Department Of Oral Radiology Research Articles

Incidence of Canine Impaction in Tribal Population of Jharkhand.

The position of the canine has a key role in facial harmony, dental aesthetics, functional occlusion, and health of temperomandibular joint. Maxillary canine impaction is the second most common tooth after third molars impaction. Maxillary canines are more prone to impaction due to longer path of eruption. All the patients were examined in the Dental Chair light and referred to the department of Oral Radiology for Orthopantomogram. Yamamoto's classification was used to classify maxillary canine impaction. Position of mandibular canine from cement-enamel junction was used for mandibular canine impaction. The study was performed on 2300 patients who consulted the orthodontic department from January 2018 to July 2022. Orthopantomogram of each patient was examined for canine impaction, retained deciduous teeth, cyst, and other anomalies. The incidence and pattern of canine impaction was assessed. The data was then statistically analyzed using Graph Pad Prism software. The incidence of impacted canine was evaluated. The effect of gender was evaluated using a t-test. A total of 2300 subjects were examined out of which 52 individuals were diagnosed with canine impaction. The incidence of canine impaction among orthodontic patients is 2.26%. The amount of canine impaction in females (60%) is higher than males (40%). The ratio of canine impaction of the maxilla and mandible is 2.5. The incidence of canine impaction was found to be 2.26 percent in the tribal dominant population of Jharkhand. Type II (50%) pattern in the maxilla and Level A (57%) impaction in the mandible was found to be the highest.

Evaluation of the Anatomic Variations of Lingual Foramen and its Bony Canals with CBCT in South Indian Sub-population: A Radiographic Observational Study

Aim: To assess prevalence and morphometrics of lingual foramen and lingual canals using Cone Beam Computerised Tomography (CBCT).
 Materials and Methods: This was a retrospective observational study, in which 144 CBCT scans were obtained from the archives of Department of Oral radiology, Vishnu dental college, Bhimavaram. Parameters such as number, location, length of the lingual canal, travel path of the lingual canals, distance from the lingual foramen to inferior border, in cases where extra foramen is present an additional criteria involving measurement of the distance between both the foramen was also evaluated. Statistical analysis was done using chi-square test and results were formulated.
 Results: Lingual foramen was a common observation in all of the examined CBCT scans and 21% of scans showed two lingual foramen. The average distance from the Inferior Lingual Foramen (ILF) to Inferior Border (IB) was 3.3 ± 1.0 mm. The mean length of the Superior Lingual Canal (SLC) was 4.2 ± 1.3mm and the mean length of the ILC (Inferior lingual canal) was 4.2 ± 1.2mm. The majority of the inferior lingual foramen (76%) were inclined and only 0.1% of foramen were vertical.
 Conclusion: Variations in the prevalence of the lingual foramen are observed due to variations in the ethnicity, geographic location. Detailed evaluation of these anatomic structures using CBCT help in prevention of the complications and will improve the treatment outcome.

Dental health of patients with X-linked hypophosphatemia: A controlled study.

The present study compared the dental health of patients with X-linked hypophosphatemia (XLH) with healthy age- and gender-matched controls to increase our knowledge of the impact of XLH on oral health. Twenty-two adult patients with XLH in the Stockholm region of Sweden were referred to the Department of Orofacial Medicine at Karolinska Institutet for an extended clinical and radiological examination. Pre-existing radiologic examinations of 44 healthy age- and gender-matched controls were retrieved from the Department of Oral Radiology, at Karolinska Institutet. The 22 patients with XLH (15 females, median age 38 years, range 20-71; 7 males, median age 49 years, range 24-67) had a significantly higher number of root-filled teeth compared to healthy controls (p = .001). In the XLH group, females had significantly better oral health than males, especially concerning endodontic and cariological status (p's = .01 and .02, respectively). Periodontal status differed non-significantly between the XLH and control groups. Patients with XLH had a significantly lower oral health status compared to a healthy population especially concerning endodontic conditions. Male patients with XLH had a higher risk of poor oral health compared to female patients with XLH.

