Intraoral Periapical Radiographs Research Articles

Assessment of Risk Factors and Prognostic Predictors for Endo-Perio Lesions in Indian Cohorts: An Observational Study.

Endodontic and periodontal tissues exhibit a significant interrelationship, whereby pathologies affecting one tissue can precipitate the involvement of the other. The primary objective of this study was to assess the risk factors associated with endo-perio lesions (EPLs). The secondary objective was to assess the prognostic predictors for such lesions and the prevalence rate of EPLs involving both pulpal and periodontal tissues in Indian cohorts. A prospective observational study was conducted on 2170 teeth with EPLs in Indian adults aged > 18 years. A detailed history of smoking, tobacco chewing, and the development of EPLs was obtained from all patients. Detailed periodontal and endodontic examinations were conducted by two calibrated examiners. Intraoral periapical radiographs (IOPAs) were obtained to diagnose EPLs. The chi-square test of association was used to analyze the association between independent and dependent variables, and the strength of association was presented by Pearsoncontingency coefficient (r). Logistic regression analysis was performed to identify reliable factors for diagnosing EPLs. A statistical significance threshold of 0.05 was established. The prevalence of EPLs involving pulpal and periodontal tissues was 29.49%. Type 1 lesions (EPLs involving only pulpal tissue) were most commonly seen at 41-45 years of age, type 2 lesions (EPLs involving primary pulpal and secondary periodontal tissue), and type 3 lesions (EPLs involving only periodontal tissue) at 26-30 years of age, and type 4 lesions (EPLs involving primary periodontal and secondary pulpal tissue) at 31-35 years of age. The pulp was found to be non-vital in all cases of type 3 lesions, and faulty restoration or improper root canal treatment (RCT) was the main risk factor for such lesions. Occupational trauma was found to be the most common risk factor for type 3 and type 4 lesions. Smoking, age, tooth type, occlusal trauma, faulty restorations and RCT, presence of caries, periapical pathology, periodontitis, bone loss, and pulp vitality were significantly associated with EPLs. Pulp vitality and bone loss were two prognostic predictors of EPLs.

Quality Assessment of Periapical Radiographs Taken by Dental Assistants Using the Recent Faculty of General Dental Practice (FGDP) Guidelines.

Periapical radiographs play a pivotal role in dentistry, offering invaluable insights essential for various dental procedures. This study aims to systematically assess the quality of intraoral periapical (IOPA) radiographs evaluating adherence to the recent guidelines established by the Faculty of General Dental Practice (FGDP). A cross-sectional study was conducted at the University College of Dentistry (UCD), employing a non-probability consecutive sampling technique to acquire a calculated sample of 300 IOPA radiographs from the operative, oral surgery, and oral radiology departments. Two senior faculty members evaluated the radiographs according to the recent two-tier grading system outlined in the FGDP guidelines. The study revealed that 197 (65.67%) of the assessed radiographs were diagnostically acceptable, while 103 (34.33%) were deemed diagnostically unacceptable. Contrast problems emerged as the most prevalent issue, accounting for 85 (28.3%) of the cases. Other common problems included incorrect film positioning in 66 (22%), incorrect vertical cone angulation in 37 (12.3%), incorrect horizontal cone angulation in 11 (3.7%), and incorrect processing in 15 (5%) of the IOPA radiographs. This study revealed that approximately two-thirds of the IOPA radiographs were deemed diagnostically acceptable. However, contrast issues emerged as the predominant concern affecting image quality. These findings highlight the critical importance of continuous quality improvement initiatives in radiographic practices to enhance diagnostic precision and ensure optimal patient care.

