Cone-beam Computed Tomography Assessment Research Articles

Root canal morphology of permanent mandibular anterior teeth in a Pakistani population: A cone beam computed tomography assessment.

To investigate the incidence of accessory canals and the variation in root canal morphology of permanent mandibular incisors and canines in Pakistani population using Cone Beam Computed Tomography (CBCT). A cross-sectional study was conducted in University College of Dentistry, The University of Lahore, Pakistan after getting institutional ethical permission from January 2020 to September 2022. The data included records of 111 patients consisting of 444 permanent mandibular incisors and 222 permanent mandibular canines. Accessory root, root canals and Vertucci canal configuration for each tooth was recorded. Data analysis was done using SPSS v20. Descriptive statistics were calculated for each anatomical parameter. Chi-square test was applied to determine association of gender with the presence of accessory roots and root canals. Among the 111 records evaluated, 48.6% were males and 51.4% were females. No accessory root was found in the central and lateral incisors. However, an accessory root was found in 4.9% of the canines. The incidence of accessory canals in the central incisors, lateral incisors and canines was 18.9%, 25.2% and 10.4% respectively. The most common canal configuration in teeth with accessory canals was Type-III, followed by Type-II and Type-V. None of the central or lateral incisor showed accessory root while it was detected in 4.9% canines. The frequency of accessory root canal was found to be 18.9%, 25.2% and 10.4% in central incisors, lateral incisors and canines respectively. The most common canal configuration was Type-I, followed by Type-III and Type-II. Type-V, VI and VII were less common.

Mandibular advancement device in obstructive sleep apnea treatment: what happens to the condyle position and patient response?

This study aims primarily to assess the mandibular condyles and patient response to MAD therapy using cone-beam computed tomography (CBCT). Also, the study proposes to analyze whether variations in condylar position, OSA severity and mandibular protrusion influence patient response. 23 patients diagnosed with mild/moderate OSA and treated with MAD comprised the sample. Clinical, CBCT, and PSG assessments were conducted at baseline and with MAD in therapeutic protrusion (4-6 months of MAD use). The condyle position was vertically and horizontally evaluated at baseline and at the therapeutic protrusion. The condyle position significantly changed with MAD, showing anterior (7.3 ± 2.8mm; p < 0.001) and inferior (3.5 ± 1mm; p < 0.001) displacement. Patients with mild OSA required more protrusion (p = 0.02) for improvement. Responders exhibited a significantly prominent (p = 0.04) anterior baseline condyle position. A negative modest correlation was found between treatment response and baseline condyle anterior position (p = 0.03; r=-0.4), as well as between OSA severity and the percentage of maximum protrusion needed for therapeutic protrusion (p = 0.02; r=-0.4). The patient protrusion amount did not predict condylar positional changes. Neither condyle position, OSA severity, nor therapeutic protrusion were predictors of MAD treatment response. MAD resulted in anterior and inferior condylar displacement, and the amount of protrusion did not predict condylar positional changes. Responders showed a more anterior baseline condyle position. OSA severity and mandibular protrusion did not predict treatment response.

A cross-sectional CBCT assessment of the relative position of one-piece titanium-zirconium mini-implants placed for mandibular overdentures using non-guided surgery.

