Intraoral Radiographs Research Articles

VISUALIZATION OF INCISIVE FORAMEN USING TWO INTRAORAL PERIAPICAL RADIOGRAPHIC TECHNIQUES

Background: Intraoral periapical radiographs are reported to show the incisive foramen as a typical anatomical landmark. In order to assess the visibility of the incisive foramen in the bisecting angle and paralleling angle approaches, as well as how visible it is in routine periapical radiographs, the current study was conducted. Methods: This descriptive cross-sectional study evaluated 90 intraoral periapical radiographs of maxillary central incisors. These were scored for visibility of incisive foramen by a radiographic expert using two intraoral radiographic techniques. The data was entered in Microsoft Office Excel sheet 2007 and calculated using SPSS version 20. Results: In both the paralleling and bisecting radiographs, the incisive foramen could be seen in a total of 63.8% and 36.2% of the images, respectively. Conclusions: The dentist must have a thorough awareness of how the incisive foramen appears on standard intraoral radiographs. Our research demonstrates that when compared to the bisecting angle technique, the paralleling technique delivers superior visibility of the incisive foramen. Therefore, it is recommended to use the paralleling technique approach to see the foramen.

A Literature Review on Dental Disease Diagnosis

Artificial intelligence (AI) has emerged as a transformative technology in various fields, including dentistry. This literature review provides an overview of recent research papers that explore the application of AI in dentistry and its impact on clinical practice. The selected papers cover a wide range of topics, including dental disease detection, dental imaging analysis, dental education, and diagnostic accuracy assessment. In the domain of dental disease detection, the use of AI algorithms has shown promising results in automating the detection of dental pathologies such as caries, periodontal diseases, and lesions. These algorithms have the potential to improve accuracy, enable early intervention, and enhance treatment planning. Furthermore, the integration of AI in dental imaging analysis has enabled advanced image interpretation and segmentation. Studies have demonstrated the effectiveness of AI algorithms in analyzing panoramic radiographs, cone-beam computed tomography (CBCT), and intraoral radiography, leading to improved identification of dental conditions such as root fractures and periapical radiolucent lesions. Moreover, the integration of AI in dental education has revolutionized the learning experience. Virtual reality simulations, computer-assisted learning, and AI-based assessment tools have enhanced student engagement, skill acquisition, and curriculum updates.Overall, this literature review highlights the potential of AI in transforming dentistry. The selected papers contribute to the growing body of knowledge on AI applications in dentistry and pave the way for further research and advancements in this field. The integration of AI has the potential to revolutionize dental practice, improve diagnostic accuracy, optimize treatment planning, and elevate the quality of patient care.

Microspatial distribution of trace elements in feline dental hard tissues: early life exposure to essential and toxic elements.

Trace elements play a key role in dental tissue development, as dental hard tissues accumulate both essential and toxic trace elements during mineralization. Characterization of the spatial accumulation pattern of trace elements may provide insight into exposure to toxic elements over time and to the nature of disease processes affecting the hard dental tissues. Here, we present the first report of the use of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) to map the microspatial distribution of multiple trace elements, essential and toxic, across feline dental hard tissues. Eleven teeth were extracted from 8 cats. Nine teeth were from 7 cats diagnosed with idiopathic tooth resorption on intraoral radiographs prior to extraction. Two teeth were included from a cadaver that had no signs of tooth resorption on intraoral radiographs. The normal dental tissue was analyzed from each sample using LA-ICP-MS to map the microspatial distribution of essential and toxic trace elements across feline enamel, dentin, and cementum. Results showed a higher accumulation of barium and strontium in coronal dentin as compared to root dentin. The timing of the accumulation mirrors nursing timelines seen in teeth from human and non-human primates, consistent with barium and strontium being sourced from maternal milk. Results also showed a higher uptake of lead in the coronal dentin, suggesting this lead exposure was likely passed from mother to offspring. This work characterizes a baseline for elemental distribution in feline teeth linked to early life exposure to toxic elements such as lead and provides a framework for future studies investigating long-term environmental exposures to trace elements, essential and toxic, and their involvement in feline systemic and dental diseases.

