Three-Dimensional Virtual Treatment Planning: Presurgical Evaluation

Farronato, Giampietro; Galbiati, G.; Esposito, Luca; Mortellaro, Carmen; Zanoni, Federica; Maspero, Cinzia

doi:10.1097/scs.0000000000004455

Cited by 23 publications

(15 citation statements)

References 22 publications

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“…Even when the second molar spontaneously erupts, it delays the beginning of the orthodontic treatment. Furthermore, if it does not spontaneously erupt, it represents a major burden to be solved during orthodontic treatment [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

et al. 2020

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The aim of this study is to assess whether operculectomy in patients with retained second molars eases spontaneous tooth eruption in respect to untreated controls. Two hundred and twenty-two patients with delayed eruption of at least one second molar were selected from the archives of the Department of Orthodontics, Milan, Italy. Eighty-eight patients, 40 males and 48 females (mean age 14.8 ± 1.3 years), met the inclusion criteria. Records were then divided into case and control groups. The case group consisted of patients that underwent removal of the overlaying mucosa over second molars (i.e., operculectomy) and the control group consisted of subjects who retained their operculum over an unerupted second molar and were followed for one year without performing any treatment. A total of 145 impacted second molars were considered (75 cases, 70 controls). A risk ratio with 95% confidence interval was used to compare the prevalence of eruption in the two groups. Spontaneous eruption occurred in 93.3% of cases in the operculectomy group (70/75), while in the control group, 10% teeth erupted spontaneously (7/70). Spontaneous eruption in the upper arch occurred in 95.2% of cases among treated patients (40 out of 42), while in the lower arch, spontaneous eruption occurred in 90.9% of cases (30 out of 33). Spontaneous eruption of the upper second molars in the control group occurred in 8.5% of cases (3 out of 35), while in the lower arch, it occurred in 8.5% (3 out of 35). Operculectomy can ease the spontaneous eruption of retained second molars and reduce the chances of inclusion.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

et al. 2020

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“…Radiation exposure from new-generation CBCT, despite continuous reduction, is still significantly higher compared to conventional bidimensional radiographs [10], and therefore, indications are restricted to complex cases whose benefits from three-dimensional information justify the increased radiation exposure according to ALARA (as low as reasonably achievable) and ALADA (as low as diagnostically acceptable) principles [11]. Cone-beam computed tomography (CBCT) is now used for orthodontic diagnosis and treatment planning for conditions such as severe asymmetries, impaction of one or more teeth, and craniomaxillofacial malformation [11–13].…”

Section: Introductionmentioning

confidence: 99%

Comparison of a tridimensional cephalometric analysis performed on 3T-MRI compared with CBCT: a pilot study in adults

et al. 2019

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ObjectiveSince the introduction of cone-beam computed tomography (CBCT) in dentistry, this technology has enabled distortion-free three-dimensional cephalometric analysis for orthodontic and orthognathic surgery diagnosis. However, CBCT is associated with significantly higher radiation exposure than traditional routine bidimensional examinations for orthodontic diagnosis, although low-dose protocols have markedly reduced radiation exposure over time.The objective of this preliminary feasibility study is to compare the accuracy and diagnostic capabilities of an already-validated three-dimensional cephalometric analysis on CBCT to those of an analysis on 3-T magnetic resonance imaging (3T-MRI) to assess whether the latter can deliver a comparable quality of information while avoiding radiation exposure.Materials and methodsIn order to test the feasibility of three-dimensional cephalometry on 3T-MRI, 18 subjects (4 male; 14 female) with mean age 37.8 ± SD 10.2, who had undergone both maxillofacial CBCT and maxillofacial 3T-MRI for various purposes within 1 month, were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione Ospedale Policlinico Maggiore, IRCCS, Milano, Italy.A three-dimensional cephalometric analysis composed of ten midsagittal and four bilateral landmarks and 24 measurements (11 angular, 13 linear) was performed on both scans using Mimics Research® v. 17.0 (NV, Technologielaan 15, 3001 Leuven, Belgium). Cephalometric analysis was performed twice by two independent orthodontists for each scan, and each orthodontist repeated the measurements 3 weeks later. Statistical analysis was performed with SPSS® 20.00 for Windows (IBM® Corporation, Sommers, NY, USA). A Bland-Altman test for each cephalometric value was performed to assess the agreement between the procedures. The intraclass correlation coefficient (ICC) was used to assess interobserver and intraobserver reliability. The coefficient of variation was used to evaluate precision.ResultsBoth procedures showed good reliability, with mean intraobserver ICCs of 0.977/0.971 for CBCT and 0.881/0.912 for MRI. The average interobserver ICCs were 0.965 for CBCT and 0.833 for MRI. A Bland-Altman analysis for the cephalometric tracing revealed a similar range of agreement between the two modalities; the bias range (mean ± SD) was − 0.25–0.66 mm (0.174 ± 0.31) for distances and − 0.41–0.54° (0.12 ± 0.33) for angles.ConclusionsWithin the main limitation of this pilot study, that is, the small sample, it is possible to state that cephalometric measurements on 3T-MRI seem to possess adequate reliability and repeatability and that they show satisfying agreement with values measured on CBCTs. An MRI examination does not expose patients to ionizing radiation and could provide an alternative to CBCT for three-dimensional cephalometrics in the future.

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“…On the other hand, three-dimensional (3D) cone beam computed tomography (CBCT) has specifically been introduced and successfully used to evaluate the bony architecture [12][13][14][15][16][17]. Its advantages include, but are not limited to low radiation dose, lower cost, high spatial resolution, excellent tissue contrast, the elimination of blurring and overlapping of adjacent teeth, and overall much more precise cephalometric analyses [18,19].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Dental Vestibular–Palatal Inclination and Alveolar Bone Remodeling after Orthodontic Treatment: A CBCT Analysis

et al. 2019

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The aim of this study was to evaluate the correlation between dental vestibular–palatal inclination changes and the cortical bone remodeling after fixed orthodontic treatment using cone beam computed tomography (CBCT). Twenty-two patients with Angle Class I malocclusion, permanent dentition, and mild to moderate dental crowding were included in the present three-dimensional (3D) analysis. Bone dimensions were evaluated by CBCT scans obtained before and after orthodontic treatment, whereas the torque values were calculated by means of digital models using the 3D VistaDent software. A paired t-test was used to compare the changes between the pretreatment and post-treatment measurements. The correlations between variables were analyzed with linear regression analysis. A significant correlation between torque variations and bone thickness changes was observed for the apical buccal level of the anterior side (P < 0.05). Limited and not significant alveolar bone resorption for the apical thickness of anterior teeth occurred at ± 5 degrees of torque variation, while for tooth inclination exceeding +5 or −5 degrees, the bone remodeling was more evident. The present study demonstrated that anterior region was the most affected area by bone remodeling and that torque variation was highly related to apical bone thickness adaptation for maxillary and mandibular incisors and maxillary canines.

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Three-Dimensional Virtual Treatment Planning: Presurgical Evaluation

Cited by 23 publications

References 22 publications

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

Comparison of a tridimensional cephalometric analysis performed on 3T-MRI compared with CBCT: a pilot study in adults

Correlation between Dental Vestibular–Palatal Inclination and Alveolar Bone Remodeling after Orthodontic Treatment: A CBCT Analysis

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