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Background. The objective of this study was to investigate the prevalence and patterns of styloid process elongation in a general Lebanese population sample. Methods. Digital panoramic radiographs of 489 Lebanese adults (218 males and 271 females, mean age of 47.56 ± 16.149) were included in this retrospective study. First, we screened for detection of elongated styloid process, then we analyzed these cases and classified the elongation types. Data obtained were transformed into SPSS v24 and descriptive and inferential analyses were done. Results. In our sample, elongated styloid process was seen in 76 cases (15.5%) (45/271 women and 31/218 men). Despite no significant gender predisposition, females were slightly more affected than males (59.2% females to 40.8% males). As for the age, elongation was significantly more likely to be present at 45-64 years of age. The right side was slightly more affected than the left side (86.8% vs. 76.3% respectively), with type 1 elongation as the most common. Nevertheless, bilateral elongation was much more common than unilateral elongation (63.2%). Interestingly, females were more likely to suffer from bilateral elongation (64.58%) compared to men (35.41%). Conclusion. Elongated styloid process represents a common finding detected fortuitously on panoramic radiographs. Therefore, being a main feature in Eagle syndrome, dentists should be aware of this clinical entity and actively screen for it.

Aim: Sialoliths are salivary gland calcifications that mainly affect submandibular and parotid glands. They are detected incidentally on dental panoramic radiographs. This study aimed to determine the prevalence of sialoliths in a Lebanese sample and evaluate the site, gender and age distribution of such findings. Methods: In this retrospective study, 500 digital panoramic radiographs, belonging to 219 males and 281 females aged 18-88 years, were examined to identify sialoliths seen as radiopacities in the parotid, submandibular and sublingual glands regions. Findings were analyzed statistically using IBM SPSS Statistics for Windows, version 20 (IBM Corp., Armonk, N.Y., USA). Descriptive statistics were presented and Chi-square tests and Spearman correlation coefficient were used to assess relationships between sialoliths and gender, age and site. Statistical significance was set at p=0.05. Results: In our sample of 500 radiographs, sialoliths were identified in 15 (3%). Submandibular sialoliths were the most common (1.8%) followed by parotid sialoliths (1.2%); no sublingual sialoliths were detected. Females were slightly more affected by submandibular sialoliths while males had higher prevalence of parotid sialoliths. No significant age or gender predilections were detected. Conclusion: Identifying sialoliths on panoramic radiographs by dental professionals is essential to avoid possibility of confusion with other soft tissue calcifications very common in the head and neck regions.

Introduction Sinus septa are bony processes that develop in a variable fashion. Such structures present a challenge for surgical procedures of the maxillary sinuses. Aim This study aims to evaluate the prevalence and patterns of maxillary sinus septa in a sample from the Lebanese population. Methods A retrospective cross-sectional study was conducted on a series of 568 Cone Beam Computed Tomography scans (CBCT) belonging to patients that presented to the Maxillofacial Radiology division of the Faculty of Dental Medicine in the Lebanese University. None of the included patients had sinus pathologies. Age ranged from 18 to 80 years with 332 females and 236 males yielding a total of 1136 maxillary sinus. Sinuses were inspected for septa, specifying their location in multiple dimensions, angulations and number. Results 36.27% of studied patients presented at least one septum (27.46% of all sinuses). No predilection towards age or sex was found. A higher number of septa were located in the middle region anteroposteriorly (38.14%), and most were localized in the inferior third coronally (81.16%). Multiple angulations are also reported. Conclusion Our results suggest a common prevalence of maxillary sinus septa in our Lebanese sample and suggest similar distribution and patterns to that of reported literature.

Metastatic lesions to the oral cavity are uncommon; they represent between 1 and 3% of all malignant oral neoplasms. In this article, we report a rare case of metastatic urothelial bladder carcinoma in the mandible detected on oral radiographic images and confirmed with multiple imaging modalities. A 67-year-old woman presented to our clinic suffering from pain in the right side of the mandible with a mild swelling. Panoramic radiograph revealed an ill-defined relatively radiolucent lesion in the right mandibular premolar-canine region presenting with permeative changes. Cone-beam computed tomography showed a relatively hypodense lesion with demineralization, interruption of the buccal cortices, and slight thickening and sclerosis of the buccal cortical bone. The patient was referred for further evaluation including additional advanced imaging radiographic techniques (MRI and PET scan) and clinical and histopathological examinations that lead to a final diagnosis of metastatic lesion from an underlying urothelial bladder carcinoma.