A clinical approach in the management of endodontic-periodontal lesions of endodontic origin: Two case reports with 2-year follow-up

Abstract The term “endodontic-periodontal” (endo-perio) lesions describe lesions with the involvement of pulpal tissues and the periodontium of a tooth. These cases regarding the diagnosis, management, and prognosis of teeth are challenging for the clinician. The aim of this article was to discuss two cases of endo-perio lesions in molars with large periapical radiolucencies. Two healthy male individuals came with a chief complaint of pain during chewing. During clinical examination, a deep periodontal pocket of 10 mm and 7 mm, respectively, was noticed in both cases, and large periapical radiolucencies extended to the apical region were confirmed by the intraoral periapical radiographs. Evaluation of the symptoms together with the clinical findings determined the diagnosis endo-perio lesion of endodontic origin and accordingly the decision for the management. The successful treatment outcome with the periodontal healing in both cases was observed soon 40 days after orthograde root canal treatment. Conservative endodontic therapy was the key to the healing of the periapical tissues in endo-perio lesions of endodontic origin. The clinical approach as well as the 2-year follow-up of those compromised endo-perio lesions showed that endodontic therapy resulted in the healing, whereas no periodontal therapy was performed and the initial decision-making was confirmed.

Alveolar bone loss is a significant contributor to tooth loss in dentate HIV+ patients: A retrospective study.

The study objectives were to determine tooth loss prevalence and to investigate the relationship between tooth loss and potential risk factors among adult dentate HIV+ patients on newer antiretroviral therapy (ART) regimens. Health records of 450 human immunodeficiency virus (HIV)-infected individuals were surveyed. Eighty-eight records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. We collected data on demographics, systemic risk factors, oral health, and HIV disease measures. Caries exposure and alveolar bone loss (ABL) were radiographically assessed. Eighty-eight percent of patients showed tooth loss. Patients with ABL ≥15% had a higher number of missing teeth (p<.01). Stepwise regression analyses indicated that tooth loss was positively associated with age (β=0.45, p<.01) and ABL (β=0.39, p<.01). By contrast number of years on ART was negatively associated with tooth loss (β=-0.28, p<.05). Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. The number of years on ART seem to improve oral health behavior and reduce tooth loss.

Comparative evaluation of the accuracy of six different apex locators in working length determination of molars using intraoral periapical radiographs: An in vivo study.

One of the crucial steps in endodontic treatment is determining the working length (WL). There are various methods for performing this procedure, one of which is an electronic apex locator (EAL) measurement. The aim of this study was to determine the accuracy of six EALs, i.e.. Root ZX, Root ZX Mini, Propex PiXi, Innvopex-1, Woodpex III, and Raypex 6 for WL estimation in the mandibular first molars. The study included 180 root canals with symptomatic irreversible pulpitis, divided into six groups using different apex locators. WL determination was compared with intraoral periapical radiographs. Results were categorized as accurate, short, or long. The data were statistically analyzed. ROOT ZX had an accuracy of 96.7%, Root ZX Mini had an accuracy of 93.3%, PiXi had an accuracy of 90.0%, Innvopex-1 had an accuracy of 90.0%, Woodpex III had an accuracy of 86.7%, and Raypex 6 had an accuracy of 83.4%, respectively. There was a statistically nonsignificant difference between groups (P < 0.05). Newly developed apex locators, such as the Innvopex-1, have shown accuracy comparable to well-established EALs like the Root ZX. This highlights the importance of conducting more extensive, large-scale research to confirm and validate their effectiveness.

Radiographic Errors in Intraoral Periapical Radiographs

Background: Radiographs are considered as pivotal aid in the diagnosis and treatment planning of various Oro-dental pathologies. Changes in the quality of radiographs may lead to misinterpretation, which results in incorrect diagnosis and treatment planning. The technical and processing errors can largely influence the radiographic interpretation. Both paralleling and bisecting angle techniques can have both technical and manual errors. Aims: To estimate the frequency of radiographical errors in conventional radiographs taken by undergraduate dental students. Materials And Method: Thousand (1000) dental radiographs taken by undergraduate students were examined. Patient's age ranged between 5 -75 years. X- ray films were examined on X-ray film viewer and were classified according to type of errors and anatomical distribution. Results: The study aimed to identify common faults encountered during routine radiography. The most frequently observed error was Improper Vertical Angulation. Interns performed better in obtaining radiographs compared to Final year students. Keywords: Radiographic errors, Dental students, Bisecting angle technique.

