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1.
Swiss Dent J ; 130(10): 768-784, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33021766

RESUMO

This review about extraoral anatomy depicted in cone beam computed tomography describes the pharyngocervical region. Large (≥ 8 × 8 cm) field of views of the maxilla and/or mandible will inevita-bly depict the pharyngocervical region that com-prises the posterior upper airway, the pharyngeal part of the digestive tract, as well as the cervical segment of the spine. The latter consists of seven cervical vertebrae (C1-C7) with corresponding distinctive features, i.e., the atlas (C1) and the axis (C2). In addition, cervical vertebrae serve as ref-erences for the vertical position of anatomical structures. For instance, C4 is a typical landmark since it generally denotes the level of the chin, of the body of the hyoid bone, of the base of the epiglottis, and of the bifurcation of the common carotid artery, respectively. The pharynx, which is functionally involved in respiration, deglutition, and vocalization, extends from the lower aspect of the skull base to the esophagus. Anatomically, the pharynx is divided into three segments, i.e. the nasopharynx, the oropharynx, and the laryn-gopharynx. All communicate anteriorly with cor-responding cavities, i.e. the nasal cavities, the oral cavity, and the larynx. Although not directly located within the pharyngocervical region, the hyoid bone and the styloid process are also dis-cussed in this review, since both structures are commonly visible on CBCT images of this region.


Assuntos
Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico , Osso Hioide/diagnóstico por imagem , Mandíbula , Faringe/diagnóstico por imagem
2.
J Contemp Dent Pract ; 21(7): 723-727, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020353

RESUMO

AIM: To compare the angulation of maxillary left (UL) and right (UR) incisors and the width of alveolar bone. MATERIALS AND METHODS: This study was conducted using archived cone-beam computed tomography (CBCT) images of 50 male and 50 female patients. The UL and UR incisors were compared in terms of incisor/palatal plane angle, collum angle, labiopalatal crown-root position, and alveolar bone width (ABW). The comparison, with reference to gender and age, was analyzed using one-way analysis of variance and independent sample t test. RESULTS: There is no substantial variance in the average differences of the assessed variables for UR and UL central incisors (p > 0.05). No significant association was found between crown labial to root and root labial to crown positions for both central incisors (p > 0.05). Statistical analyses revealed that tooth type has no significant association with the central incisors-related variables. Alveolar bone width, at various areas assessed, showed significant relation to gender. On the other hand, incisor/palatal plane angle and ABW at the cementoenamel junction and at level of Point A (subnasale) were significantly affected by age. CONCLUSION: Gender can significantly affect the development of ABW. Also, incisor/palatal plane angle and ABW at certain areas are correlated with age. CLINICAL SIGNIFICANCE: Understanding the similarities or differences between right and left maxillary central incisors may give better indication if cephalometric images are accurate in attaining such measurements. This in turn will also help orthodontist to choose the proper tool for treatment decision-making related to incisor tooth movement.


Assuntos
Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Palato , Coroa do Dente
3.
J Contemp Dent Pract ; 21(7): 756-759, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020358

RESUMO

AIM: The cervical vertebral maturation (CVM) method has proved to be effective to assess the adolescent growth peak in both body height and mandibular size. The aim of this study was to evaluate whether cone-beam computed tomography (CBCT) images can be used to detect the changes of cervical vertebral bone mineral density (BMD) distribution and whether these changes are associated with CVM changes and mandibular length. MATERIALS AND METHODS: Samples were collected from the patients of age group between 9 years and 15 years of both sexes, who reported to the Department of Orthodontics and Dentofacial Orthopedics, RajaRajeswari Dental College and Hospital, Bengaluru. All the measurements were done on constructed CBCT three-dimensional images. Gray levels, which are equivalent to the BMD, were obtained for C2 and C3 vertebrae at pretreatment (T1) and six months after starting the treatment (T2). The vertebral variables [mean, standard deviation (SD)], CVM stages, and mandibular length between T1 and T2 were compared. RESULTS: Significant changes in the examined variables were detected during the observation period. The BMD values showed a positive correlation with mandibular length increments. CONCLUSION: The CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics and the BMD distribution changed because of active bone remodeling during the maturation. CLINICAL SIGNIFICANCE: This study proves that CBCT imaging can provide additional information about the growth status of a patient above and beyond that obtained from two-dimensional cephalometric radiographs. CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics with better accuracy and minimum distortion.


