Panoramic Radiographs Research Articles

Performance Evaluation of Deep Learning Models for Dental Caries Classification via Panoramic Radiograph Images

Objective: The purpose of this study is to evaluate the ability of deep learning models to classify mandibular molar teeth according to the presence and proximity of caries to the dental pulp. This research summarizes the progress of artificial intelligence and potential dental problems in diagnosis, treatment, and disease prediction in medicine. It discusses data limitations, computational power, ethical considerations, and their implications for dentists. This can lay the groundwork for future research in this rapidly expanding field. Methods: The dataset used in this study consists of 1200 panoramic radiographs, which have been evaluated and classified into three categories: free of dental caries, coded as (H); enamel-dentin caries lesions treated with restorative filling, coded as (R); and deep dental caries that underwent root canal treatment, coded as (E). The images are prepared for the training-testing process using the k-fold crossevaluation technique and then fed into the pre-trained deep learning models for classification. Results: The VGG-19 model achieved superior results compared to the other models, with macro-average scores of 0.9111 for precision, 0.9127 for recall, and 0.9115 for f1-score, respectively. Conclusion: The promising results obtained in this study give confidence in endorsing the use of deep learning models in the dental treatments sector.

Determination of orthodontic anomaly patterns in patients in the Thrace region and assessment of the relationship between orthodontic anomalies and DMFT indices: a retrospective study

OBJECTIVE: The aim of this study was to investigate the prevalence of dental and skeletal anomalies that could be a cause of malocclusion and their relationship with caries distribution in the western region of Türkiye. MATERIALS AND METHOD: A retrospective study was conducted with 1815 digital panoramic and lateral cephalometric radiographs taken from patients, age ranging between 6 and 47 years, who applied for orthodontic treatment. The lateral cephalometric radiographs, panoramic radiographs, and dental records were reviewed according to skeletal anomaly, dental malocclusion (Angle classification), and decay-missing- filling teeth (DMFT) index. Kruskal Wallis test was used in intergroup comparisons of variables that did not show normal distribution, and Dunn’s multiple comparison test was used in subgroup comparisons. The chi-square test and Yates correction were used in comparisons of qualitative data. RESULTS: The mean DMFT of the dental Class I malocclusion group was statistically and significantly lower than Class II division 1 and Class III malocclusion groups (p < 0.05). The mean DMFT index of Class II subdivision malocclusion group was statistically and significantly lower than that of Class III malocclusion group (p < 0.05). The DMFT index was significantly lower in the skeletal Class I group compared to the skeletal Class II and Class III anomaly groups (p < 0.05). CONCLUSION: There is a correlation between DMFT indices and dental malocclusions as well as skeletal anomalies. By correcting dental malocclusions and skeletal anomalies with orthodontic treatment and providing ideal occlusion, it becomes easier for patients to maintain oral hygiene and DMFT indices might decrease.

A Semi-Supervised Transformer-Based Deep Learning Framework for Automated Tooth Segmentation and Identification on Panoramic Radiographs.

Automated tooth segmentation and identification on dental radiographs are crucial steps in establishing digital dental workflows. While deep learning networks have been developed for these tasks, their performance has been inferior in partially edentulous individuals. This study proposes a novel semi-supervised Transformer-based framework (SemiTNet), specifically designed to improve tooth segmentation and identification performance on panoramic radiographs, particularly in partially edentulous cases, and establish an open-source dataset to serve as a unified benchmark. A total of 16,317 panoramic radiographs (1589 labeled and 14,728 unlabeled images) were collected from various datasets to create a large-scale dataset (TSI15k). The labeled images were divided into training and test sets at a 7:1 ratio, while the unlabeled images were used for semi-supervised learning. The SemiTNet was developed using a semi-supervised learning method with a label-guided teacher-student knowledge distillation strategy, incorporating a Transformer-based architecture. The performance of SemiTNet was evaluated on the test set using the intersection over union (IoU), Dice coefficient, precision, recall, and F1 score, and compared with five state-of-the-art networks. Paired t-tests were performed to compare the evaluation metrics between SemiTNet and the other networks. SemiTNet outperformed other networks, achieving the highest accuracy for tooth segmentation and identification, while requiring minimal model size. SemiTNet's performance was near-perfect for fully dentate individuals (all metrics over 99.69%) and excellent for partially edentulous individuals (all metrics over 93%). In edentulous cases, SemiTNet obtained statistically significantly higher tooth identification performance than all other networks. The proposed SemiTNet outperformed previous high-complexity, state-of-the-art networks, particularly in partially edentulous cases. The established open-source TSI15k dataset could serve as a unified benchmark for future studies.