Comparison of the Extent of Root Resorption in Maxillary Anterior Teeth Retracted using Regular Temporary Anchorage Devices (TADS) Versus Conventional Anchorage Methods: A Retrospective Study

Aim The aim of this study will be to compare the amount of root resorption of maxillary anterior retracted with anterior TADs,regular TADs and without skeletal anchorage.  Materials and methods: Samples for the study will be the patients undergone orthodontic treatment at the Department of Orthodontics,K.V.G. Dental College and Hospital, Sullia Sample size of 45 patients will be divided in to 3 groups . ,Group 1 consists of patients treated with anterior TADs, Group2 consists of patients treated with regular TADs and Group 3 consists of patients treated without skeletal anchorage for retraction of maxillary anteriors. Root resorption will be measured by comparing pretreatment and post treatment intraoral periapical radiographs (IOPAR) radiographs.  Result- The study meticulously compared root resorption levels among three groups: Conventional, Anterior Temporary Anchorage Devices (TADs), and Posterior TADs. Anterior TADs exhibited the highest mean root resorption, significantly higher than both Conventional and Posterior TADs. Statistical analyses confirmed these differences, highlighting the impact of anchorage method on root resorption. Pairwise comparisons and confidence intervals further supported the findings, emphasizing the nuanced variations observed.

Radiation exposure during orthodontic treatment: risk to children and adolescents.

To estimate radiation risk to children and adolescents during orthodontic treatment by retrieving number and type of radiographs from the patient records. Radiographs, along with justifications for radiation exposure, were obtained retrospectively from the patient records of 1,790 children and adolescents referred to two Swedish orthodontic clinics. Data were grouped according to treatment stage: treatment planning, treatment, and follow-up. Estimated risk was calculated using the concept of effective dose. Each patient had received around seven radiographs for orthodontic purposes. The most common exposures during treatment planning were one panoramic, one lateral, and three intraoral periapical radiographs. A small number of patients received a tomographic examination (8.2%). Few justifications for treatment planning and follow-up, but more in the actual treatment stage, had been recorded. The most common examinations were to assess root resorption and the positions of unerupted teeth, or simply carry out an unspecified control. The estimated risk of developing fatal cancer was considered low. The radiation risk from orthodontic treatment was equivalent to about 5-10 days of natural background radiation. Children and adolescents sometimes undergo multiple radiographic examinations, but despite the low radiation burden, accumulated radiation exposure should be considered and justified in young patients.

Does Implant Placement Below the Ridge Reduce Crestal Bone Loss? A Split-Mouth Randomized Controlled Clinical Trial.

