Apex Of Tooth Research Articles

Morphometric analysis of the relationship between maxillary posterior teeth and maxillary sinus floor in central Indian population: A cone-beam computed tomography study.

The relationship between the maxillary sinus (MS) and the root apices of posterior teeth is of significant clinical relevance as it influences the diagnosis and treatment planning when operating in the posterior areas of the maxilla. The aim of this study, therefore, is to assess this anatomic relationship and evaluate the propensity of roots of posterior maxillary teeth to be intruded into the MS space using cone-beam computed tomography (CBCT) scanning. One thousand CBCT scans of patients, aged 20 years or above, were analyzed in the study. The distance from the MS floor to the root apices of the posterior teeth was measured and the relationship between the MS and the posterior teeth roots were recorded, based on Kwak's and Didilescu's classification. Based on Kwak's classification, type I configuration was frequently observed in the maxillary posterior teeth, followed by type II. Based on Didilescu's classification, the longest distance, among premolars, was observed between the palatal root of the left 1st premolar and MS, i.e., 8.2467 mm. Among molars, the longest distance was observed between mesiobuccal root of the right first molar and MS, i.e., 5.8966 mm. The shortest distance, among premolars, was observed between the buccal root of the left second premolar and MS, i.e., 3.5500 mm, and among molars, the shortest distance was between the mesiobuccal root of the left second molar and MS, i.e., 1.3556 mm. From the present study, it may be concluded that, among the central Indian population, mesiobuccal root of the second molars and buccal root of the second premolars show the closest proximity to the MS floor. Therefore, any surgical or endodontic intervention in the vicinity of these roots must be performed with utmost care.

Maxillary Odontogenic Keratocyst Superimposed by Infection: Case Report

Odontogenic Keratocysts (OKCs) are rare cystic lesions known for their aggressive behavior and tendency to recur after excision. These benign tumors usually occur in the mandible or maxilla and are believed to arise from the dental lamina. The medical community is still debating whether these lesions are developmental or neoplastic [1]. However, most experts agree that they are locally aggressive and require prompt treatment to avoid complications. On imaging, they typically appear as a solitary unilocular lesion that extends longitudinally in the posterior portions of the mandible. Although most are solitary, multiple odontogenic keratocysts can also be present in some cases, and an associated condition such as basal cell nevus syndrome should be considered. It’s worth noting that involvement of the maxillary sinus by OKC is rare, but it can happen [2]. The maxillary sinus is part of the paranasal sinuses, which are in proximity to developing tooth and root apices of premolar and molars. The overlapping of various structures makes it challenging to diagnose such lesions via maxillary radiographs. Therefore, prompt diagnosis and treatment of OKCs is essential to prevent further complications [3].

Immediate implant placement in the anterior mandible: a cone beam computed tomography study

BackgroundThe placement of implants into the alveolar socket right after tooth extraction is called immediate implant placement (IIP). This approach has its particularities depending on which region of the jaws is involved. The anterior mandible region is peculiar due to the presence of mandibular incisors, which have the shortest roots among all permanent teeth.PurposeThis study aimed to investigate the factors that could be associated with the risk of either cortical bone wall perforation or invasion of the 2 mm secure distance from the surrounding anatomical structures (defined as unsafe implant placement), with IIP in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study.Materials and methodsCBCT exams from 239 eligible subjects were investigated. Implants were virtually placed in two distinct positions: prosthetically-driven (along the long axis of the existing tooth) and bone-driven position (according to the available bone and with regard to nearby anatomical structures). Correlation between several variables was tested, and binary logistic regression analysis in order to assess of the possible associations between covariates and unsafe placement was performed.ResultsSafe placing implants was significantly higher for the bone-driven in comparison to the prosthetically-driven position (22.2% vs. 3.3%, respectively), and the 2-mm secure distance from anatomical structures was not possible to respect in the majority of cases (77.6% vs. 82.9%, respectively). Covariates associated with a higher risk of unsafe placement were tooth region (CI in relation to IL and CA), decrease of labial concavity angle (LCA), decrease of mandible basal bone height (MBBH), and decrease in mandibular bone thickness at the tooth apex level (MBT0).ConclusionThe possibility of safely placing immediate implants in the anterior mandible is significantly higher for bone-driven than in prosthetically driven position. Presurgical virtual planning with CBCT is a great tool for minimizing the risk of implant unsafe placement with regards to the anatomical conditions in the mandible.

The clinical outcomes of vital intact teeth close to large cystic lesions of endodontic origin: A prospective clinical study.