Assuntos
Densidade Óssea , Vértebras Cervicais/diagnóstico por imagem , Adolescente , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem
4.
J Contemp Dent Pract ; 21(7): 765-768, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020360

RESUMO

AIM: The present study was conducted to evaluate the reliability of cone-beam computed tomography (CBCT) in dental asymmetry with skeletal midline deviation. MATERIALS AND METHODS: This study was conducted on 124 patients (males 52, females 72) who underwent orthodontic treatment. The CBCT scan was obtained with the Planmica machine. Three maxillofacial radiologists evaluated 10 landmarks and 12 distances on maxillary and mandibular arches on CBCT images in all patients. RESULTS: Interobserver mean difference at point 1 was 0.33; point 2, 0.34; point 3, 0.32; point 4, 0.58; point 5, 0.56; point 6, 0.44; point 7, 0.28; point 8, 0.22; point 9, 0.54; point 10, 0.21; point 11, 0.34; and point 12, 0.36. The discrepancy between intra- and interobserver was not considerable (p > 0.05). CONCLUSION: Cone-beam computed tomography is useful for diagnosis of skeletal asymmetry. CLINICAL SIGNIFICANCE: Cone-beam computed tomography is a reliable and reproducible tool for diagnosis of skeletal asymmetry for successful orthodontic treatment.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Mandíbula/diagnóstico por imagem , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Reprodutibilidade dos Testes
5.
Shanghai Kou Qiang Yi Xue ; 29(3): 281-286, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043345

RESUMO

PURPOSE: To investigate the effect of extraction on condylar process position and upper airway in 12-14 years old females with skeletal ClassⅡhigh angle. METHODS: Twenty seven 12-14 years old females with skeletal ClassⅡhigh angle (experimental group) and 30 physical examinees without malocclusion (control group) in Stomatology Hospital Affiliated to Southwest Medical University from January 2016 and June 2017 were enrolled. All patients received cone-beam CT (CBCT) examinations. Mimics 20.0 was used to process the data. The changes of the condylar process position and upper airway were recorded. The data were analyzed using SPSS 20.0 software package. RESULTS: Before treatment, patients in the experimental group had higher Sa as well as lower Sp than those of the control group (P<0.05), but with no difference in Su between 2 groups before treatment (P>0.05). After treatment, Sa was decreased in the experimental group (P<0.05), but no change was observed in Sp and Su(P>0.05). After treatment, the joint space indexes were increased in the experimental group (P<0.05). Before treatment, the V total, V tongue, V mouth, and SMIN in the experimental group were significantly lower than those of the control group (P<0.05). Before treatment, V nose, V palate, V larynx, APTE, APHP and APSP in the experimental group showed no difference with those of the control group (P>0.05). V nose, V larynx, APHP and APTE showed no difference before and after treatment within the experimental group (P>0.05). After treatment, the V total, V tongue, V palate, V mouth, SMIN and APSP in the experimental group were significantly increased (P<0.05). CONCLUSIONS: Extraction treatment can widen the airway, suggesting that there may be a certain correlation between the changes of condyle position and upper airway volume.


Assuntos
Laringe , Má Oclusão de Angle Classe II , Má Oclusão , Adolescente , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Boca
6.
Shanghai Kou Qiang Yi Xue ; 29(3): 298-303, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33043348

RESUMO

PURPOSE: To explore the percentage of residual support height (Ph) and the percentage of residual root surface area (Ps) in evaluating periodontal support ability by simulating different stages of periodontitis based on the curved surface modeling. METHODS: Fifteen cone-beam CT (CBCT) images including 420 teeth in total were collected. The data were reconstructed into 3-dimensional teeth models by Mimics software.The 3D surface model of the tooth was then optimized by Geomagic software and then imported into Solidworks software to simulate different periodontal support height. Ph and Ps were measured and calculated to evaluate the consistency of Ph and Ps results in all tooth types. The data were analyzed with SPSS 22.0 software package. RESULTS: RSA in incisors, canines and premolars: coronal 1/3>middle 1/3>apical 1/3. RSA in molars: middle 1/3>coronal 1/3>apical 1/3. Maxillary first molar had the largest RSA, accounting for 11.60% of the dentition, which was about 3.18 times than mandibular central incisor. The difference between Ph and Ps in all types of teeth was statistically significant (P<0.01). The 95% confidence interval(CI) of the difference between Ph and Ps in the maxillary incisor, mandibular incisor, mandibular canine was between the clinical consistency limit (-15%, 15%). In the remaining tooth types, 95%CI of the difference between Ph and Ps was beyond the clinical consistency limit (-15%, 15%). CONCLUSIONS: For single-root tooth, except maxillary canine, the remaining periodontal support height could replace periodontal support area. For multi-rooted tooth, judging the ability of periodontal support ability only by alveolar bone absorption ratio in 2D index has significant limitations. Full consideration is needed to focus on root morphological discrepancy when determining the extent of periodontal disease.