Reducing crestal bone loss (CBL) around implants allows for soft tissue stability and long-term success. The aim of the present study was to evaluate the extent of CBL in implants placed with the implant shoulder at the equi-crestal level and 2 mm below the alveolar ridge at 2, 12, 36, and 60 months. A split-mouth randomized controlled clinical trial was conducted by selecting subjects with Kennedy Class IV partial edentulism of the lower jaw. Two implants were inserted, of equal length and diameter, one equi-crestal and the other sub-crestal, in the site corresponding to the lateral incisor. Intraoral periapical radiographs with Rinn centering devices were performed at the time of implant insertion (T0), at 2 (T1), 12 (T2), 36 (T3), and 60 months (T4). Descriptive statistics and the T-test were used, setting the significance to P⩽ 0.05. Twenty-five subjects were recruited, with a mean age of 65 years (SD 9.88, range 42-82). No subject dropped out. A total of 50 implants were inserted, 25 at crestal and 25 sub-crest level. At the 60-month follow-up, no implant or prosthetic failure was recorded. An average loss of -0.81 mm was recorded in the crestal implant group (n.25; SD: 0.40; max-min: -1.6 - -0.1) while in the implants positioned below the crest the average CBL was -0.87mm (n.25; SD: 0.41; max-min: -2 - -0.2); however, the higher CBL in the sub-crestal implant group was not statistically significant (P&#61;0.65). Comparing the mean CBL values of the two groups at the various follow-ups, a greater crestal bone resorption was recorded in sub-crest implants between T0 and T1 (-0.25 vs -0.1) and between T1 and T2 (-0.39 vs -0.23), while in subsequent follow-ups a greater, statistically significant (P&#61;0.01), crestal bone loss was recorded in ridge implants between T3 and T4 (-0.05 vs -0.18). Over time, therefore, the extent of CBL seems to be reduced in implants placed below the crest, with bone retention above the implant shoulder. Ultimately, although the position of the implant shoulder relative to the crestal ridge doesn't affect the CBL, sub-crestal placement is recommended in order to reduce the risk of exposure of the rough surface of the implant.

Comparing the Diagnostic Accuracy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in Identifying Interdental Bone Loss: An Observational Study

ABSTRACT The evaluation of conventional two-dimensional radiography is crucial in making the diagnosis of periodontitis. Radio-visiography (RVG) is one of the digital imaging modalities that have received significant recognition as a replacement for film-based radiography due to its improved image quality, quick turnaround time, and minimal radiation dose. In order to compare the diagnostic efficacy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in identifying Interdental Bone Loss, the present investigation was carried out. A cross-sectional observational study was conducted among 96 patients prospectively. Radiographs were exposed using a Gendex Oralix AC machine. Statistical data was analyzed using IBM SPSS statistical software using appropriate statistical tests. For both age categories, the radiographic method yielded a higher mean score than the periodontal probe method. The mean scores were noted to be higher following surgery. The radiographic approach recorded a greater mean score when gender groups were compared than the periodontal probe, which had a lower mean score. The mean scores after surgery were noted to be lower than the radiography approach and higher than the periodontal probe. The results demonstrate the radiographic technique’s significant advantage over clinical tests in determining furcation regions as well as its superior accuracy in spotting periodontal disintegration over clinical probing.

Association of genetic polymorphism of interleukin 1-alpha and interleukin 1-beta with external apical root resorption in orthodontic patients

Objective > To assess the allele rs 1143634 in IL-1β and rs1800587 in IL-1α in patients for orthodontically induced external apical root resorption (EARR).Material and methods > Intra-oral periapical radiograph (IOPA) of maxillary incisors of 142 Patients were evaluated for resorption at two time points; before the start of fixed mechanotherapy (T1) and after one year of treatment (T2). The individuals with root resorption< 2mm were categorized as a control group(Group 1; n=90), and resorption >2mm were categorized as case group (Group 2; n=52). Buccal swabs of all patients were taken and DNA could be isolated in 95 out of 142 samples (group 1 {n=58}, group 2 {n=37}) which were then screened for the selected two polymorphic targets to determine the nucleotide status of these targets. Tetra-primer ARMS PCR reactions were carried out using all 4 primers for each polymorphism.Results > rs11800587 was not associated with risk of EARR in any inheritance model. Chi-square test for association of alleles with EARR revealed that rs1143634 was associated with the risk of EARR in an allelic model in such a way that A allele of this SNP increased the risk of EARR 4 folds [OR = 4.375; p=0.016]. However, the adjusted level of significance using the Holm-Bonferroni method for rs1143634 was p<0.010 for A and G comparison rendering the results non-significant.Conclusion > SNP rs1143634 and SNP rs11800587 were not associated with risk of EARR in any inheritance model.

