Research progress on the clinical diagnosis of secondary vertical root fractures / 口腔疾病防治

@#Vertical root fracture is a type of longitudinal crack originating from the roots of teeth that can occur in vital teeth and teeth after root canal treatment. It is a hard tissue disease of teeth with a complex etiology and poor prognosis. The vertical root fracture that occurs in teeth after pulp treatment is called secondary vertical root fracture (SVRF). A comprehensive judgment should be made based on clinical signs such as pain, swelling, tooth looseness, sinus located near the gum edge, and deep and narrow isolated periodontal pockets, as well as apical films such as periodontal membrane widening, vertical and root bone loss, and “halo” or “J” shaped transmission shadows around the root. For teeth suspected of longitudinal root fractures, three-dimensional imaging such as cone beam computed tomography (CBCT) should be used to assist in the diagnosis. If CBCT shows a defect in the buccal or lingual bone plate, it can increase the possibility of diagnosing SVRF. The setting of CBCT parameters should be optimized by using small field CBCT, enhancing dye-assisted applications, and metal artifact reduction (MAR) tools to reduce the impact of artifacts and improve the accuracy of CBCT diagnosis of SVRF. Magnetic resonance imaging (MRI), digital subtraction radiography (DSR), optical coherence tomography (OCT), and other imaging techniques can detect cracks of different widths, and artificial intelligence (AI) diagnostic technology and predictive models provide further auxiliary means for SVRF diagnosis. SVRF cannot be determined through noninvasive methods, and the final diagnostic method is to detect the presence of SVRF through direct observation within the root canal and during flap surgery.

Retrospective study on marginal bone loss around maxillary anterior implants with or without bone graft / 대한치과보철학회지

PURPOSE: This study is to evaluate the clinical significance of implantation with simultaneous bone graft by comparing the marginal bone loss around maxillary anterior implants with or without bone graft MATERIALS AND METHODS: Patients treated with implant-retained restorations on maxillary anterior region at Implant Center, Dental Hospital, Wonkwang University between June 2011 and May 2014 were included in this study. Date of implant placement, implant diameter, implant length, implant-abutment connection type and whether the bone graft was done were investigated. The patient's periapical radiographs taken immediately after implantation and at the most recent visit were compared. Marginal bone loss was measured using Emago advanced v5.6 program (Oral diagnostic systems, Amsterdam, Netherlands). Statistical analysis was done in independent t-test by using SPSS 22.0 program. RESULTS: As a result of observing on 83 implants (without bone graft: 44, with bone graft: 39) of 52 patients for 6 - 45 months (average: 18.4 months), implants without bone graft showed 1.42 ± 0.42 mm, implants with bone graft showed 1.28 ± 0.45 mm of marginal bone loss. CONCLUSION: In limitations of this study, implants with simultaneous bone graft had significantly less marginal bone loss than implants without bone graft.

Proximal caries detection using digital subtraction radiography in the artificial caries activity model / 대한구강악안면방사선학회지

PURPOSE: The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. MATERIALS AND METHODS: Digital radiographies of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size #2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. RESULTS: In artificial caries activity model, the range of lesional depth was 572-1,374 micrometer and the range of lesional area was 36.95-138.52mm2. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. CONCLUSION: The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

Factors affecting root curvature of mandibular first molar / 대한구강악안면방사선학회지

PURPOSE: To find the cause of root curvature by use of panoramic and lateral cephalometric radiograph. MATERIALS AND METHODS: Twenty six 1st graders whose mandibular 1st molars just emerged into the mouth were selected. Panoramic and lateral cephalometric radiograph were taken at grade 1 and 6, longitudinally. In cephalometric radio graph, mandibular plane angle, ramus-occlusal plane angle, gonial angle, and gonion-gnathion distance (Go-Gn distance) were measured. In panoramic radio graph, elongated root length and root angle were measured by means of digital subtraction radiography. Occlusal plane-tooth axis angle was measured, too. Pearson correlations were used to evaluate the relationships between root curvature and elongated length and longitudinal variations of all variables. Multiple regression equation using related variables was computed. RESULTS: The Pearson correlation coefficient between curved angle and longitudinal variations of occlusal planetooth axis angle and ramus-occlusal plane angle was 0.350 and 0.401, respectively (p<0.05). There was no significant correlation between elongated root length and longitudinal variations of all variables. The resulting regression equation was Y=10.209+0.208X1+0.745X2 (Y: root angle, X1: variation of occlusal plane-tooth axis angle, X2: variation of ramus-occlusal plane angle). CONCLUSION: It was suspected that the reasons of root curvature were change of tooth axis caused by contact with 2nd deciduous tooth and amount of mesial and superior movement related to change of occlusal plane.

Clinical analysis of 10 cases of moyamoya disease / 中国基层医药

Objective To investigate clinical features,neuroradiological diagnosis and therapy of moyamoya. Methods 10 cases of moyamoya's clinical features,neuroradiological diagnosis and therapy were analysed retrospec- tively.Results In this group,there were more adults(7 cases) than children patients(3 cases);children patients pre- sented predominantly brain ischemia symptoms;stenosis or occlusion at the terminus of the siphon portions of internal carotid arteries(ICA) and proximal portions of anterior or middle cerebral arteries(ACA or MCA),and abnormal vascular networks at the base of brain were noted by the magnetic resonance angiography(MRA) and digital subtrac- tion radiography(DSA).Conclusion Children patients of moyamoya diseases presents predominantly brain isehemia s yjnptoms.MRA or DSA of brain investigation is the main way to diagnose moyamoya disease in the early age.Early diagnosis and promptly medical intervention are effective ways to improve prognosis of moyamoya disease.