To evaluate the indication of the endodontic treatment for vital intact teeth with the root apex involved in large radicular cystic lesions of endodontic origin. This prospective cohort study enrolled healthy participants with radicular cysts of endodontic origin and with the root apex of vital intact teeth involved in the bone defect, as determined by cone beam computed tomography (CBCT). Thirty-two sound vital teeth were analysed by thermal (TPT) and electric pulp tests (EPT) before surgery (T0) and 1 week (T1), 2 weeks (T2), 3 months (T3) and 6 months (T4) post-surgery. Student's t-test (p < .05) was used to compare the EPT values at baseline and T4. anova (p < .05) was used to analyse the EPT variations for all maxillary and mandibular teeth. McNemar test (p < .05) was used to compare the results according to variation in EPT values gathering by variation, no variation and no response. At T1, 75 and 65.7% of teeth responded positively whilst 25 and 34.3% did not respond to EPT and TPT, respectively. The variation of the EPT values between T0 and T1 was observed for 50.0% of teeth, whilst no variation was noticed in 25.0% of teeth. At T4, 90.6 and 87.5% of teeth responded positively whilst 9.4 and 12.5% did not respond to EPT and TPT, respectively. At T4, variation of the EPT values between T0 and T4 was observed for 28.1%, whilst no variation was noticed in 62.5% of teeth. There were no statistical differences in EPT results between T0 and T4 (p > .05), but significant differences were observed for EPT values between T1 and T4 (p < .05), and between mandibular and maxillary teeth. The pulp sensibility of maxillary teeth worsened after surgery, before reverting progressively to T0 values, whilst no statistically significant differences were observed for mandibular teeth at the different time points. These data support the inconsistence of the prophylactic endodontic treatment in healthy vital teeth with apex involvement in large cystic lesions of endodontic origin. Post-surgery follow-up with TPT and EPT is recommended to assess pulp status.

Is Augmented Reality Technology Effective in Locating the Apex of Teeth Undergoing Apicoectomy Procedures?

This study seeks to assess the accuracy of apical location using an augmented reality (AR) device with a free-hand method. Sixty (60) osteotomy site preparations were randomly assigned to one of two study groups: A. AR device (AR) (n = 30), and B. conventional free-hand method (FHM) (n = 30). Preoperative CBCT scans and intraoral scans were taken and uploaded to specialized implant-planning software to virtually plan preparations for the apical location osteotomy sites. The planning software was then used to automatically segment the teeth in each experimental model for their complete visualization using the AR device. A CBCT scan was carried out postoperatively after conducting the apical location procedures. The subsequent datasets were imported into therapeutic software to analyze the coronal, apical, and angular deviations. The Mann-Whitney non-parametric test was used. There were no statistically significant differences identified at the coronal (p = 0.1335), apical (p = 0.2401), and angular deviations (p = 0.4849) between the AR and FHM study groups. The augmented reality technique did not show a statistically significant accuracy of osteotomies for apical location when compared with the conventional free-hand method.

Cone-Beam Computerized Tomography Evaluation of the Relationship between Orthodontic Vertical Direction Parameters and the Distance from the Apex of the Upper Central Tooth to the Nasal Floor and Anterior Nasal Spine.

The aim of this study was to examine the relationship between the vertical cephalometric values and the distance from the apex tip of the upper central tooth (U1A) to the anterior nasal spine (ANS) and nasal floor (NF) using cone-beam computerized tomography (CBCT). One hundred and twenty-two patients who applied to the Department of Orthodontics between January 2011 and June 2019 were included. The distances between the U1A and the NF and ANS were measured using CBCT. Statistical significance was considered as p < 0.05. Of the 122 individuals, 73.8% (n = 90) were female and 26.2% (n = 32) were male, with a mean age of 22.8 ± 3.3 years. A statistically significant moderate positive correlation was found between the mean NF-U1A values and the N-Me, ANS-Me, ANS-Gn, S-Go, and N-ANS measurements (p < 0.01). A statistically significant positive correlation was found between the mean ANS-U1A values and the Ar-Go-Me, total posterior angles, N-Me, SN/GoGn and Y-axis angle, ANS-Me, and ANS-Gn measurements (p < 0.01). The distance from the U1A to the ANS and NF was related to the orthodontic vertical direction parameters. The ANS-U1A and NF-U1A distances can serve as reference points for identifying the orthodontic vertical growth pattern from CBCT scans.

Extraction of Tooth Cusps based on DBSCAN Density Clustering and Neighborhood Search Algorithm.

