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Sinus augmentation is performed in patients with severe atrophy of the maxillary alveolar for preparing suitable bone height for implant. Some complications are documented on occasion. However, reports of postoperative maxillary cyst (POMC) arising after sinus augmentation are rare. Another cause of POMC is endonasal surgery. The patients being at risk of infraorbital nerve injury even during endoscopic procedures. Most of POMCs resulted from operations for sinusitis, particularly the Caldwell-Luc approach. Other POMC cases have been reported a variety of causes such as gunshot injuries, mid-facial fractures, infection and orthognathic surgery. POMC is considered to be a delayed complication that occurs decades after surgical intervention in the maxillary sinus. Chief complaints are pain, swelling, or discomfort in the maxillary region. In the images it is found as a well-defined unilocular or multilocular cyst in post-operative maxillary sinus with causes bony expansion or perforation but the most of the POMC show unilocular cystic lesion. It shows discontinuity of the inferior wall of the maxillary sinus on the panoramic images and thinning, loss, or expansion of the lateral wall of the sinus on panoramic and Waters' radiographs. A previous surgical intervention is essential for diagnosis. POMC are evaluated by conventional, CT and MR images. Panoramic and Waters' views are used for evaluation of maxillary sinus disease. However, each view has its own limitations. CT is the main imaging modality for bony evaluation; therefore, CT has become a necessary method for complete evaluation of POMC. The border and extension of cysts is better seen on MR images owing to the superior ability of MRI to distinguish tissues and substances and to the absence of artifacts from dental restorations that occur on CT images. However, bony changes cannot be distinguished on MR images owing to poor visualization of bonny structures of the sinonasal area. Treatment includes enucleation or marsupialization. [ABSTRACT FROM AUTHOR]

Periodontal ligament (PDL) is a soft connective tissue between the alveolar socket and the roots. Radiographically, the distance ranges from 0.15 mm to 0.21 mm is the normal with for PDL. The most important change is widening of PDL but in some cases such as fibrous dysplasia and with age and initially tooth movement, the space may appear to be narrow. Widening of PDL may be related to abnormalities. Detection of regular or irregular shape of PDL and presence of lamina dura is important. The conditions make widening of PDL including history of parafunctions, occlusal trauma, tooth movement, malignancies, locally aggressive lesions and etc. Widening from orthodontic movement shows intact lamina dura. In contrast malignancies and aggressive lesions can grow to space, resulting lamina dura destruction. The generalized condition is observed with periodontitis, para-functions, progressive systemic sclerosis and orthodontic treatment. Irregular form is found in inflammatory lesions and malignancies. Traumatic occlusion is defined as an excessive pressure on tooth. PDL widening, thickening of the lamina dura, increased number and size of trabeculae and bone loss are radiographic features. Continuous force causes tooth movement that is marked initially by PDL narrowing. In the secondary period of tooth movement, the PDL is considerably widened. Hypercementosis and root fracture may be found. PDL widening at the apex or inter-radicular area is an important evidence for periodontal disease. PDL widening was the first radiographic finding in the most cases of pulpoperpical lesions may followed by discontinuity of the lamina dura and hyperostosis. Early osteosarcoma and chodrosarcoma may show a symmetrically PDL widened of teeth, without other radiographic findings. Widening of the PDL could be observed asymmetrically. Half of patients under orofacial radiotherapy show PDL widening as an early radiographic change and detection may be last few years after radiation. Inflammation, traumatic occlusion and other causes of PDL widening are more common than malignancies. Though PDL widening is not a pathognomonic sign for malignancies, attention should be paid to this identifiable finding in images for early diagnosis. [ABSTRACT FROM AUTHOR]

Background: Presence of voids at root canal wall‒apical seal material interface gives rise to the entrapment of toxins and microorganisms, which might have a relationship with post treatment disease. The present study was carried out to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) methods of Calcium-enriched Mixture (CEM) cement on the number and dimensions of voids in the apical plug in simulated apexification models., Material and Methods: A total of 80 human maxillary central incisors with mature apices were selected. After simulation of the open apices, the teeth were divided into 4 groups (n=20) based on the mixing and placement techniques of CEM cement: group 1, manual mixing‒manual placement; group 2, manual mixing‒manual placement in association with indirect ultrasonic technique; group 3, ultrasonic mixing‒manual placement; and group 4, ultrasonic mixing‒manual placement in association with indirect ultrasonic technique. The samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. After placement the apical plugs, a wet piece of cotton was placed on canal orifices, followed by dressing with Cavit. The samples were incubated at 37°C and 100% relative humidity for 7 days. Then the voids between the material and root canal walls were counted with the CBCT technique. The void dimensions were scored with the following scoring system: score 1, no voids; score 2, the void size less than half of the size of the evaluated cross-section; score 3, the void size larger than half of the size of the evaluated cross-section. Statistical analyses were carried out with chi-squared and Fisher's exact tests. Statistical significance was defined at P <0.05., Results: The maximum (7) and minimum (2) number of voids were detected in groups 1 and 2, respectively. The difference between these two groups was statistically significant ( p <0.05). The differences in the number of voids between groups with similar mixing technique and different mixing techniques (i.e. groups 1 and 3 and groups 2 and 4) were not significant ( p >0.05). Void dimensions in all the study groups were in score 2 category and no score 3 was recorded in the study groups., Conclusions: Under the limitations of the present study, manual placement in association with indirect ultrasonic technique was a proper technique to improve the quality of apical plug, considering the decrease in the number of voids. Key words: Apical plug, CEM cement, void., Competing Interests: Conflict of interest statement:Any.

