ABSTRACT
Statement of the Problem: Accurate measurement of the available bone height is an essential step in the pre-surgical phase of dental implantation. Panoramic radiography is a unique technique in the pre-surgical phase of dental implantations because of its low cost, relatively low-dose, and availability
Purpose: This article aimed to assess the reliability of dental panoramic radiographs in the accurate measurement of the vertical bone height with respect to the horizontal location of the alveolar crest
Materials and Method: 132 cone-beam computed tomography [CBCT] of the edentulous mandibular molar area and dental panoramic radiograph of 508 patients were selected. Exclusion criteria were bone abnormalities and detectable ideal information on each modality. The alveolar ridge morphology was categorized into 7 types according to the relative horizontal location of the alveolar crest to the mandibular canal based on CBCT findings. The available bone height [ABH] was defined as the distance between the upper border of the mandibular canal and alveolar crest. One oral radiologist and one oral surgeon measured the available bone height twice on each modality with a 7-dayinterval
Results: We found a significant correlation between dental panoramic radiographs and cone-beam computed tomography values [ICC=0.992, p< 0.001]. A positive correlation between the horizontal distance of the alveolar crest to the mandibular canal and measured differences between two radiographic modalities had been found [r=0.755, p< 0.001]. For each single unit of increase in the horizontal distance of the alveolar crest to the mandibular canal, dental panoramic radiographs showed 0.87 unit of overestimation [p< 0.001]
Conclusion: Dental panoramic radiographs can be employed safely in the pre-surgical phase of dental implantation in posterior alveolus of mandible, especially in routine and simple cases
ABSTRACT
Statement of the Problem: Due to shortage of ICU beds in hospitals, knowing what kind of orthognathic surgery patients more need ICU care after surgery would be important for surgeons and hospitals to prevent unnecessary ICU bed reservation
Purpose: The aim of the present study was to determine what kinds of orthognathic surgery patients would benefit more from ICU care after surgery
Materials and Method: 210 patients who were admitted to Chamran Hospital, Shiraz, for bimaxillary orthognathic surgery [2008-2013] were reviewed based on whether they had been admitted to ICU or maxillofacial surgery ward. Operation time, sex, intraoperative Estimated Blood Loss [EBL], postoperative complications, ICU admission, and unwanted complications resulting from staying in ICU were assessed
Results: Of 210 patients undergoing bimaxillary orthognathic surgery, 59 patients [28.1%] were postoperatively admitted to the ICU and 151 in the maxillofacial ward [71.9%]. There was not statistically significant difference in age and sex between the two groups [p> 0.05]. The groups were significantly different in terms of operation time [p< 0.001]. Blood loss For ICU admitted patients was 600.00 +/- 293.621mL and for those who were hospitalized in the ward was 350.00 +/- 298.397 mL. Statistically significant differences were found between the two groups [p< 0.001]. Moreover, there was a direct linear correlation between operation time and intraoperative estimated blood loss and this relationship was statistically significant [r=0.42, p< 0.001]. Patients with maxillary impaction and setback plus mandibular advancement plus genioplasty were among the most ICU admitted patients [44%], while these patients were only 20% of all patients who were admitted to the ward. As a final point, the result illustrated that patients who were admitted to the ICU experienced more complication such as bleeding, postoperative nausea, and pain [p< 0.001]
Conclusion: Orthognathic surgery patients [maxillary impaction and setback plus mandibular advancement plus genioplasty] due to more intraoperative bleeding and postoperative nausea and pain would benefit from ICU admission after surgery