Prevalence and location of the posterior superior alveolar artery using cone-beam computed tomography

PURPOSE: Insufficient knowledge of the anatomy of the maxillary sinuses prior to sinus graft surgery may lead to perioperative or postoperative complications. This study sought to characterize the position of the posterior superior alveolar artery (PSAA) within the maxillary sinuses using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 300 patients with edentulous posterior maxillae, including 138 females and 162 males with an age range of 33-86 years, who presented to a radiology clinic between 2013 and 2015 were enrolled in this retrospective cross-sectional study. The distance from the inferior border of the PSAA to the alveolar crest according to the residual ridge classification by Lekholm and Zarb, the distance from the PSAA to the nasal septum and zygomatic arch, and the diameter and position of the PSAA were all assessed on patients' CBCT scans. The data were analyzed using the Mann-Whitney test and the t-test. RESULTS: The PSAA was detected on the CBCT scans of 87% of the patients; it was located beneath the sinus membrane in 47% of cases and was intraosseous in 47% of cases. The diameter of the artery was between 1 and 2 mm in most patients (72%). The mean diameter of the artery was 1.29±0.39 mm, and the mean distances from the PSAA to the zygomatic arch, nasal septum, and alveolar crest were 22.59±4.89 mm, 26.51±3.52 mm, and 16.7±3.96 mm, respectively. CONCLUSION: The likelihood of detecting the PSAA on CBCT scans is high; its location is intraosseous or beneath the sinus membrane in most patients. Determining the exact location of the PSAA on CBCT scans preoperatively can help prevent it from being damaged during surgery.

Effect of titanium and stainless steel posts in detection of vertical root fractures using NewTom VG cone beam computed tomography system

PURPOSE: Vertical root fracture (VRF) is a common complication in endodontically treated teeth. Considering the poor prognosis of VRF, a reliable and valid detection method is necessary. Cone beam computed tomography (CBCT) has been reported to be a reliable tool for the detection of VRF; however, the presence of metallic intracanal posts can decrease the diagnostic values of CBCT systems. This study evaluated and compared the effects of intracanal stainless steel or titanium posts on the sensitivity, specificity, and accuracy of VRF detection using a NewTom VG CBCT system. MATERIALS AND METHODS: Eighty extracted single-rooted teeth were selected and sectioned at the cemento-enamel junction. The roots were divided into two groups of 40. Root fracture was induced in the test group by using an Instron machine, while the control group was kept intact. Roots were randomly embedded in acrylic blocks and radiographed with the NewTom VG, both with titanium and stainless steel posts and also without posts. Sensitivity, specificity, and accuracy values were calculated as compared to the gold standard. RESULTS: The sensitivity, specificity, and accuracy of VRF diagnosis were significantly lower in teeth with stainless steel and titanium posts than in those without posts. Interobserver agreement was the highest in teeth without posts, followed by stainless steel posts, and then titanium posts. CONCLUSION: Intracanal posts significantly decreased the VRF diagnostic values of CBCT. The stainless steel posts decreased the diagnostic values more than the titanium posts.

Temperature increase during different post space preparation systems: an in vitro study

The purpose of this study was to evaluate external root surface temperature rise during post space preparation using LA Axxess bur, Beefill pack System, and Peeso Reamer drill. The distal canals of forty-five extracted human permanent mandibular first molars were instrumented in crown-apical manner and obturated with lateral condensation technique. Teeth were then randomly divided into three groups according to post space preparation technique including: group 1. LA Axxess bur [Sybronendo Co., CA, USA], group 2 Beefill pack System [VD W Co., Munich, Germany] and group 3 Peeso Reamer drill [Mani Co., Tochigi-ken, Japan]. Temperature was measured by means of digital thermometer MT-405 [Comercio Co., Sao Paulo, Brazil] which was installed on the root surfaces. Data was collected and submitted to one-way ANOVA and Post hoc analysis. Root surface temperatures were found to be significantly higher [7.3 +/- 2.7 vs. 4.3 +/- 2.1 and 4 +/- 2.4,] in samples of Beefill pack System compared with the two other groups [P<0.02]. Using Beefill pack System during post space preparation may be potentially hazardous for periodontal tissues