Objectives Maxillary antroliths are calcified masses found within the maxillary sinus. The aim of this study was to investigate their presence in a sample of Lebanese population by means of digital panoramic radiographs. Material and methods In this study, 500 digital panoramic radiographs of Lebanese adult patients (281 females and 219 males) with a median age of 47.9±18.98 years were included and examined for maxillary antroliths. The statistical analysis of the data found was performed by IBM® SPSS® (IBM, Armonk, NY) version 20.0 for Windows. Results The sample investigated presented only three maxillary antroliths (0.6%). Among these, two were found in female patients and one in male; none of them was bilateral, one on the right side and two on the left side. No statistically significant relationships were observed with patients' gender and age. Conclusion Maxillary antroliths are rare entities detected accidentally on panoramic radiographs utilized frequently in dental clinics. In light of their possible association with chronic sinusitis, dentists should have a complete knowledge of their diagnosis.

Objectives The aim of this study was to demonstrate a possible correlation between radiographic trabecular bone quantified with fractal dimensions analysis and values of primary implant stability deliberated using the Osstell® monitor (Integration Diagnostics AB, Goteborgsvagen, Sweden) with the density of bone specimens harvested from the implant recipient sites and calculated using the mass and volume of the bone bloc specimens. Material and methods Fifty implants of the same brand, diameter, and length were inserted with the same surgical procedures; 25 implants in the molar premolar region of the maxilla and 25 implants in the mandibular posterior region of only healthy male patients between 20 and 50 years of age. Prior to the placement of the implants, biopsies were taken from the selected site for density calculation using a calibrated trephine. Two photostimulable phosphor digital periapical radiographs were obtained for each patient and two regions of interest were selected for a fractal dimension analysis: one site before implantation and the same site immediately postoperatively adjacent to the implant. Results There were correlations between the fractal dimensions and implant stability quotient as well as between fractal dimensions and bone density. No significant difference was found between the fractal dimensions of pre- and postoperative periapical radiographs for the same region of interest and between implant stability quotient values of the maxillae and mandible sites. Conclusion All executed analyses were helpful in assessing the bone density in the recipient site of implant placement using fractal dimensions, offering complementary information about predictable bone density assessed on a periapical radiograph.

In the last several decades, the need for 3D images in dentistry have developed. Computerized tomography was first introduced mainly with the advent of implantology, but its use remained limited to a small number of specialists, due to its indications, access and dose radiation. In the late 90's, a new technology using a cone-shaped beam and a reciprocating detector, which rotates around the patient 360 degrees and acquires projected data in a single rotation, namely the cone beam computerized tomography (CBCT), invaded dentistry, making the perception of 3D easily acceptable to dentists and their patients.

Objectives: Cone-Beam Computed Tomography (CBCT) produces vital information required for the accurate and prudent placement of dental implants. Lack of standardization between CBCT machines may result in unsafe patient exposure to harmful radiation; higher doses are not necessarily associated with improved image quality. Aim: The study aimed to assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning. Methods: Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using a CBCT (Carestream CS 9300). Cross-sectional slices of both image qualities were evaluated by five expert clinicians, for image quality for implant planning and objective bone measurements. Results: There were no significant differences in bone measurements taken on high or low dose images (p > 0.05). In qualitative image assessments, assessment and image quality for almost all observers were independent of each other. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low and high dose images. Conclusion: Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient intra-rater reliability for qualitative assessment; therefore dose reduction can be achieved without compromising diagnostic decision- making.

Aim This study aimed to investigate palatine tonsilloliths in the Lebanese population via digital panoramic radiographs. Materials and methods Digital panoramic radiographs of a sample of 500 Lebanese adult patients (281 females and 219 males) with an average age of 47.9 years were included in this study and assessed for tonsilloliths. The IBM® SPSS® (IBM, Armonk, NY, USA) version 20.0 for Windows was used to carry out statistical analysis of the data collected. Results Tonsilloliths were found in 7.2% of cases (36 out of 500; belonging to 18 females and 18 males). Among these, 13 cases were on the right side, 12 on the left side and 11 were bilateral. Affected patients' age ranged from 24 to 84 years (mean of 61 years). There was no statically significant relation between tonsilloliths presence and gender, while a low positive correlation was observed between tonsilloliths and age (r = 0.193). Conclusion Palatine tonsilloliths may be discovered fortuitously on panoramic radiographs utilized regularly in dental offices; their incidence increases with age. Clinical significance Panoramic radiographs may have a beneficial role in detecting palatine tonsilloliths sometimes connected to unpleasant symptoms such as non-specific chronic halitosis.