Middle Mesial Canals Prevalence percentage and Its Configuration type with "Egyptian subpopulation" by CBCT

The Aims of This Study: were to detect the middle mesial canals (MMCs) prevalence in mandibular 1st molars, its configuration type, and its percentage of incidence with age by Cone-Beam Computed Tomography (CBCT) analysis. Methods: CBCT scan of 1650 patients were observed between January 2021 to February 2022 were collected using the CBCT imaging system from the database of the department of oral radiology, faculty of dental medicine, Al-Azhar University - Assiut branch. CBCT scan images were analyzed by Sidexis software. CBCT images were examined to detect the following: (1) The percentage of incidence frequency of the MMCs, (2) MMCs classification, and (3) Frequency of occurrence of MMCs according to age. Results: The incidence frequency percentage of the presence of MMCs among the Egyptian population was 10.79 % (208/1926) with no statistically significant due to gender, While MMCs configuration types showed 77% (160/208) confluent anatomy merging with either the mesio buccal or mesio lingual canals, 16.3% (34/208) fin anatomy and only 6.7% (14/208) showed independent MMCs with separate orifices and apical foramen. lastly the incidence frequency percentage of the presence of MMCs decreases with age. Conclusions: The MMCs prevalence in mandibular 1st molars among some Egyptian population was 10.79%, and CBCT scan is helpful way to detect the presence of MMCs.

Assessing The Proximity of the Roots of Maxillary Molars and Premolars to the Maxillary Sinus in UAE Residents

Background: The proximity of the roots of the maxillary posterior teeth (MPT) to the maxillary sinus (MS) may result in an increased risk of the development of MS pathology. Moreover, surgical procedures for the MPT, which are close to the MS can result in several complications like oroantral communication and displacement of roots into the MS. Objective: This cross-sectional study evaluated the MPT's proximity to the MS using digital panoramic radiography in a sample of individuals living in the United Arab Emirates (UAE). Methods: A total of 141 panoramic radiographs showing the presence of all MPT were retrieved from the Oral Radiology Department of Ajman University, Fujairah Campus. Thus, the proximity of 1410 MPT to the MS was evaluated on a scale of zero to three. Results: The roots of the first and the second molars are the closest to the MS (χ2 = 374.612; p 0.000). The distance between the roots of MPT and MS did not differ statistically between males and females (χ2 = 2.44, p= .124), nor between the right and left sides (χ2 = 0.46, p= .872). However, there was a highly significant negative correlation between the root-sinus proximity and age. (rho= -.201, p < .001). Conclusion: In UAE residents, the roots of the first and second molars are closer to the MS than other MPT. Therefore, more precautions should be taken when doing a surgical procedure in this region.

A proposed new classification of maxillary sinus using panoramic radiograph

Maxillary sinus is the largest among the paranasal sinus which is of surgical clinical and anthropological significance. Classification of maxillary antrum based on shapes and sizes using panoramic radiography have not been developed till date. Different shapes and sizes of maxillary antrum were taken into notice while tracing orthopantomogram. As panoramic radiograph is the most commonly available and feasible technology, a deeper study of this topic felt compelling.: To classify maxillary antrum based on its shape, presence of septa, shape of the floor and presence of recess employing digital panoramic radiographs. A total of 1000 panoramic radiographs available in soft copies in Department of Oral Radiology, Sree Anjaneya Institute of Dental Sciences were analysed for developing this classification. The panoramic radiographs were taken using KODAK 8000 carestream machine with exposure parameters 73kVp, 12mA, 13.9 seconds. The shapes identified included cloudy, rectangle, round, trapezoidal, square, ovoidal, pentagonal, hexagonal. In which cloudy marked the highest and hexagonal the least. Among the maxillary sinuses observed a few showed septations. The sinus floor contours observed comprised scalloped, wavy, curved, straight and v-shaped. Out of which a few showed recess. This is a proposed new classification of maxillary antrum using Panoramic radiograph. From this study, eight distinct shapes of the maxillary sinus were identified, wherein cloudy type was predominant and hexagonal was the least commonest. Only a few had sepatations and recess. Six distinct shapes of floor were identified, of which scalloped marked the highest.

