The intra- and inter-rater reproducibility of bone level measurements at strategic mini-implants using dental panoramic radiography

Abstract Objectives: This experimental study focused on the intra- and inter-rater reproducibility of vertical bone level (VBL) measurements at strategic mini-implants (MI) using digital panoramic radiographs (PR). Study design: VBLs of 152 MIs for removable partial denture stabilization at 50 randomly chosen PRs from a clinical trial were digitally evaluated by three ratters. Rater deviations exceeding 0.5 mm were re-examined. The intra-class correlation coefficient (ICC) was applied to estimate reliability. The smallest detectable change (SDC) was interrelated to the minimal clinically important change of 0.2 mm. Results: The first measurement round revealed intra- and inter-rater ICCs of > 0.8. However, 28 sites (9 %) were unreadable, and 97 sites (32 %) revealed differences between observers of ≥ 0.5 mm. Following a consensus session and re-training, an additional 8 sites were excluded and all remaining VBL differences were ≤ 0.5 mm. Thus, the SDCs with 95 % credibility were improved from 0.73 to 0.31 mm in the intra-rater and from 1.52 to 0.34 mm in the interrater statistics. Given a 50 % credibility for this special setting, both the intra- and inter-rater SDCs were 0.11 mm. Conclusions: Digital PR can be reliably utilized to determine VBLs around MIs under conditions of at least two trained observers, mutual calibration sessions, and exclusion of unquantifiable radiographs. German Clinical Trials Register ID:DRKS00007589, www.germanctr.de

Mandibular assessment of panoramic radiographs for sex identification / Análise do dimorfismo sexual através de índices radiomorfométricos em radiografias panorâmicas

ABSTRACT Sex determination plays a crucial role in the post-mortem identification of human remains. One effective approach for obtaining sex-related data is to use measurements of anatomical structures such as the mandible. This study aimed to evaluate the potential of mandibular radiomorphometric indices from panoramic radiographs (PRs) for the identification of sexual dimorphism. The study sample included 300 PRs of individuals aged 51 to 80 years from the northeastern region of Brazil. Four linear measures and three numerical indices were analyzed with Inkscape® version 1.0.1 for Windows by two blinded evaluators. After statistical analysis, the results showed that the linear measurements obtained from PRs are a reliable method for sex identification. However, the calculated indices of these measurements exhibited lower efficacy for the same purpose. Therefore, PRs proved to be a valuable method for sexual identification through mandibular assessment.

RESUMO A determinação do sexo é um dado importante para a identificação post-mortem de um indivíduo ou de restos mortais humanos. Uma maneira de adquirir dados quanto ao sexo é utilizar mensurações de estruturas como a mandíbula. O objetivo principal deste estudo é avaliar a utilização de índices radiomorfométricos de mandíbulas para a identificação de dimorfismo sexual, através de radiografias panorâmicas. O estudo foi realizado em exames radiográficos panorâmicos de 300 indivíduos entre 51 e 80 anos, residentes do Nordeste brasileiro. Foram analisadas quatro medidas lineares e três índices numéricos no software Inkscape® versão 1.0.1 para Windows, por dois avaliadores cegos. Após análise estatística, os resultados demostraram que as medidas lineares obtidas se configuram como um método seguro para a identificação sexual. Entretanto, os índices obtidos através destas medidas demostraram menor eficiência para o mesmo fim. Logo, as radiografias panorâmicas podem ser utilizadas como método eficaz para a obtenção da caracterização sexual através da mandíbula.

Sex Determination in the Contemporary Chilean Population by Mandible Analysis in Panoramic Radiographies / Estimación Sexual de la Población Chilena Contemporánea Mediante Análisis de la Mandíbula en Radiografías Panorámicas

SUMMARY: Sex identification of a deceased human individual by means of the mandible is very important for forensic dentistry. The aim of the present study was to determine the sex of Chilean individuals by mandible analysis in panoramic radiographies. Linear and angular parameters of the mandible were analyzed from panoramic radiographies (PR). The study included PR of adult Chilean individuals, of both sexes, with optimum solution and contrast, and which allowed the angles and rami of the mandible to be viewed. Sex was determined by univariate and bivariate discriminant function analysis. The sample consisted of 594 PR of individuals aged between 18 and 84 years. The best sex predictor using univariate discriminant function analysis was the mandibular ramus height (MRH) (74.1 %), followed by the distance from the mental foramen - mandibular base (DMF-MB) (69.1 %) and the bicondylar breadth (BC) (66.7 %). The parameters that presented the lowest sex prediction were the angle of the mandible (AM) with 55.0 % and the distance between mental foramina (DMF) with 53.7 %. The best sex prediction was obtained by the step model of discriminant function analysis (80.2 %), including only three parameters: MRH, BC and DMF-MB. The parameters height of the mandibular ramus, bicondylar breadth and distance from the mental foramen - base of the mandible are good predictors of sex in Chilean individuals when used in conjunction; they are therefore indicated for sex determination in the contemporary Chilean population.

La identificación humana de un individuo fallecido a través de la mandíbula es muy relevante para la odontología forense. El objetivo de este estudio fue estimar el sexo de individuos Chilenos a través del análisis de la mandíbula, utilizando radiografías panorámicas. Fueron analizados parámetros lineales y angulares de la mandíbula, a través de radiografías panorámicas (RP). Se incluyeron RP de individuos chilenos adultos, ambos sexos, con solución y contraste óptimos, y que permitían la visualización de los ángulos y ramas de la mandíbula. Se realizó análisis por función discriminante univariada y bivariada para estimación del sexo. Fueron incluidas 594 RP de individuos entre 18 y 84 años. Para el análisis de función discriminante univariado, la altura de la rama mandibular (ARM) fue el parámetro más predictivo (74,1 %), seguido de la distancia foramen mentoniano - base de la mandíbula (DFM-BM) (69,1 %) y el ancho bicondilar (ABCo) (66,7 %). Los parámetros que presentaron menor predicción sexual fueron el ángulo de la mandíbula (AM) con un 55,0 % y la distancia inter-forámenes mentonianos (DIFM), con el 53.7 %. El análisis por pasos fue el modelo de análisis de función discriminante que presentó la mayor predicción sexual (79,5 %), en el cual fueron incluidos sólo tres parámetros: ARM, ABCo y DFM-BM. Los parámetros altura de la rama de la mandíbula, ancho bicondilar y distancia desde el foramen mentoniano hasta la base de la mandíbula son buenos predictores del sexo en individuos Chilenos cuando utilizados en conjunto y están indicados para estimar el sexo en la población chilena contemporánea.

