Digital Panoramic Radiographs Research Articles

Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America

Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (β=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (β=0.97, P=0.001) and the probability of transmigration increased (β=1.05, P<0.001). One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.

Radiographical Diagnostic Evaluation of Mandibular Cortical Index Classification and Mandibular Cortical Width in Female Patients Prescribed Antiosteoporosis Medication: A Retrospective Cohort Study.

Osteoporosis is often detected late and becomes severe because of a lack of subjective symptoms. Digital panoramic radiography (DPR) has been reported to be useful for osteoporosis screening based on the morphological classification of the mandibular inferior cortex. The purpose of this study was to evaluate the sensitivity and specificity of the mandibular cortical index (MCI) in the diagnosis of osteoporosis in a group of patients who were and were not using antiosteoporosis medication (AOM). Three hundred and fifty female patients aged 40 years or older who had DPR imaging performed during a 6-year period from December 2015 to February 2022 met the selection criteria. Two examiners recorded mandibular cortical width and MCI from the images. These results were statistically examined together with the patients' demographic data. Forty-nine patients were using AOM (13 nonbisphosphonate/denosumab and 36 bisphosphonate/denosumab). MCI type 3 was the most common in the AOM group. In the MCI classification, DPR imaging among the AOM group was more sensitive (0.95) than that of the control group. This method of estimating osteoporosis based on MCI classification using DPR images has high sensitivity, especially in patients using AOM, suggesting that this method is useful as a screening test.

Evaluation of the Effect of Medications Used in Children with Rheumatic Diseases on Dental Maturation.

The study's main objective is to compare dental maturation in healthy children and those with rheumatic diseases. It also aims to determine the age of children with Pediatric Rheumatic Diseases (PRD), specifically focusing on comparing those receiving medical treatment to those who are not, and to differentiate between biological and non-biological medication recipients, to identify potential differences. This observational cross-sectional study was conducted to assess the dental maturation stages in a cohort of 278 children (126 boys, 152 girls) aged between 6 and 14 years between September 2021 and December 2023. The study population included individuals with PRD requiring dental treatment and systemically healthy children. Digital panoramic radiographs were utilized for the evaluation of dental maturation in both groups. A statistically perfect agreement was found among the dental age (DA) calculated by the researchers (ICC=1.000; p&lt;0.01). A statistically perfect level of agreement was found between the chronological age (CA) of the cases and the DA measured by the Willems method (ICC=0.921; p&lt;0.01). It was found that the difference between the estimated DA and CA was higher in girls and boys in the PRD group who were taking medication. No significant differences were found in DA estimated based on gender and treatment status among individuals with PRD. The Willems method tended to underestimate the age of girls receiving biological treatment while overestimating the age in all other groups.

Is Tonsillolith a Protective Factor Against Covid-19 ?

Object: Tonsilloliths are the most common calcifications of the head and neck region and are also caused by inflammation of the pharyngeal lymphoid tissue. Changes that may occur in the lymphoid tissue due to tonsilloliths may affect the response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This radiological study aims to investigate the potential effect of tonsilloliths on Coronavirus disease 2019 (COVID-19). Material and Methods: This study, which has a cross-sectional retrospective design, was carried out by evaluating the digital panoramic radiographs taken before the pandemic period of the patient group (n=402) who had COVID -19, who applied to the Akdeniz University Faculty of Dentistry Oral, Dental and Maxillofacial radiology clinic, and the control group (n:400) who did not have COVID -19, in terms of the presence of tonsilloliths. All Statistical analyzes were performed with SPSS version 22.0 and P &amp;lt;0.05 was considered to indicate statistical significance. The Chi-square test and Student's t-test were performed. Results: The incidence of tonsillolith was significantly lower in the patient group (29.1%) than in the control group (45%) (p &amp;lt;0.01). Both groups were similar in terms of age, gender, and systemic disease status (p = 0.1, 0.08, and 0.08, respectively). Tonsilotiths were located both uni and bilaterally (p = 0.09), but unilateral ones were more common on the right side (p = 0.04). Conclusions: The results of this study showed that high-frequency tonsilloliths may have a protective effect against COVID -19.

Comparison of mandibular morphometric parameters in digital panoramic radiography in gender determination using machine learning.