A good tooth cusp extraction is helpful in evaluating the effect of cosmetic dental work in virtual tooth surgery. We propose a new tooth cusp extraction, which integrates the DBSCAN (density-based spatial clustering of applications with noise) clustering algorithm with the neighborhood search algorithm to extract tooth cusp from a three-dimensional cloud-point tooth model. This method used the point cloud height and curvature to screen out the dented point set. Then we employ the DBSCAN clustering algorithm to segment different feature regions of the tooth surface and generate the candidate point set. Finally, the candidate point set was accurately located at the tooth apex through the neighborhood search algorithm and the traversal search method of non-maximum suppression. The experimental results show that the proposed method is superior to the traditional watershed algorithm-based methods by calculating the recall rate and accuracy rate, and also has higher extraction speed and extraction precision than manual extraction methods.

Association between periapical odontogenic lesions and maxillary sinus mucosal thickening: A retrospective computed tomography analysis

Introduction: The maxillary sinuses are located in the middle of the nasal cavity and are thought to have the greatest air gaps. Cone-beam computed tomography (CBCT) imaging was used to characterize the radiographic connection between the apices of posterior maxillary teeth and the floor of the maxillary sinus. This study aims to evaluate the degree of apical periodontitis and the sinus mucosal thickness and find the associations between the patient’s age and gender and the degree of apical periodontitis with sinus mucosal thickness. Materials and Methods: A retrospective analysis of 364 individuals with maxillary sinuses which appears clearly within limited-field CBCT images was performed. It was also categorized and noted how the maxillary sinus floor related to the root tips and periapical lesions. In addition, the patient’s age gender, side, and level of apical periodontitis in relation to maxillary sinus mucosal (MSM) thickness were evaluated. Results: The MSM class and periapical index (PAI) were statistically significantly correlated (P 0.001). In comparison to respondents with PAI score I, respondents with PAI score V had 47.89 times the odds of having a higher MSM class (odds ratio [OR] =47.89, P = 0.05). Age and MSM thickening were not substantially correlated (P = 0.298), whereas gender and MSM thickening were strongly correlated (OR = 1.56, P = 0.05). Conclusions: The result of this study showed a clear association between the periapical lesions and MSM thickening.

Mutational analysis of cytoplasmic domain of integrin subunit alpha-1 and its association with periapical wound healing after surgical endodontic treatment.

Numerous studies reported that the healing after surgical endodontic retreatment is influenced by multiple factors which include the genetic profile of the patient, epigenetics, and immune responses. The genes which are primarily responsible for the healing potential in different individuals are those which are involved in the regulation of the cytoskeleton and cellular adhesion which subsequently affects bone deposition and healing. Integrins are cell-surface molecules, possess a key role in the cytoskeleton and cellular adhesion. Integrin Subunit Alpha 1 (ITGA1) is one among the integrin family and helps in regulating the Epidermal Growth Factor receptor (EGFR) pathway, consequently affects proliferation and healing. The objectives of the study were to identify mutations in the cytoplasmic domain of Integrin Subunit Alpha 1 (ITGA1), to assess the expression of activated EGFR, EGFRPhospho and TC-PTP in the periapical wound and to correlate these mutations and expression patterns with periapical wound healing. Thirty-seven patients between ages 18-60 years reported chronic apical periodontitis of single-rooted anterior teeth with periapical radiolucency, equal or greater than 4 mm or periapical lesion in an open apex of single-rooted teeth due to trauma were included in the study from 01st June 2018 till 31st October 2019. Patients with persistent radiolucency after primary root canal treatment and endodontic retreatment were kept on follow-up for 3-4 months surgical endodontic treatment was performed in cases with persistent periapical lesions of 4mm or more in diameter. Periapical lesion sample was collected and used for (1) histo-pathological analysis after Hematoxylin & Eosin staining, (2) total DNA extraction for ITGA1 cytoplasmic domain mutational analysis and immunohistochemistry for EGFR and TCPTP. A positive correlation was observed between the expression levels of EGFRPhospho and the healing of periapical lesions. Moreover, a negative weak correlation was observed between the expression levels of EGFR and TCPTP and the healing of periapical lesions. Out of nine sequences of cytoplasmic domain of ITGA1 which were analyzed, none of them was detected with SNP. Higher expression levels of EGFRPhospho and lower expression levels of EGFR and TCPTP were associated with patients with good healing potential in periapical area. However, immunohistochemistry scores were statistically insignificant to draw any conclusion.