Depth and proximity of third molars to the inferior alveolar canal in panoramic radiographs of a Latin American population

Introduction: extraction of lower third molars involve the possible occurrence of complications such as injury of the content of the Inferior Alveolar Canal. Methods: a cross-sectional study was conducted with a sample of 6488 lower molar records of digital panoramic radiographs of patients from 6 Latin American countries from 2010-2015. The variables studied were the depth of lower third molar according to the Pell and Gregory classification, and the proximity of a third molar to the Inferior Alveolar Canal that was evaluated according to the proposed classification, based on a modification of the Langlais et al classification.20 Descriptive and bivariate statistical analyses were performed. Results: in terms of the proximity, the highest frequency was Intact with 27.45%(n=1781). Regarding the depth of the lower third molar, the most frequent were the Position B with 46.90%(n=3043) and Position A with 46.75%(n=3033). The proximity and depth of the lower third molar had statistical difference according to age(p<0.01) and sex (p<0.001). The overall proximity of the lower third molar to the Inferior alveolar canal, according to depth was 37.52%(n=1766) in Position A, in Position B it was 54.51%(n=2566) and Position C was 7.97%(n=375) and had association between variables(p<0.001). Conclusions: taking into consideration the modified classification of Langlais et al.20, lower third molars are close to the Inferior Alveolar Canal, and according to the Pell and Gregory classification for the depth, the most frequent positions are A and B. In addition, proximity and depth were associated with each other, and with the co-variables country, age, and sex.

Introducción: la extracción de terceros molars inferiores implica la posible aparición de complicaciones, como la lesión del contenido del Canal Alveolar Inferior. Métodos: se realizó un estudio transversal con una muestra de 6488 registros de terceros molares inferiores de radiografías panorámicas digitales en pacientes de 6 países latinoamericanos, entre 2010-2015. Las variables fueron profundidad del tercer molar inferior según la clasificación de Pell y Gregory, y proximidad del tercer molar al Canal Alveolar Inferior, evaluada según una clasificación propuesta, basada en la clasificación modificada de Langlais et al.20 Se realizaron análisis estadísticos descriptivos y bivariados. Resultados: en la proximidad, la mayor frecuencia se presentó en Intacto con 27,45%(n=1781); en cuanto a la profundidad del tercer molar inferior, las más frecuentes fueron la Posición B con 46,90%(n=3043) y la Posición A con 46,75%(n=3033). La proximidad y profundidad del tercer molar inferior presentaron diferencias estadísticas de acuerdo con la edad (p<0,01) y sexo (p<0,001). La proximidad total del tercer molar inferior al canal alveolar inferior, según la profundidad fue de 37,52%(n=1766) en Posición A, en Posición B de 54,51%(n=2566) y Posición C de 7,97%(n=375). Además, se presentó asociación entre las variables (p<0,001). Conclusiones: considerando la clasificación modificada de Langlais et al.20, la mayoría de los terceros molares inferiores están próximos al canal alveolar inferior; y según la profundidad de Pell y Gregory, las posiciones más frecuentes son A y B. Además, la proximidad y la profundidad se asociaron entre sí, y con las co-variables país, edad y sexo.

Uso da radiografia panorâmica como fonte de informação para a identificação humana ­ relato de caso pericial / Use of panoramic radiograph as a source for human identification ­ forensic case report

Introdução: A odontologia legal permite a identificação humana por meio da comparação de dados observados em uma documentação odontológica ante mortem (AM) com as informações coletadas post mortem (PM), sendo os exames radiográficos grandes aliados neste processo. Objetivo: Demostrar a contribuição da radiografia panorâmica como fonte de informação para a identificação humana. Relato do caso: foi encaminhado um corpo carbonizado, com parte da região bucomaxilofacial preservada e que ao exame necroscópico era possível identificar a presença de restaurações e ausências dentais. A apresentação de radiografia panorâmica anterior à morte e a realização de exame radiográfico panorâmico no corpo carbonizado possibilitou a comparação de pontos coincidentes e divergências explicáveis, permitindo a identificação positiva do caso. Conclusão: Ao final da perícia foi determinada a identidade da vítima e foi comprovada a importância da radiografia panorâmica para a identificação humana com base em caracteres identificadores anatômicos e terapêuticos presentes no complexo bucomaxilofacial

Introduction: Forensic dentistry allows human identification through the comparison of data observed in ante-mortem (AM) dental documentation with information collected post-mortem (PM), with radiographic examinations being great allies in this process. Objective: To demonstrate the contribution of panoramic radiography as a source of information for human identification. Case report: a charred body was sent, with part of the oral and maxillofacial region preserved and upon necroscopic examination it was possible to identify the presence of restorations and missing teeth. The presentation of a panoramic radiograph prior to death and the performance of a panoramic radiographic examination of the charred body made it possible to compare coincident points and explainable divergences, allowing positive identification of the case. Conclusion: At the end of the forensic examination of the case, the identity of the victim was determined and the importance of panoramic radiography for human identification based on anatomical and therapeutic identifying characters present in the oral and maxillofacial complex was proven

The most requested imaging tests in the treatment of aneurysmal bone cyst and their relationship to outcome: an update / Los exámenes de imagen más solicitados en el tratamiento del quiste óseo aneurismático y su relación con el resultado: una actualización / Os exames de imagem mais frequentemente solicitados no tratamento do quisto ósseo aneurismático e a sua relação com o resultado: uma atualização

ABSTRACT This study aimed to review the most required imaging tests, their characteristics, and whether the primary choice is sufficient for lesion management. PubMed, Web of Science, and Scopus databases were searched. The included articles were case reports or series of aneurysmal bone cysts in the mandible or maxilla that had all the information about the case, from diagnosis to follow-up. The 32 included articles showed that the first imaging test required is a panoramic radiographic examination of the cases, with only a few choosing computed tomography as the first option. The treatment of choice is usually curettage, and 9 cases had recurrences, although 17 did not report follow-up. 2D imaging examinations were the most required type when diagnosing an aneurysmal bone cyst, but 3D examinations were necessary in many cases for better evaluation and to provide more details.

