Lingual Cortical Bone Research Articles

Three-Dimensional Evaluation of Impacted Mandibular Third Molar Angulation and its Impact on Lingual Cortical Bone Thickness: A Retrospective Cone-Beam Computed Tomography Study

Background: The removal of impacted lower third molars surgically can cause complications, and the lingual cortical bone thickness in this region becomes a determining factor in the risk of perforation and injury to the lingual nerve (LN). This study was conducted to assess the relationship between different angulations of impacted lower third molars based on Winter’s classification and the thickness of the lingual cortical bone. Variations in lingual cortical bone thickness among the genders were evaluated as well. Methods: Cone-beam computed tomography (CBCT) scans of 50 impacted lower third molar teeth of 50 patients (26 men and 24 women) were evaluated in this study. The lingual bone thickness surrounding impacted lower mandibular teeth was measured at three key points, namely, the cemento-enamel junction of the second mandibular molar, the mid-root of the impacted third molar, and the root apex of the impacted third molar. Mesiodistal angulation and buccolingual angulations of the impacted mandibular third molars underwent investigation. Statistical analysis was conducted using SPSS 23. Data were analyzed using the independent sample t test, one-way ANOVA, multiple linear regression analysis, and Fisher’s exact test. Results: There was a statistically significant relationship between the means of lingual cortical bone thickness surrounding the third molars based on Winter’s classification of third molars impacted at mesiodistal angulation (P=0.00). Regarding gender, buccolingual angulation demonstrated a statistically significant relationship among the means of lingual bone thickness around the third molars (P=0.022). Conclusion: In our study, the thickness of the lingual cortical bone was notably affected in the middle and apical areas of the impacted third molar region. The variable position of the LN near the mandible third molar region was significant in dental procedures due to its proximity. Three-dimensional (3D) imaging CBCT provides preoperative risk assessment that reduces preventable complications that cannot be answered by 2D imaging.

The morphology of alveolar bone of the mandibular second and third molars in skeletal Class III patients.

To investigate the alveolar bone morphology of the mandibular second and third molars in skeletal Class III patients from a buccolingual direction. Sixty skeletal Class III patients were recruited. The alveolar bone width, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination and the third molar on alveolar bone width and cortical bone thickness were evaluated. To explore the effect of third molar extraction on alveolar bone morphology, the measurements before and after third molar extraction were compared. The impacted third molar had significantly greater alveolar bone width and thicker buccal cortical bone at the cervical third of the molar, while the erupted third molar had greater alveolar bone width at the apical third. Three weeks after third molar extraction, these advantages would weaken owing to the reconstruction of the alveolar bone. Patients with lingually inclined molar were observed to own thicker lingual cortical bone. Males tended to have greater alveolar bone width, but no significant differences were shown in this study. The growth of the third molar and the second molar lingual inclination affect the alveolar bone morphology of the mandibular second and third molars significantly, but gender has trivial effects on the morphology. The alveolar bone morphology of the mandibular second and third molars would change 3 weeks after third molar extraction.

Assessing the Co-relation between Mandibular Flare and Thickness of Lingual Cortex in Relation to the Third Molars: A Retrospective Cross-sectional Study.

To assess the co-relation between mandibular flare and thickness of lingual cortex in relation to the third molars. Retrospectively obtained computed tomography (CT) data of 26 patients was used after classifying them into respective skeletal malocclusion groups (classes I, II, and III). Thickness of lingual cortex was measured at crestal, middle, and apical levels in mandibular third molar region. Two angular and two linear measurements were used to measure mandibular flare. Angular measurements included the angle between condylion (Co) and menton (Me), and between gonion (Go) and menton (Me). Linear measurements included bigonial and bicondylion widths. The two angular measurements did not differ significantly among the three skeletal malocclusion groups. Contrastingly, bicondylion width differed significantly among the three groups. Class II group showed no significant correlation between mandibular flare and lingual cortical thickness. Class III group demonstrated a significant negative correlation of linear and angular measurements with cortical bone thickness. Bicondylion width was significantly more in Class III group than in other skeletal groups, which proved an increased mandibular flare in patients with Class III malocclusion. Increase in mandibular flare was associated with decreased thickness of lingual cortical bone.