Immediate implant placement in the premolar maxillary area: a cone-beam computed tomography study.

This research aimed to investigate potential factors associated with the risk of perforation of the labial bone plate, nasal floor, or maxillary sinus floor during immediate implant placement (IIP) in the maxillary premolar area, utilizing a cone-beam computed tomography (CBCT) virtual study. CBCT exams from 179 eligible participants, encompassing 716 teeth, were included. Implants were virtually positioned in 2 orientations: along the long axis of the tooth (the prosthetically-driven position) and in an optimal position relative to adjacent anatomical structures (the bone-driven position). Binary logistic regression analysis was employed to assess potential associations between perforation or invasion and various covariates, including sex, age, tooth region, the distance from the tooth apex to the nasal floor or maxillary sinus floor, the angle between the prosthetically- and bone-driven positions (implant-line A angle [ILAA]), and the labial concavity angle (LCA). The mean ILAA was 18.3°±8.0°, and the angle was significantly larger for the second premolar compared to the first premolar. The mean minimum implant length was 13.0±2.1 mm, with a bone anchorage of 4 mm. The incidence of perforation was 84.1% for the prosthetically-driven position and 40.5% for the bone-driven position. Factors associated with a higher risk of cortical bone wall perforation or invasion of the 2-mm safety margin from surrounding anatomical structures (in the bone-driven position) included female sex, older age, shorter distance from the tooth apex to the nasal cavity/maxillary sinus, and smaller LCA. A high prevalence of cortical bone wall perforation or invasion of the 2-mm safety margin is anticipated when performing IIP in the maxillary premolar region.

A 3D dynamic finite element analysis of biomechanical behaviour of maxilla and fixative appliances following advancement Le Fort I surgery applied in different lengths

ObjectivesDynamic analysis of chewing impact on the stability of rigid fixation techniques following Le Fort I osteotomy has not been investigated in the previous literature. The aim of the present study was to evaluate segmental displacement and von Mises (VM) stress values on the fixation devices following different amounts of Le Fort I advancements under dynamic loading conditions. Materials and methodsThe 3D finite element models simulating 3, 5 and 8 mm advancement of maxilla at the Le Fort I level were generated using CBCT scan data. The models included two anterior L plates and two posterior I plates fixations bilaterally. Dynamic finite element analysis was performed to evaluate their biomechanical behavior against chewing cornflakes bio. Von Mises stresses and displacement values on three points were calculated. ResultsCalculations were made in a time of 38, 40 and 40.5 ms for 3, 5 and 8 mm advancement models, respectively. As the advancement increased, stress values on the plates and displacement values in the D1 (intersection of the apex of the canine tooth with the osteotomy line), D2 (the most prominent point of zygomatic buttress on the osteotomy line), and D3 (intersection of the midline of the second molar tooth with the osteotomy line) points increased. The lowest stress and displacement values were found in the 3 mm advancement model. As advancement increased, the highest values were found in the I plates. The stress levels on the plates and screws remained within safe limits. ConclusionsThe von Mises stresses and displacement values tend to increase in according with the amount of advancement. More stress is transferred to posterior I plates and screws under dynamic forces.

Age of Dental Apical Closure in Domestic Cats.

Data on the age of apical closure in felines is limited. Moreover, differences in age of apical closure between male and female cats have not been studied. The aim of this study was to determine the timing of apical closure in cats and determine if sex or position in the dental arch affected closure. In this retrospective descriptive study, intraoral radiographs were obtained at monthly or multiple-monthly intervals for 18 cats. Nine were intact females and 9 were neutered males, ranging from 6 to 9.4 months of age at the start of the study which ranged over an 8-month period. Radiographs were evaluated to establish age of apical closure for all canine teeth as well as the mandibular premolar and molar teeth. Mandibular canine tooth apices closed between 10 and 12 months of age and maxillary canine tooth apices closed between 12 and 14 months of age. The mesial and distal root apices of both the mandibular third and fourth premolar teeth closed between 8 and 9 months. The mandibular first molar tooth mesial and distal root apices closed between 8 and 8.5 months. Root apices of canine teeth closed earlier in female cats than in male cats with mandibular canine tooth root apices closing significantly earlier than maxillary canine tooth roots in both sexes. These findings suggest that there are notable differences in age of apical closure between male and female cats and discernible trends in timing of apical closure among teeth in the dental arcade.

