The Accuracy of Cone-Beam Computed Tomography for Evaluating Bone Density and Cortical Bone Thickness at the Implant Site: Micro-Computed Tomography and Histologic Analysis

Suttapreyasri, Srisurang; Suapear, Pradipat; Leepong, Narit

doi:10.1097/scs.0000000000004672

Cited by 27 publications

(28 citation statements)

References 40 publications

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“…The capabilities of clinical CT to characterize structural properties of human skeletons have been explored. Predicting cortical bone densities and thickness by cortical shells of the ROIs using clinical CT provided excellent correlations with micro CT results 29,30 . The accuracy of bone densities calculated from Hounsfield units (HUs) from CT data has been demonstrated 31 , and three-dimensionally (3D) reconstructed axial CT images could accurately define the border of the cortical bone 32,33 .…”

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confidence: 81%

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Hong

Kang

2020

Sci Rep

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this study aimed to clarify how masticatory muscle atrophy induced by botulinum toxin (BtX) injection affects cortical bone quality of the mandible using 3D modeling technology. A total of 39 young (26.9 ± 6.0 years) and 38 post-menopausal (55.3 ± 6.3 years) females were included. Computed tomography (CT) images were obtained before and after 12 months of treatment. Predictor variables were application of a stabilization splint, and/or two times of BtX injection in the bilateral temporalis and masseter muscles within a six-month interval. Outcome variables were changes in average Hounsfield units (HU) and cortical thickness of region of interest (ROI). 3D mandibular models were reconstructed using CT images, and models were used to calculate average HU and cortical thickness of Rois, including inferior half of the lateral surface of ascending ramus, coronoid process, and temporomandibular joint condyle. Cortical bone quality at muscle insertion site was influenced by decreased muscle thickness but seemed not to be affected by decreased functional loading. Reduced functional loading seemed to influence cortical bone quality of the condyles. These effects were more remarkable in post-menopausal females. Hence, decreased masticatory muscle thickness may lead to alterations of the mandibular cortical structures, especially in post-menopausal females. Bone is a dynamic structure that continuously undergoes a remodeling process through resorption and apposition to meet environmental requirements. The adaptation rate of the bone to functional loading is mediated by dynamic forces of the associated muscles 1. Skeletal muscles transduce mechanical loading to the bone in three ways: (1) the tensile force developed by a muscle contraction at its insertion site, (2) the compressive force developed by muscles that transduce loading across the joints, and (3) the bending force experienced by long bone associated muscles for lifting distally held objects 2. The role of mechanical stimulation by muscles to maintain bone density has been well known and the association among the amount of physical activity, body muscle mass, and quality of both cortical and trabecular bones has also been investigated 3-6. Botulinum toxin (BTX) acts as a pre-synaptic neurotoxin that blocks neuromuscular transmission by inhibiting acetylcholine release from the motor and sympathetic nerve terminals 7 as well as inflammatory mediators including substance P and glutamate 7,8. Muscle paralysis induced by BTX injection was related with not only reduced active loading but also an increased passive elastic modulus of muscle fiber bundles 9. BTX has been used not only for cosmetic purposes but also to improve symptoms associated with temporomandibular disorders (TMDs), myofascial pain syndrome, and headaches. The majorities of adverse effects associated with the application of BTX in the orofacial region are mild and transient including bruising, swelling, pain around the injection site, and masticatory muscle weakness 10. Several previous studies have rev...

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confidence: 81%

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Hong

Kang

2020

Sci Rep

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“…Consequently several comparative studies assessing the image performance of the CBCT devices with micro-CT as a possible tool of validation [11,13,[15][16][17][18][19][20]45]. Considering our results, the measured 38.71 µm mean spatial resolution of the micro-CT images provides micromorphologically reliable images, since the spatial resolution is smaller, than the scanned human anatomical structure such as human cancellous bone, in which the trabeculae have a dimension of 50 -300 µm [16,46].…”

Section: Discussionmentioning

confidence: 68%

“…Numerous publications have been investigated the use of cone beam computed tomography (CBCT) for evaluating small anatomical structures in dentistry e.g. root canal morphology in endodontics [1][2][3][4][5][6][7][8][9][10] or bone quality assessment in maxillofacial surgery [11][12][13][14][15][16][17][18][19][20]. It is essential to visualize these details to set up the proper diagnosis and treatment plan, hence clinicians need to select the adequate imaging technique with the appropriate resolution.…”