RESUMEN El objetivo de este estudio fue revisar cuáles son los exámenes de imagen más requeridos, sus características y si la elección principal es suficiente para el manejo de la lesión. Se realizaron búsquedas en las bases de datos PubMed, Web of Science y Scopus. Los artículos incluidos eran informes de casos o series de casos de quistes óseos aneurismáticos en la mandíbula o el maxilar que tenían toda la información sobre el caso, desde el diagnóstico hasta el seguimiento. Los 32 artículos incluidos mostraron que el primer examen de imagen requerido es el examen radiográfico panorámico de los casos, y solo unos pocos eligen la tomografía computarizada como primera opción. El tratamiento elegido suele ser el curetaje, y 9 casos presentaron recidivas, aunque 17 no informaron del seguimiento. Los exámenes de imagen 2D fueron el tipo más requerido a la hora de diagnosticar un quiste óseo aneurismático, pero los exámenes 3D fueron necesarios en muchos casos para una mejor evaluación y para proporcionar más detalles.

RESUMO O objetivo deste estudo foi analisar quais os exames imagiológicos mais frequentemente solicitados, as suas características e se a escolha principal é suficiente para a gestão da lesão. Foram pesquisadas as bases de dados PubMed, Web of Science e Scopus. Os artigos incluídos eram relatos de casos ou séries de casos de cistos ósseos aneurismáticos na mandíbula ou maxila que continham todas as informações sobre o caso, desde o diagnóstico até o acompanhamento. Os 32 artigos incluídos mostraram que o primeiro exame de imagem solicitado é o exame radiográfico panorâmico dos casos, sendo que apenas alguns escolheram a tomografia computadorizada como primeira opção. O tratamento de escolha é geralmente a curetagem, e 9 casos tiveram recidivas, embora 17 não tenham relatado o acompanhamento. Os exames de imagem 2D foram os mais solicitados para o diagnóstico de cisto ósseo aneurismático, mas os exames 3D foram necessários em muitos casos para uma melhor avaliação e para fornecer mais detalhes.

Frecuencia de asimetría mandibular en radiografías panorámicas en la ciudad de Cuenca, Ecuador / Frequency of mandibular asymmetry in panoramic radiographs in the city of Cuenca, Ecuador / Frequência da assimetria mandibular em radiografias panorâmicas na cidade de Cuenca, Equador

RESUMEN Objetivo: Determinar la frecuencia de asimetrías mandibulares utilizando radiografías panorámicas digitales con presencia de piezas dentales completas. Material y métodos: Se diseñó un estudio de tipo descriptivo, observacional y de corte transversal retrospectivo, donde se revisaron los registros de todas las radiografías panorámicas digitales de pacientes de entre 18 y 59 años de edad del centro radiográfico Dental Image en el período 2016-2020. Se procedió a evaluar las radiografías panorámicas con el porcentaje de asimetría mandibular según el índice de Habets mediante el trazado radiográfico digital, considerando las siguientes variables: altura de la rama ascendente (C+R), altura de la rama mandibular (RH) y altura condilar (CH), comparando las radiografías simétricas y asimétricas. Resultados: Del total de radiografías analizadas de la muestra (1000), se obtuvo que el grupo etario predominante fue el de 34-41 años de edad, con un total de 301 radiografías (30,1 %); asimismo, en cuanto a la asimetría de acuerdo al sexo, predominó el masculino con 33 (6,6%) simétricos y 467 (93,4%) asimétricos. Conclusión: Existió prevalencia en la altura de la rama ascendente derecha, siendo mayor en el sexo masculino (64,8 mm); estos valores tuvieron significancia estadística entre edad y sexo.

ABSTRACT Objective: This study aims to determine the frequency of mandibular asymmetries using digital panoramic radiographs that display complete teeth. Material and methods: A descriptive, observational, and retrospective cross-sectional study was conducted. The records of all digital panoramic radiographs from patients aged 18 to 59 years, taken at the Dental Image radiographic center during the period 2016-2020, were reviewed. Panoramic radiographs were evaluated for the presence of mandibular asymmetry using the Habets index. Digital radiographic tracing was employed to assess variables including ascending ramus height (C+R), mandibular ramus height (RH), and condylar height (CH). Symmetrical and asymmetrical radiographs were compared. Results: Out of the total sample of 1000 radiographs analyzed, the predominant age group was 34-41 years, constituting 301 radiographs (30.1%). Additionally, in terms of asymmetry based on gender, males exhibited a predominance, with 33 (6.6%) symmetrical radiographs and 467 (93.4%) asymmetrical radiographs. Conclusions: The study revealed a prevalence of height asymmetry in the right ascending ramus, with greater height observed in males (64.8 mm). These values demonstrated statistical significance in relation to both age and gender.