Diagnosis of Proximal Dental Caries Using Intraoral and Extraoral Bitewing Radiographs: A Narrative Review

Radiographic examination using intraoral bitewing (IOBW) radiography is an ideal examination to detect proximal carious lesions. Besides the risk of triggering gag reflex, the IOBW technique is susceptible to SARS-CoV-2 virus transmission through saliva-contaminated film or digital sensor. Examination using intraoral techniques during the COVID-19 pandemic should be avoided to minimize cross-contamination of the SARS-CoV-2 virus. The alteration from using IOBW to extraoral bitewing (EOBW) radiography can be a promising alternative to overcome these problems. This review article aims to describe the advantages of the EOBW technique and compares diagnostic performance of IOBW and EOBW radiographs in detecting proximal dental caries. The databases used for literature searching in the review include Google Scholar, PubMed, and Science Direct. The inclusion criteria were original articles, case reports, and English and Indonesian scientific textbooks published from 2010 to 2021. The exclusion criteria were article reviews and original articles that did not contain research methods. A total of 29 literatures were discussed in this narrative review. The EOBW technique is recommended during the COVID-19 pandemic to reduce the risk of cross-contamination in dental radiography. This technique ensures the patient for a more comfortable procedure, with shorter time needed and a wider field of view that allows it to be used to detect bone loss in the alveolar crest. Sensitivity, specificity, and area-under-curve in the IOBW technique were higher than in the EOBW. Nevertheless, EOBW shows good accuracy, so it can be used as an alternative technique for patients who find it difficult to undergo the IOBW technique, especially during the COVID-19 pandemic.

Evaluation of diagnostic accuracy of CBCT and intraoral radiography for proximal caries detection in the presence of different dental restoration materials

PurposeThis study aimed to assess the diagnostic accuracy of cone-beam computed tomography (CBCT) and digital intraoral radiography for the detection of proximal caries adjacent to amalgam, e.max porcelain, and metal-ceramic restorations (MCRs).Materials and methodsParallel intraoral radiographs were obtained from 40 posterior teeth using PSP sensors. To obtain CBCT scans, the teeth were first radiographed alone, and were then positioned next to a tooth with an amalgam restoration, MCR, and e.max porcelain crown, and radiographed again. Two blinded observers scored radiographs using a four-point scale (0: absence of proximal caries, 1: enamel caries, 2: carious lesion extending to the outer half of dentin, 3: carious lesion extending to the inner half of dentin). Tooth sections were made, and the grade of caries was determined under a light microscope at x12 magnification. The sensitivity, specificity, and accuracy of CBCT and intraoral radiographs were then calculated.ResultsArtifact-free CBCT scans and intraoral radiographs had the highest diagnostic accuracy (0.826 and 0.657, respectively) while CBCT images of the teeth next to the amalgam restorations (0.526) had the lowest accuracy. The diagnostic accuracy of CBCT images of the teeth next to the porcelain crowns and MCRs was 0.613 and 0.601, respectively.ConclusionArtifact-free CBCT images had higher diagnostic accuracy than intraoral radiography for the detection of all grades of proximal caries. The diagnostic accuracy of CBCT images of teeth adjacent to amalgam, porcelain, and MCRs was lower compared to intraoral radiographs and artifact-free CBCT images.

Accuracy of non-contact semiconductor X-ray analyzer for quality assurance in intraoral radiography: a comparison with ionization chamber dosimeter.

The aim of the present study was to evaluate the accuracy of a non-contact semiconductor X-ray analyzer for quality assurance in intraoral radiography, especially a comparison with an ionization chamber dosimeter. Intraoral radiography was performed with intraoral X-ray unit using the dental protocol at our hospital: tube voltage, 70kV; tube current, 7mA. Accuracy of dose and half-value layer (HVL) measurements was analyzed with a non-contact semiconductor X-ray analyzer and an ionization chamber dosimeter. Stability of the semiconductor sensor, effect of scattered radiation, and comparison of measured HVL between the ionization chamber and the semiconductor sensor were analyzed in this study. The values with the semiconductor sensor were tube voltage: 70.3 ± 0.2 kVp (degree of variability: 0.28%), dose: 454.1 ± 12.3μGy (degree of variability: 2.7%), and HVL: 1.91 ± 0.02 mmAl (degree of variability: 1.0%). With collimator, the dose with the semiconductor sensor and the ionization chamber decreased by 2.3 μ Gy and 5.2 μ Gy, respectively. The measured HVL of the semiconductor dosimeter was more than that of ionization chamber, and the semiconductor dosimeter was less than ionization chamber in variation of between without and with collimator. This study indicated the accuracy of a non-contact semiconductor X-ray analyzer for quality assurance in intraoral radiography, especially a comparison with an ionization chamber dosimeter. The semiconductor sensor can be useful for quality assurance in intraoral radiography.

