Reliability of Linear Measurements Made on Reconstructed CBCT Images

Objectives: Repeatability and accuracy of measurements made on cone-beam computed tomography (CBCT) images are critical in dental practice especially in implantology. The aim of this study was to investigate the reproducibility of linear measurements made on reconstructed CBCT images. Methods In this in vitro, experimental study, 5 radiopaque markers were attached to the molars (left and right side), premolars (left and right side) and midline areas of 10 human cadaver dry mandibles. The distance between the markers and the lower border of the mandible was measured by a digital caliper and considered as the gold standard. CBCT images were taken, and the distance between the markers and the lower mandibular border was measured on cross-sectional images by three maxillofacial radiologists using Romexis software. The same measurements were made 1 month later to assess the reproducibility of measurements. The intra-class correlation coefficient was calculated to assess the repeatability and agreement between the observers. Results: Compared with the gold standard, the mean error percentage in linear measurements was calculated to be 3.25%. The overall reproducibility of CBCT linear measurements was 0.865. The inter-observer agreement was calculated to be 0.972. Conclusion: CBCT showed acceptable accuracy, repeatability and reliability for linear measurements, and can be used as an accurate tool for this purpose

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

A Textbook of Advanced Oral and Maxillofacial Surgery

The scope of OMF surgery has expanded; encompassing treatment of diseases, disorders, defects and injuries of the head, face, jaws and oral cavity. This internationally-recognized specialty is evolving with advancements in technology and instrumentation. Specialists of this discipline treat patients with impacted teeth, facial pain, misaligned jaws, facial trauma, oral cancer, cysts and tumors; they also perform facial cosmetic surgery and place dental implants. The contents of this volume essentially complements the volume 1; with chapters that cover both basic and advanced concepts on complex topics in oral and maxillofacial surgery