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Primary failure of eruption (PFE) is a rare, nonsyndromic condition in which non-ankylosed teeth fail to erupt either fully or partially due to malfunction of the eruption mechanism. Three young patients are presented in this article with features consistent with a diagnosis of PFE. The features of this condition are described together with different modalities of treatment planning for such patients. The following is a discussion about zygoma implants as a new approach to treatment for patients with PFE requiring full-mouth rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address paresthesia resulting from an endodontic file penetrating the inferior alveolar nerve canal and provide a protocol for managing nerve injuries in such incidents. Case presentation: A 12-year-old girl developed paresthesia when an endodontic file separated and was inadvertently pushed through the apical foramen into the inferior alveolar nerve canal during root canal treatment of the mandibular left first molar. A CBCT scan revealed the file penetrating the canal towards the inferior border of the mandible. After considering the treatment options, intentional replantation was deemed suitable. The tooth was atraumatically extracted and preserved in sterile saline. The surgeon then carefully cleaned and irrigated the socket. The radiographic assessment confirmed successful file removal from the socket. The root ends were resected, and retrograde preparation and obturation were conducted using ultrasonic tips and mineral trioxide aggregate. The tooth was then replanted into the socket. Successful replantation was confirmed by tooth stability and an audible click. The patient was prescribed antibiotics and steroids. After completion of the endodontic treatment, a stainless steel crown was cemented. The successful intentional replantation procedure resulted in rapid improvement in the patient's condition. The normal sensation had been restored, indicating nerve recovery. At the 15-month follow-up, periapical bone healing and the eruption of the adjacent second molar were observed, affirming the treatment protocol's overall success. Conclusion: Prompt intervention and immediate intentional replantation facilitated direct inspection of the separated file within the socket. Collaboration between an oral maxillofacial surgeon and an endodontist ensures expedited and targeted treatment, leading to favorable outcomes. [ABSTRACT FROM AUTHOR]

Context: The incidence and recurrence rate of hamstring strain injuries remain persistently high, with recurrent injuries leading to increased time lost during play and extended recovery periods compared with initial injury. Ultrasound imaging assesses important factors such as hamstring fascicle length (FL), pennation angle (PA), cross-sectional area (CSA), muscle thickness (MT), echo intensity (EI), and shear wave elastography (SWE), all impacting athletic performance. However, its reliability must be established before employing any measurement tool in research or clinical settings. Objectives: To determine the reliability and measurement error of ultrasound for assessing hamstring FL, PA, CSA, MT, EI, and SWE among healthy adults and athletes; to synthesize the information regarding the operationalization of ultrasound. Evidence Acquisition: A systematic literature search was done from January 1990 to February 5, 2023, to identify reliability and validity studies of hamstring ultrasound assessment published in peer-reviewed journals with identifiable methodology of outcome measures. Evidence Synthesis: Intraclass correlation coefficient measurement of 14 included studies reported moderate to excellent intrarater, interrater, and test–retest reliabilities of FL, PA, and MT regardless of the site of muscle testing, probe size, and setting, state of muscle, and use of different techniques in the extrapolation of FL. Good to excellent test–retest reliability rates for all hamstring anatomic CSA along midmuscle and different percentages of thigh length using panoramic imaging. Good intrarater reliability of EI regardless of gender and orientation of the probe but with excellent intrarater reliability in transverse scan using maximum region of interest. Good intrarater, interrater, and interday repeatability on SWE with the muscle in a stretched position. Conclusion: Evidence from studies with a predominantly low risk of bias shows that ultrasound is a reliable tool to measure hamstring FL, PA, CSA, MT, EI, and SWE in healthy adults and athletes under various experimental conditions. [ABSTRACT FROM AUTHOR]

Successful rehabilitation of severely atrophic, short-span edentulous ridges in esthetic regions can seldom be done without some form of vertical ridge augmentation (VRA). The best available evidence shows that guided bone regeneration procedures may present a very predictable option with reduced potential for complications compared to alternative options. The present case series presents a novel technique to achieve predictable VRA with a low complication rate using tenting screws and cross-linked resorbable membranes. A total of 10 patients (5 men, 5 women) with severe vertical defects in the esthetic zone participated in this study. Following a mean healing time of 9.3 months, the mean defect resolution was 80%, with a mean vertical bone gain of 6.2 ± 1.61 mm. Only one case presented with reduced defect resolution (50%); however, the bone gain for this case was 6 mm. [ABSTRACT FROM AUTHOR]

Purpose: Patients with systemic scleroderma (SSc) often suffer from premature tooth loss. The aim of this study was to radiologically investigate bone loss at dental implants in patients with SSc and compare it with data from the literature on healthy patients. Materials and Methods: Mesial and distal bone level changes at implants were independently determined on panoramic and intraoral radiographs. They were double-checked after determination of evaluability by three different raters. Cohen's kappa was used to test for interrater reliability. Mean bone loss was estimated using linear regression analysis considering the patient as a random-effect implant and performed separately in predefined implant regions for different time points and for the mesial and distal sides of the implants. Results: Mesial and distal bone level changes were analyzed in 61 implants using periapical and panoramic radiographs. In total, 114 radiographs from 18 patients were evaluable in both the mesial and distal regions. After a maximum observation period of 60 months, the mean peri-implant bone loss was 1.68 mm (range: 0.83 to 2.54 mm) at the distal aspect and 1.65 mm (range: 0.81 to 2.48 mm) at the mesial aspect in the right posterior mandible (region 44 to 47 [FDI numbering system]), whereas in the left posterior maxilla (regions 24 to 27), the mean peri-implant bone loss was 0.61 mm (range: 0.32 to 0.91 mm) at the distal aspect and 0.59 mm (range: 0.16 to 1.03 mm) at the mesial aspect. The mean bone loss 60 months after surgery was 1.05 mm (range: 0.85 to 1.25 mm). Conclusions: Marginal bone loss at implants in patients with SSc is comparable to data from the literature collected in healthy subjects. [ABSTRACT FROM AUTHOR]

