OBJECTIVETo evaluate the accuracy of cone-beam CT (CBCT) for detection of bone defects in chronic periodontitis and its consistency with periapical film, panoramic radiograph and clinical examination.

METHODSSeventy-five patients with periodontitis were selected in the study. Each patient received clinical examination, periapical film, panoramic radiograph and CBCT examination one week after supragingival scaling. The distance from the alveolar ridge crest to enamelo-cemental junction was measured. The data were statistically analyzed.

RESULTSA total of 1 494 teeth and 8 964 sites were included in the study. Among the three kinds of imaging methods only CBCT could detect the lip (buccal) or tongue (palatine) side of alveolar bone destruction. Compared with panoramic radiographs[mesial: (4.9±0.4) mm, distal: (4.9±0.8) mm] and periapical film [mesial: (5.1±0.6) mm, distal: (5.1±0.8) mm], CBCT [mesial: (5.5±0.4) mm, distal: (5.6±0.8) mm] showed significant differences (P < 0.01) in alveolar bone defect measurements in detecting mesial and distal alveolar bone defect. There was no significant difference between clinical probing [mesial: (5.5±0.6) mm, distal: (5.5±0.6) mm] and CBCT.

CONCLUSIONSCBCT have the highest consistency with clinical probing in detecting the alveolar bone loss in chronic periodontitis.

Alveolar Bone Loss ; diagnostic imaging ; Alveolar Process ; diagnostic imaging ; Chronic Periodontitis ; diagnostic imaging ; Cone-Beam Computed Tomography ; Humans ; Radiography, Panoramic

OBJECTIVE: To test the accuracy and credibility of cone-beam computed tomography (CBCT) on measuring the height and volume of alveolar bone defects before periodontal regeneration surgery. By comparing the bone density measured by CBCT before and after the operation, the time to evaluate the efficacy of the periodontal regenerative surgery would be determined. METHODS: Periodontal regenerative surgeries were performed on three-wall bone defects of ten teeth in nine patients. The height of bone defects was measured using both periapical film of distant parallel technique and CBCT before periodontal regenerative surgery. Before the surgery, CBCT data were used to measure the volume of the bone defects and the bone density around the defective areas. The height of the bone defects was measured during periodontal regeneration surgery, and the volume of the defective areas was obtained with bone wax in operation. CBCT was taken 6, 12 and 24 weeks after surgery to measure the bone density in the regenerated region. RESULTS: The Wilcoxon test showed that the height of the bone defects measured preoperatively using periapical film was (0.822±0.222) mm deeper than the intraoperative measurement results, and the difference was statistically significant (P<0.05). Whereas CBCT measurement results was (0.150±0.171) mm less than the intraoperative measurement results, without statistical significant (P>0.05). The regression analysis and the Bland-Altman method also showed that the results of CBCT measurement were more accurate. The Wilcoxon test showed that the bone defect volume measured by CBCT preoperatively was accurate, and the difference between the preoperative and the intraoperative measurements was not statistically significant, ranging from 0.38 to 2.83 mm3 (P>0.05). The bone density of the regenerated areas measured by CBCT was (0.49±0.03) times in the sixth week, (0.74±0.09) times in the twelfth week and (1.16±0.11) times in the twentieth week as that of the areas around the bone defects after the surgery. CONCLUSION The present data suggest that using CBCT before periodontal regenerative surgery could result in accurate measurement of height and volume of alveolar bone defects. For the purpose of evaluating the effectiveness of regenerative surgery, CBCT could be taken 24 weeks after surgery.
Alveolar Bone Loss/diagnostic imaging* ; Cone-Beam Computed Tomography ; Humans ; Oral Surgical Procedures

OBJECTIVETo evaluate the morphological characteristics of alveolar bone defects of the patients with chronic periodontitis using cone-beam CT (CBCT).

METHODSSixty patients with chronic periodontitis were included in this study. CBCT was used to scan the alveolar bone and NNT software to measure the alveolar bone defects and bone loss types in different regions.

