• Title/Summary/Keyword: Maxillofacial reconstruction

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Micro-computed tomography for assessing the internal and external voids of bulk-fill composite restorations: A technical report

  • Tosco, Vincenzo;Monterubbianesi, Riccardo;Furlani, Michele;Giuliani, Alessandra;Putignano, Angelo;Orsini, Giovanna
    • Imaging Science in Dentistry
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    • v.52 no.3
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    • pp.303-308
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    • 2022
  • Purpose: This technical report aims to describe and detail the use of micro-computed tomography for a reliable evaluation of the bulk-fill composite/tooth interface. Materials and Methods: Bulk-fill composite restorations in tooth cavities were scanned using micro-computed tomography to obtain qualitatively and quantitatively valuable information. Two-dimensional information was processed using specific algorithms, and ultimately a 3-dimensional (3D) specimen reconstruction was generated. The 3D rendering allowed the visualization of voids inside bulk-fill composite materials and provided quantitative measurements. The 3D analysis software VG Studio MAX was used to perform image analysis and assess gap formation within the tooth-restoration interface. In particular, to evaluate internal adaptation, the Defect Analysis addon module of VG Studio Max was used. Results: The data, obtained with the processing software, highlighted the presence and the shape of gaps in different colours, representing the volume of porosity within a chromatic scale in which each colour quantitatively represents a well-defined volume. Conclusion: Micro-computed tomography makes it possible to obtain several quantitative parameters, providing fundamental information on defect shape and complexity. However, this technique has the limit of not discriminating materials without radiopacity and with low or no filler content, such as dental adhesives, and hence, they are difficult to visualise through software reconstruction.

Cone-beam computed tomographic reconstructions in the evaluation of maxillary impacted canines

  • David MacDonald;Sharifa Alebrahim;Edwin Yen;Jolanta Aleksejuniene
    • Imaging Science in Dentistry
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    • v.53 no.2
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    • pp.145-151
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    • 2023
  • Purpose: Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT cross-sectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered. Materials and Methods: Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm×5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart. Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration. Results: All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth. Conclusion: Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features.

CAVERNOUS SINUS THROMBOSIS : A CASE REPORT (해면 정맥동 혈전증(Cavernous Sinus Thrombosis) 치험례)

  • Chang, Hyun-Suk;Jang, Myung-Jin;Kim, Yong-Kwan;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.447-455
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    • 1995
  • Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

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Accuracy of three-dimensional periodontal ligament models generated using cone-beam computed tomography at different resolutions for the assessment of periodontal bone loss

  • Hangmiao Lyu;Li Xu;Huimin Ma;Jianxia Hou;Xiaoxia Wang;Yong Wang;Yijiao Zhao;Weiran Li;Xiaotong Li
    • The korean journal of orthodontics
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    • v.53 no.2
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    • pp.77-88
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    • 2023
  • Objective: To develop a method for generating three-dimensional (3D) digital models of the periodontal ligament (PDL) using 3D cone-beam computed tomography (CBCT) reconstruction and to evaluate the accuracy and agreement of the 3D PDL models in the measurement of periodontal bone loss. Methods: CBCT data collected from four patients with skeletal Class III malocclusion prior to periodontal surgery were reconstructed at three voxel sizes (0.2 mm, 0.25 mm, and 0.3 mm), and 3D tooth and alveolar bone models were generated to obtain digital PDL models for the maxillary and mandibular anterior teeth. Linear measurements of the alveolar bone crest obtained during periodontal surgery were compared with the digital measurements for assessment of the accuracy of the digital models. The agreement and reliability of the digital PDL models were analyzed using intra- and interexaminer correlation coefficients and Bland-Altman plots. Results: Digital models of the maxillary and mandibular anterior teeth, PDL, and alveolar bone of the four patients were successfully established. Relative to the intraoperative measurements, linear measurements obtained from the 3D digital models were accurate, and there were no significant differences among different voxel sizes at different sites. High diagnostic coincidence rates were found for the maxillary anterior teeth. The digital models showed high intra- and interexaminer agreement. Conclusions: Digital PDL models generated by 3D CBCT reconstruction can provide accurate and useful information regarding the alveolar crest morphology and facilitate reproducible measurements. This could assist clinicians in the evaluation of periodontal prognosis and establishment of an appropriate orthodontic treatment plan.

