Assessing the efficacy of a modified crushing technique for the management of concha bullosa: a cone beam computer tomography study / Avaliando a eficácia de uma técnica de esmagamento modificada para o manejo da concha bolhosa: um estudo com tomografia por feixe cônico

Abstract Introduction: Although many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results. Objectives: The purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management. Methods: Patients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6->22 months) and the long-term group had a mean followup of 56.66 (range 29->80) months. Results: Twenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p< 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations. Conclusion: Our modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.

Resumo Introdução: Embora existam muitas técnicas cirúrgicas para o tratamento da concha bolhosa, ainda se busca encontrar uma técnica menos invasiva com menor número de complicações e melhores resultados. Objetivos: Descrever e avaliar a eficácia em curto e longo prazo de uma técnica de esmagamento modificada para o manejo da concha bolhosa. Método: Os pacientes que preencheram os critérios de inclusão foram submetidos a exame nasal detalhado e tomografia computadorizada de feixe cônico antes e após septoplastia com cirurgia de esmagamento de concha bolhosa. Os pacientes foram divididos em grupos de curto e longo prazo de acordo com o período de seguimento, de modo que o grupo de curto prazo teve um seguimento médio de 15,14 meses (intervalo de 6 a 22 meses) e o grupo de longo prazo teve uma média de seguimento de 56,66 (variação de 29 a 80) meses. Resultados: Vinte e quatro casos de concha bolhosa foram incluídos neste estudo, com 13 seguimentos de curto prazo e 11 de longo prazo. Todos os pacientes apresentaram uma redução significante no tamanho da concha bolhosa no pós-operatório (p< 0,001). Não houve correlação entre a idade e a mudança na área da concha bolhosa no pós-operatório (p = 0,39) e nem diferença significante na redução da área da CB no pós-operatório entre os grupos de curto e longo prazo (p = 0,35). Nenhum paciente apresentou sangramento, sinéquia, destruição da concha ou disfunção olfatória nas avaliações de seguimento. Conclusões: Nossa técnica de esmagamento modificada é uma opção de tratamento simples, eficaz e duradoura para a concha bolhosa. Com base nessa experiência, não houve complicações e qualquer caso de recorrência na formação da concha bolhosa durante o período de seguimento.

Symphysis morphology and mandibular alveolar bone thickness in patients with ß-thalassemia major and different growth patterns.

OBJECTIVE: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. METHODS: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. RESULTS: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß-thalassemia patients (p< 0.05). CONCLUSIONS: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

A cone-beam computed tomography study to assess anterior loop and other anatomic variations in mental foramen area in an iranian population / Un estudio de tomografía computarizada de haz cónico para evaluar el asa anterior y otras variaciones anatómicas en el área del foramen mentoniano en una población iraní

Purpose: This study aimed to determine the prevalence and length of the anterior loop (AL) of the inferior alveolar nerve, and evaluate the emergence direction of the mental nerve and the location of mental foramen in a group of Iranian patients. Material and Methods: This study was carried out on CBCT scans of 150 patients (57 males and 93 females; mean age 40.8 ±14.33 years). The presence and extent of the AL was determined in reconstructed images. The emergence path of the mental nerve was classified into three groups: anteriorly directed emergence, right-angled pattern of emergence, and posteriorly directed emergence. The location of mental foramen relative to adjacent premolars was determined. Results: AL was identified in 14.7% of the cases with a mean length of 1.39± 0.91 mm (range 0.25 to 3.50 mm). No significant differences were observed in the prevalence and extent of the AL between genders (p>0.05). The right-angled pattern of emergence was more dominant (43.7%). The most prevalent location of mental foramen was between the first and second premolars (68.3%). There was no significant association between the presence of AL with the path of emergence of the mental nerve (p=0.627) or the location of the mental foramen (p= 0.10 0). Conclusion: The prevalence of anterior loop was relatively low in the present sample (14.7%) with a length range of 0.25 to 3.5 mm. Due to the importance of this anatomic variation in implant surgery, it is suggested to carefully assess CBCT images before the surgical procedure to avoid neurosensory complications.

