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Objective: Rare coexistence of disease or pathology Background: Odontogenic keratocyst (OKC) is a common odontogenic cyst, and it occurs more frequently in the mandible, with the posterior region of the dental arch, the angle, or the ramus being the most commonly affected sites. Odontogenic keratocyst occurring within the maxillary sinus is extremely rare, accounting for only about 1% of cases. Case Report: A 20-year-old female patient without any clinical symptoms underwent an oral examination, during which a dense dental shadow was identified within the maxillary sinus, surrounded by a low-density shadow. Physical examination revealed absence of the left maxillary third molar, with intact mucosa. The patient reported no history of tooth extraction. X-ray and cone-beam computed tomography revealed a high-density image within the left maxillary sinus, resembling a tooth and surrounded by a soft-tissue shadow, which exhibited a greater density in comparison to conventional odontogenic cysts. The initial diagnosis was odontogenic keratocyst in the maxillary sinus with an ectopic maxillary third molar. Surgical enucleation of the cyst and extraction of the impacted tooth were carried out utilizing the Caldwell-Luc approach. Histopathological analysis confirmed the presence of OKC. No significant recurrence was noted during the 6 months of follow-up. Conclusions: Odontogenic keratocysts in the maxillary sinus with ectopic third molar are rare and may not have any symptoms in the early stage. Surgery can be performed using the Caroler-Luke approach to achieve ideal treatment results. In view of the high recurrence rate of OKC, close follow-up should be conducted after surgery. [ABSTRACT FROM AUTHOR]

Since the development of CBCT has been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of radiology evaluation, implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement in edentulous patients digitally. CBCT images were analyzed by clinicians, measuring the maxillary and mandibular ridge heights and widths digitally of four predetermined implant sites in the maxillary and two selected implant sites in the mandibular arches of 91 patients planning for implant-supported overdenture. A total of 47 patients out of the 91 had completed implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). Both predictabilities are low, implying that CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The findings of this study indicate that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement in the edentulous ridge. [ABSTRACT FROM AUTHOR]

Since class II malocclusion and lack of space within the dental arch due to early loss of deciduous molars is a common orthodontic problem in the Polish population, bone-anchored distalizers are becoming more and more popular. The aim of the present study was to evaluate palatal soft and hard tissue thickness using cone beam computed tomography (CBCT) at the area of micro-implant placement of two appliances for maxillary first molar distalization: Beneslider and TopJet distalizer. The study data were 100 consecutively selected CBCT images (53 of men and 47 of women). Measurements of bone and mucosa thickness were performed at six locations in the palate and tested according to their correlation with sex and age. The biggest bone and mucosa thickness were recorded in the insertion site of the TopJet miniscrew. Bone thickness in all points of paramedian insertion was significantly greater in males and the mean difference was approximately 1–1.8 mm. Age correlates significantly (p < 0.05) and positively (r > 0) with the thickness of the mucosa at all points: the older the patient, the thicker the mucosa at each measurement point. Anatomical diversity of the hard palate in the population involves the need to perform bone and mucosa thickness measurements before palatal micro-implant placement. [ABSTRACT FROM AUTHOR]

