A cone beam computed tomographic analysis of cervical vertebral nonsegmentation.

OBJECTIVE: Using cone beam computed tomography (CBCT), this study aimed to investigate the radiologic features of cervical vertebral nonsegmentation (CVN) in patients with no known syndromes or pathoses. STUDY DESIGN: In this retrospective study, we examined CBCT scans of patients with CVN for the following parameters: type of nonsegmentation (partial or complete); laterality of partial nonsegmentation; level of vertebrae affected in nonsegmentation; anatomic parts of the vertebrae involved; and the presence or absence of degenerative joint disease (DJD). RESULTS: From the structured reports of 13,458 CBCT scans, we found 110 CBCT scans (0.82%) with CVN. Of this total, 77.3% were partial and 22.7% were complete. Most were located at the level of the C2 and C3 vertebrae. The transverse process alone and the transverse process and body were most frequently involved in partial CVN, whereas most complete types occurred in the transverse process and body. Degenerative joint disease was present in 45.9% of partial CVN (clearly distinguishable from nonsegmentation in 36.5%) and 20% of complete CVN, with all cases clearly distinguishable. CONCLUSIONS: Cervical vertebral nonsegmentation has a low prevalence. It is mostly partial, occurs most commonly in C2-C3, and usually involves the transverse process and body. Identification of CVN on CBCT images is important because this condition can lead to DJD in older age and may increase the risk for muscle weakness, head and neck pain, limited movement, and neurologic complications.

Survival analysis of crown margin repair: A retrospective study in a dental school setting.

BACKGROUND: Repairing crowns with defective margins is minimally invasive and cost-effective compared with replacement. The authors' objectives were to examine the survival trajectory of crown margin repairs and to determine the factors associated with survival. METHODS: Records of adult patients from January 2008 through August 2019 were reviewed for crown margin repairs completed at University of Iowa College of Dentistry. A total of 1,002 crown margin repairs were found. Each repair was followed through the end of study in 2019 or until an event (for example, additional repair, endodontic treatment, crown replacement, or extraction). A Cox proportional hazards model was used to study the relationship between selected covariates and time to event. RESULTS: During the follow-up period, 32.8% of the repairs needed reintervention. In the final model, repair material was the only significant covariate. No difference was found between the survival of repairs done with resin-modified glass ionomer and amalgam. However, the repairs done with resin-based composite and conventional glass ionomer were more likely (1.5 times: 95% CI, 1.02 to 2.10 times; and 2 times: 95% CI, 1.40 to 2.73 times, respectively) to need reintervention than were those done with amalgam. CONCLUSIONS: Median survival time of crown margin repairs was 5.1 years (95% CI, 4.48 to 5.72 years). Median survival times for amalgam, resin-modified glass ionomer, resin-based composite, and glass ionomer repair materials were 5.7 years (95% CI, 4.80 to 6.25 years), 5.3 years (95% CI, 4.73 to 6.34 years), 3.2 years (95% CI, 2.51 to 6.19 years), and 3.0 years (95% CI, 2.53 to 3.62 years), respectively. PRACTICAL IMPLICATIONS: When considering crown margin repairs, resin-modified glass ionomer or amalgam is preferable to resin-based composite or glass ionomer.

Training in radiographic caries detection and staging using an interactive tool.

INTRODUCTION: The objective of the study was to compare a dental student's practical ability to detect and stage radiographic caries per International Caries Detection and Assessment System (ICDAS), following a traditional lecture and a lecture containing an interactive session using an audience response system (ARS). Associations between the order of instructions and student performance were also evaluated. MATERIALS AND METHODS: Eighty-three dental students were randomly assigned to groups A and B. On the first day, group A received a traditional lecture and group B received content using the ARS. All students then took an electronic quiz (T1) identifying and staging caries on radiographs per ICDAS. For the second day, group A received the content using the ARS system and group B received a traditional lecture. All students subsequently took a second electronic quiz (T2). Two survey questions about the learning experience were also included. RESULTS: Wilcoxon rank-sum analysis of scores from consenting students (81) showed no difference between the quiz 1 scores of two groups (p=.61). Whilst not statistically significant (p = .07), the group that had the ARS initially scored marginally higher on quiz 2. Survey results showed that most participants preferred either the ARS alone (49.38%) or a combination of the ARS and a traditional lecture (40.74%). A majority of them (80%) found the ARS helpful. CONCLUSION: When training students in practical skills of detection and staging radiographic presence of dental caries per ICDAS, hands-on learning tools, such as an ARS, complement traditional lectures.

Obesity and its association with comorbidities and hospital charges among patients hospitalized for dental conditions.

AIM: The aim of the present study was to examine the impact of obesity on hospitalization charges and comorbid burden following hospitalization due to dental conditions. METHODS: The Nationwide Inpatient Sample for 2004-2010 was used. All hospitalizations due to dental conditions were selected. The prevalence of obesity was estimated among these hospitalizations. Multivariable linear regression models were used to examine the impact of obesity on outcomes. RESULTS: A total of 11 965 hospitalizations were attributed to dental conditions; 5.6% were related to obesity. The proportion of those who were obese increased over the study period (ranging from 3.7% in 2004 to 7.3% in 2010). The mean age of those who were obese was 45 years (compared to 38.7 years for those who were not obese). Close to 41% of those who were obese were males (compared to 51% who were not obese). Whites comprised 62.4% of those who were obese (compared to 59.2% of those who were not obese). Those who were obese had a higher comorbid burden compared to those who were not obese (83.5% of those who were obese had at least one comorbid condition, whereas 56.4% of those who were not obese had at least one comorbid condition). Those who were obese had higher hospitalization charges ($US2225 more, P = 0.0001). CONCLUSIONS: Obesity is associated with high comorbid burden and hospital charges among patients hospitalized due to dental conditions.

Prevalence of the posterior superior alveolar canal in cone beam computed tomography scans.

OBJECTIVE: This study was primarily aimed at determining the prevalence of the posterior superior alveolar (PSA) canal in cone beam computerized tomography (CBCT) scans in a North American population. MATERIALS AND METHODS: Cone beam computed tomography scans were selected on the basis of predetermined eligibility criteria from a pool of 976 data sets. Two calibrated examiners assessed the presence of PSA canal on the postero-lateral wall of the maxillary sinus using coronal sections. One examiner also recorded the presence of images compatible with sinus disease. Associations between the presence of PSA canal and sinus disease were investigated for males and females separately using statistical methods. RESULTS: A total of 254 CBCT scans were selected. The pooled prevalence of the PSA canal in CBCT scans was 94.4% and 91% on the right and left side, respectively. The ability to detect the presence of the canal was not significantly affected by the presence of intrasinusal disease. Males are more likely than females to present signs of maxillary sinus pathoses on the right (63.3% vs. 36.7%) and the left side (59.2% vs. 40.8%). CONCLUSIONS: The prevalence of the PSA canal on CBCT images in the selected population is high. The PSA canal can be consistently visualized on CBCT scans with a high level of reproducibility regardless of the presence of radiographic signs of intrasinusal pathoses.