This study aimed to evaluate the usability of morphometric features obtained from mandibular panoramic radiographs in gender determination using machine learning algorithms. High-resolution radiographs of 200 patients aged 20-77 (41.0 ± 12.7) were included in the study. Twelve different morphometric measurements were extracted from each digital panoramic radiography included in the study. These measurements were used as features in the machine learning phase in which six different machine learning algorithms were used (k-nearest neighbor, decision trees, support vector machines, naive Bayes, linear discrimination analysis, and neural networks). To evaluate the reliability, we have performed tenfold cross-validation and we repeated this 10 times for every classification process. This process enhances the reliability of the results for other datasets. When all 12 features are used together, the accuracy rate is found to be 82.6 ± 0.5%. The classification accuracies are also compared using each feature alone. Three features that give the highest accuracy are coronoid height (80.9 ± 0.9%), condyle height (78.2 ± 0.5%), and ramus height (77.2 ± 0.4%), respectively. When compared to the classification algorithms, the highest accuracy was obtained with the naive Bayes algorithm with a rate of 84.0 ± 0.4%. Machine learning techniques can accurately determine gender by analyzing mandibular morphometric structures from digital panoramic radiographs. The most precise results are achieved by evaluating the structures in combination, using attributes obtained from applying the MRMR algorithm to all features.

Identification and classification of pulp calcifications in posterior teeth according to dental condition using digital panoramic radiography and cone beam computed tomography.

To compare digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) in the detection and classification of pulp calcifications in posterior teeth in relation to tooth condition and its location. 250 patients with simultaneous DPR and CBCT scans were selected from a dental image bank. For each posterior tooth, its condition was registered (healthy, restored, or decayed). The presence of calcifications was assessed and classified according to location (coronal or radicular) and type (total obliteration, partial obliteration, narrowing, and no calcification). Chi-square and McNemar tests were used to compare DPR and CBCT results, with a significance level of 5%. DPR diagnostic values were calculated using CBCT as reference. Decayed and restored teeth showed a significantly (p < 0.001) higher prevalence of pulp calcifications than healthy teeth in both imaging exams. There was a significant discrepancy between the imaging modalities in the identification of calcifications (p < 0.001), especially for radicular calcifications of maxillary teeth (DPR = 55.2%; CBCT = 30.9%). In the case of coronal calcifications, there was a greater discrepancy between CBCT and DPR in the mandibular teeth (10.7%) than in the maxillary teeth (7.7%). Overall, DPR presents higher sensitivity (0.855) than specificity (0.483) for pulp calcifications detection. DPR considerably overestimates pulp calcifications in posterior teeth, as compared to CBCT. A higher prevalence of pulp calcifications is related to decayed and restored teeth.

Comparative efficacy of digital panoramic radiograph and cone beam computed tomography in locating mandibular foramen.

The aim of this study was to compare the accuracy of panoramic radiographs (PAN) with cone-beam computed tomography (CBCT) in locating the position of the mandibular foramen (MF). A total of 100 patients who underwent CBCT and panoramic imaging were included in the study. The location of the MF was evaluated anterior-posteriorly and superior-inferiorly on both CBCT and panoramic radiographs. Measurements were taken by two examiners, reviewed by a radiologist, and intra-examiner variability was assessed. A comparison of statistical analysis was performed using the Mann-Whitney U test, independent and paired t-test. A p-value ≤0.05 was deemed significant. The mean age of the patients was 35.03 years, with 51% females and 49% males. CBCT and panoramic radiographs showed comparable accuracy in locating the left (p=0.937) and right (p=0.371) MF anterior-posteriorly. In the superior-inferior dimension, the accuracy of CBCT and panoramic radiographs were comparable in locating the right (p=0.292) and left (p=0.640) MF. The gender-based accuracy of PAN and CBCT radiographs in locating the right (p=0.353) and left (p=0.985) MF was comparable. The study concludes that panoramic radiographs showed comparable accuracy in effectively locating MF in comparison to CBCT. The influence of gender and anatomic location (right and left sides of MF) on MF identification with panoramic radiographs was insignificant. Digital panoramic radiographs are an effective tool in accurately identifying MF location in clinical practice.

