The role of ultrasound imaging of temporomandibular joint condyle-disc complex disorders.

OBJECTIVE: This study aimed to determine the diagnostic value of ultrasonography (US) in internal derangements of temporomandibular joint (TMJ) and to compare its efficacy with magnetic resonance imaging (MRI). METHODS: Fifty patients with MRI indications due to a TMJ disorder were enrolled. Findings of the clinical examination, US examination and MRI examination were noted by seperate clinicians and the sensitivity, specificity and diagnostic accuracies of all examinations were compared. RESULTS: When compared with MRI, the sensitivity, specificity and diagnostic accuracy of the clinical examination for the internal derangements were 73%, 37%, and 70%, respectively and 75.7%, 33.3% and 73.0% for US examination, respectively. CONCLUSION: US can be considered as an alternative to MRI as it can be used to detect the disc position, internal derangements, intraarticular fluid accumulations and superficial condyle changes with minimally better results than clinical examination.

Variations and thicknesses of anterior belly of the digastric muscle: an ultrasonographic study.

PURPOSE: This study aims to evaluate the anatomy and anatomical variations of the anterior belly of the digastric muscle. METHODS: Hundred and fifty one ultrasonographic images of the digastric muscle pairs were evaluated in Near East University Faculty of Dentistry Department of Dentomaxillofacial Radiology. Morphological variations were recorded using the classification of the digastric muscle into 12 types by Kim et al. For the analysis, the Mann-Whitney U test and Chi-square test were used, and for the correlational analysis, Spearman's rho test was applied. P < 0.05 was considered statistically significant in all tests. RESULTS: Seventy female and 81 male patients aged 19-60 years were evaluated. Type 1 digastric muscle was observed in 145 of 151 patients, Type 2 in 3 patients, and Type 7 in 3 patients. The thicknesses of the right and left digastric muscles were measured, and a statistically significant difference was observed between the groups when the genders were compared. It was observed that both right and left digastric muscle thicknesses were higher in males than females. There was a statistically significant positive high correlation between right and left digastric muscle thicknesses (p = 0.000; r = 0.736). No statistically significant difference was found between genders (p = 0.596) in terms of anatomical variations. CONCLUSION: Considering that the variations of the digastric muscle may have a clinical significance role, the normal anatomy and variations of this muscle should be well known by maxillofacial surgeons and radiologists.

Radiological evaluation of odontogenic keratocysts in patients with nevoid basal cell carcinoma syndrome: A review.

Background: Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an autosomal dominant syndrome that has various expressions in each patient. Generally; NBCCS is followed by multiple nevoid basal cell carcinoma of the skin, orbital anomalies, skeletal anomalies, central nervous system anomalies and multiple odontogenic keratocysts (OK). NBCCS is usually diagnosed between the ages of 5-30 years, with multiple basal cell carcinomas of the skin and OKs in the jaws as the initial findings. The purpose of this paper is to describe and compare the radiographic findings of the OKs in NBCCS patients in the literature with additional cases. Materials and Methods: In this study, we evaluated the OKs of the patients with NBCCS in PubMed Database with 5 additional cases from our database. A total of 305 articles were found and the articles in English with full-text access were evaluated. Results: Despite all limitations for a fair discussion; we would like to state that among 59 cases that specified whether a 3D or 2D imaging modality was used, 29 cases were only interpreted with 2D data which should be avoided in OK evaluation. Discussion: According to the World Health Organization's Classification of Head and Neck Tumours Book which was published in 2017, OKs in NBCCS has a higher chance to have small satellite cystic lesions which increase their recurrence possibility post-operatively, thus, a thorough clinical and 3D radiographic evaluation should be performed both to NBCCS patients and non-syndromic OK patients to avoid any recurrence. Conclusion: High recurrence rates of OKs should be reminded all the time. Radiographic examinations with 3D imaging modalities should be done in patients with NBCCS in order to provide a concise diagnosis and optimum treatment.

The use of intraoral ultrasound in the evaluation of the benign lesions in pediatric patients.

