Panoramic Radiographs Research Articles

Synthetic, non-person related panoramic radiographs created by generative adversarial networks in research, clinical, and teaching applications

ObjectivesGenerative Adversarial Networks (GANs) can produce synthetic images free from personal data. They hold significant value in medical research, where data protection is increasingly regulated. Panoramic radiographs (PRs) are a well-suited modality due to their significant level of standardization while simultaneously displaying a high degree of personally identifiable data. MethodsWe produced synthetic PRs (syPRs) out of real PRs (rePRs) using StyleGAN2-ADA by NVIDIA©. A survey was performed on 54 medical professionals and 33 dentistry students. They assessed 45 radiological images (20 rePRs, 20 syPRs, and 5 syPRcontrols) as real or synthetic and interpreted a single-image syPR according to the image quality (0–10) and 14 different items (agreement/disagreement). They also rated the importance for the profession (0–10). A follow-up was performed for test-retest reliability with >10 % of all participants. ResultsOverall, the sensitivity was 78.2 % and the specificity was 82.5 %. For professionals, the sensitivity was 79.9 % and the specificity was 82.3 %. For students, the sensitivity was 75.5 % and the specificity was 82.7 %. In the single syPR-interpretation image quality was rated at a median of 6 and 11 items were considered as agreement. The importance for the profession was rated at a median score of 7. The Test-retest reliability yielded a value of 0.23 (Cohen's kappa). ConclusionsThe study marks a comprehensive testing to demonstrate that GANs can produce synthetic radiological images that even health professionals can sometimes not differentiate from real radiological images, thereby being genuinely considered authentic. This enables their utilization and/or modification free from personally identifiable information. Clinical significanceSynthetic images can be used for university teaching and patient education without relying on patient-related data. They can also be utilized to upscale existing training datasets to improve the accuracy of AI-based diagnostic systems. The study thereby supports clinical teaching as well as diagnostic and therapeutic decision-making.

Accuracy of Age Estimation Method Using Dental Radiographs of Permanent Mandibular Second Molars in a Southern Thailand Population

Age estimation is an important process for identifying individuals. In 2020, Duangto et al. estimated age by assessing dental development according to the method of Demirjian on permanent mandibular second molars using a panoramic radiograph. They also developed equations and tested their accuracy in a population of northern Thailand. However, several studies have shown that age estimation methods vary in suitability and accuracy depending on genetic and environmental factors within each population group. Therefore, this research aimed to test the accuracy of dental age estimation using the equations derived from panoramic radiographs of permanent mandibular second molars in a population of southern Thailand. A total of 224 radiographs of 112 males and 112 females aged 7–14 years were used for this study. The samples were categorized into eight groups (28 radiographs per group). The study identified tooth development in stages C–G that followed the Demirjian method and converted these stages into numerical values (3–7). The researchers tested these numerical values in the Duangto et al. equations. The findings revealed that age estimation using the Duangto et al. equations was not significantly different from chronological age. The accuracy had a margin of error not exceeding one year with 95% confidence intervals. In conclusion, the age estimation equations of Duangto et al. can accurately estimate the age of persons living in southern Thailand.

Artificial Intelligence for Detecting Periodontitis: Systematic Literature Review

Background The determination of the diagnosis of inflammatory periodontitis is generally based on clinical examination, which is then strengthened by radiographic examination. Still, the inequality of assessment of clinical conditions, along with limitations of radiographic interpretation, makes determining the diagnosis of the periodontal disease difficult. The use of artificial intelligence as a digital system approach is believed to reduce costs, time, the need for medical services, and medical errors that may occur due to human factors. Objective This systematic review study is to analyze the use of dental and panoramic radiographs combined with the use of artificial intelligence in establishing the diagnosis of periodontitis based on the parameters of periodontal disease severity according to the 2017 American Academy of Periodontology/European Federation of Periodontology Workshop (pocket depth, clinical attachment loss (CAL) and the pattern and level of alveolar bone damage that occurs). Methods Journal searches for articles published in English were carried out through the PubMed and Scopus databases in the 2011-2021 period, using the search terms periodontitis, periodontal disease, food impaction, trauma occlusion, periapical radiograph, panoramic, machine learning, artificial intelligence, and periodontal bone loss, after going through article selection, two suitable articles were obtained. Results Two studies fell into the analyzed category. Both list periodontal bone loss as a parameter that marks periodontitis, and the use of panoramic photos in detecting this parameter assisted by Convolutional Neural Networks as artificial intelligence. Conclusion The use of panoramic radiographs and Convolutional Neural Networks as artificial intelligence that serves as a tool to detect periodontal bone damage has almost the same results as experienced clinicians In order for this method to be developed in the future to help clinicians establish the diagnosis, more clinical and image data will be required.

