ABSTRACT
Objective:To investigate the application effect of cone-beam computed tomography (CT) positioning combined with nasal bottom approach turbo contra-angle handpiece bone removal method in maxillary mid-high impacted supernumerary teeth.Methods:A total of 78 patients with supernumerary teeth in the middle and high position of the maxilla who were admitted to Anhui Children′s Hospital from January 2020 to January 2022 were selected and divided into the observation group and the control group according to the random number table method. The patients in both groups underwent cone-beam CT localization examination. The control group used the palatal approach or the labial approach to remove the bone with the turbo contra-angle handpiece (depending on whether the supernumerary teeth were located in the palatal or labial side adjacent to the incisor as a whole), and the observation group used the nasal approach to remove the bone with the turbo contra-angle handpiece. The operation time, intraoperative blood loss, postoperative Visual Analogue Scale (VAS), occlusal force, masticatory efficiency and complications were compared between the two groups.Results:The operation time in the observation group [palatal side (21.57±3.31)min; labial side (22.82±3.53)min] was shorter than that in the control group [palatal side (36.44±6.39)min; labial side (39.25±6.78)min] ( P<0.05), and the intraoperative blood loss [palatal (14.37±2.42)ml; labial (15.64±2.67)ml] was less than that in the control group [palatal side (19.56±3.18)ml; labial side (21.89±3.55)ml] ( P<0.05). The postoperative VAS score of the observation group [palatal (2.87±0.42)points; labial (3.14±0.49)points] was lower than that of the control group [palatal side (4.75±0.67)points; labial side (5.06±0.83)points] (all P<0.05). After operation, the occlusal force and masticatory efficiency in the two groups were higher than those before the operation (all P<0.05), and the occlusal force [palatal (148.49±22.35)Ibs; labial (144.92±21.68)Ibs] and masticatory efficiency [palatal side (92.66±16.22)%; labial side (90.83±15.94)%] of the observation group were higher than those of the control group [occlusal force: palatal (121.27±19.81)Ibs, labial (118.74±18.85)Ibs; masticatory efficiency: palatal (83.47±13.76)%, labial (79.79±13.02)%] ( P<0.05). There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Cone-beam CT localization combined with turbo contra-angle handpiece osteotomy via nasal floor approach can shorten the operation time, reduce the amount of blood loss and postoperative pain, improve the comfort, and be safe and reliable for patients with maxillary mid-high impacted supernumerary teeth.
ABSTRACT
Objective:To study the value and advantage of color Doppler and cervical multi-slice spiral CT (MSCT) in the diagnosis of cervical lymphadenopathy.Methods:A total of 130 patients with cervical lymphadenopathy diagnosed and treated in the Chenzhou First People′s Hospital from January 2019 to December 2020 were selected and received color Doppler ultrasound examination and MSCT examination. The results of pathological examination were used as the gold standard to compare the efficacy of the two methods in the differential diagnosis of benign and malignant cervical lymphadenopathy.Results:Ultrasound examination of malignant lymph nodes showed irregular boundaries, uneven internal hypoecho, and abundant blood flow signals in lymph nodes; ultrasound examination of benign lymph nodes showed uniform fine dot echo, uniform growth of endothelial medulla, clear and smooth boundary, no blood flow signal or scattered dot blood flow signal. The MSCT images of malignant lymph node showed irregular shape, blurred edge, obvious and uneven enhancement and higher rate of calcification. The aspect ratio of lymph nodes in benign lymph node was significantly higher than that in malignant lymph node (2.14 ± 0.48 vs. 1.92 ± 0.43), and the maximum blood flow velocity (V max), resistance index (RI) and blood flow (BF) in systolic period were significantly lower than those in lymph node [(21.38 ± 3.61) cm/s vs. (23.17 ± 2.55) cm/s, 0.62 ± 0.14 vs. 0.71 ± 0.17, (48.82 ± 13.51) ml/(min·100 g) vs. (65.61 ± 14.64) ml/(min·100 g)], there were statistical differences ( P<0.05). The most common blood flow types was lymphatic hilum type in benign lymph node, the proportion was 51.79% (29/56), while the most common type in malignant lymph node was marginal type and central type, the proportion was 44.59% (33/74) and 25.68% (19/74). The sensitivity, specificity, accuracy and Kappa value of ultrasound combined with MSCT in diagnosis were 92.86%, 95.95%, 94.62% and 0.890. Conclusions:Both color Doppler ultrasonography and MSCT can differentiate the benign and malignant of cervical lymph node lesions with better parameters such as lymph node imaging characteristics and blood flow distribution pattern, but the combined diagnosis has higher sensitivity, specificity and accuracy.
