Pre-eruptive intramural resorption in unerupted teeth: a cone-beam computed tomography evaluation of prevalence and related factors.

OBJECTIVE: Pre-eruptive intramural resorption (PEIR) is defined as an abnormal, well-circumscribed radiolucency within the coronal dentin of the tooth, which is often overlooked in plain radiographs. This study aimed to investigate the prevalence of PEIR and its related factors using cone-beam computed tomography (CBCT). METHODS: CBCT images of 590 unerupted teeth were evaluated for the presence of PEIR, location of PEIR, number of lesions in the affected tooth, PEIR score, tooth angulation, tooth position, and pericoronal space. Binary logistic tests were used to analyze the association between the characteristics of PEIR and the patient's demographic data and related factors. RESULTS: The tooth prevalence of PEIR was 13.6% among unerupted teeth. However, it was noteworthy that 19.2% of the unerupted teeth with PEIR were planned to be kept. PEIR was significantly associated with transverse (p = 0.020), inverted-angulated (p = 0.035), and centrally-positioned teeth (p = 0.043). The severity of PEIR was more pronounced in teeth with distal (p = 0.019), lingual (p = 0.023), or inverted-angulated (p = 0.040) positions, and in the absence of pericoronal space (p = 0.036). CONCLUSION: PEIR should be suspected in transverse, inverted-angulated, centrally positioned unerupted teeth, particularly in molars, with no pericoronal space. Further monitoring through CBCT is recommended in such cases. CLINICAL RELEVANCE: The management of unerupted teeth does not always involve surgical removal. Instead, they could be utilized for artificial eruption or tooth transplantation. The present study emphasizes the significance of early detection of PEIR. Clinical recommendations for screening PEIR in unerupted teeth are also proposed, which can be applied to routine plain radiographs.

Accessory infraorbital foramen location using cone-beam computed tomography.

Background: Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods: We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results: In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions: A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.

Understanding the mandibular condyle morphology on panoramic images: A cone beam computed tomography comparison study.

OBJECTIVE: To compare variations in condylar morphology (CM) in panoramic images with those demonstrated in cone beam computed tomography (CBCT) and to investigate factors related to the variations. METHODS: Three thousand panoramic images were analyzed for CM classification and relationship between CM and patient factors. Then, CM of 178 cases of panoramic and CBCT images were compared. RESULTS: CM was classified into five types: round (70.63%), pointed (15.12%), angled (8.43%), flat (4.53%), and irregular (1.28%). CM was significantly related to all patient factors (p < 0.001). Round CM in panoramic images presented as round in CBCT images. Pointed and flat CM were observed mainly in the lateral aspect of the condyle, and no angle-shaped CM was found, according to CBCT images. CONCLUSION: Round, flat, and pointed CM seen on panoramic images possibly reflected the actual shape of the condyle, as confirmed by CBCT, whereas angled CM appeared not to exist.

Primordial odontogenic tumor with prominent calcifications: A rare case report.

Primordial odontogenic tumor (POT) is a rare odontogenic tumor. It is a new entity in the latest edition of the World Health Organization classification in 2017. In the English-language literature, only 14 cases have been documented. Most POTs show a well-defined unilocular radiolucency surrounding a crown of an unerupted molar, resembling a dentigerous cyst. Microscopically, POT may be difficult to distinguish from odontogenic myxoma, ameloblastic fibroma, hyperplastic dental follicle and dental papilla. Here, we reported a case of POT in a 17-year old female presenting with an asymptomatic bony hard swelling at the left posterior mandible. Interestingly, this case shows unique radiographic and microscopic features with prominent calcifications and stellate reticulum-like structures. These characteristics have rarely been described in all previously reported POTs. Importantly, this case is the first case of POT demonstrating radiopacity in the radiographs. We encourage more cases of POTs to be documented as POTs may have more variations in radiographic and microscopic features. Importantly, oral radiologists, surgeons and pathologists must be aware of this new and rare tumor in order to avoid a misdiagnosis and an inappropriate treatment. Key words:Calcification, mandible, odontogenic tumor, primordial odontogenic tumor.

Imaging findings of intraosseous traumatic neuroma of the mandible.

A traumatic neuroma is an uncommon pseudotumor associated with peripheral nerves and occurs following surgery or trauma. It mostly occurs in the extraosseous soft tissue; traumatic neuromas of intraosseous origin are extremely rare. We herein report an unusual case of an intraosseous traumatic neuroma associated with the inferior alveolar nerve that was incidentally found on a panoramic image. In this report, we place special emphasis on the imaging features of traumatic neuroma, including the computed tomography and magnetic resonance imaging findings.

The intravoxel incoherent motion MRI of lateral pterygoid muscle: a quantitative analysis in patients with temporomandibular joint disorders.

OBJECTIVES: To quantitatively evaluate diffusion and perfusion status of lateral pterygoid muscle (LPM) in patients with temporomandibular joint disorder (TMD) by intravoxel incoherent motion (IVIM) imaging and to correlate with findings on temporomandibular joints (TMJs) by conventional MRI. METHODS: 42 patients with TMD underwent MRI. To assess IVIM parameters, diffusion-weighted imaging was obtained by spin-echo-based single-shot echoplanar imaging. Regions of interest were created on all diffusion-weighted images of the superior belly of the lateral pterygoid (SLP) and inferior belly of the lateral pterygoid (ILP) at b-values 0-500 s mm-2. Then, IVIM parameters, diffusion (D) and perfusion (f) were calculated using biexponential fittings. The correlation of these values with conventional MRI findings on TMJs was investigated. RESULTS: For SLP, the f parameter in TMJs with anterior disc displacement without reduction was significantly higher than that in normal ones (p = 0.015). It was also significantly higher in TMJs with joint effusion than in those without (p = 0.016). On the other hand, for both SLP and ILP, the D parameter significantly increased in TMJs with osteoarthritis compared with those without (p = 0.015 and p = 0.022, respectively). CONCLUSIONS: Pathological changes of LPM in patients with TMD may be quantitatively evaluated by IVIM parameters.

Relationship between calcified carotid atheromas in digital panoramic radiographs and underlying systemic diseases in implant patients.

AIM: The aim of the present study was to evaluate the correlation between calcified carotid atheromas (CCA) detected on digital panoramic radiographs and underlying systemic diseases. METHODS: Panoramic radiographs and underlying systemic diseases of retained mandibular denture implants in 265 patients (56 males, 209 females) aged over 50 years were retrospectively evaluated at the Dental Unit of Prasat Neurological Institute, Bangkok, Thailand. RESULTS: The mean age of the patients was 71 ± 7.1 years. The prevalence of CCA was 38.49%. The major underlying systemic diseases were hypertension, hyperlipidemia, diabetes mellitus, and cardiovascular diseases (CVD), respectively. No relationship was found among these four systemic diseases in detecting CCA on panoramic radiographs. Similar findings were also observed in patients with only one systemic disease versus in combination with other diseases. CONCLUSIONS: The presence of CCA on dental panoramic radiographs was not found to be related to the presence of underlying systemic diseases, including hypertension, hyperlipidemia, diabetes mellitus, and CVD.