Panoramic Radiographic Images Research Articles

Comparative analysis of panoramic radiography and cone-beam computed tomography in treatment planning of palatally displaced canines

The objective of this research was to compare the predictive value of panoramicradiographs (PRs) and cone-beam computed tomography (CBCT) scans for the estimation of root resorption, spontaneous eruption of a canine, and time for orthodontic traction. CBCT scans and PR images of 88 patients (27 male and 61 female; aged between 11 and 44years) with 106 palatally displaced maxillary canines were retrieved from a database. Predictive values of several radiographic parameters, including the 3-dimensional angle of the canine, were analyzed using the area under the curve and multiple regression analysis. The angle to the midline and canine position category had a discriminative ability for root resorption of the central incisors with area under the curve values of 0.63 (95% confidence interval, 0.56-0.79) and 0.83 (95% confidence interval, 0.75-0.91), respectively. PR measurements were not reliable predictors of resorptions, except severe resorptions, of the lateral incisors and the premolars. The measurements describing the position of the canine in relation to the midline could predict spontaneous eruption of the canine, regardless of the imaging method. The canine angle to the midline assessed on CBCT was significantly associated with traction time of the canine, producing the following equation: canine traction time=49.6 - 0.24×canine angle to the midline (r2=0.360). Only severe resorptions of roots can be predicted with PRs. The use of CBCT is indicated in cases of impacted canines.

An evaluation of the relationship between maxillary sinus anterior wall depression and maxillary sinus opacity by computed tomography and panoramic radiography.

Maxillary sinus anterior wall depression (AWD) has been associated with patterns such as the presence of panoramic innominate line and silent sinus syndrome. The aim of this study was to evaluate the relationship between AWD of maxillary sinus and both maxillary sinus opacity and the presence of innominate line using computed tomography (CT) and panoramic radiography (PR). 250 CT and PR images (122 female, 128male) which had been taken for various reasons were randomly selected from the radiology archive of the our department. Innominate line visibility in PR is divided into three as invisible, obscure and clear. On CT images, the distance between guide line and the deepest point of the maxillary sinus anterior wall was calculated as AWD. The presence of maxillary sinus opacity and maxillary sinus AWD were evaluated on CT images. Demographic information such as age, gender and localization of the findings were noted in all measurements. In 143 (57.2%) patients, the innominate line (clear and obscure patterns) was seen on the PR images. AWD was observed in 104 (41.6%) CT images. The presence of maxillary sinus opacity was observed in 117 (46.8%) images. The mean right anterior wall depth was 5.69 and 4.88 in males and females, respectively, while the mean left anterior wall depth was 5.64 and 4.94 in males and females, respectively. Right wall depth was significantly higher in males (p < 0.05).There was no statistically significant difference in left wall depth (p > 0.05). Anterior wall depression was found to be associated with both maxillary sinus opacity and the visibility of the innominate line. Patients with AWD should be considered as susceptible to maxillary sinus diseases.

Identification of Specific Panoramic High-Risk Signs in Impacted Third Molar Cases in Which Cone Beam Computed Tomography Changes the Treatment Decision

The aim of this study was to investigate the treatment decisions of oral-maxillofacial surgeons in the management of impacted lower third molars (M3s) according to panoramic radiography (PR) and cone beam computed tomography (CBCT) risk analysis. Ten surgeons analyzed 40 deliberately selected M3 cases showing 1 or more panoramic high-risk signs: 1) darkening of the root, 2) interruption of the white line, 3) diversion of the inferior alveolar canal (IAC), 4) narrowing of the IAC, and 5) 2 or more signs occurring simultaneously (including darkening and/or interruption of the IAC). After evaluating the PR images, the observers analyzed the patients' CBCT images. The treatment decision (extraction vs coronectomy) and surgical technique (number of planned tooth sections) were recorded. On the CBCT coronal slices, direct contact between the M3 and IAC, together with narrowing and/or fenestration of the IAC, was observed most frequently when 2 or more panoramic signs were seen simultaneously on the PR images (odds ratio [OR], 7.2; P=.021). CBCT findings led to a significant decrease in the number of coronectomy decisions (23% vs 14.5%, P=.002), which was most prominent in the groups showing panoramic signs of darkening (approximately 50%, P=.007) and narrowing (approximately 66%, P=.044). A significant number of extraction decisions were modified to coronectomy when 2 or more panoramic signs occurred together (OR, 7.9; P<.001). However, there were no significant differences regarding the number of planned hypothetical tooth sections. The results showed that the surgeons' confidence in the treatment decision increased after CBCT imaging, resulting in fewer coronectomy decisions. CBCT information that changed a previous coronectomy decision to extraction was most frequently observed in cases showing darkening and narrowing PR signs. The chance of changing an extraction decision to a coronectomy decision after evaluating the patient's CBCT images was the highest when 2 or more PR signs were observed simultaneously.