Characteristics Of Pleomorphic Adenoma at Oral and Maxillofacial Surgery Department Dr. Hasan Sadikin General Hospital Bandung Period 2017-2022

Introduction: Pleomorphic adenoma (benign mixed tumors) is the most common neoplasm affecting both major and minor salivary glands, slow growing, asymptomatic, and unilateral. The most affected location of the tumor is major salivary glands namely parotid glands and in minor salivary glands, it manifests in the intraoral, namely the palate region. This study aims to obtain information about the characteristics of patients with pleomorphic adenoma at the Oral and Maxillofacial Surgery Department of Hasan Sadikin General Hospital Bandung. Methods: This study is a retrospective descriptive analysis method based on the medical data record of a patient who was diagnosed with pleomorphic adenoma and undergoing treatment at Oral and Maxillofacial Surgery Department of Hasan Sadikin General Hospital Bandung period 2017 to 2022. The data obtained include age, gender, patient domicile, tumor predilection location, supporting examination, and definitive treatment. Results: The total participants in this study were 27 patients, with women 8 (70%), range at the age of 31-50 years old (30%). The majority of patients were from Bandung City (56%). Most of the lesion were found in major salivary glands was at parotid gland with 3 patient (10%) and in minor salivary was at the palate region with 18 patients (77%). Most common supporting examination used in this study were fine needle aspiration biopsy (FNAB), panoramic x-ray, and CT scan, with definitive treatment received by the respondent were surgical excision. Conclusion: Pleomorphic adenomas are often occurred in women during third decade of life. The majority of the lesion occurred in minor salivary gland at the palate region. Surgical excision is most definitive treatment were performed. Keywords: Patient characteristics, pleomorphic Adenoma, salivary gland

The relationship of medial sigmoid depression and sigmoid notch morphology with vertical and sagittal growth patterns in Turkish population

Medial sigmoid depression (MSD) is an anatomical variation located just below the deepest point of the sigmoid notch (SN). The etiology of MSD is unknown. It has been reported that increased maximum bite force affects the occurrence of MSD, and vertical growth pattern affects SN morphology. The aim of this study was to investigate the effects of these malocclusions on the presence and morphology of MSD and SN, since bite force can change with vertical and sagittal growth patterns. This is the first study to investigate the effects of vertical growth pattern on the presence and morphology of MSD, and the effects of sagittal growth pattern on SN morphology. Panoramic and lateral cephalometric radiographs of a total of 634 (427 female, 207 male) patients aged from 18 to 35 years (mean 19.58) were included in this retrospective study. MSD and SN shapes, SN depth and width were evaluated on panoramic radiographs. Mann Whitney-U, Kruskal-Wallis and Chi-square tests were used for data analysis. Sagittal and vertical growth patterns were not significantly associated with the presence and shape of MSD (p>0.05). SN depth was greater in individuals with class III malocclusion, and both SN depth and width were lower in hyperdivergent individuals. There was no significant relationship between SN shapes and vertical and sagittal growth patterns (p>0.05). SN depth is affected by both vertical and sagittal growth pattern, and SN width is affected only by vertical growth pattern. The presence of MSD was not associated with growth pattern.

Accuracy of Gonial Angle Measurements Using Panoramic Imaging versus Lateral Cephalograms in Adults with Different Mandibular Divergence Patterns.

