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Background: Clinicians needed to be aware of the thinness of the palatal bone plate when identifying severe protrusion of maxillary incisors, as this could result in perforation of the palatal bone plate during surgical procedures associated with immediate maxillary implant placement. Purpose: This study evaluated the thickness of the palatal bone plate, the buccolingual angulation of maxillary incisors, and the correlation between these two parameters in relation to immediate implant placement. Materials and Methods: Cone‐beam computed tomography images of 37 Asian patients (20‐60 years old) with no evidence of dental treatment in the maxillary incisor area were collected and classified into groups based on sex and incisor locations. Sagittal slices were used to measure the palatal bone plate thickness at the cervical, middle, and apical levels, and the buccolingual angulation of each tooth was also measured. The intraclass correlation, Shapiro‐Wilk test, descriptive analysis, Student's t‐test, and Pearson correlation were used for statistical and correlation analyses, with P < .05 applied as the criterion for statistical significance. Results: At the apical level of all inspected teeth and the middle level of lateral incisors, the palatal bone was significantly thicker in males than in females. The inclination of the maxillary lateral incisor showed a moderate negative linear correlation with the palatal bone thickness at the apical level (R = −0.517 and R = −0.579 for males and females, respectively). Conclusions: In an Asian population, an increased buccolingual angulation of the maxillary lateral incisors was correlated with a thinner palatal bone plate at the apical level. [ABSTRACT FROM AUTHOR]

Oral submucous fibrosis (OSF) is a collagen deposition disorder that affects a patient's oral function and quality of life. It may also potentially transform into malignancy. This review summarizes the risk factors, pathogenic mechanisms, and treatments of OSF based on clinical and bio-molecular evidence. Betel nut chewing is a major risk factor that causes OSF in Asia. However, no direct evidence of arecoline-induced carcinogenesis has been found in animal models. Despite identification of numerous biomarkers of OSF lesions and conducting trials with different drug combinations, clinicians still adopt conservative treatments that primarily focus on relieving the symptoms of OSF. Treatments focus on reducing inflammation and improving mouth opening to improve a patient's quality of life. In conclusion, high-quality clinical studies are needed to aid clinicians in developing and applying molecular biomarkers as well as standard treatment guidelines. [ABSTRACT FROM AUTHOR]

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe's posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery. [ABSTRACT FROM AUTHOR]

This study used available or purchased equipment and an image reconstruction system developed by the college of dentistry to establish a basic self-assembled micro-computed tomography (micro-CT) system. Such a system would be suitable for teaching dental radiology to dental students. Specifically, it could help students to understand the principles governing dental cone-beam computed tomography (CBCT) and provide graduate students with a system for scanning small samples (e.g., individual teeth) during the early stages of research. The self-assembled micro-CT system was constructed using a portable dental X-ray tube, an intraoral digital X-ray detector, a high-precision rotation stage, related bracket accessories, and a notebook computer. Reconstructed images and three-dimensional models of the maxillary right third molar were produced using the self-assembled micro-CT system and an advanced commercially available micro-CT system (Skyscan 2211). Subsequently, the reconstructed images and 3D models produced using the two systems were compared by two senior dentists to determine whether considerable visual differences could be observed. Finally, the signal-to-noise ratio (SNR) was used for quantitative analysis and to compare the systems. Although the self-assembled micro-CT system produced image boundaries that were not as sharp as those of Skyscan 2211, the images were nonetheless remarkably similar. In addition, the two micro-CT systems produced 3D models that were almost identical in appearance and root canal shape. Quantitative analysis revealed that Skyscan 2211 had produced a SNR that was superior to that of the self-assembled micro-CT system, with the difference ranging from 36.77% to 136.22%; enamel, which has a higher density, exhibited lower SNR differences, whereas dentin, which has a lower density, exhibited higher SNR differences. The self-assembled micro-CT system with a resolution of 36 μm was created using a portable dental X-ray tube and an intraoral digital X-ray detector. Although the scanning time was relatively long (~30 min to scan images of a tooth), the images were adequate in the preliminary stage of experiments. More importantly, students were afforded the opportunity to observe the process of assembling and disassembling each component of a micro-CT scanner and thereby achieve a more comprehensive understanding of the principles governing micro-CT and dental CBCT. [ABSTRACT FROM AUTHOR]

