Panoramic Radiographs Research Articles

Jaw bone changes in panoramic radiography in patients with hyperparathyroidism

Background and aims: The current investigation aimed to evaluate jaw bone changes, and compare the presence of gonial cortex bone thickness, mental index (MI), lamina dura (LD), lower dental canal, and bone density in panoramic radiography, in patients with hyperparathyroidism. Methods: The present cross-sectional descriptive-analytical study was performed on 17 healthy individuals and 17 patients who suffered from resorptive hypercalciuria in the dialysis center of Shahid Beheshti hospital in Babol in 2018. If patients had two or more decayed teeth, they were referred to a specialized maxillofacial clinic by the dentist for free panoramic imaging. Mandibular cortical index, LD, bone change, mandibular resorption (MR), and general cortical indices underwent examination. Results: The mean age of the control and case groups was 36.58±11.81 years and 40.23±14.32 years, respectively (P=0.424). In addition, the mean MI was 4.27±0.87 and 2.98±0.75 in the control and case groups, respectively (P<0.001). Based on the results, the mean gonion region’s cortical bone thickness was 0.93±0.23 and 1.09±0.24 in the case and control groups, respectively (P<0.001). Further, bone changes (P=0.036) and MR (P=0.017) were significantly different in the case and control groups. However, LD vision showed no significant difference in the hyperparathyroidism and the control groups (P=0.141). Conclusion: The results demonstrated a decrease in the thickness of the cortical bone in the guinea pig, mental region, and lack of dental canal in resorptive hypercalciuria compared to healthy individuals.

Linear measurements of the mandible on panoramic radiograph for sex estimation in populations in Yogyakarta, Indonesia

BackgroundIdentification is one of the main aspects of forensics. Sex estimation is an essential part of identification because it can simplify the whole process. Mandible is the largest, strongest, and sexually dimorphic bone and is part of the orofacial structure, which has the second highest level of dimorphism after the pelvic bone. Sex estimation using the mandible can be performed by conducting various linear measurements on a panoramic radiograph, including right minimum ramus width (RMiRW), left minimum ramus width (LMiRW), right projective height of ramus (RPHR), left projective height of ramus (LPHR), right maximum ramus width (RMxRW), left maximum ramus width (LMxRW), right coronoid height (RCH), left coronoid height (LCH), symphysis height (SH), right mandibular corpus height (RMCH), and left mandibular corpus height (LMCH). This study aimed to analyze how linear measurements in panoramic radiographs differ between men and women and to estimate sex by utilizing these parameters.ResultsIn this study, 195 panoramic radiographs from 95 men and 100 women aged 20–40 years obtained from our dental hospital were used as a training data. Meanwhile, 61 panoramic radiographs from 29 men and 32 women outside the training data with same characteristics were used as the testing data. The linear measurements of the mandible using panoramic radiographs were taken with EzDent-i Vatech software. Independent t-test showed significant difference (p < 0.05) in some linear measurements of the mandible between adult men and women. These significantly different linear measurements were then subjected to discriminant function analysis to produce sex estimation equations. The equation accuracy percentage ranged between 63.6 and 94.4% for the training sample and 59.5% and 85% for the testing sample.ConclusionThe linear measurements of the mandible using diagnostically acceptable panoramic radiographs taken from a patient with standardized head positioning can serve as an alternative method for sex estimation. The accuracy of discriminant analysis for sex estimation varies depending on the parameter used in the estimation.

Comparative Analysis of Impacted Mandibular Third Molar Root Proximity to the Mandibular Canal using Orthopantomography and Cone-beam Computed Tomography Imaging Modalities: A Pilot Study