SEPARATION OF OVERLAPPING OBJECT SEGMENTATION USING LEVEL SET WITH AUTOMATIC INITALIZATION ON DENTAL PANORAMIC RADIOGRAPH

To extract features on dental objects, it is necessary to segment the teeth. Segmentation is separating between the teeth (objects) with another part than teeth (background). The process of segmenting individual teeth has done a lot of the recently research and obtained good results. However, when faced with overlapping teeth, this is quite challenging. Overlapping tooth segmentation using the latest algorithm produces an object that should be segmented into two objects, instantly becoming one object. This is due to the overlapping between two teeth. To separate overlapping teeth, it is necessary to extract the overlapping object first. Level set method is widely used to segment overlap objects, but it has a limitation that needs to define the initial level set method manually by the user. In this study, an automatic initialization strategy is proposed for the level set method to segment overlapping teeth using hierarchical cluster analysis on dental panoramic radiographs images. The proposed strategy was able to initialize overlapping objects properly with accuracy of 73%. Evaluation to measure quality of segmentation result are using misscassification error (ME) and relative foreground area error (RAE). ME and RAE were calculated based on the average results of individual tooth segmentation and obtain 16.41% and 52.14%, respectively. This proposed strategy are expected to be able to help separate the overlapping teeth for human age estimation through dental images in forensic odontology.

Relationship between Radiographic Evaluation with Age and Gender – A Radiographic Study

Background: Forensic odontology plays an important role in identification of man-made or natural disasters event which restricts identification through conventional methods. Various approaches have been specified which helps in the identification of the post-mortem remains. One such is the identification of the morphological features of the human skull and mandible. These features may help in sex differentiation. The aim of this study is to evaluate the relationship between radiographic evaluation with age and gender.Materials and Method: A retrospective study was done with a total of 250 panoramic radiograph image. The images of 150 males and 100 females were selected with the range of age from 20 to 70 years old and divided into group 1 (20-45 years old) and group 2 (46-70 years old). Three parameters were evaluated from the panoramic radiograph which were gonial angle, antegonial angle and mental foramen against the age and gender. Statistical analysis was done for hypothesis testing.Results: The results of this study suggests that there is no significant difference seen in the gonial angle and antegonial angle with relation to the age (p?0.05). However, the relationship between age and mental foramen is highly significant (p?0.01). With regards to gender, all the three parameter shows highly significant results with (p?0.01).Conclusion: In conclusion, the three parameter assessed in this study can be used for gender differentiation but not for age estimation which were highly significant. As for age estimation, the distance of mental foramen and tangent line of inferior border of mandible can be assessed.

Assessment of common errors and subjective quality of digital panoramic radiographs in a dental institution

Aim: The aim of the study was to determine the incidence of patient preparation and positioning errors during panoramic radiographic imaging and to assess the subjective quality of panoramic radiographs in a sample of records collected from a dental institution. Materials and Methods: The study material was 1000 randomly selected panoramic radiographs obtained from the database of the department of oral and maxillofacial radiology. Patient preparation and positioning errors of the radiographs were evaluated and categorized into nine groups. The sample radiographs were also evaluated for subjective quality according to a three-point quality scale by the National Radiological Protection Board (United Kingdom) as “excellent,” “diagnostically acceptable,” or “unacceptable.” Results: Out of 1000 radiographs evaluated, failure to position the tongue against palate was the most common error at 69.5% and patient movement during radiographic exposure was the least common error at 0.4%. As per the subjective quality ratings, 22.4% of the radiograph had excellent quality, 66.4% were diagnostically acceptable, and 13.2% were unacceptable. Conclusion: The incidence of patient positioning errors in the panoramic radiographs was relatively common. The quality of the diagnostic panoramic radiographs could be improved by better operator education and awareness in relation to patient preparation and positioning.