Gonial angle is an important craniofacial parameter providing information about symmetry and vertical dimensions of the facial skeleton. It can be measured on panoramic radiographs and lateral cephalograms. Reliable assessment of the gonial angle is challenged by the superimpositions associated with lateral cephalograms. The aim of the current study was to assess the precision of panoramic imaging in measuring the gonial angles compared to lateral cephalograms in adult patients with different mandibular divergence patterns. Panoramic radiographs and lateral cephalograms of 448 adults (18-30 years old) were utilized in the study. The gonial angle was determined on the lateral cephalograms using an online AI-driven assessment tool (WebCephTM) and compared to the panoramic measurements among the different gender, malocclusion, and mandibular divergence groups. Statistically significant differences were recorded between measurements taken on lateral cephalograms or panoramic radiographs (p=0.022). In addition, statistically significant differences were reported in gonial angle measurements on panoramic radiographs among the different mandibular divergence groups (p=0.004) for FMA (p=0.002) for Sn-GoMe. While cephalometry is considered the gold standard tool for reliable gonial angle assessment, panoramic radiographs were more accurate in detecting the differences between the divergence groups in the current study.

Panoramic Radiography in the Evaluation of the Relationship of Maxillary Molar Teeth and Maxillary Sinuses on the Deep Learning Models Improved with the Findings Obtained by Cone Beam Computed Tomography.

Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used. The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT). A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods. DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively. DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.

Diffuse idiopathic skeletal hyperostosis (DISH): Detection on dental radiologic examinations in two older adults and overview of the literature.

Diffuse idiopathic skeletal hyperostosis (DISH) is a potentially serious osteopathic disorder associated with coalescing ossifications of the anterior vertebrae and may be concomitant with a constellation of symptomatology and systemic comorbidities. There is limited dental literature describing this finding on panoramic radiographs and cone beam computed tomography (CBCT) scans. Two case reports of DISH are provided. One patient manifested extensive ossifications along the cervical vertebrae and consequent episodes of dysphagia and hoarseness. The other affected patient's cervical ossification was found at an earlier stage of formation and without symptomatology. Panoramic radiography, cervical spine radiography, and CBCT examinations have been provided. Attending dental healthcare practitioners should carefully evaluate all areas of interest and surrounding fields of view when taking panoramic radiographs and CBCT scans for manifestations of DISH and other potential disorders of the cervical vertebrae. A suspected radiologic finding of DISH should prompt timely referral for comprehensive medical assessment to mitigate neurologic deficits and other comorbidities.

AI model to detect contact relationship between maxillary sinus and posterior teeth

ObjectivesTo establish a novel deep learning networks (MSF-MPTnet) based on panoramic radiographs (PRs) for automatic assessment of relationship between maxillary sinus floor (MSF) and maxillary posterior teeth (MPT), and to compare accuracy of MSF-MPTnet, dentists and radiologists identifying contact relationship. Study designA total of 1035 PRs and 1035 Cone-beam computed tomographys （CBCT）images were collected from January 2018 to April 2022. The relationships were classified into class I and II by CBCT. Class I represents non-contact group, and class II represents contact group. 350 PRs were randomly selected as test dataset and accuracy of MSF-MPTnet, dentists, and radiologists was compared. ResultsThe intraclass correlation coefficient of dentists was 0.460–0.690 and it was 0.453–0.664 for radiologists. Sensitivity and accuracy of MSF-MPTnet were 0.682–0.852and 0.890–0.951, indicating that the output performance of MSF-MPTnet was reliable. Accuracy of maxillary premolars and molars were 79.7%–90.3 %, 76.2%–89.2 % and 72.9%–88.3 % in MSF-MPTnet model, dentists and radiologists. Accuracy of class I relationship in the MSF-MPTnet model (67.7%–94.6 %) was higher than that of dentists (56.5%–84.6 %) in maxillary first premolars and right second premolar, and accuracy of class I relationship in the MSF-MPTnet model is also higher than radiologists (40.0%–78.1 %) in all teeth positions (p < 0.05). ConclusionsMSF-MPTnet model could increase detecting accuracy of the relationship between MSF and MPT, minimize pseudo contact relationship and reduce frequency of CBCT use.

AI-Assisted Diagnostics in Dentistry: An Eye-Tracking Study on User Behavior.

