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1.
Cient. dent. (Ed. impr.) ; 17(1): 7-14, ene.-abr. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-189744

RESUMO

INTRODUCCIÓN: La inclusión de caninos tiene una alta incidencia y plantea varias complicaciones clínicas, siendo de vital importancia el diagnóstico precoz y exacto para minimizar los riesgos y complicaciones derivadas. El objetivo de este trabajo es analizar, utilizando como referencia las líneas planteadas por Alqerban, la efectividad de las dos dimensiones en el diagnóstico volumétrico de la inclusión de los caninos maxilares. MÉTODOS: Seleccionamos 27 pacientes con 36 caninos maxilares incluidos que se realizaron estudio de ortodoncia con ortopantomografía y tomografía computarizada de haz cónico (Cone Beam Computed Tomography, CBCT) del maxilar en la Clínica Universitaria de la Universidad Europea. Se trazaron tres líneas de referencia basándose en la distancia de la cúspide del canino al plano oclusal (L1), a la línea media (L2) y a su lugar ideal de erupción (L3), tanto en la ortopantomografía como en el CBCT. Como valores de referencia ideales seleccionamos un grupo control de 36 caninos maxilares erupcionados. RESULTADOS: Se compararon los resulta-dos en dos y tres dimensiones mediante la prueba T de Student, tras comprobar su distribución normal mediante la prueba de contraste de Anderson-Darling. No se obtuvo significación estadística (p > 0.05) para ninguna de las variables estudiadas. CONCLUSIONES: El uso del CBCT es vi-tal para asegurar un buen diagnóstico en cuanto a la posición del canino y su relación con estructuras adyacentes y así establecer un plan de tratamiento adecuado. Aun así, la ortopantomografía aporta información suficiente para la planificación inicial


INTRODUCTION: Impacted canines have a high incidence and pose several clinical complications, with early and exact diagnosis being of vital importance to minimise the risks and derived complications. The objective of this study is to analyse the effectiveness of the two dimensions in the volumetric diagnosis of impacted maxillary canines, using the lines proposed by Alqerban as a reference. METHODS: We selected 27 patients with 36 maxillary canines who underwent an orthodontic study with orthopantomography and cone beam computed tomography (CBCT) of the maxilla at the Madrid European University Dental Clinic. Three reference lines were drawn based on the distance from the cusp of the canine to the occlusal plane (L1), to the midline (L2) and to its ideal eruption site (L3), both in the orthopantomography and in the CBCT. As ideal reference values, we selected a control group of 36 erupted maxillary canines. RESULTS: The results were compared in 2 and 3 dimensions using the Student's t-test, after verifying their normal distribution using the Anderson-Darling test. Statistical significance (p > 0.05) was not obtained for any of the variables studied. CONCLUSIONS: The use of CBCT is vital to ensure a good diagnosis for the position of the canine and its relationship with adjacent structures, thus establishing an adequate treatment plan. However, orthopantomography provides enough information for initial planning


Assuntos
Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Dente Canino/diagnóstico por imagem , Diagnóstico Precoce , Maxila/diagnóstico por imagem , Ortodontia/métodos , Tomografia Computadorizada de Feixe Cônico , Dente Impactado/diagnóstico por imagem , Intervalos de Confiança , Radiografia Panorâmica/métodos
2.
J Appl Oral Sci ; 28: e20190103, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049131

