Residents’ journal review

Alveolar bone repair

Nampo T, Watahiki J, Enomoto A, Taguchi T, Ono M, Nakano H, et al. A new method for alveolar bone repair using extracted teeth for the graft material. J Periodontol 2010;81:1264-72

The alveolar bone graft (ABG) often requires harvested bone from the iliac crest. The ABG can be traumatic for young patients and is associated with painful recovery and complications such as risk of infection at the donor site. These authors investigated the potential for using extracted teeth as bone graft material. Sixty 12-week-old Wistar rats were randomly divided into 3 groups. Group 1 received a graft of tooth material except enamel with β-tricalcium phosphate complex. Group 2 received iliac bone and β- tricalcium phosphate complex. Group 3 was the control and received no graft. A 2-mm alveolar defect was created with a round bur after a full-thickness flap. The rats were killed at 6 and 8 weeks after surgery. The defects were sectioned and fixed. Real-time PCR was performed along with clinical, microcomputed tomography, and histologic observations. Gene expressions of P75, P0, nestin, and musashi-1 were significantly higher in group 1; this was attributed to the tooth graft containing undifferentiated neural crest-derived cells. Histology and microcomputed tomography showed new bone formation in groups 1 and 2. The dentin from group 1 was incorporated into the new bone; despite a slight inflammatory reaction, the bone quality was similar to the alveolus before the graft. This study shows promising results in an animal model. The authors posed some concerns regarding the use of teeth for ABGs in humans but suggested that further research could lead to the use of teeth as a regular graft material. Future applications would be an excellent advancement, especially in cleft lip and palate patients, where ABGs are common.

Reviewed by Ben Hoelscher

Comparison of diagnostic information from 2D and 3D images

Botticelli S, Verna C, Cattaneo PM, Heidmann J, Melsen B. Two- versus three-dimensional imaging in subjects with unerupted maxillary canines. Eur J Orthod 2010 Dec 3 [Epub ahead of print]

Although somewhat controversial, 3-dimensional (3D) radiographic imaging is more common in orthodontics than ever before. The purpose of this study was to determine whether there is any difference in diagnostic information provided by conventional 2-dimensional (2D) radiographs or 3D cone-beam computed tomography (CBCT) in subjects with unerupted maxillary canines. For each of the 39 unerupted canines in the study, 2 different sets of images were obtained. The 2D image set included panoramic, lateral cephalometric, and periapical radiographs at differing projections. The 3D image set contained various image reconstructions obtained from the CBCT raw data. The image sets were randomized and evaluated by 8 orthodontic providers with varying degrees of experience. The results were obtained by questionnaire, and each practitioner was asked to evaluate the location of the canine, the presence of lateral incisor root resorption, the perceived difficulty of the case, and the quality of the images, and to provide a treatment strategy. The results show a statistically significant difference in localization of the canine apex and crown, overlap of the lateral incisor, and identification of root resorption on the lateral incisor, when comparing the 2 methods. Additionally, the perceived difficulty of the case was higher and the practitioners were more likely to advise interceptive treatment when evaluating the CBCT data set. Concerns about radiation exposure continue to cause debate over the appropriate use of cone-beam radiographs in orthodontics. The authors presented a clinical situation in which the use of CBCT technology had a significant impact on the diagnosis and treatment plan.

Reviewed by Nicholas R. Smith

Comparison of diagnostic information from 2D and 3D images

Botticelli S, Verna C, Cattaneo PM, Heidmann J, Melsen B. Two- versus three-dimensional imaging in subjects with unerupted maxillary canines. Eur J Orthod 2010 Dec 3 [Epub ahead of print]

Although somewhat controversial, 3-dimensional (3D) radiographic imaging is more common in orthodontics than ever before. The purpose of this study was to determine whether there is any difference in diagnostic information provided by conventional 2-dimensional (2D) radiographs or 3D cone-beam computed tomography (CBCT) in subjects with unerupted maxillary canines. For each of the 39 unerupted canines in the study, 2 different sets of images were obtained. The 2D image set included panoramic, lateral cephalometric, and periapical radiographs at differing projections. The 3D image set contained various image reconstructions obtained from the CBCT raw data. The image sets were randomized and evaluated by 8 orthodontic providers with varying degrees of experience. The results were obtained by questionnaire, and each practitioner was asked to evaluate the location of the canine, the presence of lateral incisor root resorption, the perceived difficulty of the case, and the quality of the images, and to provide a treatment strategy. The results show a statistically significant difference in localization of the canine apex and crown, overlap of the lateral incisor, and identification of root resorption on the lateral incisor, when comparing the 2 methods. Additionally, the perceived difficulty of the case was higher and the practitioners were more likely to advise interceptive treatment when evaluating the CBCT data set. Concerns about radiation exposure continue to cause debate over the appropriate use of cone-beam radiographs in orthodontics. The authors presented a clinical situation in which the use of CBCT technology had a significant impact on the diagnosis and treatment plan.

Reviewed by Nicholas R. Smith

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Apr 11, 2017 | Posted by in Orthodontics | Comments Off on Residents’ journal review
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