Panoramic Radiographs Research Articles

Is Tonsillolith a Protective Factor Against Covid-19 ?

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

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

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

Application of Fractal Analysis in Detecting Trabecular Bone Characteristics Around Mandibular Impacted Third Molars on Dental Panoramic Radiographs

Purpose: Surgical extraction of third molars can be difficult for many reasons, including increased bone density, which causes bone structures to lose their elastic properties. The aim of this study is to compare the trabecular structure around the impacted mandibular third molar(M3M) and the normal alveolar trabecular pattern using the fractal analysis method. Materials and Methods: Panoramic images of 47 patients were included in the study. ROI1 is the area between the distal root of the second molar and the mesial of the third molar tooth. On the other hand, ROI2 was selected between the distal root of the first molar tooth and the mesial root of the second molar tooth. Fractal Dimension (FD) and Bone Marrow Dimension analyzes were applied to the selected ROIs using the ImageJ software. Results: The mean FD values of 47 patients were found to be 1.135 for ROI1 and 1.105 for ROI2, respectively (p=0,078).The mean Bone Marrow Dimension values were found to be 1.591 for ROI1 and 1.587 for ROI2(p=0.731). There was no significant difference in FD and Bone Marrow Dimension analysis when ROI1 and ROI2 were compared. It is very important to know the pattern of trabecular structure before surgical procedure on M3M. The bone density around the impacted M3M may be higher than the healthy alveolar bone, however, the fact that males have denser bone than females should not be ignored during the operation. Conclusion: The method of FD analysis can be useful for evaluating the trabecular structure of impacted M3M. Key words: fractal dimension; bone structure; panoramic imaging; impacted tooth; third molars

Evaluation of Knowledge Levels of Undergraduate and Postgraduate Dentists Concerning Anatomical Landmarks on Panoramic Radiography

Objective: This study aimed to evaluate the knowledge level of dental students and newly graduated dentists concerning anatomical landmarks identified on panoramic radiographs. Methods: This study was conducted as a web-based survey. Students continuing their education in the 4th and 5th grades of dentistry faculties and dentists who graduated within the last one year were included in our study. The answers given to the anatomical points on the panoramic radiograph were recorded as "true" and "false". SPSS was used to analyse the data. The data obtained were analysed by Kolmogorov-Smirnov test and Mann-Whitney U Test. p<0.05 was considered statistically significant. Results: 300 people participated of which 59.6% of the participants were female and 40.4% were male. The answers given to a total of 18 anatomical point questions did not show a significant difference according to gender (p=0.469). There was no question that all participants answered correctly. The highest correct answer rate was found for the anatomical point 'Mental foramen' with 289 (96.3%) participants. The lowest correct answer rate was found for the anatomical point 'Soft palate' with 48 (16%) participants. According to educational status, 5th grade students were the group with statistically significantly lower correct answers (p=0.017) Conclusions: These results indicate that training approaches should be developed for anatomical landmarks with lower correct response rates. Dentists working on a complicated structure should have a good command of this anatomy, and for this purpose, efforts should be made during the teaching program on anatomical structures that are difficult to identify and keep their knowledge up to date.

The Application of Al-Qahtani Method for Dental Age Estimation of Down Syndrome Children

Dental age estimation is one of the methods in the forensic dental examination. Dental age estimates are often carried out to complete the victim's identity using methods from experts such as Al-Qahtani. There have been many studies related to estimating tooth age using the Al-Qahtani method in normal humans but not in human subjects with special needs, such as children with down syndrome. This study aims to determine the estimated dental age using the Al-Qahtani method in children with down syndrome and to differentiate between chronological age and dental age in children with down syndrome. This research is a cross-sectional study. The research subjects were 13 children with down syndrome who attended special schools in the Jember Regency and met the sample criteria. Tooth age estimation is done by matching the results of panoramic radiographs with the Al-Qahtani Atlas. Data were analyzed using Shapiro-Wilk, Levene's Test, and paired sample T-Test. Estimating dental age using the Al-Qahtani method shows varying dental age values, and there is a delay in the dental age of boys compared to girls with down syndrome. The dental age of all research subjects was delayed from their chronological age. The dental age of children with Down syndrome estimated using the Al-Qahtani method shows an average value of 1 year 2.5 months, and there is a difference between dental age and chronological age with a difference of 1 year seven months. Therefore, adjustments need to be made if the Al-Qahtani method is applied to children with down syndrome.

The Detection of Pulp Stones with Automatic Deep Learning in Panoramic Radiographies: An AI Pilot Study.

