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Objective: An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address paresthesia resulting from an endodontic file penetrating the inferior alveolar nerve canal and provide a protocol for managing nerve injuries in such incidents. Case presentation: A 12-year-old girl developed paresthesia when an endodontic file separated and was inadvertently pushed through the apical foramen into the inferior alveolar nerve canal during root canal treatment of the mandibular left first molar. A CBCT scan revealed the file penetrating the canal towards the inferior border of the mandible. After considering the treatment options, intentional replantation was deemed suitable. The tooth was atraumatically extracted and preserved in sterile saline. The surgeon then carefully cleaned and irrigated the socket. The radiographic assessment confirmed successful file removal from the socket. The root ends were resected, and retrograde preparation and obturation were conducted using ultrasonic tips and mineral trioxide aggregate. The tooth was then replanted into the socket. Successful replantation was confirmed by tooth stability and an audible click. The patient was prescribed antibiotics and steroids. After completion of the endodontic treatment, a stainless steel crown was cemented. The successful intentional replantation procedure resulted in rapid improvement in the patient's condition. The normal sensation had been restored, indicating nerve recovery. At the 15-month follow-up, periapical bone healing and the eruption of the adjacent second molar were observed, affirming the treatment protocol's overall success. Conclusion: Prompt intervention and immediate intentional replantation facilitated direct inspection of the separated file within the socket. Collaboration between an oral maxillofacial surgeon and an endodontist ensures expedited and targeted treatment, leading to favorable outcomes. [ABSTRACT FROM AUTHOR]

Context: The incidence and recurrence rate of hamstring strain injuries remain persistently high, with recurrent injuries leading to increased time lost during play and extended recovery periods compared with initial injury. Ultrasound imaging assesses important factors such as hamstring fascicle length (FL), pennation angle (PA), cross-sectional area (CSA), muscle thickness (MT), echo intensity (EI), and shear wave elastography (SWE), all impacting athletic performance. However, its reliability must be established before employing any measurement tool in research or clinical settings. Objectives: To determine the reliability and measurement error of ultrasound for assessing hamstring FL, PA, CSA, MT, EI, and SWE among healthy adults and athletes; to synthesize the information regarding the operationalization of ultrasound. Evidence Acquisition: A systematic literature search was done from January 1990 to February 5, 2023, to identify reliability and validity studies of hamstring ultrasound assessment published in peer-reviewed journals with identifiable methodology of outcome measures. Evidence Synthesis: Intraclass correlation coefficient measurement of 14 included studies reported moderate to excellent intrarater, interrater, and test–retest reliabilities of FL, PA, and MT regardless of the site of muscle testing, probe size, and setting, state of muscle, and use of different techniques in the extrapolation of FL. Good to excellent test–retest reliability rates for all hamstring anatomic CSA along midmuscle and different percentages of thigh length using panoramic imaging. Good intrarater reliability of EI regardless of gender and orientation of the probe but with excellent intrarater reliability in transverse scan using maximum region of interest. Good intrarater, interrater, and interday repeatability on SWE with the muscle in a stretched position. Conclusion: Evidence from studies with a predominantly low risk of bias shows that ultrasound is a reliable tool to measure hamstring FL, PA, CSA, MT, EI, and SWE in healthy adults and athletes under various experimental conditions. [ABSTRACT FROM AUTHOR]

Purpose: Patients with systemic scleroderma (SSc) often suffer from premature tooth loss. The aim of this study was to radiologically investigate bone loss at dental implants in patients with SSc and compare it with data from the literature on healthy patients. Materials and Methods: Mesial and distal bone level changes at implants were independently determined on panoramic and intraoral radiographs. They were double-checked after determination of evaluability by three different raters. Cohen's kappa was used to test for interrater reliability. Mean bone loss was estimated using linear regression analysis considering the patient as a random-effect implant and performed separately in predefined implant regions for different time points and for the mesial and distal sides of the implants. Results: Mesial and distal bone level changes were analyzed in 61 implants using periapical and panoramic radiographs. In total, 114 radiographs from 18 patients were evaluable in both the mesial and distal regions. After a maximum observation period of 60 months, the mean peri-implant bone loss was 1.68 mm (range: 0.83 to 2.54 mm) at the distal aspect and 1.65 mm (range: 0.81 to 2.48 mm) at the mesial aspect in the right posterior mandible (region 44 to 47 [FDI numbering system]), whereas in the left posterior maxilla (regions 24 to 27), the mean peri-implant bone loss was 0.61 mm (range: 0.32 to 0.91 mm) at the distal aspect and 0.59 mm (range: 0.16 to 1.03 mm) at the mesial aspect. The mean bone loss 60 months after surgery was 1.05 mm (range: 0.85 to 1.25 mm). Conclusions: Marginal bone loss at implants in patients with SSc is comparable to data from the literature collected in healthy subjects. [ABSTRACT FROM AUTHOR]

Successful rehabilitation of severely atrophic, short-span edentulous ridges in esthetic regions can seldom be done without some form of vertical ridge augmentation (VRA). The best available evidence shows that guided bone regeneration procedures may present a very predictable option with reduced potential for complications compared to alternative options. The present case series presents a novel technique to achieve predictable VRA with a low complication rate using tenting screws and cross-linked resorbable membranes. A total of 10 patients (5 men, 5 women) with severe vertical defects in the esthetic zone participated in this study. Following a mean healing time of 9.3 months, the mean defect resolution was 80%, with a mean vertical bone gain of 6.2 ± 1.61 mm. Only one case presented with reduced defect resolution (50%); however, the bone gain for this case was 6 mm. [ABSTRACT FROM AUTHOR]

Purpose: To assess the peri-implant and flap parameters of the prefabricated microvascular fibula flap and determine the dental implant survival rate. Materials and Methods: This retrospective study investigated a cohort of subjects who received prefabricated microvascular fibula flaps at two highly specialized tumor reconstruction centers. The subjects had all suffered atrophy or a large segmental defect of the jaws due to tumor resection or injury. Two independent surgeons determined the dental implant survival rate and assessed the peri-implant parameters and flap parameters during clinical follow-up. Results: In total, 41 subjects were treated with a prefabricated fibula flap between 1999 and 2012. Of these, 17 subjects (10 male, 7 female) with a total of 62 dental implants were examined. The other 24 subjects were unavailable for assessment and had to be excluded. Ten of the 62 dental implants (16.1%) had to be removed due to peri-implantitis before the follow-up assessment. Follow-up assessments were performed at intervals ranging from 2 to 12 years (mean: 7.2 years) after fibula flap transplantation. The dental implant survival rate was found to be 83.9%. A total of 208 dental surfaces were assessed. Overall, 96% of all surfaces had a pocket depth (PD) of ≤ 4 mm and 4% had a pocket depth of > 5 mm. An attachment level (AL) of 3 mm was measured in 48.5% of implants and ≥ 5 mm was measured in 15.9% of implants. Dental implants with a PD > 4 mm showed a significantly higher plaque index (PI) (75%; P = .0057), papillary bleeding index (PBI) (62.5%; P = .0094), and radiologic bone loss (P = .0014) compared to dental implants with a PD ≤ 4 mm. Conclusions: Reconstructive surgery using microvascular fibula flaps represents an alternative tool for oral rehabilitation in subjects suffering from a large segmental defect in the maxillary or mandibular bone compared to the conventional method. However, it appears that the different ossification processes that develop the fibula and the jawbones affect dental implant survival. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. Method and materials: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. Results: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. Conclusions: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effect iveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease. [ABSTRACT FROM AUTHOR]

