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Objective: To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. Methods: Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. Results: The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68–100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). Conclusion: Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis and treatment of periodontitis, which can cause loss of bone support of the teeth, is of great importance. The use of fractal analysis method is being investigated in order to differentiate periodontal disease radiographically. Fractal analysis presents the degree of complexity in the structure of fractal objects as a numerical data, and has been used to measure changes in trabecular bone. The aim of this study was to compare the trabecular bone fractal dimension (FD) values of patients with periodontitis and gingivitis using panoramic radiographs, and to evaluate the possible relationship between age and gender with fractal dimension. Materials and methods: Panoramic radiographs of 64 patients with gingivitis and 64 patients with periodontitis were evaluated retrospectively in the study. Using the radiographs of the patients, FD values measured from the trabecular bone were calculated with the box-counting method in the Image J programme. The FD values of both groups were compared. In addition, the relationship between age and gender parameters and FD values was evaluated within the groups. Results: According to the results of the study, the calculated average FD value of the patients in the gingivitis group was 1.195, while the calculated average FD value of the patients in the periodontitis group was 1.196. No statistically significant difference was observed between the FD values of the gingivitis group and the periodontitis group (p > 0.05). No statistically significant correlation was observed between FD values and age and gender (p > 0.05). Conclusions: No statistically significant results were obtained for the calculated mean FD values of the patients in the gingivitis and periodontitis groups. [ABSTRACT FROM AUTHOR]

Tooth fusion is a dental anomaly with a prevalence of 0.1% in permanent dentition. The aim of this paper is to present the occurrence, region of fusion, and prognosis of fused tooth which is a very rare case in the literature. The authors present a very rare case with a maxillary right lateral incisor fused to a supernumerary tooth on the palatal side. The eruption was delayed, but eruption occurred naturally at 9 years and 6 months. However, cone-beam computed tomography at 11 years and 6 months revealed it was diagnosed as a fused tooth. The authors undertook a literature review over the past 10 years and found 30 articles about fused teeth between permanent teeth and supernumerary teeth. It was more common in males than females and there were no differences depending on the occurrence. Mesiodistal fusion was more common in the incisor region, while labiopalatal fusion was more common in the molar region. Most cases required dental treatment with a surgical approach, root canal treatment, or orthodontic treatment. The present study highlights the importance of long-term follow-up and suggests the region of fusion and prognosis of the fused tooth may vary depending on the occurrence. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In the context of forensic identification, sex determination is the first important step, and the mandible is of particular interest because it shows clear signs of dimorphism. Objectives: The purpose of this investigation was sex classification through the application of several craniomandibular metric variables in a Portuguese adult population. MATERIAL AND METHODS: 206 orthopantomographic images (116 females and 90 males) were selected from Portuguese adults aged between 25 and 79 years. From each image, 14 linear variables were measured using ImageJ® software. IBM SPSS® software version 27.0 was applied to analyze data presented as extremes, mean, standard deviation, and median. Statistical methodologies included intra-class analysis, normality test, t-test, Mann-Whitney test, logistic regression, and ROC curve to determine cut-off point and respective sensitivity and specificity of sex classification. RESULTS: Comparing the two sexes, all variables showed significant differences, except for the angular variables. Variables with the best area under ROC curve were height of the right (0.861) and left (0.850) mandibular ramus. Based on the logistic regression, the left coronoid height, right mandible body height, left mandible body height, and right mandible ramus height showed an accuracy level of 83.0%, sensitivity of 86.2%, and specificity of 78.9% in sex classification. CONCLUSIONS: The obtained results show identifiable mandibular dimorphism in the measurements of mandibular structures in orthopantomography images. These metric variables allow for the creation of discrimination models between males and females in a Portuguese adult population. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Mandibular third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The procedure may result in several complications, such as injury of inferior alveolar nerve (IAN) and post-operative paresthesia/dysesthesia. Objectives: To evaluate the awareness-knowledge level and practice of dentists who received specialization training in oral and maxillofacial radiology and oral and maxillofacial surgery regarding juxta-apical radiolucency (JAR). MATERIAL AND METHODS: Dentist participants who received specialization training and volunteered to participate were divided into two groups according to their specialization: group 1 - oral and maxillofacial radiology; group 2 - oral and maxillofacial surgery. A special questionnaire was prepared for this study and participants provided answers face-to-face. The form consisted of two parts: part 1 - personal information, and part 2 - awareness-knowledge level and practice regarding JAR. In part 2, dentists were asked questions on different panoramic radiography images containing JAR in a slide show. Pearson's c2 test was applied for statistical analysis. RESULTS: A total of 66 volunteers divided into two groups [group 1: n = 32 (43%); group 2: n = 34 (57%)] participated in the current study. The preliminary diagnosis of JAR was mostly associated with anatomical formation (group 1: 63.1%; group 2: 64.1%) and odontogenic/non-odontogenic lesions (group 1: 41.8%; group 2: 48.2%). Usually, participants thought that such a radiolucency would affect extraction method (group 1: 68.8%; group 2: 63.5%), posed a risk for IAN (group 1: 67.5%; group 2: 69.4%), and negatively affect healing process (group 1: 66.3%; group 2: 61.2%). A small ratio of participants was aware of JAR (group 1: 18.8%; group 2: 2.9%). CONCLUSIONS: The awareness-knowledge level of dentists who received training in oral and maxillofacial radiology and oral and maxillofacial surgery regarding JAR was low. The practice of participants of both specialties towards JAR were variable. [ABSTRACT FROM AUTHOR]

Objective: Measuring the gonial angle is an essential diagnostic tool for identifying craniofacial disorders. In this study, gonial angle measurements from panoramic radiographs and lateral cephalograms of individuals with skeletal class I malocclusion were compared. The study also attempts to determine which radiography method is best suited for precisely determining the gonial angle. Methods: Lateral cephalograms and panoramic radiographs of 70 orthodontic patients (34 males, 36 females; mean age: 16.8 years) were selected from the department's archive. On the lateral cephalograms, SNA, SNB, ANB, GoGn-SN, and gonial angle measurements were made; on the panoramic radiographs, measurements of the right and left gonial angles were made. Gender differences were analyzed using Student t-tests, and Pearson's correlation analysis was used to assess the relationship of angles. The reliability of measurements was evaluated by calculating repeatability coefficients. Results: The lateral cephalogram's mean gonial angle value was 126.4 ± 4.75, and in the panoramic radiography was 124.8 ± 5.39 on the right side, and 125.1 ± 5.67 on the left side. The differences between the gender in terms of GoGn-SN and gonial angle in lateral cephalogram were statistically significant (P < .05). The correlation between the gonial angle in lateral cephalogram and panoramic radiography was determined to be significant. Conclusion: Panoramic radiographs can accurately assess the gonial angle, just like lateral cephalograms. The advantage of using panoramic radiographs is that they allow easy measurement of both side angles without the need for superimposition of anatomical landmarks. [ABSTRACT FROM AUTHOR]

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Background: Accurate assessment of impacted canines is crucial for successful treatment planning. Radiographic techniques like Cone Beam Computed Tomography (CBCT) and Panoramic Radiography are commonly used, but their comparative accuracy remains under scrutiny. Materials and Methods: In this study, 50 patients diagnosed with impacted canines were enrolled. Both CBCT and Panoramic Radiography images were obtained for each patient using standard protocols. Two experienced dentists independently analyzed the images to determine the position of impacted canines and their relationship with neighboring structures. Results: The findings of this study revealed that CBCT provided superior accuracy in assessing the position of impacted canines compared to Panoramic Radiography. Specifically, CBCT demonstrated a mean accuracy rate of 89.5%, while Panoramic Radiography showed a mean accuracy rate of 72.3%. Moreover, CBCT allowed for better visualization of impacted canine angulation, depth, and spatial orientation. Panoramic Radiography, on the other hand, displayed limitations in precisely identifying the impacted canine's position. Conclusion: The study's outcomes underscore the higher accuracy of CBCT over Panoramic Radiography in the preoperative assessment of impacted canines. CBCT's detailed imaging provides valuable insights for treatment planning, potentially leading to improved surgical outcomes. Although CBCT entails greater radiation exposure and cost, its benefits in accurate diagnosis and treatment planning justify its use in cases of impacted canines.