RESUMO

OBJECTIVE: This study aimed to assess the association between tooth size and root canal morphology by using CBCT analysis. METHODOLOGY: In this retrospective study, tooth anatomic lengths (crown and root lengths, buccolingual and mesiodistal dimensions) of 384 patients were assessed and correlated with Vertucci's root canal morphology classification. Data was analyzed for gender-related differences using the independent sample t-test, ANOVA, and the Pearson's correlation for a possible relation between anatomic lengths and canal morphology. RESULTS: The maxillary first and second premolars showed a greater predilection for Type IV and II variants, respectively, while the mandibular first premolar showed a greater predilection for Type II canal system. The root canal system of the mandibular second premolar showed maximal diversity (47% Type I, 30% Type II, and 20% Type III). The dimensions were greater in men regardless of tooth type. The most significant relation (p<0.05) between the anatomic size and canal morphology was observed in the maxillary first premolars, followed by the mandibular canines (buccolingual dimension) and the lower second premolars (crown length). Negative correlations existed between the crown length and the patient's age for the anterior teeth and mandibular second premolar (r=-0.2, p<0.01). CONCLUSIONS: The most common canal formation for anterior teeth was the Type I. The anatomic lengths had the strongest influence on the canal configuration of the maxillary first premolar, with Type IV being the most common root canal system. The mandibular second premolars showed maximal diversity in the canal classification terms and had a significant correlation with their crown lengths. CLINICAL RELEVANCE: The complex relationship between the canal morphology and anatomic tooth sizes need meticulous awareness and recognition during endodontic procedures, in conjunction with the demographic variabilities.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/anatomia & histologia , Dente/anatomia & histologia , Adulto , Idoso , Análise de Variância , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Odontometria/métodos , Valores de Referência , Estudos Retrospectivos , Fatores Sexuais , Dente/diagnóstico por imagem , Estados Unidos
3.
J Appl Oral Sci ; 28: e20190148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049133

RESUMO

OBJECTIVE: The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. METHODOLOGY: In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). RESULTS: The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). CONCLUSIONS: The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Mandíbula/anatomia & histologia , Maxila/anatomia & histologia , Dente/anatomia & histologia , Adulto , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Odontometria/métodos , Valores de Referência , Estatísticas não Paramétricas , Dente/diagnóstico por imagem
4.
J Appl Oral Sci ; 28: e20190393, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049137

RESUMO

OBJECTIVES: This study assessed the incidence and variability features of root canals system (RCS) and their ramifications according to Pucci & Reig (PR) (1944) and the American Association of Endodontists (AAE) (2017) by micro-computed tomography (µCT). METHODOLOGY: 500 representative extracted human teeth of each tooth group (n=50) (maxillary/mandibular central and lateral incisors, canines, first and second premolars and molars) were scanned by µCT with a resolution of 26.70 µm. The reconstructed cross-sections images and the visualization of the continuous slices in the transversal axis were performed using DataViewer software. RCS were classified according to Pucci & Reig (main canal, collateral canal, lateral canal, secondary canal, accessory canal, intercanal, recurrent canal) and AAE (main canal, accessory canal, lateral canal). The apical deltas were assessed for both classifications. The prevalence of apical deltas was evaluated using the Chi-squared test (p<0.05). RESULTS: According to PR, a higher incidence of lateral canals was observed in maxillary canines (10%), central incisors (8%) and first premolars (6%). Using AAE, the highest incidence of lateral canals was observed in the mandibular first premolars (85%), first and second molars (84%), lateral incisors (67%), canines (59%), and in maxillary first premolars (52%). Regarding accessory canals, the PR showed a frequency in 2% of the maxillary lateral incisors and maxillary and mandibular first premolars and 3% of mandibular first and second molars. On the other hand, the AAE showed the highest incidence of accessory canals in 86% of the maxillary first premolars, 71% in mandibular lateral incisors, 69% in mandibular first premolars, 65% in mandibular canines, and 56% in maxillary canines. The PR showed the lowest incidence of apical deltas for all dental groups when compared with AAE (p=0.004). Interestingly, distal canals in maxillary molars showed a significant discrepancy between classifications (p=0.027). CONCLUSIONS: µCT enabled accurately describing the RC system and related ramifications, adding to the PR and AAE classifications, with some discrepancies reported for maxillary molars. Clinical Relevance This µCT study enabled a thorough description of the variability among root canals and their ramifications, including clinically relevant details on the presence and location of lateral canals and accessories in all human tooth groups, beyond the currently existing classification systems.


