The assesment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone : a prospective clinical study

Our purpose was to investigate the relationship between the angulation of mandibular third molars and the thickness of the lingual bone, which can affect the risk of lingual nerve damage during lower third molars surgical extraction. This study consisted of 104 patients (42 males and 62 females), aged between 18-42 years (24.67 ± 6.11 years). Cone Beam Computed Tomography (CBCT) images were taken for preoperative assessment. The teeth were divided into four groups according to their positions: mesioangular, distoangular, vertical and horizontal. Lingual bone thickness around impacted teeth were measured at three points: cementoenamel junction (CEJ) of the mandibular second molar, mid-root of the impacted third molar, and apex of the impacted third molar root. Two predisposing factors of lingual nerve damage were recorded: lingual bone perforated by the impacted tooth and lingual bone thinner than 1 mm. Additionally, buccolingual angulations of the teeth in each group were measured. Impacted mandibular third molars were removed in usual way. One week after surgery, the patients were evaluated regarding lingual nerve paresthesia. None of the 104 patients experienced paresthesia, including the ones who had teeth with close proximity with lingual nerve. The mean thickness of bone was 1.21±0.63 mm at CEJ of the second molar; 1.25±1.02 mm at the mid-root; and 1.06±1.31 mm at the apex. Horizontally impacted teeth had thinner lingual bone at mid-root level (p=0.016). Buccolingual angulated teeth were more often associated with perforated lingual bone (p=0.002). Buccolingual and mesial/distal angulation had negative correlation with lingual bone thickness (p<0.05). As the buccolingual and mesiodistal angulations increase, lingual bone thickness decreases. Horizontally impacted teeth seemed to compromise the integrity of the lingual bone more than impacted teeth in other positions. During the surgery, thin or perforated lingual bone may result in displacement of the impacted tooth lingually

Panoramik Radyografilerde Sahte Renklendirme ile Osteoporozun Değerlendirilmesi

Amaç: Bu çalışmanın amacı panoramik radyografiler üzerinden sahte renklendirme yapılarak mandibular kortikal indekse (MKI) dayalı olarak osteoporozun değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışma xxxxxxxxx Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Radyolojisi arşivinde yer alan 300 adet panoramik radyografinin retrospektif olarak taranmasıyla gerçekleştirilmiştir. Çalışma kapsamında değerlendirilen panoramik radyografilerde MKI’ya göre C1, C2, C3 skorları belirlenmiş, sonraki aşamada ImageJ programı kullanılarak sahte renklendirme ile skorlar arası farklılıklar görsel olarak incelenmiştir. C1-C2-C3 skorlarına karşılık gelen piksel değerlerinin farklılıkları Kruskal-Wallis testi ile analiz edilmiştir. Verilerin analizinde SPSS v21.0 (IBM Corp, Armonk, NY, USA) programı kullanılmıştır. Test sonuçları pC1). Sonuç: Image J programı kullanılarak elde edilen sahte renklendirilmiş görüntüler panoramik radyografiler üzerinden osteoporotik değişimlerin MKI’ya göre görsel ayrımında başarılı değildir ancak skorlar arası farklılıklar histogram analizi numerik olarak ortaya konabilmektedir. Anahtar kelimeler: Mandibular kortikal indeks, osteoporoz, panoramik radyografi, sahte renklendirm