The current study aimed to systematically review the literature on the accuracy of artificial intelligence (AI) models for osteoporosis (OP) diagnosis using dental images. A thorough literature search was executed in October 2022 and updated in November 2023 across multiple databases, including PubMed, Scopus, Web of Science, and Google Scholar. The research targeted studies using AI models for OP diagnosis from dental radiographs. The main outcomes were the sensitivity and specificity of AI models regarding OP diagnosis. The "meta" package from the R Foundation was selected for statistical analysis. A random-effects model, along with 95% confidence intervals, was utilized to estimate pooled values. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was employed for risk of bias and applicability assessment. Among 640 records, 22 studies were included in the qualitative analysis and 12 in the meta-analysis. The overall sensitivity for AI-assisted OP diagnosis was 0.85 (95% CI, 0.70–0.93), while the pooled specificity equaled 0.95 (95% CI, 0.91–0.97). Conventional algorithms led to a pooled sensitivity of 0.82 (95% CI, 0.57–0.94) and a pooled specificity of 0.96 (95% CI, 0.93–0.97). Deep convolutional neural networks exhibited a pooled sensitivity of 0.87 (95% CI, 0.68–0.95) and a pooled specificity of 0.92 (95% CI, 0.83–0.96). This systematic review corroborates the accuracy of AI in OP diagnosis using dental images. Future research should expand sample sizes in test and training datasets and standardize imaging techniques to establish the reliability of AI-assisted methods in OP diagnosis through dental images. [ABSTRACT FROM AUTHOR]

Background: Hypophosphatasia (HPP) is a rare inherited disease that affects multiple organ systems including bone and teeth. Limited knowledge exists on dental and oral health in patients with adult‐onset HPP (aHPP). Objective: The aim of this study was to investigate oro‐dental characteristics in patients with aHPP compared to healthy controls. Methods: This case‐control study included 20 patients with aHPP compared to 31 healthy controls. Oro‐dental manifestations were examined by standardised interviews, clinical examinations as well as radiological registrations on panoramic radiograph (OP) and cone‐beam computed tomography (CBCT) scans. Results: The subjective experience of tooth fractures (p = 0.010), caries in permanent teeth (p = 0.032) and early loss of permanent teeth (p = 0.002) was significantly higher in patients with aHPP compared to the controls. In the aHPP group, the presence of specific teeth (p ≤ 0.045) and attrition of 11 were significantly lower (p = 0.012) compared to the controls. Opacity of a few teeth (p ≤ 0.049), presence of denticles (p = 0.024), the distance between the enamel–cement junction (CEJ) and the marginal bone level at specific sites (p ≤ 0.021) and crown height of 11 (p = 0.017) were significantly higher in patients with aHPP than in healthy controls. Conclusion: The results indicate that patients with aHPP have a subjective experience of having poorer dental health. Loss of permanent teeth, less attrition, tooth opacities, denticles and larger distance between CEJ and marginal bone level are possible oro‐dental findings in patients with aHPP. [ABSTRACT FROM AUTHOR]

Background and Aim: 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. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

The objective of this study was to validate the usefulness of the W-index (Wl) for screening patients at risk of osteoporosis by correlating the Wl results with those obtained from peripheral dual-energy X-ray absorptiometry (pDXA). The W-index is based on oblique line contrast on panoramic radiographs, in which the pixel intensity of the oblique line is compared with the pixel intensity of adjacent structures at the mandibular ramus. A total of 333 patients with panoramic radiographs and pDXA results were evaluated according to T-score results and Wl measurements. A Spearman correlation test was executed to assess the correlation between measures. Patients were divided into 3 groups: normal bone mineral density (BMD), osteopenia, or osteoporosis. The Wl values were compared with the Kruskal-Wallis test. A significant but negligible correlation was found between the pDXA and Wl results for all peripheral sites assessed. Statistically significant differences in the Wl results emerged between patients with normal BMD and osteoporosis (P = 0.007) as well as between those with osteopenia and osteoporosis (P = 0.010). There were no significant differences in Wl between patients with normal BMD and osteopenia (P = 0.598). The results of the study indicate that Wl values can differentiate patients with normal BMD or osteopenia from patients with osteoporosis, suggesting that the Wl is an easy, convenient tool to screen patients for low BMD using panoramic radiographs. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of COVID-19 on the trabecular bone thickness in the mandible using fractal analysis. The researchers selected 82 healthy patients who had previously been infected with COVID-19 and had dental panoramic radiographs (DPRs) prior to contracting the virus. DPRs were obtained again after infection, and the trabecular thickness was analyzed before and after COVID-19 using statistical tests. The results revealed that the average trabecular thickness of the mandible at the angle and condyle regions decreased significantly after contracting COVID-19. The mean thickness before infection was 1.479 ± 0.128 at the angle point and 1.469 ± 0.124 at the condylar region, while after infection, it decreased to 1.200 ± 0.123 and 1.159 ± 0.114, respectively. The reduction in trabecular thickness was found to be statistically significant. This study underscores the importance of monitoring bone density in COVID-19 patients. The findings suggest that COVID-19 can have extrapulmonary effects on skeletal health, specifically the mandibular bone. The results highlight the need for preventive interventions to mitigate pathological bone loss in individuals affected by COVID-19. Overall, this research emphasizes the significance of considering skeletal manifestations and implementing appropriate measures for COVID-19 patients to safeguard their bone health. [ABSTRACT FROM AUTHOR]

Objectives: To assess the structural alterations in peri-implant bone occurring 5 years after prosthodontic loading in panoramic radiography (PR). Methods: PR images of 44 mandibular and 33 maxillary implants along with 42 healthy control teeth taken before and 5 years after prosthodontic loading were included. Two regions-of-interest (ROI) were selected from mesial and distal surrounding bone of each implant and tooth. Then, the selected ROIs were divided to obtain three sub-ROIs (coronal, middle, and apical) on each side. A total of eight ROIs and sub-ROIs from each implant and control tooth were used for the calculations of fractal dimension (FD), lacunarity, and bone area fraction (BA/TA). The paired-sample t test was used to compare measurements before and 5 years after loading (p = 0.05). Results: Overall evaluation of 77 implants showed that FD decreased at the middle and apical peri-implant bone levels 5 years after loading (p < 0.05). In mandibular implants, BA/TA decreased after loading (p < 0.05). While FD decreased at the coronal level (p = 0.022), lacunarity increased at the middle level of mandibular implants (p < 0.05). In maxillary implants, FD decreased at the middle and BA/TA decreased at the coronal level (p < 0.05). On the other hand, BA/TA increased at the apical level of maxillary implants (p = 0.016) after loading. None of the parameters revealed any difference in the control group (p > 0.05). Conclusions: FD and BA/TA can be used to analyze structural changes in peri-implant bone after prosthodontic loading. Additionally, FD, lacunarity and BA/TA may provide useful information about changes occurring at different levels of peri-implant bone. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to harmonize panoramic radiograph images from different equipment in a single institution to display similar styles. Methods: A total of 15,624 panoramic images were acquired using two different equipment: 8079 images from Rayscan Alpha Plus (R-unit) and 7545 images from Pax-i plus (P-unit). Among these, 222 image pairs (444 images) from the same patients comprised the test dataset to harmonize the P-unit images with the R-unit image style using CycleGAN. Objective evaluations included Frechet Inception Distance (FID) and Learned Perceptual Image Patch Similarity (LPIPS) assessments. Additionally, expert evaluation was conducted by two oral and maxillofacial radiologists on transformed P-unit and R-unit images. The statistical analysis of LPIPS employed a Student's t-test. Results: The FID and mean LPIPS values of the transformed P-unit images (7.362, 0.488) were lower than those of the original P-unit images (8.380, 0.519), with a significant difference in LPIPS (p < 0.05). The experts evaluated 43.3–46.7% of the transformed P-unit images as R-unit images, 20.0–28.3% as P-units, and 28.3–33.3% as undetermined images. Conclusions: CycleGAN has the potential to harmonize panoramic radiograph image styles. Enhancement of the model is anticipated for the application of images produced by additional units. [ABSTRACT FROM AUTHOR]