RESULTSSeventy-five percent (45/60) of the alveolar bone defect was the generalized type, 25% (15/60) was the localized type. In incisor and canine area, the defect of the mandibular alveolar bone was more severe than in the same sites of maxilla. There was less bone loss in the premolar area of mandible than in the same site of maxilla. In the mesial and buccal sites of mandibular molars and in the lingual site of maxillary molars, the most severe alveolar bone loss was found.

CONCLUSIONSThe obvious alveolar bone defect areas in chronic periodontitis were the palatal side of maxillary molars and the lingual side of mandibular incisors. CBCT can clearly demonstrate the degree of alveolar bone defects in different regions of chronic periodontitis.

Adult ; Alveolar Bone Loss ; diagnostic imaging ; Chronic Periodontitis ; diagnostic imaging ; Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo establish the three-dimensional images of rat's alveolar bone and to evaluate the effects of nicotine on alveolar bone loss during the process of ligature-induced periodontitis with micro-computed tomography (micro-CT).

METHODSThirty-six adult male SD rats received silk ligatures around the cervix of the right second maxillary molars. Then the animals were randomly assigned to three groups and received daily intraperitoneal injections as follows: group A (control), saline solution; group B, nicotine, 0.83 mg x kg(-1) x d(-1); and group C, nicotine, 1.67 mg x kg(-1) x d(-1). Six animals in each group were randomly selected and sacrificed at day 14 and 28. Micro-CT examinations were used to evaluate the periodontal breakdown.

RESULTSWith the nicotine dose increased, bone mineral density (BMD), bone volume fraction (BVF), and trabecular thickness (TT) gradually reduced, while the trabecular spacing (TS) and alveolar bone loss (ABL) increased. At day 28, the ABL of group C (left, right) was (0.61 +/- 0.14) mm and (1.39 +/- 0.09) mm, and significantly higher than that of group B [(0.39 +/- 0.10) mm and (1.31 +/- 0.06) mm] and group A[(0.30 +/- 0.06) mm and (0.94 +/- 0.07) mm]. The BMD of group C, group B and group A at day 28 was [(617.86 +/- 34.27), (572.46 +/- 31.62) mg/cm3], [(660.04 +/- 36.73), (604.97 +/- 32.59) mg/cm3] and [(709.15 +/- 34.95), (657.04 +/- 30.06) mg/cm3] respectively.

CONCLUSIONSDaily administration of nicotine results in significant bone loss and microstructure deteriorations in the trabeculae of alveolar bone.

Alveolar Bone Loss ; chemically induced ; diagnostic imaging ; Animals ; Male ; Nicotine ; toxicity ; Periodontitis ; diagnostic imaging ; Rats ; Rats, Sprague-Dawley ; Tooth Socket ; diagnostic imaging ; X-Ray Microtomography

OBJECTIVES: To summarize the open-eruption technique of impacted anterior maxillary teeth, this study reports a technically improved operation on surgical exposure based on dental follicles and evaluates post-treatment periodontal health considering the effect of dental follicles. METHODS: Patients who underwent open-eruption technique with unilateral labially impacted maxillary central incisors were selected. The impacted teeth were assigned to the experimental group, and the contralateral unimpacted maxillary central incisors were assigned to the control group. In the surgical exposure, the new technique makes use of dental follicles to manage the soft tissue, so as to preserve soft tissue for better aesthetic results and healthier periodontal tissue. Tooth length, root length, alveolar bone loss, and alveolar bone thickness were recorded after the therapy. RESULTS: A total of 17 patients with unilateral maxillary central incisor impaction were successfully treated. The tooth length and root length of the two groups showed a statistically significant difference between the impacted and homonym teeth, with a shorter length in the impacted tooth (P<0.05). More labial alveolar bone loss was found in the experimental group compared with that in the control group (P<0.05). The outcomes of the cementoenamel junction width, pa- latal alveolar bone loss, and alveolar bone thickness did not indicate statistical significance between the experimental and control groups (P>0.05). CONCLUSIONS In the surgical exposure, the new technique uses dental follicles to manage the soft tissue and preserve it for better aesthetic results and healthier periodontal tissues.
Humans ; Tooth, Impacted/surgery* ; Incisor ; Alveolar Bone Loss/diagnostic imaging* ; Tooth Root ; Dental Sac ; Maxilla/surgery* ; Esthetics, Dental