Objective: To evaluate transverse maxillomandibular discrepancy and dental compensation in first molar areas in 7- to 9-year-old children with skeletal Class III malocclusion without posterior crossbite using cone-beam computed tomography (CBCT). Methods: The sample of this retrospective study consisted of 60 children (7 to 9 years old), who were divided into the skeletal Class III malocclusion group (study group, skeletal Class III malocclusion without posterior crossbite, N = 31) and the Class I occlusion group (control group, Class I occlusion with one or two impacted teeth, N = 30). CBCT data were obtained from the database of the Department of Radiology of Hospital of Stomatology, Shandong University. For three-dimensional reconstruction of the head, the dental arch width, basal bone width, and buccolingual inclination angle were measured using MIMICS 21.0 software. Independent-sample t tests were used to compare the two groups. Results: The mean age of the children was 8.18±0.83years. The width of the maxillary basal bone was significantly smaller in the skeletal Class III malocclusion group (59.75 ± 3.14 mm) than in the Class I occlusion group (62.39 ± 3.01 mm) (P < 0.01). The mandibular basal bone width was significantly larger in the skeletal Class III malocclusion group (60.00 ± 2.56 mm) than in the Class I occlusion group (58.19 ± 2.42 mm) (P < 0.01). The difference in the width of the maxillary and mandibular bases in the skeletal Class III malocclusion group (–0.25 ± 1.73 mm) was significantly different from that in the Class I occlusion group (4.20 ± 1.25 mm) (P < 0.01). However, there was no significant difference in the upper or lower dental arch width between the two groups (P > 0.05). The buccal inclination of the maxillary molars in the skeletal Class III malocclusion group (31.4° ± 8.9°) was significantly higher than that in the Class I occlusion group (17.64° ± 7.3°) (P < 0.01), as was the lingual inclination angle of mandibular molars (45.24° ± 8.3° vs. 37.96° ± 10.18°; P < 0.01). Conclusion: Transverse maxillary and mandibular discrepancies in the posterior area and transverse dental compensation were found in the early mixed dentition of patients with skeletal Class III malocclusion without posterior crossbite. This suggests that even in the absence of posterior crossbite, maxillary expansion can be attempted to correct the maxillomandibular transverse discrepancy. [ABSTRACT FROM AUTHOR]

A new era in 3-dimensional analysis has begun with the use of cone-beam computed tomography (CBCT) in orthodontics, which promises to provide a more thorough understanding of the craniofacial skeletal architecture. This study aimed to investigate the correlation between the transverse basal arches discrepancy and dental compensation by utilizing CBCT width analysis. An observational study was conducted to retrospectively review 88 CBCT scans of patients presented to dental clinics from 2014 to 2020 obtained from the Planmeca Romexis x-ray system at three centers. Dental compensation data across normal and narrow maxillae were analyzed and a Pearson correlation was used to find the relationship between molar inclination and width difference. Significant maxillary molar compensation differences were observed between the normal maxilla and narrow maxilla group, where the amount of dental compensation (164.73 ± 10.15) was higher in the narrow maxilla group. A significant negative correlation (r = −0.37) was observed between width difference and maxillary molar inclination. Maxillary molars were tipped buccally to compensate for the reduced maxillary arch width. These findings are important to determine the amount of needed maxillary expansion taking into account the buccal inclination while treating cases. [ABSTRACT FROM AUTHOR]

Dental CBCT and panoramic images are important imaging modalities used in dental diagnosis and treatment planning. In order to acquire a panoramic image without an additional panoramic scan, in this study, we proposed a method of reconstructing a panoramic image by extracting panoramic projection data from dental CBCT projection data. After specifying the patient's dental arch from the patient's CBCT image, panoramic projection data are extracted from the CBCT projection data along the appropriate panoramic scan trajectory that fits the dental arch. A total of 40 clinical human datasets and one head phantom dataset were used to test the proposed method. The clinical human dataset used in this study includes cases in which it is difficult to reconstruct panoramic images from CBCT images, such as data with severe metal artifacts or data without teeth. As a result of applying the panoramic image reconstruction method proposed in this study, we were able to successfully acquire panoramic images from the CBCT projection data of various patients. The proposed method acquires a universally applicable panoramic image that is less affected by CBCT image quality and metal artifacts by extracting panoramic projection data from dental CBCT data and reconstructing a panoramic image. [ABSTRACT FROM AUTHOR]

(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction. [ABSTRACT FROM AUTHOR]

