Analysis Of Panoramic Radiographs Research Articles

PARAMETERS ASSOCIATED WITH ERUPTION OUTCOMES AND IMPACTION OF PERMANENT MAXILLARY CANINES AFTER SECONDARY ALVEOLAR BONE GRAFTING IN PATIENTS WITH CLEFT LIP AND PALATE

A cleft lip and palate (CLP) is the most prevalent anomaly affecting craniofacial structures. Alveolar bone grafting is essential for patients with CLP to ensure the proper alignment of the maxillary segments and to create a bony foundation for the permanent maxillary canines (PMC) to erupt. To reduce the risk of PMC impaction, secondary alveolar bone grafting (SABG) is usually performed in patients aged 8–12 years when the development of the canine root is 1/4 to 1/2 the expected length. The aim of this systematic literature review is to access the parameters associated with eruption outcomes and impaction of PMC after SABG in patients with CLP. A comprehensive literature search was carried out following PRISMA guidelines in the MEDLINE (PubMed) and EMBASE (ScienceDirect) electronic databases, using the combinations of the following Medical Subject Heading (MeSH) terms: (impacted canines) AND (alveolar bone grafting) [MeSH term] AND (cleft lip) [MeSH term] AND (cleft palate) [MeSH term]. A total of 276 articles were identified, of which 4 studies met the eligibility criteria. Based on the studies reviewed, the most reliable parameters to determine the risk of canine impaction through the analysis of panoramic radiographs are the angulation and vertical position of PMC. A greater risk of PMC impaction on the cleft side after SABG is associated with an increased canine angulation and a more pronounced displacement in the vertical direction.

Age Estimation in Libyan Children Based on Dental Panoramic Radiography

Background: Age estimation plays a key role in the human identification process, and in guiding police investigations. Tooth development is widely used in determining age and state of maturity. Dental age (DA) is of high importance in forensic and pediatric dentistry and also orthodontic treatment planning. Objective: The aim of this study was to assess the accuracy of the Cameriere method in estimating chronological age (CA) of a Libyan sample of 6-year-old up to 13-year-old children through analysis of panoramic radiographs on teeth, considering the relationship between age and measurements of open apices teeth. Materials and methods: Orthopantomographic images of 156 radiographs were selected for the study of which 76 belonged to boys and 80 girls children. The dental age of the subjects was determined through the Cameriere method. Differences and correlations between chronological and dental ages were assessed by paired t-tests and Pearson’s correlation analysis, respectively. Multiple regression analysis was used to predict chronologic age in Libyan from 6-13 years children population. Results: A high positive correlation was found between chronologic age and dental age (as assessed by Cameriere's formula) with r values 0.882, 0.975, and 0.758 for the total, girls and boys study population, respectively. The mean dental age assessed by Cameriere's method was significantly lower than the chronologic age in the Libyan population with boys and the total study population (p < 0.05). Six out of nine parameters were significantly associated with chronologic age (R2=0.996, F (6,155)= 2792.023, p<0.01). Conclusion: Our findings demonstrate that Cameriere’s method is a robust tool for age estimation. These results underscore the high accuracy and importance of assessing dental development for precise age estimation. Based on this research, we can conclude that Cameriere’s method is suitable for dental age estimation in Libyan children.

Visual Analysis of Panoramic Radiographs among Pediatric Dental Residents Using Eye-Tracking Technology: A Cross-Sectional Study.