To assess the relative position of mini-implants to retain a mandibular overdenture, according to the surgical protocol, technical and anatomical factors. Mandibular cone-beam computed tomography (CBCT) scans were analyzed for 73 patients who received four one-piece titanium-zirconium mini-implants. Drilling was performed using a 1.6 mm needle drill and a 2.2 mm Pilot Drill, according to the bone density with a surgical stent. Post-insertion CBCT images in DICOM format were analyzed using the E-Vol-DX software with BAR filters. Divergence angle between implants and between implants and the overdenture path of insertion was measured using CliniView 10.2.6 software. Divergence between implants ranged from 0° to 22.3° (mean = 4.2; SD = 3.7) in the lateral and from 0° to 26.2° (mean = 5.3; SD = 4.1) in the frontal projections (p < .001). Only 1 (0.2%) and 3 (0.7%) of the measurements were higher than 20° in the lateral and frontal views, respectively. The mean angulations between the implant and the path of insertion for the overdenture were 9.3° (SD = 7.5) and 4.0° (SD = 2.9) for the lateral and frontal views, respectively (p < .001). Regression analyses showed a significant association between the divergence of implants and the frontal view projection (p < .001), greater distance between the paired implants (p = .017), the flapped surgical protocol (p = .002), higher final insertion torque (p = .011), and deeper preparation with the needle drill (p < .001). The mini-implants were placed with low divergence angles and satisfactory parallelism. Factors including shorter distances between the implants, higher density bone, and a flapless surgical approach all contributed positively to improved parallelism of the mini-implants.

Pre- and Post-Operative Cone Beam Computed Tomography Assessment of the Temporomandibular Joint in Patients with Orthognathic Surgery.

This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent to 158 TMJs) (mean age = 26.62 ± 9.5 years) with a bilateral sagittal split osteotomy with or without Le Fort I surgeries (n = 29 Class II DFD, n = 50 Class III DFD) was performed. This included the compartmental measurement of TMJ spaces, in addition to the measurement of intercondylar distances and angles. Condylar position centricity was assessed using the Pullinger and Hollender formula. Clinical data were analysed for DFD class, the type of surgery and post-operative CBCT timing. Pre- and post-operative measurements were compared statistically using a paired t-test, Wilcoxon signed-rank test, and Stuart-Maxwell test. TMJ condyles tended to relocate post-operatively in a posterosuperior position with internal rotation in Class II DFD and a superior position with internal rotation in Class III DFD. However, the overall changes were within <0.5 mm translation and <4° rotation and the number of concentrically positioned condyles (according to the Pullinger and Hollender formula) did not change significantly. Orthognathic surgery is associated with minor post-operative translational and rotational condylar positional changes in Class II and III DFDs.

Comprehensive three-dimensional cone beam computed tomography assessment unilateral alveolar cleft reconstruction using autologous iliac cancellous bone combined with deproteinized bovine bone: A clinical retrospective evaluation

Large-volume autologous iliac cancellous bone grafting for alveolar cleft may lead to undesirable bone resorption and susceptible donor-site morbidity, whereas the addition of deproteinized bovine bone (DBB) could optimize outcomes. This study aimed to evaluate the effectiveness of combining autologous iliac bone with DBB using three-dimensional cone beam computed tomography (3D-CBCT) for better analysis of bone generation than conventional evaluation methods. Thirty-six patients with unilateral alveolar cleft were assigned into two groups. Group A (n = 21) underwent autogenous cancellous bone graft harvested from the anterior iliac crests, while Group B (n = 15) received a composite of autogenous iliac cancellous bone and DBB. Patients in Group B displayed higher bone filling rates (P < 0.0001) and lower bone absorption rates (P < 0.001) than those in Group A at both 6 months and 1 year postoperatively. Additionally, there were directional differences in bone absorption within the bone grafts, with more absorption observed on the alveolar crest and palatal sides than that on the nasal and labial sides (P < 0.001). This study demonstrates that employing a combination of DBB and autologous bone in alveolar cleft repair achieves better outcomes of bone grafting.

Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment

SummaryThis study investigates the effects of antiresorptive drugs and risk factors for medication-related osteonecrosis of the jaws in osteoporotic patients undergoing tooth extraction. Among the findings, antiresorptive-treated patients had thicker lamina dura and longer healing times. Additionally, corticosteroid intake and multi-rooted teeth carried a higher osteonecrosis risk. Bone sequestrum indicated osteonecrosis.PurposeTo describe the effects of antiresorptive drugs (ARD) in the maxilla and mandible and risk factors for medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients undergoing tooth extractions using clinical data and cone beam computed tomography (CBCT).MethodsThis retrospective cohort study collected clinical and CBCT data from 176 patients. The study group (n = 78; 224 extractions) received ARD treatment, underwent tooth extraction, and had a pre-operative CBCT. Additionally, age-, sex-, and tooth-matched controls were selected (n = 98; 227 extractions). Radiographic examinations were performed independently by three calibrated examiners. Statistical analysis included Chi-square, Fisher’s exact, Mann–Whitney U, and t-tests to contrast clinical and radiographic data between study and control, MRONJ + and MRONJ − , and bisphosphonate and denosumab patients/sites. Significance was set at p ≤ 0.05.ResultsFrom the study group, 4 patients (5%) and 5 sites (2%) developed MRONJ after tooth extraction. ARD-treated patients exhibited significantly more thickening of the lamina dura and a longer average mucosal healing time (4.4 weeks) than controls (2.6 weeks). In the study group, MRONJ risk significantly increased with corticosteroid intake and in multi-rooted teeth. No significant differences between bisphosphonates and denosumab use were seen in the tomographic features (p > 0.05). Lastly, bone sequestrum was exclusively observed in osteoporotic patients, who exhibited post-operative exposed bone or histological evidence of osteonecrosis.ConclusionOsteoporotic patients under ARD may exhibit thickening of the lamina dura and prolonged post-operative healing. Among these patients, multi-rooted teeth are at higher risk for MRONJ than single-rooted teeth. Sequester formation is a radiographic indicator of osteonecrosis.

Cone beam computed tomography assessment of maxillary anterior teeth cervix dimensions in healthy adults for optimal anatomic healing abutments.

The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross-sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments. CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento-enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto-palatal (b), palatal (c), mesio-palatal (d), mesial (e), mesio-labial (f), labial (g), and disto-labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored. Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines. CBCT measurements of cervical cross-sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology. The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri-implant soft tissue.

A CBCT Assessment of Orthodontic Mini-Implant Placement

ABSTRACT Objectives: This study compares the precision of cone beam computed tomography (CBCT) and two-dimensional radiography for mini-implant implantation. Materials and Method: For 30 sites (in 15 patients between the ages of 13 and 26 years), the buccal interradicular region among the 2nd premolar and 1st molar was found to be the best location for mini-implants. Next, two groups of the mini-implant implantation process were created. Mini-implants were positioned at the CBCT data-identified sites in the CBCT group. Mini-implants were inserted in the RVG group by using two-dimensional digital radiography and a specially constructed guide. To assess the precision of the mini-implant implantation, post-placement CBCT images were acquired. The obtained data were statistically analyzed. Result: The two groups showed a statistically considerable variation in the mini-implant placement’s departure from the optimal height. Due to the smaller interradicular space and decreased convenience in the posterior mandibular area, two out of 15 mini-implants in the RVG group demonstrated root contact in the mandibular jaw Conclusion: The two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement even though CBCT accurately visualizes the interradicular space in three dimensions.

Presurgical Cone-beam Computed Tomography Assessment of Maxillary Sinus Septa for Posterior Maxillary Implant Placement

Presurgical Cone-beam Computed Tomography Assessment of Maxillary Sinus Septa for Posterior Maxillary Implant Placement

CBCT assessment of mandibular molar furcation following root canal retreatment using engine-driven instruments.

This study employed e-Vol DXS cone beam computed tomography (CBCT) software to assess dentin remnants in the furcation area of mesial canals in mandibular molars during root canal retreatment (RCR). Four groups (Reciproc®, ProTaper Next®, Race Evo®, Protaper Gold®) were subjected to RCR, and CBCT images were captured before (T1) and after (T2) treatment. Measurements of remaining dentin thickness at 1 mm and 3 mm below the furcation were scrutinized. Results revealed no significant differences in mean thicknesses of mesiobuccal (MB) and mesiolingual (ML) canals at 1 mm and 3 mm from the furcation pre-treatment (T1). Post-treatment (T2) showed analogous findings, with no significant differences in mean thicknesses. However, disparities were found between MB and ML canals at both distances, both before and after retreatment. In essence, the evaluated instruments exhibited safety in RCR, implying that they are appropriate for use in critical areas of mandibular molars without inducing excessive wear. This study underscores the reliability of these instruments in navigating danger zones during RCR, and contributes valuable insights for dental practitioners who handle complex root canal scenarios in mandibular molars.

