CBCT for estimation of the cemento-enamel junction and crestal bone of anterior teeth

The aim of the study is to evaluate the usefulness of cone-beam computed tomography (CBCT) in the assessment of the relationship between the cemento-enamel junction (CEJ) and bone crest of the anterior mandibular cortex. The study population comprised 39 males and 61 females, aged 18–71. A GENDEX GXCB-500 machine, i-CAT Vision and CorelDraw 9 software were used. The distances between the CEJ and bone crest at buccal and lingual sides of six anterior mandibular teeth were measured. Descriptive statistical methods, Student’s t-test and ANOVA were used. The mean distance between the bone crest and CEJ was 2.32 mm ± 0.78 mm at the buccal and 2.52 mm ± 0.85 mm at the lingual side. It was found that in males aged over 50 years, the mean distance at the buccal side was 2.84 mm ± 0.79 mm and was significantly higher than in males aged 49 and less – 2.08 mm ± 0.41 mm. The mean distance at the lingual side was 3.28 mm ± 1.08 mm and was significantly lower in the age group of 49 years and less – 2.10 mm ± 0.41 mm. CBCT allows determining the distance between the CEJ and crestal bone margin at buccal and lingual sides. The data provide crucial information for planning orthodontic treatment, implant placement and periodontal therapy.

Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration

Surgery is an important part of the management of patients diagnosed with DFO. It consists in some selected patients, to remove all or part of the infected bone(s) or even to amputate all or part of the foot. Despite the use of sophisticated imaging techniques, it is however difficult to remove all the infected tissue while respecting the principles of an economical surgery. Bone biopsy performed at the margins of the resection permits to identify residual osteomyelitis and to adjust the post-surgical antibiotic treatment. Some recent studies have reported the way to perform bone margin biopsies and have assessed the impact of the bone results on the patient's outcome. However, the real impact of a residual osteomyelitis on the risk of recurrent DFO is still debated and questions regarding the interpretation of the results remain to be solved. Similarly, the consequences in terms of choice and duration of the antimicrobial treatment to use in case of positive bone margin are not clearly established.

Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

This study aimed to present and evaluate alternative lesion-specific mandibulectomy methods for preserving the mandibular anatomical structures as compared with the conventional virtual surgical plan. Fifteen patients who received segmental mandibulectomy were included in this study, and the following parameters were evaluated: (1) the disease-free bone margin, (2) the volume and surface between the tailor-made resection simulation and conventional resection simulation, and (3) the preserved mandibular anatomical structures. In all 15 patients, disease-free bone margins were confirmed by histopathology. Volumes of conventional resection simulation and tail-made resection simulation were 49,468.66 ± 14,007.96 mm3 and 52,610.01 ± 13,755.33 mm3 and the surfaces were 20,927.38 ± 4471.70 mm2 and 22,356.49 ± 4185.73 mm2, respectively; these were statistically significant (both, p < 0.001). Mandibular dentition was partially preserved in six patients. Twelve of the 15 patients had changes in defect classification with preservation of the mandibular inferior border. In conclusion, alternative lesion-specific mandibulectomy was a less invasive method for effectively removing mandibular lesions while preserving the important anatomical structures of the mandible.

Giant Solitary Plasmacytoma of Skull: A Case Report

Plasmacytoma is a tumor arising from plasma cell, which mainly grows within soft tissue or within axial skeleton, when it is present as a discreet solitary mass it is called as solitary plasmacytoma & it is rare, we report a 46 years male, presented to us with the complaints of painless swelling in the left front parietal region which is about 8.6x6.5cm in diameter, Magnetic resonance imaging revealed an extra axial mass in fronto parietal region with overlying bone destruction mimicking meningioma with bony erosion, we did frontoparietal craniectomy and complete resection of tumor with bone margin subsequent cranioplasty also done, histopathology of which revealed plasmacytoma,after that we did urinary bence jones protein which was negative Bang. J Neurosurgery 2019; 8(2): 115-118

Plasmacytoma of Skull Mimicking Meningioma and Metastasis

Plasmacytoma is a tumor arising from plasma cell, which mainly grows within soft tissue or within axial skeleton. When it is present as a discreet solitary mass it is called as solitary plasmacytoma and it is rare. We report a case of 46 years male presented to us with the complaints of painless swelling in the left front parietal region which is about 8.6x6.5cm in diameter .Magnetic resonance imaging(MRI) revealed an extra axial mass in fronto parietal region with overlying bone destruction mimicking meningioma with bony erosion. We did fronto parietal craniectomy and complete resection of tumor with bone margin subsequent cranioplasty also done.Histopathology of which revealed plasmacytoma. After that we did urinary bence jones protein which was negative.

Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

Background. We devised a new morphological parameter called the superior articular process area (SAPA) to evaluate the connection between lumbar foraminal stenosis (LFS) and the superior articular process. Objective. We hypothesized that the SAPA is an important morphologic parameter in the diagnosis of LFS. Methods. All patients over 60 years of age were included. Data regarding the SAPA were collected from 137 patients with LFS. A total of 167 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of a routine medical examination. We analyzed the cross-sectional area of the bone margin of the superior articular process at the level of L4-L5 facet joint in the axial plane. Results. The average SAPA was 96.3±13.6 mm2 in the control group and 128.1±17.2 mm2 in the LFS group. The LFS group was found to have significantly higher levels of SAPA (p<0.001) in comparison to the control group. In the LFS group, the optimal cut-off value was 112.1 mm2, with 84.4% sensitivity, 83.9% specificity, and AUC of 0.94 (95% CI: 0.91–0.96). Conclusions. Higher SAPA values were associated with a higher possibility of LFS. These results are important in the evaluation of patients with LFS.

Simulation of Impact Test for Determining “Health” of Percutaneous Bone Anchored Implants

There is an ongoing requirement for a clinically relevant, noninvasive technique to monitor the integrity of percutaneous implants used for dental restorations, bone-anchored hearing aids, and to retain extra-oral prostheses (ear, eye, nose, etc). Because of the limitations of conventional diagnostic techniques (CT, MRI), mechanical techniques that measure the dynamic response of the implant-abutment system are being developed. This paper documents a finite element analysis that simulates a transient response to mechanical impact testing using contact elements. The detailed model allows for a specific interface between the implant and bone and characterizes potential clinical situations including loss of bone margin height, loss of osseointegration, and development of a soft connective tissue layer at the bone-implant interface. The results also show that the expected difference in interface stiffness between soft connective tissue and osseointegrated bone will cause easily measurable changes in the response of the implant/abutment system. With respect to the loss of bone margin height, changes in the order of 0.2mm should be detectable, suggesting that this technique is at least as sensitive as radiography. A partial loss of osseointegration, while not being as readily evident as a bone margin loss, would still be detectable for losses as small as 0.5mm.