This study aims to evaluate the effectiveness of employing a deep learning approach for the automated detection of pulp stones in panoramic imaging. A comprehensive dataset comprising 2409 panoramic radiography images (7564 labels) underwent labeling using the CranioCatch labeling program, developed in Eskişehir, Turkey. The dataset was stratified into three distinct subsets: training (n = 1929, 80% of the total), validation (n = 240, 10% of the total), and test (n = 240, 10% of the total) sets. To optimize the visual clarity of labeled regions, a 3 × 3 clash operation was applied to the images. The YOLOv5 architecture was employed for artificial intelligence modeling, yielding F1, sensitivity, and precision metrics of 0.7892, 0.8026, and 0.7762, respectively, during the evaluation of the test dataset. Among deep learning-based artificial intelligence algorithms applied to panoramic radiographs, the use of numerical identification for the detection of pulp stones has achieved remarkable success. It is expected that the success rates of training models will increase by using datasets consisting of a larger number of images. The use of artificial intelligence-supported clinical decision support system software has the potential to increase the efficiency and effectiveness of dentists.

Evaluation of E-max Porcelain Veneer Failures: A Retrospective Study.

Aim This retrospective study aimed to evaluate if E-max veneers over five years caused changes in gingival, periodontal health, and veneer failures. Background As aesthetic dentistry progresses, dental veneers are becoming increasingly popular in both general and specialized dental practices. Due to technological advancements in dental ceramics and adhesive systems, porcelain veneers have become a highly sought-after solution for improving aesthetics in dental patients. The success of porcelain laminate veneers, a commonly used method for aesthetic restoration, relies on various factors. E-max veneers are frequently utilized, with their long-term durability contingent upon factors such as color stability, resistance to abrasion, as well as good compressive, tensile, and shear strength, along with maintaining marginal integrity. Methodology In this study, data was collected through a checklist form used to record clinical parameters. The clinical parameters evaluated were inflammation and bleeding on probing (BOP). The gingival health was evaluated by gingival index, gingival color, texture, and bleeding on probing, and periodontal health was evaluated by the pocket depth and radiographic evaluations. Finally, the veneer was visually inspected for chipping, staining, and debonding history. The score for most of the cases ranged between 0-1, with only 10 cases displaying moderate gingival inflammation and BOP (Gingival Index 2). Siemens Orthopantomogram (OPG) systems were used for radiological evaluation and documentation of cases. E-max porcelain veneers were only included in the research. Results Out of 28 patients, each with 6-to-10-unit veneer cases was examined, 18 patients (64.3%) displayed healthy gingival status with no bleeding area recorded in none of the veneers amongst the 6 to 10 units. In 10 patients (35.7%) most of the veneers had inflamed gingival tissue that was bleeding on probing. The majority revealed the presence of stippling (92.9%), absence of recession (96.4%), and pocket depth (67.9%). Half of our participants had their veneer for more than five years (50%) and the majority presented with no significant changes in veneer recorded like marginal staining, debonding, or chipping (89.3%). Conclusion Multiple factors such as patient selection, proper treatment planning, and design, including material selection, play a significant role in the long-lasting success of ceramic veneers. The retrospective study indicated that proper oral hygiene measures are vital for the long-term sustainability of E max veneers.

Detection and classification of mandibular fractures in panoramic radiography using artificial intelligence.

This study aimed to assess the performance of a deep learning algorithm (YOLOv5) in detecting different mandibular fracture types in panoramic images. This study utilized a dataset of panoramic radiographic images with mandibular fractures. The dataset was divided into training, validation, and testing sets, with 60%, 20%, and 20% of the images, respectively. An equal number of control panoramic radiographs, which did not contain any fractures, were also randomly distributed among the three sets. The YOLOv5 deep learning model was trained to detect six fracture types in the mandible based on the anatomical location including symphysis, body, angle, ramus, condylar neck, and condylar head. Performance metrics of accuracy, precision, sensitivity (recall), specificity, dice coefficient (F1 score), and area under the curve (AUC) were calculated for each class. A total of 498 panoramic images containing 673 fractures were collected. The accuracy was highest in detecting body (96.21%) and symphysis (95.87%), and was lowest in angle (90.51%) fractures. The highest and lowest precision values were observed in detecting symphysis (95.45%) and condylar head (63.16%) fractures, respectively. The sensitivity was highest in the body (96.67%) fractures and was lowest in the condylar head (80.00%) and condylar neck (81.25%) fractures. The highest specificity was noted in symphysis (98.96%), body (96.08%), and ramus (96.04%) fractures, respectively. The dice coefficient and AUC were highest in detecting body fractures (0.921 and 0.942, respectively), and were lowest in detecting condylar head fractures (0.706 and .812, respectively). The trained algorithm achieved promising performance metrics for the automated detection of most fracture types, with the highest performance observed in detecting body and symphysis fractures. Machine learning can provide a potential tool for assisting clinicians in mandibular fracture diagnosis.