Evaluation of tooth development stages with deep learning-based artificial intelligence algorithm

BackgroundThis study aims to evaluate the performance of a deep learning system for the evaluation of tooth development stages on images obtained from panoramic radiographs from child patients.MethodsThe study collected a total of 1500 images obtained from panoramic radiographs from child patients between the ages of 5 and 14 years. YOLOv5, a convolutional neural network (CNN)-based object detection model, was used to automatically detect the calcification states of teeth. Images obtained from panoramic radiographs from child patients were trained and tested in the YOLOv5 algorithm. True-positive (TP), false-positive (FP), and false-negative (FN) ratios were calculated. A confusion matrix was used to evaluate the performance of the model.ResultsAmong the 146 test group images with 1022 labels, there were 828 TPs, 308 FPs, and 1 FN. The sensitivity, precision, and F1-score values of the detection model of the tooth stage development model were 0.99, 0.72, and 0.84, respectively.ConclusionsIn conclusion, utilizing a deep learning-based approach for the detection of dental development on pediatric panoramic radiographs may facilitate a precise evaluation of the chronological correlation between tooth development stages and age. This can help clinicians make treatment decisions and aid dentists in finding more accurate treatment options.

Diagnostic accuracy of periapical radiography and panoramic radiography in the detection of apical periodontitis: a systematic review and meta-analysis.

Apical periodontitis (AP) is one of the most common pathologies of the oral cavity. An early and accurate diagnosis of AP lesions is crucial for proper management and planning of endodontic treatments. This study investigated the diagnostic accuracy of periapical radiography (PR) and panoramic radiography (PAN) in the detection of clinically/surgically/histopathologically confirmed AP lesions. A systematic literature review was conducted in accordance with the PRISMA guidelines. The search strategy was limited to English language articles via PubMed, Embase and Web of Science databases up to June 30, 2023. Such articles provided diagnostic accuracy values of PR and/or PAN in the detection of AP lesions or alternatively data needed to calculate them. Twelve studies met inclusion criteria and were considered for the analysis. The average value of diagnostic accuracy in assessing AP lesions was 71% for PR and 66% for PAN. According to different accuracy for specific anatomical areas, it is recommended to use PR in the analysis of AP lesions located in the upper arch and lower incisor area, whereas lower premolar and molar areas may be investigated with the same accuracy with PR or PAN. Two-dimensional imaging must be considered the first-level examination for the diagnosis of AP lesions. PR had an overall slightly higher diagnostic accuracy than PAN. Evidence from this review provided a useful tool to support radiologists and dentists in their decision-making when inflammatory periapical bone lesions are suspected to achieve the best clinical outcome for patients, improving the quality of clinical practice.

CHARACTERISTICS OF RADIOLUCENT LESIONS ASSOCIATED WITH IMPACTED TEETH AT RSGM UNPAD

Background: Impacted teeth occur when teeth fail to erupt or cannot fully erupt along the dental arch in the normal pattern of dental growth. Untreated impacted teeth can cause pain, tooth decay, inflammatory lesions, odontogenic cysts, and tumors. Pathological lesions in impacted teeth that are not clinically visible are usually found on routine radiographic examinations. Panoramic radiography is used as an initial imaging technique to evaluate impacted teeth and associated lesions. Purpose: This study aims to see the characteristics of radiolucent lesions associated with impacted teeth based on panoramic radiographic archives of patients at RSGM Unpad. Methods: This is an observational descriptive study with purposive sampling technique using secondary data of panoramic radiographs from the Dental Radiology Installation RSGM Unpad. The radiographs were inverted to enhance the visualization of characteristics such as location, shape, borders and associations. The data is presented in the table of frequency and distribution. Results: 346 samples of radiolucent lesions associated with impacted teeth were obtained from 8034 impacted teeth. There were 323 (93,4%) pericoronal lesions, 344 (99,4%) monolocular lesions, 218 (63%) had well-defined borders, and 345 (99,7%) lesions caused bone destruction. The prevalence of radiolucent lesions associated with impacted teeth is 4.3%. Conclusion: The characteristics of radiolucent lesions associated with impacted teeth at the Dental Radiology Installation RSGM Unpad most common are pericoronal lesions, monolocular shape, well-defined borders, and the effect on the surrounding structure is bone destruction.Impacted, Panoramic Radiograph, Radiolucent Lesion