Ultrasonography (US) or diagnostic sonography is a radiographic technique that uses sound waves with frequencies higher than 20 kHz to demonstrate soft tissues such as muscles, internal organs, joints, and tendons. The US has various applications in dentistry such as cervical lymph node examination, salivary gland examination, periodontal examination, maxillofacial fracture examination, temporomandibular joint examination, and orofacial swelling examination. One of the most important advantages of the US is it does not produce any ionizing radiation. Since the US does not produce any ionizing radiation, it is a favorable technique especially for the patients who are susceptible to ionizing radiation such as pregnant patients and pediatric patients. In this article, we presented benign tumor lesions that were examined with the US in children and conducted a review of the literature.

Assessing the reliability of CBCT-based AI-generated STL files in diagnosing osseous changes of the mandibular condyle: a comparative study with ground truth diagnosis.

OBJECTIVES: This study aims to evaluate the reliability of AI-generated STL files in diagnosing osseous changes of the mandibular condyle and compare them to a ground truth (GT) diagnosis made by six radiologists. METHODS: A total of 432 retrospective CBCT images from four universities were evaluated by six dentomaxillofacial radiologists who identified osseous changes such as flattening, erosion, osteophyte formation, bifid condyle formation, and osteosclerosis. All images were evaluated by each radiologist blindly and recorded on a spreadsheet. All evaluations were compared and for the disagreements, a consensus meeting was held online to create a uniform GT diagnosis spreadsheet. A web-based dental AI software was used to generate STL files of the CBCT images, which were then evaluated by two dentomaxillofacial radiologists. The new observer, GT, was compared to this new STL file evaluation, and the interclass correlation (ICC) value was calculated for each pathology. RESULTS: Out of the 864 condyles assessed, the ground truth diagnosis identified 372 cases of flattening, 185 cases of erosion, 70 cases of osteophyte formation, 117 cases of osteosclerosis, and 15 cases of bifid condyle formation. The ICC values for flattening, erosion, osteophyte formation, osteosclerosis, and bifid condyle formation were 1.000, 0.782, 1.000, 0.000, and 1.000, respectively, when comparing diagnoses made using STL files with the ground truth. CONCLUSIONS: AI-generated STL files are reliable in diagnosing bifid condyle formation, osteophyte formation, and flattening of the condyle. However, the diagnosis of osteosclerosis using AI-generated STL files is not reliable, and the accuracy of diagnosis is affected by the erosion grade.

Automatic Segmentation of Teeth, Crown-Bridge Restorations, Dental Implants, Restorative Fillings, Dental Caries, Residual Roots, and Root Canal Fillings on Orthopantomographs: Convenience and Pitfalls.

BACKGROUND: The aim of our study is to provide successful automatic segmentation of various objects on orthopantomographs (OPGs). METHODS: 8138 OPGs obtained from the archives of the Department of Dentomaxillofacial Radiology were included. OPGs were converted into PNGs and transferred to the segmentation tool's database. All teeth, crown-bridge restorations, dental implants, composite-amalgam fillings, dental caries, residual roots, and root canal fillings were manually segmented by two experts with the manual drawing semantic segmentation technique. RESULTS: The intra-class correlation coefficient (ICC) for both inter- and intra-observers for manual segmentation was excellent (ICC > 0.75). The intra-observer ICC was found to be 0.994, while the inter-observer reliability was 0.989. No significant difference was detected amongst observers (p = 0.947). The calculated DSC and accuracy values across all OPGs were 0.85 and 0.95 for the tooth segmentation, 0.88 and 0.99 for dental caries, 0.87 and 0.99 for dental restorations, 0.93 and 0.99 for crown-bridge restorations, 0.94 and 0.99 for dental implants, 0.78 and 0.99 for root canal fillings, and 0.78 and 0.99 for residual roots, respectively. CONCLUSIONS: Thanks to faster and automated diagnoses on 2D as well as 3D dental images, dentists will have higher diagnosis rates in a shorter time even without excluding cases.

Federated vs Local vs Central Deep Learning of Tooth Segmentation on Panoramic Radiographs.