En masse retraction of anterior teeth through rapid periodontal distraction by a retraction screw: A randomized control trial

Rapid distraction of the periodontal ligament is an effective method to shorten the orthodontic treatment time. The objectives of the present study were to assess the effects of an HYCON device (Adenta GmbH, Germany) on the rate of en masse retraction of the anterior teeth, duration of retraction, anchorage loss, root resorption, and soft tissue changes. This study was conducted on 60 female patients aged >18 years, divided randomly into two equal groups: Group 1 comprised 30 patients with HYCON, and group 2 comprised 30 patients with nickel-titanium closed coil springs. Skeletal, dental, and soft tissue changes were evaluated on pre- and post-retraction lateral cephalograms, and the rates of anterior tooth movement and anchorage loss were assessed monthly on the dental casts of the patients. Root resorption was assessed using intraoral periapical radiograph. Student's t test was used for the analysis of parametric data, and the Mann-Whitney U test was used for nonparametric data. HYCON significantly shortened the retraction duration by 3 months. The rate of anterior teeth retraction was two times faster in group 1, compared with group 2. There was a significant difference in the anchorage loss between the groups in only first 2 months of treatment. Group 2 showed significantly more root resorption and soft tissue changes than group 1 (P < 0.05). HYCON is an effective device for significantly shortening the duration of retraction with anchorage loss of 2 to 2.5 mm. However, careful monitoring for possible root resorption should be performed.

Diagnostic Accuracy of Cone Beam Computed Tomography and Periapical Radiography for Detecting Apical Root Resorption in Retention Phase of Orthodontic Patients: A Cross-Sectional Study.

Objectives: This clinical study aimed to evaluate and compare the diagnostic accuracy of intraoral periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting external apical root resorption (EARR) in orthodontic patients during the retention phase. Methods: The research involved 41 Caucasian patients who had undergone comprehensive orthodontic treatment, with a total of 328 teeth analyzed. The Kappa values for inter- and intra-examiner agreement were high for both PR and CBCT, indicating a robust level of agreement among examiners. The study used a four-point scale for classifying EARR. Results: This study showed comparable accuracy, sensitivity, and specificity between PR and CBCT when using the most stringent criterion of "Definitely present". The data suggested that CBCT outperformed PR when using a less stringent criterion ("Definitely present" or "Probably present"), particularly for maxillary incisors. However, overall diagnostic performance, as measured by the area under the ROC curve, showed only a slight advantage for CBCT over PR. Areas under the ROC curve range between 0.85 and 0.90 for PR and between 0.89 and 0.92 for CBCT. According to DeLong's test, there is no evidence to conclude that the area under the ROC curve is different for PR and CBCT. Conclusions: Both PR and CBCT are accurate diagnostic tools for identifying EARR, with PR being deemed more suitable for routine clinical use due to its cost-effectiveness and lower radiation exposure. The findings emphasize the importance of considering the risk-benefit ratio when deciding on imaging modalities for monitoring EARR in orthodontic patients.

