Incidental findings from a retrospective study of 318 Cone Beam Computed Tomography consultation reports

PURPOSE: Cone beam computed tomography (CBCT) is a three-dimensional radiographic technique used in planning implant therapy to help clinicians determine the volume and dimension of bone available for implant placement, and CBCT images potentially depict coincident findings. MATERIALS AND METHODS: Three hundred eighteen patients received CBCT scans prior to receiving implants, which were interpreted by blinded board-certified oral and maxillofacial radiologists. All incidental findings were defined as non-tooth-related pathologies or abnormalities. These findings were categorized and analyzed using descriptive statistics. RESULTS: The patients ranged in age from 16 to 91 years (mean age for men, 64.73 ± 15.05 years; for women, 62.47 ± 15.83 years). Controlling for age, men were 2.13 times more likely to have sinus pathology than women. Patients over age 65 were 5.01 times more likely to demonstrate vascular pathology (eg, carotid artery calcification) than patients ages 41 to 65; the likelihood versus patients ages 16 to 40 was 13.39. Women were 2.63 times more likely to display brain pathology (eg, pineal or pituitary calcifications). Controlling for gender, patients ages 41 to 65 were 3.17 times more likely to exhibit condylar pathology (eg, degenerative changes) than patients ages 16 to 40. Similarly, patients above age 65 were 3.53 times more likely to show condylar pathology than patients ages 16 to 40, and women were 1.61 times more likely to have condylar pathology than men. Versus patients ages 16 to 40, patients ages 41 to 65 were 17.69 times more likely to show signs of vertebral pathology (eg, degenerative disc changes) and patients over age 65 were 28.67 times more likely to display vertebral pathology. CONCLUSION: CBCT scans frequently reveal non-tooth-related pathologies and/or abnormalities in the head and neck region. Therefore, comprehensive review of the entire CBCT image set is necessary

Computer technology applications in surgical implant dentistry: a systematic review

Purpose: To assess the literature on accuracy and clinical performance of computer technology applications in surgical implant dentistry. Materials and Methods: Electronic and manual literature searches were conducted to collect information about (1) the accuracy and (2) clinical performance of computer-assisted implant systems. Meta-regression analysis was performed for summarizing the accuracy studies. Failure/complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 12-month proportions. Results: Twenty-nine different image guidance systems were included. From 2,827 articles, 13 clinical and 19 accuracy studies were included in this systematic review. The meta-analysis of the accuracy (19 clinical and preclinical studies) revealed a total mean error of 0.74 mm (maximum of 4.5 mm) at the entry point in the bone and 0.85 mm at the apex (maximum of 7.1 mm). For the 5 included clinical studies (total of 506 implants) using computer-assisted implant dentistry, the mean failure rate was 3.36% (0% to 8.45%) after an observation period of at least 12 months. In 4.6% of the treated cases, intraoperative complications were reported; these included limited interocclusal distances to perform guided implant placement, limited primary implant stability, or need for additional grafting procedures. Conclusion: Differing levels and quantity of evidence were available for computer-assisted implant placement, revealing high implant survival rates after only 12 months of observation in different indications and a reasonable level of accuracy. However, future long-term clinical data are necessary to identify clinical indications and to justify additional radiation doses, effort, and costs associated with computer-assisted implant surgery

Computer technology applications in surgical implant dentistry: a systematic review

PURPOSE: To assess the literature on accuracy and clinical performance of computer technology applications in surgical implant dentistry. MATERIALS AND METHODS: Electronic and manual literature searches were conducted to collect information about (1) the accuracy and (2) clinical performance of computer-assisted implant systems. Meta-regression analysis was performed for summarizing the accuracy studies. Failure/complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 12-month proportions. RESULTS: Twenty-nine different image guidance systems were included. From 2,827 articles, 13 clinical and 19 accuracy studies were included in this systematic review. The meta-analysis of the accuracy (19 clinical and preclinical studies) revealed a total mean error of 0.74 mm (maximum of 4.5 mm) at the entry point in the bone and 0.85 mm at the apex (maximum of 7.1 mm). For the 5 included clinical studies (total of 506 implants) using computer-assisted implant dentistry, the mean failure rate was 3.36% (0% to 8.45%) after an observation period of at least 12 months. In 4.6% of the treated cases, intraoperative complications were reported; these included limited interocclusal distances to perform guided implant placement, limited primary implant stability, or need for additional grafting procedures. CONCLUSION: Differing levels and quantity of evidence were available for computer-assisted implant placement, revealing high implant survival rates after only 12 months of observation in different indications and a reasonable level of accuracy. However, future long-term clinical data are necessary to identify clinical indications and to justify additional radiation doses, effort, and costs associated with computer-assisted implant surgery