OBJECTIVE: Federated Learning (FL) enables collaborative training of artificial intelligence (AI) models from multiple data sources without directly sharing data. Due to the large amount of sensitive data in dentistry, FL may be particularly relevant for oral and dental research and applications. This study, for the first time, employed FL for a dental task, automated tooth segmentation on panoramic radiographs. METHODS: We employed a dataset of 4,177 panoramic radiographs collected from nine different centers (n = 143 to n = 1881 per center) across the globe and used FL to train a machine learning model for tooth segmentation. FL performance was compared against Local Learning (LL), i.e., training models on isolated data from each center (assuming data sharing not to be an option). Further, the performance gap to Central Learning (CL), i.e., training on centrally pooled data (based on data sharing agreements) was quantified. Generalizability of models was evaluated on a pooled test dataset from all centers. RESULTS: For 8 out of 9 centers, FL outperformed LL with statistical significance (p<0.05); only the center providing the largest amount of data FL did not have such an advantage. For generalizability, FL outperformed LL across all centers. CL surpassed both FL and LL for performance and generalizability. CONCLUSION: If data pooling (for CL) is not feasible, FL is shown to be a useful alternative to train performant and, more importantly, generalizable deep learning models in dentistry, where data protection barriers are high. CLINICAL SIGNIFICANCE: This study proves the validity and utility of FL in the field of dentistry, which encourages researchers to adopt this method to improve the generalizability of dental AI models and ease their transition to the clinical environment.

Deep convolutional neural network algorithm for the automatic segmentation of oral potentially malignant disorders and oral cancers.

This study aimed to develop an algorithm to automatically segment the oral potentially malignant diseases (OPMDs) and oral cancers (OCs) of all oral subsites with various deep convolutional neural network applications. A total of 510 intraoral images of OPMDs and OCs were collected over 3 years (2006-2009). All images were confirmed both with patient records and histopathological reports. Following the labeling of the lesions the dataset was arbitrarily split, using random sampling in Python as the study dataset, validation dataset, and test dataset. Pixels were classified as the OPMDs and OCs with the OPMD/OC label and the rest as the background. U-Net architecture was used and the model with the best validation loss was chosen for the testing among the trained 500 epochs. Dice similarity coefficient (DSC) score was noted. The intra-observer ICC was found to be 0.994 while the inter-observer reliability was 0.989. The calculated DSC and validation accuracy across all clinical images were 0.697 and 0.805, respectively. Our algorithm did not maintain an excellent DSC due to multiple reasons for the detection of both OC and OPMDs in oral cavity sites. A better standardization for both 2D and 3D imaging (such as patient positioning) and a bigger dataset are required to improve the quality of such studies. This is the first study which aimed to segment OPMDs and OCs in all subsites of oral cavity which is crucial not only for the early diagnosis but also for higher survival rates.

Comparison of the Paranasal Sinus Features of Paediatric Patients with and Without Cleft Palate: A CBCT Study.

OBJECTIVES: This study is performed to compare the paranasal sinus volumes in paediatric unilateral cleft palate (UCP) and healthy patients. METHODS: Cone-beam computed tomography (CBCT) images of 80 patients (40 boys, 40 girls) with UCP and 80 healthy individuals (40 boys, 40 girls) were evaluated. Paranasal sinus volumes were segmented and measured using ITK-SNAP software. Descriptive statistics, Kolmogorov-Smirnov, paired sample t-test and student t-test were performed for statistical analysis. RESULTS: The volumes of ethmoid, frontal and sphenoid sinus on the cleft side were not significantly different than the non-cleft side (p>0.05) in UCP patients. Maxillary sinus volume of the cleft side in UCP patients was significantly lower than the non-cleft side (p<0.05). Mean maxillary sinus volume in UCP patients was 11825.23±509.95 mm3 at the cleft side and 13497.85±358.07 mm3 at the non-cleft side. While the mean volumes of ethmoid and sphenoid sinuses of patients with UCP were not significantly different from healthy individuals (p>0.05), the mean volumes of maxillary and frontal sinuses were significantly lower than healthy individuals (p<0.05). The mean maxillary sinus volume in UCP patients was 25323±597.8 mm3 and 26666±874.3 mm3 in the control group. The mean frontal sinus volume in UCP patients was 5633±323.1 mm3 and 5735±315.2 mm3 in the control group. CONCLUSIONS: UCP caused a significant reduction in maxillary and frontal sinus volumes. The results of the current study show that paranasal sinus volumes in patients with UCP should be examined in more detail to make more risk-free and effective treatment plans.

