Morphometric analysis of maxillary arch dimensions using Cone Beam Computer Tomography (CBCT).

Knowledge of morphology of the maxillary arch is important in many spacialities of dentistry. This retrospective cross-sectional study was performed using 109 randomly selected maxillary CBCT images of patients in the age range of 18-60 from the archives in Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. EzDent software was used for measurements. Measurements related to the width were acquired from coronal sections while the measurements related to antero-posterior dimensions were performed on axial sections. A majority had an oval shaped maxillary arch (64.8%) followed by V shaped one.(29.2%). The mean height of the alveolar ridge at the upper canine position was 8.9 mm and the mean height of the alveolar ridge at the first molar level was 20.1 mm. Mann Whitney U test was used to compare measurements of variables between males and females. Difference in the height of alveolar ridge at the junction of soft and hard palate, width of the alveolar ridge at the canine, first molar and second molar and also the antero-posterior distance of the arch at the inter canine distance and junction between the hard and soft palate were statistically significant. Kruskal Wallis test was used to compare the differences between age groups. Chisquare values didnot indicate significant differences of measurements according to the age group of the participants. In conclusion, there is a significant difference in all maxillary arch parameters between the different genders. No significant differences in arch parameters were observed among the different age groups.

Introduction of an interactive tool (the Dental Trauma Guide) in the undergraduate dental teaching to manage traumatic dental injuries.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education. MATERIALS AND METHODS: Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG. RESULTS: The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience. CONCLUSION: The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI.

Morphometric analysis of infraorbital foramen using cone beam computed tomography in a cohort of Sri Lankan adults / Análisis morfométrico del foramen infraorbitario mediante tomografía computarizada de haz cónico en una cohorte de adultos de Sri Lanka

SUMMARY: Infraorbital foramen (IOF) located bilaterally within the maxillary bone about 1 cm inferior to the infraorbital margin is a vital landmark when delivering local anesthesia and during surgical interventions in the midface region. A total of 122 infraorbital foramina in 61 cone beam computed tomographic (CBCT) images of 32 females and 29 males in the age range of 17 to 32 were analyzed to determine the shape, direction, presence of accessory foramina, size and the precise position of IOF in relation to the inferior orbital margin (IOM), maxillary midline (MM), lateral nasal wall (LNW), alveolus (ALV) and maxillary teeth in a group of Sri Lankan people. The IOF was oval in shape (80.3 % and 88.5 % on the right and left side, respectively) in a majority of individuals. The infraorbital foramina were located at a mean distance of 5.56 ± 3.95 and 4.91 ± 2.08 mm, below the IOM on the right and left side, 27.13 ± 2.6 and 26.99 ± 2.73 on the right and left side from the mid maxillary line, 11.96 ± 3.45 mm and 12.18 ± 3.35 from the LNW on the right and left side and 29.59 ± 3.59 and 29.65 ± 3.28 above the alveolar crest on the right and left side. There were no statistically significant differences between the left and right sides or between sexes. Majority of IOF (37.5 % and 55.9 % on the right and left side, respectively) were located in the vertical plane passing though the maxillary second premolar tooth.

RESUMEN: El foramen infraorbitario (FIO) ubicado bilateralmente dentro de la maxila, aproximadamente 1 cm inferior al margen infraorbitario, es un punto de referencia vital cuando se administra anestesia local y durante intervenciones quirúrgicas en la región media de la cara. Se analizaron un total de 122 forámenes infraorbitarios en 61 imágenes de tomografía computarizada de haz cónico (CBCT) de 32 mujeres y 29 hombres en un rango etario de 17 a 32 años para determinar la forma, dirección, presencia de forámenes accesorios, tamaño y posición precisa de FIO en relación con el mar- gen orbitario inferior (MOI), la línea mediana maxilar (MM), la pared nasal lateral (PNL), el alvéolo (ALV) y los dientes maxilares en un grupo de personas de Sri Lanka. En la mayoría de los adultos se observó que el FIO tenía forma ovalada (80,3 % y 88,5 % en el lado derecho e izquierdo, respectivamente) Los forámenes infraorbitarios se ubicaron a una distancia media de 5,56 ± 3,95 y 4,91 ± 2,08 mm, por debajo del MOI en los lados derecho e izquierdo; 27,13 ± 2,6 y 26,99 ± 2,73 en el lado derecho e izquierdo desde la línea maxilar mediana, 11,96 ± 3,45 mm y 12,18 ± 3,35 de la PNL en el lado derecho e izquierdo y 29,59 ± 3,59 y 29,65 ± 3,28 por encima de la cresta alveolar en los lados derecho e izquierdo. No hubo diferencias estadísticamente significativas entre los lados izquierdo y derecho o entre sexos. La mayoría de IOF (37,5 % y 55,9 % en el lado derecho e izquierdo, respectivamente) se ubicaron en el plano vertical que pasa por el segundo premolar maxilar.

Morphometric analysis of nasopalatine foramen in Sri Lankan population using CBCT.

Nasopalatine canal (NPC) is an important anatomical structure present in the anterior mid maxilla. It has the synonyms of incisive canal or anterior palatine canal. The objective of this study was to identify the morphometric characteristics of the NPC in group of Sri Lankan people using Cone beam computer tomography (CBCT) and to determine normal morphological course and anatomical variations. Fifty Maxillary CBCT images of anterior maxilla, obtained from the archives of the University Dental Hospital, Peradeniya were retrospectively analyzed to determine the position of the NPC. Morphology, canal dimension of NPC and its relation to the maxilla. Majority had a single opening (48%) or 2 openings (46%). Average diameter of the canal was 3.692 mm with a range of 2-6 mm. Majority of the canals had funnel shape and were vertically curved. Average length of canal was 12.142 mm and angulations of the curvature was 115.6940. Average antero-posterior diameter at nasal fossa was 2.852 mm, at mid-palate 2.366 mm and at hard palate 3.034 mm. Our findings were different from the findings reported in the literature. This may be due to the differences in ethnicity or limited size of sample. Within the limits of this study, we conclude that the form of the NPC is variable; predominantly funnel shaped with a single or two openings and with an average diameter of 3.7 mm in Sri Lankan population. Identification of variations in the position and shape will help in clinical practice specially in introducing local anesthetic block injections during dental treatment.