The Evaluation of Correlation Between Serum PTH and Dentoskeletal Changes in Panoramic Imaging of Hemodialysis Patients.

INTRODUCTION: This study aimed to investigate the relationship between serum levels of PTH and dental and bone changes in the panoramic view of hemodialysis patients. METHODS: Out of 236 patients with end-stage kidney disease (ESKD) who were hospitalized in two hemodialysis centers, 68 ones were selected and concerning their PTH serum levels, they were assigned to case group (PTH > 300 pg/mL) and control group (150 < PTH < 300 pg/mL). Patients in both groups had undergone dialysis for at least 6 months. After intraoral and extraoral examinations, panoramic radiography was performed for patients who hadn't taken any panoramic radiograph within 6 months prior to our study. All radiographs were evaluated for DMFT (decayed, missing and filled teeth) index, bone resorption, periodontal ligament (PDL), lamina dura, mandibular cortical thickness, bone granular pattern, pulp and periapical lesion and giant cell (brown) tumor. The results were analyzed by Chi square statistical tests. Significant level (P value) of test was considered less than .05. RESULTS: Among the eight variables, there was only a significant statistical difference between the case and control groups in the granular bone pattern and inferior mandibular cortex thickness. CONCLUSION: High levels of PTH in hemodialysis patients with secondary hyperparathyroidism can significantly change the trabecular alveolar bone pattern to a granular bone pattern. It also dramatically decreases the thickness of the inferior mandibular cortex. The findings of this study could influence the dental treatment plans for ESKD patients and help in early diagnosis of osteoporosis in patients on dialysis with secondary hyperparathyroidism.  DOI: 10.52547/ijkd.6817.

The frequency of maxillary sinus pathologic findings in cone-beam computed tomography images of patients candidate for dental implant treatment.

Background: Maxillary sinus pathologic conditions increase the risk of complications during sinus augmentation surgeries in the posterior maxilla. The present study aimed to determine the frequencies of maxillary sinus pathologic findings on patients' cone-beam computed tomography (CBCT) images to receive dental implants. Methods: In this descriptive/cross-sectional study, 140 CBCT images of patients who were candidates to receive dental implants were evaluated for the presence of maxillary sinus pathologic entities during 6 months, were divided into five categories: mucosal thickening of >5 mm, retention cyst, partial or complete opacification of the sinus, polypoidal mucosal thickening, and healthy patients. Age, gender, and dental status were evaluated in terms of relationship with the sinus pathologic findings. Absolute and relative frequencies were used to describe data. The chi-squared test was used to analyze the variables. Statistical significance was set at P<0.05. Results: The frequency of maxillary sinus pathologic entities on CBCT images was 63.5%. The pathologic conditions in descending frequency were as follows: mucosal thickening (31.4%), retention cyst (17.1%), partial or complete opacification of the sinus (9.3%), and polypoidal mucosal thickening (5.7%). The frequency of pathologic findings in the maxillary sinus was higher in the <46-year age group and subjects with partial edentulism; however, the differences were not significant. Conclusion: In the present study, the most frequent maxillary sinus pathologic entity was mucosal thickening. There was no relationship between age, sex, and dentition status and maxillary sinus pathologic findings.

Evaluation of the effect of the inversion filter on enhancing the visibility of the mandibular incisive canal in comparison with the original images.

BACKGROUND: The mandibular incisive canal (MIC) is a neural canal containing one of the lower branches of the inferior alveolar nerve, called the mandibular incisive nerve, which can get damaged and cause complications during the removal of bone from the interforaminal region. OBJECTIVES: The aim of this study was to determine the effect of the inversion filter (IF) on improving the visibility of MIC as compared to the original images. MATERIAL AND METHODS: In this retrospective, descriptive, analytical study, 343 samples of digital panoramic radiography were examined. The images were analyzed with and without IF. The frequency and confidence intervals (CIs) of identifying MIC were used to determine its visibility, both with IF and in the original images. Besides, the difference between the maximum and minimum diameters of the canal as well as the distance from MIC to the alveolar crest and to the mental foramen were examined. For statistical analysis, McNemar's test and the paired t-test were used, and the concordance was calculated using the kappa coefficient. RESULTS: No significant differences were found in the prevalence of the incisive canal, or in its unilateral or bilateral visibility between the original and filtered radiography in this study (p = 0.42 and p = 0.67, respectively). The absolute values of the interval difference between MIC and the mental foramen, the maximum and minimum diameters of MIC, and the distance from MIC to the alveolar crest were statistically significant between the filtered and original radiography, although the difference was clinically unimportant. CONCLUSIONS: The use of IF produced results similar to the original radiography; its application neither increased the clarity nor improved the visibility of the incisive canal.