Investigation of the Wetting Properties of Thalassemia Patients' Blood Samples on Grade 5 Titanium Implant Surfaces: A Pilot Study.

Background and Objectives: Beta-thalassemia (BT) has a high prevalence in Mediterranean, Southeast Asian, and African countries. Studies stated that thalassemia is an endemic disease that causes significant health problems in Cyprus. This study aimed to measure the contact angle between the implant and blood samples from BT major patients and healthy individuals to compare the contact angles and wettability of Grade 5 titanium implant surfaces. Materials and Methods: Grade 5 titanium discs that were 10 mm in diameter were used since they mimic the surface of dental implants. Following receiving informed consent, blood samples were taken from the patients' index fingers in each group with lancet needles and a photo of the contact angle between the blood samples and the titanium surface was taken; the collected blood was transferred to a titanium disc with a medical pipette. ImageJ software with a specific contact angle plugin was used for the contact angle measurements. Results: Theta-mean, theta-circular, and theta-ellipse values were compared between all groups, and no significant difference was found (p > 0.05). Conclusions: In this study, it was hypothesized that the patients' rheological property of decreased deformability would affect the wettability of implant surfaces in vitro; however, no such finding was reached in this study. Since in-depth studies associated with dental implant success in BTM patients are absent in the literature and Cyprus is one of the Mediterranean countries with a high prevalence of BTM, this study was conducted to enrich the literature. While some systemic diseases may affect the contact angle between the implant surface and blood, it can be concluded that this condition was not present for BTM patients in our study. Last but not least, we emphasize that this experiment was done on a single surface type and the results can be totally different when using other surface types.

Association of accessory sphenoidal septum with protrusions of sphenoid sinus.

PURPOSE: Accessory sphenoidal septum (ASS) is a septal variation that exists in addition to the primary septum of the sphenoid sinus and can be found in or near anatomically essential structures. This study aimed to investigate the relationships between protrusions of vital structures around the sphenoid sinus and the ASSs. METHODS: This cross-sectional retrospective study is based on the analysis of CBCT scans of 314 patients in axial, coronal, and sagittal planes with 0.2-0.3 slice thicknesses. Optic nerve (ON), internal carotid artery (ICA), both ON and ICA, maxillary nerve (MN), vidian canal (VN) and ASSs were detected, and the relationship between protrusions of these vital anatomical structures and ASS was evaluated. RESULTS: Statistically significant relationship was observed between the right Type 1 ON protrusion (p < 0.05) and left Type 1 ON protrusion (p = 0.001); left Type 3 ON protrusion (p < 0.05); right Type 4 ON protrusion (p < 0.05) and ASS. Statistically significant relationship was also observed between the right ICA protrusion and ASS (p < 0.05). The right Type 1 VN protrusion (p = 0.001); left Type 2 VN protrusion (p < 0.001); right and left Type 3 VN protrusions (p < 0.001) were found to be significantly associated with the ASS. CONCLUSIONS: ASSs have significant associations with some protrusions, and they tend to cause potentially severe complications in endoscopic sinus surgery. This variability requires a comprehensive understanding of regional sphenoid sinus anatomy with detailed three-dimensional tomographic imaging.

A Fused Deep Learning Architecture for the Detection of the Relationship between the Mandibular Third Molar and the Mandibular Canal.

The study aimed to generate a fused deep learning algorithm that detects and classifies the relationship between the mandibular third molar and mandibular canal on orthopantomographs. Radiographs (n = 1880) were randomly selected from the hospital archive. Two dentomaxillofacial radiologists annotated the data via MATLAB and classified them into four groups according to the overlap of the root of the mandibular third molar and mandibular canal. Each radiograph was segmented using a U-Net-like architecture. The segmented images were classified by AlexNet. Accuracy, the weighted intersection over union score, the dice coefficient, specificity, sensitivity, and area under curve metrics were used to quantify the performance of the models. Also, three dental practitioners were asked to classify the same test data, their success rate was assessed using the Intraclass Correlation Coefficient. The segmentation network achieved a global accuracy of 0.99 and a weighted intersection over union score of 0.98, average dice score overall images was 0.91. The classification network achieved an accuracy of 0.80, per class sensitivity of 0.74, 0.83, 0.86, 0.67, per class specificity of 0.92, 0.95, 0.88, 0.96 and AUC score of 0.85. The most successful dental practitioner achieved a success rate of 0.79. The fused segmentation and classification networks produced encouraging results. The final model achieved almost the same classification performance as dental practitioners. Better diagnostic accuracy of the combined artificial intelligence tools may help to improve the prediction of the risk factors, especially for recognizing such anatomical variations.

