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Abstract Background As the application of cone-beam computed tomography (CBCT) in head and neck area increases for dental treatment purposes, cosmetic filler materials are incidentally observed. Since the materials are very diverse, unnecessary referrals or additional examination may be performed when clinicians are unfamiliar with the imaging findings. Thus, this study aimed to introduce the imaging characteristics of cosmetic fillers and grafts shown in dental CBCT with dental considerations that the clinician should be aware of. Methods CBCT obtained for dental purpose presenting cosmetic material were selected. The location of the material was identified as buccal, retroantral, parotid space, nose, zygoma, and symphysis. The material was classified as single or multiple, and grouped according to morphology: speckle, round, eggshell, linear, and amorphous. The radiopacity was classified as similar to soft tissue, between soft and hard tissue, similar to hard tissue, and metal. Results Twenty-one patients were reviewed, and all patients were female with mean age of 50.5 years. The buccal space was the most frequent location for multiple filler materials. The symphysis was the next frequent location and only single material were shown in this location. Cases having multiple filler showed diverse shapes while all single materials showed round shape. Fillers showing radiopacity of hard tissue were similar to diseases producing soft tissue calcifications. Metal-density material distributed in spaces induced white and dark streak artifacts in the CBCT image. All single materials presented radiopacity between soft and hard tissue and attached to the bone surface causing mandibular bone resorption. Conclusions Cosmetic materials displayed various imaging features in CBCT acquired during dental procedure. Clinicians should consider that cosmetic material may cause mandibular bone resorption and imaging artifacts on CBCT. Knowledge of the imaging characteristics of cosmetic fillers may help correct diagnosis.

Recently, the number of patients who visit the hospital with symptoms of temporomandibular joint disorders (TMD) has been gradually increasing, and the need for special imaging such as cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) is increasing for accurate diagnosis and treatment. The purpose of this study was to help the image guideline by comparing the usefulness of CBCT and MRI according to the clinical symptoms of TMD patients and further examining whether the usefulness varies with age. A total of 473 temporomandibular joints (TMJs) with clinical symptoms of TMD who underwent both CBCT and MRI examinations were retrospectively reviewed. Clinical symptoms included pain, sound and limited mouth opening. The CBCT findings included sclerosis, flattening, erosion and osteophyte, while the MRI findings were defined as disc deformity, disc derangement or joint effusion. Joints were divided according to the presence of CBCT and MRI findings as follows: type I (neither CBCT nor MRI findings), type II (only CBCT findings), type III (only MRI findings) and type IV (both CBCT and MRI findings). We assessed the usefulness of the two imaging modalities by comparing the frequency of those four groups according to clinical symptoms and age. In TMD patients with the clinical symptoms, MRI and CBCT are complementary, but if it is difficult to choose the first of these two modalities, MRI is more recommended, and the younger the patient, the more the MRI is recommended.