RESUMO Objetivo: Determinar a frequência de assimetrias mandibulares utilizando radiografias panorâmicas digitais com todos os dentes presentes. Material e métodos: Foi elaborado um estudo descritivo, observacional, retrospectivo e transversal para analisar registros de todas as radiografias panorâmicas digitais de pacientes com idades entre 18 e 59 anos no centro radiográfico Dental Image, no período de 2016 a 2020. As radiografias panorâmicas foram avaliadas quanto à porcentagem de assimetria mandibular, utilizando o índice de Habets. Traçados radiográficos digitais foram empregados, considerando variáveis como a altura do ramo ascendente (C+R), altura do ramo mandibular (RH) e altura condilar (CH). Foram comparadas radiografias simétricas e assimétricas. Resultados: Das radiografias analisadas na amostra total (1.000), a faixa etária predominante foi de 34 a 41 años, totalizando 301 radiografias (30,1%). Em termos de assimetria por gênero, o sexo masculino apresentou predominância com 33 (6,6%) radiografias simétricas e 467 (93,4%) radiografias assimétricas. Conclusões: Observou-se prevalência na altura do ramo ascendente direito, com valores maiores no sexo masculino (64,8 mm). Esses valores demonstraram significância estatística em relação à idade e ao sexo.

Resorción intracoronal preeruptiva: una revisión de la literatura / Preeruptive intracoronal resorption: a review of the literature / Reabsorção intracoronária pré-eruptiva: uma revisão da literatura

RESUMEN La resorción intracoronal preeruptiva (RIPE) es un hallazgo radiográfico que consiste en la presencia de un área radiolúcida ubicada en la dentina coronal próxima a la unión amelodentinaria en el germen de una pieza dentaria; es usualmente singular y poco profunda (menor de 1/3 de la dentina cameral). La frecuencia reportada en la literatura varía entre 0,85 % y 27,3 %; no se ha encontrado asociación con el sexo; y afecta usualmente a las piezas posteriores. Su etiología no ha sido determinada, pero evidencias histológicas apuntan a que se trataría de secuelas de resorción dentinaria. Los defectos de la RIPE deben ser considerados como lesiones de caries una vez que la pieza erupcione en boca; y aunque no se han desarrollado esquemas de tratamiento o guías de práctica clínica, los tratamientos reportados dependen de la profundidad de los defectos y son frecuentemente conservadores. El objetivo de este trabajo fue revisar los estudios descriptivos y los reportes de casos publicados acerca de la RIPE para que estos defectos sean también considerados en la práctica clínica diaria.

ABSTRACT Preeruptive intracoronal resorption (PIRR) is a radiographic phenomenon characterized by the presence of a radiolucent area situated in the coronal dentin near the amelodentine junction within the tooth's germ. Typically, this radiolucent area is singular and shallow, encompassing less than one-third of the chambered dentin. The reported frequency in the literature varies between 0.85% and 27.3%. No association with gender has been identified, and it predominantly affects posterior teeth. While its precise etiology remains undetermined, histological evidence suggests that it results from a sequelae of dentin resorption. RIPE Defects as Caries Lesions: Once the tooth erupts into the oral cavity, RIPE defects should be regarded in a manner similar to caries lesions. Despite the absence of established treatment schemes or clinical practice guidelines, reported treatments are contingent upon the depth of the defects and frequently lean towards conservative approaches. The primary aim of this study was to comprehensively review descriptive studies and published case reports focusing on RIPE defects. This effort is directed towards integrating these defects into routine clinical practice considerations.

RESUMO A reabsorção intracoronária pré-eruptiva (RIPE) é um achado radiográfico que consiste na presença de uma área radiolúcida localizada na dentina coronária próxima à junção amelodentinária no germe de um dente. Geralmente, é singular e rasa, envolvendo menos de 1/3 da dentina da câmara. A frequência relatada na literatura varia entre 0,85% e 27,3%. Não foi encontrada associação significativa com o sexo, e a RIPE tende a afetar mais comumente os dentes posteriores. Sua etiologia ainda não foi totalmente determinada, mas evidências histológicas sugerem que pode ser consequência de reabsorção da dentina. Os defeitos de RIPE devem ser considerados como lesões de cárie quando o dente irrompe na cavidade bucal. Embora não tenham sido desenvolvidos esquemas de tratamento ou diretrizes de prática clínica específicas, os tratamentos relatados para RIPE são geralmente conservadores e baseiam-se na profundidade dos defeitos. Concluindo, a revisão dos estudos descritivos e dos relatos de casos de RIPE destaca a importância de considerar esses defeitos durante a prática clínica rotineira.

Frecuencia de calcificación del complejo estilohioideo en radiografías panorámicas digitales de un centro radiológico, Lima 2020-2021 / Stylohyoid complex calcification frequency in digital panoramic radiographs of a radiology center, Lima 2020-2021https://doi.org/10.15381/os.v26i2.25050Odontol. Sanmarquina 2023; 26(2): e25050

Objetivo: Determinar la frecuencia de calcificación del complejo estilohioideo en radio-grafías panorámicas digitales de un centro radiológico. Métodos. El tipo de estudio fue cualitativo, diseño descriptivo, transversal y retrospectivo; se estudiaron 400 radiografías panorámicas digitales entre edades de 25 a 70 años. Se realizó una evaluación visual de las radiografías panorámicas digitales donde se observó el tipo y patrón de calcificación del ligamento estilohioideo. Resultados. El 56,8% presentó calcificación del complejo estilohioideo en radiografías panorámicas digitales; según sexo en el grupo femenino se presentó en un 64,6%; respecto al grupo etario el 65.8% presentó calcificación en adultos de 30 a 59 años; según el lado afectado el 71,4% fue bilateral, según la apariencia radiográfica el tipo I presentó una mayor frecuencia con un 50,1% en el lado derecho y el 62,5% en el lado izquierdo; finalmente el patrón de calcificación más frecuente fue el completamente calcificado con un 23,8% en el lado derecho y un 48,5% en el lado izquierdo. Conclusión. La frecuencia de calcificación del complejo estilohioideo en ra-diografías panorámicas digitales en la muestra estudiada fue alta por lo que es importante el uso de la radiografía panorámica como medio de diagnóstico para poder detectar este tipo de hallazgos que junto a una evaluación clínica nos permitan hacer un correcto diagnóstico en fin de un tratamiento adecuado.