Impact of Pediatric Hematopoietic Stem-Cell Transplantation on Craniofacial Growth

OBJECTIVES:To assess the craniofacial skeletal growth in pediatric hematopoietic stem-cell transplantation (HSCT) survivors in comparison with age-sex matched-paired controls.METHODS:A case-controlled retrospective comparison of the craniofacial growth in 25 HSCT children and 25 matched-paired controls was conducted. Craniofacial growth was quantitatively assessed by linear and angular measurements in panoramic radiographic images using ImageJ¯. Stature growth and body weight were obtained through physical examination. Cancer diagnosis, myeloablative conditioning, and HSCT were retrieved from medical records.RESULTS:Patients aged 12.2 years (±3.8; 16 male, 9 female). Radiographic images were obtained on an average of 2.43 (±2.0) years after HSCT. The main malignant diagnosis was acute lymphoblastic leukemia (56%), followed by acute myeloid leukemia (36%) and myelodysplastic syndromes (8%). Total body irradiation was associated with chemotherapy at 80%. Mean age at transplantation was 10 (±4.7) years. HSCT survivors showed reduced a vertical growth of the mandibular ramus (p=0.003). This persisted among individuals below 12 years of age (p=0.017). The HSCT group showed delayed dental eruption, though there was no statistically significant difference (p=0.3668). The HSCT group showed stature deficit, increased weight, and body mass index (Z-score stature: -0.28; Z-score weight: 0.38, respectively).CONCLUSIONS:Pediatric HSCT has decreased vertical craniofacial growth compared to their matched controls. There might be an association between reduced craniofacial vertical growth and reduced estature growth. Further studies to quantitatively investigate the impact of different myeloablative regimens in craniofacial skeletal growth and development.

Bilateral canine space infection secondary to odontogenic origin. A rare case report.

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a radiolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To perform treatment of odontogenic infections, the Oral &amp; Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

RADIOMORPHOMETRIC EVALUATION OF MANDIBULAR CORTICAL INDEX AMONG YOUNG AND MIDDLE-AGED LITHUANIAN INDIVIDUALS

Background and objective. The aim of this study was morphological analysis of the cortical layer in the mandibular base distally from the mental foramen for determination of the mandibular cortical index in the Lithuanian young and middle-aged individuals according to gender, age, general health status, used medicine. Materials and methods. The study included 216 randomly selected subjects aged 19 to 50 years. A questionnaire was used to collect data on subjects’ age, gender, sociodemographic status, diseases, and used medicines, harmful habits. Skeletal bone status was examined according One – Minute test, panoramic radiography was performed, and panoramic radiographic images were analyzed to determine the mandibular cortical index. According to the classification by Klemetti, subjects were divided into 3 index morphological groups: C1, C2, and C3. Analysis was carried out by mentioned factors. Results. There was a significant relationship between mandibular cortical index and subject’s age (F=4.54; df=2; p=0.01), gender (χ2=16.22; df=2; p&lt;0.01), thyroid diseases (p=0.05), hormonal preparation use (p&lt;0.01), cigarette smoking (p&lt;0.01). Conclusions: The study data confirmed the hypothesis that morphological changes in the cortical layer at the mandibular base were found among young and middle aged individuals with normal skeletal bone status and were significantly associated with subject’s age, gender, and other factors such as cigarette smoking, diseases having an influence on bone metabolism, used medicines.

Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths

Objective: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. Materials and Methods: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman’s rho correlation coefficient, and χ² tests were used for the statistical analysis. Results: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman’s r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. Conclusion: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.