The mandibular second molars are lingually positioned relative to the alveolar ridge and have a limited amount of lingual alveolar bony support. As the maxillary second molars are articulated with the mandibular second molars, maintaining the normal buccolingual inclination of both maxillary and mandibular second molars would potentially help to not only optimize the masticatory function, but also avoid dehiscence and fenestration. The current study evaluated the buccolingual inclination of second molars in untreated adolescents and adults. One hundred and two Caucasian subjects with skeletal class I and minimum dental arch crowding/spacing were selected and divided into two groups: (1) adolescent group: age 12–18 years, N = 51 (21 females, 30 males); (2) adult group: age 19–65 years, N = 51 (40 females, 11 males). For each subject, the inclination for each second molar was measured as the angle between the long axis of each tooth and a vertical line on cone beam computed tomography images. The Mann–Whitney U test was used for intergroup comparisons. Maxillary second molars exhibited a buccal inclination of 15.30° in the adolescent group and 15.70° in the adult group. Mandibular second molars exhibited a lingual inclination of 17.05° in the adolescent group and 15.20° in the adult group. No statistically significant differences were detected between the age groups. In addition, a statistically significant difference was only found between genders in the adolescent group for the maxillary second molar inclination. In summary, maxillary second molars exhibited buccal inclination and mandibular second molars exhibited lingual inclination. The amount of buccolingual inclination of the second molars was similar in the adolescent and adult groups. [ABSTRACT FROM AUTHOR]

The aim of this study was to propose a novel 3D Enlow's counterpart analysis traced on cone-beam computed tomography (CBCT) images. Eighteen CBCT images of skeletal Class I (ANB = 2° ± 2°) subjects (12 males and 6 females, aged from 9 to 19 years) with no history of previous orthodontic treatment were selected. For each subject, a 2D Enlow's counterpart analysis was performed on lateral cephalograms extracted from the CBCT images. The following structures were identified: mandibular ramus, middle cranial floor, maxillary skeletal arch, mandibular skeletal arch, maxillary dento-alveolar arch, mandibular dento-alveolar arch. The differences between each part and its relative counterpart obtained from the 2D analysis were than compared with those obtained from a 3D analysis traced on the CBCT images. A Student's t-test did not show any statistical significant difference between the 2D and 3D measurements. The landmarks proposed by this study identified the cranio-facial structures on the 3D images in a way that could be superimposed on those described by Enlow in his analysis performed on 2D lateral cephalograms. [ABSTRACT FROM AUTHOR]

Objectives. The percentage of failure of endodontically treated maxillary molars is relatively high; one main reason is that the second mesiobuccal canal (MB2) is missing. Some techniques have been proposed for detection of the MB2. This study was aimed at assessing the diagnostic accuracy and agreement of the dental microscope and cone-beam computed tomography (CBCT) in comparison with microcomputed tomography (micro-CT) for detection of the MB2 of maxillary first molars in vitro. Materials and Methods. This in vitro, experimental study evaluated 71 permanent maxillary first molars that were stored in 100% humidity at room temperature. The teeth were mounted in 9 silicone dental arches to the level of their cementoenamel junction (8 teeth in each arch). The blocks underwent CBCT in a XG3D scanner. Access cavity was then prepared, and the teeth were inspected by a surgical microscope for negotiation of the MB2. Also, micro-CT images were obtained from the teeth to serve as the gold standard. CBCT and micro-CT images were observed by two examiners twice with a 2-week interval. Results. The frequency of the MB2 detected by dental microscope was significantly lower than micro-CT (P < 0.001) and CBCT (P = 0.008); no significant difference existed between micro-CT and CBCT in this respect. The sensitivity, specificity, positive predictive value, and negative predictive value of CBCT for detection of MB2 were 92.6%, 100%, 100%, and 81%, respectively. Conclusion. CBCT is superior to the dental microscope for detection of the MB2 of maxillary first molars and can be used for this purpose in the clinical setting with adequate accuracy. [ABSTRACT FROM AUTHOR]