Prevalence, Radiographic Features and Clinical Relevancy of Accessory Canals of the Canalis Sinuosus in Cypriot Population: A Retrospective Cone-Beam Computed Tomography (CBCT) Study.

Background and Objectives: This retrospective study aims to evaluate the prevalence, radiographic features, and clinical relevancy of the accessory canals (AC) of the canalis sinuosus (CS) in patients referred for implant surgery. Materials and Methods: Cone-beam computed tomography (CBCT) images of the patients were collected and ACs were evaluated. Age, sex, bilateral distribution, localization, diameter, distance to the buccal cortical plate, distance to the crest of the alveolar ridge, terminal ending localization, and the presence of tooth or implant were recorded. Ninety-one patients who were eligible for this study were enrolled. Results: A total of 188 ACs were found in 91 patients with 86 bilateral and 5 unilateral distributions. The mean age of the patients was 45.39. All ACs had a terminal ending at the palatal cortical border. All parameters showed a non-normal distribution; thus, the Mann-Whitney U test was preferred. Bilateral AC distribution (p = 0.761), AC distance to the crest of the alveolar ridge (p = 0.614), AC distance to the buccal cortical plate (p = 0.105), and AC diameter (p = 0.423) showed no significant difference between females and males. According to our study, a CS might be an anatomical structure rather than an anatomical variation, as all patients had at least one AC of the CS. It can be inferred that the detection of ACs will be achievable once clinicians are aware of these structures with continuous regular anatomy reworks and with small voxel-sized CBCT devices. Conclusion: This study was conducted to find the features and prevalence of the CS, and it was found that the CS is an anatomical structure rather than an anatomical variation. This argument is in line with the information on the CS in Gray's Anatomy, 42nd Edition. Impaired healings and complications of the CS can be avoided if clinicians follow the American Academy of Oral and Maxillofacial Radiology guidelines regarding pre-operative implant examination. Otherwise, avertible complications may cause significant impairments in quality of life.

AI-based automatic segmentation of craniomaxillofacial anatomy from CBCT scans for automatic detection of pharyngeal airway evaluations in OSA patients.

This study aims to generate and also validate an automatic detection algorithm for pharyngeal airway on CBCT data using an AI software (Diagnocat) which will procure a measurement method. The second aim is to validate the newly developed artificial intelligence system in comparison to commercially available software for 3D CBCT evaluation. A Convolutional Neural Network-based machine learning algorithm was used for the segmentation of the pharyngeal airways in OSA and non-OSA patients. Radiologists used semi-automatic software to manually determine the airway and their measurements were compared with the AI. OSA patients were classified as minimal, mild, moderate, and severe groups, and the mean airway volumes of the groups were compared. The narrowest points of the airway (mm), the field of the airway (mm2), and volume of the airway (cc) of both OSA and non-OSA patients were also compared. There was no statistically significant difference between the manual technique and Diagnocat measurements in all groups (p > 0.05). Inter-class correlation coefficients were 0.954 for manual and automatic segmentation, 0.956 for Diagnocat and automatic segmentation, 0.972 for Diagnocat and manual segmentation. Although there was no statistically significant difference in total airway volume measurements between the manual measurements, automatic measurements, and DC measurements in non-OSA and OSA patients, we evaluated the output images to understand why the mean value for the total airway was higher in DC measurement. It was seen that the DC algorithm also measures the epiglottis volume and the posterior nasal aperture volume due to the low soft-tissue contrast in CBCT images and that leads to higher values in airway volume measurement.

Radiological evaluation of the periosteal reactions in the jaws: a retrospective CBCT study.

