Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
권호 표지
DOI QR코드

DOI QR Code

Assessment of alveolar bone changes in response to minimally invasive periodontal surgery: A cone-beam computed tomographic evaluation

  • Solaleh Shahmirzadi (Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, Texas A&M College of Dentistry) ;
  • Taraneh Maghsoodi-Zahedi (Department of Periodontology, University of Texas Health Science Center) ;
  • Sarang Saadat (Department of Comprehensive Dentistry, University of Texas Health Science Center) ;
  • Husniye Demirturk Kocasarac (Division of Oral and Maxillofacial Radiology, Department of General Dental Sciences, Marquette University School of Dentistry) ;
  • Mehrnoosh Rezvan (Rezvan Clinic) ;
  • Rujuta A. Katkar (Division of Oral and Maxillofacial Radiology, Department of Comprehensive Dentistry, University of Texas Health Science Center) ;
  • Madhu K. Nair (Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, Texas A&M College of Dentistry)
  • Received : 2022.03.16
  • Accepted : 2022.10.21
  • Published : 2023.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST). Materials and Methods: Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured. Results: An average alveolar bone gain >0.5 mm following PST was identified using CBCT(P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years. Conclusion: PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.

Keywords

Acknowledgement

We would like to extend our thanks to Drs. John C Chao and Marcel Noujeim for their guidance and help throughout the project. Also, we express special thanks to 360Imaging for their cooperation.