Introduction:Use of cone beam computed tomography (CBCT) in orthodontics is increasing; however, some patients started treatment with conventional images. The objective of this study is to manipulate CBCT panoramic reconstruction to make it comparable to conventional panoramic image and to compare mesiodistal root angulations on both images.Materials and Methods:Concurrent conventional panoramics and CBCT volumes were obtained from 40 subjects. CBCT volumes were manipulated to generate pan-like images that mimic the occlusal plane angle of the corresponding panoramic, allowing comparison of mesiodistal root angulations and determination of the head-tilt required to produce the reconstruction.Results:Clinically meaningful differences (p< .05) in the mesiodistal root angulations between standard panoramics and CBCT reconstructions emerged for 13 out of 24 teeth (54%). Greatest variations were seen in the maxillary and mandibular sextants and in first molar regions. Ideal axial head-tilt for image acquisition was determined to be with Frankfort horizontal plane 3.3onose down.Conclusion:CBCT pan images must be used with caution due to variation between methods in specific areas of arches. The images can be useful for the assessment of mesiodistal root angulations if the volume is properly manipulated to create a pan-like image.

Introduction: Fractal dimension (FD) on periapical radiographs is used as a simple descriptor of the complex architecture of the trabecular bone surrounding the dentition. It is used on periapical and panoramic radiographs as a descriptor of the complex architecture of trabecular bone surrounding teeth. Aim: The aim of this study was to evaluate the effect of image resolution and different compression levels on fractal dimension of alveolar bone with images obtained using storage phosphor plate (SPP) system. Methods: Periapical images of premolar and molar teeth on both sides of three dry human mandibles were obtained with Digora Optime (Soredex Corp., Helsinki, Finland) SPP system. The SPPs were exposed equally and scanned immediately after exposure with standard, high and very high resolutions. All the images then were compressed and saved by degrees of 0%, 25%, 50%, 75% and 90%. FD was calculated using public domain software (ImageJ with FracLac plug-in) on two non-overlapping regions of interest (ROIs) on premolar and molar periapical bone areas of each radiograph using differential box-counting method. The ROIs on corresponding images were of the same size and position. FDs were compared using two-way ANOVA and Tukey–Kramer multiple comparison tests (p=0.05). Results: There was no significant difference in FD calculations in different levels of compression for all the resolutions. Images obtained with high resolution scans showed significantly lower variation in FD values compared to very high and standard resolutions for all compressions (p

Sjogren's syndrome is a chronic autoimmune disorder characterized by lymphocytic infiltration, and consequently hypofunction of lacrimal and salivary glands. The loss of salivary function induces oral dryness (xerostomia). This review focuses on methods for determining salivary gland function including clinical signs, salivary flow rate measurements (sialometry), analysis of salivary composition (sialochemistry), histopathological and radiologic examinations, and other recent advanced techniques.

Objective The aim of this study was to evaluate the length of the greater palatine canal in a Lebanese population using cone-beam computed tomography (CBCT) technology. Material and methods In this study, we measured the length of 148 greater palatine canals in 74 CBCT images of Lebanese adult patients (38 females and 36 males). The data obtained was analyzed statistically to determine 1) if age is related to the length of the canal, 2) if the length of the left side tends to be systematically larger or smaller than the length of the right side, and 3) if the mean length of the canals in females is different than the one in males. Results In a sagittal plane, the average length of the greater palatine canal was 30.62 (30.64 mm on the right and 30.60 mm on the left). Conclusion Within the limits of this study, we concluded that in our sample in a Lebanese population, the length of the greater palatine canal does not significantly vary according to age, gender, and side.

