Relation between maxillary sinus pneumatization and the thickness of the mandibular inferior border in panoramic radiographs.

Background: Maxillary sinus pneumatization is a physiological process that can adversely affect bone availability for further dental rehabilitation. If a relation between the thickness of the mandibular cortex and maxillary sinus pneumatization is proven, future bone availability can be deducted. Material and methods: In this cross-sectional study, 85 panoramic radiographs were evaluated. All patients were between 19 and 70, had at least lost a second premolar, first molar, or second molar on one side of the maxilla, and had these teeth on the other side. Four lines were digitally drawn on the radiographs to determine the superior and inferior borders of the sinus on both sides. The amount of inferior sinus border progression was deducted using the digitally-measured lines' ratios. The following tests were done using IBM SPSS ver. 24: Pearson's correlation coefficient test, Tukey's dual comparison posthoc test, One-way ANOVA test, and the independent T-test (p = 0.05). Results: There was a negative correlation between the inferior mandibular cortex's thickness and the maxillary sinus's pneumatization (p < 0.001). Also, there was a significant difference between maxilla sinus pneumatization in the second premolar, first, and second molar areas based on the inferior mandibular cortex's thickness (p = 0.009). Conclusions: Based on the present study, there is a significant relationship between the thickness of the inferior mandibular cortex and maxillary sinus pneumatization, especially for women and patients above 40 years old.

Sphenoid Sinus Pneumatization Types and Correlation with Adjacent Neurovascular Structures Using Cone-Beam Computed Tomography.

Aims: This study aimed to assess the sphenoid sinus pneumatization types and their correlation with adjacent neurovascular structures using cone-beam computed tomography (CBCT). Materials and methods: This cross-sectional study was conducted on 97 CBCT scans of patients over 18 years of age that were retrieved from the archives of the Oral & Maxillofacial Radiology Department of School of Dentistry. Type of sphenoid sinus pneumatization based on its relationship with sella turcica (conchal, presellar, sellar, and postsellar), the correlation of internal carotid artery (ICA) and optic nerve (ON) with the sinus cavity in the axial and coronal planes (smooth or prolonged type), and presence of Onodi cells and their correlation with the sphenoid sinus (lateral, superior, and superolateral) were all evaluated on CBCT sections. Data were analyzed by the Chi-square and Fisher's exact tests (alpha = 0.05). Results: Postsellar type was the most common sphenoid sinus pneumatization type (82.5%). The Smooth type was the most common form of correlation of ON and ICA with the sphenoid sinus. Onodi cells were noted in 28.9% of the cases; among which, the lateral type had the highest prevalence. Conclusion: Considering the high prevalence of sphenoid sinus pneumatization, Onodi cells, and ON and ICA protrusion in our study population, CBCT should be requested prior to trans-sphenoidal surgical procedures to prevent perioperative and postoperative complications. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03796-0.

Comparing dimensions of upper airway in patients with nasal septal deviation and healthy people in CBCT.

Nasal septal deviation causes the obstruction of the nasal lateral wall and sinus cavities as well as bringing some respiratory problems. Furthermore, the obstruction of the upper airway tract can cause changes in normal breathing process, which itself has an important effect on the normal development of both the mandibular and facial areas. This study aimed to assess the dimensions of airway in patients suffering from nasal septal deviation as well as comparing them with healthy individuals through CBCT images. This descriptive analytical study was performed on 127 patients (classified into two groups: with septal deviation (n=93) and without this deviation (n=34). In each patient, the presence and severity of nasal septal deviation as well as upper airway dimensions were examined from sagittal and coronal views. The obtained data were then analyzed using independent t-test and Mann-Whitney test.no significant difference was observed between the mean age of the two study groups (P=0.208). Among those subjects with and without nasal septal deviation, no significant difference was observed in the lateral view in nasopharynx (P=0.653), oropharynx (P=0.828), and hypopharynx (P=0.693) areas in terms of the anteroposterior airway dimensions. As well, no significant difference was observed in the transversal dimensions in coronal view in nasopharynx (P=0.098), oropharynx (P=0.438), and hypopharynx (P=0.676) areas. There was no significant difference in terms of anteroposterior airway dimensions in the lateral view as well as regarding transverse dimensions in coronal view in nasopharynx, oropharynx, and hypopharynx areas.

Association between the seasonal changes and mucous retention cyst of maxillary antrum in cone beam computed tomography images in a sample population of Isfahan, Iran.

OBJECTIVES: Mucous retention cysts (MRCs) of the maxillary sinuses are incidental findings in radiographs of the oral and maxillofacial structures. These cysts usually appear as rounded, dome-shaped, and soft-tissue masses, most often on the floor of the maxillary sinus. The aim of this study was to determine the prevalence of maxillary antral MRC and the effect of seasonal variation, sex and age in cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: In this simple, nonrandomized, cross-sectional study, CBCT images of patients were reviewed to evaluate the prevalence of MRCs and its location in the antrum, uni or bilateral, size, and season in which MRC occurred. The findings were analyzed using Statistical software SPSS and t-tests (P > 0.05). RESULTS: A total of 765 CBCT images were evaluated (380 males and 385 females); 180 were suggestive of MRCs, 110 occurred in males (28.9%) while 70 (18.2%) occurred in females, which resulted in a prevalence of 23.5%. The peak prevalence of MRC was found in spring (41.6% of all radiographs), but there was no significant statistical difference between the occurrence of MRCs in different seasons (P > 0.05). CONCLUSION: This study showed no significant difference between the occurrences of MRCs in different seasons. There was no significant difference between male and female and different decades of life. Furthermore, there was no significant difference between the involvement of right and left maxillary sinuses and different walls of the antrum.