The aim of this cross-sectional study was to explore the eye tracking (ET) performance of postgraduate pediatric dental students in correctly detecting abnormalities in different sets of panoramic radiographs. This observational study recruited postgraduate pediatric dental students to evaluate seven panoramic radiographs. RED-m® SMI software (Sensomotoric Instruments, Teltow, Germany) was used to track the participants' eye movements as they looked at the radiographs. The data collected for areas of interest (AOIs) included revisit counts, fixation counts, fixation times, entry times, and dwell times. Univariate and bivariate analyses were conducted to summarize the participants' characteristics and ET measures. The overall percentage of correctly located AOIs was 71.7%. The residents had significantly more revisits and fixation counts in AOIs located in one sextant than in multiple sextants (p < 0.001). Similar patterns were observed for fixation and dwell times (p < 0.001), but not for entry time. Heatmaps showed that the highest density of fixations was on the AOIs and the residents fixated more on dentition than on bony structures. In single-sextant radiographs, residents had significantly more revisits and fixation counts for AOIs compared to those of multiple sextants. Residents had slower entry times and dwelled less on AOIs located in multiple sextant(s). The reported findings can direct dental educators to develop a standardized scan scheme of panoramic radiographs to minimize misdiagnosis.

Evaluating the effects of orthodontic treatment with clear aligners and conventional brackets on mandibular condyle bone quality using fractal dimension analysis of panoramic radiographs

ObjectiveOrthodontic treatment carried out with clear aligners has become a method that is preferred by patients. In this study, the effect following orthodontic treatment with clear aligners and with conventional brackets, on the mandibular condyle trabecular bone formation is aimed to be examined. Materials and methodsThirty two individuals (16 females and 16 males) with a mean age of 16.80 ± 3,10 years who received orthodontic treatment with clear aligners and conventional brackets were included in the study. Individuals included in the study from the archive data were divided into two groups according to treatment types. The mandibular condyle bone quality in the panoramic images taken from the patients before orthodontic treatment (T0) and after orthodontic treatment (T1) has been compared retrospectively. This examination is carried out via the fractal analysis method. ResultThe mandibular condyle bone density in individuals that have undergone orthodontic treatment with clear aligners, has been reduced following orthodontic treatment. In individuals that have undergone orthodontic treatment with conventional brackets however the mandibular condyle bone density has increased following treatment (T0) in comparison to before being treated (T1). The mandibular condyle bone density change according to different treatment groups has been found to be statistically different. ConclusionOrthodontic treatment with clear aligners provides several advantages to patients. However, besides determining the effectiveness of the treatment, complications must also be examined. Application of clear aligners in orthodontic treatment may cause a decrease in bone density in the mandibular condyle. When evaluating orthodontic treatments carried out with clear aligners, the change of the mandibular condyle head bone should be taken into consideration.

Iatrogenics in dentistry: importance of radiographic examinations in identifying dental treatment failures, study by use trough the analysis of panoramic radiographs

Background: Technological advancement has also allowed dentistry to obtain new materials and techniques, as well as more predictable results in dental treatment. However, there are still many flaws related to the technique and choice of materials by dentists. Thus, the aim of this study was to evaluate through panoramic radiographs failures in dental treatment. Methods: 1250 panoramic radiographs were selected and evaluated by an experienced specialist, 609 of which had one or more iatrogenic Results: 48.72% of the radiographs analyzed showed some failure in dental treatment that focused on the age group of 31-50 years. Conclusion: Thus, it is necessary that dentists are attentive to the detection and correction of iatrogenesis, seeking a better quality of life for patients.

Effects of functional orthopedic treatment on mandibular trabecular bone in classII patients using fractal analysis.

The aim of this retrospective study was to evaluate the effects of functional orthopedic treatment on mandibular bone structure using fractal dimension (FD) analysis of panoramic radiographs. The study material consisted of the pre- and posttreatment digital panoramic radiographs of 80patients (mean age 10.1 ± 2.01years; 45girls, 35boys) with classII malocclusion who were treated with the monoblock or twin block appliances. The following regions of interest (ROI) were selected: ROI1, condylar process; ROI2, angulus mandibulae; ROI3, corpus mandibulae; and ROI4, mental foramen. Pre- and posttreatment FD values were compared for each ROI. FD values of the mandibular condyle did not change with the functional orthodontic treatment. FD values of the mandibular corpus region had the highest pretreatment values and significantly decreased with treatment (p < 0.05). Functional orthopedic treatment altered the trabeculation of the mandibular bone, but it is speculated that the changes in the occlusal forces seemed to be of primary significance for this effect.