Radiographic marginal bone level evaluation around two different tissue-level implant systems: a one-year prospective study.

Marginal bone loss, is a frequently reported variable in the evaluation of dental implants. The primary objective of this study was to evaluate radiographic marginal bone level changes around the two different tissue-level implant systems placed adjacently in the posterior maxilla or mandible. The influence of implant macro-geometry and vertical soft tissue thickness on marginal bone loss were also evaluated. Seven patients were included in the study and a total of 18 implants were analyzed. Each patient received two different implants placed adjacently in the maxilla or the mandible. The implants used in our study were either Straumann® SP cylindrical implants or JD Octa® tapered implants. During the surgery, vertical soft-tissue thickness was measured with a periodontal probe placed on the top of the bony crest and in the center of the future implant site. Healing abutments were then seated. Three months following implant placement, impressions were taken, and screw-retained metal ceramic prostheses were delivered. Standardized intraoral radiographs were taken immediately after implant placement and one year following implant loading in order to assess marginal bone level changes. Results showed a mean marginal bone loss of 0.55±0.5 mm for Straumann® SP implants and 0.39±0.49 mm for JD Octa® implants after one year of loading and the difference was not statistically significant between the two systems. A statistically significant correlation was found between soft tissue thickness and marginal bone loss; in sites with thin mucosal tissues (≤2 mm), there was significantly greater bone loss compared to sites with thick, soft tissues (> 2 mm) in both implants. Radiographic marginal bone loss was not statistically different between the two implant systems at the one-year examination period. Moreover, vertical soft tissue thickness influenced marginal bone loss regardless of the implant system used.

Radiopaque properties of polyetheretherketone crown at laboratory study

ObjectivesThere have been no reports on the radiopaque properties of new polyetheretherketone (PEEK) crowns for locating crowns during accidental ingestion or aspiration and detection of secondary caries, which is essential information for clinical application. This study aimed to investigate whether the radiopaque properties of PEEK crowns could be used to identify the site of accidental ingestion or aspiration and detect secondary caries. MethodsFour types of crowns were fabricated: three non-metal crowns (PEEK, hybrid resin, and zirconia) and one full metal cast crown (gold-silver-palladium alloy). Initially, the images for these crowns were compared using intraoral radiography, chest radiography, cone-beam computed tomography (CBCT), and multi-detector computed tomography (MDCT); computed tomography (CT) values were calculated. Subsequently, the images for the crowns placed on the secondary caries model with two artificial cavities were compared using intraoral radiography. ResultsThe PEEK crowns displayed the lowest radiopaque properties on radiography and very few artifacts were observed on CBCT and MDCT. On the other hand, the CT values of the PEEK crowns were a little lower than those of the hybrid resin crowns and considerably lower than the zirconia and full metal cast crowns. The cavity could be detected in the PEEK crown-placed secondary caries model through intraoral radiography. ConclusionsThis simulated study of radiopaque properties with four types of crowns suggested that a radiographic imaging system can be used to identify the site of accidental ingestion and aspiration of PEEK crowns and to detect secondary caries of the abutment tooth within a PEEK crown.

Assessment of the Occupational Radiation Dose from a Handheld Portable X-ray Unit During Full-mouth Intraoral Dental Radiographs in the Dog and the Cat - A Pilot Study.