Assuntos
Periodonto , Raiz Dentária , Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Incisivo , Periodonto/diagnóstico por imagem
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 772-777, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045790

RESUMO

Objective: To evaluate the MRI and cone beam CT (CBCT) image registration methods of the temporomandibular joint (TMJ), and to explore the clinical application of the registered images and clinical diagnostic data for examining the relationship between the articular disc and condyle. Methods: Three patients with TMJ disc disposition were recruited at the Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University from January to March 2018. One patient was male, aged 30, and the others were females, aged 21 and 26 respectively. Three-dimensional (3D) images of CBCT and MRI of the TMJ were reconstructed and registered by using Mimics software. The images were then evaluated after the registration. The evaluation indicators selected were the area and volume of the articular disc, the position of the articular disc or the distance between the highest point of the condyle (point C) to the center point of the articular disc (point D), the distance between the last point of the joint disc (point P) to point C, as well as the angle between line CD and FH plane (∠DCF) at either opened- or closed-mouth condition. Results: The registration images of TMJ, at the closed- and opened-mouth positions of the 3 patients, showed the anatomical structures and interrelationships of the articular disc, articular nodules, joint fossa and condyle. Combined with clinical diagnosis, the difference of CD distances at the normal articular disc position was the minimum (1.94 mm), the difference of CD distances was small at the anterior disc displacement with non-reduction and larger with reduction. When the joint disc was in the opened-mouth position, ∠DCF angle was minimal (3.81°). The patients with anterior disc displacement with non-reduction showed the largest ∠DCF angle (48.03°). Conclusions: The position of the articular disc relative to the condyle and articular nodules, either at closed- or opened-mouth conditionds, could be accurately displayed after the image registration and fusion. The registration image not only could fully show the shape and position of the articular disc in different status from a 3D perspective, but also might provide basis for clinical study of TMJ disc displacement.


Assuntos
Disco da Articulação Temporomandibular , Transtornos da Articulação Temporomandibular , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adulto Jovem
8.
Chin J Dent Res ; 23(3): 199-204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32974620

RESUMO

OBJECTIVE: To investigate the bilateral symmetry of double root canals, variation in root canal bifurcation and position of canal orifices in mandibular incisors in a Chinese population. METHODS: A total of 149 subjects with mandibular incisors with two canals were selected from 866 patients based on CBCT images and divided into three groups: group 1 (< 21 years), group 2 (21-40 years) and group 3 (> 40 years). The prevalence of bilateral symmetry of double root canals (type III and type V), the distance between the cementoenamel junction (CEJ) and the bifurcation (D1) and the distance between the two canal orifices (D2) were calculated and analysed. RESULTS: The bilateral symmetry of type III for mandibular central incisors (MCIs) (44.4%) was significantly lower than that for mandibular lateral incisors (MLIs) (63.4%). D1 was greater in group 1 (4.63 ± 1.35mm) than in group 2 (3.99 ± 1.02 mm) and group 3 (3.90 ± 1.95 mm). D2 was shorter in in MCIs (0.65 ± 0.20 mm) than in MLIs (0.74 ± 0.22 mm). CONCLUSION: Special attention is required in the root canal treatment of mandibular incisors, especially in patients aged above 21 years.