Section: Introductionmentioning

confidence: 99%

Modulation transfer function evaluation of cone beam computed and microcomputed tomography by using slanted edge phantom

Bence¹

2019

MIPT

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Modulation transfer function (MTF) is a well known and widely accepted method for evaluating the spatial resolution of a digital radiographic imaging system. In the present study our aim was to evaluate the MTF obtained from CBCT and micro-CT images. A cylinder shaped phantom designed for slanted-edge method was scanned by a CBCT device at a 100 µm isometric voxel size and by a micro-CT device at a 20 µm isometric voxel size, simultaneously. The MTF curves were calculated and the mean spatial resolutions at 10% MTF were 3.33 + 0.29 lp/mm in the case of CBCT images and 13.35 + 2.47 lp/mm in the case of micro-CT images. The values showed a strong positive correlation regarding the CBCT and the micro-CT spatial resolution values, respectively. Our results suggests that CBCT imaging devices with a voxel size of 100 µm or below might aid the validation of fine anatomical structures and allowing the opportunity for reliable micromorphometric examinations

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“…Rashad et al 13 standardised the bone samples temperatures previous perforation and showed that prolonged time of osteotomies with the tips of the ultrasonic system is associated with higher bone temperatures when compared with conventional drilling. In this study, we use bone samples with equal temperatures with a mean cortical bone thickness of 0.78 mm, bone mineral density of 1.10 g/cm 3 and standardised morphometric parameters to simulate a mandibular bone body, without variations in the bone quality of the different groups studied 16 . Anyway, the reached temperatures for the ultrasonic preparation implant site can be as equally safe as the drilling conventional rotatory system, since it is necessary to reach at least 47°C for 60 s for significant bone damage, 3,17 and, in our study, we reached a maximum mean perforation of 34.4°C and 79 s.…”

Section: Discussionmentioning

confidence: 99%

In vitro comparison of dental implant site preparation with ultrasonic system and conventional rotatory system

et al. 2019

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Aim: To compare in vitro the site preparation of dental implant using a rotatory system and an ultrasonic system by evaluating the variability of temperature, time and primary stability that is provided by the different sequences of dental implant drills and tips. Materials and methods: Sixteen osteotomies were performed with different sequences of drills (Initial, Titamax 2.0, 2/3 and 3.0) for the rotatory group (RG) and tips (IM1S, IM2P, IM2/3, IM3P) for the ultrasonic group (UG) on bovine cortical-cancellous bone samples. Micro-CT images were acquired to assess bone microarchitecture and bone mineral density of each sample to guarantee similar bone conditions. For the RG, the osteotomies were performed with a dental implant contra-angle handpiece at 800 rpm and 50 N/cm maximum torque using an implant micromotor. For the UG, the osteotomies were performed using a Piezosurgery3 system with the respective tip. The temperature was measured and four implants 3.75 9 11 Titamax were installed in each group to measure the final torque. Results: For the RG, the following mean values were found: 22.87 s, 24.2°C superficial temperature, 27.6°C perforation temperature and 32.30 N/cm torque. The UG values were 72.9 s, 26.6°C superficial temperature, 32.1°C perforation temperature and 22.60 N/cm torque. Conclusions: Rotatory and ultrasonic systems are effective methods for implant site preparation with satisfactory outcomes. For corticalcancellous preparation sites, the drills of the RG were related to lower temperatures and less time for osteotomy. Thus, the use of rotatory systems is preferred due to the heat differential generated during the dental implant sites preparation. Clinical relevanceScientific rationale for study Osteotomy techniques are superior due to greater precision when performed with ultrasonic systems; however, data on temperature and surgical times related to such systems are still controversial in the literature when compared to conventional rotatory systems. Principal findingsRotatory system was related to lower temperatures and less time for osteotomy during dental implant sites preparation.Oral Surgery 13 (2020) 108--116.

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The Accuracy of Cone-Beam Computed Tomography for Evaluating Bone Density and Cortical Bone Thickness at the Implant Site: Micro-Computed Tomography and Histologic Analysis

Cited by 27 publications

References 40 publications

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults

Modulation transfer function evaluation of cone beam computed and microcomputed tomography by using slanted edge phantom

In vitro comparison of dental implant site preparation with ultrasonic system and conventional rotatory system

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