Introduction: Individual diversity is the cornerstone of human biology, so is the crown and root morphology of teeth. The maxillary and mandibular anterior teeth can be differentiated on the basis of their crown root morphology, by measuring collum angle, labial surface angle and torque angle. Aim: To evaluate and correlate the collum angle, labial surface angle and torque angle in maxillary and mandibular anterior teeth in different skeletal patterns in Bengali population. Materials and Methods: The study was conducted on 90 CBCT scans of young adult patients aged 18-24 years. They were divided into 3 groups based on ANB angle as skeletal Class I (2o < ANB < 4), Class II (4o < ANB) and Class III (2o > ANB) with 30 subjects in each group. All the CBCT scans were selected from the pool of patients reported to the department. Results: Positive correlation was found between collum angle and labial surface angle in all types of malocclusions. Smallest collum angle is found in lower left central incisor. Maxillary lateral incisor has larger crown root angulation than central incisor. Maxillary canine and mandibular central incisor has smallest of all collum angle in maxillary arch and mandibular arch respectively. On moving from 3.5 mm to 5 mm in calculation of labial surface angle, difference of 3.9o is seen for maxillary incisors and 3.5o for mandibular incisor. Conclusion: Statistically significant difference has been seen among maxillary and mandibular anterior teeth crown root morphology. By knowing the variations and correlations among collum angle, torque angle and labial surface angle in different sagittal skeletal malocclusions the clinicians can enhance orthodontic treatment. [ABSTRACT FROM AUTHOR]

In digital orthodontic treatment, the high-precision reconstruction of complete teeth, encompassing both the crown and the actual root, plays a pivotal role. Current mainstream techniques, prioritizing the high resolution of intraoral scanned models (IOS), are confined to using IOS data for orthodontic treatments. However, the lack of root information in the IOS data may lead to complications such as dehiscence. In contrast, Cone Beam Computed Tomography (CBCT) data encompasses comprehensive dental information with roots. Nonetheless, the radiative character of CBCT scans renders patients unsuitable for repeated examinations in a short time. In addition, lower scanning precision of CBCT leads to suboptimal teeth segmentation outcomes, hindering the accurate representation of dental occlusal relationships. Therefore, in order to fully utilize the complementarity between dental multimodal data, we propose a method for high-precision 3D teeth model reconstruction based on IOS and CBCT, which mainly consists of global rigid registration and local nonrigid registration. Specifically, we extract the priori information of dental arch curves for coarse alignment to provide a good initial position for the Iterative Closest Point (ICP) algorithm, and design a conformal parameterization method for a single tooth to effectively obtain the point correspondence between IOS and CBCT crowns. The rough crown of the CBCT will gradually fit towards the IOS through iterative optimization of nonrigid registration. The experimental results show that our method robustly fuses the advantageous features of IOS and CBCT. The 3D teeth model reconstructed by our method contains the high-precision crown of IOS and the real root of CBCT, which can be effectively used in clinical orthodontic treatment. • High-precision 3D teeth model with real roots and accurate crowns. • Dental arch curves are fitted as the a priori information for coarse alignment. • The accurate point correspondence between models by conformal parameterization. • The nonrigid registration optimization method with a smoothness term. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge of transverse dentofacial dimensions is crucial for accurate diagnosis and treatment planning. Periodontitis can alter the widths of the arches by causing pathological migration of teeth and the concurrent bone loss can affect the transverse width of the arches. Aim: To compare the transverse dentofacial widths in adults with skeletal class I and class II malocclusions with horizontal growth pattern and with mild to moderate periodontitis using Cone Beam Computed Tomography (CBCT). Materials and Methods: This retrospective observational study was conducted in Department of Orthodontics, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India, from January 2019 to January 2021. Total 96 CBCT samples (48 skeletal Class I, 48 skeletal Class II) of patients between age group of 25-35 years, patients having mild to moderate periodontitis based on bone loss seen on CBCT and patients having a horizontal growth pattern with the angle between sella-nasion and mandibular plane less than 320 degrees were included in the study. Transverse dentofacial measurements were made on the coronal plane of the CBCT scans. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20. Chi-square test and Student's t-test were used to compare age, linear measurements and angular measurements between the skeletal class I and skeletal Class II groups. A p-value of <0.05 was considered statistically significant at 95% class interval. Results: In this study the mean age of patients with skeletal class I and class II was 30.89±3.23 and 30.97±3.28 years, respectively. There were 24 females and 24 males belonging to class I and class II groups, each. There was a statistically significant difference in the mean interjugal width and the antegonial width. The mean interjugal width in skeletal Class I and Class II group was 56.95±5.68 mm and 51.28±5.94 mm respectively (p-value was <0.001). The maxillomandibular difference (p-value=0.002), the mean maxillary buccal alveolar crest width difference (p-value <0.001) and mandibular buccal alveolar crest width difference (p-value <0.001) was also statistically significant. The palatal height in skeletal Class I group (21.77 mm) was significantly higher (p value <0.001) and the mean maxillary palatal alveolar crest width in skeletal Class I (36.47 mm) was lower than in the Class II group (37.97 mm). Conclusion: The dentofacial transverse widths such as the interjugal width, antegonial width, maxillomandibular difference, maxillary buccal alveolar crest width and mandibular buccal alveolar crest width were higher in skeletal Class I groups compared to skeletal Class II groups. The maxillary palatal alveolar crest width was higher in skeletal Class II groups compared to skeletal Class I group. [ABSTRACT FROM AUTHOR]