Abstract Introduction: Fully detect risks of nerve damage, which can lead to temporary or permanent issues. Cone-beam computed tomography (CBCT) offers a three-dimensional (3D) view, providing more detailed visualisation of anatomical structures and their spatial relationships, which improves the accuracy of predicting nerve exposure. The study aims to evaluate and compare these imaging techniques’ effectiveness in categorising the relationship between third molars and the inferior alveolar canal, emphasising the importance of precise imaging for safer surgical outcomes. Materials and Methods: A pilot study involving 20 patients, representing 10% of the total sample size of 200, was conducted at Ahmedabad Dental College’s Department of Oral Medicine and Radiology. Investigators, trained to interpret radiological images from orthopantomography (OPG) and CBCT, compared their interpretations with those of two experts. A high inter-rater reliability was confirmed with a kappa statistic of 0.98. Following ethical approval, data were retrospectively collected from 20 cases, with digital OPG and CBCT images analysed and classified according to established criteria. Results: The results revealed a significant association between the results diagnosed through OPG and CBCT indicating similarity in their diagnosis. It was also seen that there was no bias towards the gender and the distribution was similar in case of diagnosis through OPG or CBCT. Conclusion: CBCT demands an in-depth understanding of anatomy and pathology, coupled with proficiency in operating imaging software and the ability to identify abnormalities in cross-sectional images. When executed and interpreted accurately, CBCT proves to be an exceptionally valuable tool in clinical dental practice. Its detailed 3D imaging capabilities enhance the assessment of complex cases, such as those involving intricate anatomical structures and pathologies. By providing comprehensive views that surpass traditional two-dimensional imaging, CBCT aids in precise diagnosis and treatment planning, making it an indispensable resource for addressing various dental conditions effectively.

The radiographic diversity of dental patterns among 7219 young individuals-a contribution to disaster victim identification.

The diversity of dental patterns is a fundamental topic in disaster victim identification. The current scientific literature, however, is scarce of data regarding young individuals. This study aimed to assess the radiographic diversity of dental patterns, considering missing, unrestored, and filled teeth in young individuals. The sample consisted of 7219 panoramic radiographs of individuals between 12 and 22.9 years. The permanent teeth, except third molars, were coded as missing, unrestored, or filled and odds ratios (OR) were calculated based on sex, dental arch, and age. The sex-combined sample had 1.116 distinctive dental patterns. "All unrestored" teeth was the most common pattern (OR: 0.437) followed by the sequence of unrestored teeth except restored mandibular first molars (OR: 0.021). Females had more distinctive dental patterns than males (p < .001), while males had more unrestored teeth (p < .001). In the age category of 12-12.9 years, the OR for finding a distinctive dental pattern was 11%, while in the age category of 22-22.9 years it increased to 58%. On the other hand, the OR for "all unrestored" gradually decreased according to age (74% in the younger category, and 23% in the older age category). The distinctiveness of dental patterns among young individuals is affected by the predominance of unrestored teeth. However, registering a single filled tooth in a remaining unrestored dentition can reduce exponentially the probability of finding an identical pattern of missing, unrestored and filled teeth.

Panoramic evaluation of external root resorption in mandibular molars during orthodontic treatment: a comparison between root-filled and vital teeth treated with fixed appliances or clear aligners

BackgroundThis investigation compared the extent of external apical root resorption (EARR) in root-filled teeth (RFT) and their contralateral vital pulp teeth (VPT) counterparts during orthodontic treatment (OT) with clear aligner (CA) treatment or fixed appliance (FA) treatment.MethodsSixty-six patients with similar baseline American Board of Orthodontics (ABO) discrepancy index scores were divided into two groups: 37 patients (21 females, 16 males; mean age 17.45 ± 2.67 years) in the FA group, and 29 patients (18 females, 11 males; mean age 18.33 ± 1.96 years) in the CA group. Digital panoramic radiographs captured pre- and post-OT were used to measure tooth lengths and root surface measurements in mandibular molars. EARR in both RFT and contralateral VPT was evaluated pre- and post-OT. Statistical analysis employed paired t-tests, independent t-tests, and analysis of covariance (ANCOVA) (p < .05).ResultsAll teeth exhibited varying degrees of EARR following OT. FA treatment resulted in significantly longer treatment duration (p < .05) and greater EARR compared to CA treatment (p < .05). Moreover, statistically significant differences in EARR were observed within both groups between RFT and VPT (p < .05).ConclusionsComparison of pre- and post-OT radiographs revealed different degrees of EARR in all teeth. CA treatment resulted in less frequent and less severe EARR compared to FA treatment. RFT demonstrated greater resistance to EARR than VPT in both treatment groups.