Occupational radiation protection is an important consideration in small animal clinics world-wide. With the increased use of portable handheld X-ray devices in veterinary dentistry, concerns related to occupational radiation protection are being raised. Annual occupational dose limits for dental workers are expressed as Total Dose Equivalent (TDE) or Effective Dose. The permitted TDE can vary depending on the anatomical region, ranging from 50 millisieverts (mSv) for the external whole body exposure dose to 500 mSv for external exposure of the skin or an extremity. Although several studies have been performed in human dentistry to establish the amount of backscatter radiation produced using portable handheld X-ray devices, no similar research has been conducted in veterinary dentistry. This study aimed to determine the TDE while acquiring a full mouth intraoral radiograph set in dogs and cats and to estimate the TDE for a handheld X-ray device's operator. For this, the backscatter radiation dose recorded by three sets of monitoring dosimeters located in strategic anatomical areas of the operator was assessed after taking one hundred intraoral radiographs in each group. The study concluded that the backscatter radiation levels were far below the permitted annual occupational doses in the three patient groups of this study. Even though the portable handheld X-ray unit was demonstrated to be a safe dental radiographic unit regarding backscattering radiation, the operator's eye, ovary, and breast regions were exposed to unnecessary radiation.

The effect of different spatial resolutions and enhancement filters on radiographic detection of simulated furcation defects with intraoral digital radiography

The objective of this study was to evaluate the effects of spatial resolution and the application of enhancement filters in the diagnosis of simulated furcation defects and image quality with intraoral radiographs. Periapical images were acquired with photostimulable phosphor plates of molars in dry skulls (n=8) and mandibles (n=10) with 4 stages of furcation defect simulation. The plates were scanned in fast scan and high resolution modes to produce different spatial resolutions. Four image filters were applied. Six observers scored the detection of furcation defects. Mean values of area under the curve in receiver operating characteristic evaluation, accuracy, sensitivity, and specificity were calculated. Mean gray value (brightness), noise, and contrast-to-noise ratio (CNR) were calculated for enamel, dentin, and alveolar bone to evaluate image quality. Analysis of variance compared the values between the different spatial resolutions and filters. The significance of difference was established at P < .05. There were no significant differences in overall diagnostic values comparing image spatial resolutions and filters. Diagnostic outcomes were significantly better for the largest defects than the smallest lesions but were generally poor in detecting lesions. All structures showed greater brightness in high resolution. . Noise was greater in all structures with all enhancement filters except inversion. Dentin and alveolar bone exhibited more noise and lower CNR in high resolution. Varying spatial resolution and applying enhancement filters did not significantly affect the diagnosis of furcation defects.

Repetitive mild traumatic brain injuries in children of abuse

Repetitive mild traumatic brain injuries in children of abuse

Evaluation of Chitosan and Ferric Sulphate as Pulpotomy Agents in Primary Teeth: A Randomized Controlled Trial.

Preservation of healthy pulp tissue is detrimental for the function and vitality of carious primary teeth. Several hemostatic agents used for pulpotomy in primary teeth showed adverse effects on viable surrounding structures. To assess the clinical and radiographic success of chitosan (CH) pulpotomy in primary molars and to compare it with ferric sulphate (FS). A total of 40 carious lower primary second molars in 5-9 years children are selected for conventional pulpotomy technique. Over radicular stumps, FS is placed for 15 seconds in the control group, and CH for 4-5 minutes in the study group, followed by intermediate restoration (IRM). Intraoral periapical radiographs were taken immediately after 1 week and after 3rd and 6th months. The clinical and radiographic success rate is assessed and statistically analyzed. Chitosan (CH) showed a 65% radiographical and 100% clinical success rate, and FS showed 55 and 95%, respectively. Chitosan (CH) showed better results than FS as a pulpotomy agent in primary teeth. Guguloth S, Jamnapalli SR, Patloth T, et al. Evaluation of Chitosan and Ferric Sulphate as Pulpotomy Agents in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(2):223-226.

Virtual reality technology using a 360° video: development and evaluation of an educational tool for intraoral radiography using the bisecting angle technique