This study aimed to develop a deep learning system for the detection of three-rooted mandibular first molars (MFMs) on panoramic radiographs and to assess its diagnostic performance. Panoramic radiographs, together with cone beam computed tomographic (CBCT) images of the same subjects, were retrospectively collected from 730 patients, encompassing a total of 1444 MFMs (367 teeth were three-rooted and the remaining 1077 teeth were two-rooted). Five convolutional neural network (CNN) models (ResNet-101 and − 50, DenseNet-201, MobileNet-v3 and Inception-v3) were employed to classify three- and two-rooted MFMs on the panoramic radiographs. The diagnostic performance of each model was evaluated using standard metrics, including accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Receiver operating characteristic (ROC) curve analyses were performed, with the CBCT examination taken as the gold standard. Among the five CNN models evaluated, ResNet-101 demonstrated superior diagnostic performance, and the AUC value attained was 0.907, significantly higher than that of all other models (all P < 0.01). The accuracy, sensitivity, and specificity were 87.5%, 83.6%, and 88.9%, respectively. DenseNet-201, however, showed the lowest diagnostic performance among the five models (all P < 0.01), with an AUC value of 0.701 and an accuracy of 73.2%. Overall, the performance of the CNNs diminished when using image patches containing only the distal half of MFMs, with AUC values ranging between 0.680 and 0.800. In contrast, the diagnostic performance of the two clinicians was poorer, with AUC values of only 0.680 and 0.632, respectively. In conclusion, the CNN-based deep learning system exhibited a high level of accuracy in the detection of three-rooted MFMs on panoramic radiographs. [ABSTRACT FROM AUTHOR]

The aim of the authors was to evaluate the periapical and endodontic conditions of patients with osteoporosis and compare them with those of age- and sex-matched controls. The association between bisphosphonate (BiP) use and periapical and endodontic status in patients with osteoporosis was also investigated. Panoramic radiographs of 711 patients with osteoporosis and 711 age- and sex-matched healthy patients were examined. The presence and number of root canal–filled teeth (RCFT), inadequate RCFT (iRCFT), and teeth with apical periodontitis (AP) were evaluated. BiP treatment history of patients with osteoporosis was also recorded. No significant difference was observed between the osteoporosis group and control group in terms of endodontic and periapical conditions. Results of bivariate logistic regression analysis showed a positive association between the number of teeth with AP and the number of iRCFT with AP and osteoporosis, and a negative association between the number of RCFT with AP and osteoporosis. Among the patients with osteoporosis, 37.5% used BiPs, specifically alendronate, ibandronate, zoledronate, and risedronate (34.3%, 24.9%, 10.6%, 7.2%, respectively). In addition, the results showed a negative association between BiP use and RCFT. As the number of teeth with AP and number of iRCFT with AP increased, patients were more likely to be in the osteoporosis group. These findings imply that periapical lesions may enlarge and become more detectable in patients with osteoporosis with lower bone density, and enhanced inflammatory response. Dentists can collaborate with health care professionals to manage the overall health of patients with osteoporosis to reduce the impact of osteoporosis on oral health and effectively treat dental problems, such as AP. [ABSTRACT FROM AUTHOR]

Objectives: The C-shaped mandibular second molars (MSMs) may pose an endodontic challenge. The aim of this study was to develop a convolutional neural network (CNN)-based deep learning system for the diagnosis of C-shaped MSMs on panoramic radiographs. Materials and methods: Panoramic radiographs and cone beam computed tomographic (CBCT) images were collected from a hospital in China and subsequently divided into two groups. In Group A, conventional panoramic images and CBCT images were derived from the same patients (n = 730 individuals), and the dataset consisted of conventional panoramic image patches of 1453 MSMs. In Group B (n = 610 individuals), the patients underwent CBCT examinations in the absence of available panoramic images; CBCT images were acquired and utilized to generate simulated panoramic images, and the dataset consisted of image patches of 1211 MSMs. Five pretrained CNN networks (ResNet-101 and − 50, DenseNet-121 and − 161, and Inception-V3) were utilized for the classification of C-shaped and non-C-shaped MSMs. Finally, the networks trained on the Group B dataset were tested on the Group A dataset. The diagnostic performance of each model was evaluated using receiver operating characteristic (ROC) curve analysis, and the CBCT images were taken as the gold standard. The results were compared with those achieved by three dental professionals. Results: In Group A, all five networks exhibited satisfactory diagnostic performance, with AUC values ranging from 0.875 to 0.916 and accuracies ranging from 81.8 to 86.7%. No statistical differences were detected among the five CNNs. Notably, the models trained with Group B dataset (CBCT-generated panoramic images) achieved enhanced performance as tested on Group A dataset. The AUC values reached 0.984–0.996, and the accuracies ranged between 94.5% and 98.1%. CNNs outperformed dental professionals in classification performance, and the AUC values achieved by dental specialist, novice dentist, and dental graduate student were only 0.806, 0.767 and 0.730, respectively. Conclusion: CNN-based deep learning system demonstrated higher accuracy in the detection of C-shaped MSMs on panoramic radiographs compared to dental professionals. CBCT-generated panoramic images can serve as a substitute for conventional panoramic images in the training of CNN models when the quantity and quality of conventional panoramic image dataset is insufficient. Clinical relevance: CNN-based deep learning models have demonstrated significant potential in assisting dentists with the identification of C-shaped MSMs on panoramic radiographs, which facilitating more effective, efficient and safer dental treatment. [ABSTRACT FROM AUTHOR]

This study reports a rare case of a dentigerous cyst in a malformed tooth in the mandible of a 5-year-old Japanese boy. Panoramic radiography revealed a cystic lesion with hard tissues inside. The patient underwent surgery under general anesthesia. The histopathological diagnosis was dentigerous cyst associated with a malformed tooth. [ABSTRACT FROM AUTHOR]

Schwannomas are considered benign soft tissue tumors that originate from Schwann cells. Oral Schwannomas are rare and account for only 1% of all Schwannomas. Cellularschwannoma (CS) is a rare histological variant of schwannoma, characterized by high cellularity and cellular atypia. We present a case of localized growth of palatal mucosa that imitated the features of malignant peripheral nerve sheath tumor (MPNST) on histopathological examination; it was differentiated from MPNST by the correlation of clinical, histopathological, and immunohistochemical features. [ABSTRACT FROM AUTHOR]