Prevalence of Taurodont Molars in a Selected Iranian Adult Population.

INTRODUCTION: Taurodontism is an anomaly characterized by elongated crowns and consumedly apical location of the bifurcation area. This study aimed to determine the prevalence of taurodontism in molars based on digital panoramic radiographies in eight cities of Iran. METHODS AND MATERIALS: This descriptive cross-sectional study was conducted on 2360 digital panoramic radiographs taken for different treatment purposes. Demographic information of patients was recorded and radiographs were evaluated for presence of taurodont molars. The prevalence rates were calculated and the data were analyzed using SPSS software version 18 via paired t-test, chi square test and ANOVA. RESULTS: A total of 2360 panoramic radiographs (from 51.4% male and 48.6% female patients) were evaluated and the prevalence of taurodontism was reported 22.9% (22.6% in males and 23.3% in females) (P>0.05). Its prevalence was 51.67% in the right and 48.33% in the left quadrants (P>0.05), 34.1% in the mandible and 65.9% in the maxilla (P=0.000) and 79.52% in the second and 20.48% in the first molar (P=0.000). The prevalence of hypotaurodontism, mesotaurodontism and hypertaurodontism was 84.13%, 11.07% and 4.8%, respectively. CONCLUSION: The prevalence of taurodont molars was high in Iran and it was more common in the second molars and in the maxilla. Hypotaurodontism had the highest prevalence.

Diagnostic value of alarm symptoms for upper GI malignancy in patients referred to GI clinic: A 7 years cross sectional study.

BACKGROUND: Early upper gastrointestinal (UGI) cancer detection had led to organ-preserving endoscopic therapy. Endoscopy is a suitable method of early diagnosis of UGI malignancies. In Iran, exclusion of malignancy is the most important indication for endoscopy. This study is designed to see whether using alarm symptoms can predict the risk of cancer in patients. MATERIALS AND METHODS: A total of 3414 patients referred to a tertiary gastrointestinal (GI) clinic in Isfahan, Iran, from 2009 to 2016 with dyspepsia, gastroesophageal reflux disease (GERD), and alarm symptoms, such as weight loss, dysphagia, GI bleeding, vomiting, positive familial history for cancer, and anorexia. Each patient had been underwent UGI endoscopy and patient data, including histology results, had been collected in the computer. We used logistic regression models to estimate the diagnostic accuracy of each alarm symptoms. RESULTS: A total of 3414 patients with alarm symptoms entered in this study, of whom 72 (2.1%) had an UGI malignancy. According to the logistic regression model, dysphagia (P < 0.001) and weight loss (P < 0.001) were found to be significant positive predictive factors for malignancy. Furthermore, males were in a significantly higher risk of developing UGI malignancy. Through receiver operating characteristic curve and the area under the curve (AUC) with adequate overall calibration and model fit measures, dysphagia and weight loss as a related cancer predictor had a high diagnostic accuracy (accuracy = 0. 72, AUC = 0. 881). Using a combination of age, alarm symptoms will lead to high positive predictive value for cancer. CONCLUSION: We recommend to do an early endoscopy for any patient with UGI symptoms and to take multiple biopsies from any rudeness or suspicious lesion, especially for male gender older than 50, dysphagia, or weight loss.

Comparing the Efficacy of Three Different Nano-scale Bone Substitutes: In vivo Study.

BACKGROUND: Synthetic biocompatible bone substitutions have been used widely for bone tissue regeneration as they are safe and effective. The aim of this animal study is to compare the effectiveness of three different biocompatible bone substitutes, including nano-hydroxyapatite (nano-HA) nano-bioglass (nano-BG) and forstrite scaffolds. MATERIALS AND METHODS: In this interventional and experimental study, four healthy dogs were anesthetized, and the first to fourth premolars were extracted in each quadrant. After healing, the linear incision on the crestal ridge from molar to anterior segment prepared in each quadrant and 16 defects in each dog were prepared. Nano-HA, nano-BG, and forstrite scaffold was prepared according to the size of defects and placed in the 12 defects randomly, four defects remained as a control group. The dogs were sacrificed in four time intervals (15, 30, 45, and 60 days after) and the percentage of different types of regenerated bones (lamellar and woven) and connective tissue were recorded in histological process. The data were analyzed using Mann-Whitney test (α = 0.05). RESULTS: The difference in nano-HA and nano-BG with the control group was significant in three-time intervals regarding the amount of bone formation (P < 0.01). After 15 days, the nano-HA showed the highest amount of woven and lamellar bone regeneration (18.37 ± 1.06 and 30.44 ± 0.54). CONCLUSION: Nano-HA and nano-BG groups showed a significant amount of bone regeneration, especially after 30 days, but paying more surveys and observation to these materials as bone substitutes seem to be needed.