Assuntos
Cavidade Pulpar/anatomia & histologia , Microtomografia por Raio-X/métodos , Cavidade Pulpar/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Valores de Referência , Estatísticas não Paramétricas , Ápice Dentário/anatomia & histologia , Ápice Dentário/diagnóstico por imagem
5.
Swiss Dent J ; 130(2): 126-138, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32024348

RESUMO

This second article about extraoral anatomy as seen in cone beam computed tomography (CBCT) images presents a literature review of the zygomatico-orbital region. The latter bounds the maxillary sinus superiorly and laterally. Since pathologic changes of the maxillary sinus are a frequent indication for three-dimensional radiography, the contiguous orbital cavity and the zygomatic bone may become visible on CBCT scans. The zygomatic bone forms the cheek prominence and has large contact areas with the maxilla through the zygomaticomaxillary suture in the infraorbital region as well as with the sphenoid bone along the lateral orbital wall. Each of the three surfaces of the zygomatic bone displays foramina that transmit neurovascular structures. The orbital cavity is located immediately above the maxillary sinus from which it is separated only by a thin bony plate simultaneously serving as the orbital floor and the roof of the maxillary sinus. Several openings, such as the superior and inferior orbital fissures, the ethmoidal and cranio-orbital foramina, and the optic and infraorbital canals, connect the orbit to the anterior and middle cranial fossae as well as to the infratemporal and pterygopalatine fossae.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tomografia Computadorizada de Feixe Cônico Espiral , Maxila/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Zigoma
6.
Eur. j. anat ; 24(1): 31-35, ene. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-186062

RESUMO

The foramen tympanicum, also known as the foramen of Huschke (FH), is a permanent anatomical variation situated in the anteroinferior section of the external auditory canal, posteromedial to the temporomandibular joint. The aim of the study is to determine the prevalence of the FH in Cleft Lip and Palate (CL/P) patients, compared to healthy individuals by using Cone Beam Computed Tomography (CBCT) data. We retrospectively analyzed the CBCT images of 272 individuals, who had been referred to our Oral and Maxillofacial Radiology clinic various reasons. For comparison, 226 randomly selected healthy individuals and 46 CL/P patients (35 unilateral and 11 bilateral) were evaluated. FH in 35 (12.9%) of the 272 individuals; 26 of them healthy individuals, 9 of them CL/P patients. The FH was higher in patients with CL/P (19.6%) than healthy individuals (11.5%). Clinicians should be aware of the variability of TME and especially the FH in the ear region when radiographically examining these sites prior to CL/P surgery to prevent postoperative reconstruction and complications. Moreover, to evaluate these anatomical variations, CBCT


No disponible


Assuntos
Humanos , Fenda Labial/diagnóstico por imagem , Palato/diagnóstico por imagem , Variação Anatômica , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Palato/anatomia & histologia , Estudos Retrospectivos , Osso Temporal/anatomia & histologia , Tomografia Computadorizada de Feixe Cônico/instrumentação
7.
Int J Oral Sci ; 12(1): 4, 2020 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-31932579

RESUMO

The morphology of the alveolar bone at the maxillary anterior teeth in periodontitis patients was evaluated by cone-beam computed tomography (CBCT) to investigate the distribution of alveolar defects and provide guidance for clinical practice. Ninety periodontitis patients and 30 periodontally healthy individuals were selected to determine the morphology of the alveolar bone at the maxillary anterior teeth according to the degree of bone loss, tooth type, sex and age. The differences in the dimensions between periodontitis patients and healthy individuals were compared, and the distribution of alveolar bone defects was analyzed. A classification system was established regarding the sagittal positions and angulations of the teeth. The buccal residual bone was thicker and the lingual bone was thinner in the periodontitis patients than in the periodontally healthy individuals, and there were differences between the different tooth types, sexes and age subgroups. The buccal undercut was close to the alveolar ridge, while fenestration was reduced and the apical bone height was higher in periodontitis patients than in periodontally healthy individuals. The apical bone height increased with the aggravation of bone loss and age. The proportions of different sagittal positions changed with the aggravation of bone loss. Moreover, the teeth moved more buccally regarding the positions of the maxillary anterior teeth. The morphology of the alveolar bone at the maxillary anterior teeth differed between periodontitis patients and healthy individuals, and the differences were related to the degree of bone loss, tooth type, sex and age.