Retrospective evaluation of marginal bone loss around implants in a mandibular locator-retained denture using panoramic radiographic images and finite element analysis: A pilot study.

The follow-up of the peri-implant marginal bone loss is the most important criterion for the determination of implant success. The purpose of this study is to measure marginal bone loss using panoramic radiographic images (PRI) of patients treated using a mandibular, two implant-supported, locator-retained denture and to evaluate the compatibility of these findings with those of the finite element analysis (FEA). The PRI of patients who had a mandibular, two implant-supported, locator-retained denture were assessed, and the mesial and distal marginal bone loss of both right- and left-sided implants was measured. Mandibular and maxillary models, which have the features of bilateral balanced occlusion, were created. The surfaces of the generated models were converted in a computer-aided design model that could be transferred to the FEA software, and the forces were defined on contacts formed in maximum intercuspation, lateral, and protrusive movement position for bilateral balanced occlusion. The bone loss in the mesial and distal regions at the right- and left-sided implants was not statistically significant. Higher stresses were formed on the vestibular side under protrusive movement, on the lingual side under maximum intercuspation, on the distolingual side under left unilateral biting, and on the mesiolingual side under right unilateral biting in the FEA. According to FEA, peri-implant bone resorption may be higher in the buccal and palatal regions, implying that panoramic radiographs can be misleading in understanding the amount of peri-implant bone resorption.

Dynamic focal plane estimation for dental panoramic radiography.

The digital panoramic radiography is widely used in dental clinics and provides the anatomical information of the intraoral structure along the predefined arc-shaped path. Since the intraoral structure varies depending on the patient, however, it is nearly impossible to design a common and static focal path or plane fitted to the dentition of all patients. In response, we introduce an imaging algorithm for digital panoramic radiography that can provide a focused panoramic radiographic image for all patients, by automatically estimating the best focal plane for each patient. The aim of this study is to improve the image quality of dental panoramic radiography based on a three-dimensional (3D) dynamic focal plane. The plane is newly introduced to represent the arbitrary 3D intraoral structure of each patient. The proposed algorithm consists of three steps: preprocessing, focal plane estimation, and image reconstruction. We first perform preprocessing to improve the accuracy of focal plane estimation. The 3D dynamic focal plane is then estimated by adjusting the position of the image plane so that object boundaries in the neighboring projection data are aligned or focused on the plane. Finally, a panoramic radiographic image is reconstructed using the estimated dynamic focal plane. The proposed algorithm is evaluated using a numerical phantom dataset and four clinical human datasets. In order to examine the image quality improvement owing to the proposed algorithm, we generate panoramic radiographic images based on a conventional static focal plane and estimated 3D dynamic focal planes, respectively. Experimental results show that the image quality is dramatically improved for all datasets using the 3D dynamic focal planes that are estimated from the proposed algorithm. We propose an imaging algorithm for digital panoramic radiography that provides improved image quality by estimating dynamic focal planes fitted to each individual patient's intraoral structure.

Bony and Dental Radiographic Features of Type I and Type III Gaucher Diseased Children

Background: Gaucher disease (GD) is a lysosomal storage disease caused by an autosomal recessive inherited deficiency of the lysosomal enzyme glucocerebrosidase. The aim of this study was to describe jaw bones involvement and dental radiographic features in pediatric Gaucher disease patients (type I and type III). Subjects and Methods: The study population of this case-control study included 42 Gaucher patients (study group) and 84 medically free children (control group). Panoramic radiographic images of both groups were taken and analyzed for the following findings: generalized bone rarefaction, localized rarefaction, enlarged bone marrow spaces, thinning of cortex, pseudo-cystic radiolucent lesions, anodontia, and dental anomalies. Results: Generalized rarefaction showed almost similar percentages in both types of Gaucher disease cases. Localized rarefaction was noted in 30.77% and 18.75%, of Gaucher disease type III and type I respectively. Pseudo-cystic radiolucent lesions, thinning of cortex, anodontia and dental anomalies were more prevalent in type III Gaucher patients. Conclusion: Thinning of cortex, localized rarefaction and generalized rarefaction are the most common jaw bone findings in Gaucher patients.