Radiographic Assessment of Cleft Alveolar Bone Defects: A Preliminary Comparison of Periapical and Cone Beam Computed Tomography Images

Background &amp; Purpose Accurate radiographic assessment of secondary alveolar bone grafting (SABG) is critical in evaluating SABG outcomes in patients with cleft lip and palate. This study compared Periapical (PA) and Cone beam computed tomography (CBCT) grading of SABG outcomes and conducted an analysis of agreement rate between the two imaging modalities. Methods A retrospective chart review was performed of patients who underwent secondary alveolar bone grafting at a single institution. Bone quality of the alveolar cleft site was assessed at three root levels of the adjacent teeth on PA and CBCT images. Results 48 patients had pre- or post-operative images with both CBCT and PA that were appropriate for comparison. A total of 174 alveolar bone sections (three root levels of adjacent teeth in 58 pairs) were graded on CBCT and PA images. Agreement of CBCT grading with PA grading was 41.3% (72/174) overall. CBCT assessments rated bone quality lower than PA grading in 51.2% (89/174) of sections. CBCT had higher grading than PA image grading in 7.5% (13/174) of sections. The weighted Cohen Kappa value for comparison of CBCT and PA readings was 0.17, indicating a low rate of agreement. Wilcoxon signed rank test demonstrated that the difference between grading on CBCT and PA assessments was statistically significant ( P &lt; .001). Conclusions CBCT and PA readings demonstrated an overall low rate of agreement in the assessment of cleft alveolar bone. This investigation suggests that PA radiographs have lower sensitivity in detecting poor bone grafting outcomes.

Reliability and reproducibility of CBCT assessment of mandibular changes before and after treatment for Class III growing patients - an easy and quick way for evaluation.

The objective of this study was to evaluate intraobserver reliability and inter-observer reproducibility of a 3-dimensional (3D) assessment method for mandibular changes of growing patients after orthodontic treatment for Class III malocclusion.Methods Cone-beam computed tomography (CBCT) scans were performed before and after orthodontic treatment for 27 patients. During the scan, the patient was positioned such that his/her mandibular plane was parallel to floor. Three observers independently worked on the DICOM data, reconstructed the pre- and post-treatment 3D models in software, selected the stable anatomical structures (basal bone area from the lingual surface of the symphysis to the distal aspect of the first molars) to guide the automated superimposition process. Then, each observer registered 14 anatomical landmarks on the virtual models, for three times after suitable interval, to generate 3 sets of coordinates; the mean was taken as the coordinates for that particular landmark. The intraobserver reliability and inter-observer reproducibility of the method were analyzed.Results The ICCs was > 0.90 for 25 (92.6%) of the intraobserver assessments. The precision of the measurement method was < 0.3mm in 24 (88.9%) cases. The interobserver reproducibility errors were < 0.3mm in 21 of the 27 cases.Conclusions The intraobserver reliability and inter-observer reproducibility of 3D assessment of mandibular changes using the virtual models were excellent.

What is the Success Rate of Repeat Alveolar Bone Graft?