Assuntos
Cavidade Pulpar/diagnóstico por imagem , Incisivo , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula/diagnóstico por imagem , Raiz Dentária , Adulto Jovem
9.
Dental Press J Orthod ; 25(4): 23e1-23e7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965383

RESUMO

OBJECTIVE: This study aimed to compare the root length of maxillary and mandibular incisors between individuals with open bite versus matched individuals with adequate overbite. METHODS: This comparative, matched and retrospective study included 48 cone beam computed tomographies (CBCTs) obtained at a university radiological center. Scans belonged to 24 individuals with open bite (overbite ≤ 0 mm) and 24 individuals with adequate overbite (controls). Both groups were matched by age, sex, malocclusion classification and skeletal characteristics (ANB and FMA angles). Root length of each maxillary and mandibular incisor was measured in millimeters (mm) in a sagittal section from a perpendicular line to the enamel cement junction until the root apex (384 length measurements were made). The means of root length in both groups were compared using t-tests. In addition, correlations between variables were evaluated with the Pearson correlation coefficient (α = 0.05). RESULTS: In both groups, the root length of the upper central incisors was approximately 12 mm and the root length of the maxillary lateral incisors was approximately 13 mm (p˃ 0.05). Likewise, the root length of lower central incisors in both groups measured approximately 12 mm (p˃ 0.05). However, the mandibular lateral incisor roots of open bite patients were significantly longer than in the normal overbite patients (approximately 1 mm, p= 0.012 right side, p= 0.001 left side). CONCLUSIONS: Root length of maxillary incisors and central mandibular incisor is similar in individuals with or without open bite, but the mandibular lateral incisor roots in open bite patients were significantly longer than in the normal overbite patients.


Assuntos
Mordida Aberta/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico Espiral , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Estudos Retrospectivos
10.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 398-403, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865358

RESUMO

OBJECTIVE: To explore the correlation among gingival thickness (GT), underlying alveolar bone thickness (BT), and other periodontal biotype characteristics in the maxillary anterior. METHODS: A total of 40 young volunteers with healthy periodontal were involved in this research. The periodontal probe was previously used to divide the gingiva from thick to thin. Two records were measured by cone beam CT (CBCT) GT, which was measured at the cement-enamel junction level; and BT, which was measured at 3 locations: 1, 3, 5 mm below the alveolar crest. Oral and gypsum measurements were used to analyze the associations of the crown width/crown length ratio (CW/CL), the keratinized mucosa width (KM), and the free gingival margin curvature. RESULTS: Significant difference in the GT was observed between the thick and thin biotypes, which were divided by periodontal probe (P<0.01). Difference was observed in each periodontal biotype characteristic between the thick (GT≥1 mm) and thin biotypes (GT<1 mm) (P<0.05). BT was positively associated with GT (r=0.293, P=0.001), CW/CL (r=0.273, P=0.003), KM (r=0.291, P=0.001), and free gingival margin curvature (r=0.290, P=0.001). CONCLUSIONS: The transparency of the probing in the sulcus could analyze the GT qualitatively. The thick and thin biotypes have different periodontal biotype characteristics. Compared with individuals with thick biotype, those with thin biotype are susceptible to risk dental aesthetic.


Assuntos
Maxila , Coroa do Dente , Processo Alveolar , Tomografia Computadorizada de Feixe Cônico , Gengiva , Humanos
11.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 415-418, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865361

RESUMO

OBJECTIVE: The effects of different tube currents and voltages on image quality and radiation dose were studied to provide a theoretical basis for low-dose cone beam computed tomography (CBCT) scanning in children. METHODS: Different tube currents and voltages were used to scan the incisor area of fresh Bama pig heads by CBCT. The radiation dose was recorded, and image quality was evaluated. RESULTS: As the tube current or voltage decreased, the radiation dose and image quality gradually decreased. The computed tomographic dose index (CTDIvol) of 90 kV, 2.5 mA and 60 kV, 7.0 mA were all 1.7 mGy. The image quality score of the former was higher than that of the latter, and the difference between them was statistically significant (P<0.05). CONCLUSIONS: Low-dose CBCT scanning appears to be able to reduce the necessary tube current during imaging by improving image quality.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cabeça , Animais , Criança , Estudos de Viabilidade , Humanos , Doses de Radiação , Suínos
12.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 419-424, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865362

RESUMO

OBJECTIVE: To analyze the morphological changes in the upper airway of obstructive sleep apnea syndrome (OSAS) patients treated with oral appliance in skeletal class Ⅱ malocclusion with different vertical features by using cone beam CT (CBCT). METHODS: Thirty-six patients diagnosed with OSAS by polysomnography and daytime sleepiness scale and skeletal class Ⅱ malocclusion were treated with oral appliance for 4 months. The changes based on CBCT in the morphology of glossopharyngeal and palatopharyngeal before and after treatment in OSAS patients with different vertical features were compared. RESULTS: After treatment with oral appliance, the glossopharyngeal and palatopharyngeal morphologies of patients with mild OSAS showed significant changes. After treatment with oral appliance, the glossopharyngeal morphology of all patients showed significant changes (P<0.05). The palatopharyngeal morphology of patients in the lower and average groups also exhibited significant changes (P<0.05). Sagittal changes in the glossopharyngeal measurements of high-angle patients demonstrated significant difference, whereas the other measured values showed no significant difference. CONCLUSIONS: The morphological changes in the upper airway were significant in OSAS patients with lower and average vertical patterns when treated with oral appliance, but the changes in high vertical patterns were not significant.