Mandibular cortical bone remodeling characteristics in patients with extraction: A cone-beam computed tomography study

This study evaluated the labial and lingual cortical bone remodeling characteristics of mandibular central incisors after retraction, which remain controversial among orthodontists. Cortical bone remodeling and central incisor movement of 33 patients (aged 23.64 ± 4.30 years) who underwent mandibular first premolar extraction and incisor retraction at the crestal (S1), midroot (S2), and apical (S3) levels were analyzed using superimposed cone-beam computed tomography images on the basis of voxel-based registration of the mandibular stable region. Multivariate linear regression was used to explore the relationships between labial bone remodeling/tooth movement (BT) ratios and factors such as the ANB angle, mandibular plane angle (Mp-SN), and incisor movement patterns. The patients were divided into 4 groups according to the lingual cortical bone remodeling condition and the relationship between posttreatment incisor roots and the original lingual cortical bone border. At the 3 levels (S1, S2, and S3), the classifications of cortical bone remodeling of the mandibular incisors were calculated; t tests were used to compare the amount of labial and lingual bone remodeling, BT ratios, and lingual bone remodeling/root over the original border (BRo) ratios. The mean labial BT ratios at all 3 levels were close to 1. Multivariate linear regression indicated that the tooth movement pattern negatively correlated with the BT ratio at the S2 and S3 levels (P<0.05). Lingual bone apposition occurs when the root penetrates the original lingual cortical bone border in most patients. BRo ratios can more accurately reflect the inherent remodeling ability of the lingual cortical bone than BT ratios. The mean lingual BRo ratios were (1) S1 level: mandibular left central incisor (T31), 0.87 ± 0.25 and mandibular right incisor (T41), 0.86 ± 0.25; (2) S2 level: T31, 0.81 ± 0.12 and T41, 0.80 ± 0.22; and (3) S3 level: T31, 0.76 ± 0.20 and T41, 0.83 ± 0.26. There was no significant difference between labial BT ratios and lingual BRo ratios at the S2 and S3 levels. The amount of labial cortical bone resorption caused by mandibular incisor retraction showed varied relationships with the amount of tooth movement. Bodily retraction may decrease the labial BT ratios at the S2 and S3 levels. Active lingual cortical bone apposition occurred when the roots penetrated the original lingual border and exhibited strong remodeling ability.

Localization of Mandibular Canal in Dentulous and Edentulous Regions

Objectives: Retrospective determination of the changes in the mandibular canal (MC) course in men and women in the second premolar, first molar and second molar regions of the dentulous and edentulous mandible.&#x0D; Methods: In CBCT images of 274 patients aged 18-88 years who were systemically healthy, the distances of the outer cortex of the MC to the mandible superior, lingual, inferior and buccal cortical bone border were measured in the right and left mandible 2nd premolar, 1st molar and 2nd molar regions. In these regions, the differences in MC course between left and right hemimandible, dentulous and edentulous, and males and females were examined by independent t-test and paired t-test (p&lt; .05).&#x0D; Results: As a result of the statistical analysis, statistical significance was observed in the linear measurements of the MC to the superior cortical bone border in dentulous and edentulous patients in the relevant regions. In female and male patients, the distance of the MC to the inferior cortical edge of the mandible in the dentulous and edentulous dentition was statistically less in females. The superior distance of the mandible was found to be less in the edentulous regions than in the dentulous regions.&#x0D; Conclusions: The course of the MC in the posterior mandible is generally close to the inferior and lingual wall, but it changes direction towards the superior and buccal regions as it approaches the mental foramen. Furthermore, in women, the MC is located closer to the inferior border of the mandible compared to men.

Accessory lingual mental foramen: A case report of a rare anatomic variation.