Objectives: The goal of this examination was to compare the impact of probable sleep/awake bruxism on the mandibular trabecular bone structure by fractal analysis (FA) with digital panoramic radiograph (DPR) and radiomorphometric measurements in paediatric patients with bruxism. Methods: The examination included 130 participants with 63 patients with probable sleep/awake bruxism and 67 control groups. Bilateral regions of interest (ROI) in three regions were examined as ROI1: mandibular ramus, ROI2: mandibular angulus, ROI3: anterior to the molar teeth. Radiomorphometric measurements were taken of the mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). p < 0.05 was approved for statistical significance. Results: The ROI-1, ROI-2, and ROI-3 values were defined to be statistically significantly high in the bruxism group (p < 0.05). No significant difference was found between the groups in the other values (p > 0.05). There was no difference in the age and gender for any of the parameters (p > 0.05). Conclusion: In children and adolescents, the mandibular trabecular bone can be affected by bruxism. FA can be used as an auxiliary method for finding the mandibular trabecular differences of patients with bruxism in paediatric dentistry just as it can for adults. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the level of bone mass in digital orthopantomograms in two populations (medieval and current) using two radiomorphometric indexes, and to correlate the mandibular bone mass value, in the medieval mandible population, with stable isotope data δ13C and δ15N. An observational, cross-sectional, and analytical study on mandibles from two diachronic groups, 15 mandibles from the medieval settlement of La Torrecilla (Granada, Spain) and 15 mandibles from current patients at the Faculty of Dentistry of the University of Granada (Spain), matched by age and sex was conducted. The bone mass density was determined using the Mandibular Cortical Width Index (MCW) and the Mandibular Panoramic Index (PMI) in digital panoramic radiographs. In the medieval group, the values of bone mass density were correlated with those of two stable isotopes (δ13C and δ15N). The mean value of MCW in mm in the medieval group was 3.96 ± 0.60 (mean ± standard deviation) and in the current group was 4.02 ± 1.01. The PMI was 0.33 ± 0.06 and 0.35 ± 0.08 in the medieval and current groups respectively, with similar results in both groups (p = 0.820 and p = 0.575). A negative correlation was found between both morphometric indices and the δ15N isotope (rs = 0.56, p = 0.030 and rs = 0.61, p = 0.016, respectively). The bone mass density in mandibles belonging to the two compared populations, determined by two quantitative radiomorphometric indices, is similar. Within the medieval population, there is an inverse correlation between the δ15N value and bone mass density. [ABSTRACT FROM AUTHOR]

Background: The use of panoramic radiography (PR) is a complementary examination to aid in the diagnosis of cases in paediatric dentistry. The lack of specific protocols for these devices, however, can result in high doses of radiation, affecting critical organs such as the thyroid. Aim: To evaluate the discrepancies in ionizing radiation received by the thyroid during PR examinations using anthropomorphic paediatric simulators built from computed tomography images. Design: Two anthropomorphic paediatric phantoms were printed and used, representing children aged 6 and 11 years, with an opening in the thyroid region for the insertion of dosimetric radiographic films. The simulators were subjected to different pre‐existing protocols in the PR devices. The radiographic films were processed and analysed using a luxmeter. Results: The radiation dose to the thyroid was higher in the 6‐year‐old phantom than in the 11‐year‐old phantom, for given exposure factors. In addition, there was an increase in dose in children's protocols compared with small adult protocols. Conclusion: Therefore, companies that develop PR equipment must develop child protocols for separate age groups that will consequently reduce the radiation dose in children, especially in their critical organs. [ABSTRACT FROM AUTHOR]

Sotos syndrome is a genetic disorder characterized by distinct craniofacial features, overgrowth in childhood, and impaired intellectual development. We herein report the successful orthodontic treatment of a 14-year-old boy with Sotos syndrome caused by a heterozygous mutation in the NSD1 gene. He showed severe hypodontia, impaction of the maxillary second molars and a skeletal Class III jaw-base relationship. Orthodontic management, including space control by protraction of the maxillary first molars and traction of the impacted molars, was performed using fixed appliances and miniscrews. As a result, acceptable occlusion was obtained without any discernible relapse 18 months postretention. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the variables affecting the visibility of the submandibular fossa (SF) on panoramic images, including SF depth and types, age, gender, presence or absence of tooth, location of mandibular canal, and alveolar bone thicknesses. Methods: Cone beam computed tomography (CBCT) images and conventional panoramic images of 150 patients were analyzed retrospectively. The visibility of the SF on panoramic images was compared with its depth and adjacent alveolar bone thicknesses on CBCT. Predictive variables affecting the SF visibility were identified, and binary logistic regression analysis was performed. Results: Based on CBCT measurements, the SF depth was ≥ 2 mm in 65% of the hemi-mandibles with radiolucent area (26.7%). A significant difference was observed between the SF visibility on panoramic images and its depth, and the lingual cortical bone thickness as measured on CBCT. When the SF was visible and not, the mean SF depth was 2.24 ± 0.97 mm and 1.6 ± 0.8 mm, and lingual cortical bone thickness was 1.27 ± 0.47 mm and 1.53 ± 0.49, respectively. Regression analysis revealed significant associations between SF visibility and gender (Odds ratio (OR) = 3.28, 95% confidence interval (CI): 1.77–6.09), age (OR = 0.96, 95% CI: 0.94–0.98), SF depth (OR = 2.01, 95% CI: 1.43–2.81), and lingual cortical bone thickness (OR = 2.02, 95% CI: 1.30–3.16). Conclusions: A prominent radiolucent SF on panoramic images indicates a deeper fossa and thinner lingual cortical bone, necessitating caution by clinicians during surgical planning. [ABSTRACT FROM AUTHOR]