Introduction. Mesiodens is a midline supernumerary tooth, mostly located in the maxillary arch. We presented a rare case of a patient with nonsyndromic impacted triple supernumerary teeth precluding the eruption of central maxillary incisors. Case report. In addition to providing a detailed 3D picture of the patient's dentition, cone-beam computed tomography (CBCT) scan analysis revealed dens in dente malformation of one of the supernumeraries. Following surgical removal of all supernumerary teeth, the maxillary central incisors erupted spontaneously after a two-year period. Conclusion. To the best of our knowledge, no similar case report has been published in scientific literature. This case report highlights the importance of CBCT for proper diagnosis of supernumerary teeth as well as additional anomalies. [ABSTRACT FROM AUTHOR]

Simple Summary: Malocclusion is a misalignment or inappropriate relationship between the upper and lower dental arches when the jaws close. Orthodontics, such as tooth extraction, clear aligners, or dental braces, are frequently used to address malocclusion, followed by growth modification in children or orthognathic surgery in adults. The treatment goals are to improve facial and dental esthetics, functional occlusion, periodontal health, and stability. It is also feasible to achieve an esthetic improvement of the soft tissue. This study shows how soft tissues change after extraction of premolars in patients with Angle Class I bimaxillary alveolar protrusion through three-dimensional analysis. The results show that changes in soft tissue point A and skeletal point A are three-dimensionally related. Aim. To investigate the effect of changes in incisor tip, apex movement, and inclination on skeletal points A and B and characterize changes in skeletal points A and B to the soft tissue points A and B after incisor retraction in Angle Class I bimaxillary dentoalveolar protrusion. Methods. Twenty-two patients with Angle Class I bimaxillary dentoalveolar protrusion treated with four first premolar extractions were included in this study. The displacement of skeletal and soft tissue points A and B was measured using cone-beam computed tomography (CBCT) using a three-dimensional coordinate system. The movement of the upper and lower incisors was also measured using CBCT-synthesized lateral cephalograms. Results. Changes in the incisal tip, apex, and inclination after retraction did not significantly affect the position of points A and B in any direction (x, y, z). Linear regression analysis showed a statistically significant relationship between skeletal point A and soft tissue point A on the anteroposterior axis (z). Skeletal point A moved forward by 0.07 mm, and soft tissue point A moved forward by 0.38 mm, establishing a ratio of 0.18: 1 (r = 0.554, p < 0.01). Conclusion. The positional complexion of the skeletal points A and B was not directly influenced by changes in the incisor tip, apex, and inclination. Although the results suggest that soft tissue point A follows the anteroposterior position of skeletal point A, its clinical significance is suspected. Thus, hard and soft tissue analysis should be considered in treatment planning. [ABSTRACT FROM AUTHOR]