Success rates for alveolar bone grafting range from 30 to 96%. There is limited information regarding the success of repeat grafts. The purpose of this study was to determine the radiographic success rate of repeat alveolar bone grafts. The study designs was a retrospective cohort study of patients who underwent repeat grafting by 1 surgeon over 15years. To be included, subjects had to have: cleft lip and alveolus and a cone-beam computed tomography (CBCT) scan obtained >6months after repeat graft. Patients were excluded if CBCT was inadequate. Predictor variables were sex, age at repeat graft, cleft type, presence of an erupted canine, premaxillary osteotomy at time of repeat graft, presence of a visible oronasal fistula, size of bony defect, presence of a bony palatal bridge, and whether the surgeon who performed the repeat graft also performed the initial graft. The outcome variable was graft success determined using CBCT assessment and defined as a score of >3 out of 4 in each domain: vertical bone level, labiopalatal thickness, and piriform symmetry. The covariates were time from bone graft to CBCT (months) and age at time of CBCT (years). Frequency distributions, relative risk with 95% confidence intervals, medians, and interquartile ranges were calculated. Pearson c2 and Fisher exact tests were performed to determine predictors of outcome. A P<.05 was considered statistically significant. Fifty subjects (54% male) who had repeat bone grafting to 59 cleft sites were included. Median follow-up time from repeat graft to CBCT was 7.0months (interquartile range: 5.9months). The radiographic success rate was 81.4%:91.7% if the same surgeon performed both initial and repeat grafts, but 78.7% if initial graft was completed by another surgeon (P=.43). Despite being a multifactorial issue, extensive and bilateral clefts, the presence of an erupted tooth in the cleft area, a visible oronasal fistula, and concomitant osteotomy of the premaxilla are warning signs of the possibility of failure. Performing repeat alveolar bone grafting by an experienced surgeon appears to increase the chance of success.

Prevalence and Morphology of C-Shaped Canals in Mandibular First and Second Molars of an Iranian Population: A Cone-Beam Computed Tomography Assessment.

The complex anatomy of C-shaped canals poses challenges for clinicians compared to teeth with normal root canal anatomy. This study is aimed at evaluating the frequency and morphology of C-shaped canals in the mandibular first and second molars among an Iranian population using cone-beam computed tomography (CBCT). This cross-sectional study evaluated 369 CBCT scans from the archives of a radiology clinic in Ardabil, Iran. The sample included 248 mandibular first molars and 478 mandibular second molars. The presence of C-shaped canals and their classification, according to Fan et al., were evaluated at four levels: orifice, coronal, middle, and apical. Prevalence based on gender and tooth type was also assessed. A total of 199 (53.9%) males and 170 (46.1%) females were evaluated. C-shaped canals were found in 11 (8 males/3 females) out of 248 (4.4%) first molars and in 20 (11 males/9 females) out of 478 (3.7%) second molars. The C2 configuration was most prevalent in the orifice, coronal, and middle levels of both molar types, while C3 and C4 morphologies were most commonly found apically in the second and first molars, respectively. A significant difference in configuration was found only at the coronal level between molar types. A significant association between gender and configuration was observed only at the orifice level of the second molars. No other significant differences were found (P > 0.05). C-shaped canal configurations should be expected in 4.4% of mandibular first molars and 3.7% of the second molars in this Iranian population, with a predominance of the C2 configuration in the orifice, coronal, and middle levels.

Cone-beam computed tomography assessment of the root canal morphology of primary molars

BackgroundThis study aimed to assess the root canal morphology of primary molars using cone-beam computed tomography (CBCT).MethodsThis cross-sectional study evaluated 60 maxillary and mandibular primary first and second molars on CBCT scans of patients retrieved from the archives of Hamadan School of Dentistry between 2018–2020. The teeth were evaluated regarding the number of roots and canals, canal type according to the Vertucci’s classification, and root surface concavities. Data were analyzed descriptively and by independent t-test.ResultsThe most frequent number of canals and roots in the maxillary right and left first molars was 3 canals (60%) and 3 roots (80%). These values were 4 canals (80%) and 5 canals (50%) with 3 roots in the maxillary right and left second molars, respectively, 4 canals (100%) and 2 roots (50%), and 3 canals (60%) and 2 roots (50%) in mandibular right and left first molars, respectively, and 4 canals (92.3%) and 3 roots (61.5%) in mandibular right and left second molars. Vertucci’s type IV was the most common canal type in mesial and distal canals, type I was the most common in mesiobuccal, mesiolingual, distobuccal, and distolingual, and types I and II were the most common in the palatal canal. The maximum and minimum concavities were noted in the buccal (26.7%) and mesial (8.3%) surfaces, respectively.ConclusionsA wide variation exists in the number of roots and canals of maxillary and mandibular primary molars, which calls for further attention in treatment of such teeth.