Artificial Intelligence (AI) has increasingly been integrated into dental practices, notably in radiographic imaging like Orthopantomograms (OPGs), transforming diagnostic protocols. Eye tracking technology offers a method to understand how dentists' visual attention may differ between conventional and AI-assisted diagnostics, but its integration into daily clinical practice is challenged by the cost and complexity of traditional systems. Thirty experienced practitioners and dental students participated to evaluate the effectiveness of two low-budget eye-tracking systems, including the Peye Tracker (Eye Tracking Systems LTD, Southsea, UK) and Webgazer.js (Brown University, Providence, Rhode Island) in a clinical setting to assess their utility in capturing dentists' visual engagement with OPGs. The hardware and software setup, environmental conditions, and the process for eye-tracking data collection and analysis are illustrated. The study found significant differences in eye-tracking accuracy between the two systems, with Webgazer.js showing higher accuracy compared to Peye Tracker (p<0.001). Additionally, the influence of visual aids (glasses vs. contact lenses) on the performance of eye-tracking systems revealed significant differences for both Peye Tracker (p<0.05) and Webgazer.js (p<0.05). Low-budget eye-tracking devices present challenges in achieving the desired accuracy for analyzing dentists' visual attention in clinical practice, highlighting the need for continued innovation and improvement in this technology. Key words:Artificial intelligence, Eye-tracking device, low-budget, dentistry.

Endodontic retreatment of a mesotaurodontic mandibular first molar with C-shaped configuration in a patient with multiple taurodonts: A case report and review of literature

Abstract Taurodontism is a dental anomaly characterized by an apical displacement of the pulp chamber floor, resulting in a large pulp chamber with short roots. It can be associated with certain syndromes and abnormalities, although it is common to occur as an isolated characteristic. This anomaly can occur along with other root canal system anomalies such as C-type configuration. The aim of this report is to present the successful endodontic management of a C-shaped mesotaurodontic mandibular molar and review the literature available on this matter. A 23-year-old Persian female was referred by her dental surgeon to complete the root canal treatment of her right mandibular first molar (#46). Clinical examination showed a temporized cavity with no response to pulpoperiapical tests or visible pocket depth while an elongated root trunk with slight periodontal ligament widening, incomplete obturation of the root canal system, and periapical radiolucency was evident on the intraoral radiograph. Cone-beam computed tomography (CBCT) revealed a taurodontic and type III C-shaped root canal configuration. With a diagnosis of previous treatment and asymptomatic apical periodontitis, the patient was scheduled for root canal retreatment. The same anomaly was discovered in other molar teeth on the panoramic radiograph taken before the primary treatment of tooth #46. At a 2-month follow-up session, the tooth was found asymptomatic clinically and radiographically. The past publications about the management of nonsyndromic taurodontic molars were also reviewed. The review of 29 similar articles showed that preoperative CBCT, magnification with illumination, along with active irrigation are helpful items in managing such cases.

Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study

IntroductionProspective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study. MethodsEight-hundred five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 and 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately 8 years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and nonfatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the log-rank test and Cox proportional hazards regression adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis. ResultsIn total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root-filled tooth increased the risk of a future event. After adjustment, the number of remaining teeth and non–root-filled teeth decreased the risk of future events, whereas a higher Decayed, Missing and Filled Teeth score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. A higher Decayed, Missing and Filled Teeth score and decayed teeth increased the risk of all-cause mortality. ConclusionsTooth loss is a strong indicator of an increased risk for future cardiovascular events. Root-filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.

Teeth segmentation and carious lesions segmentation in panoramic X-ray images using CariSeg, a networks' ensemble

BackgroundDental cavities are common oral diseases that can lead to pain, discomfort, and eventually, tooth loss. Early detection and treatment of cavities can prevent these negative consequences. We propose CariSeg, an intelligent system composed of four neural networks that result in the detection of cavities in dental X-rays with 99.42% accuracy. MethodThe first model of CariSeg, trained using the U-Net architecture, segments the area of interest, the teeth, and crops the radiograph around it. The next component segments the carious lesions and it is an ensemble composed of three architectures: U-Net, Feature Pyramid Network, and DeeplabV3. For tooth identification two merged datasets were used: The Tufts Dental Database consisting of 1000 panoramic radiography images and another dataset of 116 anonymized panoramic X-rays, taken at Noor Medical Imaging Center, Qom. For carious lesion segmentation, a dataset consisting of 150 panoramic X-ray images was acquired from the Department of Oral and Maxillofacial Surgery and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca. ResultsThe experiments demonstrate that our approach results in 99.42% accuracy and a mean 68.2% Dice coefficient. ConclusionsAI helps in detecting carious lesions by analyzing dental X-rays and identifying cavities that might be missed by human observers, leading to earlier detection and treatment of cavities and resulting in better oral health outcomes.