Assessment of skeletal relationships in cleft palate with or without cleft lip: A cone-beam computed tomography study in a pakistani population.

Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities. The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement. Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant. We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05). Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.

The Correlation between Impacted Third Molar and Blood Group.

Background Blood type is among the most important genetical characteristics of any individual and is shown to be correlated with the development of a variety of illnesses including dental diseases. Finding the association of ABO and Rh blood groups and impacted tooth is important in order to predict which population is more vulnerable to grow impacted third molars that could lead to making better intervention. The present investigation tried to take a small step in that regard, by evaluating the correlation between ABO and Rh blood groups and the most commonly impacted tooth, bony impacted third molars among Iranian individuals. Methods The investigation was done retrospectively on patients who were referred to the Department of Oral Radiology, Shiraz University of Medical Science, Shiraz, Iran. The patients were classified according to their blood groups, and 40 patients were randomly selected for each blood type. Therefore, the impaction of their third molars was evaluated, and statistical analyses were done in order to find any association. Results A total of 320 participants contributed to the study; 136 (42%) were males and 184 (57%) were females. The mean age was 29 ± 6 years. Among all participants, 205 (64%) had no impacted third molar, 26 (8%) had one impacted third molar, 43 (13%) had 2 impacted third molars, 5 (1%) had 3 impacted third molars, and 41 (12%) had 4 impacted molars. Conclusion According to the results of the present study, nearly one out of three individuals has at least an impacted third molar in the Iranian population, being more prevalent in individuals between 20 and 30 years old. The evaluation of the relationship between the blood group and impacted third molar revealed that blood groups have no association with the impacted third molars. However, more studies with higher and diversified participants should be done to find comprehensive results.

Mesiodistal Width of Mandibular Central Incisors between Different Genders in Chennai Population Using Cone Beam Computed Tomography

Background: Using the CBCT, this technique has the ability to identify the proper dimensions of themesiodistal width of the tooth and other clearing techniques that in the past have been of higher value tothe other conventional techniques that can be implemented to give a three-dimensional perspective of thecomplete morphological details. With this, analysing the mesiodistal width of mandibular central incisorsbetween male and female based on CBCT can be accomplished.Methods: One hundred Cone Beam Computed Tomography (CBCT) images from different patients areselected randomly from Department of Oral Radiology of Saveetha Dental College and Hospital, India.All the CBCT images of patients are examined for the inclusion criterias in the mesiodistal width of themandibular incisors between different genders. All mesiodistal width of mandibular central incisors betweendifferent genders are investigated and compared.Conclusion:When both the genders were compared in terms of the number of canals, there was a significantdifference seen (p-value: 0.000002208). With the p-value calculated, it was found that there was a significantdifference between the genders in terms of the distance between the occlusal pit to the pulp chamber (p-value:&lt;0.0000001). Overall, there is no significant difference between the two genders at the level of the cervicalthird (p-value: 0.6554).

Evaluation of Root Canal Morphology of Maxillary 2ndPremolars Using Cone Beam Computed Tomography in Chennai Population

Background: Using the CBCT, this technique has the ability to identify the root canal morphology asdetailed as using the root canal staining and other clearing techniques that in the past have been of highervalue to the other conventional techniques that can be implemented to give a three-dimensional perspectiveof the complete morphological details. With this, analysing the variation in root canal morphology of humanmaxillary second premolar between different gender in Chennai population can be done.Methods:One hundred Cone Beam Computed Tomography (CBCT) images from different patients areselected randomly from Department of Oral Radiology of Saveetha Dental College and Hospital, India.All the CBCT images of patients are examined for the inclusion criteria in maxillary second premolarsbetween different genders based on Vertucci classification. All root canal configurations of maxillary secondpremolars between different genders are investigated and compared withVertucci Classification.Conclusion: Of all the 100 maxillary second premolars, the most common type of canal configuration forboth the genders is Type I (41%), Type III (22%), and Type V (22%). In females, the most common type ofcanal configuration discovered is Type I (35%), Type III (63.6%) and Type V (83.3%). In males, the mostcommon type of canal configuration determined is Type I (65%) and Type III (36.4%).