Idiopathic Mandibular Osteosclerosis: A Case of Complex Diagnosis

The purpose of this study is to report a case of idiopathic osteosclerosis of the mandible and to discuss the differential diagnosis of this lesion. A 17-year-old female was referred to the University Hospital of Geneva by her orthodontist following the fortuitous finding of a radio-opaque lesion in the right posterior mandible at the apex of tooth 44. Intraoral clinical examination revealed no abnormalities of the oral mucosa. Tooth 44 was asymptomatic and reacted positively to the sensitivity test. The orthopantomogram revealed a well-defined unilocular radiodense lesion, surrounded by a thin radiolucent border, measuring 10 × 33 mm, located in the IV quadrant, related to the apex of tooth 44. Differential diagnoses mainly included cementoblastoma, focal cemento-osseous dysplasia, ossifying fibroma, condensing osteitis and idiopathic osteosclerosis. The biopsy material allowed a diagnosis of idiopathic osteosclerosis. The proposed treatment was therefore a “wait and see” approach. After 2 years of follow-up, the patient was asymptomatic, and healing was complete without any neurosensory complications. Our case underlines the differential diagnosis complexity of radio-opaque lesions associated with teeth.

Management Open Apex Using Bioceramic Root Repair Material : A Case Report of Permanent Anterior Teeth

Background: Trauma to immature teeth can cause disrupt of the blood vessel supply in the pulp which leads to pulp necrosis. This can then, indirectly disrupts of root formation and incomplete apex closure.4,5 Young permanent teeth with wide open apex to be a challenge for root canal treatment, especially during obturation. Apexification is a treatment option for open apex with necrotic pulp. The purpose is to create an apical stop at the apical third of the apex so that obturation can be achieved. Case: A 27-year-old man came to RSKGMP UNAIR with chief complaints that his upper front teeth were fracture and discolored and the pain had disappeared since march 2023. From the clinical examination, tooth 21 showed Ellis fracture class III and there was tooth discoloration. Pulp vitality examination with cavity test and unresponsive k-file test, percussion (+) and bite test (+). Radiographic examination show an exposed pulp and exposed apex of tooth 21 accompanied by an unclearly defined radiolucent image at the apex of tooth 21. The diagnosis of this tooth was pulp necrosis with symptomatic apical periodontitis. Treatment: Apexification use bioceramic root repair material as apical plug at the apex. After that, obturation is achieved using a thermoplastic technique. Final restoration with individual customized post and lithium disilicate crown. Conclusion: Apexification is an option in cases of pulp necrosis with an open apex using bioceramic root repair material. Bioceramic root repair material is a bioactive material, that induces osteogenesis, is easier to apply, has faster setting time, biocompatible, hydrophilic, high pH and has anti-microbial properties.

CBCT In Imaging Radiopaque and Mixed Lesions of The Jaw

Radiolucent lesion in jawbone more than radiopaque and mixed lesion, this appears in any lesion (odontogenic, non-odontogenic). However, this group include benign and malignant bone tumor. this lesion appears rarely in crown of tooth and more than in apex tooth.

Liability and Medico-Legal Implications in Estimating the Likelihood of Having Attained 14 Years of Age in Pediatric Clinical Practice: A Pilot Study

Accurate methods of age estimation are more essential than ever due to the rise in undocumented individuals without proper identification, often linked to illegal immigration and criminal activities. This absence of reliable records presents challenges within the legal systems, where age thresholds in the context of children’s rights vary across countries. Age 14 has global significance, as established by the UN Convention on the Rights of the Child and the EU for administrative purposes. Accurate age estimation is crucial in medical decisions, reproductive health, and forensics. This study focuses on age estimation via dental radiographs, proposing a method for estimating the likelihood of having attained the age of 14. Orthopantomograms were analyzed from two samples, 191 Italian children (aged 5–15) and 822 Chilean subjects (aged 11–22), using dental maturity indices. These indices evaluated open tooth apices and complete root development. Statistical analysis confirmed the method’s reliability in identifying individuals aged 14 or older, with sex-specific cut-offs. The proposed method particularly advocates an approach based on dental mineralization, which could surpass those relying on bone growth. The collaboration between medical experts, including pediatricians and diagnostic imaging specialists, is vital for standardized age estimation strategies. Ethical concerns regarding radiation exposure and accountability are recognized, although the method’s low radiation doses are deemed acceptable. The proposed method will help health professionals to accurately predict whether or not the 14-year threshold has been reached, opening up new avenues of medico-legal interest and laying the foundations for a legal framework that would allow the pediatrician, when involved, to use a valid and recognized diagnostic approach.