The development of artificial intelligence (AI) in dentistry requires large and well-annotated datasets. However, the availability of public dental imaging datasets remains unclear. This study aimed to provide a comprehensive overview of all publicly available dental imaging datasets to address this gap and support AI development. This observational study searched all publicly available dataset resources (academic databases, preprints, and AI challenges), focusing on datasets/articles from 2020 to 2023, with PubMed searches extending back to 2011. We comprehensively searched for dental AI datasets containing images (intraoral photos, scans, radiographs, etc.) using relevant keywords. We included datasets of >50 images obtained from publicly available sources. We extracted dataset characteristics, patient demographics, country of origin, dataset size, ethical clearance, image details, FAIRness metrics, and metadata completeness. We screened 131,028 records and extracted 16 unique dental imaging datasets. The datasets were obtained from Kaggle (18.8%), GitHub, Google, Mendeley, PubMed, Zenodo (each 12.5%), Grand-Challenge, OSF, and arXiv (each 6.25%). The primary focus was tooth segmentation (62.5%) and labeling (56.2%). Panoramic radiography was the most common imaging modality (58.8%). Of the 13 countries, China contributed the most images (2,413). Of the datasets, 75% contained annotations, whereas the methods used to establish labels were often unclear and inconsistent. Only 31.2% of the datasets reported ethical approval, and 56.25% did not specify a license. Most data were obtained from dental clinics (50%). Intraoral radiographs had the highest findability score in the FAIR assessment, whereas cone-beam computed tomography datasets scored the lowest in all categories. These findings revealed a scarcity of publicly available imaging dental data and inconsistent metadata reporting. To promote the development of robust, equitable, and generalizable AI tools for dental diagnostics, treatment, and research, efforts are needed to address data scarcity, increase diversity, mandate metadata completeness, and ensure FAIRness in AI dental imaging research. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the changes in the trabecular structure of the mandibular bone and temporomandibular joint following Rapid Maxillary Expansion. Methods: Thirty-nine patients who received Rapid Maxillary Expansion treatment in the Department of Orthodontics of the Faculty of Dentistry were selected from the archieve for the study. Trabecular structure changes of the angulus mandible, corpus mandible, and condyle regions were examined using fractal analysis on the dental panoramic radiographs. Radiographs taken before the treatment (T0) and at the end of the 3-month retention period (T1) of the patients. Results: There was no statistically significant difference between T0 and T1 in the condyle, ramus mandible, and corpus mandible regions depending on time and sex. (p < 0.05) Conclusion: The results of this study showed that Rapid Maxillary Expansion treatment does not have a significant impact on the trabecular structure of the mandible and temporomandibular joint depending on time and gender. [ABSTRACT FROM AUTHOR]

Background: Congenitally missing permanent canines (CMPC) have a significant impact on function and aesthetics. The prevalence is low, and the availability of rigorous studies on this issue in China is limited. This study was designed to investigate the prevalence and distribution of CMPC in patients and concomitant anomalies. Additionally, we aimed to compare the prevalence of CMPC between two age groups. Methods: A total of 10,447 patient's panoramic radiograph (PR) images from August 2021 to December 2023 were reviewed and data regarding the location and number of CMPCs were recorded. Age and gender were obtained from the clinical records. Additionally, concomitant anomalies such as persistent primary canines, congenitally missing other permanent teeth, supernumerary teeth and microdontia were also recorded in patients with CMPC. 10,447 patients were divided into two groups: group A (< 121 months of age) and group B (≥ 121 months of age) to record the number of patients with CMPC. The data were presented as counts (n) and percentages (%), and statistically analysed using the Chi-square test. Results: The average age of patients with CMPC was 9.2 years, with a prevalence of 0.69% (n = 72). The difference between genders was not statistically significant (p = 0.950). The prevalence of CMPC in group B (1.08%, 26/2400) was significantly greater than that in group A (0.57%, 46/8047) (p = 0.008). 89.42% (93/104) of the missing permanent canines had visible primary canines in patients. CMPC were more likely to occur in the maxilla (91.67%) than in the mandible (6.94%) (p<0.001). No significant difference was found between the left and right sides (p = 0.844). With respect to concomitant anomalies among those with CMPC, 22 patients had 58 congenitally other permanent teeth missing, 3 patients had 3 supernumerary teeth, and 12 maxillary lateral incisors from 7 patients presented with microdontia. Conclusions: The prevalence of CMPC was 0.69%. CMPC were more likely to occur in the maxilla in the presence of persistent primary canines and were not influenced by gender or side. Early panoramic radiographs can improve the detection rate of CMPC, thereby facilitating prompt intervention and timely management. [ABSTRACT FROM AUTHOR]

Background: Our aim was to investigate oral health in newly diagnosed head and neck squamous cell carcinoma (HNSCC) patients in relation to long-term survival. We assessed whether the level of alveolar bone loss due to periodontitis at diagnosis, measured from orthopantomogram (OPG), and reported dental health-related quality of life (HRQoL) scores obtained at diagnosis contain prognostic information for HNSCC patients. Methods: A total of 79 patients from a consecutive cohort of 106 diagnosed with HNSCC between November 2002 and June 2005 were included. All patients reported dental HRQoL, OPG-determined alveolar bone loss were measured in 79 patients at diagnosis. Reduced alveolar bone loss (≥ 4 mm) from cement-enamel junction on at least two molars or premolars registered both horizontally and vertically served as indicator of periodontal disease. Results: With alveolar bone loss, we determined increased mortality by univariate analysis (RR = 2.28, CI: 1.22–4.28, p = 0.01) and a strong trend by multivariate analyses adjusted for standard clinical information (RR = 1.95, CI: 0.98–3.87, p = 0.056). Reported lowered dental HRQoL scores predicted long-term survival in both univariate (RR = 3.58, CI: 1.99–6.45, p < 0.001) and multivariate adjusted for standard clinical information (RR = 2.17, CI: 1.17–4.01, p = 0.014). When analyzed with Cox regression, including alveolar bone loss and dental HRQoL, both factors, adjusted by clinical variables, were significant predictors of long-term survival: dental HRQoL (p = 0.007) and present alveolar bone loss (p = 0.034). Non-HNSCC disease-specific long-term survival predicted was also predicted when alveolar bone loss and dental HRQoL were analyzed simultaneously and adjusted for standard clinical information. Conclusions: The degree of alveolar bone loss, as determined by OPG, and dental HRQoL both obtained at the time of HNSCC diagnosis, predicted long-term survival. When analyzed simultaneously, both factors remained significant in both univariate and multivariate analyses, adjusted by pertinent clinical variables, highlighting their unique prognostic value. [ABSTRACT FROM AUTHOR]