The mandibular nerve and the mental foramen have occasionally shown variations in its anatomy. This report aims to present a case of lingual mental foramen recognised on three-dimensional cone beam computed tomographic imaging (CBCT). Routine Orthopantomogram (OPG) and CBCT images were evaluated to assess the status of impact third molars in a 31-year-old female who had visited the dental clinics in our institution. The OPG image failed to reveal any anatomic variation in the position of the mental foramen. On tracing the course of the mandibular canal in CBCT images, two foramina were traced at the region of premolar. One opened towards the buccal cortical plate at the normal position of the mental foramen and an accessory lingual mental foramen had an opening on the lingual cortical bone at the same level as the mental foramen. Understanding variations of the mental foramen is extremely essential in dentistry to carry out successful anaesthetic or surgical interventions and to avoid complications such as nerve damage or excessive bleeding.

Radiological features of Stafne mandibular bone cavity in panoramic image and cone beam computed tomography

BackgroundStafne mandibular bone cavity (SMBC) is an asymptomatic radiolucent lesion observed in the mandible on X-ray images, with well-defined borders. This lesion does not require treatment, and size changes are very rare. The purpose of this article is to summarize the radiological and clinical features of SMBC, aiming to prevent misinterpretation of this benign lesion as other pathologies and aid in differential diagnosis within the field of dental practice.MethodsA total of 32 patients who visited our hospital and were radiologically diagnosed with SMBC based on cone-beam computed tomography (CBCT) and panoramic images between 2005 and 2021 were included in this study. Among them, surgical intervention was performed in one case. Gender and age distribution of the patients, radiographic location and size of the lesion, relationship with the mandibular canal in CBCT, presence of cortical bone erosion in the mandibular lingual area in panoramic images, and the amount of residual cortical bone on the affected side in CBCT were investigated.ResultPatients were 26 men (81.3%) and 6 women, with a mean age of 54.3 years. The average horizontal and vertical length was 16.6 mm and 10.6 mm. Out of a total of 32 cases, 29 cases were found in the posterior region of the mandibular body, while 3 cases were in the angle of the mandible. Lesions located below the mandibular canal were observed in 29 cases, while lesions involving the mandibular canal were present in 3 cases. Erosion of the mandibular lingual cortical bone was observed in 11 cases (34.4%), while 21 cases (65.6%) showed no erosion on panoramic images. Among the total of 14 cases (43.8%) where the cortical bone on the affected side was invaded, the average residual cortical bone thickness was 1.1 mm.ConclusionSMBC is a benign lesion primarily found in the mandibular angle and posterior body of the mandible. In most cases, treatment is not necessary, and differentiation from other lesions can be achieved by understanding its clinical characteristics and features on panoramic radiographs and CBCT.

Assessment of mandibular cortical bone thickness for miniscrew placement in relation to the vertical facial patterns using CBCT: A cross-sectional Study

Introduction: The need of more anchorage in the orthodontic daily practice has introduced the use of temporary anchorage devices (TADs). Cortical bone thickness has been one of the major factors on the success rate of the stability of TADs. Different vertical dimension patterns can be found among orthodontic patients with potentially variable cortical bone thickness. Aim of the study: to assess the cortical bone thickness in the posterior region of the mandible in relation to different vertical facial patterns using Cone-beam computed tomography (CBCT) and to evaluate the progressive change in the thickness of cortical bone from 4,6 to 8 mm from the crest of the alveolar bone toward the apical region. Methods: Thirty-six participants were selected and their cephalometric x-rays and CBCTs were analyzed and compared. Vertical facial pattern was measured with the use of the mandibular plane angle and participants were grouped in 3 categories according to the measures. On the CBCTs, buccal and lingual cortical bone thickness were measured from 4,6 and 8 mm from the alveolar crestal bone and compared. All analyses were conducted using IBM SPSS Statistics for Windows, v.26 (IBM Corp., Armonk, NY, USA). The significance level was set at α = 0.05 for all statistical analyses. Results: There was no statistically significant differences were observed between the vertical dimensions groups in terms of buccal and lingual measurements at 4, 6, and 8 mm from cemento-enamel junction (CEJ) between 44/45, 45/46, and 46/47 (P&gt;0.05). Conclusions: There was a progressive increase in cortical bone thickness in most of the studied groups from the alveolar crest to the apical region.