Cone-Beam Computed Tomography Assessment of Morphologic and Anatomic Changes of the Nasopalatine Canal: Cross-Sectional Study

Objective: To reveal the morphological and anatomical structure of the nasopalatine canal (NPC) and analyze its measurements via cone-beam computed tomography (CBCT). Methods: A total of 246 CBCT images were included in the study.) NPC diameter, length, angle, distance from the IF to buccal bone (M1), distance from the NF to buccal bone (M2), and the distance from the middle of the NPC to buccal bone (M3) were measured. Statistical significance was assumed at p &lt; 0.05. Results: There was a significant difference between gender and NPC length, M1 and M3 (p = 0.008, p = 0.019 and p &lt; 0.001, respectively), and between the presence of teeth in the anterior maxilla and M1 (p &lt; 0.001). There was a significant difference between the shape of NPC in the coronal plane and NPC angle (p = 0.012) and between the shape of NPC in the sagittal plane and NF diameter, IF diameter, M1 and the M3 (p &lt; 0.001, p = 0.006, p = 0.031 and p &lt; 0.001, respectively). Conclusion: NPC variations, gender, and the presence of teeth in the anterior maxilla could affect NPC measurements. Physicians planning surgery in the anterior maxilla should pay attention to this situation.

The effects of miniscrew-assisted rapid palatal expansion on the upper airway of adults with midpalatal suture in the last two degrees of ossification.

Transverse deficiencies of the maxillary basal bone have been treated in adult patients using miniscrew-assisted rapid palatal expansion (MARPE) therapy. However, the midpalatal suture's degree of ossification may affect the upper airway dimensions. This study compared the volumetric changes of the total upper, retropalatal, retroglossal airways, and the minimal transverse airway constriction after MARPE therapy in patients with midpalatal suture in the last stages of ossification. This controlled clinical trial included a total of 20 adult patients (mean age 24.5 ± 6.2 years) with maxillary atresia treated with MARPE. Preoperative (T0) cone-beam computed tomography scans were used to determine the degree of midpalatal suture ossification. Two groups were formed considering the last two stages of sutural ossification "D" or "E" (n=10 per group). After 120 days of the therapy (T1), cone-beam computed tomography assessments were performed to compare the pre and post-treatment outcomes. The total upper, retropalatal, and retroglossal airways and the minimal transverse airway constriction were evaluated. The three-dimensional reconstruction was performed with OsiriX MD software. The comparisons were carried out using mixed models for repeated measures at fixed time points (α=0.05). Groups D and E showed no significant difference for any of the analyzed parameters (P > 0.05). Both groups showed a statistically significant increasefor all airway segments after the treatment with MARPE (P < 0.05). The total upper airway increased (11.6% and 16.1%) for groups D and E, respectively (P=0.3356). MARPE therapy resulted in dimensional gains of the upper airway for adult patients, irrespective of the intermaxillary sutural degree of ossification.