Digital Radiographic Study of Gonial angle in Forensic Odontology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Gonial angle measurements serve as an important parameter of the craniofacial complex and are usually studied on lateral cephalograms, but recently panoramic radiographs have also been used. The aim of this study is to measure the gonial angle using orthopantomogram and lateral cephalogram based on age, gender, ethnicity, and skeletal malocclusion in a tertiary care hospital. This is a descriptive cross-sectional study comprising 350 selected radiographs of apparently healthy individuals collected for a period of one year, from the Department of Oral Radiology of a tertiary care centre of Nepal. Gonial angle measurements were recorded from digital panoramic radiograph (both right and left side) and lateral cephalogram. Data was collected in terms of age, gender, ethnicity, and skeletal malocclusion and then statistically analysed using the Statistical Package for the Social Sciences version 20. The mean gonial angle for panoramic right, left and lateral cephalogram was 122.490±7.570, 123.620±7.060, and 124.150±6.910, respectively. There was a decrease in the mean values of the gonial angle observed as age advances seen in all the radiographs. The gonial angle measured in Class III malocclusion was higher in all the radiographs, followed by Class II and Class I. Gonial angles obtained in females were higher than the males in all the radiographs. Finally, the Aryan population showed a higher gonial angle compared to the Mongolian population in all the radiographs. Panoramic radiograph (left side), could be considered as a reliable tool to measure the gonial angle.

Prevalence of oral and maxillofacial soft tissue calcifications in dental panoramic radiography: A retrospective study

Introduction: The aim of the study was to determine the prevalence of soft tissue calcifications in digital dental panoramic radiography. Materials and Methods: Digital panoramic radiographs of 1314 dental patients who visited the Oral Radiology department from November 2017 to January 2018 were analyzed for soft tissue calcifications. Results: The most common soft tissue calcification identified were submandibular sialolith 30.43%, followed by 17.39% of phlebolith and 17.39% of calcified atherosclerotic plaques, 13.04% of, tonsillolith 8.69% of calcified stylohyoid ligament and 4.34% arteriosclerosis. Conclusion: There is low prevalence of soft tissue calcifications which increases with age, Atherosclerotic plaque occurs in male than in female. Once a soft tissue calcification is diagnosed incidentally in a routine dental radiograph it can aid in prevention of the disease. Keywords: Soft tissue calcifications, Sialolith, phlebolith, Atherosclerotic plaque, Panaromic radiography, Prevalence.

CORRELATION BETWEEN VERTICAL GROWTH PATTERNS OF THE JAWS AND SELLA TURCICA'S LINEAR DIMENSIONS USING CONE BEAM COMPUTED TOMOGRAPHY IN AN EGYPTAIN SUBPOPULATION.

Abstract: The sella turcica is one of the most important landmarks used by orthodontics in analysis of growth and treatment planning. Therefore, the purpose of this retrospective study was to detect whether there is a correlation between the sella turcica's linear dimensions and the vertical growth patterns of the jaws using CBCT in an Egyptian subpopulation. 144 CBCT scans of adult patients (68 males and 76 females) were taken from the archive of the Oral Radiology Department , Faculty of Dentistry, Suez Canal University. CBCT images were divided according to the vertical growth pattern of both maxilla and mandible into three groups; hypodivergent, normodivergent and hyperdivergent. The sella turcica diameter, length and depth were measured individually for each case. There were no statistically significant differences found between sella turcica's length and diameter measurements and vertical growth pattern of the jaws. While significant difference was found regarding the depth only between the three groups where the p-value was found to be 0.001. Conclusion: CBCT could be used as a highly accurate radiographic modality in assessing the linear dimensions of sella turcica .The sellar depth was the only linear measurement found to be affected by the vertical growth pattern of the jaws.