An attempt to generate panoramic radiographs including jaw cysts using StyleGAN3.

The purpose of this study was to generate radiographs including dentigerous cysts by applying the latest generative adversarial network (GAN; StyleGAN3) to panoramic radiography. A total of 459 cystic lesions were selected, and 409 images were randomly assigned as training data and 50 images as test data. StyleGAN3 training was performed for 500 000 images. Fifty generated images were objectively evaluated by comparing them with 50 real images according to four metrics: Fréchet inception distance (FID), kernel inception distance (KID), precision and recall, and inception score (IS). A subjective evaluation of the generated images was performed by three specialists who compared them with the real images in a visual Turing test. The results of the metrics were as follows: FID, 199.28; KID, 0.14; precision, 0.0047; recall, 0.00; and IS, 2.48. The overall results of the visual Turing test were 82.3%. No significant difference was found in the human scoring of root resorption. The images generated by StyleGAN3 were of such high quality that specialists could not distinguish them from the real images.

CORELATION BETWEEN PREOPERATIVE PATHOSES, POSITION OF IMPACTED MANDIBULAR THIRD MOLAR AND DEMOGRAPHIC CHARACTERISTICS

Third mandibular molars mainly appear to be in an inappropriate position in dental arch, so become the teeth which barely erupt or stay impacted in jaws. The aim of this study is to analyze the correlation between the preoperative pathologies with the position of the impacted third mandibular molar, sex and age of the patients. The sample of the study consisted of a total of 80 patients, of both sexes, diagnosed with fully or partially impacted third mandibular molars, who were followed up after the surgery for a three-month period. All the patients were clinically examined and for each of them was registered a panoramic radiography, to analyze the factors causing the pathology, which leads to the surgical extraction of the teeth. The most manifested preoperative pathologies correlating to the position of impacted mandibular third molars were: resorption of distal root of mandibular second adjacent molar, caries of second adjacent molar, pericoronitis, periodontal disease, frontal incisal mandibular crowding. All the pathologies were associated with the tooth position, some differed by age and gender. We conclude that preoperative complaints related to the position of the impacted third mandibular molar are in positive proportion to the age of the patients, i.e. subjective complaints increase with age: pain, limited opening of the mouth, local inflammation of the gingiva and paresthesia. The position of the impacted third mandibular molar affects the occurrence of preoperative pathologies: pericoronitis was most prevalent in impacted third mandibular molars with vertical position, class II, A position and partial impaction; periodontal diseases of second adjacent mandibular molar are most prevalent in impacted third mandibular molar with mesioangular position, class III, B position and partial impaction.

Assessment of the occurrence of apical periodontitis and endodontically treated/non-treated teeth in a Lower Austrian patient population treated for osteoporosis: a cohort study.