Evaluation of the position variation of mandibular foramen

Berlinska Magdalena , Misiejuk Aleksandra , Komisarek Oskar . Evaluation of the position variation of mandibular foramen . Journal of Education, Health and Sport. 2019;9(7):1 85 -194 . eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3269410 http://ojs.ukw.edu.pl/index.php/johs/article/view/71 20 https://pbn.nauka.gov.pl/sedno-webapp/works/917520 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.06.2019. Revised: 25.06.2019. Accepted: 04.07.2019. EVALUATION OF THE POSITION VARIATION OF MANDIBULAR FORAMEN Magdalena Berlinska 1 magdalena.berlinska@onet.pl ORCID: 0000-0002-1742-5481, Aleksandra Misiejuk 1 ale.misiejuk@gmail.com ORCID: 0000-0001-8224-4962, Oskar Komisarek 2 oskarkomisarek@gmail.com ORCID: 0000-0002-1037-3711 1 Students Scientific Society of Maxillofacial and Orthognathic surgery, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan 2 Department of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan ABSTRACT INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications. Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice. AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen. SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan. RESULTS : Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location. CONCLUSIONS: Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules. KEYWORDS: Mandibular foramen; panoramic radiography; anatomic variation; inferior alveolar nerve block

Evaluation of the position variation of mandibular foramen

Berlinska Magdalena , Misiejuk Aleksandra , Komisarek Oskar . Evaluation of the position variation of mandibular foramen . Journal of Education, Health and Sport. 2019;9(7):1 85 -194 . eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3269410 http://ojs.ukw.edu.pl/index.php/johs/article/view/71 20 https://pbn.nauka.gov.pl/sedno-webapp/works/917520 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.06.2019. Revised: 25.06.2019. Accepted: 04.07.2019. EVALUATION OF THE POSITION VARIATION OF MANDIBULAR FORAMEN Magdalena Berlinska 1 magdalena.berlinska@onet.pl ORCID: 0000-0002-1742-5481, Aleksandra Misiejuk 1 ale.misiejuk@gmail.com ORCID: 0000-0001-8224-4962, Oskar Komisarek 2 oskarkomisarek@gmail.com ORCID: 0000-0002-1037-3711 1 Students Scientific Society of Maxillofacial and Orthognathic surgery, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan 2 Department of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Collegium Maius, ul. Fredry 10, 61-701 Poznan ABSTRACT INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications. Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice. AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen. SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan. RESULTS : Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location. CONCLUSIONS: Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules. KEYWORDS: Mandibular foramen; panoramic radiography; anatomic variation; inferior alveolar nerve block

Odontogenic Keratocyst: A Case Report Emphasizing on Root Canal Treatment after Surgical Intervention.

This article presents a case of odontogenic keratocyst (OKC) located in the mandible, involving teeth 36 to 45, with significant loss of alveolar bone and aseptic pulp necrosis, emphasizing on root canal treatment after surgical intervention. Orthopantomogram and computed tomography examinations revealed an extensive, well-defined, and multilocular radiolucent lesion. Histopathological examination after incisional biopsy confirmed OKC, which was removed completely with enucleation and curettage, followed by the endodontic treatments of teeth 36 to 45 using reciprocating nickel-titanium files (Reciproc) in a single session. Afterwards, teeth 33 to 36 underwent apical surgery to create an appropriate bone development. Panoramic radiographic images showed bone formation and no sign of recurrence after one-year follow-up. In conclusion, this surgical approach, combined with the endodontic treatments of the teeth involved in the lesion, was effective for the management of OKC, promoting injury regression and preservation of the natural teeth.