Evaluation of the location of mandibular foramen as an anatomic landmark using CBCT images: a pioneering study in an iranian population / Avaliação da localização do forame mandibular como referência anatômica, por meio de imagens CBCT: um estudopioneiro na população iraniana

Objective: Mandibular foramen (MF) is located on the internal surface of the ramus through which blood vessels and nerves pass. Determination of the anatomic position of the MF is very important in inferior alveolar nerve block anesthesia (IANBA), ramus osteotomy and surgical procedures of the posterior angle of mandibular ramus. The aim of this study was to determine anatomic position of the MF using anatomic landmarks on the three dimensional CBCT images. Material and Methods: A total of 103 CBCT images was evaluated. The NNT Viewer software program was used to measure the distances between the lines tangent on the MF periphery and the anterior border of the ramus, the posterior border of the ramus, the inferior border of the mandible, and the coronoid notch in mm by to age and gender. Results: The results showed a slight difference in anatomic dimensions between the right and left sides, with no significant differences. The anatomic dimensions of the MF on both sides were a little bigger in males than in females. There were no significant differences in the anatomic dimensions of superior inferior and anterior-posterior dimensions of the left and right sides in different age groups. Conclusion: No significant changes occur in the position of the MF with age. The anatomic differences between males and females should be taken into account during IANBA procedures. Males have bigger jaws than females; therefore, there is a longer distance between the MF and the anatomic landmarks evaluated...

Objetivo: O forame mandibular (FM) localiza-se na superfície interna do ramo mandíbula, onde passam vasos sanguíneos e nervos. A determinação da posição anatômica do FM é muito importante para anestesia por bloqueio do nervo alveolar inferior (ABNAI), durante osteotomiano ramo da mandíbula e para procedimentos cirúrgicos do ângulo posterior do ramo mandibular. O objetivo deste estudo foi determinar a posição anatômica do FM utilizando referências anatômicas em imagens tridimensionais de CBCT. Material e Métodos: Um total de 103 imagens de CBCTforam avaliadas. O programa de software NNT Viewer foi utilizado para medir as distâncias em milímetros entre as linhas tangentes na periferia do FM e borda anterior do ramo, borda posterior do ramo, borda inferior da mandíbula e processo coronóide, em relação à idade e o gênero. Resultados: Os resultados mostraram uma ligeira diferença de dimensões anatômicas entre os lados direito e esquerdo, sem diferenças significativas. As dimensões anatômicas do FM em ambos os lados foram um pouco maior no sexo masculino do que no feminino. Não houve diferenças significativas nas dimensões anatômicas superior-inferior e ânteroposterior, tanto do lado direito quanto esquerdo,em diferentes faixas etárias. Conclusão: Mudanças significativas na posição do FM não são observadas em função da faixa etária. As diferenças anatômicas entre homens e mulheres devem ser levadas em consideração durante procedimento ABNAI. Mandíbulas maiores são encontradas no gênero masculino, portanto, há uma maior distância entre o FM e as referências anatômicas avaliadas...

Assessment of dental implant site dimensions in cone beam computed tomography systems / Avaliação das dimensões da área de implante dentário com sistemas de tomografia computadorizada de feixe cônico

Objective: The aim was to investigate the accuracy of linear measurements of the mandibular ridge recorded using two CBCT systems. Material and Methods: Eleven human dry skull were used in which mandibles were chosen to measure width and height in 6 sites. Before scanning, the points were marked using barium sulfate radiopaque contrast media. Mandible imaging was done using two systems: Newtom3G and Cranex3D. Alveolar ridge dimensions were recorded by two observers under uniform condition using special software for each system. The measurement errors and inter-examiner reliability were calculated for each modality and compared with each other and analyzed via SPSS software version 18. The level of significance was set at P < 0.05. Results: The overall mean was 0.08 mm for Cranex system and 0.5 for Newtom system. The mean of two systems had no statistically significant difference in comparison with each other or with the gold standard. The statistical analysis showed high inter-observer reliability (P < 0.05). Conclusion: CBCT is highly accurate and reproducible in linear measurements in the different areas of the maxillofacial region.

Objetivo: O objetivo deste estudo foi investigar a acurácia de medidas lineares do rebordo mandibular utilizando dois sistemas de TCFC. Material e Métodos: Onze crânios secos humanos foram utilizadas e seis regiões das mandíbulas foram escolhidos para mensuração da largura e da altura. Antes da digitalização, os pontos foram marcados com contraste radiopaco de sulfato de bário. Imagens da mandíbula foram realizadas usando dois sistemas: Newtom3G e Cranex3D . As dimensões rebordo alveolar foram determinadas por dois observadores em condições uniformes utilizando software específico para cada sistema. Os erros de medição e confiabilidade interexaminadores foram calculados para cada modalidade, utilizando o software SPSS versão 18, e comparados entre si. O nível de significância adotado foi p < 0,05. Resultados: A média geral para o sistema Cranexfoi de 0,08 mm e 0,5 para o sistema de Newton. As médias dos dois sistemas não apresentaram diferença estatisticamente significativa em comparação entre si ou com o padrão-ouro. A análise estatística mostrou alta confiabilidade interexaminador (p < 0,05). Conclusão: TCFC é altamente precisa e reprodutível em medidas lineares nas diferentes áreas da região maxilofacial.