Amaç: Bu çalışmanın amacı; bir grup Türk alt popülasyonunda mandibular dişlerin köklerine göre mental foramenin (MF) horizontal, vertikal konumunu ve anterior loop (AL) görülme sıklığını panoramik radyografi ve konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri üzerinden değerlendirmekti. Ayrıca her iki görüntüleme yöntemi arasında AL görülme sıklığını tespit etmede fark olup olmadığını belirlemekti. Gereç ve Yöntemler: Bu çalışmaya dahil edilme/dışlama kriterini sağlayan 16 ile 80 yaşları arasında 435 hasta dahil edilmiştir. Mental foramenin horizontal konumu mandibular 1. premolar diş (PM1), mandibular 2. premolar diş (PM2) ve mandibular 1. molar dişe göre, vertikal konumu da PM1’nin ve PM2’nin apekslerini birleştiren yatay çizgiye göre belirlenmiştir. AL görülme sıklığı ise inferior alveolar sinirin üç farklı yapıda sonlanmasına göre değerlendirilmiştir. Verilerin normal dağılıma uygunluğu Kruskal Wallis ve Shapiro Wilk testi ile analiz edilmiş olup, kategorik değişkenler arasındaki farklılıkların saptanmasında ki-kare analizi kullanılmıştır. Gerekli koşullarda Yates düzeltmesi ve Fisher Exact testi kullanılmıştır. p

Background and Objective: Sinus extension is a physiological process that occurs in the growth cells of the paranasal sinuses and leads to increasing their volume over time, causing challenges in the dental implant process. This study was conducted to evaluate maxillary sinus morphometrics by cone-beam computed tomography (CBCT). Methods: This descriptive-analytical study was conducted on the CBCT images of 100 people (52 male and 48 female) with a mean age of 45.32 ± 17.41 and the age range of 27 to 63 years referring to an oral and maxillofacial specialized radiology clinic in Babol, Iran during 2019. The amount of maxillary sinus extension in the panoramic-like view was recorded based on the amount of its extension in terms of the first anterior tooth and the last posterior tooth. In the new net technologies (NNT) software, in the section related to creating panoramic-like views, first, in the axial sections, the starting point of the maxillary sinus was specified from the occlusal side, and the mediolateral dimensions were measured at distances of 3 mm above and 3 mm below. Results: The highest amount of maxillary sinus progress in the right anterior side was related to the mesial of tooth 5 (15%), and the highest amount of sinus progress in the left anterior side was related to the distal of tooth 3 (15%) and the mesial of tooth 4 (15%), which had no statistically significant differences. The most progress in the anterior area was related to the distal of the canine tooth and the mesial of the first premolar. The mean mediolateral sinus progress at 3 mm above the right nasal floor was higher in females than in males (P

Background: Dental anomalies can lead to malocclusions, compromise aesthetics, complicate endodontic procedures and tooth extraction. The presence of dental anomalies can predispose the individual to other oral and dental diseases. The aim of this study was to investigate the prevalence of dental anomalies of permanent dentition in a sample of Iranian population.Material and Methods: Through this cross-sectional study, panoramic radiographs which were taken from September 2016-2020 were retrieved form the archived files of a private radiographic center in Bushehr, Iran. Radiographs of individuals with permanent dentition were selected, and a random sample was obtained using a non-randomized cluster sampling method. Radiographs were evaluated by a single oral and maxillofacial radiologist, and dental anomalies were identified and categorized. Descriptive statistics were presented as frequency, mean and standard deviation. Chi-square test was used and significance level was set at 0.05.Results: A total of 4962 radiographs were evaluated; 913 cases (18. 40%) had at least one dental anomaly. Abnormalities such as dens in dent (10. 3%), congenital missing (3. 35%) and impaction (2. 64%) were the most prevalent. The permanent left maxillary lateral incisor was the most common tooth in terms of prevalence of dental anomalies. The prevalence of dental anomalies in males was significantly higher than females (P= 0.03)Conclusion: Anomalies in morphology, number especially dens in dente and missing were the most common anomalies in the investigated population. The prevalence of dental anomalies was significantly higher in the maxilla and especially in the lateral incisors. Therefore, early identification and treatment is necessary in order to prevent the complications caused by these anomalies.

Abstract Background Accurate age estimation is vital for clinical and forensic purposes. With the rapid advancement of artificial intelligence(AI) technologies, traditional methods relying on tooth development, while reliable, can be enhanced by leveraging deep learning, particularly neural networks. This study evaluated the efficiency of an AI model by applying the entire panoramic image for age estimation. The outcome performances were analyzed through supervised learning (SL) models. Methods Total of 27,877 dental panorama images from 5 to 90 years of age were classified by 2 types of grouping. In type 1 they were classified by each age and in type 2, applying heuristic grouping, the age over 20 years were classified by every 5 years. Wide ResNet (WRN) and DenseNet (DN) were used for supervised learning. In addition, the analysis with ± 3 years of deviation in both types were performed. Results For the DN model, while the type 1 grouping achieved an accuracy of 0.1016 and F1 score of 0.058, the type 2 achieved an accuracy of 0.3146 and F1 score of 0.2027. Incorporating ± 3years of deviation, the accuracy of type 1 and 2 were 0.281, 0.7323 respectively; and the F1 score were 0.1768, 0.6583 respectively. For the WRN model, while the type 1 grouping achieved an accuracy of 0.1041 and F1 score of 0.0599, the type 2 achieved an accuracy of 0.3182 and F1 score of 0.2071. Incorporating ± 3years of deviation, the accuracy of type 1 and 2 were 0.2716, 0.7323 respectively; and the F1 score were 0.1709, 0.6437 respectively. Conclusions The application of entire panorama image data for supervised with classification by heuristics grouping with ± 3years of deviation for supervised learning models and demonstrated satisfactory outcome for the age estimation.

Abstract Background Radiation shielding in radiology has historically been achieved with lead; however, there has been an increasing demand for radiation shielding to be more environmentally friendly. Barium has shown promise as a substitute in many radiology applications. This study aims to investigate a barium sulphate shield in protecting the thyroid and the eye lens during panoramic radiography. Methods During a simulated panoramic examination, an anthropomorphic phantom and a solid-state detector measured the radiation dose to the surface thyroid and the eye lens. The measurements were taken using no shield and a barium sulphate shield. A Welch's T-test was employed to compute the shield's effect on radiation. Two radiologists assessed the image quality with and without the thyroid shields. Results The dose reduction was between 66 and 75% for the barium shield at the thyroid. The dose reduction ranged between 15 and 61% in the eye region. Images using a barium shield were deemed adequate for diagnostic interpretation. Conclusions Barium shields effectively reduce the radiation dose in the thyroid region during panoramic radiography without degrading image quality. The dose reduction depends on the tube voltage and the area of interest.