Background: Dental age estimation is one of the most reliable methods for determining age, commonly used for forensic, criminal, and anthropological purposes. The purpose of this study was to assess and compare the precision of the Bedek models and the Cameriere-European Formula (CF) in determinating dental age in a sample of Turkish individuals. Methods: Retrospective panoramic radiographs of 1018 subjects (497 boys and 521 girls) aged 5–14 years were evaluated using the Bedek models and the CF. The differences between calculated dental age (DA) and chronological age (CA) for each sex and age group were analyzed using the paired sample t-test and the Wilcoxon signed-rank test. The accuracy of the methods used to estimate dental age was determined by calculating the mean absolute error (MAE) based on the proximity of the dental age to the chronological age. Results: The CF method overestimated CA by 0.1 year in the entire sample. Conversely, the Bedek models tended to overestimate CA, with the three-, four-, and seven-tooth models exhibiting the most significant difference. There was a statistically significant difference between boys and girls in the DA-CA calculation using the CF method in the entire sample. Among the Bedek models, the three- and four-tooth models had the lowest MAE in the entire sample, while the single-tooth model had the highest MAE. Conclusion: The CF method showed higher accuracy in predicting the age of children living in eastern Turkey compared to the Bedek Models. [ABSTRACT FROM AUTHOR]

Background: Cemento-osseous dysplasias (CODs) are rare lesions of the jawbone. Their occurrence, localization, type, size, and shape can vary between cases. This fibro-osseous lesion is typically found in the jaw near tooth-bearing areas and is often asymptomatic, discovered incidentally, and may be associated with the periapical region of the teeth. In rare cases, COD can lead to secondary bone osteomyelitis. Currently, there is limited information in the literature on the occurrence and characteristics of COD. This paper's main aim was to focus on the authors' COD experience in the lower Silesian area. Methods: A retrospective evaluation of radiographies (RTG-Panx, cone-beam computed tomography (CBCT)) was conducted on patients treated, diagnosed, or consulted by the authors. A statistical correlation analysis was made to establish any relationship within the gathered data. Results: COD is predominantly an incidental finding in the mandibular bone near tooth apices. It is most commonly diagnosed in females. Both CBCT and panoramic radiographies are generally sufficient for diagnosing the lesion. COD rarely requires treatment. Conclusions: COD lesions are mostly discovered incidentally during routine radiographies or cone-beam computed tomography (CBCT) scans. In most cases, clinical and radiological monitoring is sufficient, along with evaluating the teeth's response to cold stimuli and assessing the surrounding bone structures. Biopsies or tooth extractions are seldom necessary. When oral hygiene is well-maintained and no periapical inflammation is present, COD lesions typically remain asymptomatic. [ABSTRACT FROM AUTHOR]

Background: The present systematic review evaluated clinical and radiographic features and treatment outcomes of peri‐implantitis‐induced medication‐related osteonecrosis of the jaws (Pi‐MRONJ). Materials and Methods: Literature search was performed in PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and Scopus databases. Studies reporting Pi‐MRONJ were included. No time restrictions were applied. Results: In total, 571 articles were retrieved, and 24 articles were included in the final review. Study population consisted of 111 patients (70% pharmacologically treated for osteoporosis and 30% for oncologic disease). Pi‐MRONJ was characterized by pain, bone exposure and suppuration, and involved a single implant in 55 cases, two implants in 37 cases, three implants in 10 cases, and more than four implants in nine cases. Most of the lesions were assigned Stage II and III. MRONJ developed on average 46.5 ± 33.2 months following implant placement. Sixty‐one lesions were surgically treated with implant removal and debridement of the surrounding necrotic bone. Complete wound healing was observed in 85% of cases. Conclusions: The presence of dental implants in patients treated with antiresorptive drugs should be considered as a potential risk factor for MRONJ onset. In cases of periimplantitis with delayed wound healing following nonsurgical therapy, the clinician should rule out the presence of Pi‐MRONJ. [ABSTRACT FROM AUTHOR]

Panoramic ultrasound (US) is an extended field‐of‐view (EFOV) imaging technique that enables visualization of large‐scale skeletal muscles. This technique has previously been found to produce valid and reliable quantifications of muscle morphology in primarily young male subjects. The purpose was to investigate the intra‐rater between‐session test–retest reliability of panoramic US imaging for determining vastus lateralis (VL) and rectus femoris (RF) cross‐sectional area (mCSA) in healthy middle‐aged to elderly adults. In this cross‐sectional study, axial panoramic US images of the RF and VL muscles were captured in 23 healthy females and males aged 47 to 78. Assessed across two sessions 3–7 days apart, intra‐rater reliability was evaluated by intraclass correlation coefficients (ICC3,2), within‐subject coefficient of variation CVw−s$$ \left({\mathrm{CV}}_{\mathrm{w}-\mathrm{s}}\right) $$, standard error of measurement (SEM), and minimal detectable change (MDC). Mean mCSA for RF was mean ± SD, 7.5 ± 2.7 cm2 on both test days, with a numeric difference of 0.8%. Mean VL mCSA was 20.6 ± 6.6 cm2 and 20.5 ± 6.5 cm2 on test days 1 and 2, respectively. Test–retest ICC were: 0.997 (95% CI: 0.994–0.999) for RF and 0.995 (95% CI: 0.989–0.998) for VL. CVw−s$$ {\mathrm{CV}}_{\mathrm{w}-\mathrm{s}} $$ was 2.6% for RF and 2.4% for VL. SEM was 0.2 cm2 for RF and 0.5 cm2 for VL. MDC was 0.4 cm2 for RF and 1.3 cm2 for VL. In conclusion, panoramic EFOV US is a highly reliable imaging technique for assessing RF and VL mCSA in middle‐aged and elderly adults. These findings endorse the clinical and research utility of EFOV US and its sensitivity for detecting even minor changes in skeletal muscle size. [ABSTRACT FROM AUTHOR]

Some medical conditions present with missing or malformed teeth and other unusual oral manifestations that complicate prosthodontic treatment. Outlining the simple and complicated treatment options to the patient allows them to make an informed decision about the treatment they wish to pursue. This report describes the management of a patient diagnosed with pseudohypoparathyroidism. Taking a patient-centred approach, with their involvement in the planning process, was essential to a successful outcome. CPD/Clinical Relevance: Adopting a holistic approach to treatment planning enables patients to make informed decisions, ensuring patient-centred care that not only targets the condition, but supports overall wellbeing. [ABSTRACT FROM AUTHOR]

Periapical periodontitis may manifest as a radiographic lesion radiographically. Periapical lesions are amongst the most common dental pathologies that present as periapical radiolucencies on panoramic radiographs. The objective of this research is to assess the diagnostic accuracy of an artificial intelligence (AI) model based on U²-Net architecture in the detection of periapical lesions on dental panoramic radiographs and to determine whether they can be useful in aiding clinicians with diagnosis of periapical lesions and improving their clinical workflow. 400 panoramic radiographs that included at least one periapical radiolucency were selected retrospectively. 780 periapical radiolucencies in these anonymized radiographs were manually labeled by two independent examiners. These radiographs were later used to train the AI model based on U²-Net architecture trained using a deep supervision algorithm. An AI model based on the U²-Net architecture was implemented. The model achieved a dice score of 0.8 on the validation set and precision, recall, and F1-score of 0.82, 0.77, and 0.8 respectively on the test set. This study has shown that an AI model based on U²-Net architecture can accurately diagnose periapical lesions on panoramic radiographs. The research provides evidence that AI-based models have promising applications as adjunct tools for dentists in diagnosing periapical radiolucencies and procedure planning. Further studies with larger data sets would be required to improve the diagnostic accuracy of AI-based detection models. [ABSTRACT FROM AUTHOR]

The article describes the case of a ten-year-old boy who sought orthodontic treatment after dental trauma three years ago, which led to the avulsion of the upper right central incisor. Topics include factors to which the decision to open or close a space is attributed, orthodontic treatment, and restorative treatment.