Background: This retrospective study aimed to investigate the relationships between the radiographic features of impacted maxillary canines (IMCs) and traction duration and the factors affecting treatment success. Methods: Pre-treatment panoramic radiographs and patient records of 121 consecutive patients with IMCs were analyzed. The measurements included the angle of the IMC with the midline (α-angle), the horizontal position of the IMC relative to the adjacent teeth (S-Sector), the distance from the IMC to the occlusal plane (d-distance), the apex position of the IMC (A), and the vertical height of the IMC relative to the adjacent lateral tooth (V). The measurements were repeated 1 week later. The intraclass correlation coefficient was used to evaluate the relationship between two measurements. Binary logistic regression was performed to determine the factors affecting treatment success. Linear regression was conducted to determine the relationships between traction duration and other parameters. Receiver operating characteristic (ROC) curve analysis was performed to determine the α-angle and the d-distance cutoff values for treatment success. The significance level was set at p < 0.05. Results: The buccally IMCs were mostly located in sectors 1–2, whereas the palatally IMCs were mostly located in sectors 3-4-5. The effects of the parameters on the treatment success were significant according to the logistic regression of age (p = 0.003), d-distance (p = 0.002), and α-angle (p = 0.001). Linear regression analysis revealed that traction duration was statistically significant (p < 0.001). Conclusion: According to the results of this retrospective study, the α-angle, d-distance, and sector can be used to predict the buccopalatal position of the IMC. The patient's age, d-distance, and α-angle affected the treatment success. The patient's age, d-distance, and the sector of the impacted canine affected the traction duration. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Functional teeth are important for maintaining appropriate masticatory function and nutritional intake, affecting physical function in older adults. This study aimed to evaluate the association between number of functional teeth and physical function in community-dwelling older Korean adults. Methods: This cross-sectional study was conducted among a total of 2,527 participants (mean age, 76.5 ± 3.9; 53.4% women) who were enrolled in the Korean Frailty and Aging Cohort Study (2016–2017). Participants were categorized based on the number of functional teeth into two groups: < 20 and ≥ 20 functional teeth. Functional teeth were defined as the remaining natural teeth with visible crowns, with or without restorations, prosthetic pontics, or dental implants on panoramic radiography. Physical function was assessed using handgrip strength, gait speed, five-times sit-to-stand test (5TSTS) duration, and the Short Physical Performance Battery (SPPB) score. Multivariate linear and logistic regression models were used to evaluate the association between number of functional teeth and physical function. Results: Of all the participants, 869 (34.3%) had < 20 functional teeth. After full adjustment for sociodemographic factors, lifestyle, health condition, and oral health, an increase in one functional tooth was associated with a corresponding increase in gait speed (men: B = 0.002, p = 0.032; women: B = 0.002, p = 0.013) and SPPB (men: B = 0.019, p < 0.001; women: B = 0.018, p < 0.001) in both men and women. The time taken for the 5TSTS was shorter for an increase in one more functional tooth (men, B=-0.033, p = 0.006; women, B=-0.036, p = 0.021) in both men and women. An increase in one functional tooth was associated with a corresponding increase in handgrip strength only in men (men, B = 0.049, p = 0.009; women, B=-0.003, p = 0.814). The associations between < 20 functional teeth and low handgrip strength [odds ratio (OR) = 1.46, 95% confidence interval (CI): 1.03–2.06], long 5TSTS duration (OR = 1.47, 95% CI: 1.07–2.02), and low SPPB scores (OR = 1.64, 95% CI: 1.07–2.53) were significant in fully adjusted model compared with ≥ 20 functional teeth only in men. Conclusions: Fewer functional teeth were associated with low physical function in older adults. Our results emphasize the importance of maintaining adequate functional teeth to preserve physical function in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the effect of surgeons' experience and the benefit of using cone-beam computed tomography (CBCT) images, compared to the use of panoramic radiography (PAN) images, on their decisions with regard to mandibular third molar treatment modality. Panoramic radiographs and CBCTs from a total of 143 patients who had undergone impacted third molar surgery were randomly evaluated for treatment decision by 10 participants with differing clinical experience (5 novices and 5 experienced surgeons). The degree of agreement between the same type of participants was 'Substantial Agreement' (0.61–0.80) or 'Almost Perfect' (0.81–1.00). When the treatment modality decisions of the experienced and novice surgeons, using PAN and CBCT images, were compared, a statistically significant difference was found (p<0.01) between the variables. In 50 cases, experienced surgeons decided from CBCT images that total extraction was the best treatment method but opted for coronectomy when presented with PAN images of the same cases. In 164 cases novice surgeons decided on total extraction from CBCT images but chose coronectomy when presented with PAN images of the same cases. The results obtained from this study revealed that the degree of professional experience of the surgeon was a significant factor in determining the treatment decision. Moreover, the treatment choice of experienced surgeons was less affected by the change in imaging technique employed, when compared to novice surgeons. [ABSTRACT FROM AUTHOR]

This study aimed to develop a deep learning system for the detection of three-rooted mandibular first molars (MFMs) on panoramic radiographs and to assess its diagnostic performance. Panoramic radiographs, together with cone beam computed tomographic (CBCT) images of the same subjects, were retrospectively collected from 730 patients, encompassing a total of 1444 MFMs (367 teeth were three-rooted and the remaining 1077 teeth were two-rooted). Five convolutional neural network (CNN) models (ResNet-101 and − 50, DenseNet-201, MobileNet-v3 and Inception-v3) were employed to classify three- and two-rooted MFMs on the panoramic radiographs. The diagnostic performance of each model was evaluated using standard metrics, including accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Receiver operating characteristic (ROC) curve analyses were performed, with the CBCT examination taken as the gold standard. Among the five CNN models evaluated, ResNet-101 demonstrated superior diagnostic performance, and the AUC value attained was 0.907, significantly higher than that of all other models (all P < 0.01). The accuracy, sensitivity, and specificity were 87.5%, 83.6%, and 88.9%, respectively. DenseNet-201, however, showed the lowest diagnostic performance among the five models (all P < 0.01), with an AUC value of 0.701 and an accuracy of 73.2%. Overall, the performance of the CNNs diminished when using image patches containing only the distal half of MFMs, with AUC values ranging between 0.680 and 0.800. In contrast, the diagnostic performance of the two clinicians was poorer, with AUC values of only 0.680 and 0.632, respectively. In conclusion, the CNN-based deep learning system exhibited a high level of accuracy in the detection of three-rooted MFMs on panoramic radiographs. [ABSTRACT FROM AUTHOR]