Background: Success of dental implants is affected by the quality and density of the alveolar bone. These parameters are essential for implant stability and influence its load-bearing capacity. Their assessment is usually based on preoperative radiographs used as a tool prior to implant procedures. Objective: The aim of the study was to compare the bone density of surgically harvested bone specimens at implant recipient sites in the maxillary and mandibular posterior region using histological analysis to the radiographic bone density using fractal dimension for reliability and determining an image based classification of bone density prior surgery. Methods: Fifty implants were placed in the posterior region of male patients, (twenty five implants in the maxilla and twenty five in the mandible). The edentulous regions were presurgically assessed using Photo Stimulable Phosphor Plate (PSP) intra-oral radiographs and the fractal dimension box counting of region of interest was calculated at the implant recipient site. During surgery, bone core specimens were trephined, and bone densities and minerals parameters were evaluated based on histological analysis using SEM (Scanning Electron Microscopy), and atomic absorption spectrometry. Results: Fractal dimensions (FD) values for the same region of interest (ROI) selected on the radiographs of bone blocks and edentulous sites were different but showed a proportional variation in molar and premolar region of the maxilla and mandible. Bone density results, calculated by the ratio of bone mass (BM) to the bone volume (BV) of the bone core specimen (D=M/V), increased in the mandibular bone blocks, and decreased in the maxilla specimens. Moreover, fractal dimension values of preoperative radiographs at implant recipient sites and bone density of trephined showed a statistically similar distribution. However, no significant difference was shown in the percentage of minerals contents and mass of calcium phosphate of each bone specimen between maxilla and mandible based on scanning electron microscopy analysis. Four types of bone densities were classified according to the distribution of FD values based on preoperative radiographs and on the densities of bone cores calculations. Conclusion: Radiographic estimation of bone quality calculated with fractal dimension could be a useful, non-invasive tool when using preoperative intra-oral radiographs to predict bone density at implant recipient sites with caution and limits concerning the kind of digital radiographs and size of region of interest, especially when these results were based with bone specimens harvested from implant site as an absolute reference.

Different techniques for the enucleation of jaw cyst lesion in the oral and maxillofacial regions have been proposed, including the bone lid technique. The purpose of this case report is to describe the case of a cystic lesion, approached with the bone lid technique performed using a piezoelectric device, with an 8-month clinical and radiographic follow-up. A 14-year-old male patient was treated for a suspicious lesion detected on a panoramic radiograph. The concerned area was surgically accessed, and a radiographically predetermined bony window was drawn, and the beveled bony lid was removed. The underlying lesion was enucleated and sent for pathology as a routine procedure, and the removed bony lid was repositioned in situ and secured with a collagen tape. Healing was uneventful with limited swelling and reduced pain. A complete radiographic bone healing at the previously diseased site was confirmed with an 8-month cone beam computed tomography (CBCT) scan with no buccal bone resorption nor ridge collapse. The bone lid technique with a piezoelectric device was noninvasive and atraumatic in this case. Further studies are needed and could lead to the adaptation of this approach as a possible standard of care.

Objective: The purpose of this study is to compare the detected number of holes on a stepwedge on images resulting from the application of the 5th degree polynomial model compared to the images resulting from the application of linear enhancement.Material and Methods:A 10-step aluminum step wedge with holes randomly drilled on each step was exposed with three different kVp and five exposure times per kVp on a Schick33®sensor. The images were enhanced by brightness/contrast adjustment, histogram equalization and with the 5th degree polynomial model and compared to the original non-enhanced images by six observers in two separate readings.Results:There was no significant difference between the readers and between the first and second reading. There was a significant three-factor interaction among Method, Exposure time, and kVp in detecting holes. The overall pattern was: “Poly” results in the highest counts, “Original” in the lowest counts, with “B/C” and “Equalized” intermediate.Conclusion:The 5th degree polynomial model showed more holes when compared to the other modalities.

Objective: The aim of this study was to describe the diameter and the position of the greater palatine foramen (GPF) in relation to adjacent anatomical landmarks in the maxilla in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 58 Lebanese adult patients were included in this study and a total of 116 GPF were evaluated bilaterally. The diameter of the GPF and its position relative to the maxillary molars, and distances to the midline maxillary suture and to the anterior nasal spine were analyzed. Results: Of all foramina assessed, 41.38% were located opposite to the third molar, 29.31% were distal to it, 27.59% were between the second and the third, and only 1.72% were opposite to the second. The average diameter was 5.633 mm on the right and 5.723 mm on the left, and the average distances to midline maxillary suture and anterior nasal spine were 16.228 mm and 48.294 mm on the right and 14.907 mm and 48.122 mm on the left, respectively. Conclusion: Within the limits of this study, we conclude that in Lebanese patients, the GPF location is variable, very rarely opposite to the second molar, and more closely related to the third, but may present mesial or distal to it in one-fourth of patients.