Propósito: Este estudio tuvo como objetivo determinar la prevalencia y la longitud del loop anterior (LA) del nervio alveolar inferior, y evaluar la dirección de emergencia del nervio mentoniano y la ubicación del foramen mentoniano en un grupo de pacientes iraníes. Material y Métodos: Este estudio se llevó a cabo en exploraciones de tomografía computarizada de haz cónico de 150 pacientes (57 hombres y 93 mujeres; edad media 40,8 ± 14,33 años). La presencia y extensión de la LA se determinó en imágenes reconstruidas. La vía de emergencia del nervio mentoniano se clasificó en tres grupos: emergencia dirigida anteriormente, patrón de emergencia en ángulo recto y emergencia dirigida posteriormente. Se determinó la ubicación del foramen mentoniano en relación con los premolares adyacentes. Resultados: Se identificó LA en el 14,7% de los casos con una longitud media de 1,39± 0,91 mm (rango 0,25 mm a 3,50 mm). No se observaron diferencias significativas en la prevalencia y extensión de la AL entre sexos (p>0,05). El patrón de emergencia en ángulo recto fue más dominante (43,7%). La localización más prevalente del foramen men-toniano fue entre el primer y segundo premolar (68,3%). No hubo asociación significativa entre la presencia de AL con la vía de emergencia del nervio mentoniano (p=0,627) o la ubicación del foramen mentoniano p=0,100).Conclusión: La prevalencia de asa anterior fue rela-tivamente baja en la presente muestra (14,7%) con un rango de longitud de 0,25 mm a 3,5 mm. Debido a la importancia de esta variación anatómica en la cirugía de implantes, se sugiere evaluar cuidadosamente las imágenes de tomografía computarizada de haz cónico antes del procedimiento quirúrgico para evitar complicaciones neurosensoriales.

Skeletal maturation and the location of the mandibular foramen within the ramus mandibulae.

PURPOSE: It is well documented that the mandible does not grow at a constant rate. There are significant correlations between the increase of mandibular size and cervical vertebral maturation. The peak growth velocity of the mandible occurs after the third stage of cervical vertebral maturation. The location of the mandibular foramen (MF) and its changes subsequent to growth are of great interest to clinicians as they relate to the anesthesia of the inferior alveolar nerve and to mandibular surgical procedures. Therefore, the aim of the present study was to assess the influence of the mandibular growth spurt on the location of the MF in various skeletal growth patterns. METHODS: Panoramic and lateral cephalometric radiographs of 98 (32 orthognathic, 50 retrognathic, 16 prognathic) patients before and after the growth peak were collected. For each subject, the maturational stage of the cervical vertebrae was defined on successive lateral cephalograms and the vertical and horizontal position of the MF was evaluated on two panoramic radiographs, one before and one after the growth peak. RESULTS: The MF-Post/MF-Ant ratio (MF distance to the posterior border of the ramus/MF distance to the anterior border of the ramus) significantly increased after the growth peak in orthognathic and retrognathic subjects (P = 0.015 and 0.02, respectively). This ratio did not significantly increase in prognathic subjects (P = 0.882). No statistically significant changes in the vertical position of the MF were found in the three groups after the growth spurt. CONCLUSION: The horizontal position of the MF moves in an anterior direction in orthognathic and retrognathic subjects during the mandibular growth spurt. The vertical position of the mandibular foramen remains unchanged during this period.

Assessing the efficacy of a modified crushing technique for the management of concha bullosa: a cone beam computer tomography study.