Assessing current clinical eruption stage of mandibular third molars by dental panoramic radiography.

We examined whether dental panoramic radiography (PAN) can be used to identify the clinical stage of eruption of mandibular third molars at the time of radiological examination. Cross-sectional data included records from clinical oral examination and PANs of university students. In the retrospective analysis of 345 mandibular third molars in 189 participants (20% men, 80% women; mean age 20.7 years; standard deviation [SD] ± 0.6), clinical stages of eruption were compared with their radiographic depth in bone, inclination, and root development. Statistics included χ2, Mann-Whitney U tests, and logistic regression. Significant (p < 0.001) predictor variables for assessing the clinical stage of eruption were radiographic depth in bone and inclination. All teeth radiologically at a depth of the cementoenamel (CE) junction of the neighbouring second molar or deeper were clinically unerupted. Above the CE junction, 80% of vertical and 97% of distoangular teeth were connected to the oral cavity, and 82% of mesioangular and 69% of horizontal teeth were clinically unerupted. All teeth below or at the CE junction are clinically unerupted. Above the CE junction, stage of eruption should be assessed together with the inclination, but horizontally inclined teeth are recommended to be verified clinically.

Potential Association of Molar-Incisor Hypomineralization (MIH) with Dental Agenesis and Infraoccluded Deciduous Molars: Is MIH Related to Dental Anomaly Pattern (DAP)? An Observational Cross-Sectional Study.

Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8-14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis.

Comparisons of Two Different Treatment Methods for Impacted Maxillary Canines: A Retrospective Study.

Background: The impaction of the maxillary canine is a common occurrence, and orthodontists must be prepared to manage it. The purpose of this article is to present a study of the efficacy of a double-wire orthodontic appliance compared to a control group in the alignment of impacted maxillary canines in the dental arch. Methods: To diagnose an impacted maxillary canine, a panoramic radiograph was taken and a detailed analysis was performed by the same orthodontist. This article presents the results of 28 impacted maxillary canines with inclusion criteria of A2 (tooth angulation to the midline 16°-45°), V1 (vertical height of the tooth crown above the cementoenamel junction but less than half the length of the root of the maxillary lateral incisor), and O3 (medial position of the canine crown of more than half but less than the entire root width of the lateral incisor) positions in 21 patients (7 males and 14 females) with a mean age of 14.02 years (SD = 1.61) who were treated by the same orthodontist for impacted maxillary canines using a fixed double-wire orthodontic appliance. The analyzed data were compared with the control group (treated with a fixed orthodontic appliance and active ligature), which was matched for pretreatment age and the A2, V1, and O3 positions of the impacted maxillary canine. Results: With both methods, the impacted maxillary canines were aligned and guided into a correct position in the dental arch, but the mean active orthodontic traction of 31 ± 4.2 weeks in the SG was statistically significantly shorter (p < 0.05) in comparison to 37 ± 6.3 weeks in the CG, and the number of visits was statistically significantly (p < 0.05) fewer in the SG (5 ± 2) than in the CG (11 ± 5). Conclusions: The findings of this study are important to the field of orthodontics and show that the alignment of impacted maxillary canines with A2, V1, and O3 positions can be achieved with both methods, but with the double-wire appliance, the treatment time was shorter and the number of visits was statistically significantly fewer. The results of this study suggest that this approach may be more efficient and cost-effective compared to conventional methods.

A rare case of unilateral double Stafne bone defects and literature review.

Stafne bone defect (SBD) is a rare developmental bone defect characterized by an asymptomatic focal concavity of the cortical bone, typically on the lingual aspect of the mandibular body, which generally contains salivary gland tissue. It can be detected during routine dental examinations and typically appears as an ovoid, well-defined, well-corticated, radiolucent depression in the posterior mandibular region below the inferior alveolar nerve (IAN) (in: Neville et al, Oral and maxillofacial pathology, Elsevier, Inc, St. Louis, MO, 2016).An 80-year-old male presented to our clinic for a routine dental examination. Panoramic radiography and cone-beam computed tomography (CBCT) displayed two well-defined, well-corticated, ovoid radiolucencies inferior to the IAN canal on the left mandibular molar region. The working diagnosis was SBD, and the patient was informed of the findings. Irregular margins on the superior aspect of the anterior defect were noted on CBCT imaging; therefore, follow-up with panoramic images at 6months, 1 and 5years was recommended.