Abstract Background Panoramic radiographs, in which anatomic landmarks can be observed, are used to detect cases closely related to pediatric dentistry. The purpose of the study is to investigate the success and reliability of the detection of maxillary and mandibular anatomic structures observed on panoramic radiographs in children using artificial intelligence. Methods A total of 981 mixed images of pediatric patients for 9 different pediatric anatomic landmarks including maxillary sinus, orbita, mandibular canal, mental foramen, foramen mandible, incisura mandible, articular eminence, condylar and coronoid processes were labelled, the training was carried out using 2D convolutional neural networks (CNN) architectures, by giving 500 training epochs and Pytorch-implemented YOLO-v5 models were produced. The success rate of the AI model prediction was tested on a 10% test data set. Results A total of 14,804 labels including maxillary sinus (1922), orbita (1944), mandibular canal (1879), mental foramen (884), foramen mandible (1885), incisura mandible (1922), articular eminence (1645), condylar (1733) and coronoid (990) processes were made. The most successful F1 Scores were obtained from orbita (1), incisura mandible (0.99), maxillary sinus (0.98), and mandibular canal (0.97). The best sensitivity values were obtained from orbita, maxillary sinus, mandibular canal, incisura mandible, and condylar process. The worst sensitivity values were obtained from mental foramen (0.92) and articular eminence (0.92). Conclusions The regular and standardized labelling, the relatively larger areas, and the success of the YOLO-v5 algorithm contributed to obtaining these successful results. Automatic segmentation of these structures will save time for physicians in clinical diagnosis and will increase the visibility of pathologies related to structures and the awareness of physicians.

Mohamed Skitioui, Dounia Jaoui, Lauzan Haj Khalaf, Babacar Tour&#x00E9Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, MoroccoCorrespondence: Mohamed Skitioui, Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco, Email mohamed.skitioui@uir.ac.maObjective: The aim of this study was to determine the prevalence of mandibular third molar malposition and its impact in relation to the lower second molar using panoramic radiography.Methods and Materials: This was a cross-sectional descriptive study of 353 panoramic images of patients who visited the Dental Clinic of the International University of Rabat. Panoramic images were analyzed in order to determine the number of second molar pathologies associated with the positions of third molars. The following radiographic lesions on the second molar were recorded: caries, root resorption and distal alveolysis. The Chi-square test was used to assess the association between different variables.Results: Of these 353 radiographies, 169 were males, ie, 48%, and 184 were females, ie, 52%. The age range was from 18 to 63 years. The prevalence of the impacted position of the lower third molar was noted in 60%. Distal caries on the second mandibular molar was present in 47.5% of instances having an impacted third molar. Caries was present in 65.5% of wisdom teeth in a normal position and was also present in 79.6% of the impacted teeth. This difference was statistically significant with p = 0.01. The angulation of the third molar is a factor of caries of the second molar: 58.56% of them were carious. Of all the teeth in association with an angulation, 72.03% showed distal alveolysis in the second molar. In addition, root resorption was found in 20.4% of second molars linked to a wisdom tooth in all angulation occurrences.Conclusion: It has been noted that among the pathologies seen on the mandibular second molar, distal alveolysis accounts for the majority of cases (58%), followed by caries (47.5%) and root resorption (13.3%). This study illustrated the importance of performing Orthopantomogram X-rays at each new consultation in patients over the age of 18.Keywords: impacted, partially-erupted, panoramic radiography, mandibular third molar, root resorption, caries, alveolysis, prevalence

Two nasal foreign bodies were discovered by a dental practitioner on a routine radiographic examination of a 15-year-old autistic patient. Going over past radiographs, one of the nasal foreign bodies was detected in a radiograph performed 2 years previously. No nasal complaints or other clues to the problem were apparent. The patient was referred to the emergency room, and the foreign bodies were removed by an Ear Nose and Throat specialist, under general anesthesia. This paper reviews the diagnosis and treatment of nasal foreign bodies, and highlights the important role of the dental practitioner in the proper detection and diagnosis, prompt referral for management, and reduction in related complications. [ABSTRACT FROM AUTHOR]

Purpose: The main objective of this study was to assess the influence of bone remodeling on late marginal bone loss in immediately loaded, implant-supported, complete-arch restorations and, secondarily, to determine its relationship to peri-implant disease occurrence using a multilevel analysis. Materials and Methods: A retrospective cohort study of patients treated consecutively in a private clinic with immediately loaded full-arch restorations with at least 12 months of follow-up was conducted. Bone remodeling and marginal bone loss were determined through measurements made on panoramic radiographs by two calibrated examiners. Peri-implant health status was diagnosed in a visit for peri-implant maintenance. Descriptive, bivariate, and multilevel analyses were performed with Stata/IC 15.1 software (StataCorp). Results: A total of 30 patients (11 men and 19 women, mean age: 63.3 ± 10.4 years), with a mean follow-up of 37.7 ± 19.6 months were included. Forty arches (20 maxillary and 20 mandibular) received 207 implants. Bone remodeling had an inversely proportional effect on marginal bone loss (P =.005) but was not related to peri-implantitis (P =.103; hazard rate [HR] = 2.1). Conclusion: Taking into account the limitations of this study, bone remodeling around immediately loaded dental implants supporting complete-arch restorations does not appear to increase marginal bone loss or peri-implantitis. [ABSTRACT FROM AUTHOR]

Objective: To describe and report on the use of virtual clinical competency examinations (VCCEs) for D3 dental students in a radiology clinic during the COVID-19 pandemic and relate the technology to other clinical and educational applications. Method and materials: Paper-based clinical competency examinations (CCEs) were converted to three different VCCEs to closely replicate the CCEs. Existing grading rubrics were used to assess students' abilities to evaluate technical issues and interpret intraoral full-mouth series and panoramic radiographs. The grading rubrics were modified from their clinical versions to eliminate non-reproducible skills, such as patient management and application of selection criteria. Radiographs were selected from clinic records and anonymized. VCCEs were conducted via WebEx conferences that were scheduled via an appointment app. These experiences can be extended to virtual patient contacts, teleradiology, and telemedicine, as well as continuing dental education experiences. Results: Approximately 200 VCCEs were administered by four oral and maxillofacial radiology faculty over a 10-week period. Both students and faculty managed the technology well, with few missed appointments. All students were successful in challenging the examinations and appeared to be satisfied with the experience. Conclusions: Although direct comparisons between the CCEs and the new VCCEs are difficult, as there was no time to pilot the VCCEs, students were successful in challenging the examinations and informally reported satisfaction with the experience. Although components of CCEs that could not be replicated on the VCEs could not be assessed, it is felt that the students had adequate experience in selection of radiographs and patient management prior to the COVID-19 lockdown. Additional benefits of the VCCEs included contact with students to check on their well-being. The experience indicates that VCCEs can be used in the future in hybrid models of oral & maxillofacial radiology education, clinical care, patient screening, and telemedicine. Moreover, the success of this demonstration points to potential for personalized distance learning in continuing dental education. [ABSTRACT FROM AUTHOR]

