Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

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Abstract

Background

The periodontal healing distal to the mandibular second molar (M2M) after coronectomy of the M3M has shown controversial results. We aimed to combine a digital method with cone-beam computed tomography (CBCT) and estimate periodontal healing of M2M after M3M coronectomy. An accurate and stable indicator in three dimensions was also explored tentatively.

Methods

Patients with a M3M in contact with the inferior alveolar canal were included. CBCT was applied immediately after coronectomy (baseline) and 6-months later. Data were investigated with digital software for registration. Previously reported and coronectomy-related factors were included for univariate and multivariate analyses.

Results

A total of 181 patients (213 M3Ms) completed 6-month follow-up. Significant reduction in the distal intra-bony defect (DBD) depth of the M2M was shown (1.28 ± 1.24 mm, P < 0.001). DBD depth of the M2M at baseline was the most influential factor ( r = 0.59), followed by preoperative M3M condition, age, rotation and migration of the root complex. Remaining enamel (OR = 6.93) and small retromolar space (0.67) contributed to re-contact of the root complex and M2M. Bone volume regenerated in the distal 2 mm was associated significantly with DBD-depth reduction ( r = 0.74, P < 0.001).

Conclusions

Bone volume regenerated in the distal 2 mm of the M2M denoted stability of distal periodontal healing of the M2M. DBD depth at baseline was the most influential factor for healing of a DBD of the M2M after M3M coronectomy. The remaining enamel and a small retromolar space could contribute to re-contact of the root complex and the M2M.

Trial registration

China Clinical Trial Center, ChiCTR1800014862. Registered 10 February 2018,

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Most cited references 34

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Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review.

Anton Sculean, Dimitris Nikolidakis, George Nikou … (2015)

Intrabony periodontal defects are a frequent complication of periodontitis and, if left untreated, may negatively affect long-term tooth prognosis. The optimal outcome of treatment in intrabony defects is considered to be the absence of bleeding on probing, the presence of shallow pockets associated with periodontal regeneration (i.e. formation of new root cementum with functionally orientated inserting periodontal ligament fibers connected to new alveolar bone) and no soft-tissue recession. A plethora of different surgical techniques, often including implantation of various types of bone graft and/or bone substitutes, root surface demineralization, guided tissue regeneration, growth and differentiation factors, enamel matrix proteins or various combinations thereof, have been employed to achieve periodontal regeneration. Despite positive observations in animal models and successful outcomes reported for many of the available regenerative techniques and materials in patients, including histologic reports, robust information on the degree to which reported clinical improvements reflect true periodontal regeneration does not exist. Thus, the aim of this review was to summarize, in a systematic manner, the available histologic evidence on the effect of reconstructive periodontal surgery using various types of biomaterials to enhance periodontal wound healing/regeneration in human intrabony defects. In addition, the inherent problems associated with performing human histologic studies and in interpreting the results, as well as certain ethical considerations, are discussed. The results of the present systematic review indicate that periodontal regeneration in human intrabony defects can be achieved to a variable extent using a range of methods and materials. Periodontal regeneration has been observed following the use of a variety of bone grafts and substitutes, guided tissue regeneration, biological factors and combinations thereof. Combination approaches appear to provide the best outcomes, whilst implantation of alloplastic material alone demonstrated limited, to no, periodontal regeneration.

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Tissue engineering: a new paradigm for periodontal regeneration based on molecular and cell biology.

P. Mark Bartold, CHRISTOPHER A. G. MCCULLOCH, A. Narayanan … (2000)

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Registration of cone beam computed tomography data and intraoral surface scans – A prerequisite for guided implant surgery with CAD/CAM drilling guides

Tabea Flügge, Wiebe Derksen, Jobine te Poel … (2016)

Abstract Objectives Guided implant surgery (GIS) is performed with drilling guides that are produced on the virtual tooth model using CAD/CAM technology. The prerequisite for this workflow is the alignment of patients cone beam computed tomography CBCT and surface scan (registration). Dental restorations may cause deteriorating imaging artifacts in CBCT data, which in turn can have an impact on the registration process. The influence of the user and the preprocessing of data and of image artifacts on the registration accuracy were examined. Material and Methods CBCT data and intraoral surface scans of 36 patients were used for virtual implant planning in coDiagnostiX (Dentalwings, Montreal, Canada). CBCT data were reconstructed to a three‐dimensional anatomical model with the default settings provided by the software and also manually by four different examiners. Subsequently, the CBCT and intraoral surface models were registered by each examiner with the help of anatomical landmarks. Patients' data were subdivided into four groups (A–D) according to the number of metallic restorations: A = 0–2 restorations, B = 3–5 restorations, C = 6–8 restorations and D > 8 restorations. After registration, the distances between CBCT and dental surface models were measured. Linear regression models were used to assess the influence of the segmentation, the examiner and to the number of restorations (P < 0.05). Results The deviations between surface scan and CBCT models accounted to 0.54 mm (mean). The mean deviations were 0.69 mm (max. 24.8 mm) and 0.4 mm (max. 9.1 mm) for default and manual segmentation, respectively. Mean deviations of 0.36 mm (Group A), 0.43 mm (Group B), 0.67 mm (Group C) and 1.01 mm (Group D) were recorded. The segmentation (P = 0.000), the user (P = 0.0052) and the number of restorations (P = 0.0337) had a significant influence on the registration accuracy. Conclusions The deviation between CBCT and surface scan model resulting from inaccurate registration is transferred to the surgical field and results in a deviation between the planned and actual implant position. The registration accuracy in commercial virtual implant planning software is significantly influenced by the preprocessing of imported data, by the user and by the number of restorations resulting in clinically non‐acceptable deviations encoded in drilling guides.

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Author and article information

Contributors

C. B. Guo: chuanbinguo@pkuss.bjmu.edu.cn

N. H. Cui:

ORCID: http://orcid.org/0000-0003-0642-5942

drcuinianhui@163.com

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 24 September 2020

Publication date PMC-release: 24 September 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 264

Affiliations

[1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Oral and Maxillofacial Surgery, , Peking University School and Hospital of Stomatology, ; 22 South Street Zhong Guan Cun, Haidian District, Beijing, 100081 China

[2 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Medical Statistics, , Peking University Clinical Research Institute, ; Beijing, China

[3 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Oral and Maxillofacial Radiology, , Peking University School and Hospital of Stomatology, ; Beijing, China

Author information

N. H. Cui http://orcid.org/0000-0003-0642-5942

Article

Publisher ID: 1250

DOI: 10.1186/s12903-020-01250-z

PMC ID: 7513308

PubMed ID: 32972396

SO-VID: 542f9941-676b-4f7a-b3a6-b20d0136e7b1

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 2 June 2020

Date accepted : 9 September 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100009504, School of Stomatology, Peking University;

Award ID: PKUSSNCT-18A12

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: coronectomy,computer-aided 3d assessment,distal intra-bony defect,periodontal healing,re-contact,volume of bone regenerated

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ScienceOpen disciplines: Dentistry

Keywords: coronectomy, computer-aided 3d assessment, distal intra-bony defect, periodontal healing, re-contact, volume of bone regenerated

Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

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Trial registration

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Arab Journal of Forensic Sciences & Forensic Medicine (AJFSFM)

Most cited references 34

Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review.

Tissue engineering: a new paradigm for periodontal regeneration based on molecular and cell biology.

Registration of cone beam computed tomography data and intraoral surface scans – A prerequisite for guided implant surgery with CAD/CAM drilling guides

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