Introduction Detection of root fracture is challenging both clinically and radiographically. Root fractures occur in different planes with unpredictable presentations. Aim The aim of the study was to evaluate the diagnostic accuracy of selected digital image enhancement tools in the detection of horizontal Root Fracture (RF). Materials and methods Fifty three roots, of single and multi-rooted teeth, in eight dentate human cadaver mandibles were selected for this study. Following minimally traumatic extraction of the teeth, horizontal fractures were induced in 23 roots and remounted in the empty sockets of their respective human dry mandibles. The remaining teeth with no fractures were used as the control group. Twenty two periapical radiographs were obtained by using the paralleling technique and using Complementary Metal Oxide Semiconductor (CMOS). Image J software was used to enhance the original images with the Inversion (IN), Histogram-Equalization (EQ) and Polynomial (Poly) tools. A total of 88 periapical images (original and three enhanced images) were reviewed independently by three Oral and Maxillofacial Radiologists and two Endodontists. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the accuracy of fracture detection and the kappa statistic was used to assess agreement among reviewers. Results The diagnostic accuracy for one of the observers was significantly different in detection of RF with only EQ enhancement tool. Sensitivity and specificity were not significantly different. Interobserver agreement showed no significant difference between imaging methods. Intra-observer agreement was high to moderate. Conclusion There was no significant difference between the different imaging modalities. No statistical difference for the agreement was found among or between the endodontists and radiologists in this study.

BACKGROUND: Differences in CBCT units and the lack of standardization result in exposure to radiation doses beyond what is required for diagnostic purposes, especially when planning the surgical placement of dental implants. AIM: To assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning among senior specialists (5 years of experience) and juniors (fresh graduates). MATERIALS AND METHODS: Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using the Carestream CS 9300 machine. Cross-sectional slices of both image qualities were evaluated by the 5 seniors and the 5 juniors for subjective image utility for implant planning and for objective linear bone measurements. RESULTS: There were no significant differences in bone measurements taken on high- or low-dose images by all seniors and by the majority of juniors (p > 0.05). In qualitative image assessments, there was independence between assessment and image quality for almost all observers. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low- and high-dose images for senior observers (from K = 0.287 at low dose to K = 0.718 at high does) but not for juniors (K = 0.661 and K = 0.509 for low and high dose, respectively). CONCLUSION: Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient concordance for qualitative assessment. Judicious optimization of milliamperage settings based on individual diagnostic requirements can result in significant dose reduction without compromising diagnostic decision-making.

CLINICAL PRESENTATION In 2009, a 43-year-old white woman was referred to the Department of Oral and Maxillofacial Imaging at the Lebanese University with an approximately 1 year history of a slowly expanding, painless mass along the left inferior part of the mandible in the premolar region. The patient initially consulted her dentist in 2007, and a panoramic radiograph was acquired at that time (Figure 1). The practitioner told her that there is nothing to worry about, and he scheduled a follow-up appointment. Sixteen months later, the patient went to the dental school for a second opinion. She was referred to our department, where a panoramic radiograph was taken (Figure 2). It showed a well-circumscribed, round, radiolucent area extending from the inferior border of the mandible in the premolar region and overlapping the mandibular canal. Cone beam computed tomography imaging (using i-CAT (Imaging Sciences International, USA) with voxel size 0.3 mm (field of volume 6 cm), tube voltage of 120 kV, current of 23.87 mA, and exposure time of 20 s) demonstrated a 13 11 mm lytic lesion in the left mandibular premolar region. The lesion was situated on the buccal aspect in the inferior third of the mandible. The lesion was irregular in shape, noncorticated, but fairly well demarcated. The alveolar process was interrupted, with the presence of what seemed to be a communication between the buccal and lingual aspect and a bone structure connecting the mesial and distal sides. The mandibular canal was displaced to the lingual side; the lingual cortex was intact (Figure 3). During the clinical examination, the patient complained of mild pain over the swollen area; however, she reported that chewing, swallowing, and speech were normal. On clinical examination, there was a slightly firm swelling in the region, slightly painful on pressure. Skin and the oral mucosa over the swelling were normal; however, the swelling could not be

A case report of a 45-year-old male who presented with a deep defect in the alveolar crest at the buccal side of the upper right 1 st molar strongly suggesting a perforation of the floor of the maxillary sinus and an oro-antral communication. Clinical signs and symptoms supported this diagnosis. After radiographic evaluation with Cone Beam Computed Tomography (CBCT), the diagnosis was shifting away from oro-antral communication. The diagnosis of a residual cyst was established after surgical exploration and removal, and histopathologic evaluation. The maxillary sinus membrane was intact.

