Dental Literature Research Articles

Twelve-Year Changes in Pre-Schoolers’ Oral Health and Parental Involvement in Children’s Dental Care: Results from Two Repeated Cross-Sectional Surveys in Lithuania

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children.

Oral invasive procedures in Glanzmann Thrombasthenia: a retrospective observational study

BackgroundGlanzmann Thrombasthenia (GT) is a very rare inherited autosomal bleeding disease affecting megakaryocyte lineage with impacts on oral health such as gingival bleeding and requiring specific management protocols. Only very few clinical cases have been published in the dental and hematological literature. ObjectivesThis study focuses on a series of 21 patients affected specifically by GT and their hemorrhagic prophylaxis management with the use of recombinant factor VIIa (rFVIIa) for dental extractions and full-mouth debridement. Results41 full-mouth debridement and 176 dental extractions were performed along 102 sessions of dental care in outpatient setting. A total of 226 injections of rFVIIa was delivered. The mean of injection was 2.2 (range 1 to 4) per dental procedure. The overall rate of bleeding complication was 5.9% (n = 6). All of these six hemorrhagic complications were classified as minor bleeding. No thromboembolic event was observed nor allergic reaction. ConclusionThe data presented in this retrospective observational study support the efficacy and safety of rFVIIa for the prevention of bleeding for invasive dental procedures in patients affected by GT. rFVIIa protocol presented here seems to be a safe and efficient protocol for the prevention of bleeding for invasive oral procedures.

E-Professionalism's Impact on Dental Professionalism: A Rapid Scoping Review.

Dental regulators and educational institutions are increasingly concerned about the influence of digital platforms used by the profession for social, business, digital interaction with the public/patients and its impact on the professionalism in practice now and going forward. However, academic knowledge and research within dentistry are relevant to e-professionalism at a level of engagement and approach in delivering guidance to students through the current dental curriculum. The question therefore asked was what breadth of academic material, research, debate and discourse is available to inform our understanding, guidance and teaching on this ever-evolving topic. To map how e-professionalism has developed in academic dental literature as a topic within the study of professionalism in practice. A rapid scoping review was conducted to identify published research that describes and tests the topic of professionalism from 2016 to 2023. Studies were synthesised narratively using thematic analysis to inform the understanding of what has been already researched in the field. Thirteen articles were included in the review. After undertaking a thematic analysis, five themes were constructed. These included: curriculum, opportunities and safe professional use, reflections, personal and professional identity issues, and students as co-creators. Within dental research there is consensus that e-professionalism could present a tangible threat to the identity of dental professionals their clinical practice and interaction with patients/public however, less is known about what educational strategies are most effective when teaching e-professionalism.

A Literature Review on the Uncommon Use of Extraoral Periapical Radiography

Periapical radiography is a regular radiographic procedure performed by dentists. However, at times, it may not be possible to position the image receptor into a patient’s mouth in an optimized or practical way. For these cases, some dentists advocated the use of extraoral periapical radiography (EOPA). This literature review aimed to review the dental literature on the use of EOPA. In October 2023, PubMed, Web of Science, and Scopus were searched to identify papers that reported on the use of EOPA, supplemented by manual reference tracing and Google Scholar searches. After screening, 18 papers published between 2003 and 2022 were identified, including 14 original articles and 4 reviews. From very limited and conflicting evidence, it was found that root length/working length measurements between EOPA and IOPA did not significantly differ or EOPA showed inferiority. No data were available to compare EOPA with other extraoral modalities such as panoramic radiography. The technique used in EOPA to visualize posterior teeth in the maxilla and mandible varied across studies, such as the vertical angulation of the primary beam, whether mouth should be opened or closed, and whether a holder should be used or not. At the current time, EOPA probably should not be advocated for regular use.

Emerging Evidence Supports Broader Definition of Chairside Behavior Guidance and Familial Compliance.

Behavior management as a set of clinical techniques to induce desirable clinical treatment and subsequent compliance behaviors in children and families varies internationally based on professional training, access to care, health literacy, and societal norms. This report proposes non-typical diagnostic considerations of additional inherent behavioral conditions and familial and social qualifiers that may help predict success both at the chairside and in compliance with home self-care behaviors to reduce caries susceptibility. A review of the medical and dental literature provides ample support for the consideration of changing characteristics of both the patient and the environment. The current recommendations for choice of behavior guidance in direct clinical care, as used in the USA, often fall short of efficacy for a variety of reasons including the provider limitations, the extent and difficulty of treatment, and most recently appreciated, the complexity of negative childhood experiences, subclinical behavioral disorders, and immutable negative determinants of health outside the dental setting affecting interaction with health professionals. These same factors, such as family dysfunction and societal stresses, also impact compliance with out-of-clinic preventive efforts that many oral health care providers rely upon to help mitigate treatment limitations in reaching children. There are also behavioral elements of compliance and attitudes toward health that dentists need to recognize. A broader, more inclusive concept of behavior guidance to include factors beyond those typically associated with a dental patient affecting treatment and compliance with preventive behaviors may be beneficial. Every population and patient will have differing characteristics and require individualized care.