Duration and dose of chemotherapy and dental development.

Given the susceptibility of developing tissues to drugs, even small doses of anticancer drugs may affect odontogenesis. Although any toxic effect is transient, the treatment regimens are based on repeated drug administration. The study aimed to establish the impact of antineoplastic therapy on the occurrence of longterm adverse dental effects in a dose-dependent manner in young survivors treated for cancer before 10 years of age. In total, 37 cancer survivors treated with antineoplastic therapy before 10 years of age underwent a dental examination with a thorough analysis of panoramic radiographs. A total of 236 teeth with 243 different developmental abnormalities were revealed in 28 survivors. Agenesis, tooth size reduction, taurodontia, and enamel and root abnormalities were diagnosed. All survivors received multi-agent chemotherapy, with the most frequently used drugs being vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), ifosfamide (IF), etoposide (VP-16), carboplatin (CBDCA), cisplatin (CDDP), and actinomycin-D (ActD). A detailed analysis of medical records was also performed to assess the relationship between the treatment duration as well as the cumulative drug dose administered and the occurrence of particular disturbances. When analyzing the treatment duration and the drug doses in the affected and non-affected participants, there were no statistically significant differences between the survivors with different disturbances within most of the specific drug groups. In some groups, the mean cumulative treatment dose was significantly higher in the non-affected patients. According to Spearman's rho, no significant relationships were observed. In the present study, no significant differences in terms of treatment duration or drug doses were observed between the patients with particular abnormalities. The developmental stage of tooth formation during chemotherapy is likely the most important factor influencing dental changes. For future research with respect to different treatment protocols, an analysis of a more homogenous group of survivors is warranted.

Duration and dose of chemotherapy and dental development

The study aimed to establish an anticancer drug- and its dose-dependency of long-term adverse dental effects occurrence in cancer survivors. The objective of the research was a dental examination with a thorough analysis of panoramic radiographs in 37 cancer survivors treated with antineoplastic therapy before 10 year of age and at least 2 years after therapy completion. A total of 236 teeth with 243 different developmental abnormalities were revealed. Twenty-eight survivors presented with 236 teeth with 243 developmental abnormalities, such as agenesis, tooth size reduction, taurodontia and enamel and root abnormalities. All the survivors received multiagent chemotherapy with the most frequent use of VCR, DXR, CP, IF, VP-16, CBDCA, CDDP, ACTD. A detailed analysis of medical records in order to assess a relationship between treatment duration and cumulative drug doses administered and occurrence of particular disturbances was also performed. There were no statistically significant differences between survivors with different disturbances within almost all particular drug groups when analyzing treatment duration and drug doses in the affected and non-affected participants. In some groups the mean cumulative treatment dose was statistically significantly higher in the non-affected patients. According to Spearman's rho, no reasonable relationship can be confirmed. With respect to different treatment protocols used an analysis of a more homogenous group of survivors seems necessary. The developmental stage of tooth formation during chemotherapy is likely to be the most important decisive factor for dental changes.

Late adverse effects of childhood acute lymphoblastic leukemia treatment on developing dentition.

Childhood cancer survivors show a variety of late adverse effects on dental health. The purpose of this study was to examine the prevalence and severity of dental abnormalities in permanent dentition in childhood leukemia survivors. Retrospective analysis of panoramic radiographs was performed for 178 childhood leukemia survivors aged below 17years at the time of diagnosis. Sex, age at diagnosis, interval between ALL diagnosis and the follow-up radiograph, treatment protocol, and risk grouping were recorded. Abnormalities of tooth development and defect index were used to assess the frequency and severity of dental abnormalities. One hundred eight (61%) patients had no dental abnormalities at follow-up examination at a median of 6.1years after diagnosis. Microdontia was more frequent in children under 6years of age at the time of diagnosis (5.7% vs. 0.6%, p<.001). Significant differences were noted between distinct ALL treatment protocols with more common microdontia in patients treated according to the NOPHO ALL2008 protocol. Tooth agenesis was more frequent in patients that underwent therapy according to high-risk arms compared to intermediate- or standard-risk arms (3.8% vs. 1.4%, p=.01). Patients under 6years of age at diagnosis had a significantly higher average defect index score than older patients (7.0 vs. 2.8, p=.01). Children and adolescents who received ALL treatment were at risk for dental damage. Young age and high-intensity therapy were associated with the severity of dental abnormalities.

