Three dimensional condylar positional and morphological changes following mandibular reconstruction based on CBCT analysis: a prospective study (original) (raw)
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Bioengineering, 2022
The aim of this study was to assess the condylar volume in adult patients with different skeletal classes and vertical patterns using cone-beam computed tomography (CBCT). CBCT scans of 146 condyles from 73 patients (mean age 30 ± 12 years old; 49 female, 24 male) were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione IRCCS Ca’ Granda, Milan, Italy, and retrospectively analyzed. The following inclusion criteria were used: adult patients; CBCT performed with the same protocol (0.4 mm slice thickness, 16 × 22 cm field of view, 20 s scan time); no systemic diseases; and no previous orthodontic treatments. Three-dimensional cephalometric tracings were performed for each patient, the mandibular condyles were segmented and the relevant volumes calculated using Mimics Materialize 20.0® software (Materialise, Leuven, Belgium). Right and left variables were analyzed together using random-intercept linear regression models. No significant associa...
Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography
Brazilian Oral …, 2010
There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: 1) axial, coronal and sagittal multiplanar reconstruction (MPR); and 2) sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill # 1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis.
Volumetric analysis of the mandibular condyle using cone beam computed tomography
European Journal of Radiology, 2012
Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers' measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers' measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.
Indian Journal of Radiology and Imaging
Background The temporomandibular joint (TMJ) is included in the category of ginglymoarthrodial synovial joints. The mandibular condyle plays a vital part in the development of the craniofacial complex. Hence, the evaluation and assessment of the condylar volume and its morphology are of utmost importance. Aim The aim of this research was to use cone beam computed tomography (CBCT) imaging modality to evaluate the morphology of the mandibular condyle and glenoid fossa in a selected population and document any morphometric changes. Setting and Design It is an observational study. Materials and Methods A retrospective CBCT analysis was performed on 119 patients. The length, width, height, linear measurements of the joint spaces (anterior, posterior, and superior), volume of the condyle, and roof of glenoid fossa thickness were evaluated on both the left and right sides in both males and females. Results The height, width, and length of mandibular condyle were significantly increased in...
IP Innovative Publication Pvt. Ltd., 2017
Objectives: Purpose of present study was to assess the validity of Orthopantomograph (OPG), limited volume Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT) in evaluating the simulated lesions over the mandibular condyles. Materials and Method: 15 dry human mandibles (30 mandibular condyles) with intact mandibular condyles were used in this study. Total of 46 lesions were created randomly on anterosuperior (AS), superior (S) and posterosuperior (PS) surfaces of the condyle with 1mm surgical bur. Subsequently all the mandibles were subjected to OPG, CBCT and CT for assessing artificially created lesions. Two observers assessed the images for presence or absence of the lesions, number and surface of the lesions in each condyle. Results: Statistically good agreement was obtained between 2 observers in assessment of the lesions with all the three imaging modalities. With CBCT 100% sensitivity and specificity was obtained. CT produced 96.67% sensitivity and 100% specificity. Sensitivity obtained with OPG was 24.14% and specificity was 100%. Good agreement was obtained between CT and CBCT in detecting the lesions and it was found to be 96.67%. Conclusion: Accuracy of CBCT was found to be 100% and it was superior to CT (96.67%) in detecting the lesions over the mandibular condyle and OPG produced least accuracy (24.14%). Owing to the facts like high radiation dose and high cost of CT, we suggest CBCT as a better imaging modality for incipient bony changes of TMJ. However further studies with more samples are required to confirm these results.