Objectives: To examine whether a surgeons' position affects the axial angulation of dental implants placed freehand. Method and materials: Implants' axial angulation was assessed on digital panoramic radiographs. An occlusal line was plotted based on the neighboring teeth/crowns. The mesial angle between the long axis of the implant and the occlusal line was measured. In addition, post-hoc ideal implant-positioning planning was done on the panoramic digital image, and the angle of the intersection between the long axis of the actual and posthoc ideal implant was measured. Student t test for unpaired observations and the Kolmogorov-Smirnov nonparametric tests were utilized to compare the ipsi- and contralateral sides and between clinicians. Results: Seventy-seven patients (149 implants) were eligible for the study. Implants had slight mesial inclination (mean 97.7 ± 8.7 degrees) which was similar for both the ipsi- (98.2 ± 8.4 degrees) and contralateral sides (97.2 ± 9.1 degrees), P = .491. For the post-hoc planning versus actual placement comparison, the overall median (interquartile range) of implant angular deviation was minimal (-0.25 degrees [-2.98, +3.47]). This was true for both the ipsilateral (-0.5 degrees [-2.9, +2.9]) and contralateral (-0.2 [-4.2, +5.4]) sides, P = .55. For the actual versus post-hoc planning, most observations clustered around the midline (zero to minimal deviation), while for the implant to occlusal plane angle, a tendency towards slight mesial angulation was observed. Conclusions: Dental implants placed freehand by experienced clinicians have only slight axial de viation as measured from post-hoc optimal position. Implants placed in ipsilateral and contralateral sides and by leftand right-dominant-hand clinicians had similar angulations. [ABSTRACT FROM AUTHOR]

Patients with chronic and severe hearing loss, refractory to nonsurgically‐worn devices, may consider use of cochlear implants to regain auditory capability. Cochlear implants consist of surgically emplaced and externally worn components. There are few published examples of the radiographic presentation of these devices appearing in the special needs‐based dental literature. This article features a case report and panoramic radiographic examination involving a 67‐year‐old patient who received bilateral cochlear implants after experiencing a traumatic brain injury and onset loss of hearing. A brief review of strategies for communicating with individuals with severe hearing impairment has also been provided. [ABSTRACT FROM AUTHOR]

Tessier No. 7 cleft, known as lateral facial cleft, is a rare and understudied entity with an incidence of 1/80,000–1/300,000 live births. Besides perioral tissue abnormalities manifesting as macrostomia, Tessier 7 cleft also involves anomalies of the underlying bony structures. It can appear as part of a syndrome, such as Treacher-Collins syndrome or Goldenhar/Orbito-Auriculo-Vestibular Spectrum, or as an isolated form (unilateral or bilateral) with variable expressions. Bilateral maxillary duplication in Tessier 7 cleft is considered extremely rare, accounting for only two previously presented cases. Given that the cases presented in the literature mainly focus on clinical appearance and surgical treatment, without providing sufficient imaging, we aim to present key radiological features of Tessier 7 cleft in terms of evaluating the involved structures, which is essential for the therapeutic approach and final outcome. A 17-year-old male with incompetent lips and orthodontic abnormalities was referred to our Radiology Department for orthopantomography (OPG) and CT examinations. Hetero-anamnestic data revealed a history of surgical treatment of the commissural cleft conducted 2 months after the birth to enable feeding. Intraoral examination showed a maxillary cleft and supernumerary teeth. Since the given clinical presentation was inconclusive, radiological diagnostics took precedence in elucidating this complex entity. [ABSTRACT FROM AUTHOR]

Image processing with artificial intelligence has shown significant promise in various medical imaging applications. The present study aims to evaluate the performance of 16 different convolutional neural networks (CNNs) in predicting age and gender from panoramic radiographs in children and young adults. The networks tested included DarkNet-19, DarkNet-53, Inception-ResNet-v2, VGG-19, DenseNet-201, ResNet-50, GoogLeNet, VGG-16, SqueezeNet, ResNet-101, ResNet-18, ShuffleNet, MobileNet-v2, NasNet-Mobile, AlexNet, and Xception. These networks were trained on a dataset of 7336 radiographs from individuals aged between 5 and 21. Age and gender estimation accuracy and mean absolute age prediction errors were evaluated on 340 radiographs. Statistical analyses were conducted using Shapiro–Wilk, one-way ANOVA, and Tukey tests (p < 0.05). The gender prediction accuracy and the mean absolute age prediction error were, respectively, 87.94% and 0.582 for DarkNet-53, 86.18% and 0.427 for DarkNet-19, 84.71% and 0.703 for GoogLeNet, 81.76% and 0.756 for DenseNet-201, 81.76% and 1.115 for ResNet-18, 80.88% and 0.650 for VGG-19, 79.41% and 0.988 for SqueezeNet, 79.12% and 0.682 for Inception-Resnet-v2, 78.24% and 0.747 for ResNet-50, 77.35% and 1.047 for VGG-16, 76.47% and 1.109 for Xception, 75.88% and 0.977 for ResNet-101, 73.24% and 0.894 for ShuffleNet, 72.35% and 1.206 for AlexNet, 71.18% and 1.094 for NasNet-Mobile, and 62.94% and 1.327 for MobileNet-v2. No statistical difference in age prediction performance was found between DarkNet-19 and DarkNet-53, which demonstrated the most successful age estimation results. Despite these promising results, all tested CNNs performed below 90% accuracy and were not deemed suitable for clinical use. Future studies should continue with more-advanced networks and larger datasets.

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth’s apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle–Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients’ population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis’s potential impact on apical periodontitis development.

The chronological age estimation of living individuals is a crucial part of forensic practice and clinical practice, such as in orthodontic treatment. It is well-known that methods for age estimation in living children should be tested on different populations. Ethnic affiliations in Brazil are divided into several major groups depending on the region, with the south of Brazil being known for its German immigration. (1) Background: This study aimed to evaluate the correlation between chronological age and dental age using Demirjian’s method and Cameriere’s method in a group of children from Joinville, South Brazil to investigate if both methods can be used to estimate dental age in this population. (2) Methods: The sample consisted of 229 panoramic radiographs (119 were males and were 110 females) from Brazilian children (ages ranging from 6 to 12 years). The chronological age at the time of the panoramic radiographic exam was calculated for each child. The dental age was estimated according to Demirjian’s method and Cameriere’s method. All continuous data were tested for normality by using the Shapiro–Wilk test. The Pearson correlation coefficient test was applied. An alpha of 5% (p < 0.05) was used for all analyses. (3) Results: The mean chronological age was 8.75 years. According to Demirjian’s method, the mean dental age was 9.3 years, while according to Cameriere’s method, the mean dental age was 8.66 years. A strong correlation between chronological age and dental age according to Demirjian (r = 0.776 and p < 0.0001) and Cameriere (r = 0.735 and p < 0.0001) was observed for both genders. (4) Conclusions: Both methods presented a good correlation with chronological age in the studied population and could be used to assess dental age in this population.

