Assessment of Gingival Thickness Using CBCT Compared to Transgingival Probing and Its Correlation with Labial Bone Defects: A Cross-Sectional Study.

PURPOSE: The aims of this study were to determine the accuracy and repeatability of CBCT for assessing gingival thickness (GT) as compared to transgingival probing and to investigate the correlation between GT and labial bone defects. MATERIALS AND METHODS: This cross-sectional study comprised 37 patients who underwent CBCT imaging. A total of 111 sites were examined, and measurements were obtained from the same points on selected index teeth. The GT was measured, and the presence of dehiscence and fenestration defects was evaluated on the CBCT scans. Transgingival probing was performed at the same points as those used on the scans. Intraexaminer reliability for clinical and radiographic measurements and interexaminer reliability for radiographic measurements were tested. Agreement between the measurement methods and the correlations between GT and labial bone defects were assessed using intraclass correlation coefficient (ICC) and chi-square test, respectively. RESULTS: The agreement between both measurement methods was excellent and statistically significant (ICC = 0.888; P < .001), with a bias of 0.04 (95% CI: 0.01 to 0.08). Significant differences in the occurrence of fenestration (P = .023) and dehiscence defects (P < .001) between the thin and thick gingival phenotypes were observed, and the defects were positively correlated with the thin gingival phenotype. CONCLUSION: CBCT demonstrated high diagnostic accuracy for GT measurements, with minimal discrepancies from the transgingival method. The presence of dehiscence and fenestration defects was positively correlated with thin gingival phenotype.

Bone regeneration and graft material resorption in extraction sockets grafted with bioactive silica-calcium phosphate composite (SCPC) versus non-grafted sockets: clinical, radiographic, and histological findings.

PURPOSE: The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets. METHODS: Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively. RESULTS: A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density. CONCLUSIONS: The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03897010.

Osteoma Cutis and Tonsillolith: A Cone Beam Computed Tomography Study.

In this study, we report a rare case of osteoma cutis (OC) and tonsillolith, diagnosed using cone beam computed tomography. The dystrophic calcifications in the face and tonsils were incidentally found during examination of the patient's scan with no relation to the main chief complaint. The diagnosis was OC, combined with dystrophic calcification of the tonsils. It is important to mention that OC is a rare soft-tissue ossification of cutaneous tissue, typically on the face and clinically asymptomatic. It may be primary but the majority of cases are secondary. Incidental finding of OC and tonsilloliths on a two-dimensional dental radiograph does not provide sufficient information concerning the location of these calcifications. Thus, cone beam computed tomography (CBCT) provides critical information for the diagnosis of asymptomatic OC lesions not available through any other means of clinical detection.

An Immature Ten-year Long-standing Case of Ossifying Fibroma.

Ossifying fibroma is a rare benign bone neoplasm common in middle age, with definite female predominance. Here, we describe a case of an ossifying fibroma in a 36-year-old female, with a right facial deformity. The lesion had been present for almost 10 years. The panoramic image showed a multilocular appearance with scattered radiopacities. Advanced imaging revealed an expansile multilocular lesion with multiple small radiopaque foci and a few dense radiopaque masses. A histopathological examination confirmed the diagnosis. The case represents a non-aggressive form of an immature ossifying fibroma.

Radiographic Diagnosis of a Central Giant Cell Granuloma Using Advanced Imaging: Cone Beam Computed Tomography.

Central giant cell granuloma (CGCG) is a benign non-neoplastic, proliferative intraosseous lesion of the jaw with an unknown etiology often diagnosed during the first two decades of life. The true nature of this lesion is controversial and remains elusive. Here, we report a case of central giant cell granuloma, diagnosed using cone-beam computed tomography (CBCT). A 21-year-old female presented to the clinic complaining of a painless swelling involving the right side of the mandible that had started one year previously. A CBCT scan revealed a well-defined, multilocular radiolucent lesion on the right side of the mandible extending from the molar region to the ramus with wispy septations. Wispy septations and undulating borders are some of the characteristic radiographic features of a central giant cell granuloma. The patient underwent an excisional biopsy. The biopsy revealed multinucleated giant cells in a fibrous stroma confirming our radiographic diagnosis of a central giant cell lesion.