Classification of Complete-Arch Implant Scanning Techniques Recorded by Using Intraoral Scanners.

To classify the complete-arch implant scanning techniques recorded by using intraoral scanners (IOSs). Different implant scanning techniques have been described for recording complete-arch implant scans by using IOSs. However, dental literature lacks on a classification of these implant scanning techniques. Implant scanning techniques aim is to record the 3-dimensional position of the implants being scanned, while implant scanning workflows require additional scans to record all the information needed for designing an implant prosthesis. This additional information includes soft tissue information, tooth position, antagonist arch, and maxillomandibular relationship. There are five complete-arch implant scanning techniques captured by using IOSs: non-splinting, non-calibrated splinting, calibrated implant scan bodies, calibrated frameworks, and reverse impression methods. The digital workflow varies depending on the implant scanning technique selected. The understanding of the varying implant scanning techniques and the main differences among them may ease the decision criteria for recording digital implant scans by using intraoral scanners.

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.

Effect of Guided Implant Drilling on Bone Temperature Changes During Implant Osteotomy: A Comprehensive Systematic Review.

The preparation of the implant site and the quality of the bone are crucial factors for preliminary healing following implant surgery. Therefore, any thermal or mechanical damage to the bone must be minimized during osteotomy preparation. The use of guided implant drilling is now widely employed for the precise placement of implants. Although guided implants are accurate, they are said to generate more heat compared to non-guided osteotomy. This systematic review was conducted to evaluate the heat generation that occurs during osteotomy with both guided and non-guided drilling. A comprehensive search of dental literature in PubMed, EBSCOhost, and Google Scholar was performed for articles published from 2010 to 2024. The search strategy incorporated MeSH terms and Boolean operators. The initial search across all three databases yielded a total of 548 articles. Of these, 477 were discarded after reviewing the titles and abstracts, 26 were removed as duplicates, 15 studies were excluded due to unavailable full texts, and 19 were excluded for not meeting the study design criteria set for the systematic review. Eleven articles were ultimately selected for review and data extraction. After analyzing and collating the results from all the studies, it can be concluded that using surgical guides does cause significant heat generation in the bone at the osteotomy site. However, this rise in temperature generally remains below the threshold that could cause bone necrosis. Additionally, other factors, such as irrigation temperature, drill length, drill diameter, and drilling speed, also influence heat generation during osteotomy in guided drilling.

Exploring the ambiguity in the anatomical terminology among Dental professionals

BackgroundAnatomical terms in medical literature have been used with varying meanings, leading to confusion in clinical practice. This study aims to investigate the ambiguity of anatomical terms in clinical dentistry.MethodsDentists who have undergone specialised training with at least one year of clinical experience were recruited to participate in the study. They were requested to localize specific terms on a skull and provide explanations based on their experience or opinion. All data were recorded, and then descriptive statistics were used for analysis.ResultsSeventy-eight participating dentists gave their consent and were eligible to study. For each anatomical term presented to dentists at least two meanings were provided, with some terms having up to eight interpretations. While most meanings were consistent with medical or dental literature, some responses revealed new interpretations not documented in textbooks.ConclusionsDentists expressed anatomical terms with diverse meanings, possibly influenced by their various subspecialties. It is crucial to acknowledge this variability to prevent confusion. Emphasizing the consistent use of anatomical terms among dental professionals in the future is essential.

Self-assessment of professional competence and influential factors among dental students.

Competency-based education is recognized for evaluating dental students' knowledge and skills. However, practical management training, which is the hands-on education and experience in managing operations and patient interactions, does not align fully with this framework. This study aims to assess professional competence and related factors among dental students using self-assessment, contributing to dental education literature, and identifying areas for improvement. A cross-sectional study included 50 total senior dental students from a top-ranked dental school. With a response rate of 100%, data were collected using a structured questionnaire with three sections: personal information, self-assessment of professional competency, and factors influencing competency. Statistical analysis, including descriptive statistics and tests like Chi-square and ANOVA, analyzed the data. The average self-reported professional competence score was 71.15 with a standard deviation of 3.05. Associations between age, gender, grade point average (GPA), and self-reported professional competence were assessed, with no significant links found (p>0.05). Influential factors included interaction with clinical instructors (69.24%) and interest in dentistry (67.03%). No significant differences in self-reported professional competence were observed among students residing on-campus versus off-campus. Age, gender, and GPA do not significantly impact dental students' self-reported professional competence. Positive interaction with instructors and interest in dentistry contribute to skill development. Practical experience and effective educational relationships are crucial. Dental education institutions should improve clinical competence by fostering strong student-instructor relationships, increasing hands-on clinical training, and fostering student interest in dentistry.