Objectives: The purpose of this study was to develop a deep learning algorithm capable of diagnosing radicular cysts in the lower jaw on panoramic radiographs. Materials and Methods: In this study, we conducted a comprehensive analysis of 138 radicular cysts and 100 normal panoramic radiographs collected from 2013 to 2023 at Clinical Hospital Dubrava. The images were annotated by a team comprising a radiologist and a maxillofacial surgeon, utilizing the GNU Image Manipulation Program. Furthermore, the dataset was enriched through the application of various augmentation techniques to improve its robustness. The evaluation of the algorithm’s performance and a deep dive into its mechanics were achieved using performance metrics and EigenCAM maps. Results: In the task of diagnosing radicular cysts, the initial algorithm performance—without the use of augmentation techniques—yielded the following scores: precision at 85.8%, recall at 66.7%, mean average precision (mAP)@50 threshold at 70.9%, and mAP@50-95 thresholds at 60.2%. The introduction of image augmentation techniques led to the precision of 74%, recall of 77.8%, mAP@50 threshold to 89.6%, and mAP@50-95 thresholds of 71.7, respectively. Also, the precision and recall were transformed into F1 scores to provide a balanced evaluation of model performance. The weighted function of these metrics determined the overall efficacy of our models. In our evaluation, non-augmented data achieved F1 scores of 0.750, while augmented data achieved slightly higher scores of 0.758. Conclusion: Our study underscores the pivotal role that deep learning is poised to play in the future of oral and maxillofacial radiology. Furthermore, the algorithm developed through this research demonstrates a capability to diagnose radicular cysts accurately, heralding a significant advancement in the field.

Abstract Purpose Sinus lift operations are a tried and tested means of providing adequate implant prosthetics to patients with compromised jawbones. Knowledge of the arterial supply of the maxillary sinus region is essential for surgical treatment in this area. The aim of the present comparative study was to determine whether alveolar antral artery (AAA) canal can be diagnosed both in corresponding panoramic radiography (PR) and cone-beam computed tomography (CBCT). Methods A total of 335 patients with 635 sites and corresponding maxillary sinus in both PR and CBCT were selected and examined for AAA canal visibility. Results The visibility of the AAA canal was significantly higher in CBCT than in PR. A total of 154 (46.0%) AAA canals could be identified in the maxillary sinus on the right. However, only four (1.2%) of these were also visible in PR. The detected values of the AAA canals in the maxillary sinus on the left in the PR and CBCT images were similar to those of the right. While 164 AAA canals (49%) were observed in CBCT images, only 1 (0.3%) was identifiable in PR. Conclusions The results show that CBCT can be recommended for visualising the AAA canal when surgically planning sinus augmentation procedures. Graphical Abstract

Abstract Background Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle’s Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle’s syndrome occurs in 4–10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide. Methods The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant’s gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at

Statement of the Problem: Developmental anomalies such as dilacerations can affect the eruption pattern of permanent anterior teeth. They are characterized by a curvature in the crown and roots of the teeth relative to their normal axis. This anomaly can cause some complexities in routine dental treatments such as root canal treatment, orthodontics, and surgery.Purpose: The purpose of this study was to assess the prevalence of dilaceration in maxillary and mandibular anterior and canine teeth in Shiraz, Iran using cone-beam computed tomography (CBCT).Materials and Method: In this retrospective study, a total of 1537 encompassed 400 CBCT images collected from 4 private radiology clinics in Shiraz were assessed. Each tooth was radiographically examined in order to diagnose root dilacerations considering their location (apical, middle, coronal), position in the jaw (maxillary or mandibular), direction (mesial, distal buccal and palatal/lingual), and severity of dilaceration (mild, moderate, and severe). The obtained data were analyzed by Chi-square statistical test and Fisher’s exact test. Results: In this study, out of 1537 studied teeth, 5.98% had dilaceration. The maxillary and mandibular canine teeth (9.8% and 9.7%, respectively) were significantly the most common teeth involved in this anomaly (p< 0.001). The distal direction with mild severity in the apical third of the root was also the most common result obtained from this study (p

AMAÇ: Bu çalışmada; 2018-2019 yılları arasında Gazi Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalı’na başvuran hastaların gömülü üçüncü molar dişlerinin; Winter, Archer ile Pell ve Gregory sınıflandırmalarına göre pozisyonlarının, sürme seviyelerinin ve gömüklülük durumlarının retrospektif olarak değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Yaş ortalaması 25.78 olan 1548 hastadan alınan panoramik filmlerde tespit edilen 5523 gömülü üçüncü molar dişi, yaş ve cinsiyet özelliklerine göre değerlendirilmiştir. Tüm gömülü üçüncü molar dişlerin pozisyonlarına göre sınıflandırılması yapılmış ve elde edilen sonuçlar literatür ile karşılaştırılmıştır. BULGULAR: Analiz sonuçları doğrultusunda; cinsiyet ile Winter sınıflamasına göre 18, 38 ve 48 nolu dişlerin pozisyonları arasında, cinsiyet ile Archer sınıflamasına göre 18, 28 ve 48 nolu dişlerin sürme seviyeleri arasında; cinsiyet ve 38-48 nolu gömülü dişlerin mandibular kanal ile olan ilişkisi arasında istatistiksel olarak anlamlı bir ilişki olduğu (p=0.000), cinsiyet ile Pell & Gregory sınıflamasına göre 38-48 nolu gömülü dişlerin M3 mesafesi arasında istatistiksel olarak anlamlı bir ilişki olmadığı tespit edilmiştir (p>0.05). SONUÇ: Gömülü üçüncü molar dişlerin çekiminde bazı riskler bulunmaktadır. Bu riskler dişlerin gömüklülük durumundan ve pozisyonlarından kaynaklanabilir. Özellikle gömülü alt üçüncü molar diş köklerinin mandibular kanal ile olan ilişkisi açısından olası risklerin tespit edilerek en aza indirilmesi amacıyla preoperatif değerlendirme yapılması elzemdir.

Objective To discuss the effectiveness and mechanism for movement of maxillary buccally transposed canines by using a door-shaped individualized dental archwire mechanic and to provide a reference for clinicians. Methods Eight patients with unilateral maxillary transposed canines were enrolled. All patients were treated with door-shaped individualized archwires. Before treatment (T1) and after the crowns of the transposed canines were moved to the right buccal positions in the dental arch during the treatment (T2), orthopantomograms were taken both at T1 and T2 to compare the linear changes (distance changes of the crown and root apex) and angular changes to study the mechanisms of tooth movement. The probing depth and buccal crown height were measured using a periodontal probe to compare periodontal changes before treatment (T1) and after treatment (T3) between the transposed canines and contralateral canines. Results All eight transposed canines were successfully brought back to their normal dental arch position but were made more buccal by using the door-shaped individualized dental archwire, with a mean of (11.5 ± 2.7) months. The average overall duration was (28.3 ± 4.7) months. The crown distance changes of the canines from T1 to T2 (8.1 mm) were greater than those of the root apexes (1.5 mm) (P0.05). Conclusion The buccal movement of maxillary transposed canines under a door-shaped individualized dental archwire was effective and feasible. The movement pattern under this mechanism was controlled tipping.

