The Early Detection of Osteoporosis Through the Measurement of Hard Palate Thickness (HPT) Using Dental Cone Beam Computed Tomography (CBCT): A New Indicator for Osteoporosis?

Background/Objectives: Osteoporosis is a widespread and chronic systemic bone disease that affects the jaws and teeth and, therefore, also dentistry. Osteoporosis can be diagnosed by different radiological methods. Dental cone beam computed tomography (CBCT) plays an important role in dentistry imaging. The aim of our retrospective pilot study was to find criteria in CBCT that point to the possible existence of osteoporosis. Methods: Pilot study. The hard palate thickness (HPT) of the patients was measured at a defined location in the CBCT. Additionally, the CBCT images were presented to a radiologist for visual assessment. Both results were compared with the DXA measurements—as the “gold standard”—and patient history. Results: We found a consistent correlation between the visual assessments using established radiological criteria, including the new criterion of hard palate thickness (HPT), and the diagnosis of normal or pathological bone density. Secondly, for the HPT measurement all “pathologic” CBCT had an HPT of ≤0.9 mm, and all normal patients had an HPT of ≥0.9 mm. Conclusions: Despite the small sample size, this CBCT pilot study showed a correlation between HPT and systemic bone disease. Therefore, as our main result, we found a new CBCT diagnostic criterion, which quickly and uncomplicatedly points to the possible existence of bone disease, especially osteoporosis. We propose HPT as a new criterion in the evaluation of CBCT images. A threshold of <0.9 mm may be indicative for osteoporosis or osteopenia, indicating a need for further evaluation

Physics in Medicine / Development of dispersion layers for dental drills with reduced nickel release

Objectives: Without rotating instruments, for example diamond-coated drills with a core made of stainless steel, the dental routine would be unimaginable, since these are used in almost every dental activity and are thus indispensable for the professional practice. Unfortunately, such drills release Nickel particles to a high content into the cooling water of the drill. Values up to 1.3 mg/l Nickel were found by ICP \u2013 OES in the cooling water of the drillers which is of course also transferred into the patient's oral cavity with possible severe negative effects. Therefore, novel plating procedures have to be developed to increase the patients (and dentists) safety during treatment. Methods: Dispersion layers with the hard metal Tungsten carbide (WC) particles on stainless steel blanks were deposited following two synthesis routines (i) Plasma-Electrolytic Oxidation (PEO) and (ii) galvanic plating out of a Watts bath. Both were accomplished using water-based electrolytes. Results: In order to verify the dental applicability of the developed coatings, tests-drills were accomplished under defined conditions on plastic teeth for the sake of reproducibility. Commercially produced drills were compared with the newly plated ones by Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and the drilling cooling water was examined for heavy metal residues using Inductively Coupled Plasma (ICP) analytics. The resulting grinding patterns in the plastic teeth were investigated by light microscopy and SEM. It could be shown that dispersion layers plated by a galvanic procedure showed a reduced Nickel release compared to a commercial driller by factor 7.6 and 13.4 compared to PEO plated ones during dental treatments. Conclusions: Following the clinical significance the Watts bath plated drillers showed a better WC particle distribution on the surface and better abrasive properties during the drilling experiments compared to PEO plated drillers. In addition the Nickel release during dental use is much less from the galvanic treated ones. By optimising the plating condition from the Watts dispersion bath further novel drilling devices with significantly reduced release of Nickel particles can be developed for the benefit of the patients.Version of recor

A Cone Bean Computer Tomography Investigation of the Newly Formed Mandibular Anterior Ridge following the Treatment of an Extended Comminuted Fracture: A 12-Year Follow-Up

Introduction. Extensive comminuted fractures are associated with tooth loss that ultimately leads to dimensional changes in the hard and soft tissues of the alveolar ridge. Reconstruction of the lost mandibular anterior ridge is very complex due to the natural curvature of the region. Case Presentation. In this case report, the combination of the modified shell technique with autologous bone plates and the guided bone regeneration (GBR) technique was performed on an 18-year-old patient after a comminuted fracture, to ensure new bone formation in the anterior ridge with a natural curvature. After the treatment progressed without complications, three dental implants were placed. Annual cone beam computed tomography (CBCT) images were obtained and evaluated using the GNU Image Manipulation Program (GIMP© 2.10). This allowed measurements of the buccal and lingual bone around the implants, showing the annual bone loss in a twelve-year observation period. Discussion. The treatment of the comminuted fracture and the combination of the modified shell technique with autologous bone plates, the GBR technique, and implant placement can be considered successful. The three dental implants were osseointegrated in 2010, with the buccal bone level averaging 1.31 mm below the implant shoulder and the lingual bone level 1.57 mm above the implant shoulder. In 2021, the measurements showed a bone loss of 0.99 mm at the buccal implant shoulder and 0.69 mm at the lingual implant shoulder. Conclusion. The combination of the modified shell technique with autologous bone plates and the GBR technique is a reliable method to ensure new bone formation in the anterior ridge. The use of CBCT is an excellent method to evaluate bone resorption around dental implants, but due to minimal bone resorption in the observation period, an annual CBCT examination is exaggerated