An investigation of tooth loss factors in elderly patients using panoramic radiographs.

The aim of this study was to observe the dental condition in a group of elderly patients over a period of 10years in order to clarify important risk factors. Participants were elderly patients (in their eighties) who took panoramic radiographs between 2015 and 2016, and for whom panoramic radiographs taken around 10year earlier were also available. The number of remaining and lost teeth, the Eichner Index, the presence or absence of molar occlusion, the respective condition of dental pulp, dental crowns, alveolar bone resorption, as well as periapical lesions were investigated through the analysis of panoramic radiographs. Additionally, other important variables were collected from patients' medical records. From the obtained panoramic radiograph sets, the patients' dental condition was investigated, and a systematic comparison was conducted. The analysis of the panoramic radiographs showed that the number of remaining teeth decreased from an average of 20.8-15.5, and the percentage of patients with 20 or more teeth decreased from 69.2 to 26.9%. A factor analysis investigating tooth loss risk suggested that tooth loss was associated with the bridge, P2 or greater resorption of the alveolar bone, and apical lesions, and gender (with males having a higher risk compared to females). Teeth showing P2 or greater alveolar bone resorption, bridge, and apical lesions on panoramic radiographs are most likely to be lost in an elderly patient's near future. Consequently, this group should be encouraged to visit their dental clinics regularly and receive comprehensive instruction on individual self-care methods.

Does the third molar position influence periodontal status and overall condition of patients with acute pericoronitis? A cross-sectional study.

The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.

Prevalence of dental anomalies and bone alterations in children’s panoramic radiographies

ABSTRACT Objective To verify the prevalence of dental anomalies in terms of number, position and shape, and the presence of bone alterations, through analysis of panoramic radiographs. Methods This study evaluated dental anomalies and bone alterations in children aged 6 to 12 years-old, detected on panoramic radiographies recorded in the radiographic database of the Federal University of Espírito Santo between 2012 and 2016. Clinical and demographic information were registered. Dental records were retrieved to obtain the medical history involving syndromes or other diseases that may interfere with the anomalies and alterations. Chi-square and exact Fischer’s statistical tests were performed. Results There were alterations in 83 out of 301 panoramic radiographs analyzed. There were 169 anomalies or alterations (mean of 2,04±1,38 anomalies/patient), involving 201 teeth. The most prevalent anomaly was tooth impaction (26.63%), which affected the canines more frequently, followed by hypodontia (24.26%), more often found in the second premolar, and both affected mostly females. Hyperdontia and radiolucent lesions showed the same prevalence (18.93%), the most affected teeth were those of the anterosuperior region and the first mandibular molars, respectively. The least prevalent anomalies were dilaceration (7.69%), taurodontism (2.37%) and radiopaque lesions (1.18%). Bone alterations were significantly more found in mandible and in the posterior region, which confirms the prevalence in the lower molars. Conclusion Although there was no statistically significant difference regarding sex, there was a high prevalence of anomalies and alterations in our study population, which indicates the importance of its diagnosis by means of a panoramic x-ray examination.

Sequence and chronology of tooth eruption in children and adolescents from Santa Maria - southern Brazil

The literature reports a standard chronological sequence in the eruption of permanent teeth. However, evidence indicates that regional differences may interfere in this process. Thus, the aim of the present study was to compare dental age and chronological age in children and adolescents in a city in southern Brazil to determine the specific pattern in this population. We analyzed the orthodontic records of 250 children and adolescents at the undergraduate course in dentistry of Universidade Franciscana in the city of Santa Maria (southern Brazil). The dental age of each individual was determined through the analysis of panoramic radiographs using the Nolla’s method. Data were also collected on the child’s chronological age, sex, and race. No significant difference was found between average chronological age and that determined using Nolla’s method, indicating that dental and chronological age are similar in this population. However, the eruption periods of all tooth groups were slightly ahead in comparison to the world standard.