Osteoporosis (OP) is a bone disease linked to low bone mass and heightened fracture risk. Apical periodontitis (AP) is an inflammation of the apical periodontium, visible on radiographs, often associated with infection or necrosis of the root canal system. Both conditions, AP and OP, share inflammation and ageing as common factors, warranting exploration of their potential interactions. This study examined the association between AP and endodontically treated/non-treated teeth in patients with OP in Lower Austria. The authors included 425 patients (7924 examined teeth) aged over 60 years (average age 68±10years) with 208 patients (3537 examined teeth) [179 women (3027 teeth) and 29 men (510 teeth)] initially diagnosed and treated for OP and a corresponding control group with 217 patients (4387 examined teeth) [187 women (3781 teeth) and 30 men (606 teeth)] without an OP diagnosis. For the diagnosis of AP, the panoramic radiographs and medical history taken at the initial presentation were analysed. In patients treated for OP, AP was diagnosed as follows: in 134 (26%) treated and 234 (9%) non-treated teeth among women (511 treated/2516 non-treated teeth) and in 23 (27%) treated and 50 (11%) non-treated teeth among men (83 treated/427 non-treated teeth). The control group without OP consisted of: women (569 treated/ 3212 non-treated teeth) in 147 (25%) treated and 403 (12%) non-treated teeth; men (77 treated/ 529 non-treated teeth) 17 (22%) treated and 29 (6%) non-treated teeth.When comparing AP in endodontically treated teeth according to sex, no statistically significant differences were observed between patients with and without OP (P>0.05). The same result was observed in endodontically non-treated teeth (P>0.05). The authors' results indicate that there is no association between the occurrence of AP and endodontically or non-endodontically treated teeth in female and male patients treated for OP.

A rare case of bone lesion: Mandible’s fibrous dysplasia

Fibrous dysplasia is a rare genetic syndrome that affects bone tissue. This pathology replaces the mineralized matrix of the bone affected with connective and fibrous tissue. This article describes a mandibular fibrous osseous dysplasia case and its surgical treatment. A 45-year-old woman complained about a slow development of swelling of the left mandibular bone. The orthopantomography (OPT) and the cone beam computed tomography (CBCT) revealed a well-circumscribed sclerotic lesion with a ground-glass appearance apical to the 3.5 element. The surgery was performed to excise the lesion. Anatomopathological examination of tissue confirmed the suspects among the diagnosis of fibrous dysplasia. The patient underwent to follow-up of 4 years, and no recurrences were found. In the absence of a univocal consensus on therapy, surgery remains the treatment of choice for unifocal forms.

Spontaneous bacterial peritonitis and soft tissue healing after tooth extraction in liver cirrhosis patients

The objective of this study was to identify the association between tooth extraction and occurrence of spontaneous bacterial peritonitis (SBP) and to assess delayed soft tissue healing of extraction sockets in patients with cirrhosis. One hundred nineteen participants awaiting liver transplantation who required tooth extraction were included. Seven days before the surgery, the patients underwent panoramic radiography and laboratory examinations. Soft tissue healing was evaluated 7 days after the tooth extraction and medical records were checked after 21 days for development of SBP. The relationship between predictive factors and outcomes was assessed by using multiple binomial logistic regression. One hundred ninety-five teeth were extracted, resulting in 146 alveolar wounds, in which the majority (47%) consisted of alveolar sockets of multirooted teeth. One participant was diagnosed with SBP (Escherichia coli [E. coli]) and another diagnosed with bacterascites (Streptococcus viridans [S. viridans] group), occurring 11 and 6 days after tooth extraction. Poor soft tissue healing was observed in 20 (13.7%) patients, which was correlated to 2 risk factors, that is, jaundice (P = .007, adjusted odds ratio [OR] = 4.91, 95% confidence interval [CI] = 1.56-15.47) and moderate neutropenia (P = .048, adjusted OR = 13.99, 95% CI = 1.02-192.07). No association was found between tooth extraction and SBP in patients with cirrhosis. The delayed soft tissue healing was related to jaundice (hyperbilirubinemia) and moderate neutropenia.

Assessment of Diagnosis of Apical Root Fractures During Tooth Extraction Using Different Radiographic Techniques: An Ex-vivo Study