References

  1. Jati AS, Furquim LZ, Consolaro A. Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press J Orthod 2016; 21: 18-29.  https://doi.org/10.1590/2177-6709.21.3.018-029.oin
  2. Cairo F, Pagliaro U, Buti J, Baccini M, Graziani F, Tonelli P, et al. Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta-analysis. J Clin Periodontol 2016; 43: 965-75.  https://doi.org/10.1111/jcpe.12603
  3. Cairo F, Nieri M, Pagliaro U. Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. J Clin Periodontol 2014; 41 Suppl 15: S44-62.  https://doi.org/10.1111/jcpe.12182
  4. Lee YM, Kim JY, Seol YJ, Lee YK, Ku Y, Rhyu IC, et al. A 3-year longitudinal evaluation of subpedicle free connective tissue graft for gingival recession coverage. J Periodontol 2002; 73: 1412-8.  https://doi.org/10.1902/jop.2002.73.12.1412
  5. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol 2006; 77: 2070-9.  https://doi.org/10.1902/jop.2006.050296
  6. Chao JC. A novel approach to root coverage: the pinhole surgical technique. Int J Periodontics Restorative Dent 2012; 32: 521-31. 
  7. Mostafa D, Al Shateb S, Thobaiti B, Alotaibi B, Al Rabeea S, Aldossry M, et al. The pinhole technique in the treatment of gingival recession defects. Adv Dent Oral Health 2020; 13: 555855. 
  8. Reddy SS. Pinhole surgical technique for treatment of marginal tissue recession: a case series. J Indian Soc Periodontol 2017; 21: 507-11. 
  9. Zucchelli G, Mele M, Mazzotti C, Marzadori M, Montebugnoli L, De Sanctis M. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comparative controlled randomized clinical trial. J Periodontol 2009; 80: 1083-94.  https://doi.org/10.1902/jop.2009.090041
  10. Mostafa D, Mandil OA. Treatment of gingival recession defects using non-invasive pinhole technique with propolis application, a case report. Int J Surg Case Rep 2021; 83: 106042. 
  11. Agarwal MC, Kumar G, Manjunath RG, Karthikeyan SS, Gummaluri SS. Pinhole surgical technique - a novel minimally invasive approach for treatment of multiple gingival recession defects: a case series. Contemp Clin Dent 2020; 11: 97-100.  https://doi.org/10.4103/ccd.ccd_449_19
  12. Bruno JF, Bowers GM. Histology of a human biopsy section following the placement of a subepithelial connective tissue graft. Int J Periodontics Restorative Dent 2000; 20: 225-31. 
  13. Pasquinelli KL. The histology of new attachment utilizing a thick autogenous soft tissue graft in an area of deep recession: a case report. Int J Periodontics Restorative Dent 1995; 15: 248-57. 
  14. Ozcan G, Sekerci AE. Classification of alveolar bone destruction patterns on maxillary molars by using cone-beam computed tomography. Niger J Clin Pract 2017; 20: 1010-9.  https://doi.org/10.4103/1119-3077.180074
  15. Van Dessel J, Nicolielo LF, Huang Y, Coudyzer W, Salmon B, Lambrichts I, et al. Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-CT. Eur J Oral Implantol 2017; 10: 95-105. 
  16. Niederberger M, Spranger J. Delphi technique in health sciences: a map. Front Public Health 2020; 8: 457. 
  17. Al-Almaie S. Feasibilities of the pinhole surgical technique: mini review. Adv Dent Oral Health 2017; 4: 555638. 
  18. Zucchelli G, De Sanctis M. Treatment of multiple recession-type defects in patients with esthetic demands. J Periodontol 2000; 71: 1506-14.  https://doi.org/10.1902/jop.2000.71.9.1506
  19. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol 2006; 77: 2070-9.  https://doi.org/10.1902/jop.2006.050296
  20. Harris RJ. A short-term and long-term comparison of root coverage with an acellular dermal matrix and a subepithelial graft. J Periodontol 2004; 75: 734-43.  https://doi.org/10.1902/jop.2004.75.5.734
  21. Virk MS, Conduah A, Park SH, Liu N, Sugiyama O, Cuomo A, et al. Influence of short-term adenoviral vector and prolonged lentiviral vector mediated bone morphogenetic protein-2 expression on the quality of bone repair in a rat femoral defect model. Bone 2008; 42: 921-31.  https://doi.org/10.1016/j.bone.2007.12.216
  22. Rakmanee T, Griffiths GS, Auplish G, Darbar U, Petrie A, Olsen I, et al. Radiographic outcomes following treatment of intrabony defect with guided tissue regeneration in aggressive periodontitis. Clin Oral Investig 2016; 20: 1227-35.  https://doi.org/10.1007/s00784-015-1609-y
  23. Linares A, Cortellini P, Lang NP, Suvan J, Tonetti MS, European Research Group on Periodontology (ErgoPerio). Guided tissue regeneration/deproteinized bovine bone mineral or papilla preservation flaps alone for treatment of intrabony defects. II: radiographic predictors and outcomes. J Clin Periodontol 2006; 33: 351-8.  https://doi.org/10.1111/j.1600-051X.2006.00911.x
  24. Wang Y, Chai Z, Zhang Y, Deng F, Wang Z, Song J. Influence of low-intensity pulsed ultrasound on osteogenic tissue regeneration in a periodontal injury model: X-ray image alterations assessed by micro-computed tomography. Ultrasonics 2014; 54: 1581-4.  https://doi.org/10.1016/j.ultras.2014.03.015
  25. Jeffcoat MK, Wang IC, Reddy MS. Radiographic diagnosis in periodontics. Periodontol 2000 1995; 7: 54-68.  https://doi.org/10.1111/j.1600-0757.1995.tb00036.x
  26. Reddy MS, Jeffcoat MK. Methods of assessing periodontal regeneration. Periodontol 2000 1999; 19: 87-103.  https://doi.org/10.1111/j.1600-0757.1999.tb00149.x
  27. Zhang W, Rajani S, Wang BY. Comparison of periodontal evaluation by cone-beam computed tomography, and clinical and intraoral radiographic examinations. Oral Radiol 2018; 34: 208-18.  https://doi.org/10.1007/s11282-017-0298-4
  28. Rafini F, Priaminiarti M, Sukardi I, Lessang R. Digital radiographic evaluation of alveolar bone loss, density and lamina dura integrity on post splinting mandibular anterior with chronic periodontitis. J Phys Conf Ser 2017; 884: 012053. 
  29. Kornman KS, Robertson PB. Fundamental principles affecting the outcomes of therapy for osseous lesions. Periodontol 2000 2000; 22: 22-43. https://doi.org/10.1034/j.1600-0757.2000.2220103.x