This study reports a rare case of a dentigerous cyst in a malformed tooth in the mandible of a 5-year-old Japanese boy. Panoramic radiography revealed a cystic lesion with hard tissues inside. The patient underwent surgery under general anesthesia. The histopathological diagnosis was dentigerous cyst associated with a malformed tooth. [ABSTRACT FROM AUTHOR]

Objectives: The C-shaped mandibular second molars (MSMs) may pose an endodontic challenge. The aim of this study was to develop a convolutional neural network (CNN)-based deep learning system for the diagnosis of C-shaped MSMs on panoramic radiographs. Materials and methods: Panoramic radiographs and cone beam computed tomographic (CBCT) images were collected from a hospital in China and subsequently divided into two groups. In Group A, conventional panoramic images and CBCT images were derived from the same patients (n = 730 individuals), and the dataset consisted of conventional panoramic image patches of 1453 MSMs. In Group B (n = 610 individuals), the patients underwent CBCT examinations in the absence of available panoramic images; CBCT images were acquired and utilized to generate simulated panoramic images, and the dataset consisted of image patches of 1211 MSMs. Five pretrained CNN networks (ResNet-101 and − 50, DenseNet-121 and − 161, and Inception-V3) were utilized for the classification of C-shaped and non-C-shaped MSMs. Finally, the networks trained on the Group B dataset were tested on the Group A dataset. The diagnostic performance of each model was evaluated using receiver operating characteristic (ROC) curve analysis, and the CBCT images were taken as the gold standard. The results were compared with those achieved by three dental professionals. Results: In Group A, all five networks exhibited satisfactory diagnostic performance, with AUC values ranging from 0.875 to 0.916 and accuracies ranging from 81.8 to 86.7%. No statistical differences were detected among the five CNNs. Notably, the models trained with Group B dataset (CBCT-generated panoramic images) achieved enhanced performance as tested on Group A dataset. The AUC values reached 0.984–0.996, and the accuracies ranged between 94.5% and 98.1%. CNNs outperformed dental professionals in classification performance, and the AUC values achieved by dental specialist, novice dentist, and dental graduate student were only 0.806, 0.767 and 0.730, respectively. Conclusion: CNN-based deep learning system demonstrated higher accuracy in the detection of C-shaped MSMs on panoramic radiographs compared to dental professionals. CBCT-generated panoramic images can serve as a substitute for conventional panoramic images in the training of CNN models when the quantity and quality of conventional panoramic image dataset is insufficient. Clinical relevance: CNN-based deep learning models have demonstrated significant potential in assisting dentists with the identification of C-shaped MSMs on panoramic radiographs, which facilitating more effective, efficient and safer dental treatment. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to perform clinical diagnosis and treatment planning of mucous retention cysts with high accuracy and low error using the deep learning-based EfficientNet method. For this purpose, a hybrid approach that distinguishes healthy individuals from individuals with mucous retention cysts using panoramic radiographic images was presented. Material and Methods: Radiographs of patients who applied to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Fırat University between 2020 and 2022 and had panoramic radiography for various reasons were evaluated retrospectively. A total of 161 radiographs, 82 panoramic radiographs with mucous retention cysts and 79 panoramic radiographs without mucous retention cysts, were included in the study. In the classification process, deep feature representations or feature maps of the images were created using eight different deep learning models of EfficientNet from B0 to B7. The efficient features obtained from these networks were given as input to the support vector machine classifier, and healthy individuals and patients with mucous retention cysts were classified. Results: As a result of the model training, it was determined that the EfficientNetB6 model performed the best. When all performance parameters of the model were evaluated together, the accuracy, precision, sensitivity, specificity, and F1 score values were obtained 0.878, 0.785, 0.916, 0.857, and 0.846, respectively. Conclusion: The proposed hybrid artificial intelligence model showed a successful classification performance in the diagnosis of mucous retention cysts. The study will shed light on other future studies that will serve the same purpose. [ABSTRACT FROM AUTHOR]

Background: This systematic review aimed to determine whether cone-beam computed tomography (CBCT) and panoramic radiography (PR) yield consistent results in determining the degree of impacted lower third molar teeth based on existing classification parameters. Methods: A comprehensive literature search was conducted of PubMed, Embase, Cochrane, and PLOS One, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, a manual search was also carried out. There were no restrictions on publication dates, allowing a broader scope of literature. Only articles published in English were eligible for inclusion. Furthermore, all studies that compared the outcomes of CBCT and panoramic images concerning the position of impacted teeth, according to the Winter and the Pell & Gregory classifications, were included. Results: Four studies met the inclusion criteria. One study used the Pell & Gregory classification to assess differences, finding a significant result (p< 0.001). Two studies used both the Winter and the Pell & Gregory classifications. In these assessments, one study found no significant differences in the Winter classification (p= 1.000) or the Pell & Gregory assessment (p= 0.500). However, another study identified significant differences using both the winter and the Pell & Gregory classifications (p< 0.001). One study conducted an assessment using only Winter classification and found no significant differences between PR and CBCT (p> 0.05). Conclusion: There are inter-modality differences in the agreement concerning the degree of impaction of the third molar when using CBCT compared with panoramic imaging across various classification levels. Improved assessment methods are necessary to determine the most appropriate imaging modality for therapeutic management. [ABSTRACT FROM AUTHOR]