INTRODUCTION: Although many surgical techniques exist to manage obstructive concha bullosa, there continues to be a drive to find the least invasive technique with the fewest complications and best results. OBJECTIVES: The purpose of this study is to describe and assess the short- and long-term efficacy of a modified crushing technique for concha bullosa management. METHODS: Patients who met inclusion criteria underwent a detailed nasal examination and cone beam computed tomography imaging prior to and after septoplasty with crushing surgery for obstructive concha bullosa. Patients were divided into short- and long-term groups based on their followup period such that the short-term group had a mean followup of 15.14 months (range 6-22 months) and the long-term group had a mean followup of 56.66 (range 29-80) months. RESULTS: Twenty-four cases of obstructive concha bullosa were included in this study with 13 short-term and 11 long-term follow-ups. All patients showed a significantly decreased postoperative CB size (p < 0.001). There was no correlation between age and postoperative CB change in area (p = 0.39) and no significant difference in the amount of postoperative CB area reduction between the short-term and long-term groups (p = 0.35). No patients experienced bleeding, synechia, conchal destruction, or olfactory dysfunction on followup evaluations. CONCLUSIONS: Our modified crushing technique is a simple, effective, and lasting treatment option for concha bullosa. From our experience, there have been no complications and no instances of concha bullosa reformation during the follow-up period.

The impact of age mimicry bias on the accuracy of methods for age estimation based on Kvaal's pulp/tooth ratios: a bootstrap study.

INTRODUCTION: Methods based on pulp/tooth ratios proposed by Kvaal et al. (1995) have been widely used for age estimation in adults. The tendency of age estimates to mimic the age structure of the reference population, i.e. age mimicry bias, is a possible source of controversy in the results of studies. The primary objective of the present study was to evaluate the effect of age mimicry bias on the accuracy of the original Kvaal's method and its recent modification proposed by Roh et al. (2018). METHOD AND MATERIAL: The study sample comprised 240 cone-beam computed tomography scans of an Iranian population. The bootstrap procedure was used to study the impact of age mimicry bias on age estimates by constructing reference populations with different age structures. The accuracy of Kvaal's and Roh's variables for age estimation was assessed using a twofold cross-validation technique and principal component analysis. RESULTS: The application of original equations resulted in SEE values highly greater than the acceptable threshold for forensic purposes (10 years). The population-specific equations obtained SEE values of 9.18, 11.03, and 9.22 years using Kvaal's variables and 9.19, 11.13, and 9.14 years using Roh's variable for the maxillary, mandibular, and all teeth, respectively. The bootstrap procedure revealed that using uneven reference populations to formulate the equation resulted in significantly greater SEEs (almost all >10 years) that were not acceptable for forensic purposes. Moreover, using an older (a younger) reference population contributed to a sharp rise in the amount of over- (under-) estimation for younger (older) age groups. CONCLUSION: Age mimicry bias had an undesirable impact on the accuracy of dental age estimation based on Kvaal's and Roh's methods. The accuracy of the original equations was low for age estimation in the Iranian sample. However, the performance of the population-specific equations was reasonably acceptable for the maxillary and all six teeth.

Symphysis morphology and mandibular alveolar bone thickness in patients with β-thalassemia major and different growth patterns