The article describes interdisciplinary dentistry (ID) and how it can be applied to better care for pediatric patients. Topics discussed include the interdisciplinary dental treatment process, ID treatment plan, and University of Washington interdisciplinary dentistry example interdisciplinary problem list template.

The infraocclusion (IO) of primary molars, often seen in retained deciduous teeth, is a common condition that presents significant challenges for pediatric oral health. It occurs when primary molars are positioned below the occlusal plane due to the absence of permanent successors, leading to complications such as misaligned teeth, impaired chewing, and long-term dental health issues. Objectives: This study examines IO prevalence, diagnosis, and treatment approaches. Methods: A systematic review following PRISMA guidelines was conducted, searching PubMed, Web of Science, and Scopus for articles from the last 15 years. Nine articles were included for qualitative analysis. Results: IO was associated with several complications, including root resorption, altered eruption of adjacent teeth, and space loss within the dental arch. Clinical and radiographic evaluations are key to early detection. Severe cases often require invasive treatments, such as tooth extraction and space maintenance, while mild cases could be monitored. Conclusions: IO is prevalent in pediatric dentistry and can lead to significant dental issues if untreated. Early detection and intervention are crucial for preventing complications like tooth misalignment and impacted premolars. Tailored treatment strategies based on severity, along with increased awareness among dental practitioners, are essential to improve long-term outcomes for affected children. [ABSTRACT FROM AUTHOR]

This study aimed to predict the skeletal growth maturation using convolutional neural network-based deep learning methods using cervical vertebral maturation and the lower 2nd molar calcification level so that skeletal maturation can be detected from orthopantomography using multiclass classification. About 1200 cephalometric radiographs and 1200 OPGs were selected from patients seeking treatment in dental centers. The level of skeletal maturation was detected by CNN using the multiclass classification method, and each image was identified as a cervical vertebral maturation index (CVMI); meanwhile, the chronological age was estimated from the level of the 2nd molar calcification. The model's final result demonstrates a high degree of accuracy with which each stage and gender can be predicted. Cervical vertebral maturation reported high accuracy in males (98%), while females showed high accuracy of 2nd molar calcification. CNN multiclass classification is an accurate method to detect the level of maturation, whether from cervical maturation or the calcification of the lower 2nd molar, and the calcification level of the lower 2nd molar is a reliable method to trust in the growth level, so the traditional OPG is enough for this purpose. [ABSTRACT FROM AUTHOR]

Objective: Apical periodontitis (AP) is one of the most common pathologies of the oral cavity. An early and accurate diagnosis of AP lesions is crucial for proper management and planning of endodontic treatments. This study investigated the diagnostic accuracy of periapical radiography (PR) and panoramic radiography (PAN) in the detection of clinically/surgically/histopathologically confirmed AP lesions. Method: A systematic literature review was conducted in accordance with the PRISMA guidelines. The search strategy was limited to English language articles via PubMed, Embase and Web of Science databases up to June 30, 2023. Such articles provided diagnostic accuracy values of PR and/or PAN in the detection of AP lesions or alternatively data needed to calculate them. Results: Twelve studies met inclusion criteria and were considered for the analysis. The average value of diagnostic accuracy in assessing AP lesions was 71% for PR and 66% for PAN. According to different accuracy for specific anatomical areas, it is recommended to use PR in the analysis of AP lesions located in the upper arch and lower incisor area, whereas lower premolar and molar areas may be investigated with the same accuracy with PR or PAN. Conclusions: Two-dimensional imaging must be considered the first-level examination for the diagnosis of AP lesions. PR had an overall slightly higher diagnostic accuracy than PAN. Evidence from this review provided a useful tool to support radiologists and dentists in their decision-making when inflammatory periapical bone lesions are suspected to achieve the best clinical outcome for patients, improving the quality of clinical practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the trabeculation increase of treated mandibular cysts. Material and method: The study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization (n = 29) and enucleation (n = 30). Four groups in cyst types: dentigerous cyst (n = 21), keratocyst (n = 19), radicular cyst (n = 15) and residual cyst (n = 4). Cyst size was divided into two categories: smaller than 5.5 cm (n = 31) and larger than 5.5 cm (n = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month. Result: At the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time. Conclusions: FA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types. Clinical trial number: Clinical trial number: Not applicable [ABSTRACT FROM AUTHOR]

Background: The oculo-facio-cardio-dental syndrome (OFCD) is an ultra-rare multiple congenital anomaly. This report describes clinical findings emphasising dental phenotype in five, molecularly confirmed, female cases from two Czech families. Case presentation: Dental examinations were carried out. An orthopantomogram was taken in three patients, and all patients' intraoral cavities and teeth were photographed. Exome sequencing was performed in both probands. Results were validated by Sanger DNA sequencing which was also used to follow segregation of the variants in first-degree relatives. Dental abnormalities and congenital cataracts were present in all five cases, whilst other signs were variable and included facial dysmorphism, microphthalmia, and cardiac and skeletal abnormalities. Two individuals had cleft lip and/or cleft palate. Radiculomegaly occurred in three patients with permanent teeth and was diagnosed on orthopantomograms. Two patients had agenesis of permanent teeth. Malocclusion was also present in two patients due to crowding and a Class III malocclusion and mandibular overjet. De novo novel pathogenic variants in the BCOR gene were identified; c.2382del p.(Lys795Argfs*12) and c.3914dup p.(Gln1306Alafs*20) and co-segregated with the disease in each family. Conclusions: The OFCD syndrome has a unique dental phenotype and dentists should be aware of signs of this ultra-rare genetic disorder. All patients with congenital cataracts and dental abnormalities, including those without a family history, should be referred for genetic testing and indicated to specialised dental care. [ABSTRACT FROM AUTHOR]