Radiological assessment of the inferior alveolar canal and mental foramen using cone beam computed tomography for pre-operative evaluation of surgeries in the mandible: A single-center five-year retrospective study

IntroductionCone beam computed tomography (CBCT) plays a significant role in studying the anatomical structures of the mandible. AimThis retrospective study aimed to assess the role of CBCT at the pre-assessment stage of mandibular surgery. Materials and methodsA total of 250 CBCT images were collected. The inferior alveolar canal (IAC) and mental foramen (MF) were measured bilaterally to the mandibular teeth apexes, including molars, premolars, and canines, to the buccal, lingual cortical bone, and to the inferior border of the mandible. ResultsThere were no differences in the average number of extracted teeth between the right and left sides (P-value > 0.05, median = three teeth). It was noticed that the average measures of each point of the IAC and MF on the right side were closely matched to the similar point on the left side (P-value > 0.05). T-tests showed that there were differences between males and females on the M2 and M3 on the right side (P-value < 0.05) and on the M1, M2, and M3 on the left side (P-value < 0.05). Using one-way ANOVA tests, results showed that there were some differences in measures at P0 (F = 3.376, P-value = 0.003), P4 (F = 3.782, P-value = 0.001) on the right side, and at P3 (F = 5.620, P-value = 0.019) on the left side of the mandible. ConclusionsThere were no significant differences in IAC and MF positions between the right and left sides.However, between males and females, MF measurements showed significant differences on some points on the right and left sides. Although the history of extracted teeth showed no statistically significant difference in the location of IAC and MF, the number of extracted teeth showed an effect in the IAC position on the right and left sides, but not with the MF.

Comparison of linear and angular measurements in mandibular symphyseal region using lateral cephalometric and cone beam CT images

AbstractAimTo compare the linear and angular measurements of the mandibular symphyseal region using lateral cephalometric (LC) and cone beam computed tomography (CBCT) images.Materials and MethodsOne hundred patients justifying both LC and CBCT exposures were included. Both lateral cephalometric and CBCT images of the patients were used for angular and linear measurements. Angular measurements included vestibular concavity and lingual and tooth inclination angles. Vestibular and lingual cortical bone and total bone thickness measurements were obtained for the comparison of linear measurements. Three radiologists performed the measurements on 200 images. Comparison of the measurements and the imaging methods were done using paired‐ and Wilcoxon t‐tests. Inter‐observer reliability was evaluated with the intra‐class correlation coefficient (ICC).ResultsA significant difference was observed between measurements of two imaging methods for tooth inclination and vestibular concavity angles; however, no difference was found between LC and CBCT measurements for lingual inclination angle (p &gt; 0.05). Vestibular cortical bone and total bone thickness measurements showed a significant difference (p &lt; 0.05), whereas no difference was obtained in lingual bone thickness measurements of two imaging methods (p &gt; 0.05).ConclusionCBCT imaging is recommended in selected patients where recipient bone or bone augmentation site(s) reveal suspect in clinical examination and lateral cephalometric imaging may not reveal the true anatomic structure and relationships.

Prevalence of Pre-Existing Lingual Cortex Perforation Prior to Extraction of Mandibular Third Molars

The research aims to determine the relationship between the mandibular third molars and the nearby lingual cortical bone as well as to determine the frequency of lingual cortex perforation.The analysis was carried out by “CBCTs (cone beam computed tomographic scans)” of 18-65 years old patients. Lingual cortex fenestration at both root tips was observed. Almost three-quarters of radiographs showed the majority of the lingual area on the upper portion of a root (51.2% and 52.8%). The most lingual region and the area surrounding the root tip were both 1.25 mm thick. Mandibular third molars and perforated across both base levels were shown to be significantly related (P value.001). More than 50% of patients had lingual cortical perforation brought on by mandible third-molar teeth. The likelihood of lingual cortical rupture following extraction of the mandibular third molars is a sign of a prior problem rather than surgery.

CBCT Analysis of Edentulous Mandibular Symphysis in Iraqi Patients for Treatment with Implant-Supported Overdentures. Cross-Sectional Single-Center Study.