Evaluation of age estimation using alveolar bone images

ObjectiveThe purpose of this study is to examine the time-related changes of alveolar bone in 2D images quantitatively and to estimate age groups based on the change index. Materials and methodsThe 238 panoramic X-ray images and 140 CT panoramic reconstructed images of the permanent dentition period were used to examine age-related changes. Comparisons between the younger age group and each of the other age groups were calculated using the landmark method of Procrustes analysis. As aging changes were observed in each age group, age estimation was performed using antemortem panoramic X-ray images and postmortem CT images so that they could be used in practice. The CT images used in the age estimation were performed using forty-two postmortem CT panoramic reconstructed images of known age submitted to the judicial autopsy. ResultsBoth panoramic and CT images showed changes in the alveolar bone over time. Age estimation using postmortem CT images provided a certain assessment. ConclusionIn this study, clinically observed changes in alveolar bone over time were quantified on the images. Furthermore, the possibility of age estimation by alveolar bone was also suggested. The use of an updatable clinical database that can be stored in coordinate values offers the potential for age estimation in line with the times.

X-ray Image Analysis for Dental Disease: A Deep Learning Approach Using EfficientNets

Dental cavities are a highly common persistent dental problem that impacts populations across different age groups on a global scale. It is crucial to get a dental issue diagnosed as early as possible and with as much accuracy as possible to treat it efficiently and prevent any related issues. If a dental infection is not treated, it will eventually grow and cause tooth loss. Dental X-ray images are crucial and beneficial in the diagnostic process of dental diseases for dentists. By applying Deep Learning (DL) techniques to dental X-ray images, dental experts can efficiently and precisely detect dental conditions, including dental cavities, fillings and implants. The objective of this research is to assess the performance of DL-based methods for dental disease detection via panoramic radiographs. In this study, we evaluated the performance of all of the EfficientNet variants (e.g., EfficientNets B0-B7) to determine which one is the most effective model for detecting dental disease. Moreover, we utilized the Borderline Synthetic Minority Oversampling Technique (SMOTE) to cope with the issue related to the minority classes contained in the dataset. To assess the efficacy of the model, various metrics are employed, including recall, accuracy, precision, loss, and F1-score. As a result, the performance of the EfficientNet-B5 model was superior to that of the other EfficientNet models. The EfficientNet-B5 model achieved the following values for its metrics: F1-score, accuracy, recall, AUC, and precision: 98.37%, 98.32%, 98.32%, 99.21%, and 98.32%, respectively. The accuracy rates for the EfficientNet-B0, EfficientNet-B1, EfficientNet-B2, EfficientNet-B3, EfficientNet-B4, EfficientNet-B6, and EfficientNet-B7, are 91.59%, 94.12%, 93.28%, 85.71%, 94.96%, 96.64% and 90.76%, respectively. The results indicated that the EfficientNet-B5 model performs better than other EfficientNet classifiers, which supports dental professionals significantly in the recognition of dental diseases.

Enhanced Osteoporosis Detection Using Artificial Intelligence: A Deep Learning Approach to Panoramic Radiographs with an Emphasis on the Mental Foramen.

Osteoporosis, a skeletal disorder, is expected to affect 60% of women aged over 50 years. Dual-energy X-ray absorptiometry (DXA) scans, the current gold standard, are typically used post-fracture, highlighting the need for early detection tools. Panoramic radiographs (PRs), common in annual dental evaluations, have been explored for osteoporosis detection using deep learning, but methodological flaws have cast doubt on otherwise optimistic results. This study aims to develop a robust artificial intelligence (AI) application for accurate osteoporosis identification in PRs, contributing to early and reliable diagnostics. A total of 250 PRs from three groups (A: osteoporosis group, B: non-osteoporosis group matching A in age and gender, C: non-osteoporosis group differing from A in age and gender) were cropped to the mental foramen region. A pretrained convolutional neural network (CNN) classifier was used for training, testing, and validation with a random split of the dataset into subsets (A vs. B, A vs. C). Detection accuracy and area under the curve (AUC) were calculated. The method achieved an F1 score of 0.74 and an AUC of 0.8401 (A vs. B). For young patients (A vs. C), it performed with 98% accuracy and an AUC of 0.9812. This study presents a proof-of-concept algorithm, demonstrating the potential of deep learning to identify osteoporosis in dental radiographs. It also highlights the importance of methodological rigor, as not all optimistic results are credible.

Comparison of Faster R-CNN, YOLO, and SSD for Third Molar Angle Detection in Dental Panoramic X-rays.