ABSTRACT
Objective: To detect the vascular paths in the lateral wall of maxillary sinus using cone beam computer tomography (CBCT), and to retrospect the surgical managements of avoiding bleeding complication during the lateral approach maxillary sinus elevation.Methods: The documents of 71 consecutive patients with 81 sides maxillary sinus elevation surgery were collected.The vascular paths in the lateral wall of maxillary sinus were detected by the preoperative CBCT, and the messages about the vascular in surgical records were analyzed.Results: The paths of the vascular could be detected in 77 (95.1%) sides maxillary sinus in the reconstruction panoramic images of CBCT.At the position of the first molar, the paths of the vascular of the lateral maxillary sinus walls could be detected in 54 sides (66.7%) in the reconstruction coronal images of CBCT, and the other 27 sides (33.3%) could not be detected.Two approximately parallel paths of the vascular were found in 3 sides (3.7%) of the lateral maxillary sinus walls.The different diagnoses occurred in 6 sinuses between two observers.The kappa of diagnostic consistency of the two observers was 0.842 (P<0.001).The mean distance between the lower border of the vascular path to the plane of the alveolar crest of 54 sides maxillary sinuses was about (13.0±4.7) mm.The mean distance between lower border of vascular path to the plane of the floor of the sinus was (9.3±4.8) mm.The vascular path was located in the floor wall in 1 sinus.During the lateral approach maxillary sinus elevation operation, intraosseous vessels were dissected in 4 sides sinus lateral wall, the vascular path was avoided consciously in 3 sides, and the sinus elevation surgery had to be given up in 1 side for the vessel was torn and bleeding.There were no vascular related messages in 73 sides of the lateral approach maxillary sinus elevation operation records.Conclusion: The vascular paths of maxillary sinus wall could be detected by CBCT in most cases.Preoperative CBCT examination was proved to be reliable.The vascular paths of maxillary sinus wall should be examined carefully.It was helpful to make the surgical design perfectible and reduce the risk of tearing the vessel in operation.
ABSTRACT
Objective To explore the diagnostic value of dynamic multi-detector computer tomography (MDCT) with volume helical shuttle (VHS) technique in children with congenital heart disease (CHD) combined with tracheomalacia. Methods We retrospectively analyzed the imaging and clinical data of 26 patients (16 males, 10 females) with CHD who underwent both MDCT with VHS technique and fiber bronchoscope between Oct 2014 and Aug. 2016. According to the results of fiber bronchoscope, the patients were divided into tracheomalacia (n = 7) and nontracheomalacia (n=19) groups. The intracardiac structures and the anatomy of the great arteries were demonstrated by maximum intensity projection (MIP) and volume render (VR) reconstruction. The patterns of the tracheobronchial tree were demonstrated using minimum intensity projection (MinIP) reconstruction. The Mimics 17. 0 software was employed to automatically segment the CT images of different respiratory phases of each patient and to measure the cross sectional area of the airway. According to the golden-standard of fiber bronchoscopic findings and operative results, we calculated the diagnostic accuracy of VHS for CHD and the sensitivity, specificity and accuracy for tracheomalacia Results Compared with nontracheomalacia group, the patients in tracheomalacia group showed significantly greater cross-sectional area change of the trachea (34.23%-74. 95% vs 13. 73%-78. 87%, P= 0. 02). The diagnostic sensitivity, specificity and accuracy of VHS technique for tracheomalacia were 85.71%(6/7), 84. 21%(16/19) and 84. 62%(22/26), respectively. VHS showed accuracies of 100%(12/12) and 91. 67%(11/12) in diagnosing extracardiac and intracardiac defects, respectively. Conclusion Dynamic MDCT with VHS technique can provide a one-step diagnosis of tracheomalacia with CHI) in children.