Amaç: Bu çalışmanın amacı, retrospektif olarak incelenen panoramik radyografilerde görülen dental anomalilerin tüm tip ve alt tiplerinin prevalansını değerlendirmekti. Gereç ve Yöntemler: 2019 yılının son 6 ayında, bir fakülte hastanesine başvuran ve panoramik röntgeni çekilen 14 – 70 yaş aralığındaki 1266 hastanın radyografisi incelendi. Durum, büyüklük, sayı, biçim ve doku olarak 5 tip, toplamda 21 alt tip (Transpozisyon, Ektopi, Enversiyon, Median diastema, Mikrodonti, Makrodonti, Hipodonti, Oligodonti, Anadonti, Supernumerer, Meziodens, Talon tüberkülü (dens evaginatus), Taurodontizm, Dilaserasyon, Geminasyon, Füzyon, Concrescence, Dens in dente (dens invaginatus), Amelogenezis imperfekta, Dentinogenezis imperfekta, Dentin displazisi) gelişimsel diş anomalisi araştırıldı. Yaş ortalamaları için bağımsız örneklem t-testi, anomalilerin dağılımlarını değerlendirmek için ki-kare ve Fisher’s Exact testi kullanıldı. Bulgular: Yaş ortalaması 36.9 olan hastaların % 27.8’inde dental anomali görüldü. Kadınlarda anomali görülme prevalansı (% 30.3) erkeklere göre (% 23.8) anlamlı olarak daha yüksekti. Anomaliye sahip kadınlarda ise biçim anomalisi (% 68.6) ve alt tipi olarak talon tüberkülü (% 40.3) prevalansı anlamlı olarak yüksekti. Diğer anomali alt tipleri ve cinsiyetler arasında istatistiksel olarak anlamlı bir fark yoktu. En sık, sırasıyla talon tüberkülü (% 36.1), dilaserasyon (% 15.3), median diastema (% 12.8), tek diş eksikliği (% 11.9) ve dens in dente (% 11.6) alt tiplerine rastlanıldı. Sonuç: Her dört hastadan birinde dental anomaliye rastlama ihtimali olduğunu gösteren çalışmanın sonucu, başvuran her hastadan panoramik radyografi alınmasının ve detaylı bir incelemenin önemini bir kez daha ortaya koymuştur.

Abstract The nasal cavity is an important landmark when considering implant insertion into the anterior region of the maxillary arch. The perforation of implants into the nasal cavity may cause complications, such as implant migration, inflammation, or changes in nasal airflow; thus, precise assessment of the nasal cavity is mandatory. Three cases of nasal cavity perforation by dental implants are presented, including one case of implant fixture migration into the nasal cavity. On panoramic radiographs of the patients, the following common features were observed: the horizontal radiopaque line of the hard palate was observed to be inferior to or similar to that of the antral floor and the bone between the lateral wall of the nasal cavity and the medial wall of the maxillary sinus was emphasized in a triangular shape. When the maxillary sinus is small and alveolar bone resorption is severe, panoramic evaluation may cause overestimation of the available residual bone, particularly in the maxillary canine/premolar region. Therefore, the residual bone should be reevaluated three-dimensionally to measure the exact bony shape and volume.

Objective:Our study aimed to examine the effects of age and gender for both tooth groups by determining the current status of the permanent mandibular first and second molars, presence/absence status of them and disease/health status of them in geriatric patients.Methods:Panoramic radiographs of 1,500 patients, 815 women and 685 men, aged 65 and over, who were admitted to Bezmialem Vakıf University Faculty of Dentistry between 2019-2021, were examined. A single investigator reviewed each patient’s X-ray. The patients were classified according to their age groups and genders. Age classification was made as 65-74 years, 75-84 years and ≥85 years. Conditions of permanent lower first and second molars were recorded as present or absent. If present, it was reported whether healthy, canal treated, filled orroot canal treated + prosthetic restoration. Root residue and the presence of implants were also noted.Results:Among 1,500 geriatric patients who were admitted to Bezmialem Vakıf University Faculty of Dentistry between 2019-2021, 1,127 (75.1%) were in the 65-74 years of age group, 321 (21.4) in the 75-84 years of age group, and 52 (3.5%) in the ≥85 years of age group. Of the permanent left mandibular first molars, 6.7% were healthy and 72.1% were absent. Of the permanent left mandibular second molars, 10.3% were healthy and 67% were absent. While 6.1% of the permanent right mandibular first molars were healthy, 73.3% were absent. On the other hand, 10% of the permanent right mandibular second molars were healthy, while 66.8% were absent. While the number of geriatric patients with no missing teeth was 97, the number of patients with four missing teeth was found to be 785.Conclusion:The survival percentage of permanent mandibular second molars is higher than permanent mandibular first molars. Despite the prolongation of life expectancy, there is no increase in the frequency of permanent molars.

Abstract Objectives This scoping review aimed to assess the current state of knowledge regarding the relationship between bruxism and changes in density or volume of mandibular bone, based on medical imaging. Methods Literature review was conducted following the PRISMA-ScR protocol. PubMed, Web of Science and Cochrane library databases were searched for peer-reviewed articles by two blinded reviewers. Studies based on the evaluation of mandibular bone density and/or bone volume with imaging examination in adult patients were examined. The selected articles were summarized in PICOS tables and assessed for methodological quality. Results Nine articles were included, according to the inclusion criteria. They showed that bruxer patients had more bony exostoses of the mandibular angle, smaller condyles, and morphological changes for cancellous and cortical mandibular bone compared to non-bruxer patients. Conclusion Bruxism seems to induce morphological and anatomical changes in the different regions of the mandibular bone (condyles, mandibular angle, mandible body). Given the heterogeneity of the included studies, these results should be interpreted with caution. Further studies are needed to support these results, in particular via the analysis of three-dimensional imaging to overcome the limitations of panoramic radiograph.

Background/purpose: In lower third molar (LM3) surgery, panoramic radiography (PAN) is important for the initial assessment of the anatomical association between LM3 and the inferior alveolar nerve (IAN). This study aimed to develop a deep learning model for the automated evaluation of the LM3–IAN association on PAN. Further, its performance was compared with that of oral surgeons using original and external datasets. Materials and methods: In total, 579 panoramic images of LM3 from 384 patients in the original dataset were utilized. The images were divided into 483 images for the training dataset and 96 for the testing dataset at a ratio of 83:17. The external dataset comprising 58 images from an independent institution was used for testing only. The LM3–IAN associations on PAN were categorized into direct or indirect contact based on cone-beam computed tomography (CBCT). The You Only Look Once (YOLO) version 3 algorithm, a fast object detection system, was applied. To increase the amount of training data for deep learning, PAN images were augmented using the rotation and flip techniques. Results: The final YOLO model had high accuracy (0.894 in the original dataset and 0.927 in the external dataset), recall (0.925, 0.919), precision (0.891, 0.971), and f1-score (0.908, 0.944). Meanwhile, oral surgeons had lower accuracy (0.628, 0.615), recall (0.821, 0.497), precision (0.607, 0.876), and f1-score (0.698, 0.634). Conclusion: The YOLO-driven deep learning model can help oral surgeons in the decision-making process of applying additional CBCT to confirm the LM3–IAN association based on PAN images.

ABSTRACT Objective: Evaluate the inter and intra-observer reliability of Nash and Moe’s grades, used to assess patients diagnosed with Adolescent Idiopathic Scoliosis (AIS). Methodology: Forty-seven representative x-rays of patients with AIS were randomly selected to evaluate the apical vertebral rotation (AVR) using Nash and Moe’s grades. The evaluation of the AVR was made independently in two distinct moments by two observers. The inclusion criteria in the study were a patient diagnosed with AIS and an orthostasis radiography with a good-quality image. An agreement study between the evaluations and the inter and intraobserver’s reliability was determined using Kappa’s statistics with a confidence interval of 95%. Results: The interobservers’ Kappa’s value in the first evaluation was 0,44 (CI 95%; 0,22-0,66) and 0,37 (CI 95%; 0,17-0,56) in the second. In the intraobservers’ evaluations, the Kappa’s value for examiner 1 was 0,61 (CI 95%; 0,40-0,81) and 0,46 (CI 95%; 0,22-0,70) for examiner 2. Conclusion: This study’s results demonstrated that Nash and Moe’s grades are unreliable for evaluating vertebral rotation in patients with AIS. Level of Evidence III; A Cross-Sectional Study.