The aim of the authors was to evaluate the periapical and endodontic conditions of patients with osteoporosis and compare them with those of age- and sex-matched controls. The association between bisphosphonate (BiP) use and periapical and endodontic status in patients with osteoporosis was also investigated. Panoramic radiographs of 711 patients with osteoporosis and 711 age- and sex-matched healthy patients were examined. The presence and number of root canal–filled teeth (RCFT), inadequate RCFT (iRCFT), and teeth with apical periodontitis (AP) were evaluated. BiP treatment history of patients with osteoporosis was also recorded. No significant difference was observed between the osteoporosis group and control group in terms of endodontic and periapical conditions. Results of bivariate logistic regression analysis showed a positive association between the number of teeth with AP and the number of iRCFT with AP and osteoporosis, and a negative association between the number of RCFT with AP and osteoporosis. Among the patients with osteoporosis, 37.5% used BiPs, specifically alendronate, ibandronate, zoledronate, and risedronate (34.3%, 24.9%, 10.6%, 7.2%, respectively). In addition, the results showed a negative association between BiP use and RCFT. As the number of teeth with AP and number of iRCFT with AP increased, patients were more likely to be in the osteoporosis group. These findings imply that periapical lesions may enlarge and become more detectable in patients with osteoporosis with lower bone density, and enhanced inflammatory response. Dentists can collaborate with health care professionals to manage the overall health of patients with osteoporosis to reduce the impact of osteoporosis on oral health and effectively treat dental problems, such as AP. [ABSTRACT FROM AUTHOR]

Aim: To identify serum‐ and salivary‐derived inflammatory biomarkers of periodontitis progression and determine their response to non‐surgical treatment. Materials and Methods: Periodontally healthy (H; n = 113) and periodontitis patients (P; n = 302) were monitored bi‐monthly for 1 year without therapy. Periodontitis patients were re‐examined 6 months after non‐surgical periodontal therapy (NSPT). Participants were classified according to disease progression: P0 (no sites progressed; P1: 1–2 sites progressed; P2: 3 or more sites progressed). Ten salivary and five serum biomarkers were measured using Luminex. Log‐transformed levels were compared over time according to baseline diagnosis, progression trajectory and after NSPT. Significant differences were sought using linear mixed models. Results: P2 presented higher levels (p <.05) of salivary IFNγ, IL‐6, VEGF, IL‐1β, MMP‐8, IL‐10 and OPG over time. Serum analytes were not associated with progression. NSPT led to clinical improvement and significant reduction of IFNγ, IL‐6, IL‐8, IL‐1β, MMP‐8, IL‐10, OPG and MMP‐9 in saliva and of CRP, MMP‐8, MMP‐9 and MPO in serum. Conclusions: Periodontitis progression results from a sustained pro‐inflammatory milieu that is reflected in salivary biomarkers, but less so in serum, likely because of the limited amount of progression per patient. NSPT can significantly decrease the levels of several salivary analytes. [ABSTRACT FROM AUTHOR]

Cherubism is a skeletal dysplasia limited to the maxilla and mandible, affecting children and adolescents. A 13-year-old male patient was referred to the Oxford University Hospitals Oral and Maxillofacial Surgery Department, by his orthodontist, following an incidental finding of bilateral multilocular radiolucencies of the mandible. This led to multiple clinical, radiographic, histopathological, genetic and biochemical investigations involving various medical and dental specialities. The multidisciplinary approach led to the successful management of this patient. Even though cherubism is self-limiting, long-term radiographic and clinical surveillance is required. CPD/Clinical Relevance: Dentists should understand the clinico-radiographic presentation of cherubism and have an awareness of how the possible functional and aesthetic complications associated with the condition are managed. [ABSTRACT FROM AUTHOR]

Schwannomas are considered benign soft tissue tumors that originate from Schwann cells. Oral Schwannomas are rare and account for only 1% of all Schwannomas. Cellularschwannoma (CS) is a rare histological variant of schwannoma, characterized by high cellularity and cellular atypia. We present a case of localized growth of palatal mucosa that imitated the features of malignant peripheral nerve sheath tumor (MPNST) on histopathological examination; it was differentiated from MPNST by the correlation of clinical, histopathological, and immunohistochemical features. [ABSTRACT FROM AUTHOR]

Purpose: Periarticular and generalized osteoporosis are well-known comorbidities of rheumatoid arthritis (RA), associated with either the disease itself or glucocorticoid therapy. This study was performed to quantitatively evaluate changes in the jawbones of patients with RA using fractal analysis (FA). Materials and Methods: The study comprised 186 participants, including 144 women and 42 men. Of these, 93 were patients with RA and 93 were healthy controls. For the RA group, disease duration, laboratory findings, and medication use were recorded. Measurements of fractal dimension (FD), lacunarity (Lac), bone area fraction (BA/TA), and trabecular thickness (Tb.Th) were taken at the mandibular condyle and angle. These measurements were obtained from panoramic radiographs using ImageJ version 1.52p (National Institutes of Health, Bethesda, MD, USA). Results: Relative to control participants, patients with RA exhibited higher FD values for both mandibular condyle and angle regions (P<0.05). Conversely, the RA group displayed lower Lac values for both regions (P<0.05). Similarly, Tb.Th values were significantly lower in the RA patient group for both the condyle and the angle (P<0.05). Furthermore, a significant negative correlation was identified between disease duration and FD at the mandibular condyle (P<0.05). Conclusion: The results demonstrate that FA can be used to quantitatively assess changes in trabecular bone in the jawbones of patients with RA. Image analysis parameters derived from panoramic radiographs, including FA, Lac, BA/TA, and Tb.Th, hold promise in guiding patients with RA toward appropriate medical examinations. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the quality of clinically indicated digital dental panoramic radiographs (DPRs) of children with mixed dentition. Despite the likely widespread use of this modality, recent research detailing errors on DPRs is scarce. Materials and Methods: A consecutive case series was performed, including 178 DPRs from patients aged 6 to 12 years. Each DPR was reviewed for 10 distinct errors. The findings were analyzed to identify potential solutions. Results: Nearly three-quarters of the DPRs contained multiple errors. Linear regression analysis indicated that the number of errors decreased with increasing patient age; however, this trend was not statistically significant. Notably, 3 groups of errors (2 errors each) frequently appeared together on the same DPR. When similar errors were grouped, the error incidence decreased significantly with age. Both leftward head tilting and rightward head rotation were observed, likely attributable to the design of the DPR room and the door location. The inter-rater and intra-rater reliability agreements were deemed "substantial" or "almost perfect, beyond chance" for the detection of most errors, particularly the most frequent types, which involved the "chin," "tongue," and "lips-open" positions. Conclusion: As a pediatric patient ages, the number of DPR errors decreases. The results suggest several pre-exposure strategies that could reduce the error rate. These include, monitoring for a "lips-open" position as an indicator of a potential "tongue" error (occluding the palate-glossal space), and implementing dry runs. Asymmetries observed on DPR must be documented and should prompt re-examination, as they may be genuine. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the fractal dimension values of trabecular bone in periapical lesions and healthy mandibular first permanent molars, based on age and gender, using panoramic radiographs. Material and Methods: The panoramic radiographs of a total of 216 patients aged 6-16 years who applied to Dicle University Faculty of Dentistry Department of Pedodontics in 2022 were retrospectively examined. The patients were equally distributed by gender into three age groups: 6-9, 10-12, and 13-16 years. Fractal analysis was applied using the ImageJ program to the regions of interest (ROI’s) of 25x25 pixels determined from two different regions on each digital panoramic radiograph, and fractal dimension calculations were performed. The data were analyzed using the Shapiro-Wilk and/or Kolmogorov-Smirnov tests, as well as the Mann-Whitney U and Kruskal-Wallis H tests. The confidence interval for all statistical tests was set at 95%, and the significance level was accepted as p<0.05. Results: According to the results of the study, the average fractal dimension value of the lesioned region was 1.106, while the average fractal dimension value of the healthy region was 1.116. No statistically significant difference was found in the fractal dimension values between both the lesioned and healthy groups, as well as between the age and gender groups (p>0.05). Conclusion: Fractal dimension (FD) calculation is a reliable method for detecting early-stage periapical lesions. However, to achieve more comprehensive evaluations, future studies should integrate histological and clinical parameters and compare 2D and 3D imaging techniques with larger sample sizes. [ABSTRACT FROM AUTHOR]