Comparative Evaluation of the Anesthetic Efficacy of Needle-Free Anesthesia and Conventional Anesthesia in Patients With Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Introduction Pain is the primary reason for which most of the patients seek endodontic treatment. Local anesthesia is considered to be the most important step in the procedure to reduce the pain. However, the majority of the patients do not cooperate due to the fear of syringe anesthesia. The aim of this clinical trial was to compare the anesthetic efficacy of needle-free anesthesia and conventional anesthesia in patients with symptomatic irreversible pulpitis undergoing root canal therapy. Materials and methods A total of 54 patients were enrolled in the study, and the treatment was administered by a single operator. The initial assessment of vitality included cold testing, heat testing, and electric pulp testing. Preoperative pain was assessed using the Visual Analog Scale (VAS) before the administration of anesthesia. Local anesthesia was administered according to the group assigned: Group 1 (conventional anesthesia) and Group 2 (needle-free anesthesia). The pain was assessed during the administration of anesthesia. Following the administration of anesthesia, the vitality of the tooth was evaluated using cold testing, heat testing, and electric pulp testing. Subsequently, the tooth was isolated with a rubber dam, and the access cavity was prepared. The pain was assessed during access cavity preparation and during the first file insertion. Working length was determined using an apex locator (Root ZX Mini, J Morita, Saitama, Japan) and was confirmed using intraoral periapical radiographs. Later on, further treatment was carried out. Results A total of 54 participants were included in this clinical trial. There was no significant difference in mean age distribution between the two groups (p=0.852). Considering the frequency distribution of gender, there was no significant difference; however, Group 1 had more female participants (59.3%) compared to Group 2 (33.3%). There was a significant reduction in the mean pain score in Group 2 compared to Group 1 during the delivery of anesthetic agents (p=0.000). Conclusion Needle-free anesthesia proves to be equally effective as the conventional syringe system in patients experiencing symptomatic irreversible pulpitis undergoing root canal treatment. However, it is noteworthy that patients exhibited greater comfort levels with needle-free anesthesia systems specifically during the administration of the anesthetic solution.

Evaluation of Carisolv in the Chemico-Mechanical Removal of Carious Dentine in Primary Molars (In vivo study)

Caries removal by the Chemo-mechanical technique involves the application of chemical agents, to cause a selective softening of the carious dentine and facilitate removal by gentle excavation. Carisolv is one such new chemical agent used in this minimal invasive technique of carious dentine removal. The aims of this study was to evaluate the efficacy of Carisolv in the chemo-mechanical removal of carious dentine in primary teeth, the time taken for caries removal and to evaluate the restorations radiographically. Forty primary 1st and 2nd molars with dentinal carious lesions were excavated using this technique of caries removal. After isolation of the involved tooth, the Carisolv " new gel" marketed by Mediteam Dental AB (Goteborg, Sweden) was applied then the superficial softened carious dentine was gently excavated and scraped using a spoon excavator, the procedure repeated until the cavity was free from caries and the cavity was checked for remaining caries using an explorer. The time taken for the removal of carious dentine, beginning from the application of the gel until the completion of the procedure was evaluated using a stopwatch. After the placement of the restoration an intra-oral periapical radiograph was taken for immediate evaluation and after a period of six months, the longevity of the restorations and the presence of secondary caries at the restoration- dentine interface were evaluated radiographically. The statistical analysis of the results showed that the soft carious dentine was removed more effectively than the hard carious dentine and the removal of the soft carious dentine required a shorter period of time (4.96±0.99) minutes when compared to the removal of hard carious dentine (6.09±1.04) minutes and on radiographic evaluation of the restoration, none of the treated lesions showed the presence of secondary caries. In conclusion, the chemico-mechanical caries removal technique using Carisolv proved to be an effective atraumatic treatment modality with potential interest for use in clinical pediatric dentistry.

Comparison of Root Canal Morphology in Intraoral Periapical Radiographs and Cone-Beam Computed Tomography: An In vitro Study

Backgrounds and Objectives: Intraoral periapical radiographs (IOPAR) are routinely used to fulfill the preoperative, par-operative and postoperative imaging needs in endodontic treatment. IOPAR is not a sensitive tool for identification of complex root canal morphology with failure rates of up to 34%. Cone-beam computed tomography (CBCT) provides three-dimensional imaging and has been recommended when endodontic imaging needs cannot be met by IOPAR. There is a need to understand which anatomic parameters are better viewed in CBCT and which on IOPAR. Hence, this study is planned to compare the root canal morphology on IOPAR and CBCT and correlate with chemically cleared tooth. Methods: One hundred recently extracted teeth were collected and subjected to IOPAR and CBCT scanning. A total of six root canal morphologies were compared in both the imaging modalities and with the teeth itself after making it chemically transparent. Results: CBCT and IOPAR showed a good agreement in detection of fractured tooth roots with P &lt; 0.005. However, CBCT was better than IOPAR in detection of the number of accessory canals, ramifications, and obliterations in the root canal and fractures with P &lt; 0.005. IOPAR showed reduced artifacts with P &lt; 0.005. During working length measurement, both CBCT and IOPAR showed increased values than the cleared teeth although CBCT was more accurate. Conclusion: We can conclude from this study CBCT is more accurate in detection of root canal morphologies in comparison to IOPAR.