Evaluation of EMLA cream with microneedle patches in palatal anesthesia in children: a randomized controlled clinical trial

Palatal injections are considered to be one of the most painful dental procedures. As a result, it was important to find alternatives to this painful injection to improve children's cooperation. The dental literature mentioned using EMLA cream as a possible alternative to conventional injections, but its anesthetic effect was debated. Therefore, it was valuable to research the impact of microneedle patches to enhance the effectiveness of this cream. The purpose of this randomized controlled clinical trial was to compare the effectiveness of different methods of anesthesia and pain levels in children aged 7–11 years. The study compared the use of EMLA cream, EMLA with microneedles, and conventional palatal injections. A total of 90 children were randomly assigned to three groups: Group 1 received conventional palatal anesthesia (control), Group 2 received EMLA cream only, and Group 3 received EMLA with microneedles. Pain levels were assessed using the FLACC and Wong-Baker scales at three different time points: T1(during anesthesia), T2(on palatal probing), and T3(during extraction). The FLACC scale revealed a significant difference in pain between groups only at T1 (P value = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value = 1.00). Similarly, the Wong-Baker scale also demonstrated a statistically significant difference in pain between groups only at T1 (P value = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value = 0.091). The study concludes that both EMLA cream alone and EMLA with microneedles can be used as an alternative to conventional palatal anesthesia for children.

Assessment of studies on oral manifestations and COVID-19

Aim: This study aimed to evaluate how different study designs influences the presence and characteristics of diagnosis of oral manifestations in patients with COVID-19. Methods: This study is a meta-search conducted with studies evaluating the relationship between patients with oral manifestations and COVID-19. A search was conducted in three databases (PubMed, Web of Science, and Scopus), using terms specific to COVID-19 and oral lesions, including only primary studies. Study selection was undertaken by two reviewers independently. A descriptive analysis was performed. Results: The results included 55 studies in the data synthesis analysis. Most of the studies were case reports and case series. Some of the studies did not relate a biological test to confirm COVID-19. The ulcer lesion and that clinical examination by specialists were the most reported lesion in case reports and case series studies, while taste alterations and patient self-report were more reported in observational studies. Conclusions: This review concluded that the oral lesions in patients with COVID-19 differ according to the study design. The lack of high-quality scientific evidence in the dental literature on COVID-19 makes the findings inconsistent by the lack of sample selection criteria, diagnostic criteria and classification of oral lesions.

The past forty-three years of dental implantology literature. A global mapping and scientometric analysis

PurposeThe aim of this research is to make a scientometric analysis of the dental implantology literature and to present the results in a more understandable way to the reader by visualizing them with maps. MethodsThe dental implantology literature was accessed through the Web of Science database. Scientometric data was obtained with Citespace 6.1 software, co-citation, clustering analysis, citation burst, and mapping analyzes were performed. Scimago Graphica software was used for additional visualizations. ResultsA total of 35,704 articles were included in the analysis. There were 88,616 authors, 72,333 institutes, 142 countries/regions, and 3,265 journals contributing to the dental implantology literature. The United States was first with 7,334 publications and 225,868 citations. The literature between 1980 and 2023 was divided into 19 different clusters, and the literature between 2000 and 2023 was divided into 16 different clusters. ConclusionsKey themes in the field include the use of autogenous bone, advancements in implant surface technology, and the use of platform switching and intraoral scanners. Emerging topics of interest include esthetic considerations in the treatment of the anterior region, stress distribution, the use of zirconia, and the impact of implant treatment on oral health-related quality of life. With similar scientometric analysis studies to be done in the future, the progress of the literature can be followed on the basis of evidence.

A Case Against the Implant.