Assuntos
Má Oclusão de Angle Classe II , Apneia Obstrutiva do Sono , Tomografia Computadorizada de Feixe Cônico , Humanos , Polissonografia
13.
Am J Orthod Dentofacial Orthop ; 158(3): 349-356, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862936

RESUMO

INTRODUCTION: The purpose of this study was to use cone-beam computed tomography (CBCT) to determine bone thickness in the mandibular buccal shelf (MBS) and the infrazygomatic crest (IC) in individuals with different vertical facial heights for ultimate placement of miniscrews. METHODS: The sample consisted of 100 individuals aged at least 16 years, of whom 58 were women, and 42 were men. The mean age was 19.18 years (± 5.5 standard deviation). The patients' facial height was determined by the gonial angle. Cross-sectional slices of the MBS and IC were obtained with CBCT to evaluate bone thickness for the insertion of miniscrews in these extra-alveolar sites. Spearman's nonparametric test was used to correlate the gonial angle with MBS and IC thickness. The level of significance was 5%. RESULTS: The gonial angle ranged from 102.4° to 143.2°. Bone thickness in the MBS increased posteriorly, whereas bone thickness in the IC decreased posteriorly. There was an inversely proportional correlation between the gonial angle and the MBS. There was no correlation between the IC and the gonial angle. CONCLUSIONS: Short-faced individuals had higher bone thickness values in the MBS than long-faced ones. There was no correlation between the patients' vertical face height and the bone width in the IC. The best site to install miniscrews in the MBS is buccal to the second molar distal root, whereas in the IC, it is buccal to the first molar mesiobuccal root. CBCT may be necessary to install extra-alveolar miniscrews correctly, especially in the IC.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Feminino , Humanos , Masculino , Mandíbula , Maxila , Dente Molar , Adulto Jovem
14.
Acta Odontol Latinoam ; 33(2): 69-81, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920608

RESUMO

The aim of this study was to evaluate changes in periodontal status and maxillary buccal bone by considering clinical and tomographic parameters during the first year of orthodontic expansion with Invisalign® aligners. Upper first (1PM) and upper second (2PM) premolars of 19 patients with orthodontic expansion requirement treated with Invisalign® aligners were evaluated. Plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and cone beam tomographic (CBCT) records were collected at 76 sites before starting treatment (T0) and at 12 months (T1). Bone height was measured from cementoenamel junction (CEJ) to the crest cortical bone (CC). Bone thickness was measured at two levels: 4 mm (CEJ+4) and 6 mm (CEJ+6) apical to the CEJ. A descriptive analysis was made of the variations of bone thickness and height in a series of cases. The average expansion was 1.93 mm for 1PM and 167 mm for 2PM. Arithmetic mean of distance CEJ-CC in 1PM was 3.05 mm at T0, and remained at 3.05 mm at T1. Arithmetic mean of distance CEJ-CC in 2PM was 2.06 mm at T0 and 2.31 at T1. Post-expansion, most of the analyzed sites (86%) exhibited a bone thickness of ≥0.5 mm. The greatest variations between T0 and T1 were observed at the level of 1PM CEJ+ 4 and 2PM CEJ+ 6. The minimal changes in the clinical records (GI, PI, PPD and CAL) between T0 and T1 were compatible with the maintenance of gingivalperiodontal health. Invisalign® for expansion movements did not produce substantial changes in the evaluated periodontal clinical parameters or in the bone measurements. Removable appliances reduce plaque retentive factors and favor adequate oral hygiene.