Investigation of Frequency of Heterotopic Teeth: A Cone Beam CT Study

Aim: Teeth that occur in distant places from the alveolar arch (maxillary sinus, orbit, infratemporal fossa, condylar region, etc.) because of various local or systemic factors are named heterotopic teeth. The heterotopic tooth is a rare phenomenon. Although the etiology is still unknown, it is known that it may be seen due to pathologies caused by cystic lesions, cleft lip-palate, trauma history, and infectious conditions. They are usually asymptomatic, so they are detected by chance in routine clinical and radiological examinations. This study aims to determine the frequency of heterotopic permanent teeth and their anatomical localization with the help of cone-beam computed tomography (CBCT). Methods: This study was retrospectively performed with CBCT slices. CBCT sections of 2590 individuals (1432 females, 1158 males) between the ages of 10-89 (mean: 44 ± 17 years) were evaluated in the study. Heterotopic teeth were investigated using coronal, axial, sagittal CBCT sections in regions distant from the maxillary-mandibular arch. SPSS V.21 software (IBM Corp., Armonk, NY, USA) was used for data analysis. Results: Heterotopic teeth were found in 10 of 2590 individuals (0.4%). All of the heterotopic teeth detected are molar teeth; 4 are mandibular third molar teeth, 5 are maxillary third molar teeth and 1 is maxillary second molar tooth. The frequency of heterotopic teeth according to gender did not show a statistically significant difference (4 females, 6 males) p> 0.05. The average age of individuals with heterotopic teeth is 35.3 (17-65 years). 4 of the heterotopic impacted teeth are located in the ramus and 6 in the maxillary sinus. Conclusions: The prevalence of heterotopic teeth is very rare (0.4%). The teeth with the highest frequency of heterotopia are the third molars. Heterotopic teeth do not have an anatomical location and gender that they prefer predominantly

Frequency of Pericoronal Radiolucency in Impacted Teeth: A Panoramic Radiography Study

Aim All permanent teeth can remain impacted. Impacted teeth can remain in the jaw for years without showing any symptoms and causing a pathological event, and they can also cause neuralgiform pain, infection, teinporomandibular joint complaints, root resorption in neighboring teeth, and pathologies. Pericoronal radiolucency observed over 2.5 mm in radiographic imaging is suspicious. The aim of this study is to investigate the frequency of pericoronal radiolucency in impacted teeth examined on panoramic radiographs. Methods The study was conducted by retrospectively examining panoramic radiographs of 1128 patients (633 females, 495 males) over the age of 18. Permanent impacted teeth with complete root development were included in the study, and primary teeth, mesiodens, supernumerary and supplemental impacted teeth were excluded from the study. Pericoronal radiolucency was recorded as 'present' in case of pericoronal radiolucency (>3 mm) associated with impacted permanent tooth on panoramic radiographs. SPSS v.21 (IBM Corp., Armonk, NY, USA) program was used to analyze the data. Results The mean age of the individuals included in the study was 31±11 years (18-85). A total of 2247 impacted teeth from 1128 individuals were evaluated. Pericoronal radiolucency was detected in 208 impacted teeth (9.3%). There was a statistically significant relationship between gender and the frequency of pericoronal radiolucency (

Evaluation of cortical and trabecular bone structure of the mandible in patients using L-Thyroxine

Abstract Background Long-term use of L-Thyroxine (LT4), the synthetic thyroxine hormone used for thyroid hormone replacement therapy, is an important risk factor for osteoporosis. The aim of this study was to investigate the differences between mandibular cortical index (MCI) and trabecular bone fractal dimension (FD) values on panoramic radiographs of patients using LT4 and control subjects. Methods A total of 142 female patients, 71 cases and 71 controls, were analyzed in the study. Ages were matched in case and control groups and the mean age was 36.6 ± 8.2 (18 to 50) years. MCI consisting of C1 (Normal Mandibular Cortex), C2 (Moderately Resorbed Mandibular Cortex) and, C3 (Severely Resorbed Cortex) scores was determined for case and control groups. Fractal analysis was performed using ImageJ on selected regions of interest from the gonial and interdental regions. The box-count method was used to calculate FD values. Wilcoxon signed-rank test, Mann-Whitney U test, and Spearman correlation analysis were applied to compare the measurements. Statistical significance of differences was established at P  0.05). The mean FD in the right gonial region was 1.38 ± 0.07 in the case group and 1.38 ± 0.08 in the control group (p = 0.715). The mean FD in the right interdental region was 1.37 ± 0.06 in the cases and 1.36 ± 0.06 in the control group (p = 0.373). The mean FD in the left gonial region was 1.39 ± 0.07 in the cases and 1.39 ± 0.07 in the control group (p = 0.865). The mean FD in the left interdental region is 1.37 ± 0.06 in the cases and 1.38 ± 0.05 in the control group (p = 0.369). The most common MCI score was C1, with 62% in the cases and 83.1% in the control group. MCI scores showed a statistically significant difference between cases and controls (p = 0.016, p < 0.05). While the C2 score was higher in the cases, the C1 score was higher in the controls. Conclusions LT4 use was not associated with the FD of mandibular trabecular bone, but was associated with MCI values of cortical bone. Further studies on larger samples with different imaging modalities and image processing methods are needed