Third molar surgery is one of the most common surgical procedures performed in oral and maxillofacial surgery. Considering the patient's young age and the often-elective nature of the procedure, a comprehensive preoperative evaluation of the surgical site, relying heavily on preoperative imaging, is key to providing accurate diagnostic work-up, evidence-based clinical decision making, and, when appropriate, indication-specific surgical planning. Given the rapid developments of dental imaging in the field, the aim of this article is to provide a comprehensive, up-to-date clinical overview of various imaging techniques related to perioperative imaging in third molar surgery, ranging from panoramic radiography to emerging technologies, such as photon-counting computed tomography and magnetic resonance imaging. Each modality's advantages, limitations, and recent improvements are evaluated, highlighting their role in treatment planning, complication prevention, and postoperative follow-ups. The integration of recent technological advances, including artificial intelligence and machine learning in biomedical imaging, coupled with a thorough preoperative clinical evaluation, marks another step towards personalized dentistry in high-risk third molar surgery. This approach enables minimally invasive surgical approaches while reducing inefficiencies and risks by incorporating additional imaging modality- and patient-specific parameters, potentially facilitating and improving patient management. [ABSTRACT FROM AUTHOR]

Background: Changes in mandibular cortical bone have been documented in children with chronic diseases but not in healthy populations. Aim: We aimed to qualitatively and quantitatively evaluate the mandibular cortical bone of a healthy paediatric population using dental panoramic radiographs (DPTs). The secondary objective was to assess the effect of dental status on cortical bone. Design: The DPTs of 660 individuals, aged 6–18 years, were evaluated by two blinded examiners. Bone was qualitatively categorized according to the Mandibular Cortical Index (MCI), and its width was calculated using the Mandibular Cortical Width Index (MCW). Differences between gender and age were tested using Fisher's exact and correlation with dental status with the chi-square test. Results: A significant correlation was observed between bone morphology and gender, with girls having more frequent even and sharp endosteal margins than boys, who showed semilunar defects. The degree of erosion increased with age, as did bone thickness. A positive correlation between thickness and type of dentition was recorded, with normal bone predominating in children in the mixed dentition stage. Νο correlation was found between bone morphology or thickness and the factors associated with dental status. Conclusions: Bone quality and quantity vary significantly between different genders and age groups. Dental needs and treatment characteristics did not seem to affect the above parameters. [ABSTRACT FROM AUTHOR]

Background: Accurate age estimation is vital for clinical and forensic purposes. With the rapid advancement of artificial intelligence(AI) technologies, traditional methods relying on tooth development, while reliable, can be enhanced by leveraging deep learning, particularly neural networks. This study evaluated the efficiency of an AI model by applying the entire panoramic image for age estimation. The outcome performances were analyzed through supervised learning (SL) models. Methods: Total of 27,877 dental panorama images from 5 to 90 years of age were classified by 2 types of grouping. In type 1 they were classified by each age and in type 2, applying heuristic grouping, the age over 20 years were classified by every 5 years. Wide ResNet (WRN) and DenseNet (DN) were used for supervised learning. In addition, the analysis with ± 3 years of deviation in both types were performed. Results: For the DN model, while the type 1 grouping achieved an accuracy of 0.1016 and F1 score of 0.058, the type 2 achieved an accuracy of 0.3146 and F1 score of 0.2027. Incorporating ± 3years of deviation, the accuracy of type 1 and 2 were 0.281, 0.7323 respectively; and the F1 score were 0.1768, 0.6583 respectively. For the WRN model, while the type 1 grouping achieved an accuracy of 0.1041 and F1 score of 0.0599, the type 2 achieved an accuracy of 0.3182 and F1 score of 0.2071. Incorporating ± 3years of deviation, the accuracy of type 1 and 2 were 0.2716, 0.7323 respectively; and the F1 score were 0.1709, 0.6437 respectively. Conclusions: The application of entire panorama image data for supervised with classification by heuristics grouping with ± 3years of deviation for supervised learning models and demonstrated satisfactory outcome for the age estimation. [ABSTRACT FROM AUTHOR]

The prevalence of osteoporosis is high, reportedly affecting 200 million people worldwide. A major problem associated with osteoporosis is that femoral fractures cause a decline in general function and loss of independence, greatly reducing patients' quality of life. Notably, osteoporosis is an asymptomatic chronic metabolic disease, and its detection is thus often delayed. Interestingly, mandibular cortical index (MCI) classification using dental panoramic radiography is reportedly useful for early detection of osteoporosis. However, this visual classification method can lead to differences in diagnoses among surgeons. The aim of this preliminary study was to analyze cone-beam computed tomography (CBCT) data and examine an objective MCI classification using the findings obtained. MCI classification (classified as C1, C2, or C3) was performed by three examiners on 70 women (91 sites) aged ≥20 years. The mandibular cortical width of all sites was measured using CBCT images. The results showed that the mandibular cortical width was not particularly correlated with age or number of present teeth, and no significant quantitative differences were found between C1 and C2. However, coronal CBCT images of C2 revealed multiple characteristic trabecular bone structures. These structures may be an important finding affecting the classification of two-dimensional dental panoramic radiography images. [ABSTRACT FROM AUTHOR]

The dental characteristics created by acquired dental treatments can be used as age estimators. This pilot study aimed to analyze the correlation between the number of teeth observed for dental characteristics and chronological age and to develop new non-invasive age estimation models. Dental features on panoramic radiographs (420 radiographs of subjects aged 20-89 years) were classified and coded. The correlation between the number of teeth for each selected code (codes V, X, T, F, P, and L) and age was observed, and multiple regression was performed to analyze the relationship between them. Eleven regression models with various combinations of dental sextants were presented. The model with the data from both sides of the posterior teeth on both jaws showed the best performance (root mean square error of 14.78 years and an adjusted R2 of 0.461). The model with all teeth was the second-best. Based on these results, we confirmed statistically significant correlations between certain dental features and chronological age. We also observed that some regression models performed sufficiently well to be used as adjunctive methods in forensic practice. These results provide valuable information for the design and performance of future full-scale studies. [ABSTRACT FROM AUTHOR]