Objective: To determine the frequency of the stylohyoid complex calcification in digital panoramic radiographs of a radiological center. Methods.The type of study was quali-tative, descriptive, cross-sectional and retrospective design; 400 digital panoramic radio-graphs between the ages of 25 and 70 were analyzed. A visual evaluation of the digital panoramic radiographs was performed to assess the type and pattern of the stylohyoid ligament calcification. Results. The 56.8% presented calcification of the stylohyoid com-plex in digital panoramic radiographs; according to sex in the female group it was present in 64.6%; Regarding the age group, 65.8% presented calcification in adults aged 30-59 years-old; According to the affected side, 71.4% were bilateral, according to the radio-graphic appearance, type I presented a higher frequency with 50.1% on the right side and 62.5% on the left side. Finally, the most frequent calcification was the completely calcified pattern, with 23.8% on the right side and 48.5% on the left side. Conclusion.The frequency of calcification of the stylohyoid complex in digital panoramic radio-graphs in the sample studied was high, so it is important to use panoramic radiography as a means of diagnosis to be able to detect this type of findings that, together with a clinical evaluation, allow us to make a correct diagnosis and perform an adequate treatment.

Effects of early unilateral mandibular first molar extraction on condylar and ramal asymmetry / Efectos de la extracción temprana del primer molar mandibular unilateral sobre la asimetría condilar y ramal

SUMMARY: Craniofacial symmetry is an important factor in creating a harmonious facial appearance. Genetic and external factors may cause the formation of mandibular asymmetry. The aim of this study was to evaluate vertical mandibular asymmetries in adolescents who had unilateral mandibular first permanent molar (FPM) teeth extracted at an early age. The study group consisted of 60 subjects (30 females, 30 males with a mean age of 16.18±1.04 years) who had their mandibular permanent first molar tooth extracted before the age of 12, and the control group consisted of 60 healthy subjects (30 females, 30 males with a mean age of 16.23±0.92 years). Condylar asymmetry index (CAI), ramal asymmetry index (RAI), and condylar-ramal asymmetry index (CRAI) were calculated using panoramic radiographs of the subjects. Independent samples t-test was used to evaluate the differences between groups. CAI, RAI, and CRAI values were similar between male and female subjects in both control and study groups, and no statistically significant difference was found (p>0.05). No statistically significant difference was observed between the group who had their mandibular first permanent molar teeth extracted at an early age and the control group (p>0.05). CAI values were relatively higher in both groups, but there was no significant difference between the CAI, RAI, and CRAI values between the groups.

La simetría craneofacial es un factor importante para crear una apariencia facial armoniosa. Factores genéticos y externos pueden causar la formación de asimetría mandibular. El objetivo de este estudio fue evaluar las asimetrías mandibulares verticales en adolescentes a quienes se les extrajo el primer molar permanente (FPM) mandibular unilateral a una edad temprana. El grupo de estudio consistió en 60 sujetos (30 mujeres, 30 hombres con una edad media de 16,18±1,04 años) a quienes se les extrajo el primer molar mandibular permanente antes de los 12 años, y el grupo control consistió en 60 sujetos sanos (30 mujeres, 30 hombres con una edad media de 16,23±0,92 años). El índice de asimetría condilar (CAI), el índice de asimetría ramal (RAI) y el índice de asimetría condilar-ramal (CRAI) se calcularon utilizando radiografías panorámicas de los sujetos. Se utilizó la prueba t de muestras independientes para evaluar las diferencias entre los grupos. Los valores de CAI, RAI y CRAI fueron similares entre los hombres y las mujeres tanto en el grupo control como en el de estudio, y no se encontraron diferencias estadísticamente significativas (p>0.05). No se observaron diferencias estadísticamente significativas entre el grupo al que se le extrajo el primer molar permanente mandibular a una edad temprana y el grupo control (p>0,05). Los valores de CAI fueron relativamente más altos en ambos grupos, pero no hubo diferencias significativas entre los valores de CAI, RAI y CRAI entre los grupos.

Age estimation of Russian individuals by teeth using the London Atlas / Análise da estimativa de idade em indivíduos russos utilizando a metodologia London Atlas

Knowing an individual's age is necessary for several situations, both in the living and the deceased. The London Atlas uses dental development and eruption to estimate age. Testing the method in different populations is necessary to assess its performance. This study aimed to assess the performance of the London Atlas method in a Russian sample using panoramic radiographs. A sample of 703 panoramic radiographs of Russian individuals (n = 405 females, 57.61% and n = 298 males, 42.39%) with ages between 8 and 23 years were analyzed. The results showed overestimation in individuals from 8 to 14 years and underestimation from 15 to 23 years. The mean difference between estimated and chronological ages did not exceed 0.7 years among individuals with ages below 19 years. The difference increased to over three years in individuals from 20 to 23 years. Statistically significant differences were found between females and males between 17 and 18 years (p<0.05). The London Atlas is suitable for Russian children and adolescents aged between 8 and 19 years; however, it showed unsatisfactory results for application in individuals over 20 years (AU).

Conhecer a idade de um indivíduo, vivo ou morto, é essencial em diversas situações. O método London Atlas utiliza desenvolvimento e erupção dentais para estimar a idade. Testar o método em diferentes populações é importante para avaliar sua performance. Esse estudo objetivou analisar o desempenho do London Atlas em uma amostra de origem russa, utilizando radiografias panorâmicas. Uma amostra de 703 indivíduos russos (n = 405 mulheres, 57,61% e n = 298 homens, 42,39%), com idades entre 8 e 23 anos foram analisadas. Resultados obtidos mostram uma superestimação em indivíduos de 8 a 14 anos e subestimação nos grupos de 15 a 23 anos. A diferença média entre idades estimadas e reais não excederam o valor de 0,7 anos nos indivíduos com idade abaixo de 19 anos. Essa diferença aumentou em até três anos em indivíduos de 20 a 23 anos. Diferenças estatisticamente significantes foram encontradas entre homens e mulheres com 17 e 18 anos (p<0,05). O London Atlas é adequado para crianças e adolescentes de origem russa, com idades de 8 a 19 anos. No entanto, observou-se resultados insatisfatórios para sua aplicação em indivíduos acima de 20 anos (AU).