Performance evaluation of a deep learning model for automatic detection and localization of idiopathic osteosclerosis on dental panoramic radiographs

Abstract Idiopathic osteosclerosis (IO) are focal radiopacities of unknown etiology observed in the jaws. These radiopacities are incidentally detected on dental panoramic radiographs taken for other reasons. In this study, we investigated the performance of a deep learning model in detecting IO using a small dataset of dental panoramic radiographs with varying contrasts and features. Two radiologists collected 175 IO-diagnosed dental panoramic radiographs from the dental school database. The dataset size is limited due to the rarity of IO, with its incidence in the Turkish population reported as 2.7% in studies. To overcome this limitation, data augmentation was performed by horizontally flipping the images, resulting in an augmented dataset of 350 panoramic radiographs. The images were annotated by two radiologists and divided into approximately 70% for training (245 radiographs), 15% for validation (53 radiographs), and 15% for testing (52 radiographs). The study employing the YOLOv5 deep learning model evaluated the results using precision, recall, F1-score, mAP (mean Average Precision), and average inference time score metrics. The training and testing processes were conducted on the Google Colab Pro virtual machine. The test process's performance criteria were obtained with a precision value of 0.981, a recall value of 0.929, an F1-score value of 0.954, and an average inference time of 25.4 ms. Although radiographs diagnosed with IO have a small dataset and exhibit different contrasts and features, it has been observed that the deep learning model provides high detection speed, accuracy, and localization results. The automatic identification of IO lesions using artificial intelligence algorithms, with high success rates, can contribute to the clinical workflow of dentists by preventing unnecessary biopsy procedure

MAKSİLLA POSTERİOR BÖLGEDE MONOSTOTİK FİBRÖZ DİSPLAZİ: BİR VAKA RAPORU

Giriş: Fibröz displazi (FD), fibroosseöz dokunun normal kemiğin yerini aldığı bir kemik hastalığıdır. FD monostotik veya poliostotik (McCune-Albright Sendromu) formda olabilir. Tanı radyolojik ve histopatolojik incelemeye dayanır. Bu çalışmada konservatif kontur düzeltme yaklaşımı ile tedavi edilen ağrılı monostotik FD olgusu sunulmuştur. Olgu Tanımlaması: Kliniğimize üst çenesinde 4 aydır mevcut olan ağrı şikâyetiyle başvuran sistemik yönden sağlıklı 38 yaşındaki erkek hastanın yapılan intarooral muayenesinde sağ posterior maksillasında ekspansiyon gösteren, üzeri normal mukoza ile örtülü palpasyonda sert kıvamlı şişlik tespit edilmiştir. Yapılan radyografik ve histopatolojik tetkikler sonucu buzlu cam görünümü veren ekspansif lezyonun tanısı monostotik FD olarak doğrulanmıştır. Sonuç: FD de cerrahi tedavi semptomatik lezyonları tedavi etmek, deformiteleri düzeltmek, patolojik fraktürleri önlemek amacıyla uygulanmaktadır. Hastalığın nüks etme ve düşük malign transformasyon görülme risklerine karşı hasta takipleri düzenli olarak yapılmalıdır