ABSTRACT Objective: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. Methods: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. Results: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß‐thalassemia patients (p< 0.05). Conclusions: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a morfologia da sínfise e a espessura do osso alveolar (EOA) ao redor dos incisivos inferiores de pacientes com talassemia, em comparação a indivíduos sem a doença. Métodos: Esse estudo de caso-controle foi conduzido por meio da análise de radiografias cefalométricas de pacientes Classe II à procura de tratamento ortodôntico na Clínica Odontológica da Shiraz University of Medical Sciences, sendo 60 pacientes com talassemia e 60 sem a doença. A amostra foi dividida em três subgrupos, de acordo com o índice de Jarabak: hiperdivergente, normodivergente e hipodivergente. As dimensões da sínfise e a espessura do osso alveolar ao redor dos incisivos inferiores foram medidas no programa AutoCAD. Por último, foi avaliada a correlação entre a espessura do osso alveolar e a morfologia da sínfise. Resultados: No geral, as dimensões do mento e a espessura do osso nos diferentes níveis da raiz dos incisivos inferiores (cervical, médio e apical) foram menores em adolescentes talassêmicos do que nos pacientes controle. Tanto na amostra total quanto no subgrupo normodivergente, valores significativamente menores foram observados nos pacientes talassêmicos para a largura da sínfise, EOA total no terço cervical e EOA lingual no terço apical da raiz, comparados aos pacientes controle (p< 0,05). O padrão de crescimento hipodivergente não foi associado a qualquer diferença estatisticamente significativa entre os grupos (p> 0,05). Em ambos os grupos de pacientes, talassêmicos e controle, a largura da sínfise mostrou uma correlação positiva de fraca a moderada com a EOA dos incisivos inferiores (p< 0,05), enquanto a altura da sínfise mostrou uma correlação positiva moderada com a EOA cervical apenas nos pacientes com talassemia beta (p< 0,05). Conclusões: Comparados aos pacientes controle, os pacientes com talassemia beta apresentaram um osso alveolar mais fino em diferentes níveis das raízes dos incisivos inferiores e dimensões menores da sínfise. Houve correlação significativa entre as dimensões da sínfise e a espessura do osso alveolar dos incisivos inferiores na amostra.

Assessment of the relationship between the maxillary sinus and the canine root tip using cone beam computed tomography.

BACKGROUND: The purpose of the present study is to investigate the relationship between the maxillary sinus and the canine root apices in cone beam computed tomographic images (CBCT) and to assess the amount of extension of the maxillary sinus to the anterior region of the jaw in different sexes and age groups. METHODS: CBCT of 300 individuals (154 males and 146 females) over 20 years (with a mean age of 35.12 ± 8.40 years) were evaluated. The subjects were categorized into three age groups (20-30, 30-40, and 40-50 years). When the maxillary sinus extended to the canine area, the vertical distance between them was measured, and their relationship was classified into three types: I (more than 2 mm distance), II (less than 2 mm distance or in-contact), and III (interlock). RESULTS: 413 out of 600 maxillary sinuses (68.8%) were extended into the canine area or beyond. Among them, 15 maxillary sinuses pneumatized into the incisor area (2.5%). The prevalence of the maxillary sinuses extended to the anterior region of the jaw was not significantly different between genders. However, it was significantly less frequent in the older age group and more frequent on the left side. In addition, the mean amount of anterior extension of the maxillary sinus (mm) was significantly lower in the older age group. Type I was the most frequent vertical relationship between the maxillary sinuses and canine apices with no significant difference in gender, side, and age groups. CONCLUSIONS: In most cases, the maxillary sinus extended to the canine area and sometimes reached the incisor region. This necessitates paying more attention to the maxillary anterior sextant during surgical procedures.

Cone Beam Computed Tomography Analysis of Sphenoid Sinus Pneumatization and Relationship with Neurovascular Structures.

BACKGROUND: The sphenoid sinus is considered as the most variable pneumatized structure of the skull. PURPOSE: The aim of the present study was to determine the prevalence of the Onodi cell as well as to evaluate the relationship between the sphenoid sinus type of pneumatization and the presence of surrounding neurovascular protrusion using cone beam computed tomography (CBCT). METHODS: The CBCT images of 500 patients/996 sides [203 males (40.6%) and 297 females (59.4%)] were analyzed in this study. The type of sphenoid sinus pneumatization, prevalence of internal carotid artery (ICA) and optic nerve (ON) protrusion and dehiscence, and also the frequency of Onodi cell were assessed. RESULTS: The percentages of the conchal, presellar, sellar, postsellar (a), and postsellar (b) types of pneumatization were 1%, 11.5%, 35.5%, 38.9%, and 13.1%, respectively. The more the sphenoid sinuses pneumatized, the greater the frequency of ON and ICA protrusion and dehiscence of their wall to the sinus. The prevalence of Onodi cell was 38.8%. A significant correlation was found between ON dehiscence and the presence of Onodi cells. CONCLUSION: The present study demonstrated a significant relationship between the sinus type and frequency of neurovascular protrusions. Therefore, the sphenoid sinus extent of pneumatization might be useful in predicting the risk of iatrogenic damage to the surrounding structures.

