pour déterminer cette vitesse, 9) dimensions de capacité d’impression, 10) capacité d’utiliser des matériaux ne provenant pas de l’entreprise constructrice, 11) capacité d’utiliser des matériaux biocompatibles, 12) poids (en kg) et dimensions de l’imprimante (en cm), 13) systèmes d’exploitation compatibles, 14) types de fichier d’impression 3D compatibles, 15) gestion du service après-vente et durée de la garantie, 16) prix, en indiquant si les taxes sont incluses ou non. Nous avons constaté une grande hétérogénéité des informations présentes et des informations souvent absentes en ce qui concerne : 1) le type de calibrage, 2) la vitesse d’impression, 3) le prix, 4) le service après-vente, 5) la garantie ainsi que 6) les matériaux qui sont pris en compte par l’imprimante 3D. Nous avons décrit des difficultés de communication multiples avec nos interlocuteurs et un développement très dynamique du monde d’impression 3D. Enfin, nous avons proposé des caractéristiques d’une imprimante 3D dentaire « idéale » et d’une entreprise-partenaire « idéale» pour un dentiste désireux de se procurer l’imprimante 3D de son choix.

Revue illustrée des principales indications de CBCT en orthodontie.

Cette revue illustrée porte sur les principales indications actuellement recommandées dans la littérature d’utilisation du cone beam computed tomography (CBCT) en orthodontie. Il s’agit des anomalies dentaires, des canines incluses, des dents surnuméraires, des troubles de l’éruption et des résorptions radiculaires externes liées aux traitements orthodontiques. L’examen CBCT doit être justifié individuellement, au cas par cas, et de pouvoir apporter un bénéfice au patient en terme de diagnostic et/ou de traitement orthodontique. L’orthodontiste prescripteur doit être capable d’interpréter et est responsable de l’interprétation de tout ce qui est visible sur l’ensemble du champs de vue du CBCT.