Overdentures supported by dental implants are a useful treatment strategy for patients with edentulous mandibles. The aim of this study was to evaluate certain characteristics of the mandibular symphyseal edentulous cases for dental implant treatment using CBCT; and if it is associated with gender differences. Ninety patients (45 females and 45 males) were included in this investigation. A section along the midline of each CBCT image was chosen for the edentulous symphyseal area. Symphysis height, width, and cortical thickness was measured for each patient. Bone density were calculated at four points A two-sample Student's t-test and Pearson correlation were used for statistical analysis. Males had a considerably greater symphysis height (26.66±6.21 mm) than females (24.07±5.00 mm) (p = 0.02). Similar results were found for bone width; males had greater means than females. In case of cortical bone thickness; males had thicker bone cortex in the buccal region than females (p = 0.01). While the difference in bone density between genders was small. However, a positive relationship was recorded between symphysis height and width. Height and width of the mandibular symphysis were influenced by gender in edentulous patients, with men showing higher measurements. The reduction of symphyseal height decreased concurrently with the width after teeth were lost, while bone density was maintained in both genders with no difference between them. The lingual cortical bone is significantly thicker than the buccal cortex at the lower part of the symphysis.

Diagnosis of ameloblastic fibro-odontoma: case report

Objective: the present report describes the clinical, radiographic, and histopathological features of an ameloblastic fibro-odontoma (AFO) lesion. Case report: we report a clinical case of a 14-year-old boy with asymptomatic edema. Panoramic radiography detected a unilocular lesion with defined margins located in the posterior region of the mandible. The internal structure of the lesion presented several degrees of radiopacity with the involvement of the third molar. Cone-beam computed tomography revealed expanded buccal and lingual cortical bones, perforation of the lingual cortical bone, and displacement of the mandibular canal. AFO was suspected based on the radiographic and clinical characteristics. Total excision was performed and histologically examined, confirming the diagnosis of AFO. No recurrence occurred during a 24-month follow-up period. Final considerations: the evaluation of the clinical, radiographic, and histopathologic findings needs to be accurate for a correct diagnosis and appropriate treatment for case of AFO since the presentation is often asymptomatic.Keywords: odontogenic tumors; radiography panoramic; cone-beam computed tomography.

A CBCT Evaluation of the Proximity of Mandibular Molar Roots and Lingual Cortical Bone in Various Vertical Facial Patterns and Factors Related to Root-Cortical Bone Contact

The objective of this study was to assess the proximity of the mandibular molar roots and the lingual cortical bone in patients with various vertical facial patterns and determine factors related to root-cortical bone contact. A total of 145 patients (84 males, 61 females, mean age: 22.0 ± 1.76 years) were assigned to hypodivergent (36 patients), normovergent (80 patients) and hyperdivergent (29 patients) groups based on their facial height ratio. Cone-beam computed tomography (CBCT) images were used to measure the distance between the mandibular molar roots and the lingual cortical bone, and any instances of root-cortical bone contact were identified. The study investigated the correlation between the contact of the mandibular molar roots with the lingual cortical bone and several variables, including sex and cephalometric measurements. The distance between the mandibular molar roots and the lingual cortical bone was significantly shorter in the hyperdivergent group than in the hypodivergent group (p &lt; 0.05). Of the total root-cortical bone contact, 87.6% was observed in the mandibular second molars, and the distal roots of the mandibular second molars had the highest contact rate at 43.1% in the hyperdivergent group (p &lt; 0.05). Among the evaluated variables, only the distance between the distal root apex of the mandibular second molar and the mandibular plane was found to be associated with contact of the mandibular molar roots with the lingual cortical bone. An increase of 1 mm in this distance was associated with a 22% decrease in the likelihood of contact between the mandibular second molar roots and lingual cortical bone (p &lt; 0.001). Given the proximity and high contact ratio between the mandibular molar roots and lingual cortical bone, it is recommended that these structures be evaluated using CBCT before planning molar distalization or intrusion in hyperdivergent patients.

Fractal dimension, lacunarity, and cortical thickness in the mandible: Analyzing differences between healthy men and women with cone-beam computed tomography.