Association between Adult Attention-Deficit/Hyperactivity Disorder and Driving Behaviors among Iranian Motorcyclists.

OBJECTIVE: To investigate the association between attention-deficit/hyperactivity disorder (ADHD) score and driving behaviors among motorcycle drivers in Iran. METHODS: This multi-center cross-sectional study was conducted on 1747 motorcyclists in three cities of Iran. We used a random sampling method in this study and gathered data using two standard questionnaires. Data were presented using descriptive statistics, also t-test, and ANOVA used for analysis. RESULTS: The mean age of participants was 27.41±8.80 years. ADHD scores of the participants ranged from 0 to 87, with a mean score 31±15.86. All risky driving behaviors (RDBs) were significantly associated with a higher mean of ADHD score. For example, driving with illegal speed (p<0.001), not wearing a crash helmet (p=0.016), driving while exhausting (p<0.001), talking with other passengers (p<0.001), being fined by the police in the past year (p=0.028), and maneuvering while driving (p<0.001) were related to a higher mean of ADHD score. CONCLUSION: All RDBs were significantly associated with the ADHD score among motorcyclists in Iran. In this regard, health care providers should inform people with ADHD about the negative consequences associated with driving and ADHD. Public health policymakers should consider management of ADHD through a comprehensive approach to improve driving performance and competencies among motorcyclists in order to decrease RDBs and traffic accidents.

Assessment of mandibular characteristics in patients affected with ß-thalassaemia major: A retrospective case-control study.

OBJECTIVE: Thalassemia is the most common hereditary blood disorder across the world. This study aimed to identify some mandibular features of thalassaemic patients and compare them with unaffected counterparts. MATERIAL AND METHODS: This retrospective case-control study was carried out on lateral cephalograms of 60 subjects (26 males, 34 females) with class II malocclusion and age range of 11 to 15 years. The control group consisted of 60 non-thalassaemic subjects with class II malocclusion and similar chronological age, gender and vertical facial dimension. Based on the Jarabak index, the case and control subjects were classified into hyperdivergent, normodivergent and hypodivergent growth patterns. Four linear (ramus height, ramus width, mandibular depth, and antegonial notch depth) and 3 angular (symphyseal angle, gonial angle, and mandibular arc angle) cephalometric parameters were measured to represent mandibular morphology. The data were analysed using Chi-square test and Student's t-test. RESULTS: No significant difference was found in linear measurements between thalassaemic patients and controls. The symphysis angle was significantly greater and the mandibular arc angle was significantly smaller in the total thalassaemic sample than the control individuals (P<0.001 and P=0.004, respectively). The difference in symphysis angle was significant in both hyperdivergent and normodivergent subjects (P=0.004 and P=0.002, respectively), whereas the difference in mandibular arc angle was only significant in the normodivergent subgroup P=0.001). CONCLUSIONS: The smaller mandibular arc angle in the thalassaemic sample suggests a more superior than posterior growth direction of condyles compared with healthy individuals. The difference in symphyseal angle represents inherent differences in chin morphology between thalassaemic subjects and controls.

