ABSTRACT
Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion: The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.
ABSTRACT
OBJECTIVES: The objective of this study was to evaluate, compare and validate different protocols of inferior alveolar canal tracing. METHODS: 60 DICOM files with a total of 80 inferior alveolar canals were retrieved and imported to a third-party software where all proposed protocols can be performed. Initially, inferior alveolar canal was traced by two oral and maxillofacial radiologists together on cone beam CT cross-sectional images and considered as the baseline for future comparisons. Oral and maxillofacial surgeon performed the proposed different protocols. The protocols were color-coded differently by the surgeon before being compared with the baseline canal by the radiologists through a 5-point scale. RESULTS: Results showed that no single protocol was successful in all cases, even the cross-sectional protocol. According to the present study, the hybrid protocol was the most accurate while the automatic protocol was the least accurate. CONCLUSIONS: The hybrid protocol was reliable and showed the highest number of successful applications followed by the commonly used cross-sectional protocol. Dental practitioners should be aware of the application of multiple protocols and their pros and cons as no single protocol was successful in all the cases. Applying the same protocols on a larger sample size using different cone beam CT and multislice CT machines with different exposure parameters is recommended.
Subject(s)
Spiral Cone-Beam Computed Tomography , Cone-Beam Computed Tomography , Dentists , Humans , Mandible , Mandibular Canal , Professional RoleABSTRACT
OBJECTIVES: to systemically integrate the available data on various published treatment strategies for intraosseous hemangioma of the zygoma in an updated comprehensive systematic review, and to present a new case of treated resection and immediate reconstruction using computer guided patient specific composite graft. CASE PRESENTATION: A 29 years old female patient with intraosseos zygomatic hemangioma treated using computer guided resection and immediate reconstruction. The resection was performed using a resection template constructed based on preoperative 3D planning. The reconstruction was performed using ramus bone graft and titanium mesh. The patient was followed up for 3 years with no complications. METHODS: An electronic search was performed on 3 data bases; additional hand search of bibliographies of selected articles was performed. Eligibility criteria include human studies presenting intraosseous zygomatico-orbital hemangioma with clearly reported therapeutic strategies. RESULTS: 53 articles with 73 cases were included. The lesion was highly prevalent in females compared to males (2.28:1). Fifth decade represents the highest prevalence with mean age of 44.1⯱â¯1.8 years. The main patient concern was swelling and facial deformity. Total tumor resection can assure no recurrence, while partial resection and curettage are associated with high recurrence rate.
ABSTRACT
In this prospective, cohort, clinical follow-up study we aimed to investigate the role of conservative gap arthroplasty without interpositional material in managing ankylosis of the temporomandibular joint (TMJ). Thirteen patients (15 joints) with ankylosis who fulfilled the other inclusion criteria were enrolled. The ankylotic mass was excised to create a gap of 7-9mm. No interpositional material was used. Ipsilateral or bilateral masseter reflection, pterygomasseteric sling, and temporalis tendon release plus coronoidectomy were considered if maximum mouth opening failed to reach 35mm. A physiotherapy protocol was started on the first day. Patients' ages ranged from 13-38 (mean (SD) 18 (7) years). Trauma was the main cause. Duration of ankylosis at presentation ranged from 1-17 years (mean (SD) 5 (4) years). Eleven patients had unilateral, and two bilateral, ankylosis that did not involve the sigmoid notch. The mean (SD) maximum incisal opening (mm) was 38 (4) two years' postoperatively. The facial nerve was affected temporarily in two patients. Mean (SD) duration of follow-up was 4 (2) years without recurrence. Within our selection criteria, conservative gap arthroplasty of 7-9mm without interpositional material and with vigorous postoperative physiotherapy has a role in treating ankylosis of the TMJ and preventing its recurrence for more than four years.