The influence of tobacco smoking on dental periapical condition in a sample of an adult population of the Łódź region, Poland.

Epidemiological studies show that apical periodontitis (AP), alongside tooth decay, is the most common oral disease. The aim of the study was to evaluate the influence of smoking on the prevalence of AP in the population of the Łódź region, Poland. The study involved 815 first-time, randomly selected patients reporting to the Central Teaching Hospital of the Medical University of Lodz. The studied group was a systematic sample of the population admitted for treatment in 2016. The study consisted of a questionnaire and a radiological part. Each patient filled out a questionnaire containing demographic data, and an interview regarding smoking and diabetes. The radiological part of the study included the analysis of panoramic radiographs which showed the periapical status, and the presence and quality of root canal treatment. Teeth with AP were observed more frequently in patients addicted to tobacco either at the time of the study or in the past (group 1) - 7.2% than in people who had never smoked (group 2) - 5.2% (p < 0.0005). In the teeth without root canal treatment, AP was observed more frequently in group 1 - 3.5% than in group 2 - 1.9% (p < 0.0005). A statistically significant difference was found in the percentage of endodontically treated teeth between group 1 and group 2 (10.7% vs. 9.6%) (p = 0.017). However, no difference was observed in the frequency of AP in the endodontically treated teeth in both groups (37.6% vs. 35.8%) (p = 0.451). Smokers are a group facing an increased risk of AP and, therefore, there is a need for an early detection and treatment of caries and its complications in this group of patients. The multifactorial etiology of AP indicates the necessity to undertake further studies on the effect of smoking on the periapical status. Int J Occup Med Environ Health. 2020;33(1):45-57.

Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis

BackgroundOsteomyelitis is an intraosseous inflammatory disease characterized by progressive inflammatory osteoclasia and ossification. The use of quantitative analysis to assist interpretation of osteomyelitis is increasingly being considered. The objective of this study was to perform early diagnosis of osteomyelitis on digital panoramic radiographs using basic functions provided by picture archiving and communication system (PACS), a program used to show radiographic images.MethodsThis study targeted a total of 95 patients whose symptoms were confirmed as osteomyelitis under clinical, radiologic, pathological diagnosis over 11 years from 2008 to 2017. Five categorized patients were osteoradionecrosis, bisphosphonate-related osteonecrosis of jaw (BRONJ, suppurative and sclerosing type), and bacterial osteomyelitis (suppurative and sclerosing type), and the control group was 117 randomly sampled. The photographic density in a certain area of the digital panoramic radiograph was determined and compared using the “measure area rectangle,” one of the basic PACS functions in INFINITT PACS® (INFINITT Healthcare, Seoul, South Korea). A conditional inference tree, one type of decision making tree, was generated with the program R for statistical analysis with SPSS®.ResultsIn the conditional inference tree generated from the obtained data, cases where the difference in average value exceeded 54.49 and the difference in minimum value was less than 54.49 and greater than 12.81 and the difference in minimum value exceeded 39 were considered suspicious of osteomyelitis. From these results, the disease could be correctly classified with a probability of 88.1%. There was no difference in photographic density value of BRONJ and bacterial osteomyelitis; therefore, it was not possible to classify BRONJ and bacterial osteomyelitis by quantitative analysis of panoramic radiographs based on existing research.ConclusionsThis study demonstrates that it is feasible to measure photographic density using a basic function in PACS and apply the data to assist in the diagnosis of osteomyelitis.

Study of pattern and prevalence of mandibular impacted third molar among Delhi-National Capital Region population with newer proposed classification of mandibular impacted third molar: A retrospective study.

