Cone Beam CT-Based Preoperative Volumetric Estimation of Bone Graft Required for Lateral Window Sinus Augmentation, Compared with Intraoperative Findings: A Pilot Study

Abstract

Introduction:The presence of an atrophic maxilla creates a serious challenge in cases of implant placement, while maxillary sinus pneumatization further complicates the surgery. This pilot study was performed to investigate the validity of two techniques used to estimate the volumes of bone graft material required in cases that included lateral window sinus augmentation.Materials and Methods:Cone beam computed tomography was used for preoperative volumetric analysis of the maxillary sinus. The analysis was performed using the manual measurement of sinus dimensions, as well as automated measurements via the segmentation technique. The estimated volumes of required bone graft material were compared with actual intraoperative findings in cases requiring lateral window sinus augmentation. For this pilot study, only 5 patients were selected to be included.Results:To achieve 80% power and confidence interval of 95%, the sample size should be 35 patients. The correlation coefficient between the segmented volume and mm3 used was – 0.5332, whereas the coefficient between the manual volume and mm3 used was – 0.6784. Consequently, both results indicate that the two methods have a moderate negative correlation with the mm3 used.Conclusion:Performing a similar study with an increased number of patients, according to the calculated sample size, increases the possibility of revealing higher correlation between the methods used to analyze the partial volume of the sinus cavity. The estimated sinus volume of the area of augmentation, obtained by using either manual or segmentation techniques, could be considered as a maximum estimate for the required amount of graft material. Furthermore, the segmentation technique may be valuable in preoperative planning of sinus augmentation, as it reveals the topographic shape and morphology of the sinus.

CBCT for Diagnostics, Treatment Planning and Monitoring of Sinus Floor Elevation Procedures

“…Adequate preoperative planning of the graft volume may help to avoid sinus over-filling and potentially occluding the ostium, decide on the ratio of bone and bone substitutes to be mixed, and estimate the cost of xenografts prior to the actual operation [47,48]. It is worth noting that in cases where an autogenous graft will be harvested, preoperative knowledge of the amount of graft required is useful in selecting the optimal donor region, reducing the time and complexity of the surgical procedures, as well as minimizing potential postoperative complications [84].…”

Incidental Findings Following Dental Implants Procedures in Mandible: A New Post-processing CBCT Software Analysis

“…Given the risks of failure in implant treatments and the technological advancements and new techniques frequently indicated for dental approaches, prior evaluation of the mandibular region where dental implants are intended to be placed becomes essential for planning [34]. Intraoral imaging exams are essential tools for guiding treatment plans in modern dentistry [35][36][37].…”

Comparação entre ressonância magnética e tomografiacomputadorizada por feixe cônico para diagnóstico de regiões com enxertos em seios maxilares

“…No entanto, o osso medular se mostrou mais hiperintenso como resultado dos prótons de hidrogênio presentes na água e em 2018, obteve imagens de TCFC de cinco pacientes, para avaliar a quantidade de enxerto ósseo necessário a ser colocado em região do seio maxilar dos mesmos, e comparou as medidas lineares obtidas das imagens com as mensurações feitas no momento intra-operatório. Os resultados mostraram uma correlação moderada entre as medidas obtidas através das imagens e no momento cirúrgico; e os autores concluíram que a TCFC pode ser uma técnica precisa no planejamento pré-cirúrgico para colocação de enxertos em região de seio maxilar porque revela a forma topográfica e morfológica dessa cavidade sinusal(28).Em um outro estudo foi comparado imagens de RM e TC para o planejamento pré-cirúrgico de implantes dentários. Foram selecionados 30 pacientes e em todos os casos foi possível planejar, através das duas técnicas de imagens, a instalação dos implantes dentários.…”