Assuntos
Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Periodontite/diagnóstico por imagem , Adulto , Processo Alveolar/anatomia & histologia , Feminino , Humanos , Incisivo/anatomia & histologia , Masculino , Maxila/anatomia & histologia , Estudos Retrospectivos , Ápice Dentário/anatomia & histologia , Ápice Dentário/diagnóstico por imagem , Colo do Dente/anatomia & histologia , Colo do Dente/diagnóstico por imagem
8.
J Craniofac Surg ; 31(1): 130-133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31652212

RESUMO

Authors tried to investigate the maxillomandibular morphology of Korean nationality with computerized tomography images and establish a series of cephalometric values which should be considered in orthognathic plastic surgery in Korea.The computerized tomography images of 200 patients were retrospectively reviewed with the computer workstation in Sanggye Paik Hospital, Inje University College of Medicine from 2016 to 2017.The mean distance between nasion to point A (NA) line and the maxillary central incisor was 5.07 cm. The mean distance from nasion to point B (NB) line to the mandibular central incisor was 7.11 cm. The mean angle between NA line and the long axis of the maxillary central incisor was 20.58 degree. The mean angle between NB line and the long axis of the mandibular central incisor was 26.47 degree. The mean angle between SN (sella to nasion) line and NA line was 83.18 degree. The mean angle between SN line and NB line was 78.83 degree. The mean angle between NA line and NB line was 4.35 degree. There were no any statistically significant differences between age groups. But there were statistically significant difference in the mean of angle between NB line and the long axis of the mandibular central incisor (P = 0.025, between sex groups) and in the mean of angle between NA line and the long axis of the maxillary central incisor between sex groups in the 51 to 60 age group (P = 0.045).The maxillomandibular profile of Korean adults was established which can be applied for orthognathic surgery of Korean patients.


Assuntos
Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Cefalometria , Feminino , Humanos , Masculino , Maxila/cirurgia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Ortognáticos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Clin Nucl Med ; 45(2): e122-e124, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31714280

RESUMO

Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory condition that can manifest in atypical locations. We present the case of a middle-aged woman presenting with isolated IgG4-RD of left maxilla and nasal septum, confirmed with F-FDG PET/CT. She achieved complete metabolic response with multiple pharmacologic treatment, but 1 year later, she experienced local relapse, and FDG PET/CT found new additional lesions in humeral vasculature and lungs. This case illustrates the usefulness of FDG PET/CT for initial evaluation and monitoring of IgG4-RD with unusual nasomaxillary involvement.


Assuntos
Fluordesoxiglucose F18 , Doença Relacionada a Imunoglobulina G4/diagnóstico por imagem , Maxila/diagnóstico por imagem , Septo Nasal/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Recidiva
10.
J Forensic Sci ; 65(2): 372-379, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31573085

RESUMO

Standards for estimating mouth width and Cupid's bow width in craniofacial approximation and superimposition are limited. Currently, the only guideline for mouth width, using direct skeletal references, is a general rule indicating a 75% inter-canine to mouth width ratio. The philtrum, which closely corresponds to the Cupid's bow, is said to be equal to the inter-superior prominences of the maxillary central incisors. This study tested these guidelines against newly generated regression models and mean values. Cone-beam CT scans of 120 black and 39 white southern African adults were used. Comparative hard and soft tissue measurements were taken using a 3D DICOM viewer. Regression equations accounting population, sex, and approximate age variables (20-39 and 40+ years), utilizing maxillary inter-canine width to estimate mouth width and maxillary central-lateral incisor junction width to estimate Cupid's bow width, performed statistically best. The regression models were more reliable than existing standards in validation tests.


