Evaluation of use of cone beam computed tomography in paediatric patients: A cross-sectional study.

BACKGROUND: Cone beam computed tomography (CBCT) is widely used in paediatric dentistry. Appropriate use of CBCT is important because children are more vulnerable to ionizing radiation than adults. AIM: To investigate the use of CBCT in children by describing reasons for requesting it and its distribution according to age, oral region, and department. DESIGN: Cone beam computed tomography scans of patients (age < 19 years) who presented to our dental clinic were investigated retrospectively according to sex, age (6-12 [Group 1] and 13-18 [Group 2] years based on dentition), referring department, imaging area (anterior/posterior, mandible/maxilla), and indication. Indications were grouped under five headings according to 2011 SEDENTEXCT guidelines: dental anomalies, impacted teeth, endodontics, bone pathosis, and others. RESULTS: Overall, 334 CBCT scans at different times and for different reasons in 319 patients were evaluated. In recent years, CBCT requests increased in both age groups. Eighty-five CBCT scans (25.44%) of 78 patients (24.45%) with a mean age of 10.37 ± 1.60 years were examined in Group 1, whereas 249 CBCT scans (%74.55) of 241 patients (75.54%) with a mean age of 15.66 ± 1.70 years were examined in Group 2. The most frequent indication was the assessment of impacted teeth (46.1%). The anterior maxilla was the most frequently monitored region (41.6%). The oral and maxillofacial radiology department was the department that made the most CBCT requests in all the years considered (53.6%). CONCLUSIONS: The most common indications were the assessment of dentigerous cysts and impacted teeth. There was an increase in the number of referrals to paediatric dentistry.

Pre-eruptive intracoronal resorption of permanent dentition: A new classification and a multidisciplinary study.

The aims of this study were to develop a new classification for pre-eruptive intracoronal resorption(PIR) with different resorption areas and sizes and to compare the new classification scores among observers from different specialities and professional experience. The PIR was evaluated according to the new classification by two dentomaxillofacial radiologists and two endodontists. Information regarding the patient's age, gender, systemic diseases, the number of PIR, the affected tooth area and the size of the PIR was recorded. The new classification system showed that PIR six and seven defects were the most detected. Regarding jaw regions, the highest reliability was seen in the maxillary central teeth between observers I and IV, and maxillary premolar-molar teeth between observers II and III. This study revealed that PIR can be found in both root and crown dentine. Professional experience and specialty and awareness of the PIR defect may affect the diagnosis.

Evaluation of mandibular condyle trabecular structure in patients with rheumatoid arthritis using fractal analysis.

OBJECTIVES: The aim of this study was to compare the fractal dimension (FD) of trabecular structure of the mandibular condyles in patients with rheumatoid arthritis (RA) to patients without RA. Correlations between condylar FD and bone mineral density T-scores in the femoral neck and lumbar spine were also examined. STUDY DESIGN: The RA study group patients were divided into 3 categories (33 normal, 33 osteopenic, and 34 osteoporotic) according to T-scores. The control group without RA was sex- and age-matched with the study group. FD was calculated from panoramic radiographs and compared between the study and control groups. The relationships between FD values and femoral neck and L1-L4 lumbar spine T-scores were investigated for study and control groups. Significance was established at P < .05. RESULTS: The mean FD values of the entire study group and of each category in the study group were significantly lower than those of the control group (P < .001). There were no significant differences in FD values among the 3 RA categories (P > .05). No significant correlations appeared between FD and femoral neck or lumbar spine T-scores (P ≥ .063). CONCLUSIONS: Fractal analysis of the condyles on panoramic radiographs can distinguish RA from healthy condyles, even if the patients with RA have normal bone mineral density T-scores.

Assessment of intravertebral pneumatocysts, degenerative joint disease, and ponticulus posticus in the cervical spine through cone beam computed tomography examination.

OBJECTIVE: To identify the prevalence rates and radiologic characteristics of intravertebral pneumatocysts (IVP), degenerative joint disease (DJD), and ponticulus posticus (PP) in the cervical spine by using cone beam computed tomography (CBCT) images. The correlations of the lesions with patient age and sex, as well as the correlations among the lesions, were also evaluated. STUDY DESIGN: CBCT images obtained from 440 patients were assessed retrospectively. Correlations between patient demographic characteristics and IVP, DJD, and PP in the cervical vertebrae were analyzed by using χ2 tests and logistic regression analysis. A difference of P < .05 was considered statistically significant. RESULTS: IVP occurred in 22 of 1792 vertebrae (1.2%) and in 17 of 440 patients (3.9%). DJD findings were observed in the cervical vertebrae of 260 patients (59.1%). PPs were found in 245 patients (55.7%). The prevalence rate of DJD varied significantly by age group (P = .002), whereas the prevalence rates of IVP and PP did not. There was a significant correlation between both DJD and PP with demographic characteristics (P < .001) and between DJD and PP in patients without IVPs (P = .038). CONCLUSIONS: Although DJD is common, radiologists should carefully examine CBCT scans of vertebrae for IVP and PP. Patients with DJD should be evaluated for the presence of PP.