Introduction. This study is aimed at illustrating the bimaxillary basal bone contours, to clarify the match of the basal bone arches of the upper and lower, especially the posterior segments, including the second molar and retromolar region. Methods. Based on 100 cone-beam computed tomography (CBCT) images (50 males and 50 females), we obtained 100 pairs of basal bone arches, which were the horizontal inner cortex contours passing the furcation of the first molar paralleled to the lower occlusal plane. The Generalized Procrustes Analysis (GPA) was applied to depict average contours and calculate the ratio and difference width of both upper and lower dental arches in different positions. Variations of the basal bone morphology among individuals were revealed using Principal Component Analysis (PCA). Results. The width discrepancy occurred at 7-7 segment (male: upper 65.62 mm and lower 68.81 mm and female: upper 62.98 mm and lower 68.38 mm) and the retromolar region (male: upper 64.67 mm and lower 71.96 mm and female: upper 62.34 mm and lower 71.44 mm). The ratio (p = 0.006) and difference value (p = 0.009) of 7-7 segment and the ratio of retromolar region (p = 0.044) differed in genders. Setting 2 mm overjet, the upper basal bone arch was wider than the lower by approximate 2 mm on both sides, except the second molar and retromolar region. According to PCA, the variation of basal bone arches appeared mainly at terminal segments. Conclusions. For both male and female, the bimaxillary basal bone matched except terminal segments. Mismatch of female bimaxillary posterior basal bone was more pronounced than male. The basal bone arches of male were wider and longer than that of female. [ABSTRACT FROM AUTHOR]

In this study, alveolar crest height (CH) and width (CW) in patients with edentulous mandible were measured, also the impact of gender and age factors on obtained values were evaluated. Cone beam computed tomography (CBCT) images of 39 males and 38 females were analyzed retrospectively. CH and CW at 10 mm distal of right mental foramen of patients were measured on sectional images. Independent sample T-test and One-way ANOVA test were used for statistical analysis. In CH measurements, there was no significant difference between males and females (p= 0.058). However, males had significantly higher CW values compared to females (p=0.039). Considering age criteria, it was understood that age of patient have no significant effect on CW (p=0.586) and CH (p=0.465). In this study, males just had significantly higher CW values. Besides, age factor had no significant effect on crest dimensions and it was concluded that each patient should be evaluated in itself during dental implant replacement regardless of age and gender. [ABSTRACT FROM AUTHOR]

Context and Aim: Dental implants are widely used for the rehabilitation of edentulous arches. Yet, placement of oral implants in the mandible is associated with numerous complications, including hemorrhage and neurosensory disturbances. Enumerating precise information concerning the vital structures of the mandible, thus, becomes all the more important before the placement of implants. The aim of the present study was to determine the efficiency and accuracy of digital orthopantomography (OPG) and cone-beam computed tomography (CBCT) in determining the location of mandibular canal in preoperative assessment of the mandibles for implant placement. Materials and Methods: Ten dry edentulous mandibles of adult humans were selected for this study which comprised two phases, namely a radiographic phase and an in vitro phase. The radiographic phase was based on the obtaining digital orthopantomographs and cone-beam computed tomograms. During the in vitro phase, all the mandibles were sectioned at an angle of 90° to the inferior border of the mandible, and in vitro measurements were obtained. Statistical Analysis Used: Statistical analysis was done using IBM SPSS statistics 20 (Chicago, IL, USA). Paired and unpaired t-tests were used to do a comparative analysis of the two modalities used. P < 0.05 was considered to be statistically significant. Results: The results of the present study revealed that the measurements of both the vertical (D1 and D2) and the buccolingual distances of the mandible (D3 and D4) obtained by CBCT were in accordance with the ones obtained with the help of in vitro measurements, and there was no statistically significant difference in the studied variables (D1, D2, D3, and D4) between the two measurements. On the contrary, there was a significant statistical difference between the values obtained from digital OPG (D1 and D2) when compared to the values obtained by in vitro measurements. Conclusion: The findings of the present study implied that CBCT is the most efficient and accurate diagnostic tool available to locate the course of mandibular canal in the selection of potential implant sites. The accuracy of the CBCT was found to be superior to the digital panoramic images in the present study because of multiplanar three-dimensional reconstructions. [ABSTRACT FROM AUTHOR]