Evaluation of Developmental Dental Anomalies in an Adult Dentate Iraqi Sub-Population of Sulaimani City by Using Panoramic Radiographs

Objective: The present study attempts to evaluate the prevalence of developmental dental anomalies in patients aged 18 years and over by using panoramic radiographs among the Kurdish subpopulation in Sulaimani city.&#x0D; Methods: Seven hundred and ninety-four OPGs between 2010 and 2022 were evaluated retrospectively in this study. Using panoramicradiography to evaluate the frequency of dental anomalies in shape, structure, number, and size.&#x0D; Results: The prevalence of dental anomalies diagnosed by panoramic radiographs was 26.6% among the sample. Anomalies of shapewere the most common abnormalities, followed by number, size, and structure. The most common anomaly seen in this study wasdilaceration (18.52%), followed by hypodontia and microdontia (both 16.67%), taurodontism, and macrodontia (16.05.%). Lessfrequent sub-types were amelogenesis imperfecta, peg-shaped lateral incisors and ghost teeth, accounting for 0.62%.&#x0D; Conclusions: Tooth shape anomalies were the most prevalent forms of developmental dental defects among the Kurdish subpopulation in Sulaimani city. Dilaceration, hypodontia, microdontia and taurodontism were the most prevalent categories ofabnormalities. The study confirmed that racial variables play a role in the incidence of dental anomalies. In addition, digital panoramicradiography is a beneficial method for the detection of dental abnormalities. Importantly, patient management and the treatment design are dependent on an early diagnosis.

Gender determination using mandibular ramus on digital panoramic radiography: A retrospective study in Delhi NCR population

Gender determination using mandibular ramus on digital panoramic radiography: A retrospective study in Delhi NCR population

Risk factor analysis for perioperative complications in impacted third molar surgery - a single center experience.

The surgical removal of impacted third molars is usually carried out by an oral/maxillofacial surgeon. Two specific risks of surgical removal of impacted third molars are oroantral communication (OAC) when extracting ​​upper third molars and hypesthesia of the inferior alveolar nerve (IAN) ​​when extracting lower third molars. The aim of this study is to determine the distribution of complications in deeply impacted third molar surgery, to identify specific risk factors influencing the most common perioperative (OAC, IAN hypesthesia) and to compare these results with other studies. The clinical findings, digital panoramic radiographs, intra- and postoperative data of 80 patients with a total of 232 impacted third molars that had been subjected for tooth extraction, from December 2022 and August 2023, were collected and analyzed. Perioperative complications (IAN hypesthesia, OAC, hypesthesia lingual nerve, postoperative bleeding, postoperative infection) were identified. A risk analysis for OAC and IAN hypesthesia was performed regarding perioperative data. Overall, the rate of OAC for the right upper third molar was 12.8% and for the left upper third molar 15.6%. The complication rates regarding transient hypesthesia were 8.1% for the left IAN and 7.3% for the right IAN. The distance to maxillary sinus, the depth score according to Pell and Gregory, the bone coverage score, the operation time, the tooth's angulation and the type of surgeon (oral surgeon, DMD) were identified as significant risk factors for the occurrence of OAC. The minimum distance to IAN, the bone coverage score, the total operation time and the operation by an oral surgeon (DMD) were identified as significant risk factors for hypesthesia of the IAN. Next to the risk factors from above, the present study is one of the first showing that patients who were primarily operated on by an oral surgeon (DMD) and not a maxillofacial surgeon (MD, DMD) showed higher rates of OAC and IAN hypesthesia in impacted third molar extraction. The results of this study can serve as a baseline for further studies to investigate complication patterns in impacted third molar surgery.

Comparison of periapical radiography, panoramic radiography, and CBCT in the evaluation of trabecular bone structure using fractal analysis.

The aim of this study is to compare imaging techniques to evaluate trabecular bone structure using Fractal Analysis (FA). Fifteen sheep hemimandibles were used for this study. Digital images were obtained using periapical radiography, panoramic radiography, and cone-beam computed tomography (CBCT). CBCT imaging was performed in standard (STD) and high-resolution (HR) modes. FA was conducted using ImageJ 1.3 software with the box-counting method on the images. The fractal dimension (FD) values were analyzed by the statistical software Jamovi 1.6.23. Statistical significance was accepted as p < 0.05. The highest mean FD value was the FD on digital periapical radiographs (PaFD) (1.28 ± 0.04), and the lowest mean FD value was the FD on standard resolution cone-beam computed tomography images (STD-CBCTFD) (1.12 ± 0.10). Although there was no statistically significant difference between the PaFD and the FD on digital panoramic radiographs (PanFD) (p = 0.485), the PaFD was found to be significantly higher than STD-CBCTFD (p < 0.001), and the FD on high-resolution cone-beam computed tomography images (HR-CBCTFD) (p = 0.007). The PanFD was found to be significantly higher than the STD-CBCTFD (p = 0.004). According to our results, in the evaluation of trabecular bone structure using FA, periapical radiographs and panoramic radiographs have similar image quality for assessment of the FD. On the other hand, CBCT results did not correlate with results from any of the other techniques in this study.

