Liene Zamure-Damberga

Objectives: The aim of this study was to investigate whether any feature of carotid artery calcification (CAC) detected on panoramic radiographs (PRs) is associated with more severe signs of cardiovascular disease (CVD), as assessed by carotid ultrasound (CUS) including multi-view assessment of carotid intima media thickness (cIMT). Methods: The present investigation was a retrospective sub-study of the randomized controlled trial visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA), which included 60-, 50-, and 40-year-old inhabitants of Västerbotten County, each of whom underwent CUS. The present sub-study included 135 participants who had undergone PR for odontological indications within 18 months before or after CUS examination. Findings of CAC on PR were compared with CUS findings of cIMT and carotid plaque. CAC features were categorized into 4 types: single, scattered, vessel width-defining, or vessel-outlining. Results: Compared to participants without CAC on PR, those with any CAC type on PR exhibited significantly more carotid plaque (80.9% vs 43.2%, P < .001) and a higher average cIMT score (0.83 vs 0.77 mm, P = .013) on CUS. The vessel-outlining CAC group exhibited the most pronounced cIMT and carotid plaque occurrence (P = .011). Conclusions: All CAC types detected on PR were associated with CVD on CUS, and vessel-outlining CAC indicated more severe CVD. By detecting CAC on PR, especially vessel-outlining CACs, dentists could contribute to the early identification of patients with asymptomatic CVD, and recommend that these patients seek medical attention for preventive treatment. Advances in knowledge: All types of CAC detected on PR—particularly the vessel-outlining type—are associated with carotid ultrasound findings, including carotid intima media thickness, indicating CVD and increased risk of stroke and myocardial infarction. Thus, dentists can identify patients at increased risk of cardiovascular events by detecting CAC on PR, with higher diagnostic reliability in cases with vessel-outlining calcification.

Background: It is important to accurately determine the legal age at which a person is considered and treated as an adult; in many countries, it is 18. With the increasing migration flow to European countries, accurate age estimation methods must be implemented. In this study, the third molar maturity (I_3m) index and mandible condyle cortication stage were tested to distinguish adult from non-adult Latvian individuals using dental panoramic radiographs. Methods: This study included 716 selected dental panoramic radiographs of patients between the ages of 14 and 22. The lower-left third molar apical root parts were analyzed, and the I_3m index was calculated. In addition, the condyle cortication stage was evaluated. Results: All logistic regression models achieved statistically significant results (p < 0.001). The accuracy was high for all groups (males: 0.90, females: 0.87, both genders: 0.89), and the sensitivity was lower than the specificity, particularly for females (sensitivity: 0.55). The I_3m index appears to be a strong predictor across all models, while the mandibular condyle cortication stage plays a more nuanced role, depending on sex and the stage of condyle maturation. A higher I_3m index value (greater than the cut-off of 0.095 in males) indicates a higher likelihood of being classified as a non-adult male for this model; however, in females, a cut-off point higher than 0.150 indicated a higher likelihood of being classified as a non-adult female. The new proposed cut-off values need to be tested on a new sample. Conclusions: The I_3m index is a reliable age estimation tool, and a modified cut-off value could be determined for each gender in Latvian individuals. The condyle cortication stage is a weak tool for chronological age estimation in dental panoramic radiographs.

Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window technique and a xenograft, alone or in combination with the patient’s autologous bone from the mandible. Cone beam computed tomography (CBCT) images were used to compare the volumetric changes in the augmented bone for patients over a period of 6 or more years. No significant bone reduction was seen in the augmented bone region when comparing MSFA after 7 months and 6 or more years after dental implantation.

Purpose: In patients who underwent virtual planning and guided flapless implant surgery for teeth missing in the anterior maxilla, we compared buccal bone loss between those treated with and without autogenous bone augmentation. Methods: Of 22 patients with teeth missing because of trauma or aplasia, 10 (18 implant sites) were reconstructed with buccally placed bone graft harvested from the mandibular ramus, and 12 were non-reconstructed (16 sites). Baseline cone-beam computed tomography allowed for implant planning using the NobelClinician® software and was performed again at 1 year after functional loading. The marginal bone level was assessed radiographically at post-implant baseline and at follow-up. Results: At follow-up, buccal bone loss differed significantly between groups at the central level of the implant (p = 0.0005) but not at the coronal level (p = 0.329). The mean marginal bone level change was 0.6 mm, with no significant between-group difference (p = 0.876). The actual implant position often deviated in the vertical or sagittal plane by an average of 0.3–0.6 mm from the planned position. Conclusion: Compared with non-reconstructed patients, reconstructed patients experienced significantly more buccal bone loss at the central level of implants. The groups did not differ at the coronal level or in marginal bone loss, possibly because of the more augmented bone at the central level among reconstructed patients. Differences between planned versus actual implant positions should be considered in situations of limited bone volume at the planned implant site.

Sinus lift surgery elevation is a procedure that requires radiological maxillary sinus evaluation and procedure planning. The condition of the maxillary sinus before and after sinus lift surgery was assessed. Sixty-five sinuses of 49 patients were included in the study. Preoperative and postoperative cone beam computed tomography (CBCT) scans were performed. The sinuses were analysed radiologically for pathological changes: mucosal thickening, ostia obstruction and accessory opening. The presence of concha bullosa in nasal cavity and septa in the maxillary sinus were recorded. The sinus volume also was measured before and after surgery. Thickened mucosa was found more often in postoperative scans than in preoperative scans (63.1% and 67.7%, respectively). Concha bullosa was found in 30 preoperative scans and in 33 postoperative scans. A correlation between mucosal thickening and ostia obstruction was found. The mean sinus volume decreased after surgery and the changes were statistically significant. In conclusion, changes of the maxillarysinus and nasal cavity can be detected with CBCT. Sinus lift surgery does not excacerebate the existing conditions of the maxillary sinus; however, there is a tendency for pathological features to increase after surgery. Sinus lift surgery is a safe surgery with regard to the maxillary sinus if performed with care.