Objective: This study aimed to examine the diagnostic ability of different imaging techniques for apical root fractures that occur during tooth extraction by specialist dentists in different branches. Methods: Dry human mandibles used for education at Faculty of Dentistry and teeth extracted for routine treatment were used. After the root lengths were measured using a periodontal probe, the samples were adjusted to different lengths. These specimens were placed on a dry human mandible, and images were obtained and recorded using a periapical device, panoramic device, and computed tomography. Radiographs and recordings were performed by an oral and maxillofacial radiologist. The evaluation process was performed by an oral and maxillofacial radiologist, periodontologist, and oral and maxillofacial surgeon. Results: The diagnosis of 1 mm root presence and absence on periapical radiographs showed significant agreement among all observers. In the presence of 2 mm and 3 mm roots, all observers stated that the roots were present. On the panoramic radiographs, moderate agreement was observed in teeth with a 1 mm root. However, poor agreement between observers was observed for teeth with 2 mm and 3 mm roots. Cone-beam computed tomography (CBCT) was effective for the diagnosis of all observers. Conclusion: Consistent with the literature, the present study showed a higher interobserver agreement in CBCT. However, considering the patient's anxiety during the procedure, the duration of local anesthesia, and the surgeon's fatigue, two-dimensional radiographs are generally preferred over CBCT, which has a longer image processing time. Diagnosis using periapical radiographs was more effective than that using panoramic radiographs.

Jaw Morphology and Factors Associated with Upper Impacted Canines: Case-Controlled Trial

Introduction and aim: Orthodontic treatment of impacted maxillary canines is challenging and expensive. This study investigated factors associated with impaction risk and the need for surgical exposure. Methods: Seventy-five participants of similar age, skeletal maturity, and gender (32 impacted canines, 43 controls) were included in the case-controlled trial. Three-dimensional study models were created (Trios 3, 3Shape), and panoramic radiographs were taken. The 3D digital models were measured using software to obtain morphological characteristics of the maxilla, such as maxillary surface area (mm2) and volume (mm3). Results: The impacted canine group displayed a significantly higher prevalence of deep bite (OR = 5.01), hypoplastic lateral incisors (OR = 5.47), and rotated adjacent teeth (OR = 3.56) compared to the control group. The impacted canine group exhibited a smaller maxillary surface area and volume. Within the impacted canine group, factors associated with a greater need for surgical exposure included the presence of a persistent deciduous canine (OR = 10.15), a palatal canine position (OR = 7.50), and a steeper canine angulation (p < 0.001). Conclusions: These findings suggest that several signs can serve as potential predictors of increased risk for maxillary canine impaction and the need for surgical intervention. Identifying these factors can aid in early diagnosis and treatment planning for improved patient outcomes.

Clinical Features of Molar Root-Incisor Malformation: A Retrospective Study

This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.

Gonial angle and mandibular ramus height in Surabaya population: comparison and correlation analysis in panoramic radiograph

Gonial angle and mandibular ramus height in Surabaya population: comparison and correlation analysis in panoramic radiograph

Management of preeruptive intracoronal radiolucency (PEIR): a case series with up to 8 years follow-up.

Preeruptive intracoronal radiolucency (PEIR) is a rare dental anomaly often incidentally detected during routine radiographic examinations. This condition manifests as a radiolucent lesion beneath the enamel-dentin junction of unerupted teeth, particularly in mandibular molars, posing diagnostic and management challenges due to its asymptomatic nature. The treatment of PEIR depends on the extent of the lesion and the degree of pulp involvement. Case series: This case series reports on four patients with progressive PEIR. In Cases 1 and 2, lesions were incidentally discovered in panoramic radiographs during orthodontic planning (mandibular permanent second molars), and additional surgical exposure to access the lesion was required as teeth were only partially erupted. Interestingly, in Case 3, the PEIR was not visible in earlier radiographs though the crown of the tooth was already mineralized (mandibular permanent second molar). For Case 4, the tooth presented with symptoms of reversible pulpitis (mandibular permanent first molar). All lesions were treated with indirect pulp capping using biocompat-ible material. The patients were followed up for a period of up to 8 years to evaluate treatment success. Indirect pulp capping and restorations were found to be successful in all four cases in the last follow-up: 1 year (Case 2), 1.4 years (Case 4), 1.5 years (Case 1), and 8 years (Case 3). Conclusion: This case series demonstrates the effectiveness of early intervention via surgical exposure and indirect pulp capping and restoration for managing severe cases of PEIR. However, further research with larger samples and long follow-up is necessary.