Aim/Objective:The mandibular third molar is the most frequently impacted tooth with incidence varies from 9.5% to 68% in different populations. Hence, the aim was to study the prevalence and pattern of mandibular impacted third molar among Delhi-National Capital Region (NCR) population.Materials and Methods:The study was conducted with data collected from registered hospitals and dental clinics of Delhi NCR region. The study represents a retrospective analysis of panoramic radiographs and intraoral periapical radiograph of patients at these centers from June 2014 to June 2016.Results:Out of 960 patients with the third molar investigated, a total of 250 patients having impacted mandibular third molar (152 [60.8%] males and 98 [39.2%]) females between June 2014 and June 2016 were included in the study. The age ranged from 20 to 55 years, with a mean age of 27.6 years and the standard deviation was 5.8 years. The prevalence of impacted mandibular third molars for this study was 26.04%.Conclusion:This study demonstrated that males (60.8%) were more likely to present with impacted mandibular third molars than females (39.2%). The prevalence of third molar impactions was almost the same on both the left (45.8%) and right (54.2%) sides. This study also noted that mesioangular impactions (49.2%) were the most common type of impaction. The least common form of impactions was the transverse types (2%). The prevalence of impacted mandibular third molars for this study was 26.04%.

Evaluation of jawbonemorphology and bonedensityindices in panoramic radiographs of selectiveserotoninreuptakeinhibitorusers: a preliminary study.

To assess the influence of selective serotonin reuptake inhibitor (SSRI) use on jawbone and bone mineral density by retrospective analysis of panoramic radiographs. Radiographic and clinical records were sourced from the Division of Orthodontics and TMJD, Eastman Institute for Oral Health, University of Rochester. Randomly selected adults (20-65 years) were categorized into: "Active" (with history of SSRI use of >6 months) and a "Control" group. Panoramic indices: Klemetti index (KI), panoramic mandibular index, antegonial notching index, condylar pathology, mandibular cortical width (MCW)⁠ and mean ramus height were recorded. Frequency-weighted Χ2 tests and multinomial regression controlling for age and gender were applied to categorical indices (KI, condylar pathology, antegonial notching index). Multivariate generalized linear modeling was applied to mean ramus height, MCW and panoramic mandibular index. Multiple regression analyses determined: (a) panoramic indices that best predicted SSRI use, and (b) independent predictors of KI category. 64 SSRI users and 48 Controls were assessed. SSRI users had significantly higher odds of having worse KI status than normal [mildly to moderately eroded cortex: odds ratio (OR) = 2.926, 95% CI (1.07-8.04) and severely eroded cortex: OR = 19.86, 95% CI (3.91-100.69)], more frequent flat condylar anatomy (right side: p = 0.009, left side: p < 0.001) but greater ramus height (p = 0.001) and mandibular cortical width (p = 0.032). Age, gender, SSRI use each significantly impacted KI. Only SSRI use significantly impacted condylar pathology, ramus height and MCW. KI category (OR = 1.3) was the best panoramic predictor of SSRI use. Conversely, KI category C3 was significantly predicted by SSRI use (OR = 31.2, p = 0.002), female gender (17.5, p = 0.006), and severe antegonial notching (OR = 1289, p < 0.001). SRRI use was significantly associated with worse panoramic morphometric indices: KI, condylar pathology, ramus height, and MCW, where KI was its strongest predictor. Worse KI was independently predicted by SSRI use.

Evaluation of Periodontal Space Widening in Patients with Antiresorptive Drug-related Osteonecrosis of the Jaws (ARONJ) on Panoramic Radiographs.

The purpose of this study was to evaluate a potential widening of the periodontal space as an initial measurable imaging criterium on panoramic radiographs in patients with the diagnosis of antiresorptive drug related osteonecrosis of the jaw (ARONJ). A retrospective analysis of panoramic radiographs of 16 patients (12 females and 4 males; mean age is 70.5 years, standard deviation is 14 years) was performed, over a period of 12 months with the diagnosis of ARONJ. Panoramic radiographs of 16 healthy patients (12 females and 4 males; mean age was 70.6 years, standard deviation was 13.8 years) without diagnosis of ARONJ served as controls. All images were taken with the same device and were evaluated by two experienced maxillofacial surgeons and one dentist. Compared to the control group, a mean widening of the periodontal space of 0.06 mm (confidence interval (CI)=0.05-0.17 mm) was found in the study group. However, this difference was not statistically significant. Although a very extensive and sophisticated interindividual comparison was performed to evaluate for slight changes of the periodontal space in patients with antiresorptive drug therapy, our results demonstrate that PDS widening is not a predictive parameter for ARONJ. Therefore, our results indicate that panoramic radiographs are not sufficient enough to allow assessment of stages and disease progress in ARONJ patients regarding to periodontal space widening.

