ABSTRACT

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software.

Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blinded to the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria. A scoring system with 3 subscores was created and used to compare the protocols.

Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply.

Conclusion: This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensure consistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation. (Imaging Sci Dent 20240073)

Abstract:

Background: This research was designed to assess the nasopalatine canal shape, size as well as anatomic variations according to age & gender in a sample of the Egyptian population utilising CBCT .

Material and Methods: This research was conducted on 100 CBCT scans belonging to 31 males & 69 women, with mean age of (35.8 ± 12.3) years. Inclusion and exclusion criteria as well as ethical issues were designed. CBCT scans were classified according to gender (male and female) and according to age (18-40 year and 41-61 year). All nasopalatine canals were evaluated to assess nasopalatine canal shape in coronal view and sagittal view as well as measurements of the nasopalatine canal in the sagittal & axial cross-section CBCT. The data were collected, computed, tabulated and statistically analyzed.

Results: Was observed no statistically substantial association amongst gender & NPC shape. Also, was noted no statistically substantial association amongst age group and NPC shape. Males showed statistically significantly higher mean diameter of incisive foramen and nasopalatine canal length than females. Subjects aged 18 – 40 years old showed statistically significantly lower mean antero-posterior diameter of nasal foramen, medio-lateral diameter of incisive foramen as well as canal diameter than those aged 41 – 61 years old.

Conclusions: The most frequent NPC shape in coronal view is variation of the Y-type of NPC in half of participants followed by single canal and the least was 2 parallel canals. The most frequent NPC shape in sagittal view is funnel shape (29%) followed by cylindrical shape (28%). The antero-posterior diameter of the incisive foramen & the nasopalatine canal length are higher in men than women. The antero-posterior diameter of the nasal foramen, the medio-lateral diameter of the IF and the NPC increase with aging.

ABSTRACT

Aim: The aim of this study was to evaluate the immediate implant placement versus delayed implant placement 3 months later of the splitting of thin alveolar bone sites using flapless crest splitting technique.

Subjects and Methods: This study was designed as a prospective clinical trial of 35 implants over 8 patients with 16 alveolar splitting sites. Eight sites were splitted and immediately implanted and submitted to group I, the another eight sites were splitted and implanted after 3 months they were submitted to group II, After alveolar ridge spiltting both groups were grafted via xenografts and covered with collagen membranes for guided bonr regeneration (GTR). For both groups we clinically assessed insertion torque, Implant stability quotient (ISQ) and radiographically horizontal bone gain and bone density at 3 intervals postoperatively, 3 and 6 months.

Results: The mean ISQ and insertion torque ± SD in group II was higher than group I. Group I showed a higher increase in bone gain than group II.

Conclusion: Immediate implantation after piezotome ridge splitting can be a useful procedure in ridges which have low bone quality and a thin cortex. Delayed implantation after piezotome ridge splitting is recommended when the initial stability of the implants is predicted to be poor. Both techniques using piezotome alveolar ridge splitting are effective in avoiding adjacent nerve injury.

ABSTRACT

Aim: This study was conducted to compare Computed guided arthrocentesis with conventional arthrocentesis followed by I-PRF prolotherapy in the treatment of TMJ internal derangement.

Subjects and methods: the study was carried out on 20 patients divided into two groups: Group I, patients underwent arthrocentesis followed by I-PRF injection using conventional TMJ injection technique with the aid of facial anatomical landmarks. Group II, patients underwent arthrocentesis followed by I-PRF injection using a CT-guided 3D printed surgical guide. Pain scores measured and MIO, preoperatively, immediately after the procedures, 1 week, 1 month, and 3 months. MRI was made 1 week and 3 months after the procedures. The number of attempts of needle insertions of 1st & 2nd needle (Right -Left) were assessed and the Time of operation and pain during the operation were assessed. Results: a significant decrease in pain during procedures, immediately post-operative, 1 week and 1 month post-operative, number of insertions and relocation of the needles in each joint, and time of the procedures in the guided arthrocentesis group compared to the conventional arthrocentesis group. On the other hand, there was no significant difference between both groups in MIO, preoperative pain after 3 months.

Conclusion: Digital arthrocentesis and prolotherapy of TMJ showed superiority and could replace the current conventional and prolotherapy types. Intra-articular PRF injection after arthrocentesis is an effective treatment method for the pain relief of TMJ internal derangements.