OBJECTIVES: The objective of this study is to evaluate the relationship between the radiological features of periosteal reactions (PR) and histopathological features of the lesions. METHODS: A total of 4605 CBCT images were evaluated and they were classified according to their radiological differential diagnosis. Images with pathologies were listed according to their histopathological examinations as cystic lesions, benign tumours, malignant tumours, fibro-osseous lesions and osteonecrosis, while images without pathologies were listed as traumas and others. All groups were reclassified as with or without the presence of detected PR. RESULTS: Pathologies and traumas were detected in 1801 of 4605 patients. There were 3 PR in 1140 cystic lesions, 4 PR in 102 benign tumours, 16 PR in 43 malignant tumours, 67 PR in 156 osteonecrosis/osteomyelitis cases and 3 PR in 262 trauma cases. As a result of the chi-square test between groups, there was a significant relationship between histopathologic diagnoses and periosteal reaction patterns (p = 0.000). CONCLUSIONS: Although there is a significant overlap between the patterns of PRs, PRs can be used to narrow the possibilities in the differential diagnosis. However, PRs alone are not sufficient variables for differential diagnosis in the absence of cortical bone destruction, localization, clinical and systemic findings.

Ultrasonographic evaluation of the titanium-prepared platelet-rich fibrin effect in free gingival graft procedures.

BACKGROUND: Complications after free gingival graft (FGG) operations are generally related to the donor site. The titanium-prepared, platelet-rich fibrin (T-PRF) placement in the donor site accelerate the wound healing and prevent postoperative complications such as pain and hemorrhage. We aim to evaluate the effect of T-PRF regarding vascularization and tissue thickness and to report the advantages of the ultrasonography (US) in FGG. METHODS: Ten individuals were divided into two groups as T-PRF and control. While the T-PRF membrane was placed at the donor site in the T-PRF group, a gelatin sponge was placed in the control group. All patients underwent US examination in terms of vascularization and tissue thickness of left and right donor sites. The correlation between the right and left donor sites was analyzed with the Pearson correlation test. Tissue thicknesses and pulsatility index (PI) were analyzed with independent samples t-test. The results were evaluated statistically at the P <0.05 significance level. RESULTS: The T-PRF group showed increased vascularity which can be interpreted to improve healing in soft tissue. However, not a difference, but a positively very high correlation was observed between the right and left tissue thicknesses (P = 0,00; r = +0902). CONCLUSIONS: Evaluation of tissue thickness and vascularization density of donor sites with US not only increases clinical success rate but also reduces the risk of complications during surgery and postoperative pain in FGG. Studies evaluating T-PRF membrane as palatal dressing after FGG are only clinical, however, the efficiency of T-PRF was evaluated radiologically in this study for the first time.

Optimization of Dental Devices and Tools Used on Teeth.

Taking decisions is important in every aspect of life. Decision-making has become a difficult problem in any situation where there are multiple criteria. The application of multicriteria decision-making methods that can bring mathematical and logical solutions to the problem from an analytical perspective has experienced considerable growth recently. It provides great benefits in solution and subsequent stages. Medical equipment selection is also a challenging, complex, and difficult problem for the decision-maker, due to the requirements of conflicting criteria, which must be taken into account simultaneously. In this context, the aim of this study implicates the principle of multicriteria decision-making theories on various types of instruments used in dentistry. Since the data used in this study are not numeric but linguistic, the Fuzzy PROMETHEE decision-making method is used. In this research, six dental tools most commonly used by professionals to perform operations on patients are compared and evaluated. Fuzzy PROMETHEE decision-making method investigations show that the dental mirror is the most effective tool among all compared tools, followed by dental suction, dental air abrasion, dental handpiece, dental laser, and dental X-ray, consequently, basing on the selected criteria and the importance weight given to each criterion. Using this technique, one can obtain more specific ranking results based on a specific preference level.

CBCT analysis of haller cells: relationship with accessory maxillary ostium and maxillary sinus pathologies.