A Random Forest-based Automatic Classification of Dental Types and Pathologies using Panoramic Radiography Images

A Random Forest-based Automatic Classification of Dental Types and Pathologies using Panoramic Radiography Images

The prevalence and distribution of hypodontia in children of North Syria

Abstract Introduction: Congenital absence of teeth is a common developmental dental anomaly in humans that affects the occlusal development and the beauty of the smile in particular and the face in general, especially if the injury is in the frontal area. Aim: This study aimed to investigate the prevalence and distribution of hypodontia of permanent teeth in a Syrian population. Materials and Methods: Four hundred and sixty panoramic X-rays of children in North Syria, whose ages ranged from approximately 6–12 years, were taken at the dental clinics of the hospital of Syrian University for Science and Technology, Aleppo, Syria. The prevalence and distribution of hypodontia were recorded, and descriptive statistics were performed. A Chi-square test was used to determine the difference between genders (α =0.05). Results and Discussion: The prevalence of hypodontia was 7.8% (females 9.6% and males 6.5%). The most frequently missing teeth were the mandibular second premolar, maxillary lateral incisors, and mandibular central incisors. Missing was significantly more frequent in the mandible compared to the maxilla (P &lt; 0.05). Conclusions: The number of cases of congenital absence of permanent teeth is impressive. These conditions can cause many dental problems, so careful examination and proper investigation are required to diagnose them and prevent subsequent problems.

Differences in mental index value in patients with type II diabetes mellitus using panoramic radiography

Objectives: This research is aimed to determine the mandibular cortical thickness by the Mental Index value using panoramic radiography in patients with type 2 DM based on length of suffering ≤ 5 years and &gt; 5 years. Materials and Methods: This research is using unpaired comparative analytical design with a cross-sectional stratified random sampling method and unpaired T-test statistic. Results: 34 samples of patients with type 2 DM showed that the mean mental index was 4.219 ± 1.223. The two groups did not have a difference in the meaning of the MI value. The MI of the group with a shorter history of suffering (≤ 5 years) was 4.227 ± 1.063 and the group with a longer history of suffering (&gt;5 years) was 4.211 ± 1.399. There were 8 people who experienced thinning bone from the whole age group, the most were from the age group of 51-60 years old. Conclusion: Mental Index (MI) value is greater or exceeds the normal value (≥ 3,1 mm) in both groups of patients with type 2 DM based on length of suffering ≤ 5 years and &gt; 5 years. Keywords: Diabetes mellitus type 2, Mental Index, Mandibular Cortical Bone, Panoramic Radiography, Bone Mineral Density.

Orthodontic diagnosis rates based on panoramic radiographs in children aged 6-8 years: A retrospective study.

This study aimed to retrospectively analyze the prevalence of orthodontic problems and the proportion of patients who underwent orthodontic diagnosis among children aged 6 (n = 300), 7 (n = 400), and 8 (n = 400) years who had undergone panoramic radiography. Children were divided into five groups according to their chief complaint and consultation: conservative dentistry, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics). Chief complaints investigated included first molar eruption, lack of space for incisor eruption, frequency of eruption problems, lack of space, impaction, supernumerary teeth (SNT), missing teeth, and ectropion eruption. The number of patients whose chief complaint was not related to orthodontics but had dental problems requiring orthodontic treatment was counted. The proportion of patients with orthodontic problems who received an orthodontic diagnosis was also examined. Dental trauma and SNT were the most frequent chief complaints among the children. The proportion of patients with orthodontic problems increased with age. However, the orthodontic diagnosis rates based on panoramic radiographs among children aged 6, 7, 8 years were only 1.5% (6 years) and 23% (7 and 8 years). Accurate information should be provided to patient caregivers to correct misconceptions regarding the appropriateness of delaying orthodontic examination until permanent dentition is established.

