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This retrospective clinical study aimed to compare the sensitivity of cone-beam computed tomographic (CBCT) images and periapical (PA) radiographs to reveal cracked teeth, split teeth, and teeth with vertical root fractures (VRFs). The authors included 98 patients (98 teeth) diagnosed with a longitudinal tooth fracture (LTF) (cracked tooth, split tooth, VRF) through direct visualization after extraction and with comprehensive clinical and radiographic records. They collected demographic, clinical, and radiographic data. The authors evaluated PA radiographs and CBCT images to identify fractures, fracture lines, and the different patterns of bone loss associated with these teeth. They used the McNemar test to compare PA radiographs and CBCT scans when assessing bone loss. They used the Fisher test to determine statistical relationships between fracture types and demographic, clinical, and radiologic traits. They used an analysis of variance test to compare patient age with fracture types. CBCT images were significantly more effective (P <.05) in detecting bone loss patterns associated with LTFs than with PA radiographs, with 71% of cases detected via CBCT images compared with 42% via radiographs. Mean age was significantly greater (P <.05) in patients with teeth with VRFs than in patients with split teeth. A significant relationship was observed between the type of fracture and the following variables: root canal treatment (split, VRF, P =.002), deep probing depth (≥ 5 mm) (VRF, P =.026), and having more than 8 teeth extracted from the mouth (VRF, P =.032). Overall, there was a significant difference (P <.001) between the visualization of fracture lines (45% on PA radiographs, 65% on CBCT images). CBCT scans provided more information on LTFs than PA radiographs, particularly in the identification of periradicular bone changes. CBCT imaging can assist in making the clinical diagnosis of LTFs through observation of bone loss patterns, providing more information than PA radiographs. [ABSTRACT FROM AUTHOR]

Introduction: Radix entomolaris presents with an unusual morphology and is a rare occurrence. It is mainly observed in mandibular first molars. The incidence varies in different populations but it is far from common. This is especially true for mandibular second molars which possess the lowest prevalence. Some case reports have shown the presence of this finding in mandibular second molars; however, cases of patients of a white background have not been reported.Case Presentation: The diagnosis and treatment of an infected radix entomolaris in a mandibular second molar in a 45-year-old white man is presented. The diagnosis was made with standard endodontic techniques. Conventional radiographic imaging was augmented with cone-beam computed tomography scans and three-dimensional images which were constructed with dedicated software. The endodontic treatment was done using accepted endodontic procedures. Clinical and radiographic evidence of healing was seen after a 14-month follow-up.Conclusions: The implications of complex and unpredictable root anatomy are discussed in this report. The clinician should consider the possibility of encountering a mandibular second molar with a radix entomolaris. Cone-beam computed tomography is a useful tool in the diagnosis and improvement of root canal therapy. [ABSTRACT FROM AUTHOR]

This case report involves a 10-yr-old boy diagnosed with spinal muscular atrophy type 2 who underwent nighttime mechanical ventilation with bilevel positive airway pressure. The oral examination revealed restricted mouth opening, lip interposition, dental crowding, and maxillary compression. After maxillary expansion, the upper airway volume increased 18.6%; 13 episodes of airway infections (20 days of hospitalization) were recorded in the 2 yrs before the maxillary expansion and only 4 episodes (no hospital admissions) in the 2 subsequent years. In conclusion, maxillary expansion in children with systemic disease that involves respiratory impairment may, in some cases, provide functional and clinical improvements, increase upper airway airflows, and possibly decrease the number of respiratory infections [ABSTRACT FROM AUTHOR]