ABSTRACT
Objective To evaluate the diagnosis accuracy for coronary stenosis from diameter measurements of differ?ent severities of stenosis by using gemstone spectral imaging (GSI). Methods Totally 3 different coronary artery models(in?ternal diameter:3.00 mm) that with different severities of stenosis (residual lumen diameter ratio:75%, 50%and 25%) were placed in a pulsating cardiac phantom (ALPHA 1-VT PC, Fuyo Corporation, Japan). The coronary phantom was scanned in two models:gemstone spectral imaging (GSI) and axial scan model(AXIAL). All the spectral imaging data were analyzed by using GSI viewer to reconstruct the VMS images (40-140 keV by 10 keV interval) and AXIAL. CT values (HU) of the re?mained lumen from all different stenosis lumens were measured. The residual rate (%) was calculated by dividing the diame?ters of the remained lumen to normal lumen on the reformatted short axial images. One-way ANOVA was used to compare the measurement difference of residual rates between VMS images. Student t-test was used to compare the measurement dif?ference of residual rate between VMS and AXIAL. Bland-Altman test was used to compare the measured residual rates and the gold standard. Results There were no significant differences in measured residual rate betweeb VMS images (P>0.05). From student t-test, only significant difference was found on 50%stenosis between 70 keV VMS and AXIAL(t=4.617,P<0.042). From the Bland-Altman test, measurement of residual rate was more accurate from 70 keV VMS than that of AXIAL by taking the stenosis rate of real model as gold standard(t=14.560,P<0.001). Conclusion VMS image (70 keV) shows more accurate rate than AXIAL images on both diameter measurement and evaluation of the coronary stenosis.
ABSTRACT
Nodular fasciitis (NF) is a benign tumor-like fibroblastic proliferation, and there have only been few reports about NF involving the parotid gland. Here, we report our experience of three cases of NF in the parotid gland, as well as our evaluation of the diagnostic tools for NF in the parotid gland, such as fine-needle aspiration cytology (FNAC), CT, and clinicopathologic investigations. In the three cases observed, all had growing masses in the parotid gland, and the lesions showed heterogeneous or peripheral rim enhancement on the contrast-enhanced CT, which could have been misdiagnosed as parotid malignancy. On FNAC, the cells had an elongated spindle shape and contained variable amounts of stromal matrix, which could have caused misinterpreted as pleomorphic adenoma. We observed dense cellularity and varying amounts of collagenous stroma, and immunohistochemical staining revealed positive reactivity to CD10, CD34, and smooth muscle actin. NF should be considered in the differential diagnosis of benign and malignant parotid tumors.
Subject(s)
Actins , Adenoma, Pleomorphic , Biopsy, Fine-Needle , Collagen , Diagnosis, Differential , Fasciitis , Fibroblasts , Muscle, Smooth , Parotid Gland , Parotid Neoplasms , Pathology , Spiral Cone-Beam Computed Tomography , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the accuracy and reliability of cone-beam computed tomography (CBCT) in the diagnosis of periodontal bone defects in the elderly.Methods The 38 teeth of 27 cases were collected and scanned both with CBCT technology and periapical radiography (PA).Periodontal bony defects were identified and linear measurements were made for all defects.All cases were treated with periodontal flap surgery with the bony defects and their linear measurements detected during operation as the gold standard.Results All periodontal bony defects were identified with CBCT with its accuracy rate of 100.0％ (72/72),but the buccal and lingual defects could not be measured by PA with its accuracy rate of 62.5％ (45/72).Linear measurements for all defects revealed no statistical differences between CBCT and direct measurement [(5.516 ± 0.393) mm vs.(5.385± 0.415) mm,t=1.948,P＞0.05],but there was a significant difference in linear measurement between PA and direct measurement [(6.311±0.439) mm vs.(5.411±0.418) mm,t=9.956,P＜0.05].Conclusions CBCT can offer the diagnostic information for periodontal bone defect from three dimensional direction in the elderly,provide objective and accurate assessment of alveolar bone resorption,and has higher accuracy and reliability.
ABSTRACT
Este estudo avaliou quantitativamente altura e espessura óssea alveolar nos incisivos centrais e laterais inferiores e reabsorção radicular apical em todas as raízes, após uso do aparelho Herbst. Amostra composta por 23 indivíduos brasileiros (11 gênero masculino e 12 gênero feminino), média de idade 15,76 ± 1,75, má oclusão Classe II divisão 1, tratados com Herbst. Tomografias computadorizadas de feixe cônico (TCFC) foram realizadas antes e após o tratamento com Herbst. A altura e a espessura óssea alveolar dos incisivos inferiores foram avaliadas. As espessuras ósseas vestibular (V), lingual (L) e total (T) foram mensuradas nos terços cervical (1), médio (2) e apical (3) dos incisivos inferiores. A reabsorção radicular apical foi determinada pelo método da navegação axial guiada nas imagens de TCFC. O Teste t de Student e o Teste T de Wilcoxon compararam as amostras dependentes nos casos paramétricos e não paramétricos, respectivamente. Os resultados foram considerados para um nível de significância de 5%. Os incisivos inferiores não apresentaram diferença estatística significante para a altura óssea alveolar. A espessura óssea alveolar dos incisivos inferiores reduziu significativamente após o tratamento em V1, V2, V3, T1 e aumentou em L2. A reabsorção radicular apical foi detectada pela TCFC em 57,96% das 980 raízes avaliadas. A TCFC, por permitir a avaliação tridimensional das raízes dentárias, demonstrou que o aparelho Herbst induz reabsorção radicular apical suave, principalmente nos dentes de ancoragem, e o deslocamento dentário induzido por esse aparelho causa redução da espessura óssea alveolar vestibular nos incisivos inferiores.