The objective of this study was to assess the fractal dimension, lacunarity, trabecular microarchitecture parameters, and cortical linear measurements in the mandibles of male and female individuals to identify differences between them. In total, 116 cone-beam computed tomography scans of healthy individuals of different ages (57 men and 59 women, aged between 20 and 60 years) were selected. The following bone parameters were measured: 1) buccal, lingual, and basal cortical bone thickness in 5 standard parasagittal sections (the midline, the left and right sides of the lower lateral incisors, and the left and right sides of the lower canines); 2) the bone volume fraction of 10 sequential axial sections from each patient by creating a volume of interest in the area between the lower canines; and 3) fractal dimension and lacunarity using grayscale images of the same region of the volume of interest in the anterior mandible. Spearman correlation coefficients and the Mann-Whitney test were used. A significant and positive correlation was found between age and cortical thickness, especially in the region of the central incisors. Significant differences between sexes in terms of fractal dimension, lacunarity, and bone volume were found. Women revealed lower fractal dimension values and higher lacunarity and bone volume ratio values than men. Fractal dimension, lacunarity, trabecular bone volume, and cortical thickness were different between men and women of different ages.

Evaluation of the Anatomic Position of the Mandibular Canal Regarding to the Segments of the Mandibular Sagittal Split Ramus Osteotomy to Diminish the Possibility of Injuries: a Pilot Study.

This pilot study evaluated the relationship between inferior alveolar nerve location through computed tomography scan and intraoperative inferior alveolar nerve entrapment after bilateral sagittal split osteotomy. Overall, 20 helicoidal computed tomography scans were evaluated in patients with facial deformities who underwent to bilateral sagittal split osteotomy (BSSO). The distance from the mandibular canal to the internal surface of the buccal and lingual cortical bone, mandibular thickness, bone density and proportion of medullary and cortical bone in 3 regions were evaluated. During the intraoperative period, the segment to which the nerve remained adhered after performing BSSO was analysed, and the data correlated. The distance from the mandibular canal to the buccal cortical bone showed a mean of 2.6 mm when the inferior alveolar nerve was adhered to the distal segment and mean of 0.7 mm when the nerve was adhered to the proximal segment. The thickness was 11.2 mm and 9.8 mm when the nerve was adhered the distal the proximal segments respectively. Mandibular thickness, distance from the mandibular canal to the buccal and lingual cortical were statistically related to intraoperative nerve entrapment (P < 0.05). Narrow jaws and the distance from the mandibular canal to buccal cortical bone less than 2 mm increases the risk of the inferior alveolar nerve entrapment in bilateral sagittal split osteotomy.

Evaluation of the correlation between facial index and the cortical bone thickness of the maxilla and mandible—A computer tomography based study

Objectivescortical bone thickness confines the position of teeth and thus can be a limiting factor for orthodontic tooth movement. The study is aimed to correlate the cortical bone thickness of the maxilla and mandible with that of different face types, viz; dolichofacial, brachyfacial, and mesofacial. MethodsForty CT scans were analysed for the face types and were grouped into dolichofacial (13), brachyfacial (13) and mesofacial (14) face types. The scans were measured for the right and left side buccal and lingual cortical bone thickness at the central incisor, first and second molar regions on both the maxilla and mandible. Other parameters like basal cortical bone thickness, height, and width of cortical bone were also measured. To determine the correlation and difference between the different parameters, the obtained data was subjected to the correlation coefficient, t test, and ANOVA statistical analysis. ResultsMaxillary buccal cortical bone thickness of central incisors was found to be highly correlated to facial index with a correlation coefficient of − 0.833 * *. Mandibular buccal bone thickness correlated with face type and cortical bone thickness at the central incisor, first, and second molars by-0.531 * *, − 0.474 * *, and − 0.589 * *, respectively. There was a significant difference between the right and left side cortical bone thickness (p < 0.05) and also for all the parameters amongst the different face types (p < 0.05). ConclusionThere exists a definite correlation between the face type and the certain anatomical measurements of cortical bone morphology. Dolichofacial face types show thin buccal cortical bone, which implies the limitation of orthodontic tooth movement in these types of individuals.