The Comparative Study on the Mental Index and Panoramic Mandibular Index in Thai Osteoporotic, Osteopenic, and Non-osteoporotic Patients: A Cross-sectional Study

Background Osteoporosis is one of the clinical problems in the elderly. Many previous studies focused on the index obtained from dental radiography as an adjunctive tool, which is considered beneficial for the screening of osteoporosis. Objective The purpose of this study was to compare the Mental Index (MI) and Panoramic Mandibular Index (PMI) acquired from panoramic radiographs in osteoporotic, osteopenic, and non-osteoporotic patients. Methods This research was approved by the Ethics Committee for Human Research, Srinakharinwirot University (certification number SWUEC-061/2562E). This study compared 150 osteoporotic patients undergoing treatment at the HRH Princess Maha Chakri Sirindhorn Medical Center with age-sex matched to 150 non-osteoporotic patients undergoing dental treatment at the Dental Hospital, Faculty of Dentistry, Srinakharinwirot University, using digital panoramic radiographs. MI and PMI were collected and analyzed using an independent T-test and Pearson correlation. Results The mean age of the 300 participants in the study was 57.82±12.25 years, while the mean age of the osteoporotic and non-osteoporotic patients was 57.95±12.30 years and 57.69±12.19 years, respectively. The mean MI for osteoporotic patients and non-osteoporotic patients was 0.314±0.088 cm and 0.3840±0.073 cm, respectively. Similarly, the mean PMI for osteoporotic patients and non-osteoporotic patients was 0.302±0.092 and 0.342±0.064, respectively. A significant difference in MI and PMI was observed between osteoporotic and non-osteoporotic patients (p=0.00). Conclusion Osteoporosis has a statistically significant effect on MI and PMI (p&lt;0.05).

To Determine the Association of Elongated Styloid Process and Eagle’s syndrome Using Digital Panoramic Radiograph: A Retrospective Study

To Determine the Association of Elongated Styloid Process and Eagle’s syndrome Using Digital Panoramic Radiograph: A Retrospective Study

Mandibular Bone Height Measurements for Tooth Implantation by Using Film and Digital Panoramic Radiograph

An important objective of the preoperative radiographs evaluation of the implant is to determine the height and width of the bone available for implant insertion. The aim of the study is to confirm the ability of film and digital panoramic radiographs by measuring the distance from the crest of alveolar bone to the roof of the mandibular canal, also compare each type of radiographs using with the tracing chart reading which is a standard measure for both implant length and diameter that supply with the implant system.In this study thirty nine patients needing implants in the lower premolars and molars region in both sides were included. Digital panoramic radiograph were examined by using computerized analysis by software of dimax system , by measuring the distance from the crest of alveolar bone to the roof of the mandibular canal , while in film panoramic radiograph, a ruler was used to measure the distance from the crest of the alveolar bone to the roof of the mandibular canal with the utilization of a viewing box. it was found that film panoramic radiograph had higher value than digital panoramic radiograph in all sites of the teeth specially in the molar region.

Cone Beam Computed Tomography (CBCT) Aid in the Management of Apical Root Resorption of Impacted Maxillary Canines and Physiologically Erupted Maxillary Canines after Orthodontic Treatment

The aim of this study is to evaluate the effects of orthodontic traction, by means of light and controlled forces, on root length in impacted maxillary canines and physiologically erupted maxillary canines. Disinclusion of impacted maxillary canines is a frequent procedure in orthodontics due to their higher incidence of impaction. The effects of orthodontic traction, by means of light and controlled forces, can lead to a resorption of the root length in impacted and physiologically erupted teeth. Therefore, apical root resorption is a common phenomenon that must be taken into consideration. Apical root resorption measurements were taken using pre-treatment CBCTs and pre-treatment and post-treatment digital panoramic radiographs of 52 patients who underwent fixed-appliance treatment by using light and controlled orthodontic forces. The experimental group consisted of 26 patients with one impacted maxillary canine. The control group consisted of 26 patients without any impaction. Apical root resorption was calculated from root lengths before and after orthodontic treatment. In the experimental group, impacted canines with incomplete apical formation underwent root elongation, while impacted canines with completed root formation went through apical root resorption. The latter showed a slightly greater apical root resorption (0.2 mm) compared to the control group (95% confidence interval; p = 0.04). The extent of root resorption of impacted canines was significantly higher than that of physiologically erupted ones. However, this differential resorption did not compromise the structural and functional integrity of the involved teeth. The orthodontic treatment performed with light and controlled forces is, therefore, a procedure to be considered acceptable and safe.