Determination of Demographic, Systemic, and Radiographic Characteristics of Patients Applied to the Oral and Maxillofacial Radiology Clinic

Objective: Anamnesis, extraoral intraoral examination, radiographic examination, and other special examination methods are used to diagnose diseases in the oral and maxillofacial regions. The aim of this study was to establish the demographic, systemic, and radiographic characteristics of the patients by analyzing the records of patients who were treated at the Oral and Maxillofacial Radiology Clinic of the University Faculty of Dentistry. Methods: The anamnesis and diagnostic records of patients who were treated at the OMR clinic between 01.01.2013 and 31.12.2019 and the radiographic records of the patients referred to the X-ray department were retrospectively analyzed. The number of patients was analyzed according to demographic, systemic, and radiographic classifications, and tables were created according to years and total numbers. Results: The number of females who applied between 2013-2019 was statistically significantly higher than that of males. When the age distribution of all patients who applied to the OMR clinic was analyzed, it was observed that the patients who applied were 15 years of age and older, and 29.3% of these patients were in the 30-44 age group, with the highest proportion. When radiographic data were analyzed, it was observed that the most common radiograph obtained was a panoramic radiograph (90%). Conclusion: Anamnesis records revealed the systemic disease characteristics of the study area, which is helpful for diagnosis and treatment planning. The most requested radiographic types and clinics that requested the most radiographs were determined. This will help improve the functioning within and between departments. By determining the common diagnoses in panoramic radiographs, the issues to be considered in patients of certain age and sex groups have been clarified.

Distribution of dental anomalies in panoramic radiography at RSGMP Universitas Airlangga

Objectives: This research was aimed to determine the distribution of dental anomaly cases on panoramic radiographs at Universitas Airlangga Dental Hospital (RSGMP). Materials and Methods: This research used a descriptive observational design with a total sampling technique from panoramic radiographic data at the Radiology Clinic of RSGMP Universitas Airlangga during 2018–2020, which had cases of dental anomalies. Results: The result showed 116 cases of dental anomalies, with more incidence in female (64%) than in male (36%). The most common dental anomaly category was the number of teeth anomalies (47.41%), followed by tooth size anomalies (29.31%), tooth shape anomalies (23.28%), and there were no cases of anomalies in tooth structure and position. The most common types of dental anomalies were microdontia (27.59%), missing teeth/agenesis (25%), supernumerary teeth (22.41%), dilaceration (16.38%), talon cusp (3.45%), taurodontism (2.59%), macrodontia (1.72%), gemination (0.86%). Conclusion: The most common cases of dental anomalies were based on their categories, namely anomalies in the number of teeth, followed by tooth size, and tooth shape.

Evaluation of changes in alveolar bone remodeling after orthodontic treatment using fractal analysis: A retrospective study

Aim: The aim of this retrospective study was to analyze trabecular changes in alveolar bone remodeling after orthodontic treatment by evaluating dental panoramic radiographs using the fractal dimension (FD) analysis method. Methodology: This study included 146 individuals with dental class II malocclusion who had undergone fixed orthodontic treatment. The mean age of the patients was 14.88±2.11 years. Patients were divided into three groups: nonextraction control group (Group 1, n=45), moderate anchorage group with extraction (Group 2, n=53), and maximum anchorage group with extraction (Group 3, n=48). The region of interest in the maxillary first premolar apical area was determined using pre- and post-treatment (T0 and T1) panoramic radiographs obtained from archival records. FD analysis was conducted using ImageJ software (version 1.53, NIH). For intragroup data comparison, the paired sample t-test and Wilcoxon test were used. For intergroup data comparison, the Kruskal–Wallis and Mann–Whitney U tests were used. Statistical significance was set at p&lt;0.05. Results: No significant difference in FD values was found between the groups at T0 (p&gt;0.05). At T1, compared to T0, FD values showed a significant decrease in Groups 2 and 3 (p&lt;0.05) and no significant change in Group 1 (p&gt;0.05). At T1, FD values of Groups 2 and 3 were significantly lower than those for Group 1 (p&lt;0.05); no significant difference was found within Groups 2 and 3 (p&gt;0.05). T0/T1 FD change was significantly more in Groups 2 and 3 compared to Group 1 (p&lt;0.05). Conclusion: Although fixed orthodontic treatments with extraction caused significant changes in the fractal dimensions of alveolar trabecular structures when compared to nonextraction, they did not cause destructive changes. How to cite this article: Çiçek O, Yılmaz H, Melayim H. Evaluation of changes in alveolar bone remodeling after orthodontic treatment using fractal analysis: A retrospective study. Int Dent Res 2024;14(1):19-26. https://doi.org/10.5577/intdentres.517