Evaluation of Soft Tissue Calcifications in the Head and Neck Region on Panoramic Radiography of Edentulous Patients

Evaluation of Soft Tissue Calcifications in the Head and Neck Region on Panoramic Radiography of Edentulous Patients

Two-step deep learning models for detection and identification of the manufacturers and types of dental implants on panoramic radiographs.

The purpose of this study is to develop two-step deep learning models that can automatically detect implant regions on panoramic radiographs and identify several types of implants. A total of 1,574 panoramic radiographs containing 3675 implants were included. The implant manufacturers were Kyocera, Dentsply Sirona, Straumann, and Nobel Biocare. Model A was created to detect oral implants and identify the manufacturers using You Only Look Once (YOLO) v7. After preparing the image patches that cropped the implant regions detected by model A, model B was created to identify the implant types per manufacturer using EfficientNet. Model A achieved very high performance, with recall of 1.000, precision of 0.979, and F1 score of 0.989. It also had accuracy, recall, precision, and F1 score of 0.98 or higher for the classification of the manufacturers. Model B had high classification metrics above 0.92, exception for Nobel's class 2 (Parallel). In this study, two-step deep learning models were built to detect implant regions, identify four manufacturers, and identify implant types per manufacturer.

Pulp Cavity Calcification in SLE Patient Associated with Long-term Use of Glucocorticoids: A Case Study with Endodontic Approaches

Background Calcification in the tooth pulp cavity occurs in response to various factors, including dental trauma and chronic irritation. Systemic lupus erythematosus (SLE) is the most common type of lupus, causing widespread inflammation and tissue damage in the affected organs. The SLE condition is generally managed by long-term use of drugs, including glucocorticoids (GCs). Objective This study aimed to assess the association of pulp cavity calcification in SLE patients with long-term use of GCs and to present endodontic perspectives on the issue. Case Presentation A female SLE patient with a history of long-term use of GCs visited our hospital for an oral surgery examination due to an accident. The crown of tooth 11 was visibly fractured. The tooth was sensitive to cold stimulus, while tooth 21 was mobile. Various examinations (including electric pulp test and panoramic radiography) pointed to the diagnosis of chronic pulpitis in the affected teeth (11 and 21), and cone beam computed tomography (CBCT) revealed that the pulp cavities in all teeth were almost completely calcified. Thus, the root canal treatment (RCT) was attempted and followed by crown restoration for the affected teeth. The involvement of GCs in the pulp cavity calcification was assessed. Conclusion According to this case and a series of related studies, long-term use of glucocorticoids is associated with the incidence of pulp cavity obliteration (PCO). More frequent dental examinations and appropriate adjustments in medication use (dose and duration) should be considered and implemented.

Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth

BackgroundIt is still unclear whether the trabecular structure of the jaw is different in individuals with hypodontia than in those without hypodontia; this is important for clinicians. The aim was to determine whether the mandibular trabecular bone structure of children and adolescents with hypodontia differs from the control group by using the fractal analysis (FA) method in this study.MethodsA total of 138 panoramic radiographs of 69 cases and 69 control subjects (mean age 13.2 ± 10.1) were evaluated. The age and gender of subjects in the case and control groups were matched. Three regions of interest (ROIs) were selected from the panoramic radiographs. ROI1 refers to the center of the ramus rising above the mandibular foramen. ROI2 refers to the area between the apical level of the mandibular molar and the upper border of the mandibular canal. ROI3, the missing tooth region, refers to the apical third of the mesial side of the erupting or fully erupted permanent mandibular first molar. Mann-Whitney U and Wilcoxon tests were used. p < 0.05 was accepted for the significance value.ResultsThe mean fractal dimension (FD) values of ROI1, ROI2, and ROI3 were 1,25, 1,20, and 1,13, respectively. The means FD values obtained from the ramus region were higher than the other regions (p < 0.05). The FD values did not differ significantly according to gender and age (p > 0.05). The FD values of the case group were lower than the control group for ROI3 (p < 0.05).ConclusionThe results of this study showed that the mandibular trabecular bone quality of pediatric patients with one missing tooth was different from the healthy group. The difference in the mean FD values from the ROIs indicates that the ramus has a denser structure than the mandibular corpus. Clinicians should factor this into their dental treatment planning process.