Distribution and impaction patterns of third molars in a sample of German population: Retrospective analysis in a high turnover maxillofacial department

BackgroundThe surgical removal of impacted third molars is considered a routine procedure for oral and maxillofacial surgeons. However, the distribution of impacted molars varies among different populations. A study into impaction patterns in the German population is currently not described. The aim of this retrospective study is to determine patterns of impacted third molars in a sample of German population, to identify gender and age specific differences as well as further risk factors for impacted molar extraction and to compare these results with other studies. Materials and methodsThe clinical findings and digital panoramic radiographs of 84 patients with a total of 243 impacted third molars that had been subjected for tooth extraction, from January to September 2023, were collected and analyzed. All third molars were analyzed according to Winter´s angulation, Pell and Gregory Score of depth and relationship to ramus. Furthermore, inferior alveolar nerve and maxillary sinus proximity were identified through a newly developed risk score and an analysis of patient´s gender and age regarding impaction patterns was performed. ResultsNo significant gender specific differences were found regarding the impaction patterns. Third molar angulations significantly differed regarding patient´s age (cut-off 26 years). In comparison, third molar depth, bone coverage, nerve approximity and angulation patterns differed from the results of other populations. ConclusionThe results of this study can serve as a baseline for further studies of third molar impactions in the German population to minimize perioperative complications in impacted third molar surgery.

Salivary biochemical parameters in people living with HIV on ART and dental caries: a cross-sectional study in Monastir, Tunisia

BackgroundStudies regarding salivary biochemical parameters and dental caries in adult people living with HIV/AIDS (PLWHA) are scanty. Aim: To investigate salivary biochemical parameters and dental caries in adult PLWHA who are on antiretroviral therapy (ART) and compare the findings with people negative for HIV infection.MethodsThe study included 50 HIV positive individuals as a test group (TG) and 50 HIV negative individuals as a control group (CG). Dental examination was performed according to WHO guidelines to assess DMFT. Digital panoramic radiographs were taken to detect additional infectious foci. Non-stimulated saliva was collected between 9 and 12 a. m for 5 min to evaluate 18 biochemical parameters and salivary flow rate (SFR). Parametric and non parametric tests were used according to data distribution. The level of significance was set at p < 0.05%.ResultsPatients’ mean ages and M/F sex ratios for TG and CG were 38.80 ± 9.69 y/o. vs. 37.98 ± 13.47 y/o. and 3.54 vs. 2.33, respectively. Higher means of decayed teeth were recorded in TG, 4.47 ± 3.00 vs. 3.88 ± 2.81 in CG with no significant difference (p = 0.41). Means of filled teeth were significantly lower in TG 2.38 ± 2.16 vs. 4.16 ± 3.35 in CG (p = 0.01), respectively. No statistical significant difference was noted in DMFT indices between the 2 groups (8.04 ± 6.90 vs. 8.52 ± 6.24, p = 0.71). The following salivary parameters were significantly lower in TG compared to CG, respectively: mean SFR 0.44 ± 0.18 ml/min vs. 0.61 ± 0.26 ml/min; median levels of sodium and chlorides, 4 mmol/L and 13.5 mmol/L vs. 9 mmol/L and 19 mmol/L (p < 0.001) and uric acid, 103.50 mmol/L vs. 163 (p = 0.009). However, higher median levels were recorded with calcium, 1.09 mmol/L vs. 0.54 (p < 0.001) and sIgA 23 mg/dl vs. 5 mg/dl (p < 0.001). In TG, a positive correlation was found between DC, potassium, urea, and chlorides (p < 0.05). Salivary renal and hepatic biomarkers were comparable between the two groups.ConclusionsPLWHA have shown an alteration in some salivary parameters, more decayed teeth and less filled teeth. Preventive measures should be implemented to lower dental caries and enhance accessibility to oral care services. In addition, saliva can be utilized to monitor oral and general health status among PLWHA on ART.