Assuntos
Placa Dentária/etiologia , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Saúde Bucal , Aparelhos Ortodônticos Removíveis/efeitos adversos , Técnicas de Movimentação Dentária/efeitos adversos , Tomografia Computadorizada de Feixe Cônico , Placa Dentária/microbiologia , Índice de Placa Dentária , Nível de Saúde , Humanos , Técnicas de Movimentação Dentária/instrumentação
15.
Tokai J Exp Clin Med ; 45(3): 108-112, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901896

RESUMO

A 33G, 12-mm needle broke and entered the soft tissue in a 60-year old man. Panoramic X-ray imaging and cone-beam computed tomography (CT), which we performed a few hours after the breakage, revealed the needle in the soft tissue of the lower right mandibular molar. We immediately made an incision in the buccal gingiva of the lower right mandibular molar under local anesthesia and attempted to remove the needle but could not locate it. Thereafter, we adopted a watch-and-wait approach, as the patient had no subjective symptoms. Nine months later, we confirmed via CT that the needle had migrated subcutaneously to the right side of the neck. Two months later, we identified its location using C-arm fluoroscopy and removed it under general anesthesia. This report is a rare case and we are the first to document the subcutaneous migration of a fractured needle.


Assuntos
Corpos Estranhos , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/cirurgia , Gengiva , Mandíbula , Pescoço , Agulhas/efeitos adversos , Anestesia Dentária , Anestesia Local , Tomografia Computadorizada de Feixe Cônico , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade
16.
Head Face Med ; 16(1): 21, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32900389

RESUMO

OBJECTIVE: To assess and compare volumetric and shape changes of the orbital cavity in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). STUDY DESIGN: Forty adolescents with bilateral maxillary cross-bite received tooth-borne (TB group = 20; mean age 14.27 ± 1.36 years) or bone-borne (BB group = 20; mean age of 14.62 ± 1.45 years) maxillary expander. Cone-beam computed tomography (CBCT) were taken before treatment (T1) and 6-month after the expander activation (T2). Volumetric and shape changes of orbital cavities were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student's t tests were used to 1) compare T1 and T2 volumes of orbital cavities in TB and BB groups, 2) compare volumetric changes and the percentage of matching of 3D orbital models (T1-T2) between the two groups. RESULTS: Both TB and BB groups showed a slight increase of the orbital volume (0.64 cm3 and 0.77 cm3) (p < 0.0001). This increment were significant between the two groups (p < 0.05) while no differences were found in the percentage of matching of T1/T2 orbital 3D models (p > 0.05). The areas of greater changes were detected in the proximity of the frontozygomatic and frontomaxillary sutures. CONCLUSION: TB-RME and BB-RME would not seem to considerably affect the anatomy or the volume of the orbital cavity in adolescents.


Assuntos
Técnica de Expansão Palatina , Dente , Adolescente , Criança , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Órbita
17.
Medicine (Baltimore) ; 99(33): e21761, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872071

RESUMO

RATIONALE: Three root canals (mesiobuccal, distobuccal and palatal) are rarely found (frequency <1%) in the maxillary central incisor even though root canal morphology in maxillary premolars is highly variable. Therefore, research papers showed that dentists can easily miss the root canals in diagnosis and inflammatory diffusion; which could cause unsuccessful root canal treatment leading to various possible infections and no change in original inflammations. In this report, the diagnose and clinical management of an unusual case of a maxillary center incisor with three independent roots and three root canals is presented, along with a demonstration of using CBCT (Cone Beam Computed Tomography) and collaborate with other departments to successfully accomplish an accurate diagnosis of the morphology and quantity of the root canal system. PATIENT CONCERNS: The patient was referred to clinic for his repeatedly abscessed in the gums of the left upper central incisor. DIAGNOSES: Based on clinical and radiographic evidences, the patient was tentatively diagnosed with a chronic periapical periodontitis for #21 tooth. INTERVENTIONS: The patient was performed with the conventional root canal treatment and then clinical observed. OUTCOMES: At the second visit after 7 days, the patient was not sensitive to percussion. After operation for 3 months, and found that the sinus opening had not healed. Then, the patient was undergone with the periodontal flap surgery to remove root infection for 2 weeks. LESSONS: From this clinical case, the lesson learned is that the previous clinical experiences cannot be used to make judgments or decisions; it requires specific analysis from the information gathered through CBCT(Cone Beam Computed Tomography)and the cooperation between different departments to come up with a responsible decision. In any stomatological hospitals, due to the large number of departments and the strong specialized focuses for each department; it is very important to encourage and support the cooperation between the departments, to limit any judgment bias due to lack of knowledge and maximize each department's strengths.