Background: Environmental and genetic factors associated with canine impaction have been extensively researched, whereas the bone characteristics in the impaction area have not been thoroughly studied. Accordingly, the objective of this investigation was to provide a skeletal assessment in terms of bone density, bone microstructure, bone volume, and palatal volume in subjects with unilaterally impacted maxillary canines. Methods: A retrospective design has been employed to address the aim of this study, where the initial pre-treatment cone-beam computed tomography (CBCT) scans of 30 patients with unilateral maxillary canine impaction were assessed. The obtained patients' data were equally divided according to the location of the impaction into 2 groups, one with buccally impacted canines, and another with palatal impactions, with the contra-lateral sides in both groups serving as the controls. Skeletal measurements such as bone density (BD), bone microstructure in terms of fractal dimension (FD), maxillary bone volume (MBV), and palatal volume (PV) were evaluated from the acquired CBCTs in both groups and compared to the controls. Results: With buccal impactions, significantly greater BD and FD have been reported (p < 0.001), whereas non-significant differences were found regarding the PV when compared with controls (p = 0.56). MBV was significantly greater on the non-impaction side in comparison with buccal impaction sides (p < 0.001). For palatal impactions: BD, FD, and MBV were significantly greater on the impaction sides (p < 0.001), and conversely with PV which has been reported to be significantly greater on the non-impaction sides (p < 0.001). Conclusions: As per the obtained results, buccally impacted canines are associated with greater BD and FD, and less MBV, whereas palatally impacted canines are accompanied with greater BD, FD, and MBV, in addition to less PV, when both conditions are compared with the non-impaction sides. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate external apical root resorption (EARR) in cases with extraction and non-extraction fixed orthodontic treatment. Methods: Ninety subjects were included in this study. The patients were divided into two groups: 43 with extraction treatment and 47 with non-extraction orthodontic treatment. EARR was measured using the crown-to-root ratio of the maxillary and mandibular incisors and canines on panoramic radiographs taken at the beginning (T0) and end of the treatment (T1). The Bonferroni corrected Z test was used for multiple comparisons. Results: There were 24 (55.8%) individuals in the extraction group and 12 (25.5%) in the non-extraction group, with a minimum of one tooth with severe resorption. There was no resorption in 0% of individuals in the extraction group and five (10.6%) individuals in the non-extraction group. There was a statistically significant correlation between the groups and the degree of resorption (p = 0.008). When the maxillary and mandibular teeth in the extraction group were compared, a significant difference was found in all degrees of resorption except for mild resorption. Conclusions: There was a significant difference in EARR between the extraction and non-extraction treatment groups, with maxillary incisors showing more resorption in the extraction treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: The integration of AI into dentistry holds promise for improving diagnostic workflows, particularly in the detection of dental pathologies and pre-radiotherapy screening for head and neck cancer patients. This study aimed to develop and validate an AI model for detecting various dental conditions, with a focus on identifying teeth at risk prior to radiotherapy. Methods: A YOLOv8 model was trained on a dataset of 1628 annotated panoramic radiographs and externally validated on 180 radiographs from multiple centers. The model was designed to detect a variety of dental conditions, including periapical lesions, impacted teeth, root fragments, prosthetic restorations, and orthodontic devices. Results: The model showed strong performance in detecting implants, endodontic treatments, and surgical devices, with precision and recall values exceeding 0.8 for several conditions. However, performance declined during external validation, highlighting the need for improvements in generalizability. Conclusions: YOLOv8 demonstrated robust detection capabilities for several dental conditions, especially in training data. However, further refinement is needed to enhance generalizability in external datasets and improve performance for conditions like periapical lesions and bone loss. [ABSTRACT FROM AUTHOR]

Background: The impaction of mandibular lateral incisors presents significant aesthetic and functional challenges in orthodontics, including Bolton ratio discrepancies and anterior occlusal anomalies. The increasing preference for nonextraction treatment further complicates space management within the dental arch. However, the advent of digital-assisted orthodontic technologies, particularly advanced digital simulations, has revolutionized the precision and effectiveness of diagnosis and treatment planning. These technologies enable clinicians to strategically leverage natural jaw development and create the necessary space for the alignment of impacted teeth without resorting to extraction. Case presentation: This case report details the treatment of a 12-year-old male with an impacted mandibular lateral incisor, which resulted in both aesthetic concerns and functional impairments, alongside Class II malocclusion. By employing a digital-assisted diagnostic approach, including comprehensive digital simulations, we meticulously evaluated the feasibility of a nonextraction treatment plan. The strategy centred on harnessing the patient's mandibular growth potential to expand the available space naturally. The treatment involved surgical exposure of the impacted tooth, followed by precise orthodontic traction guided by continuous digital monitoring. The integration of digital tools throughout the treatment process was crucial in achieving successful eruption and alignment of the impacted tooth, thus restoring optimal aesthetics and function without the need for extraction. Conclusion: This case highlights the transformative impact of digital-assisted technologies in the management of complex orthodontic cases, such as impacted mandibular lateral incisors. The successful integration of these advanced tools with a nonextraction treatment approach underscores their potential to significantly enhance clinical outcomes. Digital technologies not only improve the accuracy and effectiveness of treatment but also facilitate a multidisciplinary approach that elevates the standard of patient care in addressing complex orthodontic challenges. [ABSTRACT FROM AUTHOR]

Background: Recently, deep learning has been increasingly applied in the field of dentistry. The aim of this study is to develop a model for the automatic segmentation, numbering, and state assessment of teeth on panoramic radiographs. Methods: We created a dual-labeled dataset on panoramic radiographs for training, incorporating both numbering and state labels. We then developed a fusion model that combines a YOLOv9-e instance segmentation model with an EfficientNetv2-l classification model. The instance segmentation model is used for tooth segmentation and numbering, whereas the classification model is used for state evaluation. The final prediction results integrate tooth position, numbering, and state information. The model's output includes result visualization and automatic report generation. Results: Precision, Recall, mAP50 (mean Average Precision), and mAP50-95 for the tooth instance segmentation task are 0.989, 0.955, 0.975, and 0.840, respectively. Precision, Recall, Specificity, and F1 Score for the tooth classification task are 0.943, 0.933, 0.985, and 0.936, respectively. Conclusions: This fusion model is the first to integrate automatic dental segmentation, numbering, and state assessment. It provides highly accurate results, including detailed visualizations and automated report generation. [ABSTRACT FROM AUTHOR]

Background: This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT). Methods: In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05. Results: The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05). Conclusion: CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial. [ABSTRACT FROM AUTHOR]

Background: Limited data exist on the mid‐ to long‐term masticatory capacity of mandibular overdenture (IOD) wearers, particularly regarding the use of posterior implants to retention. Objectives: To periodically evaluate mastication of IOD wearers, comparing the effectiveness of two to four implants to retain the prosthesis. Methods: In a randomised controlled clinical trial, 20 complete edentulous patients (14 women), aged 51–84 years (mean age 69.1 ± 9.6), received new bimaxillary complete dentures (CD). After adaptation, baseline measurements of masticatory performance (X50) and swallowing threshold were conducted using the sieving method. Patients were then randomly assigned to groups: control (two intra‐foraminal regular implants) and experimental (two intra‐foraminal regular implants and two extra‐short posterior implants) (n = 10 each). After 4 months, implants were splinted, and a new mandibular IOD was fabricated with bar/clip retention. Mastication was reassessed after 6, 12, and 48 months, and data analysed with repeated measures ANOVA and Sidak's post hoc (α = 0.05). Results: Despite a loss of two patients per group, masticatory performance significantly improved after mandibular IOD installation (p =.031) in both groups (p =.670). A second improvement was observed after 6 months (p =.027), with no subsequent changes (p >.05). Swallowing threshold improvements were noted with IOD, and no discernible differences between groups were observed (p >.05). Conclusion: Masticatory function significantly improved after mandibular IOD installation, with the number of implants demonstrating minimal influence. Clinical Trial Registration: The present study was not registered in a public database, as mandated. It is important to note that the recommendation for registration was initiated in 2017 by the Committee of Medical Journal Editors, while patient inclusion in the research took place in 2016. Given that the data presented in this manuscript cover a follow‐up period of up to 4 years post‐surgical intervention, delayed registration was not feasible. [ABSTRACT FROM AUTHOR]