Comparación de la radiografía panorámica con la tomografía computarizada de haz cónico para evaluar la relación entre los dientes posteriores y el seno maxilar / Comparison of panoramic radiography with cone beam computed tomography for assessing the relationship between posterior teeth and the maxillary sinus

RESUMEN Objetivo : Comparar la radiografía panorámica (RP) con la tomografía computarizada de haz cónico (TCHC) para evaluar la relación entre los dientes posteriores y el seno maxilar (SM). Material y métodos : Se analizaron 533 dientes posteriores del maxilar superior en 80 sujetos sometidos a RP y TCHC en el Centro Dental Docente (CDD) de la Universidad Peruana Cayetano Heredia (UPCH), durante el periodo 2016-2019. Se realizó un estudio transversal, observacional, descriptivo y retrospectivo. Los datos y las observaciones se registraron en una ficha de datos diseñada para este estudio. Resultados : La relación diente-seno maxilar más frecuente fue la clase 0 (ápice radicular sin contacto con el piso del seno maxilar [PSM]), con predominio del sexo femenino, del rango etario de 48-57 años y en ambos premolares. En la clase 0 se encontró una mayor concordancia entre ambas técnicas de imagen. La RP fue muy precisa para detectar la clase 0 en ambos premolares; sin embargo, mostró una precisión muy pobre para detectar la clase 3 (PSM curvado hacia abajo y ápice por encima del mismo) en todos los tipos de dientes. Conclusiones : Las RP y TCHC presentan baja concordancia en relaciones de clase 3, dado que todos estos casos observados en RP muestran una clasificación menor en TCHC; por lo tanto, la RP es suficiente para proporcionar la verdadera relación entre premolares y SM, pero en el caso de molares es necesaria una TCHC.

ABSTRACT Objective : To compare panoramic radiography (PR) with cone beam computed tomography (CBCT) to assess the relationship between posterior teeth and the maxillary sinus. Material and methods : A comprehensive analysis was conducted on 533 posterior teeth of the maxilla of 80 subjects who underwent panoramic and tomographic imaging at the Teaching Dental Center (TDC) of the Universidad Peruana Cayetano Heredia (UPCH) between 2016 and 2019. It was a cross-sectional, observational, descriptive, and retrospective study. Data and observations were recorded on a data sheet designed for this study. Results : The most frequent relationship between teeth and maxillary sinus (MS) was class 0 (root apex without contact with the floor of the MS), predominantly observed on women aged 48 to 57, and in both premolars. In class 0, a greater concordance was found between both radiographic methods. PR was very accurate in detecting class 0 in both premolars, but very inaccurate in detecting class 3 (floor of MS curved downward and apex above it) in all tooth types. Conclusions : Panoramic and tomographic images present low concordance in class 3 relationships as all cases observed in panoramic images show a lower classification in tomography. Therefore, PR is sufficient to provide the true relationship between premolars and maxillary sinus. However, in the case of molars, a three-dimensional image is required.

Prevalencia del pseudoquiste antral y mucositis apical en los senos maxilares como entidades frecuentes encontradas en radiografías panorámicas en pacientes de un centro radiológico de Huacho, Lima-Perú, 2019 / Prevalence of antral pseudocyst and apical mucositis in the maxillary sinus as common entities found in panoramic x-rays among patients at a radiological center in Huacho, Lima, Peru, 2019

RESUMEN Antecedentes: Los senos maxilares están directamente relacionados con el proceso dentoalveolar, por lo que el conocimiento de las patologías que pueden afectar y comprometer cualquiera de ambas estructuras facilitará un correcto diagnóstico y tratamiento. Objetivo: Determinar la prevalencia de pseudoquiste antral y mucositis como entidades frecuentes encontradas en radiografías panorámicas en pacientes de un centro radiológico de Huacho, Lima-Perú, en 2019. Material y métodos: Estudio transversal, observacional, descriptivo y retrospectivo. De un total de 1646 radiografías panorámicas virtuales recolectadas en el centro radiológico de Huacho, se asignó como población muestral 1224 radiografías, luego de tener en cuenta los criterios de inclusión y exclusión. Las variables fueron pseudoquiste antral, engrosamiento de la mucosa, periodontitis apical, mucositis, edad, sexo y mes de toma radiográfica. Se realizó análisis descriptivo y bivariado. Resultados: La prevalencia de pseudoquiste antral de origen respiratorio fue de 5,71 %; de mucositis, 13,07 %; y de ambas entidades correlacionadas, 0,90 %. Se encontró asociación significativa entre la presencia de pseudoquiste antral de origen respiratorio y el sexo masculino (p = 0,007). Conclusiones: La presencia de lesiones apicales que condicionan tanto el engrosamiento de la mucosa antral como la presencia de pseudoquiste antral odontogénico, correlacionadas, resultó poco prevalente (y no rara).

