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We evaluated the accuracy of a new scale of surgical difficulty for the extraction of impacted mandibular third molars, which includes consideration of previously underestimated variables. Two hundred patients with impacted third molars were enrolled, and a preoperative clinical and radiographic assessment of difficulty was made by an oral surgeon using the new index. Five oral surgeons with similar degrees of experience then evaluated the surgical difficulty during operation. The kappa test and weighted kappa were used to evaluate the level of agreement between the preoperative and postoperative evaluations. This was 0.73, which indicated a substantial concordance between the preoperative and postoperative assessments of difficulty indicated by the new scale. The linear weight of kappa was 0.8 and the quadratic weight 0.87. We recommend this new scale of surgical difficulty for the extraction of impacted third molars for use in clinical practice.

To compare corneal thickness (CT) measurements obtained with SP3000P specular microscope and Pentacam in eyes screened to undergo refractive surgery (RS).In this prospective study, a non-randomized consecutive series of 73 healthy eyes (age range: 14-78 years; mean=38.4±14.9) underwent CT measurement with both Oculus Pentacam and Topcon SP3000P specular microscope to assess their suitability to undergo corneal RS.CT measurements with SP3000P ranged from 451 to 609 μs (mean 523.1±34.4 μs). The measurements obtained with Pentacam ranged at the corneal apex from 477 to 672 μs (mean 558.9±38.9 μs), at the pupil center from 477 to 672 μs (mean 557.9±38.9 μs) and at the thinnest point from 474 to 669 μs (mean 551.1±39.4 μs). CT measurements showed a good correlation but a statistically significant difference at the pupil center (mean -34.9±14.6 μs, R(2)=0.860, p0.001), at the apex (mean -35.9±14.9 μs, R(2)=0.856, p0.001) and at the thinnest point (mean -32±14.8 μs, R(2)=0.862, p0.001). The calculated regression formulas were: y=0.816x+66.94 for the apex, y=0.819x+66.07 for the pupil center and y=0.810x+73.13 for the thinnest point; where y is the CT measured with the SP3000P and x is the measurement obtained with the Oculus Pentacam.Our results suggest that SP3000P measures thinner corneas compared to the Pentacam and that the correcting factor we identified should be applied to make comparisons between these two devices.

Purpose The aim of this study was to assess the anatomy of the mandibular lingual foramen (MLF) and its linked canals (mandibular lingual vascular canals – MLVC), describing their frequency, diameter, location, and course. Materials and methods One hundred and fourteen computed tomography (CT) images of the mandible (57 male and 57 female; mean age 44.70 ± 12.53; age range 13–75 years, were evaluated. The CT sections were obtained on axial plane by using a bone reconstruction algorithm and then processed with dedicated software (Dentascan), with a standard protocol. Results 103 patients (90.35%) had at least one lingual vascular canal and 52 (45.61%) had multiple (two or three) canals. The typical locations of MLVC were the midline of the mandible (median lingual canal [MLC]). The mean diameter of the lingual canals in the midline (MLC) was 0.8 mm ± 0. The direction of MLC progresses in an anterior and slightly caudal sense. Conclusions Dental CT examination easily demonstrates the presence, position, direction and size of the lingual foramen and of the lingual vascular canals of the mandible. Radiologists and oral surgeons should be aware of these canals and their importance, in order to prevent bleeding complications during implants placement and other surgical procedures.