Atrophic Alveolar Ridge Augmentation using Autogenous Block Bone Graft for Implant Placement (임플란트 식립을 위해 블록형 자가골이식을 이용한 퇴축된 치조골의 재건)

  • Chee, Young-Deok;Cho, Jin-Hyoung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.2
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    • pp.161-171
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    • 2006
  • Endosseous implants have restored normal function and dental health to many patients. When implants were introduced as an effective treatment modality, their efficacy was limited by the amount of available bone. Today, various grafting procedures can surgically create bone width and volume. Implants can be placed in more ideal locations for successful prosthetic reconstruction. The use of autogenous bone grafts represents the "gold standard" for bone augmentation procedures. Either intraoral or extraoral sites may be considered for donor sites. Alveolar ridge augmentation using autogenous bone block, can be done during implant placement or staged with implant placement, after bone graft healing. In the staged technique, a better implant positioning and the use of wide diameter implants are possible. Alveolar ridge augmentation using autogenous block graft is a predictable way of treatment, for the atrophic alveolar ridge before implant placement. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft in generating effective new bone fill for dental implant placement.

A STUDY ON THE DIMENSIONAL ACCURACY OF MODELS USING 3-DIMENSIONAL COMPUTER TOMOGRAPHY AND 2 RAPID PROTOTYPING METHODS

  • Cho Lee-Ra;Park Chan-Jin;Park In-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.6
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    • pp.633-640
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    • 2001
  • Statement of problem. Relatively low success rate of root analogue implant system was supposed to be due to the time duration between extraction and implant installation. The use of three-dimensional computer tomography and the reconstruction of objects using rapid prototyping methods would be helpful to shorten this time. Purpose. This aim of this study was to evaluate the application possibility of the 3-dimensional computer tomography and the rapid prototyping to root analogue implants. Material and methods. Ten single rooted teeth were prepared. Width and height of the teeth were measured by the marking points. This was followed by CT scanning, data conversion and rapid prototyping model fabrication. 2 methods were used; fused deposition modelling and stereolithography. Same width and height of this models were measured and compared to the original tooth. Results. Fused deposition modelling showed an enlarged width and reduced height. The stereolithography showed more exact data compared with the fused deposition modelling. Smaller standard deviation were recorded in the stereolithographic method. Overall width error from tooth to rapid prototyping was 7.15% in fused deposition modelling and 0.2% in stereolithography. Overall height showed the tendency of reducing dimensions. Conclusion. From the results of this study, stereolithography seems to be very predictable method of fabricating root analogue implant.

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Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

  • Sinanoglu, Alper;Helvacioglu-Yigit, Dilek;Mutlu, Ibrahim
    • Restorative Dentistry and Endodontics
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    • v.40 no.2
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    • pp.161-165
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    • 2015
  • Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea

  • Lee, Keun-Ha;Kim, Kyung-A;Kwon, Yong-Dae;Kim, Sung-Wan;Kim, Su-Jung
    • The korean journal of orthodontics
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    • v.49 no.4
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    • pp.265-276
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    • 2019
  • Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.

Flow Characteristics in a Human Airway model for Oral Cancer Surgery by PIV Experiment and Numerical Simulation (PIV 측정 및 수치해석을 이용한 구강암 수술에 따른 기도 형상 내 유동 특성)

  • Hong, Hyeonji;An, Se Hyeon;Seo, Heerim;Song, Jae Min;Yeom, Eunseop
    • Journal of the Korean Society of Visualization
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    • v.19 no.3
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    • pp.115-122
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    • 2021
  • Oral cancer surgery typically consists of resection of lesion, neck dissection and reconstruction, and it has an impact on the position of hyoid bone. Therefore, morphological change of airway can occur since the geometric parameter of airway is correlated with the hyoid bone. Airflow is affected by geometry of the airway. In this study, flow characteristics were compared between pre- and post-surgery models by both particle image velocimetry (PIV) and numerical simulation. 3D model of upper airway was reconstructed based on CT data. Velocity is accelerated by the reduced channel area, and vortex and recirculation region are observed in pre- and post-surgery models. For the post-surgery model, high pressure distribution is developed by significantly decreased hydraulic diameter, and the longitudinal flow stream is also interrupted.

Open Reduction of an Isolated Anterior Nasal Spine Fracture: A Case Report and Review of the Literature

  • Jinwoo Park;In Sik Yun;Tai Suk Roh;Young Seok Kim
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.389-392
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    • 2023
  • A 14-year-old girl had a midfacial trauma event caused by hitting against an opening door and experienced discomfort and swelling of the columella and upper lip. Physical examination revealed mild tenderness on light palpation without any discomfort with upper lip movement. A computed tomography scan of the maxillofacial bones with three-dimensional reconstruction showed a fracture of the anterior nasal spine with obvious leftward displacement, mild-deviation of the caudal aspect of the nasal septum, and no sign of nasal bone fracture. Open reduction and internal fixation was performed with regard to aesthetic and functional concerns, including nasal septum deviation. The postoperative course was uneventful, and healing proceeded normally without complications. Herein, we emphasize the importance of differential diagnosis of isolated anterior nasal spine fractures in patients with midfacial trauma and clinicians' strategic decision-making in treatment modalities.