Multiple procedures are used to detect the presence of second mesiobuccal canal in the mesial root of the upper first molar In this article a case will be presented in order to show the use of cone beam computed tomography CBCT in the detection of asecond mesiobuccal MB canal in maxillary first molar unidentified neither clinically nor with conventional radiographic methods

Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides); however, the GPC-PPF length does not significantly vary according to gender and side.

Objective:Triticeous cartilage is a small ovoid structure belonging to the laryngeal skeleton. When calcified, it becomes visible on panoramic radiographs and be mistaken for a carotid artery calcification (CAC) associated with cerebrovascular accidents. This study aimed to estimate the prevalence of calcified triticeous cartilage (CTC) detected by means of digital panoramic radiographs in a sample of Lebanese population.Materials and Methods:Digital panoramic radiographs of 500 Lebanese adult patients (281 females and 219 males) with a mean age of 47.9 years were included in this study and examined for CTC. The IBM®SPSS®for Windows version 20.0 (SPSS, Chicago, IL, USA) was used to carry out statistical analysis of the data collected.Results:Nearly 10.6% (53 out of 500) of the radiographs examined presented CTC. Of all the calcifications, 11 were on the right side, 5 on the left side, and 37 were bilateral. The cases detected belonged to 31 females and 22 males with an average age of 55.6 years (ranging from 24 to 85 years). Chi-square test did not show any statistical connection between gender and CTC, while Spearman's correlation analysis showed low positive correlation with age (r= 0.146).Conclusion:CTC can be detected on panoramic radiographs taken in daily dental practice; its identification is essential to avoid misdiagnosis with other calcifications in the neck region closely related to life-threatening risks such as CAC.

The blood supply to both the lateral wall of the maxillary sinus and the overlying membrane originates from the posterosuperior alveolar artery (PSAA) and the infraorbital artery. The purpose of the present study was to evaluate the anatomic characteristics of the PSAA in a large number of subjects of the Lebanese population. Images of 696 sinuses were analyzed using cone beam computed tomography (CT). Coronal, axial, and sagittal CT images were evaluated for the presence of an osseous canal in the lateral wall of the sinus, and the prevalence, position, and location of the canal were studied and presented.

Background: Effective cleaning of dentures is important to maintain a good oral hygiene for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of hexetidine 0.1% in eliminating C. albicans colonizing dentures. Materials and Methods: A total of 40 denture wearers (18 men, 22 women; age range 40-80 years) with clinical evidence of DS were randomly divided into 2 groups, 1 test, and 1 control. The dentures of the test group were treated by immersion in hexetidine 0.1% while those of the control group were immersed in distilled water. Swab samples from the palatal surfaces of the upper dentures were collected before and after of cleaner use and examined mycologically. Results: Reduction in the number of colony-forming units (CFU) of C. albicans after immersion of the dentures with hexetidine 0.1% was evaluated compared to those of the control group. Conclusion: Hexetidine 0.1% solution tested for the first time as a product of disinfection of the acrylic dentures showed average results after immersion of 8 night hours for 4 days.

Objective: The aim of this study was to evaluate the mandibular lingual foramina (LF) and canals and their anatomic variations using cone-beam computed tomography (CBCT) technology in a Lebanese population. Materials and Methods: In this study, we analyzed CBCT images of 90 adult Lebanese patients (41 males and 49 females). We assessed the number and location of the LF. In additional, we measured: (a) The distance from both the alveolar crest and the inferior border of the mandible to the LF and (b) the length of the lingual canals (LCs). The data obtained was analyzed statistically using Shapiro–Wilk normality test, t-test, Chi-square, and Fisher's exact tests. Statistical significance was set at 0.05. Results: In our sample, the LF and canals were present in 93.33% of the CBCT analyzed, and the majority (76.64%) was located above the genial tubercles. The distance from the foramen of the superior and the inferior LCs to the alveolar crest was 16.24 ± 2.82 mm and 25.49 ± 2.43 mm, respectively. The distance from the foramen of the superior canal to the inferior border of the mandible was 14 ± 2.32 mm. The mean length of the superior canal was 5.81 ± 1.6 mm and 4.25 ± 1.2 mm for the inferior one. There were no gender-related differences in the anatomic characteristics of the LF and canals except for the distance measured from the superior canal foramina to the alveolar crest where the measurement was significantly greater in males compared to females. Neither the number of canals nor the positions of the foramina were different between males and females. Conclusion: Within the limits of this study, we concluded that in our sample of Lebanese adults, there was substantial variability in the LF and canals anatomy and location.