This study evaluated quantitatively, alveolar bone height and thickness in the central and lateral lower incisors and apical root resorption in all roots after using Herbst appliance. The sample comprised 23 patients (11 men, 12 women), mean ages 15.76 ± 1.75 years, presenting class II division 1, treated with Herbst appliance. Cone-beam computed tomography (CBCT) images were obtained before and after Herbst treatment. The vertical alveolar bone level and the alveolar bone thickness of lower incisors were assessed. Vestibular (V), lingual (L) and total (T) bone thicknesses were assessed at the crestal (1), midroot (2) and apical (3) levels of the lower incisors. The apical root resorption was determined using axial guided navigation of CBCT images. The Student's t-Test and Wilcoxon t-Test were used to compare dependent samples in parametric and non-parametric cases, respectively. The results were considered at a significance level of 5%. The lower incisors showed no statistical significance for the vertical alveolar bone level. The alveolar bone thickness of lower incisors significantly reduced after the treatment at V1, V2, V3, T1 and significantly increased at L2. Apical root resorption was detected by CBCT in 57.96% of 980 roots that underwent treatment. The CBCT, for allowing three-dimensional evaluation of dental roots, showed that Herbst appliance induces mild apical root resorption, mostly in the anchoring teeth, and the tooth movement induced by this appliance causes alveolar bone reduction on the vestibular side of lower incisors
Subject(s)
Humans , Male , Female , Root Resorption , Orthodontic Appliances, Functional , Incisor , Malocclusion, Angle Class II , Mandibular Advancement , Periodontium , Spiral Cone-Beam Computed Tomography , Statistics, NonparametricABSTRACT
INTRODUÇÃO: a espessura das tábuas ósseas que recobrem os dentes por vestibular e lingual constitui um dos fatores limitantes da movimentação dentária. O avanço tecnológico em Imaginologia permitiu avaliar detalhadamente essas regiões anatômicas por meio da utilização da tomografia computadorizada de feixe cônico (TCFC). OBJETIVO: descrever e padronizar, pormenorizadamente, um método para mensuração das tábuas ósseas vestibular e lingual dos maxilares nas imagens de tomografia computadorizada de feixe cônico. METODOLOGIA: a padronização digital da posição da imagem da face deve constituir o primeiro passo antes da seleção dos cortes de TCFC. Dois cortes axiais de cada maxilar foram empregados para a mensuração da espessura do osso alveolar vestibular e lingual. Utilizou-se como referência a junção cemento-esmalte dos primeiros molares permanentes, tanto na arcada superior quanto na inferior. RESULTADOS: cortes axiais paralelos ao plano palatino foram indicados para avaliação quantitativa do osso alveolar na maxila. Na arcada inferior, os cortes axiais devem ser paralelos ao plano oclusal funcional. CONCLUSÃO: o método descrito apresenta reprodutibilidade para utilização em pesquisas, assim como para a avaliação clínica das repercussões periodontais da movimentação dentária, ao permitir a comparação de imagens pré e pós-tratamento.
INTRODUCTION: The thickness of the buccal and lingual bone plates constitutes one of the limiting factors of the orthodontic movement. The imaging technology has permitted the evaluation of this anatomical region, by means of cone beam computed tomography. PURPOSE: To describe and standardize, in details, a method for measuring the buccal and lingual bone plate thickness in CBCT images. METHODOLOGY: Digital standardization of face image should constitute the first step before the selection of CBCT slices. Two axial sections of each jaw were used for measuring the thickness of buccal and lingual bone plates. The cemento-enamel junction of the first permanent molars was used as a reference, both in the upper and lower arches. RESULTS: Axial sections parallel to the palatine plane were recommended for quantitative evaluation of the alveolar bone plate in the maxilla. In the mandibular arch, the axial sections should be parallel to the functional occlusal plane. CONCLUSION: The method described shows reproducibility for evaluating the periodontal effects of tooth movement for clinical or researching purposes, permitting the comparison between pre and post-treatment images.