CBCT study of morphologic variations of maxillary sinus septa in relevance to sinus augmentation procedures

Background:Augmentation of the maxillary sinus increases the lost height of ridge in the posterior maxilla. Bony convolutions from the floor of the sinus called septa may be encountered during the procedure and significantly impact the outcome of the procedure.Materials and Methods:For this retrospective study, 120 cone-beam computed tomography (CBCT) scans were collected from the archives of the department of oral radiology in the time period between January 2016 and August 2018. Planmeca Romexis® software version 3.2.7 was used to check for the incidence, and then among the septa, plane of orientation, location with respect to the wall of the sinus, and in terms of relation to tooth were examined. The average height and average width of all the septa were measured using a measuring tool in the software.Results:Thirty-five of the total 88 patients showed septa in 40 sinuses, in which 36 sinuses showed one septum and 4 sinuses showed 2 septa. Forty-one septa were located on the floor of the sinus in the frontal orientation and 3 septa were located on the lateral wall of the sinus in the axial orientation. The mean height and mean width of the 41 septa on the floor of the sinus were 5.72 mm and 3.47 mm, respectively. The mean height of septa found on the lateral wall of the sinus was 5.59 mm.Conclusion:Septa had a higher tendency to be in bucco-palatal direction and on the floor of the sinus and frequent occurrence in the region of molars. A thorough prediagnostic evaluation using CBCT is necessary prior to sinus augmentation procedures.

Measurement of Length of Styloid Process by Orthopantomography

Background: Styloid process (SP) is an anatomical structure whose elongation is not well understood. Proper clinical and radiological assessment is needed to detect an elongated SP. Anatomical variation is also common. SP is said to be elongated if longer than 30 mm. Orthopantomogram (OPG) is also an imaging modality by which we can view SP.&#x0D; Objective: The objective of this study was to assess the SP on OPG and identify eagle syndrome.&#x0D; Materials and Methods: The study was conducted on archived OPG radiographs available in the Department of Oral Radiology, Gandaki Medical College Teaching hospital and Research Centre. These radiographs were from patients who were subjected to radiographic examination for other dental problems. The length of SP was measured on both sides using the measurement tool bars on the accompanying analysis software.&#x0D; Results: Average length of SP on males was 26.5 mm ±14.4 mm in right and 25.5 mm ±6.19 mm in left; and on females was 23.78 mm ±5.93 mm on right and 24.7 mm ±10.44 mm in left. Elongated SP was more on males compared to females. Elongated styloid process (ESP) was more prevalent in 21 - 30 years of age group, similarly unilateral and bilateral elongation was also predominant on males compared to females.&#x0D; Conclusion: OPG is also useful for detection of an ESP in patients with or without symptoms and helps to avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal or muscular origin as well as Eagle syndrome (ES).

Re-exposure in cone beam CT of the dentomaxillofacial region: a retrospective study.

In a retrospective cohort study CBCT images of 4986 patients from the patient database from the Department of Oral Radiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany were included and the rate of re-exposures was counted. Patients were stratified into those who received a scan with the small field-of-view CBCT or the large field-of-view CBCT. The effect of patient-related parameters as age and gender was implicated. As a further device-specific parameter, the statistical analysis included whether the selection of the field of view due to the device type had a significant influence on the occurrence of re-exposures. Furthermore, the rescans were analyzed with regard to their causes. In total, CBCT images of 82 (1.6%) patients had to be repeated. Looking at the two different devices, in 42 (1.3%) patients that received a scan with the large field-of-view CBCT and in 40 (2.3%) patients that received a scan with the small field-of-view CBCT respectively needed a retake. There was no statistically significant correlation between age and gender to retakes. For the small field-of-view-size significantly more retakes were observed than for the large one. With 46% motion artifacts were the most frequent causes for a re-exposure of the patient. Gender and age did not have an impact on the occurrence of re-exposures. Patients who received a scan with the small field-of-view CBCT were significantly more often rescanned than those with the large field-of-view CBCT.