Objective The aim of this study was to evaluate the anatomy of the nasopalatine canal in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and methods CBCT images of 63 Lebanese adult patients were included in this study. The length, shape, diameter of the oral opening corresponding to the incisive foramen and inclination in relation to the hard palate of the nasopalatine canal were analyzed. Results Of all canals assessed, 13 were hourglass-shaped, 23 were cylindrical-shaped, 23 were funnel-shaped and 4 were spindle-shaped. The mean canal length and the incisive foramen anteroposterior diameter were respectively 11.52 mm and 4.91 mm. The average canal inclination related to the hard palate was 17.09 degrees. Conclusion Within the limits of this study, we conclude that in Lebanese patients, the shape of the nasopalatine canal is variable. No statistical significance was noticed between genders except for the canal length which was found shorter in our female sample.

Objectives The objective of this study was to compare the accuracy of root fracture detection in endodontically treated teeth using scans acquired with a 180° rotation motion compared with a 360° after which the patient exposure and number of basis images are doubled. Methods Sixty-six roots were collected and decoronated. All were treated endodontically. One-half of the roots were fractured, resulting in 2 root fragments which were then glued together. The roots were placed randomly in 8 prepared beef rib fragments. Five reviewers independently reviewed the scans twice, at different times. Results The specificity of the 360° scan was significantly higher than the 180° scan; doubling the basis images leads to a significant decrease in false-positive rates. Accuracy and sensitivity were not significantly different. Conclusions Only the specificity is improved by the increased rotation and doubling of images. The accuracy and sensitivity are not improved.

This study sought to identify and follow the course of the incisive canal in the mental interforaminal region of the human mandible and to describe other anatomical landmarks present in this region. Cone beam computerized tomography (CBCT) studies for 40 patients were collected from the database at the Department of OralMaxillofacial Radiology, School of Dentistry, Lebanese University. Ten patients had edentulous mandibles; the other 30 had partially or completely dentate mandibles. Axial native images and panoramic and cross-sectional reconstructions were examined to assess the anatomical landmarks in the anterior mandible. Multiple neurovascular canals and foramina were clearly detected on CBCT studies of the mandible. Numerous foramina were seen on the internal surface of the mandible, even distant from the midline. The incisive canal was identified in 97.5% of the images. These anatomical landmarks should be evaluated carefully during preoperative planning.

A case of fibrosis in the cheek of a 42-year-old woman is presented. The panoramic radiograph showed a well-defined, round radiopacity in the maxillary right third molar region. Other techniques revealed that it was a superimposition. The lesion was hard and painless and associated with hypertrophic scarring secondary to a burn injury many years earlier. Clinicians must be aware of the radiologic image of this fibrosis, so as not to confuse it with other radiopaque lesions of hard tissue origin that occur in both arches. A differential diagnosis is described.

Background: Maxillary nerve block through the greater palatine canal is rarely adopted by dental practitioners due to lack of experience in the technique at hand which may lead into several complications. Nevertheless, it is an excellent method to achieve profound anesthesia in the maxilla. This review focuses on the anatomy as well as the indications, contraindications, and complications associated with this technique. Materials and Methods: A literature search was performed using the scientific databases (PubMed and Google Scholar) for articles published up to December 2014 in English, using the key words “maxillary nerve block via the greater palatine canal.” A total of 34 references met the inclusion criteria for this review and were selected. Conclusion: Block of the maxillary nerve through the greater palatine canal is a useful technique providing profound anesthesia in the hemi-maxilla, if practiced properly.

We report about two cases of accidental radiological discovery of a radiolucent area that seemed to be related to the apex of the teeth. The diagnosis of a cyst is contested by performing a sialographic study of the submaxillary salivary gland, which demonstrates a benign abnormality known as Stafne's lacuna.

Lingual paresthesia following the surgical placement of implants does not occur frequently. When it does occur, a serious problem may result for the practitioner, especially if the patient has not been informed of the risk before surgery. This report emphasizes the importance of practitioner experience and competence. It also addresses the need for knowledge of the course of the lingual nerve and preoperative planning of implant placement in the mandible.