Evaluation of dentoskeletal effects of surgically assisted rapid maxillary expansion using computed tomography

Introduction: Patients with transverse maxillary deficiency may have unilateral or bilateral posterior crossbite, crowded and rotated teeth and narrow palate. The treatment for adults is surgically assisted rapid maxillary expansion, a procedure that results in changes not only to bones, but also to teeth, nasal cavity, air space, lips and surrounding soft tissues. Objective: This study evaluated dentoskeletal changes in patients that underwent surgically assisted rapid maxillary expansion (SARME). Methods: Cone beam computed tomography (CBCT) scans were obtained before and after SARME. The thickness of buccal and lingual cortical bone and the angle of the long axis of posterior maxillary teeth were measured. Data were analyzed statistically. Results showed changes in thickness of buccal and lingual cortical bone and tooth movement and tipping. Conclusion: Tooth tipping increased and buccal bone thickness decreased, although osteotomies were used.

Clinic and Radiographic Evaluation of Cemento-osseous Dysplasia: Case Series

Aim: Cemento-osseous dysplasia (COD) is usually asymptomatic and slowly progressive benign fibro-osseous lesion characterized by the replacement of normal bone with fibrous tissue. The aim of this presentation is to evaluate the clinical and radiographical findings of six COD cases that were detected incidentally during radiographic examination.&#x0D; Case Report: Six female patients who four (%66) of them with different dental complaints and two (%33) of them for routine control examination of the previously diagnosed COD with a mean age of 38 applied to our clinic. It was learned that the patients did not have any systemic disorders in their medical anamnesis. There is not any finding on extraoral examination. In intraoral examination, teeth associated with COD lesions were vital as a result of the electric pulp test, and there is no other finding related to the lesion. In the radiography examination, different sizes radiolucent, mixed, and radiopaque lesions were detected in the mandible on control panoramic radiographs. The lesions were examined in detail with cone-beam computed tomography. Local thinning and resorption were observed in the buccal and lingual cortical bone in the relevant region. Histopathological examination revealed that the lesions were definitively diagnosed as SOD in four patients. Based on clinical, radiographic, and histopathological examinations, three (%50) of the lesions were diagnosed as periapical COD and the others (%50) were diagnosed with fluoride COD. All patients were followed up periodically for six months.&#x0D; Conclusion: The findings of this case series showed that all lesions examined were clinically asymptomatic and mixed on radiography. Due to insufficient vascular support of the bone in the COD area, there is a risk of infection and osteomyelitis may occur. Therefore, dentists should be aware of the clinical and radiographic features of COD in clinical practice and follow the patients periodically.

SURGICAL TREATMENT OF CALCIFYING ODONTOGENIC CYST—CASE REPORT

An 18-year-old male patient reporting swelling in the mouth was referred to the oral and maxillofacial surgery service. On intraoral examination, the presence of a bulge along the bottom of the posterior right mandibular vestibule was noted, with normal color and a smooth surface. Panoramic radiographic examination revealed a multilocular radiolucent intraosseous lesion, with well-defined limits and radiopaque structure inside. Cone beam computed tomography showed root apices resorption of teeth 45, 46, and 47; expansion of the buccal and lingual cortical bone; and close contact of the lesion with the inferior alveolar vasculature-nervous bundle. Incisional biopsy revealed a calcifying odontogenic cyst. Surgical treatment was performed through enucleation, followed by curettage of the intraosseous lesion, under general anesthesia. The 1-year postoperative follow-up showed complete bone regeneration and there were no signs of recurrence. An 18-year-old male patient reporting swelling in the mouth was referred to the oral and maxillofacial surgery service. On intraoral examination, the presence of a bulge along the bottom of the posterior right mandibular vestibule was noted, with normal color and a smooth surface. Panoramic radiographic examination revealed a multilocular radiolucent intraosseous lesion, with well-defined limits and radiopaque structure inside. Cone beam computed tomography showed root apices resorption of teeth 45, 46, and 47; expansion of the buccal and lingual cortical bone; and close contact of the lesion with the inferior alveolar vasculature-nervous bundle. Incisional biopsy revealed a calcifying odontogenic cyst. Surgical treatment was performed through enucleation, followed by curettage of the intraosseous lesion, under general anesthesia. The 1-year postoperative follow-up showed complete bone regeneration and there were no signs of recurrence.