Assuntos
Lábio/anatomia & histologia , Boca/anatomia & histologia , Adulto , Grupo com Ancestrais do Continente Africano , Envelhecimento , Tomografia Computadorizada de Feixe Cônico , Grupo com Ancestrais do Continente Europeu , Antropologia Forense , Humanos , Imageamento Tridimensional , Lábio/diagnóstico por imagem , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Boca/diagnóstico por imagem , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/diagnóstico por imagem , Valores de Referência , Análise de Regressão , Reprodutibilidade dos Testes , África do Sul , Adulto Jovem
11.
J Craniofac Surg ; 31(1): e4-e6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31403513

RESUMO

PURPOSE: To assess the morphology of nasopalatine canal and to determine the variation of this canal in correlations to age and gender in Iraqi sample using cone beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 200 requested CBCT images for nasopalatine canal evaluation before dental implantology at the anterior maxillary region. The morphology of canals was classified into 3 groups in coronal cross-sections. The effects of age and gender were also measured. RESULTS: The study comprised 100 males and 100 females with mean age of 30.64 ±â€Š9.46 years. Most of the cases showed Y-shape configuration type III 43.5% followed by type I single canal 35.5%, and type II with 2 parallel canals 21%, CONCLUSION:: Due to the wide variation in the morphology of nasopalatine canals, it is highly recommended to perform CBCT evaluation to the anterior maxilla before dental implantology in order to prevent any damage to the neurovascular bundle.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Adulto Jovem
12.
J Craniofac Surg ; 31(1): 207-209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31469733

RESUMO

BACKGROUND: Chronic inflammation in the lacrimal sac may lead to thickening of the surrounding bony tissues. This study aimed to assess the thickness of lacrimal bone surrounding the lacrimal sac, and the thickness of maxilla, based on the presence of purulent secretion in the lacrimal sac in patients who underwent EDCR. MATERIAL AND METHODS: Lacrimal bone thickness and the maximum and midpoint maxillary bone thickness of 70 patients (mean age of 49.07 years) who underwent EDCR, were assessed along 3 planes (upper, middle, and lower) using CT of the paranasal sinus. The patients were divided into 2 groups: the 1 who had purulent secretion in the lacrimal sac during the intraoperative period (Group 1) and another who did not have purulent secretion (Group 2). RESULTS: No significant difference was detected between the 2 groups in terms of maximum and midpoint maxillary bone thickness. The increase in the thickness of lacrimal bone in Group 1 was statistically significant in all the 3 planes as compared to that in Group 2. Cutoff values for the thickness of the upper, middle, and lower plane of lacrimal bone were detected to be 0.710 mm, 0.685 mm, and 0.675 mm, respectively. CONCLUSION: The presence of purulent secretion in the lacrimal sac, along with the detected increase in the thickness of the lacrimal bone, as assessed by CT, offers an insight on the lacrimal sac before the surgery.


Assuntos
Dacriocistite/diagnóstico por imagem , Ducto Nasolacrimal/diagnóstico por imagem , Adulto , Dacriocistite/cirurgia , Dacriocistorinostomia , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Órbita/diagnóstico por imagem , Órbita/cirurgia
13.
Dentomaxillofac Radiol ; 49(1): 20190249, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31356110

RESUMO

OBJECTIVES: Aim of this technical note is to show the applicability of cinematic rendering (CR) for a photorealistic 3-dimensional (3D) visualization of maxillofacial structures. The focus is on maxillofacial hard tissue pathologies. METHODS: High density maxillofacial pathologies were selected in which CR is applicable. Data from both, CT and cone beam CT (CBCT) were postprocessed using a prototype CR software. RESULTS: CR 3D postprocessing of CT and CBCT imaging data is applicable on high density structures and pathologies such as bones, teeth, and tissue calcifications. Image reconstruction allows for a detailed visualization of surface structures, their plasticity, and 3D configuration. CONCLUSIONS: CR allows for the generation of photorealistic 3D reconstructions of high density structures and pathologies. Potential applications for maxillofacial bone and tooth imaging are given and examples for CT and CBCT images are displayed.