The use of artificial intelligence algorithms (AI) has gained importance for dental applications in recent years. Analyzing AI information from different sensor data such as images or panoramic radiographs (panoramic X-rays) can help to improve medical decisions and achieve early diagnosis of different dental pathologies. In particular, the use of deep learning (DL) techniques based on convolutional neural networks (CNNs) has obtained promising results in dental applications based on images, in which approaches based on classification, detection, and segmentation are being studied with growing interest. However, there are still several challenges to be tackled, such as the data quality and quantity, the variability among categories, and the analysis of the possible bias and variance associated with each dataset distribution. This study aims to compare the performance of three deep learning object detection models-Faster R-CNN, YOLO V2, and SSD-using different ResNet architectures (ResNet-18, ResNet-50, and ResNet-101) as feature extractors for detecting and classifying third molar angles in panoramic X-rays according to Winter's classification criterion. Each object detection architecture was trained, calibrated, validated, and tested with three different feature extraction CNNs which are ResNet-18, ResNet-50, and ResNet-101, which were the networks that best fit our dataset distribution. Based on such detection networks, we detect four different categories of angles in third molars using panoramic X-rays by using Winter's classification criterion. This criterion characterizes the third molar's position relative to the second molar's longitudinal axis. The detected categories for the third molars are distoangular, vertical, mesioangular, and horizontal. For training, we used a total of 644 panoramic X-rays. The results obtained in the testing dataset reached up to 99% mean average accuracy performance, demonstrating the YOLOV2 obtained higher effectiveness in solving the third molar angle detection problem. These results demonstrate that the use of CNNs for object detection in panoramic radiographs represents a promising solution in dental applications.

DentAge: Deep learning for automated age prediction using panoramic dental X-ray images.

Age estimation plays a crucial role in various fields, including forensic science and anthropology. This study aims to develop and validate DentAge, a deep-learning model for automated age prediction using panoramic dental X-ray images. DentAge was trained on a dataset comprising 21,007 panoramic dental X-ray images sourced from a private dental center in Slovenia. The dataset included subjects aged 4 to 97 years with various dental conditions. Transfer learning was employed, initializing the model with ImageNet weights and fine-tuning on the dental image dataset. The model was trained using stochastic gradient descent with momentum, and mean absolute error (MAE) served as the objective function. Across the test dataset, DentAge achieved an MAE of 3.12 years, demonstrating its efficacy in age prediction. Notably, the model performed well across different age groups, with MAEs ranging from 1.94 (age group [10-20]) to 13.40 years (age group [90-100]). Visual evaluation revealed factors contributing to prediction errors, including prosthetic restorations, tooth loss, and bone resorption. DentAge represents a significant advancement in automated age prediction within dentistry. The model's robust performance across diverse age groups and dental conditions underscores its potential utility in real-world scenarios. Our model will be accessible to the public for further adjustments and validation, ensuring DentAge's effectiveness and trustworthiness in practical scenarios.

Prevalence of Radiolucent and Radiopaque Jawbone Lesions Using Panoramic Radiographic Analysis in Hail, Saudi Arabia: A Retrospective, Cross-Sectional, Observational Study.

Background Oral diseases are among the most prevalent public health issues worldwide, underscoring the importance of early diagnosis and effective prevention programs. Determining the prevalence of jawbone lesions is crucial for developing targeted interventions and ensuring timely treatment. Panoramic radiography, also known as orthopantomogram, has become a cornerstone in radiographic examinations, offering a comprehensive view of the dental and maxillofacial regions. Its accessibility and ability to detect a wide range of pathologies make it an invaluable diagnostic tool. This study aimed to assess the prevalence and distribution of radiolucent and radiopaque jawbone lesions in the population of Hail, Saudi Arabia, using panoramic radiographic analysis. Methodology A retrospective, cross-sectional study was conducted using pre-existing panoramic radiographs of individuals aged 18 years and older in Hail, Saudi Arabia. The radiographs were analyzed for the presence of jawbone lesions, classified as radiolucent, radiopaque, or mixed, and their anatomical distribution was recorded. Statistical analysis was performed using the chi-square test, with a significance level set at p-values <0.05. Results A total of 389 jawbone lesions were identified in 177 subjects, representing a prevalence of 45.5%. Radiolucent lesions were the most common, observed in 153 (39.3%) subjects, while radiopaque lesions were found in 18 (4.6%) subjects, and mixed lesions in six (1.5%) subjects. The mandible was more frequently affected than the maxilla, with 104 (59%) lesions occurring in the mandible and 52 (29%) lesions in the maxilla. The posterior region of the jaw was the most commonly involved site, accounting for 124 (31.9%) cases. Gender and age did not significantly influence the prevalence or type of lesions, although a higher incidence was noted in the 31-45-year age group. Conclusions This study revealed a significant prevalence of jawbone lesions in the Hail population, with radiolucent lesions being the most common type, predominantly affecting theposterior region of the mandible. The findings highlight the importance of early detection and targeted dental health initiatives in this region. Further research, particularly longitudinal studies, is recommended to explore the natural history of these lesions and their impact on oral health over time.