Cone Beam Computed Tomography 3D Reconstruction of the Mandibular Condyle
Angle Orthodontist, 2008
Objective: To determine the ideal window level and width needed for cone beam computed threedimensional (3D) reconstruction of the condyle. Materials and Methods: Linear dimensions were measured with a digital caliper to assess the anatomic truth for 50 dry human mandibular condyles. Condyles were scanned with the i-CAT cone beam computed tomography (CBCT) and 3D-models were reconstructed. Three linear threedimensional measurements were made on each of the 50 condyles at 8 different Hounsfield unit (HU) windows. These measurements were compared with the anatomic truth. Volumetric measurements were also completed on all 50 condyles, at 23 different window levels, to define the volumetric distribution of bone mineral density (BMD) within the condyle. Results: Significant differences were found in two of the three linear measurement groups at and below the recommended viewing window for osseous structures. The most accurate measurements were made within the soft tissue range for HU window levels. Volumetric distribution measurements revealed that the condyles were mostly comprised of low-density bone, and that condyles exhibiting significant changes in linear measurements were shown to have higher percentages of low-density bone than those condyles with little change from the anatomic truth. Conclusions: CBCT assessment of the mandibular condyle, using the 3D reconstruction, is most accurate when accomplished at density levels below that recommended for osseous examination. However, utilizing lower window levels which extend into the soft tissue range, may compromise one's capacity to view the bony topography.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
The aim of this study was to validate the ability of cone beam computed tomography (CBCT) to measure condylar internal trabecular bone structure and bone texture parameters accurately. Study Design. Sixteen resected condyles of individuals undergoing temporomandibular joint replacement were collected and used as samples. These condyles were then radiographically imaged by using clinically oriented dental CBCT and research oriented micro-computed tomography (micro-CT). The CBCT scans were then compared with the gold standard micro-CT scans in terms of 21 bone imaging parameters. Descriptive histologic investigation of the specimens was also performed. Results. Significant correlations were found for several imaging parameters between the CBCT and micro-CT images, including trabecular thickness (r = 0.92), trabecular separation (r = 0.78), bone volume (r = 0.90), bone surface area (r = 0.79), and degree of anisotropy measurements (r = 0.77). Conclusions. Measurements of trabecular thickness, trabecular separation, bone volume, bone surface area, and degree of anisotropy obtained from high-resolution dental CBCT images may be suitable bone imaging biomarkers that can be utilized clinically and in future research.
Validation of a 3d CBCT-based protocol for the follow-up of mandibular condyle remodeling
Dentomaxillofacial Radiology
Objectives: Three-dimensional models of mandibular condyles provide a way for condylar remodeling follow-up. The overall aim was to develop and validate a user-friendly workflow for CBCT-based semi-automatic condylar registration and segmentation. Methods: A rigid voxel-based registration (VBR) technique for registration of two postoperative CBCT-scans was tested. Two modified mandibular rami, with or without gonial angle, were investigated as the volume of interest for registration. Inter- and intra operator reproducibility of this technique was tested on 10 mandibular rami of orthognathic patients by means of intra class correlation coefficients (ICC’s) and descriptive statistics of the transformation values from the VBR. The difference in reproducibility between the two modified rami was evaluated using a paired t-test (p < 0,05). For the segmentation, eight fresh frozen cadaver heads were scanned with CBCT and micro-CT. This data was used to test the inter- and intra operator...
Objective: Having detailed knowledge about the anatomical structure of mandible is important for anthropologists, forensic scientists and reconstructive surgeons. There are several imaging modalities visualizing the mandibular morphology. Cone Beam Computed Tomography (CBCT) is a developing technique that is being increasingly used in dento-maxillo-facial imaging due to its relatively low dose and high spatial resolution features. It has created a revolution in maxillofacial imaging by providing the transition of dental diagnosis from two dimensional (2D) to three dimensional (3D) images. This study was designed to evaluate mandibular notch, coronoid process, and mandibular condyle morphology by using CBCT. Methods: The study was conducted based on archived records of CBCT images of a total of 108 patients. Configurations of coronoid process, mandibular notch and condylar process were reviewed on axial, coronal and sagittal CBCT sections. 216 (108 mandibles) coronoid processes, mandibular notches and mandibular condyles from 108 mandibles were evaluated. Results: There was statistically significant relation between age and condyle shapes on coronal sections (p<0.001). Gender had no effect on the condyle shapes on both coronal and sagittal CBCT sections (p>0.05). Conclusion: The data were obtained from this study can be used as anthropological markers to assess different races. CBCT can be a preferred 3D imaging method to detect possible morphological modifications on the mandibular bone and coronal CBCT sections can be useful in forensic sciences based on the influence of aging on mandibular condyle morphology.
Major Mandibular Surgical Procedures as an Indication for Intraoperative Imaging
Journal of Oral and Maxillofacial Surgery, 2008
Purpose: This study investigated 3-dimensional (3D) imaging with intraoperative cone beam computed tomography (CBCT) in major mandibular reconstruction procedures. Patients and Methods: The study group was comprised of 125 patients (83 males, 42 females) admitted for surgical treatment of the mandible. The patients ranged in age from 3 months to 91 years (average age, 40.72 Ϯ 22.843 years). Surgical procedures of the mandible were subdivided into repair of body fractures (17 patients), angle fractures (21 patients), condylar fractures (14 patients), and multiple fractures (30 patient). In addition, the study group included 21 patients undergoing orthognatic surgery and 22 undergoing reconstructive surgery on the mandible. Intraoperatively, 3D images were generated with a mobile CBCT scanner (Arcadis Orbic 3D; Siemens Medical Solutions, Erlangen, Germany).