OBJECTIVES: The purpose of this study is to evaluate the prevalence of Haller Cell (HC) in a group of the Turkish population and to evaluate its relationship with accessory maxillary ostium (AMO) in presence of maxillary sinusitis. METHODS: 621 CBCT images which were performed for various dental complaints between December 2015 and December 2017 were evaluated retrospectively. Presence of HC, AMO and maxillary sinus pathologies was analyzed. The Pearson's Chi-square test was used between the groups. RESULTS: The incidence of HC in our patients was 7.73%. 36 female and 12 male patients with HC were found; thus, the female:male ratio was 3:1 (p < 0.05). Among 1242 maxillary sinuses, 61maxillary sinuses have HC (4.9%) which makes 27.1% of the HC as unilateral cases. 307 of the 1242 maxillary sinus had AMO (24.7%). The relationship between the presence of AMO and maxillary sinus pathology was found significant (p < 0.05); however, the relationship between HC and maxillary sinus pathology was not significant (p > 0.05). CONCLUSION: Although HC is a possible predisposal factor, it is not a determinant for maxillary sinus pathologies per se.

Craniofacial Fibrous Dysplasia Involvements of Mccune-Albright Syndrome: A Review with an Additional Case.

BACKGROUND: McCune-Albright Syndrome (MAS) is a genetic disorder with a triad of endocrine diseases, café-au-lait macules and fibrous dysplasias. Craniofacial fibrous dysplasia is a term that is used to describe the fibrous dysplasia, which was localized at the craniofacial skeleton and is common in MAS patients. OBJECTIVE: The objective of this review is to determine the involvement frequency of cranial and facial bones in patients with MAS and CFD. METHODS: Articles in PubMed was searched with the following details "(mccune[Title/Abstract] OR albright[Title/Abstract]) OR ("craniofacial fibrous dysplasia"[MeSH Terms] OR ("craniofacial"[ All Fields] AND "fibrous"[All Fields] AND "dysplasia"[All Fields]) OR "craniofacial fibrous dysplasia"[All Fields])". The articles in which the authors did not state the involved bones or did not add any radiographic images were excluded from the study. RESULTS: 26 cases in 25 articles met the inclusion criteria. Among the 26 cases and our case, sphenoid and frontal bones were involved in 17 cases, parietal and occipital bones were involved in 15 cases, mandible and ethmoid bone were involved in 14 cases, maxilla-zygoma-temporal and palate was involved in 13, 11, 6 and 3 cases, respectively. Palate was involved in cases where maxilla was also involved. Our case was the only case that was evaluated with CBCT. CONCLUSION: Routine follow-ups are important since new CFDs can occur in different cranial or facial bones. 2D imaging techniques may not be able to demonstrate early CFDs; thus, an advanced imaging technique should be used after MAS diagnosis.

Cone-beam computed tomography evaluation of impacted and transmigrated mandibular canines: a retrospective study.

OBJECTIVES: The purpose of this study is to evaluate CBCT images of impacted mandibular canines in detail and to discuss implications for diagnosis and treatment. METHODS: CBCT images of dental patients applied between December 2015 and December 2017 were evaluated retrospectively. 2591 CBCT images, including mandible in their field of view, were determined and evaluated regarding the presence of mandibular canine impaction. 66 impacted mandibular canines of 58 patients were analyzed in detail regarding their location, morphology, associated pathologies, and their relationship with the neighboring anatomic structures, the role of these factors on transmigration, as well as treatments applied. The Pearson Chi square test was used between the groups. RESULTS: Transmigration was observed in 53% of impacted mandibular canines. Teeth with transmigration were localized horizontally, below the apex of adjacent teeth frequently, and had no contact with mandibular cortical bone mostly. 62% of mandibular canines were in contact/proximity with the incisive mandibular canal. The most applied treatment for transmigrated teeth was surgical removal, followed by radiographic monitoring, but orthodontic traction was not preferred in any case. For non-transmigrated teeth, the most applied treatment options were surgical removal, orthodontic traction, and radiographic monitoring, respectively. Autotransplantation was not preferred in any case of impacted teeth. Vertical position of the crown tip (p < 0.05) and the presence of deciduous mandibular canines and their resorption showed significant relation to transmigration (p < 0.05). CONCLUSION: Transmigration is common among impacted mandibular canines. Resorption of adjacent teeth roots was one of the possible complications of impaction and likely contact/proximity of incisive mandibular canal with impacted mandibular canines, which may pose difficulties in surgical treatment, can be better detected by CBCT.