Cone-beam computed tomography vs conventional radiography in visualization of maxillary impacted-canine localization: A systematic review of comparative studies.

INTRODUCTION: We systematically reviewed observational, experimental, and diagnostic accuracy studies to assess the comparisons between cone-beam computed tomography (CBCT) and conventional radiography (CR) in the localization of maxillary impacted canines. METHODS: An open-ended electronic search of PubMed, Web of Science, ProQuest, and other databases for both published and unpublished articles up to May 2016 was performed. The reference lists of the included studies were screened. Two authors performed the searches with no language restrictions. The research questions were outlined based on a hierarchical model. The primary outcomes were diagnostic accuracy, level of intermodalities agreement, effect of these images on treatment planning and treatment outcomes, and societal efficacy between the CBCT and CR in the localization of impacted canines. Two reviewers evaluated the risk of bias assessment by using the Quality Assessment of Diagnostic Accuracy Studies tool and the Newcastle Ottawa Scale. RESULTS: Eight studies met the inclusion criteria. Two studies reported diagnostic accuracy, 6 reported intermodalities agreement in impacted canine localization, and 3 reported treatment planning agreement between the modalities. No therapeutic and societal efficacy study found. The accuracy of CBCT ranged from 50% to 95%, and the accuracy of CR ranged from 39% to 85%. A wide range of kappa intermodalities agreement from 0.20 to 0.82, with observed agreement of 64% to 84%, was reported in canine localization. Broad kappa treatment planning agreement values from 0.36 to 0.72 were reported. Most studies suffered from a high risk of bias in subject selection. CONCLUSIONS: The fair to moderate intermodalities agreement in maxillary canine localization might mean that the information obtained through these modalities is deviant and ultimately might affect treatment planning. Although there is still a lack of strong evidence, CBCT is more effective than CR in evaluating cases that are difficult to diagnose in the initial evaluation with CR. FUNDING: No funding was received for this study.

Are three-dimensional airway evaluations obtained through computed and cone-beam computed tomography scans predictable from lateral cephalograms? A systematic review of evidence.

OBJECTIVE: To systematically review the literature correlating upper airway parameters between lateral cephalograms (LC) and cone-beam computed tomography (CBCT) or computed tomography (CT) scans to determine the utility of using LC to predict three-dimensional airway parameters. MATERIALS AND METHODS: Both electronic and manual searches of the included studies were performed by two reviewers, and the quality of the studies that met selection criteria were assessed. RESULTS: A total of 11 studies from the literature met the selection criteria. Assessed outcome variables showed correlation r < .7 between the LC and CT scans. The correlation between the LC and CBCT ranged from weak to strong with -.78 ≤ r and r ≤ .93 reported in the nasopharyngeal segment. In the oropharyngeal segment, a weak to strong correlation was reported with a range of -37 ≤ r and r ≤ .83 between the CBCT and LC. All associations in the hypopharyngeal segment showed a weak correlation. Four of studies were of weak quality, five were of moderate quality, and two were rated to be of strong quality. CONCLUSION: No strong correlations were reported between the LC and CT scans. However, the LC-derived adenoid-nasopharyngeal ratio and the linear measurement (posterior nasal spine, PNS, to posterior pharyngeal wall) had a strong correlation with upright nasopharyngeal area and volume in the CBCTs. The area measurement in conventional LC can be also used as an initial screening tool to predict the upright three-dimensional oropharyngeal volumetric data. The variability of the hypopharyngeal segment cannot be predicted by LCs. However, more well-designed studies are needed to determine the clinical utility of using LC to predict airway size.

Correlation of maxillary anterior tooth width and outer intercanthal distance.

The selection of the correct maxillary anterior teeth to establish proper mesiodistal width in a prosthesis is one of the most crucial phases of prosthodontic treatment. The ratio of facial measurements to natural tooth width could be considered a helpful scale. The aim of this study was to explore the relationship between outer intercanthal distance (OICD) and the combined anterior width (CAW) of maxillary teeth. The CAW between the canine distal contacts and the OICD of 100 men and 100 women were measured. Pearson correlation coefficients demonstrated a positive correlation between OICD and CAW. There was no statistically significant difference between the sexes in mean difference between OICD and CAW. Within the limitations of this study, the results suggest that the OICD can be used as a fairly reliable method to determine the CAW for edentulous patients.

Current state of the effectiveness of problem-based learning in prosthodontics: a systematic review.

The aim of this study was to systematically review the available literature on the effectiveness of problem-based learning (PBL) in prosthodontics. Both electronic and manual searches were performed by two reviewers. Of the 440 studies identified, ten met the inclusion criteria (Kappa=0.83). Various assessment tools such as standardized examinations (National Board Dental Examination and North East Regional Board of Dental Examiners exam) (22 percent), tutor evaluation (practical and examinations performance) (20 percent), curriculum time (20 percent) and number of units (10 percent), peer evaluation (10 percent), and self-evaluation (100 percent) were used in the included studies. Thirty percent of the studies adopted a control group for all measurements, 30 percent did for only some measurements, and the others lacked any control group. Although 30 percent of the studies implemented a hybrid PBL, the other studies did not mention the type of PBL. Based on the Effective Public Health Practice Project (EPHPP), all of the included studies were rated as being of weak quality. Heterogeneity across these studies in outcome variables, study designs, levels of PBL intervention, and study population limits any attempt to generalize the outcomes. The generally poor quality assessment outcomes warrant further studies on the effectiveness of PBL in prosthodontics education compared to a non-PBL curriculum.