The purpose of this multicentre study was to evaluate the efficacy of the 'dredging–marsupialization–curettage' (D–M–C) strategy in the treatment of conventional intraosseous ameloblastoma of the mandible. A total of 31 patients from three institutions, who had a pathological diagnosis of conventional ameloblastoma of the mandible, were treated with the D–M–C strategy. The surgical protocol comprised a dredging and marsupialization (D–M) step, with additional D–M steps as required. The patients then underwent curettage (C) once an obvious effect of the D–M step had been achieved during follow-up. Eight patients were followed up for ≥36 months but <60 months, while 23 were followed up for ≥60 months. Nineteen of the 23 patients followed up for ≥60 months were disease-free at the last follow-up, with no evidence of recurrence. The D–M step is effective for reducing the tumour size and preserving vital structures. The D–M–C surgical strategy may be a feasible treatment option for conventional ameloblastoma of the mandible. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri 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: Schizophrenia is a chronic severe mental disorder characterized by impairment in cognition, emotion, perception, and other aspects of behavior. In light of the association of craniofacial dysmorphology with schizophrenia, mandibular morphology may provide clues about the role of neurodevelopment in the pathophysiology of schizophrenia. This retrospective cross-sectional study aimed to compare the mandibular morphology of patients with schizophrenia with controls using digital panoramic radiography (DPR). Methods: 302 recorded diagnostic panoramic images obtained from 143 schizophrenia patients (98 males, 45 females), and 159 controls (73 males, 86 females), aged 18–45 years, were evaluated. Seven mandibular measurements consisting of ramus height, condylar height, gonial angle, antegonial angle, antegonial notch depth, ramal notch depth and bigonial width were measured from the DPRs in a double-blinded manner. Bivariate comparisons were carried out using the Independent t-test and Mann–Whitney U test. Logistic regression analysis was used for multivariate comparisons. Results: Linear measurements were higher while angular measurements were lower in schizophrenia patients. Regression analyses indicated that female patients had greater ramus height (OR = 1.243; P = 0.001), condylar height (OR = 1.463; P = 0.048) and bigonial width (OR = 1.082; P < 0.001); male patients had greater ramus heights (OR = 1.216; P = 0.001) and bigonial width (OR = 1.076; P < 0.001) as well as lower antegonial angle (OR = 0.908; P = 0.012) compared to their respective controls. Conclusion: Quantitative differences in mandibular morphology in schizophrenia patients versus controls deserve attention and corroborate with the concept of abnormal neurodevelopment in schizophrenia. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office 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.)

Gardner's syndrome has been recognized as a hereditary affliction that is autosomal in nature. This disorder is known to exhibit characteristics of familial adenomatous polyposis, of which it is also considered a variation. The features of this syndrome include the gradual development of osteomas and epidermoid cysts, including a characteristic feature that is the noted presence of intestinal polyps, which are generally multiple in number. Additionally, dental anomalies have been observed and recorded in a sizeable ratio of cases encompassing an increased frequency of multiple odontomas that are benign tumors linked to the development of a tooth and tooth agenesis/hypodontia that refers to developmental absence of one or more teeth. The other dental ascertainment includes abnormal morphology of the tooth/teeth as well as the presence of supernumerary teeth and impacted or unerupted teeth. This case report outlines the case of a 59-year-old male patient who had reported to the clinic, and was then diagnosed with Gardner's syndrome post a thorough examination. On radiographic examination, the manifestation of multiple osteomas in the frontal bone was revealed. The presence of a motley of diffused benign lesions of the bone in both the upper and lower jaw as well as the presence of an epidermoid cyst on the scalp was suggestive of an exemplar presentation of Gardner's syndrome. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to assess the consistencies and performances of deep learning (DL) models in the diagnosis of condylar osteoarthritis (OA) among patients with dentofacial deformities using panoramic temporomandibular joint (TMJ) projection images. Methods: A total of 68 TMJs with or without condylar OA in dentofacial deformity patients were tested to verify the consistencies and performances of DL models created using 252 TMJs with or without OA in TMJ disorder and dentofacial deformity patients; these models were used to diagnose OA on conventional panoramic (Con-Pa) images and open (Open-TMJ) and closed (Closed-TMJ) mouth TMJ projection images. The GoogLeNet and VGG-16 networks were used to create the DL models. For comparison, two dental residents with < 1 year of experience interpreting radiographs evaluated the same condyle data that had been used to test the DL models. Results: On Open-TMJ images, the DL models showed moderate to very good consistency, whereas the residents' demonstrated fair consistency on all images. The areas under the curve (AUCs) of both DL models on Con-Pa (0.84 for GoogLeNet and 0.75 for VGG-16) and Open-TMJ images (0.89 for both models) were significantly higher than the residents' AUCs (p < 0.01). The AUCs of the DL models on Open-TMJ images (0.89 for both models) were higher than the AUCs on Closed-TMJ images (0.72 for both models). Conclusions: The DL models created in this study could help residents to interpret Con-Pa and Open-TMJ images in the diagnosis of condylar OA. [ABSTRACT FROM AUTHOR]

Objective: To compare and analyze professional (P chart) and simple (S chart) clinical image evaluation charts for evaluating panoramic radiograph image quality. Methods: Ten evaluators assessed 285 clinical panoramic radiograph images. The evaluators were divided into oral and maxillofacial radiologists (OMFR, n = 5) and general dentist (dentists not specializing in oral and maxillofacial radiology, G, n = 5) groups. For image evaluation, P and S charts provided by the Korean Academy of Oral and Maxillofacial Radiology were used. Scores of items for each evaluation chart were used to compare the reliability, correlation, evaluation scores, evaluation time, and preference, and statistical analyses were performed using IBM SPSS Statistics. Results: The S chart showed similar levels of evaluation scores at shorter evaluation time, as compared to the P chart. In the results for each evaluation chart, all analyzed correlations were statistically significant. Total score, image density/contrast/sharpness, and overall image quality items showed a very high positive correlation in the P chart. While the overall range of correlation coefficients was relatively lower in the S chart than the P chart, the same items showed high correlation coefficients. In the preference evaluation, both the professional and generalist groups preferred the S chart. Conclusions: A comparative analysis with the P chart, revisions, and upgrades are needed for the S chart items that showed low correlations in this study, such as artifacts, coverage area, and patient movement. [ABSTRACT FROM AUTHOR]