Presence of radix entomolaris in primary mandibular first molars: A review of rare entity

Numerous developmental anomalies with respect to crown and root are commonly seen in permanent dentition and while rarely in the primary dentition. Radix entomolaris (RE), an extra root seen on the distolingual aspect of mandibular molars, is one such aberration found. The presence of extra root in primary mandibular first molars is of extreme rarity and such two reports its significance had been discussed. Two children of 5- and 7 years old reported to the pediatric and preventive dentistry department with a chief complaint of pain in the right and left mandibular back teeth region, respectively. A diagnosis of chronic irreversible pulpitis was made in both cases with the accidental appraisal of RE in both the primary first molars on intraoral periapical radiographs. Standard pulpectomy was performed in both cases. Pediatric dentists as well as clinicians should update regarding the abnormal morphologies of primary molars and its diagnostic including treatment strategies.

Assessment of Perception of Pain with E-Speed Film, CCD Sensor and Photostimulable Phosphor Plates for Intraoral Radiographs in Children using Three Pain Rating Scales

Abstract Background: Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales. Aim: To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong–Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS). Materials and Methods: A sample of 35 children aged 6–12 years were divided into two groups: group 1 (6–8 years) and group 2 (9–12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure. Statistical Analysis Used: A one-way analysis of variance (ANOVA) test and paired-samples t-test are used. Results: The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6–8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P &lt; 0.001). Conclusion: It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.

Glandular Odontogenic Cyst of Maxillary Anterior Region: Report of a Rare Case

Glandular Odontogenic Cyst (GOC) is a rare odontogenic cyst that indicates the pluripotency of the oral epithelium due to the exhibition of glandular characteristics. It is more prevalent in the mandibular anterior region and shows a predilection in males. The cyst was first described by Padayachee and van Wyk in 1987. It has non distinct clinical and radiographic features but very characteristic histopathological features. Here, the authors report a rare case of GOC occurring in a 36-year-old male patient in the maxillary anterior region. An intraoral periapical radiograph revealed a large unilocular radiolucency from the apex of 11 to the mesial aspect of 15. The cyst was enucleated under local anaesthesia, and endodontic treatment was performed for the associated teeth. No recurrence was seen at the two-month follow-up.

The Morphology of Peri-Implantitis Bone Defects: A Retrospective Study on Periapical Radiographs.

The aims of this study were to assess the morphologic features of peri-implant defects, as measured on 2D intraoral radiographs, and to investigate the possible correlation between such morphology and other parameters related to the position and characteristics of the implant or the implant-supported prosthesis. Implants with peri-implantitis were included in this retrospective study. Data collected were related both to the patients and to the position/characteristics of the implants and the implant-supported prosthesis. Measurements of the morphologic defects were performed by two operators on digitalized intraoral periapical radiographs. Results and Conclusion. In total, 73 implants in 27 patients were included. The measurements of the periapical radiograph suggested that the most common defect conformation was crateriform, with both intraosseous and horizontal components. An inverse correlation was found between the extension of the peri-implant lesion and the time between the radiographic assessment and the implant placement. The total lesion area was strongly correlated to oral hygiene levels. No correlations between lesion extension and smoking, diabetes, history of periodontal were found. In conclusion, the results from this 2D radiographic study showed the prevalence of crateriform peri-implant defects, with a hygiene-correlated extension, perceptible on the mesial and distal aspects; 3D imaging could be used when available for further research and clinical investigation.