Change in the mesiodistal axial inclination of the maxillary lateral teeth during the mixed dentition stage: Morphometric analysis of panoramic radiographs from two cases of mild crowding with a high canine

Objective The aim of this study was to investigate the changes of the mesiodistal axial inclination of the maxillary lateral teeth relative to the functional occlusal plane (FOP) on panoramic radiographs in patients with Angle Class I maxillary anterior crowding with high canines during the mixed dentition stage. Materials and Methods Panoramic radiographs were used to measure the mesiodistal axial inclination of the teeth before orthodontic treatment in Cases 1 and 2. The long axes of the teeth were determined according to the previous study by Ursi et al. Finally, the angles between the long axes of teeth and the FOP were measured. Results The first premolar and canine showed mesial tipping in the alveolar bone during eruption. The crown of the second premolar was located close to the apex of the first molar and showed excessive mesial inclination relative to the long axis of the second deciduous molar. Before orthodontic treatment, considerable autonomous changes in the mesiodistal inclination were found in the canine and the second premolar in the maxillary alveolar bone during eruption. With respect to the first molar, the mesiodistal inclination was invariable, or the angle was almost 90° without any significant change during the observation period. Conclusions Based on the results of this study, two new findings are described. Autonomous changes in the inclination of the mesiodistal maxillary teeth were observed during exfoliation, particularly in the canine and second premolars. In addition, the eruption of the maxillary lateral teeth influenced the neighboring teeth, whereas the first molar maintained an environmentally defined position.

Análise das variações anatômicas do canal da mandíbula encontradas em radiografias panorâmicas

INTRODUÇÃO: No âmbito da clínica odontológica, o bloqueio do nervo alveolar inferior é o mais utilizado; todavia, diversos estudos têm mostrado as mais altas taxas de fracasso, as quais, normalmente, têm como motivo a falha na observação da posição, da forma e da anatomia dos nervos. Essas falhas decorrentes da variação anatômica do nervo alveolar inferior já vêm sendo estudadas na literatura, através de estudos com a análise de radiografias panorâmicas, como proposto neste estudo. OBJETIVO: O objetivo deste estudo foi verificar a ocorrência e a prevalência das variações anatômicas, bem como a correlação das variações do canal da mandíbula com lado e sexo, que podem ocorrer no canal mandibular, por meio de radiografias panorâmicas de pacientes atendidos no Departamento de Odontologia da Universidade Federal de Sergipe (UFS). MATERIAL E MÉTODO: Foram analisadas 1.500 radiografias panorâmicas de pacientes atendidos pelo Departamento de Odontologia da Universidade Federal de Sergipe (UFS). Imagens radiográficas foram observadas sobre um negatoscópio, utilizando-se uma máscara preta ao redor das radiografias, em ambiente com luminosidade apropriada. RESULTADO: Neste estudo, foram observados 5,3% de bifurcações do canal mandibular; 47,5% de canais altos; 16,8% de canais intermediários; 27,1% de canais baixos, e 8,6% de canais com outras variações. CONCLUSÃO: Baseando-se na altura do canal mandibular, houve maior prevalência dos canais altos do que os demais nas mulheres, sendo que não houve diferenças entre os gêneros com relação aos demais tipos e lados afetados. Na classificação dos canais bífidos, não houve diferença estatisticamente significante entre homens e mulheres. Observou-se que a maior prevalência foi para canais sem bifurcação.