Analysis of Dental Prosthetic Treatment in Patients with Cancer Aged 65 Years and Older after Expanded Health Insurance Coverage: A Retrospective Clinical Study.

Background and Objectives: With increases in cancer incidence and the number of cancer survivors, the demand for cancer management is growing. However, studies on dental prosthetic treatment for patients with cancer are rare. We aim to investigate the dental prosthetic treatment in patients with cancer aged ≥65 years after expanded health insurance coverage. Materials and Methods: This retrospective study included patients who were treated with implants and removable dentures at Ulsan University Hospital in South Korea between June 2015 and June 2023. Data on age, sex, cancer location, comorbid systemic diseases, number of remaining teeth, dental prosthetic treatment history, type of dental prosthetic treatment, and insurance coverage status were extracted from patient medical records and panoramic radiographs. The influence of multiple variables on dental prosthetic treatment was analyzed using the Chi-square and Fisher's exact tests. Results: The study included 61 patients with cancer (32 men, 29 women; average age: 70.9 years). Among them, 56 (91.8%) had insurance coverage benefits, and 34 (55.7%) received treatments such as implants, removable partial dentures, or complete dentures for the first time. Treatment types included 37 (60.7%) cases of implant prostheses and 24 (39.3%) conventional removable dentures. No statistical differences were observed in the type of dental prosthetic treatment according to sex, age, cancer location, number of systemic diseases, and dental prosthetic treatment history (p > 0.05). Patients with <10 remaining teeth received treatment with conventional removable dentures, which was statistically significant (p < 0.001). Conclusions: Of the 61 patients, 56 (91.8%) received insurance benefits, and 34 (55.7%) underwent dental prosthetic treatment for the first time. Within the limitations of this retrospective study, the expanded health insurance coverage alleviated the unmet demand for dental prosthetic treatment. As cancer prevalence continues to increase, expanding customized health insurance coverage is crucial to meet this demand.

Ability assessment of the craniofacial structures radiological anatomy on panoramic radiography among dental student during pandemic of Covid-19. Ability assessment on OPG among dental student during pandemic of Covid-19.

Orthopantomography (OPG) is a routine imaging method in dental practice and an essential di- agnostic tool in dentistry. However, OPGs are challenging to interpret due to many overlapping structures. Graduates of dental schools should be aware of image distortions caused by various factors and be able to distinguish them from typical structures to make an accurate diagnosis. The aim was to determine the correlation between the knowledge regarding the location of craniofacial structures of the 1st through 3rd- year dental students and the ability to recognized them on OPGs. The study was conducted in 2021 on 131 dental students using the Microsoft Teams program. Each participant had to determine the location of 4 anthropometric points on 4 OPGs. Using proprietary software, the authors determined the Articular angle between them. The researchers performed the statistical analysis. The Bioethics Committee approved the research. The results of students from particular years of studies did not show statistical significance. There was no statistically significant difference between males and females. Only the answers from third-year male students regarding the one Articular angle showed statistically significant differences compared to the rest of the participants. Recognizing joint structures on OPG is very important from the clinical point of view, although it is often overlooked in diagnostics. Students in the first years of dental school acquire the ability to assess and analyze TMJ on OPGs properly. OPGs have many advantages, including high availability, low cost and low radiation dose. In conclusion we can say that in the first three years of studies, dental students' image assessment skills in the craniofacial radiology field remain the same.