Background: The CBCT imaging technique exhibits proper accuracy to determine the internal anatomy of teeth. Therefore, this technique can use to estimate age by measuring the amount of decrease in the volume of the pulpal cavity of teeth. The aim of the present study was to evaluate the correlation between chronological age and pulp-to-tooth volume ratios in anterior teeth with the use of the CBCT technique and to determine a regression model to estimate human age., Material and Methods: In this present descriptive-analytical study, 122 subjects (46 males and 76 females), with an age range of 13-70 years, were evaluated. The MIMICS software program was used to determine the pulp-to-tooth volume ratios in 732 anterior teeth. Regression analysis was used to assess the correlation between age and pulp to tooth volume ratios., Results: In all the teeth evaluated, there was an inverse and significant correlation between age and the pulp-to-tooth volume ratios in males and females, with a stronger correlation in males. In addition, such a correlation was stronger in maxillary central incisors and canines. In the model in which the mean of ratios in anterior teeth was used to estimate age the correlation was stronger compared to that in single tooth., Conclusions: In general, the results of the present study showed that it is advisable to use the mean of all the ratios of anterior teeth in forensics to estimate age. Key words: Age estimation , cone-beam CT, forensic dentistry, secondary dentin, pulp cavity., Competing Interests: Conflict of interest statement:The authors have declared that no conflict of interest exist.

Background: It is necessary apical plug material to exhibit proper adaptation with the root canal walls. Presence of voids at the interface between the root canal wall and this material result in micro leakage, which might have a relationship with post treatment disease. The aim of the present study was to evaluate the effect of different mixing (manual and ultrasonic) and placement (manual and manual in association with indirect ultrasonic) method of Mineral Trioxide Aggregate (MTA) on the void count and dimension in the apical plug in natural teeth with simulated open apices., Material and Methods: Eighty human maxillary central incisors were selected. After simulation of the open apex model, the teeth were assigned to 4 groups based on the mixing and placement techniques of MTA: group 1, manual mixing and manual placement; group 2, manual mixing and manual placement in association with indirect ultrasonic; group 3, ultrasonic mixing and and manual placement; and group 4, ultrasonic mixing and manual placement in association with indirect ultrasonic. The prepared samples were placed within gypsum sockets in which the periodontal ligament was reconstructed with polyether impression material. In group 1, after mixing, the material was condensed with a hand plugger. In group 2, after mixing, the ultrasonic tip was contacted with the hand plugger for 2 seconds. In groups 3 and 4, mixing was carried out with the ultrasonic tip for 5 seconds and in groups 3 and 4, similar to groups 1 and 2, respectively, the materials were placed as apical plugs, measuring 3 mm in length. A wet cotton pellet was placed at canal orifices and dressed with Cavit. After one week, the cone beam computed tomography (CBCT) technique was used to count the number of voids between the material and root canal walls. The void dimensions were determined using the following scoring system: score 1, absence of voids; score 2, the void size less than half of the dimensions of the evaluated cross-section; score 3, the void size larger than half of the dimensions of the evaluated cross-section. Chi-squared and Fisher's exact tests were used for statistical analyses. Statistical significance was set at P <0.05., Results: The maximum (13) and minimum (3) number of voids were detected in groups 2 and 3, respectively. There were no significant differences between groups 1 and 3 in the number of voids ( p >0.05). Evaluation of void dimensions showed no score 3 in any of the study groups and the dimensions of all the voids conformed to score 2., Conclusions: Under the limitations of the present study, use of ultrasonic mixing and manual placement techniques resulted in a decrease in the number of voids in the apical plug. Key words: Apical plug, MTA, ultrasonic, void., Competing Interests: Conflict of interest statement:The authors deny any conflict of interest.