Assuntos
Imageamento Tridimensional , Dente , Tomografia Computadorizada de Feixe Cônico , Humanos , Processamento de Imagem Assistida por Computador , Maxila/diagnóstico por imagem , Software , Dente/diagnóstico por imagem , Dente/patologia
14.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(5): 533-536, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31721503

RESUMO

OBJECTIVE: This study aims to compare the effects of fast and slow expansion on nasal cavity structure. METHODS: A total of 40 patients were selected and randomly divided into two groups. Cone-beam computer tomography (CBCT) was obtained before and after surgery and used for comparing the changes in nasal structure before and after treatment. RESULTS: Fast expansion had resulted in greater changes in the basilar and nasal bone arch extension structures than slow expansion. No significant difference at maxillary width and nasal parenchyma. CONCLUSIONS: Rapid expansion therapy has more beneficial effects on nasal function.


Assuntos
Maxila , Técnica de Expansão Palatina , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila/diagnóstico por imagem , Cavidade Nasal , Nariz
15.
Am J Orthod Dentofacial Orthop ; 156(5): 653-662, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31677674

RESUMO

INTRODUCTION: The aim of this study was to investigate 3-dimensional changes of the zygomaticomaxillary complex (ZMC) after mini-implant assisted rapid maxillary expansion (MARME). METHODS: A total of 15 pairs of cone-beam computed tomography 3-dimensional images taken before expansion (T0) and after expansion (T1) were analyzed by measuring changes in the coordinates of the landmarks of the ZMC. RESULTS: Changes in the x coordinates of the landmarks showed significant expansion (P <0.01) and greater expansion at the lower than upper portion of the ZMC (P <0.05) in the transverse dimension. All y coordinates of the landmarks except the jugal point (J) showed forward displacement (P <0.05), and the z coordinates of ANS, PNS, Alare, A, and ectocanine showed downward displacement (P <0.01) in the sagittal and vertical dimensions. Also, z coordinates of the landmarks that were closer to the midsagittal plane and in a more posterior portion of the ZMC displaced further downward (P <0.05). SNA and ANB angles increased (P <0.05 and P <0.001, respectively) and the SNB angle decreased (P <0.01). There was a significant correlation between changes in the x coordinates of the ectomolare and ectocanine and the amount of expansion measured from the center of resistance of the maxillary first molars (CR6; P <0.05). There was no significant correlation between the amount of CR6 expansion and changes in y and z coordinates of the landmarks. CONCLUSIONS: 3-Dimensional changes of the ZMC after MARME showed expansion in a pyramidal shape from the coronal view, downward and forward displacement from the sagittal view, and parallel palatal expansion from the axial view. These findings might be useful for understanding skeletal expansion patterns using MARME.


Assuntos
Maxila , Técnica de Expansão Palatina , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Dimensão Vertical
16.
J Craniofac Surg ; 30(8): 2560-2564, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31689731

RESUMO

BACKGROUND: This study aimed to analyze 3-dimensional nasolabial soft tissue changes following double jaw surgery with Le Fort I maxillary advancement and relate them to underlying surgical movements. METHODS: Pre- and post-surgical cone-beam computed tomography images of 37 maxillomandibular surgery patients with ≥2 mm of advancement at A-point were analyzed. Lateral cephalograms were constructed to determine horizontal and vertical surgical movements and 3-dimensional facial images were created from the CBCTs to calculate linear and angular changes. RESULTS: Alar base width increased 1.9 mm, nasal tip protrusion decreased 0.74 mm, the upper lip flattened 7.71 degree and increased 0.9 mm in length, nasal tip was displaced 2.47 mm superiorly causing an increased concavity of 5.52 degree for the overall dorsal surface and 3.99 degree at the supratip break angle (SBA), nasal tip angle decreased 2.16 degree and nasolabial angle decreased 7.37 degree. Correlations were found between underlying surgical movements and nasal tip protrusion, SBA, nasolabial angle (NLA), and nasal tip elevation (NTE). Multiple linear regression equations were calculated to predict changes in SBA from horizontal change at A-point, NLA from horizontal change at B-point, and NTE from the change at A-point horizontally and U1-tip vertically. CONCLUSION: Double jaw surgery with maxillary advancement has significant effects on nasolabial anatomy.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Face/anatomia & histologia , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
17.
Plast Reconstr Surg ; 144(6): 1010e-1013e, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764642