Correlation between the presence of tonsilloliths and the bone defects by periodontitis on imaging analysis: a pilot study

BackgroundVery recently, a significant relationship between tonsilloliths and dental plaque-related pathologies was reported using digital panoramic radiographs. Their dynamics over time suggest that tonsilloliths may be in a permanently active phase that functions to remove foreign matter. The aim of the study was to evaluate the relationship between the occurrence of tonsilloliths and the extent of periodontitis.MethodsA total of 608 patients who underwent both CT and panoramic radiographs were included in the study. Both of two imaging were retrospectively and independently assessed with respect to the presence of tonsilloliths detected on CT and panoramic radiographs, and bone defects caused by periodontitis detected on panoramic radiographs. The type of retrospective study is case-control. Then, the differences between age groups were evaluated with respect to the degree of bone resorption and its correlation with the presence of tonsilloliths. The relationships between categorical variables were assessed using Pearson’s correlation coefficient or Spearman’s correlation coefficient.ResultsThere was a significant relationship between tonsilloliths on CT and the extent of the bone defect on panoramic radiographs (Spearman’s correlation coefficient, r = 0.648, p = 0.043). In addition, there was a significant difference in the extent of the bone defect caused by periodontitis between subjects with and without tonsilloliths in the 60 to 69-year-old group (Mann-Whitney U test, p = 0.025), 70 to 79-year-old group (Mann-Whitney U test, p = 0.002), and 80 to 89-year-old group (Mann-Whitney U test, p = 0.022), but not in other age groups (Mann-Whitney U test: under 9-year-old group, p = 1.000; 10 to 19-year-old group, p = 1.000; 20 to 29-year-old group, p = 0.854; 30 to 39-year-old group, p = 0.191, 40 to 49-year-old group, p = 0.749; 50 to 59-year-old group, p = 0.627; ≥90-year-old group, p = 1.000).ConclusionsThe presence of tonsilloliths was related to the extent of periodontitis because the structures were responding dynamically.

A comparison of estimated age based on pulp volume from cone beam computed tomography (CT) images and panoramic radiography data with chronological age.

This retrospective study was conducted to evaluate different methods for dental age estimation in children and to examine the feasibility of using cone beam computed tomography (CBCT) data for age estimation. A total of 200 radiographic records (both digital panoramic radiographs and CBCTs) were acquired from 100 children aged 9 to 16 years, all taken on the same dates. Radiographic data was acquired from archived records and included both panoramic radiography and CBCT data belonging to the same individual. CBCT was used when panoramic radiographic data was insufficient. The pulp volume and pulp/tooth volume ratio of the left first molar teeth in the mandible were calculated from the CBCT data using MIMICS software. In addition, age was estimated by the Demirjian and Willems methods from data obtained from panoramic radiography images. Statistical analyses and linear regression analysis were performed as necessary. There was a statistically significant difference between the mean difference between the Demirjian method and chronological age, and between the Willems method and chronological age (p < 0.001). Statistically significance was achieved in a linear regression model created from pulp volume (R2 = 0.098) and pulp/tooth volume ratio (R2 = 0.395) data for the estimated dental age analysis (p < 0.001) and a negative correlation was observed with chronological age. When compared estimated dental age from CBCT data with chronological age, the pulp/tooth volume ratio method yielded results closer to chronological age than using only pulp volume data. When considering both panoramic radiographic age estimation methods and age estimation methods using CBCT data, we found that the results obtained with the Willems method, a panoramic radiographic age estimation technique, provided the closest results to the chronological age. More contributions should be made to the literature regarding the feasibility of age estimation using pulp and tooth volume as an alternative method.

Fractal analysis and radiomorphometric indices: comparison of mandibular bone structure changes on digital panoramic radiographs of smokers

Purpose: The purpose of the study was to assess how smoking affected the mandibular bone structure using a variety of radiomorphometric indices and fractal dimension (FD) analysis.&#x0D; &#x0D; Materials and methods: 56 patients (28 smokers and 28 non-smokers) were included in this retrospective study. In the trabecular bone of the mandible, eight areas of interest of 45x45 pixels were chosen, and fractal dimension analysis was carried out. All digital panoramic radiographs were used to measure the mandibular index and mandibular cortical width. All values were compared between groups. Utilizing the Shapiro-Wilk and Mann-Whitney U tests, collected data were evaluated.&#x0D; &#x0D; Results: There was a statistically significant difference between the groups in ROI4 and ROI8, but not in the mean FD values of ROI1, ROI2, ROI3, ROI5, ROI6 and ROI7 in the mandibular trabecular bone. No statistically significant differences between groups were seen for PMI and MCW measures (p &gt; .05). The intraclass correlation coefficient (ICC) values for the FD, PMI and MCW measurements were excellent.&#x0D; &#x0D; Conclusion: The trabecular bone structures of the anterior of the mental foramen and the condyle were different in smokers. There was no difference in cortical bone structures.