Intraoral radiography (IOR) practice education is essential for dental students. However, the risk of radiation exposure has resulted in the use of textbooks to learn IOR. Thus, a new educational tool that can effectively use fewer shots or provide indirect experience when practice is not feasible is needed. In this study, we developed a new educational tool called “educational media for the bisecting angle technique” using virtual reality (EMBAT-VR) and evaluated the user experience among students. IOR was divided into 12 steps for 14 teeth, and a scenario was prepared from the perspectives of the operator and patient. On the basis of this scenario, the IOR was reenacted and recorded using a 360° camera. The tool was built on a head-mounted display using the Unity Engine. Eighty-four students were enrolled to evaluate the task performance, browsing search, and satisfaction on a 5-point Likert scale; the corresponding values for the tests were 3. 78 ± 0.70, 3.88 ± 0.76, and 4.01 ± 0.71, respectively. EMBAT-VR was used to investigate the satisfaction (user experience). Responses to 21 questions from 24 students who used traditional textbooks (control group) and 22 students who used the VR educational tool (experimental group) were statistically analyzed using the Mann–Whitney U test. A statistically significant difference was observed between the experimental (4.16 ± 0.64) and control (2.69 ± 0.54) groups. In the usability evaluation, EMBAT-VR presented with a higher score than traditional textbooks. Nonetheless, its effect when performing actual IOR imaging needs follow-up research.

A Gradually Increasing Painless Swelling in the Upper Maxilla – A Case Report of Peripheral Giant Cell Granuloma

Peripheral giant cell granuloma (PGCG) is a benign inflammatory hyperplasic, exophytic lesion of unknown etiology. It develops on the gingiva and alveolar ridge. It could represent a local reaction to trauma or irritation. Management requires a surgical excision of the lesion and elaborate recall due to possible recurrence. This article describes the clinical and histopathological features and management of PGCG as it appeared in the maxillary anterior region of a 35-year-old female patient with a chief complaint of painless swelling in the anterior maxillary region. Intraoral periapical radiograph showed the features that suggested a soft-tissue lesion causing cupping resorption of the maxilla. The lesion was completely excised, biopsy was performed after that, under local anesthesia, and the tissue was examined histopathologically. The lesion was diagnosed as PGCG after thorough clinical, radiologic, and histopathologic examinations. A surgical excision of the growth, including its base, as well as the eradication of any underlying causes should be included in the therapy due to its fast growth pattern and propensity to resorb bone with subsequent tooth movement. Regular postsurgical follow-up is crucial to preventing the tumor from reoccurring.

An evaluation of 1654 premolars transplanted in the posterior region-A retrospective analysis of survival, success and complications.

The aim of this retrospective analysis was to evaluate the survival, success and possible complications of transplanted premolars in the posterior region subdivided by developmental stage and patient age. This study included patients who underwent tooth transplantation between April 2004 and December 2021. A total of 1654 premolars were transplanted into 1243 patients. Tooth mobility, oral hygiene and periodontal parameters were clinically evaluated. Intraoral radiographs were used to evaluate pulpal and periodontal healing, and root formation. The cumulative survival rate was calculated using the Kaplan-Meier method. Data were subdivided into three groups based on the stage of root development and patient age. The mean age at surgery was 14.5 years. The main indication for transplantation was agenesis, followed by trauma and other indications, such as impacted or malformed teeth. A total of 11 premolars were lost during the study period. The overall survival and success rates in the immature premolar group after an observation period of 10 years were 99.7% and 99.4%, respectively. High survival and success rates (95.7% and 95.5%, respectively) were also observed when fully developed premolars were transplanted into the posterior region of adolescents. In adults, the success rate after 10-year follow-up is 83.3%. Transplantation of premolars with developing and fully developed roots is a predictable treatment modality.

Comparative Evaluation of Two Implant Designs Based on Bone Loss and Stability with Early Loading Method.

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents.

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm2 and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm2 and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (p ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, p ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics-reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.

Interdisciplinary approach for diagnosis and management of the tooth with type III palatogingival groove

Palatogingival grooves (PGGs) are developmental anomalies well known for causing endodontic and periodontal diseases to the teeth that have no evidence of caries or trauma. It is a rare developmental defect that frequently exhibits the palatal aspect of maxillary anterior teeth. The aim of this case report is to diagnose PGG using cone-beam computed tomography (CBCT) and manage it with an interdisciplinary approach by endodontic and periodontic intervention. A 20-year-old healthy female patient came with a chief complaint of foul smell and discharge of pus from the gum region. During clinical examination, a sinus opening and deep periodontal pocket were noticed with respect to the maxillary left lateral incisor. The tooth showed mild tenderness to percussion and a negative response to thermal and electric pulp testing. The intraoral periapical radiograph showed a vertical radiolucent line with periapical radiolucency, giving suspicion of PGG, which was confirmed by CBCT investigation. The diagnosis of pulp necrosis with chronic periapical abscess was made. After root canal treatment, surgical intervention was done and sealed the groove with Biodentine. This case report shows the successful outcome of a tooth associated with PGG after a 9-month follow-up. The tooth associated with this anomaly can be correctly diagnosed and planned with CBCT, and successfully treated using an interdisciplinary approach with a bioactive restorative material.