RESUMO

The occlusal plane angle is an important factor in lateral facial aesthetics. Low occlusal plane facial profiles appear planar and long-faced, whereas high occlusal plane facial profiles are considered more attractive, especially in Asian regions. Clockwise rotation of the occlusal plane for truly aesthetic purposes can be accomplished with double jaw surgery, without need for orthodontic treatments. Patients with normal occlusion who desired to improve their lateral facial aesthetics were included in this study. A conventional Le Fort I osteotomy was followed by a sagittal split ramus osteotomy under general anesthesia. The movement of the maxillomandibular complex was determined in accord with a preoperative analysis. From 2015 to 2017, 43 patients with normal occlusion underwent double jaw surgery without orthodontic treatment. Whereas all patients were subjectively satisfied with the surgery, two underwent orthodontic treatment to correct mild occlusal discrepancies noticed after surgery. There were no delayed occlusal problems or relapses reported during the study. For patients who desired to improve their lateral facial aesthetics but had normal occlusion, orthognathic surgery without orthodontic treatment can be effective. Clockwise rotation of the occlusal plane by double jaw surgery without orthodontic treatment resulted in satisfactory aesthetic outcomes with stable and reliable long-term results. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.


Assuntos
Oclusão Dentária , Estética , Mandíbula/cirurgia , Maxila/cirurgia , Osteotomia de Le Fort/métodos , Adulto , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Satisfação do Paciente , Ritidoplastia/métodos , Rotação , Resultado do Tratamento , Adulto Jovem
18.
Head Face Med ; 15(1): 25, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640721

RESUMO

BACKGROUND: The purpose of the present study was to describe the CT imaging findings of normal incisive canals and incisive canal cysts and propose cut-off values to differentiate between them. METHODS: A total of 220 normal subjects and 40 patients with incisive canal cysts on multi-detector row computed tomography (MDCT) were retrospectively analyzed. The shapes, sizes, anatomic variations, Hounsfield scale values, and so on of maxillary incisive canals and the sizes and Hounsfield scale values of maxillary incisive canal cysts were analyzed. RESULTS: A significant difference in sizes of maxillary incisive canals in normal subjects was found between males and females. The sizes of maxillary incisive canals were significantly wider during aging, but shapes, anatomic variations, and Hounsfield scale values in the maxillary incisive canals were not significantly different with aging. A significant difference in sizes but not Hounsfield scale values was found between normal maxillary incisive canals and maxillary incisive canal cysts. Based on a cut-off of over 6 mm in the width of incisive canals, maxillary incisive canal cysts could not be appropriately diagnosed for subjects over 60 years of age. Over 60 years of age, maxillary incisive canal cysts could be appropriately diagnosed based on a cut-off of over 7.1 mm in width of incisive canals. When maxillary incisive canals of the hourglass types were seen on sagittal sections, significantly more patients had maxillary incisive canal cysts than other types. CONCLUSION: In coincidentally diagnosing asymptomatic incisive canal cysts on imaging, we should apply different cut-offs for the size of the maxillary incisive canal for patients over and under 60 years of age. Specifically, the cut-offs for the long axis of maxillary incisive canal cysts were 7.1 mm for patients over 60 years of age and 6.0 mm for those under 60 years of age. In addition, we should pay attention to wider canals with hourglass shapes as indicative of cystic change of maxillary incisive canals.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cistos , Maxila , Cistos/diagnóstico por imagem , Feminino , Humanos , Japão , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
J Healthc Eng ; 2019: 9687127, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31485303