Cone-Beam Computed Tomography Assessment of Bifid and Trifid Mandibular Canals: A Cross-Sectional Study

The exact knowledge of the mandibular canal position is fundamental in oral surgery and implantology. Clinicians have to be extremely cautious when operating in close proximity to this structure in order to avoid damaging the neurovascular bundle. Several anatomical variations of the mandibular canal have been described in the literature, such as bifid or trifid structures. The use of cone-beam computed tomography (CBCT) offers a detailed representation of the inferior alveolar nerve path, albeit with some difficulties of identification when dental implants or metal prosthesis are present. The aim of this study is to retrospectively evaluate the prevalence and location of bifid/trifid mandibular canals (BMC/TMC) by CBCT in Italian patients. The screening phase involved 584 patients, only 238 enrolled (97 men; 141 women), with an average age of 51 ± 17.20. A total of 36 patients (15.25%) showed at least one bifid mandibular canal; only 2 patients (0.84%) showed a trifid mandibular canal. Overall, 12 patients (5.04%) presented this variation bilaterally. There was no association with the sex of the enrolled sample. In conclusion, the presence of BMCs and TMCs may be considered as a risk factor for the onset of neurovascular complications. Being aware of changes in the mandibular canal helps clinicians to prevent inferior alveolar nerve impairments that may occur during oral surgery and implantology.

TMJ degenerative joint disease: relationships between CBCT findings, clinical symptoms, and signs

Objectives The relationships between cone-beam computed tomography (CBCT) findings, Temporomandibular disorder (TMD) symptoms, and signs were investigated in patients with TMJ degenerative joint disease (DJD). Material and Methods Adult patients with Diagnostic Criteria for TMDs (DC/TMD)-defined intra-articular conditions were enrolled and subjected to CBCT assessment. The participants were organized into three groups, namely no (NT), early (ET), and late (LT) TMJ DJD based on radiographic findings. TMD symptoms/signs were appraised using the DC/TMD methodology. Statistical analyses were performed using Chi-square/non-parametric tests and Kappa statistics (α = 0.05). Results The mean age of the participants (n = 877) was 30.60 ± 11.50 years (86.6% women). NT, ET, and LT were observed in 39.7%, 17.0%, and 43.3% of the study sample. Significant differences in the prevalence of TMD symptoms (TMD pain, TMJ sounds, opening, and closing difficulty) and signs (TMD/TMJ pain, TMJ clicking/crepitus, and opening limitation) were discerned among the three groups (p ≤ .001). TMD/TMJ pain and opening difficulty/limitation were more prevalent in early rather than late degenerative changes. While moderate agreements between symptoms and signs were observed for TMD pain/opening limitation, the concurrence for TMJ sounds was fair. Conclusions Young adults with TMJ sounds and pain should be examined with CBCT to establish the extent/progress of osseous changes.

Cone-Beam Computed Tomography Assessment of Quality of Endodontic Treatment and Prevalence of Procedural Errors in Mandibular Molars.

This study assessed the quality of endodontic treatment and the prevalence of procedural errors in permanent mandibular molars using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 328 CBCT scans (182 females and 146 males) of endodontically treated mandibular molars retrieved from the archives of two radiology centers in Ardabil city, Iran, in 2019. Mandibular molars were evaluated on sagittal, coronal, and axial sections regarding obturation length, obturation density (voids), missed canals, broken instruments, apical perforation, strip perforation, ledge formation, transportation, root fracture, root resorption, and periapical lesions by a senior dental student under the supervision of an oral and maxillofacial radiologist and an endodontist. Differences between the frequency of procedural errors and tooth type and gender were analyzed by the chi-square test. The frequency of underfilling, missed canals, overfilling, voids, apical perforation, transportation, ledge formation, broken instruments, root fracture, strip perforation, root resorption, and periapical lesions was 34.8%, 17.4%, 16.8%, 14.3%, 7.3%, 6.1%, 4.3%, 3%, 1.2%, 0.6%, 5.5%, and 46%, respectively. The frequency of root fracture was significantly higher in females than in males (P < 0.05). The prevalence of underfilling was the highest in right second molars (47.2%), followed by right first molars, left second molars, and left first molars (P < 0.005). The frequency of transportation was maximum in right first molars (10%), followed by right second molars, left first molars, and left second molars (P < 0.04). Underfilling, missed canals, and overfilling were the most prevalent procedural errors in mandibular molars in our study population.