Comparative evaluation of hydroxyapatite and nano-bioglass in two forms of conventional micro- and nano-particles in repairing bone defects (an animal study).

CONTEXT: Many synthetic bone materials have been introduced for repairing bone defects. AIM: The aim of this study is to comparatively evaluate the efficacy of nano-hydroxyapatite (HA) and nano-bioglass bone materials with their traditional micro counterparts in repairing bone defects. MATERIALS AND METHODS: In this prospective animal study, four healthy dogs were included. First to fourth premolars were extracted in each quadrant and five cavities in each quadrant were created using trephine. Sixteen cavities in each dog were filled by HA, nano-HA, bioglass, and nano-bioglass and four defects were left as the control group. All defects were covered by a nonrestorable membrane. Dogs were sacrificed after 15, 30, 45, and 60 days sequentially. All 20 samples were extracted by trephine #8 with a sufficient amount of surrounding bone. All specimens were investigated under an optical microscope and the percentage of total regenerated bone, lamellar, and woven bone were evaluated. STATISTICAL ANALYSIS USED: Data analysis was carried out by SPSS Software ver. 15 and Mann-Whitney U-test (α =0.05). RESULTS: After 15 days, the bone formation percentage showed a significant difference between HA and nano-HA and between HA and bioglass (P < 0.001). The nano-HA group showed the highest rate of bone formation after 15 days. Nano-bioglass and bioglass and nano-HA and nano-bioglass groups represented a significant difference and nano-bioglass showed the highest rate of bone formation after 30 days (P = 0.01). After 45 days, the bone formation percentage showed a significant difference between nano-bioglass and bioglass and between nano-HA and nano-bioglass groups (P = 0.01). CONCLUSIONS: Nano-HA and nano-bioglass biomaterials showed promising results when compared to conventional micro-particles in the repair of bone defects.

The effect of voxel size on the measurement of mandibular thickness in cone-beam computed tomography.

BACKGROUND: Cone-beam computed tomography (CBCT) is a new imaging technology that has been widely used in implantology, oral and maxillofacial surgery and orthodontics. This method provides 3-D images that are composed of voxel, which is the smallest image unit, and determines image resolution. Smaller voxel is associated with the higher resolution and also greater radiation exposure. This study was aimed to find out the effect of voxel size on the measurement of mandibular thickness. MATERIALS AND METHODS: Using voxel sizes of 0.30 mm and 0.15 mm, two CBCT protocols (protocol 1: Field of view (FOV) of 15 cm, 85 kVp, 42 mAs, 0.15 mm voxel, 14 s scan time; protocol 2: FOV of 15 cm, 85 kVp, 10 mAs, 0.30 mm voxel, 14 s scan time) were carried out on 16 dry human mandibles with permanent dentition. Mandibular thickness was measured at seven different sites (midline region, bilateral canine regions, bilateral mental foramen regions and bilateral molar regions). Analysis of variance was used for analysis of data using the Statistical Package for the Social Sciences version 20 (SPSS Inc., Chicago, IL, USA). P < 0.05 considered to be statistically significant. RESULTS: No statistically significant differences were found between different protocols regarding the mandibular thickness (P > 0.05). CONCLUSION: Considering the insignificant differences of the mandibular thickness measurements using different voxel sizes, it would be more reasonable to use 0.30 mm voxel size instead of 0.15 mm voxel size to avoid unnecessary radiation exposure.

Aplasia and hypoplasia of the maxillary sinus: A case series.

Maxillary sinus aplasia and hypoplasia are rare conditions that can cause symptoms such as headaches and voice alteration. The majority of patients are asymptomatic, but these conditions must be noticed for importance of differential diagnosis such as infection and neoplasms. Conventional radiographs could not differentiate between inflammatory mucosal thickening, neoplasm, and hypoplasia of the sinus. Computed tomography (CT) and also cone beam computed tomography (CBCT) are the proper modalities to detect these conditions. In the present study, CBCT findings of three cases with maxillary sinus hypoplasia and aplasia are reported.

Maxillofacial brown tumors in secondary hyperparathyroidism: A case report and literature review.

Parathyroid glands produce parathyroid hormone (PTH). PTH has a main role in bone formation. Hyperparathyroidism (HPT) is explained as primary, secondary and tertiary types defined as overproduction of PTH. The brown tumor or osteitis fibrosa cystica is a benign bone lesion that is caused by HPT. This complication has been decreased by diagnosis and successful treatment of secondary hyperparathyroidism. Pelvis, ribs, clavicle, mandible and the extremities are most commonly affected bone in brown tumor, whereas maxillary involvement is rare. The present article report a 29-year-old man with chief complaints of bone pain, swelling cheeks and teeth displacement with secondary HPT. Parathyroidectomy was done due to bone disorder. It is important for dentists and endocrinologists to understand maxillofacial manifestation of secondary HPT to prevent its complication.