A Cone-Beam Computed Tomographic Study of Alveolar Bone Morphology in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVE: To evaluate the bony support around the teeth adjacent to the unilateral cleft lip and palate (ULCLP) using cone-beam computed tomography. METHODS AND MATERIALS: Cone-beam computed tomographies of 48 cleft-adjacent teeth (28 anterior and 20 posterior to the cleft) and 48 noncleft control teeth were evaluated. The alveolar bone thickness at 3 and 6 mm apical to the cement-enamel junction (CEJ), the distance between the alveolar crest and CEJ (Alv-CEJ), and the presence of fenestration were assessed in buccal, palatal, and proximal surfaces. RESULTS: The alveolar bone on the buccal and palatal sides of the teeth anterior to the cleft was significantly thinner than the noncleft teeth (all P < .05). The Alv-CEJ was significantly greater on the buccal and distal surfaces of the teeth anterior to the cleft (P < .001 and P = .010, respectively) and on the palatal and mesial surfaces of the teeth posterior to the cleft (P = .024 and P = .003, respectively) when compared to the noncleft teeth. The frequency of reduced alveolar bone height (>2 mm) was higher than noncleft side for buccal and distal sides of the teeth anterior to the cleft (P = .016 and .006, respectively) and the buccal and mesial sides of the teeth posterior to the cleft (P = .008 and <.001, respectively). The teeth anterior to the cleft had a higher prevalence of fenestration (P = .004). CONCLUSION: Reduced alveolar bone height is more common in the cleft side compared to the control side. The teeth anterior to the ULCLP have thinner alveolar bone support and higher frequency of fenestration.

Assessing the Accuracy of Caries Diagnosis in Bitewing Radiographs Using Different Reproduction Media.

STATEMENT OF THE PROBLEM: After introducing digital radiography, practitioners started reading radiographs from computer monitors; however, many still prefer hard-copy radiographs. PURPOSE: This study aimed to assess the possible superiority of either type of radiograph recording media (computer monitor, film, or paper) in diagnosis and perception of the depth of the cariogenic lesions. MATERIALS AND METHOD: Twenty digital bitewing radiographs, obtained from 200 posterior extracted teeth, were displayed on an LG monitor and printed on paper and film using Kodak printers. Two observers independently measured lesions depth on the images. Serial sections of teeth were obtained and the sections were evaluated by a stereomicroscope to determine the actual depth of cariogenic lesions. The efficacy of the each medium was assessed by determining its specificity and sensitivity in comparison with those of histological images. Weighted kappa coefficients and the ROC analysis were used for the statistical analysis. RESULTS: Strong intra- and inter-observer agreements (0.818 to 0.958, 0.77 to 0.85) were found for all detection methods. The highest Az value was obtained with the monitor-displayed images (Az: 0.879); however, differences between detection methods were not statistically significant (p> 0.05). CONCLUSION: Monitor-displayed bitewing radiographs, paper, and film prints used in our study performed similarly in the detection of proximal caries.

How the Prevalence of Pulp Stone in a Population Predicts the Risk for Kidney Stone.

INTRODUCTION: Conflicting researches exist on relationship between pulp stones and systemic disorders. Nephrolithiasis is a common disease with severe pain and discomfort with increasing prevalence worldwide. The purpose of this study is to evaluate the correlation between pulp and kidney stones to help find a method for early detection of kidney stones. METHODS AND MATERIALS: the sample of this case-control study comprised of 154 subjects (77 patients with and 77 patients without kidney stone approved by sonographic examination). Two oral and maxillofacial radiologists evaluated their panoramic images for the presence of pulpal stones. RESULTS: A total of 42.9% of subjects showed pulp stones. Most of the teeth with pulp stone in case and control groups were molars (86.30% and 72.97%, respectively). In the group with kidney stones, pulp stones were detected in 38 patients (49.4%), while in the control group, they were detected in 28 subjects (36.4%). Although there was not a significant relationship between the presence/absence of pulp stone and kidney stone (P=0.143), there was statistically significant association between number of teeth with pulp stone in a patient and the presence of kidney stone (P<0.013). The chance of having kidney stone is 5.78 times higher in the subjects having pulp stone in three teeth or more (≥ 3 teeth). CONCLUSION: Although there is not a correlation between the presence of pulp and kidney stone, the chance of having kidney stone is 5.78 times higher in the subjects with ≥ 3 teeth having pulp stone. Thus, the number of teeth with pulp stone can serve as a predictor for possibility of having kidney stone.