351 Trends Between Periodontitis and Medial Arterial Calcification in Undiagnosed Type II Diabetes Mellitus

OBJECTIVES/GOALS: The overall objective of this study is to determine if medial arterial calcification (MAC) is an independent predictor of diabetes and to evaluate the relationship between MAC, periodontitis and Type II diabetes mellitus. METHODS/STUDY POPULATION: A retrospective case-control model analyzing radiographs for periodontitis and MAC to identify potential biomarkers for underlying systemic conditions, such as diabetes. Charts of patients attending UPENN School of Dental Medicine clinics between 2015 and 2022 were reviewed. Demographics, medical and dental history, diabetic status (identified by POC blood glucose level, fasting blood glucose and/or A1C), and medication history were documented amongst other variables. Patients aged 18 years or older with diabetes and having full mouth intraoral radiographs (FMX), panoramic radiographs and CBCTs were included. Patients with radiographs of poor quality were excluded. Multivariate analysis was used to determine possible associations between diabetes and periodontitis among persons with or without MAC. RESULTS/ANTICIPATED RESULTS: In our pilot study involving 28 participants, 53% of the population with moderate or severe periodontitis had MAC. By the Fisher’s Exact Test, there was an association, meaning those with more periodontal disease are more likely to have MAC (p=0.014). Sixty-three percent of patients with diabetes had MAC, while 19% of patients without evidence of diabetes also had MAC, (p=0.067). There was not enough evidence of association between diabetes and presence of MAC at this time, due to a small sample size, however there was a high prevalence of MAC among the diabetics. We hypothesized that periodontitis, a condition that shares many risk factors with diabetes would also be associated with incident MAC. Findings from this study will be key for the implementation of preventive screening protocols and referral systems. DISCUSSION/SIGNIFICANCE: Diabetes is on the rise and about half of diabetics are undiagnosed. CBCT imaging frequently used in dentistry can detect incidental findings such as MAC. This study has the potential of detecting statistically significant links between MAC, periodontitis and diabetes, hence serving as a sensitive radiographic biomarker for diabetes.

A Comparative Evaluation of Soft and Hard Tissue Changes Around Dental Implants Placed With and Without Platelet-Rich Fibrin.

A patient's ability to maintain a healthy bone-implant interface seems to be a major predictor of implant longevity over the long term. The implant surface is protected from the oral environment, the bone, and the implant itself by the peri-implant tissues. Platelet-rich fibrin (PRF) has been shown to help in the regeneration of bone and other connective tissues. Since there has been inadequate information on the role of PRF in maintaining soft tissue integrity and crestal bone changes, the present study aimed to evaluate these challenges clinically and radiographically in human patients who had dental implants placed with PRF. There were a total of 15 patients who were recalled for the analysis, and they were split into two groups. PRF was used to complete the implant procedure in the experimental group, but PRF was not used in the control group. Cone beam computed tomography (CBCT)was used to evaluate the amount of alveolar bone prior to dental implant placement and intra-oral periapical radiograph (IOPAR) for postoperativeassessment. Gingival index, plaque index, probing depths, papilla bleeding index, and crestal bone changes were used to document clinical limits. IOPAR using a similar approach was used to evaluate the crestal bone level alterations. Patients were evaluated clinically and radiographically for changes in the peri-implant soft tissue and crestal bone during implant placement, sixand nine monthspostoperatively. From baseline (p=0.02) to six months (p=0.04) and nine months (p=0.04), both groups showed changes in crestal bone loss and soft tissue although the changes in the test group were smaller. Soft tissue changes showed significant differences for probing depth and papilla index score at baseline and at the end of the six and nine months (p<0.05), whereas no significant difference was noted with bleeding index and plaque index score during the follow-up (p>0.05). To conclude, the provided data demonstrated that the local injection of PRF during implant placement has the potential to favorably stimulatebone formation, and may be used as a therapeutic adjuvant in the clinical setting of implant placement.