Changes in Image Examinations at the Department of Oral Radiology

Changes in Image Examinations at the Department of Oral Radiology

Audiovisual modeling: An efficient, time-saving, radiation-specified method of reducing dental anxiety in children undergoing panoramic radiographic imaging and IOPA radiographic imaging

Background: Children undergoing panoramic radiographic imaging (PRI) and intraoral periapical (IOPA) radiographic imaging show anxiety due to the presence of a revolving PRI machine and IOPA X-ray unit and a different environment which can pose behavioral concerns. Staying still for 15–20 s is not possible for young children. This could lead to distortions and require repetitions, leading to more radiation exposure. Aim: The aim of the study was to reduce the dental anxiety and reduce the increased radiation exposure and saving time in PRI and IOPA radiographic imaging by audiovisual modeling. Methodology: Forty children age 2–12 years indicated for PRI and IOPA radiographic imaging were subjected and observed before and after audiovisual modeling. The patients were modeled by audiovisual modeling before imaging in the oral radiology department. The anxious and disruptive behavior was assessed using the anxious and disruptive behavior code by a single blinded observer. Statistical Analysis Used: Statistical Software SPSS 13.0. Results: There was significant difference in the occurrence of body movement and complaining and restraint before and after audiovisual modeling in the same patients. There were statistically significant differences in the overall events before and after audiovisual modeling. Conclusion: The basic behavior management technique and use of audiovisual modeling can reduce the anxiety and disruptive behavior in children undergoing PRI and IOPA radiographic imaging and also reduces increased radiation exposure, saving time for the process thus reducing the cost of repeated imaging.

An Alternative Approach to Periapical Radiography for Gaggers

Context: Most difficult and common problem, while taking intraoral periapical radiographs in the posterior region of the jaw is gagging. Severe gag reflex at times does not allow periapical radiography causing an additional financial burden on the patient who is then sent for extraoral radiography. Aim: The aim of this study was to device a new technique with which the radiograph of maxillary and mandibular third molars can be obtained without causing much discomfort and additional financial burden to the patient. Settings and Design: The present technique was applied and tested for its validity on the routine patients visiting oral radiology department for radiograph of maxillary or mandibular third molars and who demonstrated severe gag reflex preventing periapical radiography. Subjects and Methods: The present technique required a dental chair, intraoral dental X-ray machine, regular size of two periapical films, and artery forceps. The film is placed parallel to the occlusal plane as in case of occlusal radiography with the embossed dot side facing toward the teeth to be radiographed, and exposures were made. Results: The resulting radiographs taken by the present technique showed a complete image of third molars without causing stimulation of gag reflex and without superimposition of the zygomatic process on roots of maxillary third molars. Conclusion: The present technique can be used satisfactorily for taking third molar radiographs in patients with severe gag reflex.

Demographics and referral patterns of a university-based oral maxillofacial radiology clinic over a 20 year period

The aim of this study was to review the referral patterns, distribution of interpretations, and type of diagnostic imaging used in a university based oral maxillofacial radiology clinic for patients referred for consultation from both dental and nondental clinicians. The database of the Special Procedures clinic in the oral radiology department of the University of Toronto, Faculty of Dentistry, containing over 5000 entries, from 1993 to 2013, was queried. Using descriptive categorical analysis, the results were analyzed to describe patient demographic characteristics, the specialty of the referring clinicians, the imaging modalities used, and the interpretation provided. Most referrals were from oral and maxillofacial surgeons and general dentists. Approximately 25% of referrals were interpreted as variations of normal anatomic structures. The most common reasons for referral were intraosseous lesions (42%), temporomandibular joints (39%), and sialography. Ten percent of all referrals were for recall examinations. The distribution of image modalities has changed through the years covered by this study. This study reflects a lower proportion of referrals reported as normal structures and their variations, than reported in a previous comparable study.