Objectives: Alveolar bone loss (ABL) and periodontal lesions are common diseases that have an undeniable effect on teeth maintenance and health. Current diagnostic methods include probing, intraoral radiography, and panoramic radiography; each has its limitations. In this study, we aimed to assess the diagnostic accuracy of panoramic radiography in the diagnosis of interdental ABL. Material and Methods: In this cross‐sectional study, panoramic and cone‐beam computed tomography (CBCT) images from 80 patients were collected from the archives of an oral and maxillofacial radiology center. The amount of ABL was obtained by measuring the distance from the Cemento‐Enamel Junction (CEJ) to the alveolar bone crest on both panoramic and CBCT images. Patients were divided into healthy (ABL ≤ 2 mm) and diseased (2 mm < ABL) groups in terms of periodontal disease. Results: There was no statistically significant difference in the average ABL in the premolar, maxillary molar, and mandibular molar areas between the two techniques. However, in other areas, the ABL size was significantly lower in the panoramic view (p < 0.05). Also, the panoramic technique correctly recognized 89.1% of normal and 88.4% of ABL cases. The overall accuracy of panoramic radiography in the diagnosis of ABL was 85%, indicating the good accuracy of this technique. In maxilla, the highest diagnostic accuracy of the panoramic technique was in the molars, and the lowest was in the incisors. In the mandible, the highest and lowest diagnostic accuracy of the panoramic technique was related to molars and premolars, respectively. According to the kappa statistic, there was a significant good to very good agreement between the two types of techniques in all maxillary areas (p < 0.001). Conclusions: Panoramic radiography is accurate in showing ABL. Measuring ABL in the posterior mandibular areas in panoramic radiographs is quite reliable; however, in general, digital panoramic radiography shows less ABL than the actual amount. [ABSTRACT FROM AUTHOR]

The development of artificial intelligence (AI) in dentistry requires large and well-annotated datasets. However, the availability of public dental imaging datasets remains unclear. This study aimed to provide a comprehensive overview of all publicly available dental imaging datasets to address this gap and support AI development. This observational study searched all publicly available dataset resources (academic databases, preprints, and AI challenges), focusing on datasets/articles from 2020 to 2023, with PubMed searches extending back to 2011. We comprehensively searched for dental AI datasets containing images (intraoral photos, scans, radiographs, etc.) using relevant keywords. We included datasets of >50 images obtained from publicly available sources. We extracted dataset characteristics, patient demographics, country of origin, dataset size, ethical clearance, image details, FAIRness metrics, and metadata completeness. We screened 131,028 records and extracted 16 unique dental imaging datasets. The datasets were obtained from Kaggle (18.8%), GitHub, Google, Mendeley, PubMed, Zenodo (each 12.5%), Grand-Challenge, OSF, and arXiv (each 6.25%). The primary focus was tooth segmentation (62.5%) and labeling (56.2%). Panoramic radiography was the most common imaging modality (58.8%). Of the 13 countries, China contributed the most images (2,413). Of the datasets, 75% contained annotations, whereas the methods used to establish labels were often unclear and inconsistent. Only 31.2% of the datasets reported ethical approval, and 56.25% did not specify a license. Most data were obtained from dental clinics (50%). Intraoral radiographs had the highest findability score in the FAIR assessment, whereas cone-beam computed tomography datasets scored the lowest in all categories. These findings revealed a scarcity of publicly available imaging dental data and inconsistent metadata reporting. To promote the development of robust, equitable, and generalizable AI tools for dental diagnostics, treatment, and research, efforts are needed to address data scarcity, increase diversity, mandate metadata completeness, and ensure FAIRness in AI dental imaging research. [ABSTRACT FROM AUTHOR]

Osteoporosis, a systemic disorder characterized by reduced bone density and microarchitectural deterioration, significantly affects bone health, including the mandibular and periodontal structures. This study aimed to evaluate the relationship between osteoporosis and periodontal pathology using imaging techniques in patients diagnosed with osteoporosis. Material and methods: The retrospective, descriptive study included 63 patients diagnosed with osteoporosis and other systemic conditions. Periodontal status was assessed clinically and paraclinically using the EGOHID evaluation system, while bone density was evaluated radiographically using indices such as the Mandibular Cortical Index (MCI), Mental Index (MI), Panoramic Mandibular Index (PMI), and Mandibular Cortical Width (MCW). Results: Results revealed significant periodontal involvement, with 42.9% of patients exhibiting moderate chronic marginal periodontitis and 46% severe periodontitis, more pronounced in the maxillary arch than the mandibular. Radiographic evaluation demonstrated that 58.7% of patients with osteoporosis had a slightly eroded mandibular cortex (C2), while 34.9% showed severe erosion (C3). The average cortical thickness (MCW) was significantly reduced in osteoporotic patients compared to non-osteoporotic individuals, highlighting its potential as a screening indicator. Conclusions: Osteoporosis is strongly associated with significant periodontal alterations and mandibular cortical resorption. These findings underline the importance of integrating bone health assessments into periodontal evaluations, emphasizing the role of imaging as a non-invasive screening tool for osteoporosis.