A dentinogenic ghost cell tumor (DGCT) is a rare benign odontogenic tumor that commonly shows characteristics of solid proliferation and has a relatively high risk of recurrence after surgical treatment. We herein report a case of a central DGCT that occurred in the maxilla and resulted in bone expansion. This study highlights new imaging findings (particularly magnetic resonance imaging) along with histopathological observations. In addition, we conducted a review of the existing literature on this rare tumor. A 37-year-old man developed swelling around the right cheek. A benign odontogenic tumor such as ameloblastoma was suspected based on the imaging examination findings (including bone expansion and the internal characteristics of the tumor) on panoramic imaging, computed tomography, and magnetic resonance imaging. The lesion was surgically excised from the right maxilla. Postoperative histopathological examination led to a definitive diagnosis of central DGCT. The tumor comprised epithelial neoplastic islands, resembling ameloblastoma, inside tight fibroconnective tissue; masses of ghost cells and formation of dentin were also observed. We had suspected that the minute high-density region around the molars on the imaging examinations represented alveolar bone change; however, it represented dentin formation. This led to difficulty diagnosing the lesion. Although DGCT may present characteristic findings on imaging examinations, its occurrence is infrequent, and in some cases, the findings may include the presence or absence of an impacted tooth without obvious calcification. The present case suggests that we should consider the possibility of an odontogenic tumor with calcification when high-density structures are observed inside the lesion. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma of the jaws is a rare primary malignant tumor of bone. The clinical, radiological and histopathological features of a case associated with cemento-osseous dysplasia is presented. Case Report: A 57-year-old mixed-race female presented with a large, progressive, swelling of the right mandible. Radiographic examination revealed two associated lesions. Partially defined irregular radiopacities were noted in the left mandible, extending from the premolar to the molar region. The lesion had a cotton-wool appearance and resembled a fibro-osseous lesion; i.e. cemento-osseous dysplasia. A second large, expansive and irregular, radiopaque lesion was noted on the right angle of the mandible, extending beyond the inferior cortex of the mandible. The internal structure was heterogeneous and resembled irregular bone formation. The classic "sunburst" appearance of radiating bony spicules can be seen in the posterior–anterior view and the CBCT 3D reconstruction, indicating the outgrowth of the tumor matrix. Histopathological exam confirmed a final diagnosis of osteosarcoma closely associated with cemento-osseous dysplasia. The patient underwent a fludeoxyglucose-18 (FDG) positron emission tomography (PET) scan which indicated metastasis in the left lung and increased uptake in the right mandible. Chemotherapy was initially administered with a plan to resect the tumor, however, the patient demised as a result of medical complications. Conclusion: The question in the literature remains whether these two entities are coincidentally found or arise from each other. Nevertheless, it is important for clinicians to closely monitor patients with cemento-osseous dysplasia and biopsy any suspicious lesions that may develop into osteosarcoma. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the age-based prevalence of dens invaginatus cases and to learn the radiologic findings. In addition, fractal analysis of the periapical regions of unilateral dens invaginatus cases and contralateral teeth was performed to determine the effect of possible microleakage on fractal dimension. Methods: A total of 136 patients (170 teeth) identified in panoramic radiographs taken for diagnostic purposes between January 2018 and December 2023 at our Department of Oral and Maxillofacial Radiology were included in the study. Data were analysed using IBM SPSS V23. The Chi-square test was used for comparing categorical variables between groups. The relationship between the FD values calculated around the apexes of the teeth with unilateral dens invaginatus and the contralateral teeth was analyzed by paired t test. A significance level of p < 0.050 was adopted. Results: The mean age of the cases was calculated as 28.1 (8–63) years. 66 (48.5%) of the cases were female, and 70 (51.1%) were male. The lateral incisor was the most affected tooth among these cases. Bilateral cases were observed in 34 patients. Type 2 was detected in 93 patients, Type 1 in 35 patients, and Type 3 dens invagination in 8 patients. Dens invaginatus cases were observed in 134 maxillary and 2 mandibular teeth. Periapical lesions were seen in 22 of these cases. Conclusions: Dens invaginatus cases are a congenital anomaly encountered at any age. Early diagnosis is crucial to prevent the loss of pulp vitality due to these invaginations. It should be noted that these invaginations can affect both jaws. However, due to the prevalence of occurrence in the maxillary anterior teeth and asymptomatic nonvitality, particular attention should be paid to evaluating this region. [ABSTRACT FROM AUTHOR]

Abstract This study aimed to develop a deep learning system for the detection of three-rooted mandibular first molars (MFMs) on panoramic radiographs and to assess its diagnostic performance. Panoramic radiographs, together with cone beam computed tomographic (CBCT) images of the same subjects, were retrospectively collected from 730 patients, encompassing a total of 1444 MFMs (367 teeth were three-rooted and the remaining 1077 teeth were two-rooted). Five convolutional neural network (CNN) models (ResNet-101 and − 50, DenseNet-201, MobileNet-v3 and Inception-v3) were employed to classify three- and two-rooted MFMs on the panoramic radiographs. The diagnostic performance of each model was evaluated using standard metrics, including accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Receiver operating characteristic (ROC) curve analyses were performed, with the CBCT examination taken as the gold standard. Among the five CNN models evaluated, ResNet-101 demonstrated superior diagnostic performance, and the AUC value attained was 0.907, significantly higher than that of all other models (all P

Abstract Background The aim of this study is to evaluate the changes in the trabecular structure of the mandibular bone and temporomandibular joint following Rapid Maxillary Expansion. Methods Thirty-nine patients who received Rapid Maxillary Expansion treatment in the Department of Orthodontics of the Faculty of Dentistry were selected from the archieve for the study. Trabecular structure changes of the angulus mandible, corpus mandible, and condyle regions were examined using fractal analysis on the dental panoramic radiographs. Radiographs taken before the treatment (T0) and at the end of the 3-month retention period (T1) of the patients. Results There was no statistically significant difference between T0 and T1 in the condyle, ramus mandible, and corpus mandible regions depending on time and sex. (p

Objective To develop a deep learning network based on attention mechanism to identify the number of the vertical mandibular third molar(MTM) roots(single or double) on panoramic radiographs in an automatic way. Methods The sample consisted of 1 045 patients with 1 642 MTMs on paired panoramic radiographs and Cone-beam computed tomography(CBCT) and were randomly grouped into the training(80%), the validation(10%), and the test(10%). The evaluation of CBCT was defined as the ground truth. A deep learning network based on attention mechanism, which was named as RN-MTMnet, was trained to judge if the MTM on panoramic radiographs had one or two roots. Diagnostic performance was evaluated by accuracy, sensitivity, specificity, and positive predict value(PPV), and the receiver operating characteristic(ROC)curve with the area under the ROC curve(AUC). Its diagnostic performance was compared with dentists’ diagnosis, Faster-RCNN, CenterNet, and SSD using evaluation metrics. Results On CBCT images, single-rooted MTM was observed on 336(20.46%) sides, while two-rooted MTM was 1 306(79.54%). The RN-MTMnet achieved an accuracy of 0.888, a sensitivity of 0.885, a specificity of 0.903, a PPV of 0.976, and the AUC value of 0.90. Conclusion RN-MTMnet is developed as a novel, robust and accurate method for detecting the numberof MTM roots on panoramic radiographs.