Assuntos
Incisivo/anormalidades , Tratamento do Canal Radicular , Variação Anatômica , Tomografia Computadorizada de Feixe Cônico , Humanos , Incisivo/diagnóstico por imagem , Incisivo/cirurgia , Masculino , Adulto Jovem
18.
Medicine (Baltimore) ; 99(37): e22189, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925793

RESUMO

Herein, a Harris corner detection algorithm is proposed based on the concepts of iterated threshold segmentation and adaptive iterative threshold (AIT-Harris), and a stepwise local stitching algorithm is used to obtain wide-field ultrasound (US) images.Cone-beam computer tomography (CBCT) and US images from 9 cervical cancer patients and 1 prostate cancer patient were examined. In the experiment, corner features were extracted based on the AIT-Harris, Harris, and Morave algorithms. Accordingly, wide-field ultrasonic images were obtained based on the extracted features after local stitching, and the corner matching rates of all tested algorithms were compared. The accuracies of the drawn contours of organs at risk (OARs) were compared based on the stitched ultrasonic images and CBCT.The corner matching rate of the Morave algorithm was compared with those obtained by the Harris and AIT-Harris algorithms, and paired sample t tests were conducted (t = 6.142, t = 31.859, P < .05). The results showed that the differences were statistically significant. The average Dice similarity coefficient between the automatically delineated bladder region based on wide-field US images and the manually delineated bladder region based on ground truth CBCT images was 0.924, and the average Jaccard coefficient was 0.894.The proposed algorithm improved the accuracy of corner detection, and the stitched wide-field US image could modify the delineation range of OARs in the pelvic cavity.


Assuntos
Algoritmos , Tomografia Computadorizada de Feixe Cônico/métodos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias do Colo do Útero/diagnóstico por imagem , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Ultrassonografia/métodos
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 613-616, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878394

RESUMO

The document represented the consensus amongst the professionals from the Society of TMD & Occlusion, Chinese Stomatological Association and provided guidelines with the cone-beam CT examination specification and diagnostic criteria of temporomandibular disorders.


Assuntos
Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Consenso , Humanos , Côndilo Mandibular
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 617-623, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878395

RESUMO

Objective: To establish a three-dimensional (3D) quantitative measurement and evaluate the condylar bone remodeling of temporomandibular joint (TMJ). Methods: Pre-and post-treatment cone-beam CT (CBCT) data were obtained from 41 patients ï¼»10 males, 31 females, mean age of (19.7±4.4) years (12-30 years old)ï¼½, who visited the Center for TMD and Orofacial Pain, Peking University School and Hospital of Stomatology from November 2014 to August 2019, and diagnosed with acute disc displacement without reduction or disc displacement with reduction, with intermittent locking and treated by manual disc reduction followed by anterior repositioning splint. First, condylar bone remodeling was evaluated according to the number of "double contour image" and qualitatively classified as no remodeling (no double contour image), partial remodeling (1-4 double contour images) and remarkable remodeling (5-6 double contour images). Then, condylar bone remodeling was quantitatively evaluated by CBCT based 3D measurement: segmenting condylar images using a semi-automatic method of the manually preliminary mark combined with watershed algorithm, reconstructing the surface models, superimposing the pre-and post-treatment condylar images and finally calculating the volumetric differences of condyle and condylar head, respectively. Results: The Kappa values of two-dimensional (2D) qualitative evaluation were 0.66-0.87, and 3D quantitative measurements of condyle and condylar head volume were also reliable, with the intraclass correlation coefficient (ICC) values of intra-observer 0.998/0.941 and inter-observer 0.999/0.942 respectively. The volumetric increment of the condyle and condylar head after treatment was (41.7±90.2) mm³ and (62.8±70.9) mm³, respectively. Eighty-two condyles were divided into three sub-groups: no remodeling (21), partial remodeling (20) and remarkable remodeling (41). Ranking of the volumetric increment of the condyle and condylar head after treatment was as follows: remarkable remodeling group>partial remodeling group>no remodeling group (P<0.05). Conclusions: The 3D quantitative measurement for evaluating condylar bone remodeling had excellent consistency and reliability, which was consistent with the qualitative classification for condylar bone remodeling. The condylar head as a region of interest was more sensitive to the volumetric changes.


Assuntos
Côndilo Mandibular/diagnóstico por imagem , Articulação Temporomandibular , Adolescente , Adulto , Remodelação Óssea , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imageamento Tridimensional , Masculino , Reprodutibilidade dos Testes , Adulto Jovem
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