OBJECTIVE: To evaluate the accuracy and reliability of detecting alveolar bone dehiscence and fenestration of maxillary anterior teeth of Angle class III by cone-beam computed tomography (CBCT). METHODS: Eighteen Angle class III patients with 108 maxillary anterior teeth were included (3 males and 15 females) who accepted modified corticotomy in orthodontic therapy. The mean age was 23.6 years (18-30 years). The clinical detection of dehiscence and fenestration was done when modified corticotomy was performed by the same periodontist. The CBCT examination was conducted pre-operation and the detection of dehiscence and fenestration by CBCT was done by two periodontists. The data in modified corticotomy were used as the golden standard to calculate the parameters, such as sensitivity, specificity, positive and negative predictive values, Youden index (YI), positive and negative likelihood ratio. Kappa statistic was used to analyze the agreement between the clinical detection and the CBCT detection. RESULTS: The incidence of dehiscence and fenestration was about 10.19% and 13.89% respectively, which mainly occurred on lateral incisors and canines. The median values of length and width of dehiscence were about 5 mm and 4 mm, and the median values of length and width of fenestration were 3 mm and 2 mm, respectively. Most fenestrations were detected on the middle third to the apical third of the root. For dehiscence, the agreement between clinical detection and CBCT detection was statistically significant (P<0.05). For fenestration, the agreement between clinical detection and CBCT detection was statistically significant (P<0.05). The values of sensitivity and specificity for detecting dehiscence were more than 0.7. The values of positive and negative predictive values for detecting dehiscence were 0.44 and 0.97. The values of sensitivity and specificity for detecting fenestration were 0.93 and 0.52. The values of positive and negative predictive values for detecting fenestration were 0.24 and 0.98. CONCLUSION For dehiscence, the agreement between clinical detection and CBCT detection was good. For fenestration, the agreement between clinical detection and CBCT detection was general. Detection of dehiscence and fenestration of maxillary anterior teeth of Angle class III by CBCT had limited diagnostic value in clinical practice with overestimation of dehiscence and fenestration incidence.
Adolescent ; Adult ; Alveolar Bone Loss/diagnostic imaging* ; Alveolar Process/diagnostic imaging* ; Cone-Beam Computed Tomography ; Female ; Humans ; Incisor ; Male ; Malocclusion, Angle Class III/diagnostic imaging* ; Reproducibility of Results ; Young Adult

OBJECTIVETo investigate the mandibular bone mineral density (BMD) change of senile osteoporosis patients and the relationship between the mandible bone loss and systemic bone loss.

METHODSForty senile osteoporotic patients (group A), 40 non-osteoporosis control elders (group B) and 40 healthy youths (group C) were included in this study. Standard digital panoramic tomography (SDPTG) was taken for each participant. Cortical width (CW), panoramic mandibular index (PMI), alveolar bone density and alveolar bone height were measured on the SDPTG. Lumbar and hip BMD were measured with dual energy X-ray absorptiometry (DXA).

RESULTSClose relationship was found between CW (3.57 +/- 0.82) and systemic BMD for osteoporosis patients (P < 0.05). All the SDPTG indices including CW, PMI, alveolar bone density and alveolar bone height were different for osteoporosis patients from the healthy youths (P < 0.05). The osteoporosis patients had thinner CW (3.57 +/- 0.82) and smaller PMI (0.29 +/- 0.06) than non-osteoporosis control elders (CW: 4.07 +/- 0.75, PMI: 0.32 +/- 0.07, P < 0.05). The alveolar bone density (105.40 +/- 20.48) and alveolar bone height (10.42 +/- 1.82) of the non-osteoporosis control elders reduced compared with the healthy youths (alveolar bone density: 117.10 +/- 22.23, alveolar bone height: 11.69 +/- 1.63, P < 0.05).

CONCLUSIONSThe senile osteoporotic patients had significant mandibular cortical bone loss.

Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Alveolar Bone Loss ; diagnostic imaging ; pathology ; Body Mass Index ; Bone Density ; Female ; Humans ; Male ; Mandible ; diagnostic imaging ; pathology ; Middle Aged ; Osteoporosis ; diagnostic imaging ; pathology ; Osteoporosis, Postmenopausal ; diagnostic imaging ; pathology ; Radiography, Panoramic

Alveolar Bone Loss ; diagnostic imaging ; etiology ; prevention & control ; surgery ; Alveolar Process ; diagnostic imaging ; pathology ; Bone Substitutes ; therapeutic use ; Cone-Beam Computed Tomography ; Dental Implantation ; methods ; Guided Tissue Regeneration, Periodontal ; methods ; Humans

OBJECTIVETo discuss the technique of installation of zygomatic implants in severely resorbed edentulous maxillae, and maxillary defect.

METHODSFive patients received 8 zygoma implants and 11 dental implants. On the basis of an axial spiral CT data, anatomical models of natural size were manufactured using CAD/CAM system and before operation preoperative measurements of relevant parameters (length, areas, and volumes) carried out. Theses maxillary and zygomatic measurements obtained were referred for installing zygomatic implants.

RESULTSThe ideal direction and position of installation of the 8 zygomatic fixtures were obtained in 5 patients. The anatomical model and surgical plate were used for preoperative planning and intraoperative control of the insertion of zygomatic fixtures. The implants could be positioned precisely as preoperatively planned. The length of the zygomatic implants was between 40 mm and 50 mm.

CONCLUSIONSThe use of surgical drilling guides should be encouraged for zygomatic implant placement. 3-D image data and anatomical models improves preoperative planning and facilitates clinical procedure.

Adult ; Alveolar Bone Loss ; diagnostic imaging ; surgery ; Dental Implantation, Endosseous ; methods ; Dental Implants ; Female ; Humans ; Male ; Maxilla ; diagnostic imaging ; injuries ; surgery ; Middle Aged ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Zygoma ; diagnostic imaging ; surgery

OBJECTIVETo evaluate the status of residual alveolar bone in aggressive periodontitis (AgP) nuclear families and to investigate the influence of teeth with root abnormity on residual alveolar bone and the heredity of root abnormity, the premolar cone-root and proportion of crown and root.

METHODSNineteen AgP probands (9 males and 10 females) at average age of 24.5 and 38 parents at average age 51.0 were included. A full set of periapical radiographs of all the subjects were taken. The residual alveolar bone of each tooth was measured by the ratio (shown as percentage) of the distance between apical and the alveolar bone crest to the whole root length. The abnormity of roots was detected on a full set of periapical radiographs. All the roots and crowns of teeth were measured. The relationship between the residual bone and the ratio was studied. The heredity grade of the premolar cone-root, proportion of crown and root, and root abnormity were computed.

RESULTSThe average residual alveolar bone of probands was less than that of their parents.In 11 families, the father's residual alveolar bone was less than that of the mother's. The average residual alveolar bone of the teeth with root abnormity was less than that of normal teeth. The average residual alveolar bone of the teeth with abnormity of roots and the normal teeth were (67.5 ± 22.2)% and (73.1 ± 18.7)% respectively, with statistical significance (P < 0.001). The heredity grade of the premolar cone-root was 40.1%, the heredity grade of proportion of crown and root was 46.8%, the heredity grade of root abnormity was 30.3%.

CONCLUSIONSThe residual alveolar bone of the teeth with root abnormity was less than that of normal teeth in nuclear families. The heritability of the root abnormity, the cone-root and proportion of crown and root in our sample was 0.3-0.5, which means that genetic factors accounted for about one third to half of the efficiency for AgP.

Adolescent ; Adult ; Aggressive Periodontitis ; diagnostic imaging ; genetics ; pathology ; Alveolar Bone Loss ; diagnostic imaging ; genetics ; pathology ; Alveolar Process ; pathology ; Bicuspid ; diagnostic imaging ; pathology ; Female ; Heredity ; Humans ; Male ; Middle Aged ; Nuclear Family ; Radiography ; Tooth Crown ; diagnostic imaging ; pathology ; Tooth Root ; diagnostic imaging ; pathology ; Young Adult