ABSTRACT Maxillary sinuses are directly related to the dentoalveolar process, so knowledge of the pathologies that may affect and compromise either of the two structures can facilitate a correct diagnosis and treatment. Objective: To determine antral pseudocyst and apical mucositis prevalence as frequent entities found in panoramic x-rays among patients at a radiological center in Huacho, Lima, Peru, 2019. Material and Methods: Cross-sectional, observational, descriptive and retrospective study. From a total of 1,646 virtual panoramic x-rays collected at a radiological center in Huacho, 1,224 x-rays were used as sample population after taking into account the inclusion and exclusion criteria. The variables were antral pseudocyst, thickening of the mucosa, apical periodontitis, apical mucositis, age, gender, and month in which x-ray was taken. Descriptive and bivariate analysis was performed. Results: Antral pseudocyst of respiratory origin prevalence was 5.71%, mucositis prevalence was 13.07%, and prevalence of both correlated entities was 0.90%. A significant association was found between the presence of antral pseudocyst of respiratory origin and male gender (p=0,007). Conclusion: The occurrence of apical lesions leading to both thickening of the antral mucosa and the presence of odontogenic antral pseudocysts, while not rare, was found to be of low prevalence.

Resorción intracoronal preeruptiva: reportes radiográficos y tomográficos de cuatro casos / Preeruptive Intracoronal Resorption: X-Ray and Tomographic Reports of Four Cases

RESUMEN La resorción intracoronal preeruptiva (RIPE) se presenta como un defecto ubicado en la dentina coronal próxima a la unión amelodentinaria en la corona de un germen dentario. Este defecto de profundidad y ubicación anteroposterior variables solo puede ser diagnosticado mediante radiografías extraorales, intraorales y tomografías dentales. La etiología no ha sido determinada, pero los estudios de histopatología sugieren que este defecto sería una secuela de resorción dentaria. En el presente manuscrito, se presentan radiografías panorámicas y tomografías de haz cónico (THC) de cuatro pacientes con dicha afección, en las que encontramos los defectos dentinarios y discontinuidades en el esmalte adyacente, por lo que se discutirá la utilidad de la THC en el diagnóstico y la planificación de tratamiento de los casos con RIPE.

ABSTRACT Preeruptive Intracoronal Resorption (PIR) manifests as a defect located in the dentin of a dental germ, adjacent to the amelodentinal junction in the crown. This defect, which varies in depth and anteroposterior location, can only be diagnosed through extraoral and intraoral x-rays, as well as dental tomography. The etiology of PIR remains undetermined, although histopathological studies suggest it could be a consequence of dental resorption. In this paper, panoramic x-rays and cone beam computed tomography (CBCT) scans of four patients with PIR are presented. The dental defects and enamel discontinuities adjacent to them are identified, highlighting the usefulness of CBCT in diagnosing and planning treatment for PIR cases.

Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

Prevalence of soft tissue calcifications in the maxillofacial region: a radiographic study

Aim: To evaluate the prevalence of soft tissue calcifications in orofacial region and their panoramic radiographic characteristics using digital panoramic radiographs among patients reporting to a tertiary dental hospital. Methods: 1,578 digital panoramic radiographs were retrieved from the archives and scrutinized for the presence of calcifications. Soft tissue calcifications were recorded according to age, gender, site (left or right). Data were analysed using Chi-square and Fisher's exact test using SPSS software and a p < 0.05 was considered statistically significant. Results: Among the total number of radiographs, calcified carotid artery (34.3%), calcified stylohyoid ligament (21%), tonsillolith (10.3%), phlebolith (17.6%), antrolith (6.3%), sialolith (5.9%), rhinolith (2.5%) and calcified lymph nodes (1.9%) were identified. The most commonly observed calcifications were calcification of carotid artery and stylohyoid ligament and the least commonly observed calcifications were rhinolith and calcified lymph node. A statistically significant association of the presence of calcifications of carotid artery and stylohyoid ligament on the left and right side was observed in females and tonsillolith on the right side in males (p-value < 0.05). Considering the gender and age group, the occurrence of antrolith among males and rhinolith among females of young-adult population, tonsillolith among the males, calcified carotid artery and stylohyoid ligament among the females of middle-aged population was found to be significant. Conclusion: Soft tissue calcifications are often encountered in dental panoramic radiographs. Our study revealed that the soft tissue calcifications in orofacial region were more common in women and were found to be increased above 40 years of age

Prevalência de radiolucência justa-apical e sua relação com terceiros molares inferiores em radiografias panorâmicas / Prevalence of juxta-apical radiolucency and association/relations with the lower third molar in panoramic radiography

Objetivo: Avaliar a prevalência da radiolucência justa-apical (RJA) e sua relação com os terceiros molares inferiores, em 1054 radiografias panorâmicas. Métodos: A amostra foi constituída por radiografias panorâmicas digitais de indivíduos maiores de 18 anos, com pelo menos um terceiro molar inferior. As imagens foram analisadas para a presença de RJA em relação à corticalização, localização, relação com o canal mandibular, angulação e profundidade de impactação do terceiro molar. Os dados foram analisados através de estatística descritiva e pelo teste Qui-quadrado, sendo que valores de p < 0,05 foram considerados como significativos. Resultados:Foi encontrada uma prevalência de 2,75% de RJA, sendo predominante no sexo feminino (p = 0,01). A RJA foi visualizada em maior número corticalizada (58,63%), lateroapical (48,27%), em dentes parcialmente intraósseo (68,97%) e mesioangulados (55,17%). Em relação ao canal mandibular, houve maior prevalência na posição sobreposta ao canal mandibular (65,52%). Conclusão: A prevalência de RJA foi de 2,75% do total de 1054 radiografias panorâmicas avaliadas. Em relação ao canal mandibular, apresentou maior prevalência sobreposto. Além disso, a maior parte das RJA se apresentaram corticalizadas, em posição lateroapical, associada a dentes em posição mesioangular. Descritores: Radiografia panorâmica. Dente serotino. Nervo mandibular.Prevalência de radiolucência justa-apical e sua relação com terceiros molares inferiores em radiografias panorâmicas