Prevalence of anatomic variations of temporomandibular joint on orthopantomogram and cone-beam computed tomography: A retrospective study

Maxillofacial radiography by means of orthopantamogram is used as a routine screening tool in the diagnosis and treatment planning in various fields of dentistry and is found to be less expensive when compared to other advanced imaging modalities like computed tomography, magnetic resonance imaging and cone-beam computed tomography. Morphological variations in the shape of mandibular condyle, coronoid process and sigmoid notch have been documented in the literature as indispensable aids in anthropological and forensic studies. 100 OPG and CBCT scans of same participants, comprising of 200 temporo-mandibular joints were evaluated for anatomical variations in shapes of mandibular condyle, coronoid process and sigmoid notch. The prevalence of various morphological variations were correlated with age and gender and subjected to statistical analysis. The most common shape of condyle, coronoid process and sigmoid notch on OPG was round, whereas on CBCT the most common shape of condyle, coronoid process and sigmoid notch were flat, triangular and wide respectively. Variations in the morphology of shape of mandibular condyle, coronoid process and sigmoid notch using panoramic radiographs can be tentatively used as a screening tool in human identification, owing to its ready availability and low cost.

Comparison of the accuracy and bias of Demirjian’s method for East Asian children and development of Japanese population-specific age estimation formulae

Despite the increased global mobility owing to the development of the international community, there remains a need for population-specific methods to estimate children’s ages. Therefore, this study aimed to substantiate the necessity for a Japanese-specific age estimation method by contrasting the formerly reported age estimation accuracy and bias using Demirjian’s method for Chinese, Taiwanese, South Korean, and Japanese children. We analyzed 1,558 panoramic radiographs from Japanese children (777 boys and 781 girls), assessed the maturity of seven left permanent teeth using Demirjian’s criteria, and calculated the estimated age using Demirjian’s method. The accuracy of the estimated ages was compared with previous reports of children from other East Asian countries which used the same age estimation method. Chinese, Taiwanese, and South Korean boys and girls were all reported to be older than their chronological ages, with the Eastern and Northern Chinese regions being the only exceptions. The same was true for Japanese children: the estimated ages of both sexes tended to be higher than their chronological age. However, there were significant variations in the values, indicating the differences in tooth growth and development between East Asian countries and sexes. Therefore, new regression equations specific to the Japanese population were formulated, and their accuracy was evaluated as the final result of this study.

Radiation protection in dental imaging: Evaluating the impact of the SABA thyroid shield during panoramic and cone beam computed tomography

BackgroundDental panoramic radiography (DPR) and cone beam computed tomography (CBCT) are an imaging modalities in dentistry. However, these procedures involve exposure to ionising radiation, raising concerns about radiation-induced thyroid damage. To mitigate these risks, thyroid shields have been introduced. This study aimed to evaluate the effectiveness of the SABA thyroid shield in reducing thyroid radiation exposure during DPR and CBCT scans. MethodAn experimental study to measure surface dose in the thyroid region during (DPR) and (CBCT) scans using an Anthropomorphic Phantom and a Solid-State Detector. The attenuation percentage was calculated between radiation surface doses with and without shielding. The significance of the Saba thyroid shield was calculated using a t-test. ResultsFor DPR scans, the average surface doses in the thyroid reduced significantly from 301.1 μGy (at 85 kVp) and 170.3 μGy (at 60 kVp) to 64.43 μGy and 12.94 μGy, respectively, when the Saba thyroid shield was used. For CBCT scans, the average surface doses in the thyroid decreased significantly from 814.43 μGy (for 11 × 13 cm2 field size) and 32.40 μGy (for 5 × 5 cm2 field size) to 62.91 μGy and 12.07 μGy, respectively, with the application of the Saba thyroid shield. The maximum attenuation percentages in the thyroid for the DPR and CBCT scans were 92.40% and 92.27%, respectively. Statistically significant differences between the surface dose reduction with the Saba shield and without it was observed in both DPR scans (p < 0.0000) and CBCT scans (p < 0.0003). ConclusionThe study demonstrates that Saba thyroid shields effectively reduce doses in the thyroid region during dental DPR and CBCT scans. The dose reduction depends on tube voltage for DPR scans, field size, and its position for CBCT scans. Findings highlight the importance of using Saba thyroid shields to minimise radiation exposure and protect the thyroid gland during dental scans.

Vascular Anomalies and Congenital Infiltrating Lipomatosis May Affect Dental Maturation and Development - a Case Control Study.