The analysis of bitemarks has been mostly done through analogical methods. The advent of current technologies brings new and more reliable tools for analyzing evidence. Bitemarks can now be turned into more consistent evidence by using a digital tridimensional (3D) analysis. The aim of this study is to propose a reliable, accurate and monitorized approach of 3D bitemark analysis. 12 cranium Cone Beam Computed Tomographic (CBCT) files were randomly selected from a clinical database (Coimbra Hospital and University Center/Faculty of Medicine of the University of Coimbra). The individuals were recalled to bite an apple (golden delicious 65/80) immediately subjected to a CBCT scan. The 3D rendering of every bitemark was compared with the 3D upper dental arches obtained from the CBCT cranium scans of the simulated suspects. The research team was composed by 5 elements. The matching process consists of corresponding landmark points, in both the bitemark and the suspects' dentition (upper dental arch). 144 comparisons were obtained. The Kappa statistics analysis was performed. Cohen's Kappa values were obtained between 0,690 and 0,910. Fleiss Kappa obtained a value of 0,767. The Friedman's test was performed and the normality assumption was not verified (p>0,05). A non-destructive protocol of bitemark study by 3D analysis of tomographic volumes was presented. The statistic analysis supports its accuracy and reliability. This experimental study opens doors to a future where bitemark analysis could be done through software that searches for matching dentitions in a CBCT database. [ABSTRACT FROM AUTHOR]

Objective: To assess the amount of maxillary and mandibular inter-radicular bone mass and determine the most reliable mini-screw placement sites. Materials and methods: Retrospective Cone Beam Computed Tomography (CBCT) images of 40 Angle Class I subjects (20 females, 20 males, aged 16 to 32) were obtained. Measurements on the buccal (BI), medial (MI) and lingual (LI) sides of the inter-radicular spaces were taken at 0, 1, 2, 3, 4, 5 mm from the cemento-enamel junction (CEJ) in an apical direction. Results: The male and female BI scores ranged from 2.99±0.73 mm to 6.18±1.03 mm and 2.69±0.84 mm to 6.21 ±1.22 mm respectively. The male and female MI scores ranged from 1.36±0.38 mm to 4.50±0.99 and 1.53±0.66 to 4.77±1.99 mm respectively. LI scores ranged from 2.37±0.70 to 6.47±1.0 mm and 2.45±0.56 mm and 6.66±1.33 mm respectively. In both maxillary and mandibular arch, the inter-radicular space increased in the apical direction except for the buccal and medial inter-radicular spaces between the maxillary first and second molars. Conclusion: The medial inter-radicular spaces are the decisive parameter for mini-screw placement. In the maxillary arch, regions between central and lateral incisors, lateral incisor and canine, first and second molars are not viable for mini-screw insertion. The residual inter-radicular regions are proper for implantation at 3 mm above the CEJ. In the mandible, the regions between incisors and canines are too narrow for mini-screw insertion and the reliable sites for mini-screws are regions between premolars, molars or first molar and second premolar at 2 mm below the CEJ. [ABSTRACT FROM AUTHOR]

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive medication. The aim of this study was to evaluate the incidence of denosumab-related osteonecrosis of the jaw and to compare the clinical and radiological extent of osteonecrosis. A retrospective study of patients who received Xgeva® at the Institut de Cancérologie de Lorraine (ICL) was performed. Patients for whom clinical and radiological (CBCT) data were available were divided into two groups: "exposed" for patients with bone exposure and "fistula" when only a fistula through which the bone could be probed was observed. The difference between clinical and radiological extent was assessed. The p-value was set at 0.05, and a total of 246 patients were included. The cumulative incidence of osteonecrosis was 0.9% at 6 months, 7% at 12 months, and 15% from 24 months. The clinical extent of MRONJ was significantly less than their radiological extent: in the "exposed" group, 17 areas (45%) were less extensive clinically than radiologically (p < 0.001) and respectively 6 (67%) for the "fistula" group (p < 0.031). It would seem that a CBCT is essential to know the real extent of MRONJ. Thus, it would seem interesting to systematically perform a CBCT during the diagnosis of MRONJ, exploring the entire affected dental arch. [ABSTRACT FROM AUTHOR]

Background: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. Methods: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. Results: When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. Conclusion: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms. [ABSTRACT FROM AUTHOR]