It is incumbent upon our profession to reevaluate our preference for routinely replacing a missing single maxillary incisor, especially a maxillary lateral incisor, with a dental implant in a young adult. The dental literature is replete with beautiful restorative results using implants in this area, but there is minimal discussion regarding the long-term consequences of this treatment. The maxillary lateral incisor is one of the most commonly missing teeth due to agenesis, and it is also one of the most common teeth to be lost due to trauma in the developing child.1 Therefore, the decision for replacement must be made with the long-term in mind, as these restorations are commonly placed between ages 18 and 21 and must serve the patient for many decades. There are several reasons that implants can be associated with complications or even fail, including the following: (1) Continued craniofacial growth, which has a predominant anterior and vertical component and has been shown to occur in the maxilla, resulting in the apparent submersion of the implant crown as the natural teeth move incisally in relation to the implant2,3-there is no evidence that this can be predicted, let alone how far into the future it may happen; (2) peri-implantitis, which has a patient-level prevalence estimate of nearly 25% according to the findings of a recent systematic review;4 (3) thinning and recession of the peri-implant mucosa due to poor implant placement, inadequate prosthetic management, and/or poor case selection, often resulting in compromised esthetics and a predisposition for the onset and progression of peri-implant diseases; and (4) mechanical failure of the implant, abutment screw, transmucosal abutment, and/or crown. Clinicians should also keep in mind that, once an implant is placed in the anterior maxilla, it precludes the possibility for palatal expansion in the adult patient because the space created by the expansion cannot be redistributed orthodontically. Canine substitution is one traditional method for replacement of the missing maxillary lateral incisor. It is still a viable option when the canine tooth has an acceptable shape and color, and the occlusion will not be compromised by the substitution.5 Additionally, the bonded single-wing zirconia bridge has become a primary treatment option.6 Zirconia has the strength of metal and beauty of porcelain, which makes it an ideal substrate for a bonded bridge. The literature has demonstrated the long-term success of this replacement option for the missing maxillary incisor.7 There are clearly many potential long-term disadvantages associated with replacing a single missing maxillary incisor with an implant in young adults. We should be prescribing the least-invasive treatment option for the replacement of these teeth. Therefore, when treatment-planning for a missing maxillary incisor in a young adult, alternatives to implant therapy-such as the bonded single-wing zirconia bridge and canine substitution-should be the primary treatment options. The implant should only be considered as a secondary treatment when the other options are not viable or have previously failed.

Diffuse idiopathic skeletal hyperostosis (DISH): Detection on dental radiologic examinations in two older adults and overview of the literature.

Diffuse idiopathic skeletal hyperostosis (DISH) is a potentially serious osteopathic disorder associated with coalescing ossifications of the anterior vertebrae and may be concomitant with a constellation of symptomatology and systemic comorbidities. There is limited dental literature describing this finding on panoramic radiographs and cone beam computed tomography (CBCT) scans. Two case reports of DISH are provided. One patient manifested extensive ossifications along the cervical vertebrae and consequent episodes of dysphagia and hoarseness. The other affected patient's cervical ossification was found at an earlier stage of formation and without symptomatology. Panoramic radiography, cervical spine radiography, and CBCT examinations have been provided. Attending dental healthcare practitioners should carefully evaluate all areas of interest and surrounding fields of view when taking panoramic radiographs and CBCT scans for manifestations of DISH and other potential disorders of the cervical vertebrae. A suspected radiologic finding of DISH should prompt timely referral for comprehensive medical assessment to mitigate neurologic deficits and other comorbidities.

Current Emerging Concepts on the Pathogenesis of Periimplant Diseases: A Narrative Review.

To describe the emerging evidence concerning etiologic factors and pathophysiologic mechanisms involved in peri-implant inflammatory diseases. An electronic search for articles published until November 2022 was conducted in MEDLINE by three independent reviewers to identify the manuscripts' reporting data on etiologic factors and pathophysiologic mechanisms associated with peri-implant diseases. Current evidence suggests that peri-implant mucositis and peri-implantitis are inflammatory conditions linked to a microbial challenge. However, in recent years there has been increasing evidence indicating that certain peri-implant inflammatory conditions may not be primarily related to biofilm-mediated infectious processes but rather to other biologic mechanisms, such as a foreign body response. Current evidence in the dental and medical literature opens new avenues for a more complex interpretation of the etiopathogenetic factors involved in peri-implant diseases. A better understanding of various factors related to the host response, including dysbiosis mechanisms associated with changes in microbiota composition, is necessary for a more precise physiopathologic characterization of these diseases.