RESUMO

Aim: To evaluate the biomechanical effects of four different auxiliary-aligner combinations for the extrusion of a maxillary central incisor and to define the most effective design through finite element analysis (FEA). Materials and Methods: A full maxillary arch (14 teeth) was modelled by combining two different imaging techniques: cone beam computed tomography and surface-structured light scan. The appliance and auxiliary element geometries were created by exploiting computer-aided design (CAD) procedures. The reconstructed digital models were imported within the finite element solver (Ansys® 17). For the extrusion movement, the authors compared the aligner without an attachment with three auxiliary-aligner designs: a rectangular palatal attachment, a rectangular buccal attachment, and an ellipsoid buccal attachment. The resulting force-moment (MF) system delivered by the aligner to the target tooth and the tooth displacement were calculated for each scenario. Results: The maximum tooth displacement along the z-axis (0.07 mm) was obtained with the rectangular palatal attachment, while the minimum (0.02 mm) was obtained without any attachments. With the ellipsoid attachment, the highest undesired moments M x and M y were found. The rectangular palatal attachment showed the highest F z (2.0 N) with the lowest undesired forces (F x = 0.4 N; F y = -0.2 N). Conclusions: FEA demonstrated that the rectangular palatal attachment can improve the effectiveness of the appliance for the extrusion of an upper central incisor.


Assuntos
Incisivo/fisiologia , Maxila/diagnóstico por imagem , Maxila/fisiologia , Ortodontia/métodos , Fenômenos Biomecânicos , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Análise de Elementos Finitos , Humanos , Fenômenos Mecânicos , Dente Molar , Dinâmica não Linear , Desenho de Aparelho Ortodôntico , Ligamento Periodontal , Estresse Mecânico , Técnicas de Movimentação Dentária
20.
Scanning ; 2019: 4274715, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31531155

RESUMO

Purpose: To present a digital method that combines intraoral and face scanning for the computer-assisted design/computer-assisted manufacturing (CAD/CAM) fabrication of implant-supported bars for maxillary overdentures. Methods: Over a 2-year period, all patients presenting to a private dental clinic with a removable complete denture in the maxilla, seeking rehabilitation with implants, were considered for inclusion in this study. Inclusion criteria were fully edentulous maxilla, functional problems with the preexisting denture, opposing dentition, and sufficient bone volume to insert four implants. Exclusion criteria were age < 55 years, need for bone augmentation, uncompensated diabetes mellitus, immunocompromised status, radio- and/or chemotherapy, and previous treatment with oral and/or intravenous aminobisphosphonates. All patients were rehabilitated with a maxillary overdenture supported by a CAD/CAM polyether-ether-ketone (PEEK) implant-supported bar. The outcomes of the study were the passive fit/adaptation of the bar, the 1-year implant survival, and the success rates of the implant-supported overdentures. Results: 15 patients (6 males, 9 females; mean age 68.8 ± 4.7 years) received 60 implants and were rehabilitated with a maxillary overdenture supported by a PEEK bar, designed and milled from an intraoral digital impression. The intraoral scans were integrated with face scans, in order to design each bar with all available patient data (soft tissues, prosthesis, implants, and face) in the correct spatial position. When testing the 3D-printed resin bar, 12 bars out of 15 (80%) had a perfect passive adaptation and fit; in contrast, 3 out of 15 (20%) did not have a sufficient passive fit or adaptation. No implants were lost, for a 1-year survival of 100% (60/60 surviving implants). However, some complications (two fixtures with peri-implantitis in the same patient and two repaired overdentures in two different patients) occurred. This determined a 1-year success rate of 80% for the implant-supported overdenture. Conclusions: In this study, the combination of intraoral and face scans allowed to successfully restore fully edentulous patients with maxillary overdentures supported by 4 implants and a CAD/CAM PEEK bar. Further studies are needed to confirm these outcomes.


Assuntos
Desenho Assistido por Computador/instrumentação , Técnica de Moldagem Odontológica , Prótese Dentária Fixada por Implante/métodos , Revestimento de Dentadura , Arcada Edêntula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Idoso , Feminino , Humanos , Arcada Edêntula/patologia , Arcada Edêntula/cirurgia , Cetonas/química , Masculino , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Polietilenoglicóis/química , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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