Aim: To evaluate the prevalence of juxta-apical radiolucency (JAR) and its relationship with the lower third molars and adjacent structures, in 1,054 panoramic radiographs. Methods: The sample consisted of digital panoramic radiographs of individuals over 18 years of age, with at least one lower third molar. The images were analyzed for the presence of JAR in relation to corticalization, location, impaction depth, relationship with the mandibular canal, angulation, and impaction of the third molar. Data were analyzed using descriptive statistics and the chi-square test, and values of p < 0.05 were considered significant.Results: A prevalence of 2.75% of JAR was found, with a statistical difference between JAR and gender (p = 0.01), which proved to be predominant in females. The JAR was seen in greater numbers as corticalized (58.63%), lateroapical (48.27%), and mesioangulated (55.17%), as well as in erupted teeth (31.03%). In relation to the mandibular canal, it presented a higher prevalence when superimposed upon the mandibular canal (65.52%). Conclusions:The prevalence of RJA was 2.75% of the 1,054 evaluated panoramic radiographs. In relation to the mandibular canal, it presented a higher prevalence of superimposition. In addition, most of the RJA were corticalized, in a lateroapical position, associated with teeth in a mesioangular position. Uniterms: Panoramic radiography. Third molar. Mandibular nerve.

Relación entre el diagnóstico histopatológico de sacos foliculares de terceros molares y la medida radiográfca estandarizada en radiografía panorámica digital / Relationship between histopathologic diagnosis of third molar follicular sacs and standardized radiographic measurement on digital panoramic radiography

Objetivo: establecer la relación entre el diagnóstico histopatológico de sacos foliculares de terceros molares y la medida radiográfca estandarizada en radiografía panorámica digital. Métodos: se llevó a cabo un estudio descriptivo en el que se incluyeron 28 sacos foliculares de terceros molares. Dos observadores midieron la radiolucidez pericoronal en radiografías panorámicas digitales usando un método estandarizado y se calculó el índice de correlación intraclase. Se estableció un diagnóstico radiográfco según la medida del saco, con <2.5 mm como el límite para sacos foliculares normales. Dicho diagnóstico fue comparado con el respectivo diagnóstico histopatológico. Se calculó sensibilidad y especifcidad; se aplicó la prueba de chi-cuadrado, exacta de Fisher y, fnalmente, el índice Kappa. Resultados: se obtuvo un alto grado de acuerdo entre los observadores. La prueba radiográfca tuvo una baja sensibilidad (0.27) y especifcidad (0.6) y no se encontró diferencia estadísticamente signifcativa entre estos. Conclusiones: la ausencia de hallazgos radiográfcos no implica ausencia de enfermedad. Además, no se puede establecer relación entre la presencia de quistes dentígeros y radiolucidez ≥ 2.5 mm en radiografía panorámica digital.

Objective: To establish the relationship between the histopathological diagnosis of follicular sacs of third molars and the standardized radiographic measurement in digital panoramic radiography. Methods: This was a descriptive study in which 28 follicular sacs of third molars were included. In digital panoramic radiographs two observers measured the pericoronal radiolucency using a standardized method and the intraclass correlation index was calculated. A radiographic diagnosis was established according to the size of the sac, with <2.5mm being the limit for normal follicular sacs. This diagnosis was compared with the respective histopathological diagnosis. Sensitivity and specifcity were calculated; the chi-square test, Fisher's exact test and fnally the Kappa index were applied. Results: A high degree of agreement was obtained among the observers. The radiographic test had a low sensitivity (0.27) and specifcity (0.6) and no statistically signifcant diference was found between these. Conclusions: The absence of radiographic fndings does not imply absence of disease, furthermore, no relationship can be established between the presence of dentigerous cysts and radiolucency ≥ 2.5 mm in digital panoramic radiography.

Analysis of the influence of probe position on quality control test results of dental panoramic radiography equipment / 中国辐射卫生

Objective To quantitatively study the influence of changes in probe position on the quality control test results of dental panoramic radiography and to provide a reference for analyzing the sources of deviations in quality control test results. Methods Eight different models of dental panoramic X-ray machines were selected for this study. The film analysis method was used to determine the position of the central axis of the main beam on the image detector. The position of the probe was accurately controlled through an auxiliary moving device. The tube voltage, radiation output, and half-value layer of the useful beam were measured for positions at the center of the beam; 1 cm upward, downward, left, and right from the center of the beam; and 2 cm upward, downward, left, and right from the center of the beam. Results The tube voltage, radiation output, and half-value layer had a maximum value at the center of the beam, with a decrease in the value as the position deviated from the center. There were significant differences in the probe position sensitivity between different models of dental panoramic radiography equipment. A 2 cm deviation in the probe position resulted in an impact on the measured tube voltage of less than 5.3 kV (5.8%) for less sensitive equipment. A 2 mm deviation in the probe position resulted in an impact on the measured tube voltage of less than 5.4 kV (6.0%) for sensitive equipment. Conclusion The probe position can lead to deviation in the quality control test results of dental panoramic photography. Therefore, determining the position of the central axis of the main beam on the image detector for accurate positioning of the probe is crucial for quality control testing.

Comparison of panoramic radiography and cone-beam computed tomography images for detecting external root resorption of mandibular second molar associated with third molar impaction / 口腔医学

Objective@# To compare the diagnostic performance between panoramic radiography(PR)and cone beam computed tomography(CBCT)in the assessment of external root resorption(ERR)of mandibular second molars associated with impacted third molars. @*Methods@# A total number of 832 patients with 1 074 mesially and horizontally impacted mandibular third molars treated at our institution from January 2019 to December 2020 were retrospectively analyzed. Presence of ERR on the adjacent second molar was investigated with PR and CBCT. Factors affecting the diagnostic accuracy of PR were determined. @*Results@# The overall incidence of ERR in second molars was 33.15%(356/1 074)as detected by CBCT images. The accuracy of PR was 66.39%. Multivariate Logistic regression analyses further revealed that middle and Class Ⅲ impaction, crown contact or overlap with the root of adjacent tooth were risk factors for inaccurate diagnosis of PR(P<0.05). @*Conclusion@#The accuracy of detection on ERR of mandibular second molar associated with impacted third molar using panoramic radiography is lower. CBCT is recommended for this clinical scenario.