Abstract Objective This study aimed to investigate the variables affecting the visibility of the submandibular fossa (SF) on panoramic images, including SF depth and types, age, gender, presence or absence of tooth, location of mandibular canal, and alveolar bone thicknesses. Methods Cone beam computed tomography (CBCT) images and conventional panoramic images of 150 patients were analyzed retrospectively. The visibility of the SF on panoramic images was compared with its depth and adjacent alveolar bone thicknesses on CBCT. Predictive variables affecting the SF visibility were identified, and binary logistic regression analysis was performed. Results Based on CBCT measurements, the SF depth was ≥ 2 mm in 65% of the hemi-mandibles with radiolucent area (26.7%). A significant difference was observed between the SF visibility on panoramic images and its depth, and the lingual cortical bone thickness as measured on CBCT. When the SF was visible and not, the mean SF depth was 2.24 ± 0.97 mm and 1.6 ± 0.8 mm, and lingual cortical bone thickness was 1.27 ± 0.47 mm and 1.53 ± 0.49, respectively. Regression analysis revealed significant associations between SF visibility and gender (Odds ratio (OR) = 3.28, 95% confidence interval (CI): 1.77–6.09), age (OR = 0.96, 95% CI: 0.94–0.98), SF depth (OR = 2.01, 95% CI: 1.43–2.81), and lingual cortical bone thickness (OR = 2.02, 95% CI: 1.30–3.16). Conclusions A prominent radiolucent SF on panoramic images indicates a deeper fossa and thinner lingual cortical bone, necessitating caution by clinicians during surgical planning.

Purpose: To assess the peri-implant and flap parameters of the prefabricated microvascular fibula flap and determine the dental implant survival rate. Materials and Methods: This retrospective study investigated a cohort of subjects who received prefabricated microvascular fibula flaps at two highly specialized tumor reconstruction centers. The subjects had all suffered atrophy or a large segmental defect of the jaws due to tumor resection or injury. Two independent surgeons determined the dental implant survival rate and assessed the peri-implant parameters and flap parameters during clinical follow-up. Results: In total, 41 subjects were treated with a prefabricated fibula flap between 1999 and 2012. Of these, 17 subjects (10 male, 7 female) with a total of 62 dental implants were examined. The other 24 subjects were unavailable for assessment and had to be excluded. Ten of the 62 dental implants (16.1%) had to be removed due to peri-implantitis before the follow-up assessment. Follow-up assessments were performed at intervals ranging from 2 to 12 years (mean: 7.2 years) after fibula flap transplantation. The dental implant survival rate was found to be 83.9%. A total of 208 dental surfaces were assessed. Overall, 96% of all surfaces had a pocket depth (PD) of ≤ 4 mm and 4% had a pocket depth of > 5 mm. An attachment level (AL) of 3 mm was measured in 48.5% of implants and ≥ 5 mm was measured in 15.9% of implants. Dental implants with a PD > 4 mm showed a significantly higher plaque index (PI) (75%; P = .0057), papillary bleeding index (PBI) (62.5%; P = .0094), and radiologic bone loss (P = .0014) compared to dental implants with a PD ≤ 4 mm. Conclusions: Reconstructive surgery using microvascular fibula flaps represents an alternative tool for oral rehabilitation in subjects suffering from a large segmental defect in the maxillary or mandibular bone compared to the conventional method. However, it appears that the different ossification processes that develop the fibula and the jawbones affect dental implant survival. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. Method and materials: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. Results: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. Conclusions: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effect iveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease. [ABSTRACT FROM AUTHOR]

Dentinogenic ghost cell tumor (DGCT) is an uncommon odontogenic tumor considered to be the solid, tumorous variant of calcifying odontogenic cyst. DGCT is characterized by islands of ameloblastoma-like epithelial cells that resemble the enamel organ, the presence of ghost cells, and dentinoid material. This article reports a rare case of dentinogenic ghost cell tumor as sociated with an odontoma in an adult patient, with a review of the literature. To the best of the authors' knowledge, there have only been four case reports of DGCT associated with odontoma, all of which occurred in children and adults younger than 30 years old. [ABSTRACT FROM AUTHOR]

Vestibular schwannoma (VS) is a benign peripheral nerve sheath tumor involving the vestibulocochlear nerve. Affected patients typically experience a gradual emergence of episodic imbalance and unilateral hearing loss, tinnitus, and headache. Less often, VS may be associated with facial pain; ocular, otic, and taste disturbance; paresthesia of the tongue and face; and temporomandibular disorder-like presentations. There is limited information in the dental literature relating the myriad of oral and maxillofacial manifestations of VS. The objective of this article is to underscore the importance for dental clinicians to seek clinicopathologic correlations with VS-related symptomatology, potentially resulting in a timelier diagnosis and improved patient outcomes. To convey this clinical challenge, a detailed narrative of a 45-year-old patient with an 11-year delay in diagnosis has been reported. In addition, the typical radiographic appearance of an implanted cranial device placed following VS resection has been provided. [ABSTRACT FROM AUTHOR]

Background: The evaluation of radiomorphometric indices of the mandible can aid dentists not only in forensic investigations but also in diagnosing developmental abnormalities, age-related changes, and gender-specific characteristics that are crucial for treatment planning. This study aimed to evaluate radiomorphometric indices of mandibular bone on panoramic radiographs for estimating gender and approximate age.Methods and Materials: In this descriptive-cross-sectional study a total 180 panoramic radiographs were retrieved from the Oral and Maxillofacial Radiology Department of Yazd Dental School. Seven different indices were measured: upper ramus breadth (URB), lower ramus breadth (LRB), Condylar ramus height (CH), Projective ramus height (PRH), Coronoid ramus height (CRH), the Gonial angle (GA) and Antegonial notch (AN). Linear and angular measurements were performed on the images. Data analysis was conducted using SPSS 17 with ANOVA, t-tests, linear regression, and logistic regression.Results: The panoramic radiographs were taken from 90 male and 90 female patients with a mean age 39.29 ±15.9 years. For age estimation in males, the most important indices were the AN, GA, PRH, and CRH. In females, the CRH and LRB were the most relevant indices. For gender determination, the AN, PRH, CRH, and CH indices can be used in descending order of significance. Using the prediction equation, gender determination accuracy was 77% for males, 86% for females, and 82% overall. Mean values for all parameters were higher in males than females.Conclusion: Morphometric analysis of mandibular ramus indices on panoramic radiographs is a reliable method for gender determination and age estimation in the Iranian population. These findings support the use of mandibular ramus indices in forensic dentistry for population-specific applications.