A Comprehensive Analysis of Covid-19 Research in Turkish Dentistry

To analyze, classify and summarize current data in Turkish dentistry literature related to COVID-19 in 2-year duration from beginning of the pandemic to the end of 2021. The terms ‘‘COVID-19”, “koronavirüs”, “diş hekimliği”, “pandemic”, “coronavirus”, “dentistry”, “pandemics”, “SARS-Cov-2”’’ were searched separately and in combinations in PubMed and Google Academic databases. Regardless of whether the studies were in Turkish and/or English, it was taken into account that they belong to Turkish dentists, interventional and/or observational, and have been published in the duration starts from the beginning of the pandemic to the end of 2021 and contain information on the COVID-19 pandemic in dentistry. 46 studies in PubMed database and 74 studies in Google Scholar were identified. Studies were classified under 8 main topics (knowledge level and behavioral assessment, psychological effects, research specific to dentistry departments, practices, education, importance of the pandemic, infection control and precautions, social media and social network analysis). Through the findings of the analysis, it will be ensured that dentists and healthcare professionals serving in the field of dentistry will be updated on their knowledge, attitudes and behaviors, be prepared for possible future pandemic situations and shape their perspectives on infectious diseases under the guidance of the literature.

Effectiveness of reframing as behaviour management technique in paediatric dentistry: A scoping review

Background: For children with fear and anxiety, dental appointments are considered as stressful situations. The dental literature has mentioned various behaviour management techniques used to reduce the dental fear and anxiety. Reframing is one such technique which is used for behaviour management with wide applications in health sciences. Hence, exploring this technique in the dental literature is of prime importance.Objectives: This scoping review aims to identify the evidence on the effectiveness of reframing as behaviour management technique in children undergoing dental treatment in the available literature.Method: The Joanna Briggs Institute methodology for scoping reviews is followed in this study and relevant published data from case reports, randomized and nonrandomized controlled clinical trials and literature reviews published without restricting time line till August 2023 from online databases of PubMed, Scopus, ProQuest were assessed by two reviewers for their suitability with our aim of study. The data were synthesized using content analysis.Results: Through literature search, 108 articles were found based on search strategy. After screening the titles, keywords and abstract and removing the duplicates only 10 articles were included for full text review. In the end only 5 articles were included for scoping review for their content analysis.Conclusions: The searched literature has revealed that reframing had changed the behaviour of the child towards dental outcomes but the literature is sparse regarding behaviour management technique for children to alleviate fear and anxiety. Also, there were no clinical trials done to know the efficacy of this technique and means to measure the outcome.

Children's rights and dental care treatment.

Dentists, especially paediatric dentists, should inform their young patients of the treatment to be undertaken in an appropriate and comprehensive manner. In 1989, the UN Convention on the Rights of the Child (United Nations Convention on the Rights of the Child - UNCRC - https://www.unicef. org/child-rights-convention/convention-text) was adopted, comprising of 54 articles concerning every aspect of a child's life, notably health, including oral health. More than 30 years after the Declaration of the Rights of the Child, both health professionals and parents still struggle to grasp this subject, resulting in its scarce application in daily practice. Children's rights have also been mentioned several times in medical and dental literature, reminding health professionals that the approach to young patients must be age-appropriate. The clinician must learn to consider children as the main protagonists in the choices concerning their health, and they must be aware of their rights from an early age. Particularly in the field of dentistry, it is a matter of guaranteeing the best dental care for every child with particular attention to the indigent or disabled (Article 23). In addition to this, the most effective and up-to-date treatment must be proposed, avoiding unnecessary extractions and favouring conservative therapy that can guarantee a better quality of life in the future, while reducing treatment under general anaesthesia. In current practice, consent to treatment is often demanded from the parents, without involving the child. However, every child has the right to freely express their opinion and be actively involved in any matter that concerns them. This opinion is expressed in different ways according to age and stage of maturity. Pictures, drawings, cartoons and videos can help the healthcare provider when explaining procedures to the young patient, thus allowing them to obtain consent and cooperation. In individual countries, it would be advisable to have guidelines that facilitate the child's active consent to health treatments. So, what happens in your country?

CT and MR Appearance of Teeth: Analysis of Anatomy and Embryology and Implications for Disease.

Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various stages of maturation are required for the appreciation of abnormal dental development. While many tooth abnormalities are well-depicted on dedicated dental radiographs, the first encounter with a dental anomaly may be by a radiologist on a computed tomographic (CT) or magnetic resonance (MR) exam performed for other reasons. This article depicts normal dental anatomy and development, describing the appearance of the neonatal dentition on CT and MRI, the modalities most often encountered by clinical radiologists. The radiology and dental literature are reviewed, and key concepts are illustrated with supplemental cases from our institution. The value of knowledge of dental development is investigated using the analysis of consecutive MR brain examinations. Finally, the anatomical principles are applied to the diagnosis of odontogenic infection on CT. Through analysis of the literature and case data, the contrast of dental pathology with normal anatomy and development facilitates the detection and characterization of both congenital and acquired dental disease.