Background/Aim: Although previous studies have revealed the influence of the mandibular third molar (M3) on mandibular condylar fracture risk and that the presence of M3 could result in different incidences of condylar and angle fractures, there have been no analyses of the influence of M3 on fracture patterns. Moreover, evaluations of M3 position using panoramic radiography have shown insufficient accuracy. This study investigated the relationship between condylar fracture patterns and M3 position using panoramic radiography and computed tomography. Materials and Methods: This retrospective study included 280 patients with unilateral mandibular condylar fractures and ipsilateral M3 admitted to West China Hospital of Stomatology between January 2016 and June 2022. Patient medical records, panoramic radiographs, and computed tomography images were collected. The vertical and horizontal positions of M3 were classified using the Pell and Gregory system. M3 angulation was defined as the angle between the long axis of M3 and the mandibular occlusal plane. Condylar fracture patterns were classified as intracapsular (Types A–C) or extracapsular (neck and base). Data were analyzed using McNemar–Bowker test, Pearson chi‐squared test, and Fisher's exact test. Results: Classification of M3 position differed significantly between panoramic radiography and computed tomography images (p <.05). There was a significant association between the mandibular condylar fracture pattern and M3 horizontal position on computed tomography (p <.05). Class I M3 position on computed tomography was associated with a higher incidence of intracapsular than extracapsular fractures, along with a higher incidence of Type B than base fractures; the opposite relationships were observed for Class II. No such association was identified on panoramic radiography. Conclusions: Mandibular condylar fracture patterns were presumably influenced by M3 horizontal position on computed tomography. The imaging modality affected the classification of M3 position and subsequent analyses. Computed tomography is recommended for future studies to improve accuracy and reliability. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the prevalence of pulp stones in a Turkish paediatric cohort from the Isparta district using panoramic radiographs. Methods: Panoramic radiographs of 19,857 children and adolescents between the ages of 9 and 18 years were retrospectively analysed to determine the prevalence and distribution of pulp stones. Teeth with pulp stones were classified in terms of dentition, location, dental status and complete or incomplete root formation. Statistical analysis was carried out by applying Chi‑square and Mann–Whitney U. Univariate logistic regression analysis was applied to determine the factors affecting pulp stone status. Differences were considered as significant when p < 0.05. Results: Out of a total of 19,857 patients, pulp stones were identified in 6.5%. Among the 548,415 teeth examined, 0.96% had pulp stones. The incidence of pulp stones in girls (7.4%) was higher than in boys (5.7%) (p < 0.001). The prevalence of pulp stones increased with age and was significantly higher in molar teeth. A significant difference existed in the incidence of pulp stones according to the jaws (p < 0.001). In both jaws, no statistically significant difference was observed in terms of teeth with pulp stones being on the right and left (p = 0.834). Of molars with pulp stones, 91.8% had completed root formation. The majority of patients (37.7%) had pulp stones in four teeth. Conclusion: Knowing the incidence of pulp stones in paediatric patients by dentists, endodontists, and paediatric dentists will help prevent complications that may occur during applications by facilitating the determination of appropriate methods, especially during endodontic procedures. [ABSTRACT FROM AUTHOR]

Background and Objectives: The purpose of this study was to develop and evaluate a deep learning model capable of autonomously detecting and segmenting radiolucent lesions in the lower jaw by utilizing You Only Look Once (YOLO) v8. Materials and Methods: This study involved the analysis of 226 lesions present in panoramic radiographs captured between 2013 and 2023 at the Clinical Hospital Dubrava and the School of Dental Medicine, University of Zagreb. Panoramic radiographs included radiolucent lesions such as radicular cysts, ameloblastomas, odontogenic keratocysts (OKC), dentigerous cysts and residual cysts. To enhance the database, we applied techniques such as translation, scaling, rotation, horizontal flipping and mosaic effects. We have employed the deep neural network to tackle our detection and segmentation objectives. Also, to improve our model's generalization capabilities, we conducted five-fold cross-validation. The assessment of the model's performance was carried out through metrics like Intersection over Union (IoU), precision, recall and mean average precision (mAP)@50 and mAP@50-95. Results: In the detection task, the precision, recall, mAP@50 and mAP@50-95 scores without augmentation were recorded at 91.8%, 57.1%, 75.8% and 47.3%, while, with augmentation, were 95.2%, 94.4%, 97.5% and 68.7%, respectively. Similarly, in the segmentation task, the precision, recall, mAP@50 and mAP@50-95 values achieved without augmentation were 76%, 75.5%, 75.1% and 48.3%, respectively. Augmentation techniques led to an improvement of these scores to 100%, 94.5%, 96.6% and 72.2%. Conclusions: Our study confirmed that the model developed using the advanced YOLOv8 has the remarkable capability to automatically detect and segment radiolucent lesions in the mandible. With its continual evolution and integration into various medical fields, the deep learning model holds the potential to revolutionize patient care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Aydin Dental Journal is the property of Aydin Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Atherosclerosis and its secondary diseases display a major threat to patient's health. Sequelae, like carotid artery calcification (CAC), usually develop over decades and remain asymptomatic for a long time, making preventive measures to reduce mortality and morbidity extremely important. Through panoramic radiography (PR) and cone beam computed tomography (CBCT), dentists may have helpful tools in aiding the holistic care of patients. In this context, the correlation of atherosclerotic risk factors and CAC development have not yet been sufficiently investigated. Thus, the aim of this observational radiological study was to evaluate the diagnostic value of PR compared with CBCT for the detection of CAC in patients older than 60 years. The radiological findings were correlated with gender, age, and cardiac risk factors. Methods: PRs and CBCTs of N = 607 patients were used for the qualitative analysis and compared. Basic patient information such as age, gender, body mass index (BMI), smoking history as well as patient's detailed medical history, including heart disease and cardiovascular risk factors such as hypercholesterolemia, arterial hypertension and diabetes mellitus type II were documented and their relation to CAC provided by radiological data was estimated in the form of odds ratios (OR), which were calculated using logistic regression models. Proportions of CAC in different risk groups were compared using Fisher's exact test, the significance level was set to α ≤ 0.05. The interrater reliability of two physicians was estimated using Cohen's kappa. Results: With an accuracy of 90.6%, a sensitivity of 67.5% and a specificity of 99.5% compared to CBCT, PR was a reliable method for the diagnosis of CAC. The overall detection rate for CAC was 27.8% across all age groups. Age (OR: 1.351; p = 0.021), the male sex (OR: 1.645; p = 0.006), arterial hypertension (OR: 2.217; p = < 0.001), heart disease (OR: 1.675; p = 0.006), hypercholesterolemia (OR: 1.904; p = 0.003) and chronic obstructive pulmonary disease (OR: 2.016; p = 0.036) were statistically significant risk factors. When correlated, neither history of stroke nor nicotine abuse showed any statistical significance. Conclusions: Due to the capabilities of PR in the diagnosis of CAC, dentists can play a vital role in the early diagnosis of vascular disease. Awareness should therefore be raised among dentists regarding the detection of CAC in patients over 60 years of age, with a particular focus on those with arterial hypertension and hypercholesterolaemia. [ABSTRACT FROM AUTHOR]

Background: Radiation shielding in radiology has historically been achieved with lead; however, there has been an increasing demand for radiation shielding to be more environmentally friendly. Barium has shown promise as a substitute in many radiology applications. This study aims to investigate a barium sulphate shield in protecting the thyroid and the eye lens during panoramic radiography. Methods: During a simulated panoramic examination, an anthropomorphic phantom and a solid-state detector measured the radiation dose to the surface thyroid and the eye lens. The measurements were taken using no shield and a barium sulphate shield. A Welch's T-test was employed to compute the shield's effect on radiation. Two radiologists assessed the image quality with and without the thyroid shields. Results: The dose reduction was between 66 and 75% for the barium shield at the thyroid. The dose reduction ranged between 15 and 61% in the eye region. Images using a barium shield were deemed adequate for diagnostic interpretation. Conclusions: Barium shields effectively reduce the radiation dose in the thyroid region during panoramic radiography without degrading image quality. The dose reduction depends on the tube voltage and the area of interest. [ABSTRACT FROM AUTHOR]