Management of oronasal fistula using L-PRF and palatal flap due to residual cyst in maxilla: A case report

Study Design: Case Report. Oronasal communication can be a result of congenital disorders, pathological lesions, or inadequate treatment. It consists of abnormal communication between the nasal and oral cavities. Objective: This paper aims to present a case report of a female patient who intended for dental implants but was referred to the maxillofacial surgery department presenting a cone beam computed tomography with incidental finding in the anterior part of the maxilla. Methods: The first surgical procedure consisted of the resection of the lesion associated with bone graft with buccal fat pad flap and posterior histopathological study. After three months the patient developed an oronasal fistula. During the second surgical management, the authors chose platelet concentrates (L-PRF) to fill the bone defects associated with the palatal flap. Results: After one year of follow-up, the patient presented definitive soft tissue healing, no exposure of bone tissue, and the closure of oronasal communication. The new CT scan and panoramic x-ray showed satisfactory bone healing. Conclusion: The present study demonstrated the association of L-PRF with xenograft and palatal flap can be a viable method for the management of patients with oronasal fistula. This report adheres to the SCARE guidelines for the reporting of surgical cases in medical literature.

Analyzing Oral Health Conditions in Sex Workers-A Comparative Retrospective Clinical and Radiographic Study.

This study highlights the oral health condition of female sex workers (SWs), who face increased risks associated with habits such as excessive alcohol and tobacco use. These behaviors heighten the likelihood of issues like oral cancer and dental diseases, underscoring the need for targeted health interventions. The study examines the oral health disparities between SWs and the general population (GP). A retrospective study analyzed the health records of 40 SWs and 40 controls matched by age and gender who were examined between 1 January 2020 and 30 May 2023. Intra-oral and panoramic radiographs, alongside clinical examination, were used to evaluate missing teeth, periodontal bone support, and caries. T-tests and chi-square tests were used to compare dental health indicators. A comparative analysis of these 80 patients revealed significant disparities: SWs had a higher incidence of missing teeth (5.8 ± 7.3 vs. 0.7 ± 1.4, p < 0.01) and caries (6.1 ± 6.2 vs. 0.8 ± 1.2, p < 0.05) compared to the GP. The DMFT (Decayed, Missing, and Filled Teeth) index was notably higher in SWs (16.1 ± 8.09) than in the GP (7.95 ± 5.48, p < 0.001). Additionally, 12% of SWs used removable dentures, unlike the GP. This study underscores significant oral health challenges in SWs, emphasizing the need for targeted healthcare strategies to improve their health conditions.

Isolated dentinogenesis imperfecta: Novel DSPP variants and insights on genetic counselling

ObjectiveDentinogenesis imperfecta (DI) is an inherited dentin defect and may be isolated or associated with disorders such as osteogenesis imperfecta, odontochondrodysplasia Ehler-Danlos and others. Isolated DI is caused mainly by pathogenic variants in DSPP gene and around 50 different variants have been described in this gene. Herein, we report on 19 patients from two unrelated Egyptian families with isolated DI. Additionally, we focused on genetic counselling of the two families.Materials and methodsThe patients were examined clinically and dentally. Panoramic X-rays were done to some patients. Whole exome sequencing (WES) and Sanger sequencing were used.ResultsWES revealed two new nonsense variants in DSPP gene, c.288T > A (p.Tyr96Ter) and c.255G > A (p.Trp85Ter). Segregation analysis by Sanger sequencing confirmed the presence of the first variant in all affected members of Family 1 while the second variant was confirmed to be de novo in the patient of Family 2.Conclusions and clinical relevanceOur study extends the number of DSPP pathogenic variants and strengthens the fact that DSPP is the most common DI causative gene irrespective of patients’ ethnicity. In addition, we provide insights on genetic counseling issues in patients with inherited DSPP variants taking into consideration the variable religion, culture and laws in our society.

Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

Medication-related osteonecrosis of the jaw (MRONJ) poses a challenging form of osteomyelitis in patients undergoing antiresorptive therapies in contrast to conventional osteomyelitis. This study aimed to compare the clinical and radiological features of MRONJ between patients receiving low-dose medications for osteoporosis and those receiving high-dose medications for oncologic purposes. The clinical, panoramic radiographic, and computed tomography data of 159 patients with MRONJ (osteoporotic group, n = 120; oncologic group, n = 39) who developed the condition after using antiresorptive medications for the management of osteoporosis or bone malignancy were analyzed. The osteoporotic group was older (75.8 vs. 60.4 years, p < 0.01) and had a longer duration of medication usage than the oncologic group (58.1 vs. 28.0 months, p < 0.01). Pus discharge and swelling were more common in the osteoporotic group (p < 0.05), whereas bone exposure was more frequent in the oncologic group (p < 0.01). The mandibular cortical index (MCI) in panoramic radiographs was higher in the osteoporotic group (p < 0.01). The mean sequestra size was larger in the oncologic group than in the osteoporotic group (15.3 vs. 10.6 mm, p < 0.05). The cured rate was significantly higher in the osteoporotic group (66.3% vs. 33.3%, p < 0.01). Oncologic MRONJ exhibited distinct clinical findings including rapid disease onset, fewer purulent signs, and lower cure rates than osteoporotic MRONJ. Radiological features such as sequestrum size on CT scan, and MCI values on panoramic radiographs, may aid in differentiating MRONJ in osteoporotic and oncologic patients.

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

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

Direct-Acting Oral Anticoagulant/Vitamin K Antagonists: Do They Affect the Trabecular and Cortical Structure of the Mandible?

Background: This study aimed to evaluate the mandibular bone structure of patients using oral anticoagulants (OACs) vitamin K antagonist drugs (warfarin) and other OACs including direct oral anticoagulants [(DOACs) apixaban, rivaroxaban, dabigatran, edoxaban]. Analyses were based upon the fractal dimension (FD), the panoramic mandibular index (PMI) and the Klemetti index (KI), which is also known as the mandibular cortical index (MCI).Methodology: Ninety participants were divided into three groups: group 1: 30 systemically healthy individuals who had not used any anticoagulants before, group 2: 30 individuals using warfarin, and group 3: 30 individuals using DOACs. FD was used to analyze trabecular bone architecture in the condyle, angle, and two sites in the alveolar bone. PMI was used to evaluate the quantity of cortical bone and KI was used to evaluate the cortical bone quality.Results: There was no difference between the groups regarding FD analysis and KI; however, a difference was found between groups 1, 2, and 3 in the PMI (P≤ 0.001). The PMI in group 1 was higher than in groups 2 and 3.Conclusion: Mandibular radiomorphometric indices can be used on panoramic radiographs to evaluate the quantity of mandibular cortical bone in patients using oral anticoagulants.

Determination of the position of impacted maxillary canine – A panoramic radiographic study

Maxillary canines are one of the most common impacted teeth. The objective in localization of an impacted canine is to be able to decide such a radiographic technique which has minimal radiation dose, cost and minimum superimpositions. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines, when compared to cone-beam computed tomography.OPG and CBCT images of 100 maxillary impacted canines were included in the study irrespective of site. Each OPG was evaluated for vertical angulation and the data obtained was tabulated and subjected to statistical analysis.In the present study, the female to male ratio was 2.57:1, with a slightly higher prevalence of impacted maxillary canines on left side. The results of the present study show a 100% concordance between OPG and CBCT for palatal and buccal impactions, and 91% for mid-alveolus impactions.Based on the results of the present study, it may be concluded that panoramic radiographs are useful for predicting the location of impacted maxillary canines against the confirmatory radiographic modality like CBCT.

Comparison of two methods in maxillary canine retraction

The aim of this prospective clinical study is to evaluate the effects of laceback and Uprighter techniques on maxillary canine retraction using digital models and panoramic radiographs and to compare the results.Sixteen patients (10 females, 6 males) with an average chronological age of 16.24±2.99 years, requiring fixed orthodontic treatment with upper canines located in a high vestibular position and the need for bilateral first premolar extraction, were included in this study. 0.018-inch Roth brackets were used in the patients. In this split-mouth design study, while laceback was used on one side, Uprighter was used on the other side. Tooth movements were measured on three-dimensional models and panoramic radiographs obtained at the beginning of treatment (T0), 2 months later (T1), and 3.5 months later (T2). Two-way analysis of variance was applied for the comparison of differences between the groups in repeated measurements.The difference between groups was found to be statistically significant in terms of canine distalization, canine rotation, and molar angulation amounts. There was no statistically significant difference in the other parameters.Both uprighter and laceback techniques can be applied in maxillary canine cases located in the high vestibule. When Uprighter is used, the canine is distalized much more. However, it should be noted that while more molar tipping may occur when laceback is used, more canine distopalatal rotation may occur when uprighter is used.