Microcomputed tomography (micro-CT) analysis of apical mandibular premolar in relation to clinical sign presentation: An in vitro study

IntroductionVariations in anatomic apex and apical foramina of root canals are common in different teeth types. The sophisticated 3D micro-CT aids researchers in investigating the apical morphology, such as the apical foramen (AF) and constriction (AC). ObjectivesTo measure the length between the foramen and the apex and the physiological length to the apex, in lower premolar teeth. Furthermore, a measurement was conducted on the average length from the foramen to the apex of the lower premolar teeth with respect to the presence of clinical and non-clinical signs. MethodsA total of 80 lower premolar teeth were selected based on the inclusion criteria. All samples were scanned using micro-CT ZEISS X-Radia (17 µm), and the datasets were analysed. The root canal AF and AC were reconstructed using Drishti software (V3.0) by utilising a 4-digit system code in millimetres (mm). ResultsMore than half of the lower premolars (n = 47, 58.8 %) demonstrated a clinical signs presentation, while the rest had a non-clinical sign (n = 33, 41.3 %). There was a significant difference (p = 0.013) between the non-clinical and clinical groups in the mean length from the apical foramen to the apex (AFA) at 0.59 mm and 0.47 mm, respectively. Meanwhile, the non-clinical and clinical mean length from apical constriction to apex (ACA) were 0.75 mm and 0.73 mm, and the mean length from AF to AC (AFC) was 0.48 mm and 0.53 mm, respectively. Nonetheless, no significant differences were detected between the ACA and AFC of non-clinical and clinical groups. ConclusionThe clinical signs presentation observed in lower premolars mainly affected the apical morphology, particularly the position and length of the root AF, and less so the AC position and length. Therefore, the information is useful for clinical purposes.

Orthopantomography Versus Cone Beam Computed Tomography for the Assessment of the Proximity of Posterior Maxillary Apexes with the Maxillary Sinus: A Cross-sectional Study.

The lack of knowledge of the relation of the maxillary sinus with the apexes of maxillary posterior teeth can lead to important complications during common dental procedures. This can be avoided using different imaging techniques, such as orthopantomography (OPG) and cone beam computed tomography (CBCT). The present study aims to compare the performance of OPG with CBCT in measuring the vertical distance of the apexes of posterior-superior teeth to the maxillary sinus. This study corresponded to a cross-sectional study. OPGs and CBCT scans were obtained from the same individuals, and the qualitative and quantitative vertical distance of the apexes in relation to the maxillary sinus was categorized and measured in mm. A total of 28 pairs of OPGs and CBCT scans from the same patients were obtained. About 381 roots were analysed, which included 89 upper first premolars, 51 upper second premolars, 115 upper first molars, and 126 upper second molars. Projection/protrusion was observed with more frequency in molars, specially 1º molars in both OPG (n= 75, 65.2%) and CBCT (n= 31, 27%); however, 106 more cases (27.9%) were classified as projected in the OPG compared to CBCT (p < 0.05). When comparing the performance of the OPG and CBTC for analysing all roots qualitatively, there was a 57.8% agreement between both techniques. This difference was statistically significant (p <0.0001). Statistically significant differences were also observed when comparing the millimetric differences. This study showed that OPG is not an accurate technique to observe the relationship between the maxillary sinus and the apexes of the upper posterior teeth. In those cases where precision is required when performing dental procedures in this area, CBCT should be used. When not available, the clinicians should be aware of the limitations of the OPG and add other complementary techniques.

Florid osseous dysplasia mimicking odontogenic infections: A report of two cases and literature review

Abstract Florid cemento-osseous dysplasia (FCOD) is an uncommon fibro-osseous lesion that can affect the jaws. It involves the deposition of dense, acellular amorphous bone on a foundation of fibrous connective tissue, replacing normal cancellous bone. This condition often affects middle-aged women, with a mean age of 42. The lesion’s epicenter is at the teeth apices and typically appears posterior to the canines. We present two cases of female patients, aged 49 and 26, who were both initially misdiagnosed with periapical infection and underwent root canal treatments while the lesions remained. Both patients visited our clinic. After careful history taking and clinical and radiographic examination, FCOD was diagnosed, and both patients were treated conservatively.

Limits of Conventional Treatment of Odontogenic Cutaneous Sinus Tract: A Case Report

Odontogenic Cutaneous Sinus Tract (OCST) is a rare and intriguing clinical entity that represents a pathway through the alveolar bone initiating at the apex of the infected tooth and vacates pus through the face or neck skin.