Performance of dental pattern analysis system with treatment chronology on panoramic radiography

The present study was conducted to improve human identification based on dental pattern with adopting chronology of dental treatment within the system. Five hundred adult patients were randomly selected, and their initial and recent panoramic radiography images were assumed as antemortem (AM) and postmortem (PM) images, respectively. For each radiographic image, the dental pattern was analyzed. The analysis system was newly developed considering sequence of dental treatment in time order. AM and PM databases were constructed with information of dental patterns, patient age, and gender. For the PM database, age information was stored as the actual age ± 10 years, which was defined as the estimated age. According to dental pattern of PM record, the possible AM records were selected as candidates. Then candidates were sorted in order of dental pattern similarity to the PM record, and the rank of the true AM record was identified. The total 500 AM records were reduced to 14.5 ± 13.4 candidates in average when the dental pattern, gender, and estimated age were considered. When the candidates were sorted in order of similarity, the true AM record received an average ranking of 2.0 ± 2.6. When dental pattern and gender were considered, 46.7 ± 42.3 candidates were selected among 500 records and the true AM record was ranked at 3.0 ± 5.0, in average. The dental pattern analysis adopting dental treatment chronology was contributed to reduce the sample population. This method would become more efficient and comprehensive if the dental pattern analysis process is automatized in the near future.

Is Panoramic Imaging Equivalent to Cone-Beam Computed Tomography for Classifying Impacted Lower Third Molars?

Preoperative recognition of the relative position of the mandibular third molars may contribute to more reliable treatment planning, avoiding injuries and decreasing surgical and recovery times. The research questions for this study were as follows: 1) Is panoramic radiography (PR) equivalent to cone-beam computed tomography (CBCT) in determining the degree of mandibular third molar impaction? 2) For PR, is the external oblique ridge a more reliable reference to determine the degree of mandibular third molar impaction? This retrospective case-series study assessed whether the imaging modalities (primary predictor variable) are equivalent in determining the degree of impaction of third molars (primary outcome variable) according to the parameters of the Pell and Gregory classification. Two oral and maxillofacial radiologists evaluated PR and CBCT images presenting at least 1 mandibular third molar. The degrees of impaction related to the ascending ramus and related to the external oblique ridge (secondary outcome variables) also were assessed. The agreement rates between PR and CBCT were presented, and the imaging modalities were compared by the McNemar-Bowker test (α=.05). A total of 173 patients were included (66 male and 107 female patients). Among these patients, 313 mandibular third molars were assessed. In relation to the occlusal plane, the agreement rate between PR and CBCT was 82.1% for Pell and Gregory class A, 90.5% for class B, and 65.6% for class C (P=.116). The overall agreement rate between the classifications in relation to the mandibular ramus on PR and CBCT ranged from 66.8% (considering the ascending ramus, P<.001) to 76.4% (considering the external oblique ridge, P<.001). PR performs similarly to CBCT in the classification of impaction in relation to the occlusal plane. However, PR shows a tendency to underestimate the space for accommodation of the third molar compared with CBCT. Furthermore, the external oblique ridge is not a reliable alternative landmark on PR.

Brief Report: Estimating the Dental Age of Children with Autism Spectrum Disorders.

Determining a patient's dental age is essential from the dental standpoint but can also have connotations of a forensic, anthropological and medicolegalnature. In this study, we assessed the correspondence between dental age and chronological age in a group of 50 children with autism spectrum disorders, with a chronological age range of 3-17years. The dental age was calculated using panoramic radiography images, applying linear regression models derived from the classical indices by Nolla and Demirjian. In 2 of every 3 boys, the dental age was ahead of the chronological age, and in almost 1 of every 3 cases, the difference was ≥ 12months. In the girls, conversely, we found no significant differences between dental age and chronological age.

Iterated Region for Interactive Image Segmentation on Dental Panoramic Radiograph

Image Segmentation is a process to separate between foreground and background. Segmentation process in low contrast image such as dental panoramic radiograph image is not easily determined. Image segmentation accuracy determines the success or failure of the final analysis process. The process of segmentation can occur ambiguity. This ambiguity is due to an ambiguous area if it is not selected as a region so it may have occurred cluster errors. To solve this ambiguity, we proposed a new region merging by iterated region merging process on dental panoramic radiograph image. The proposed method starts from the user marking and works iteratively to label the surrounding regions. In each iteration, the minimal gray-levels value is merged so the unknown regions significantly reduced. This experiment shows that the proposed method is effective with an average of ME and RAE of 0.04% and 0.06%.