Comparison of Cone-beam Computed Tomography and Multi-slice Spiral Computed Tomography Bone Density Measurements in the Maxilla and Mandible.

UNLABELLED: The purpose of this study was to compare cone-beam computer tomography (CBCT) and multi-slice spiral computed tomography (MSCT) bone density measurements in the maxilla and mandible to determine whether any discrepancies between imaging modalities exist. MATERIAL & METHODS: 33 sets of CBCT and MSCT scans were evaluated using Simplant software. Density measurements were made in eight regions of interest on each scan and were compared and analyzed. RESULTS: Correlation of density measurements at specific regions of interest between CBCT and MSCT was only fair and ranged from 0.61-0.86. High-density areas, such as the anterior mandible, showed a higher correlation between imaging modalities than low-density regions, such as the posterior maxilla. CONCLUSION: Care should be taken when relying upon CBCT to determine bone density, especially in low-density regions such as the posterior maxilla.

Surgical management of the buccal bifurcation cyst: bone grafting as a treatment adjunct to enucleation and curettage.

The buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst of unknown etiology. It typically develops on the buccal aspect of the permanent mandibular first molar and occasionally on the permanent mandibular second molar in children 4 to 14 years old. Distinct clinical findings of the BBC include involvement of a vital partially or fully erupted mandibular first or second molar, swelling in the affected mandibular molar region, delayed or altered eruption pattern of the involved tooth, and an increase in periodontal pocket depth when the affected tooth is partially erupted. Specific radiographic features include a radiolucent lesion on the buccal aspect of the tooth involving the roots to a variable extent, tilting of the involved molar so that the root apices are toward the lingual cortical plate, an intact periodontal ligament space and lamina dura, a periosteal reaction on the buccal surface, and an intact inferior border of the mandible. The histopathology of the lesion has been described as similar to a radicular or inflammatory odontogenic cyst. Most of the current literature supports simple enucleation and curettage of the cyst without extraction of the involved tooth as the treatment of choice. This report presents 3 cases of BBCs that were treated with enucleation and curettage without extraction of the involved tooth, in addition to a bone graft placed primarily or secondarily as an adjunctive treatment approach to the current therapies.

Augmentation of the anterior maxilla with intraoral onlay grafts for implant placement.

The use of autogenous cortical cancellous block grafts to augment the premaxilla is a safe and effective technique to provide adequate bone height and width when reconstructing patients with atrophic premaxilla ridge when endosteal implants are planned. Intraoral bone graft harvests have the advantages of proximity of the donor site to the graft site, convenient surgical access, minimal operative time, and ease of performance in an office setting. The major limitation of these donor sites is the smaller quantity of graft obtainable compared with iliac crest bone harvest sites.