The quantitative analysis by digital subtraction radiography on the effect of Enamel Matrix Protein and Platelet-Rich Plasma, combined with Xenograft in the treatment of intrabony defect in humans / 대한치주과학회지

Various biological approaches to the promotion of periodontal regeneration have been used. These can be divided into the use of growth and differentiation factors, application of extracellular matrix proteins and attachment factors and use of mediators of bone metabolism. The purpose of this study was to evaluate the effect of enamel matrix protein and platelet-rich plasma on the treatment of intrabony defect, with bovine-derived bone powder in humans by digital subtraction radiography. 12 teeth(experimental I group) were treated with enamel matrix protein combined with bovine-derived bone powder and 12 teeth(experimental II group) were treated with platelet-rich plasma combined with bovine-derived bone powder. The change of bone density was assessed by digital subtraction radiography in this study. The change of mineral content was assessed in the method that two radiographs were put into computer program to be overlapped and the previous image was subtracted by the later one. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-whitney Test using SPSS program for windows(5% significance level). The results were as follows: 1. The radiolucency in 3 months after surgery was significantly increased than 1 month after surgery in both groups(experimental I and II groups)(p<0.05). 2. The radiopacity in 6 months after surgery was significantly increased than 3 months after surgery in both groups(experimental I and II groups)(p<0.05). 3. In experimental I group, there was no significant difference between 1 month and 6 months after surgery. 4. In experimental II group, the radiopacity in 6 months after surgery was significantly increased than 1 month after surgery(p<0.05). 5. There was no significant difference between experimental I and II group at 1 month and 3 months after surgery, but the radiopacity in experimental II group was significantly increased at 6 months after surgery(p<0.05). In conclusion, platelet-rich plasma can enhance bone density than enamel matrix protein until 6 months after surgery.

O efeito da ciclosporina-A na osseointegração / The influence of cyclosporin-A on osseointegration

Agentes imunossupressores provocam alterações severas no metabolismo ósseo mineral podendo resultar em osteopenia. Tais alterações podem ser prejudiciais no processo e manutenção da osseointegração. Este estudo teve o objetivo de avaliar a influência da administração de ciclosporina-A (CSA) na osseointegração de implantes de titânio, através da avaliação: durante a cicatrização óssea ao redor de implantes dentais (Estudo I); da densidade óssea ao redor implantes dentais (Estudo II); da retenção do implante após a cicatrização óssea de implantes dentais (Estudo III) e radiográfica daa qualidade óssea ao redor de implantes dentais já osseointegrados (Estudo IV). Os resultados peermitiram concluir que a administração de CSA durante a cicatrização óssea resulta em diminuição da osseointegração e da densidade óssea ao redor do implante dental. Ainda, a administraçao de CSA após o período de cicatrização óssea ao redor do implante reduz a sua retenção mecânica ao tecido ósseo e promove a diminuição da qualidade e da densidade óssea radiográfica ao redor do implante dental

Immunosupressive agents may induce severe changes on bone mineral metabolism resulting in osteopenia. These alterations may impair the osseointegration processes. The purposes of this study were evaluate the cyclosporin-A (CSA) influence: on bone healing around dental implants (Study I); on bone density around dental implants (Study II); on mechanical retention of dental implants integrated to the bone (Study III) and on radiographic bone density and quality around dental implants integrated to the bone (Study IV). The CSA administration may impair the osseointegration and bone density during the bone healing. Besides, the administration of CSA after bone healing may impair the dental implant mechanical retention and decrease the radiographic bone density and bone quality around dental implants integrated to the bone

Discussion on direct digital dual energy subtraction radiography and clinical application value / 医疗卫生装备

Objective To introduce direct digital dual energy subtraction radiography and explore it's clinical application.Methods The cases acquired separately by direct digital conventional radiography and direct digital dual energy subtraction radiography were compared.Results The detection rate,sensitivity and accuracy of calcifications in lungs,pulmonary nodules,stones in urinary system,calcifications of coronary artery and cardiovalvular were improved by using direct digital dual energy subtraction radiography.Conclusion Direct digital dual energy subtraction radiography is more valuable in clinical applications.

Surgical Correction of Submucous Cleft Palate with Furlow's Palatoplasty

Furlow's palatoplasty has been used as the primary treatment for cleft palate. From 1991 to 1999, 24 submucous cleft palate patients underwent Furlow's palatoplasty. The follow-up period was 3 months to 8 years (mean 24 months). Patients were selected after a thorough study for velopharyngeal insufficiency including intraoral examinatioin, speech assessment, digital subtraction radiography (DSR). Postoperatively velopharyngeal function was reevaluated with speech assessment and digital subtraction radiography in the 7 cooperative patients. Speech parameters including hypernasality, nasal emission, and Allison scale were improved after surgery. Digital subtraction radiography provided the value of velopharyngeal gap and the degree of the motion of lateral pharyngeal wall, both of which were improved after surgery. Furlows palatoplasty has advantage such as no impairment of nasopharyngeal physiology, no hannful effect on the hard palate and the realignment of the levator muscle which plays important role on the movement of the soft palate. The results show that a Furlow's palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected submucous cleft palate patients.