Background Dental implants have become reliable and predictable tools for treating missing teeth. The survival rate of dental implants is markedly influenced by the host bone quality and quantity of the jawbone. A better host bone provides higher initial stability of the dental implant, resulting in better osseointegration and a higher success rate. Host bone quality and quantity are determined by the crestal cortical bone thickness and inner cancellous bone density. Objective The purpose of this study was to determine the crestal cortical bone thickness at dental implant sites in different regions of the jawbone through the use of dental cone-beam computed tomographic (CBCT) images. Materials and Methods A total of 661 dental implant sites (81 in the anterior mandible, 122 in the anterior maxilla, 224 in the posterior mandible, and 234 in the posterior maxilla) were obtained from the jawbones of 173 humans. The data were subjected to statistical analysis to determine any correlation between crestal cortical bone thicknesses and jawbone regions using one-way analysis of variance with Tukey's post-test. Results The crestal cortical bone thicknesses at dental implant sites in the four regions decreased in the following order: posterior mandible (1.07 ± 0.47 mm, mean ± SD) >anterior mandible (0.99 ± 0.36 mm) >anterior maxilla (0.82 ± 0.30 mm) >posterior maxilla (0.75 ± 0.35 mm). Conclusion The dental CBCT data demonstrate that crestal cortical bone thickness varies markedly between dental implant sites in the four regions of the jawbone. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the inclinations of right and left sides the mandibular fossa in Asian population using computed tomography (CT) images and determine its effects according to the parameters of gender, age, and asymmetry. CT images of the heads of 198 Asian subjects [95 females aged 44.2 ± 20.7 years, range 11-88 years; and 103 males aged 44.5 ± 19.7 years, range 15-98 years] were selected. The following eight parameters characterizing the inclinations of the mandibular fossa were measured by medical imaging software: anterior and posterior inclinations on the left and right sides on a sagittal view, and medial and lateral inclinations on the left and right sides on a coronal view. The anterior inclination was significant steeper in males than in females on both the left and right sides. A moderate positive correlation was found between age and anterior inclinations on the left and right sides. None of the other parameters were significantly affected by age or gender. None of the parameters differed significantly between the right and left sides of the mandibular fossa in males, females, or all subjects. The anterior inclination of the mandibular fossa was affected by aging and gender becoming steeper in Asians males than females. Besides, there were no asymmetry in the right and left side inclinations of the mandibular fossa. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study investigated the surrounding bone stress and the implant–bone interfacial sliding of implant designs and implant sizes of immediately loaded implant with maxillary sinus augmentation by using three-dimensional (3D) non-linear finite element (FE) analysis. Methods: Twenty-four FE models including four implant designs (cylindrical, threaded, stepped and step-thread implants) and three implant dimensions (standard, long and wide threaded implants) with a bonded and three levels of frictional contact of implant–bone interfaces were analyzed. The maxillary model was constructed from computer tomography (CT) images of a human skull and all 3D implant models were created via the computer-aided design (CAD) software. Results: The use of threaded implants decreased the bone stress and sliding distance obviously about 30% as compared with non-threaded (cylindrical and stepped) implants. Increasing the implant''s length or diameter reduced the bone stress by 13–26%. Employing a immediately loaded implant with smooth machine surface (μ =0.3, μ represents frictional coefficient) increased the bone stress by 28–63% as compared with the osseointegrated (bonded interfaces) implants. Roughening the implant surface (μ >0.3) did not reduced the bone stress, however it did decrease the interfacial sliding between implant and bone. Conclusions: For an immediately loaded implant placed with sinus augmentation, using threaded implant could decrease both the bone stress and implant–bone sliding distance which may improve the implant initial stability and long-term survival. Rough surface of implants shows no benefit to reduce the bone stress but they could lower the interfacial sliding. On the contrary, employing long or wide implants decrease the bone stress but they cannot diminish the interfacial sliding. [Copyright &y& Elsevier]

Background: Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two levels of marginal bone loss.Methods: Twenty implants were divided into Groups A and B, with simulated bone losses of 3.0 and 1.5 mm, respectively. Groups A and B were also each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments and (2) titanium implants connected to zirconia abutments. The maximum deformation and failure forces of each sample was determined using a universal testing machine. The data were analyzed using the nonparametric Mann-Whitney test.Results: The mean maximum deformation and failure forces obtained the subgroups were as follows: A1 (simulated bone loss of 3.0 mm, titanium-alloy abutment) = 540.6 N and 656.9 N, respectively; A2 (simulated bone loss of 3.0 mm, zirconia abutment) = 531.8 N and 852.7 N; B1 (simulated bone loss of 1.5 mm, titanium-alloy abutment) = 1070.9 N and 1260.2 N; and B2 (simulated bone loss of 1.5 mm, zirconia abutment) = 907.3 N and 1182.8 N. The maximum deformation force differed significantly between Groups B1 and B2 but not between Groups A1 and A2. The failure force did not differ between Groups A1 and A2 or between Groups B1 and B2. The maximum deformation and failure forces differed significantly between Groups A1 and B1 and between Groups A2 and B2.Conclusions: Based on this experimental study, the maximum deformation and failure forces are lower for implants with a marginal bone loss of 3.0 mm than of 1.5 mm. Zirconia abutments can withstand physiological occlusal forces applied in the anterior region. [ABSTRACT FROM AUTHOR]