The aim of this study is to evaluate the efficacy of zero echo time magnetic resonance imaging (ZTE MRI) as an ionizing radiation-free diagnostic method to evaluate both hard and soft tissues and maxillary sinus region before dental implants in the posterior maxillary region.
Today, cone beam computed tomography (CBCT) is routinely used to evaluate the bone structure of the surgical area, to define the anatomical landmarks in the area, to detect variations, if any, and to evaluate the presence of pathologies before dental implant treatment. However, soft tissue evaluations, which are an important factor in treatment planning and the success of the treatment, cannot be performed adequately on CBCT images, and in addition, there is a significant increase in the exposure of patients to ionizing radiation. Using zero echo time magnetic resonance imaging (ZTE MRI) as a diagnostic tool that does not involve ionizing radiation in dentistry may provide a solution to this situation. The aim of the present project is to evaluate the efficacy of ZTE MRI as an ionizing radiation-free diagnostic method to evaluate both hard and soft tissues and the maxillary sinus region before dental implants in the posterior maxillary region. For this purpose, it is planned to examine CBCT and ZTE MRI images of patients planned for dental implant treatment, to perform digital measurements with an intraoral scanner and intraoral direct measurements during surgery and to compare the results of bone and soft tissue measurements obtained.
Study Type
OBSERVATIONAL
Enrollment
20
Department of Periodontology, Faculty of Dentistry, Hacettepe University,
Ankara, Turkey (Türkiye)
RECRUITINGHacettepe University Faculty of Medicine
Ankara, Turkey (Türkiye)
RECRUITINGEvaluation of maxillary sinus area with ZET-MR
These maxillary sinus evaluations will be conducted on both ZTE MR and CBCT images: 1. Thickness of the sinus membrane in millimeters. 2. Shape of thickening (dome shape or flat). 3. Presence and characteristics of septa in the maxillary sinus. To evaluate the direction of the septum, the angle with the vertical axis will be measured; then the direction of the septum will be classified as vertical (\<30°), oblique (between 30° and 60°), and horizontal (between 60° and 90°). In terms of morphology, if the septum extends from one sinus wall to the opposite sinus wall, it will be classified as 'complete'; if it does not reach the opposite wall, it will be considered 'partial'. 4. Presence and variations of the posterior superior alveolar artery (intraosseous or below the membrane or on the outer cortex of the lateral sinus wall) 5. Diameter of the artery and distances to the sinus floor and alveolar crest in millimeters. 6. Thickness of the lateral sinus wall in milimeters.
Time frame: Baseline-18 months
Evaluation of alveolar bone dimensions in maxillary premolar and molar areas with ZET-MR, CBCT and directly
These assessments will be conducted on both preoperative CBCT and zero echo time MR images, as well as directly during surgery using a caliper. * Repeated bone thickness measurements at 1, 3, 5, 7, and 9 mm points relative to the crest top * The bone height from the crest top to the sinus floor at 5 mm mesiodistally from the last tooth
Time frame: Baseline-18 months
Evaluation of soft tissue for dental implant planning Evaluation of gingival tissue dimensions in maxillary premolar and molar areas with ZET-MR and directly during surgery
Gingival thickness measurements will be performed at 2, 4, and 6 mm apically from the alveolar crest through to apical area with three different methods: 1. ZET-MR images in milimeters. 2. Intraoral scanner images overlapped with CBCT data in milimeters. 3. Clinically during dental implant surgery with a periodontal probe after local anesthesia in milimeters.
Time frame: Baseline -18 months
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