Vascular anomalies are often associated with hypertrophy and asymmetry of soft tissues and bony structures. The aim of this retrospective cross-sectional radiographic study was to evaluate dental maturation and development in patients with facial vascular anomalies and congenital infiltrating lipomatosis. A sample of 342 patients with different vascular anomalies or congenital infiltrating lipomatosis involving the head and neck area was narrowed down to 31 patients with dental panoramic radiographs taken in the mixed dentition. A control group of 172 age-matched healthy subjects was used. Individual permanent teeth were given a maturation score from 1 to 12 and alveolar eruption stage according to Haavikko et al. 1970. The laterality of the anomaly was noted if applicable. Differences in dental development between affected and unaffected sides were recorded. The study data included both syndromic and non-syndromic vascular anomalies as well as congenital infiltrating lipomatosis and segmental odontomaxillary dysplasia. Teeth on the side of the anomaly were more developed and the eruption of teeth was accelerated with canines, premolars and second molars being most affected. Interestingly all the patients with Sturge-Weber syndrome (n = 4) and infiltrating lipomatosis (n = 2) showed accelerated dental maturation of multiple permanent teeth on the side of the anomaly. Hypodontia, dental root resorption and macrodontia were also found. Accelerated development and eruption of permanent teeth unilaterally in patients with vascular anomalies and congenital infiltrating lipomatosis may have a significant impact on the developing occlusion and should be thus followed by an orthodontist.

Does Periodontitis Increase the Risk for Future Cardiovascular Events? Long-Term Follow-Up of the PAROKRANK Study.

The study 'Periodontitis and Its Relation to Coronary Artery Disease' (PAROKRANK) reported an association between periodontitis (PD) and the first myocardial infarction (MI). This follow-up study aims to test the hypothesis that those with PD-compared to periodontally healthy individuals-are at increased risk for cardiovascular (CV) events and death. A total of 1587 participants (age <75 years; females 19%) had a dental examination including panoramic radiographs between 2010 and 2014. PD was categorized as healthy (≥80% alveolar bone height), mild/moderate (79%-66%) or severe (<66%). A composite CV event (first of all-cause death, non-fatal MI or stroke and hospitalization following to heart failure) was investigated during a mean follow-up period of 9.9 years (range 0.2-12.5 years). Participants were divided into two groups: those with and without PD. The primary event rate, stratified by periodontal status at baseline, was calculated using the Kaplan-Meier method and Cox regression. The number of events was 187 in the 985 periodontally healthy participants (19%) and 174 in the 602 participants with PD (29%; p < 0.0001). Those with PD had a higher likelihood for a future event (hazard ratio [HR] = 1.26; 95% CI: 1.01-1.57; p = 0.038), following adjustment for age, smoking and diabetes. The PAROKRANK follow-up revealed that CV events were more common among participants with PD, which supports the assumption that there might be a direct relation between PD and CV disease.

Artificial Intelligence (AI) Assessment of Pediatric Dental Panoramic Radiographs (DPRs): A Clinical Study.

This clinical study aimed to evaluate the sensitivity, specificity, accuracy, and precision of artificial intelligence (AI) in assessing permanent teeth in pediatric patients. Over one thousand consecutive DPRs taken in Kielce, Poland, with the Carestream CS9600 device were screened. In the study material, 35 dental panoramic radiographs (DPRs) of patients of developmental age were identified and included. They were automatically evaluated with an AI algorithm. The DPRs were then analyzed by researchers. The status of the following dichotomous variables was assessed: (1) decay, (2) missing tooth, (3) filled tooth, (4) root canal filling, and (5) endodontic lesion. The results showed high specificity and accuracy (all above 85%) in detecting caries, dental fillings, and missing teeth but low precision. This study provided a detailed assessment of AI performance in a previously neglected age group. In conclusion, the overall accuracy of AI algorithms for evaluating permanent dentition in dental panoramic radiographs is lower for pediatric patients than adults or the entire population. Hence, identifying primary teeth should be implemented in AI-driven software, at least so as to ignore them when assessing mixed dentition (ClinicalTrials.gov registration number: NCT06258798).

Interdisciplinary CBT treatment for patients with odontophobia and dental anxiety related to psychological trauma experiences: a case series

BackgroundWhile cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample’s oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach.MethodsThe study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study.ResultsAll patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2).ConclusionsTADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes.Trial registrationThe study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority.