The Relationship between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps

Abstract Introduction The maxillary sinus and its variations are very important to dentistry and rhinology. Objective To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. Methods The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Results Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. Conclusion This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

The Relationship between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps.

Introduction The maxillary sinus and its variations are very important to dentistry and rhinology. Objective To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. Methods The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Results Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. Conclusion This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

Morphological Measurement and Anatomical Variations of the Clivus Using Computed Tomography.

Objectives The aim of this study was to evaluate the clivus morphology, including fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CC), on computed tomography (CT) images. Design This is a retrospective study. Setting Faculty of Dentistry, Department of Dentomaxillofacial Radiology. Participants The CT images of 500 patients (253 males; 247 females) were evaluated. Main Outcome Measures The prevalence of FNM, CBM, and CPC; the length, width, and depth of FNM; and CBM types were recorded. Also, a morphological analysis of the clivus (length of the clivus, angle between the clivus and the posterior margin of the foramen magnum, angle between the clivus and the dens axis, and anteroposterior diameter of the foramen magnum) was performed. Results FNM was identified in 5.4%, CBM in 4%, and CC in 0.8% of the study group. Type 5 CBM was not found. Type 6 was the most common CBM type. There was no significant correlation between the age and gender of patients with FNM. There were significant differences between the clivus length, the angle between the clivus and the dens axis, the anteroposterior diameter of the foramen magnum, and gender. Also, there was a significant difference between the angle between the clivus and the foramen magnum and age. Conclusions The anatomical variations of the clivus are rare and important for the oral and maxillofacial radiologist to make the differential diagnosis. These anatomical variations should not be confused with pathologic formations. The morphological measurements and anatomical variations of the clivus can be evaluated in detail on CT images.

THE ANATOMICAL AND MEASUREMENT STUDY OF ROSENMÜLLER FOSSA AND OROPHARYNGEAL STRUCTURES USING CONE BEAM COMPUTED TOMOGRAPHY.

The objective of this study was to assess Rosenmüller fossa (RF) anatomy and neighboring structures using cone beam computed tomography (CBCT). A total of 1000 patients were analyzed using CBCT. The reference points were based on the spina nasalis posterior (Snp) and basion. The length between RF and neighboring structures were measured.The mean distance from Snp to the posterior pharyngeal wall was 17.7 mm. The mean distance from right to left torus levatorius was 25.69 mm. The mean depth of right RF was 5.54 mm while the mean depth of left RF was 5.26 mm. RF, also described as the lateral pharyngeal recess, is a source location of nasopharyngeal carcinoma development. Its location is on the lateral pharyngeal wall posterior to the cartilaginous part of the eustachian tube, the torus tubarius. The knowledge of RF is important to diagnose and perform treatment planning of nasopharyngeal carcinoma.

Effects of nocturnal complete denture usage on cardiorespiratory parameters: A pilot study.

STATEMENT OF PROBLEM: Sleeping without conventional complete dentures (CCDs) has been stated by some to induce negative effects on the cardiorespiratory functions of edentulous patients with obstructive sleep apnea (OSA), although others have reported the exact opposite. Therefore, a consensus on nocturnal CCD usage is lacking. PURPOSE: The purpose of this clinical study was to assess the effects of nocturnal denture usage on cardiorespiratory stability by using pulse oximetry (PO). MATERIALS AND METHODS: Thirty CCD wearers were enrolled in the study. The first nocturnal pulse oximetry (FNPO) recordings were made on 3 different nights while the participants were sleeping without dentures (WOD). Oxygen desaturation index (ODI) and other PO parameters of the participants, including total respiratory event (TRE), basal SpO2 (BSpO2), time≤88 (T88), average low SpO2 (ALSpO2), total pulse event (TPE), average pulse rate (APR), and heart rate variability index (HRVI), were processed and the obtained data were recorded as WOD condition values. According to the ODI scores, the OSA status of the participants was grouped as normal (ODI<5), mild (530). Complete dentures were fabricated by an experienced prosthodontist and a dental laboratory technician by following conventional procedures. At the end of the first month of the follow-up period, the second nocturnal PO recordings (SNPO) were made on 3 different nights while the participants slept wearing dentures (WID), and the data obtained were recorded as WID condition values. The comparison of mean PO values obtained from WOD and WID were analyzed with the Wilcoxon signed- rank test (α=.05). RESULTS: Significant differences were found between WOD and WID values in terms of TRE (P=.01), ODI (P=.001), ALSpO2 (P=.006), TPE (P=.001), and HRVI (P=.001) parameters. The significance of the improvements in the WID condition increased with the severity of OSA. CONCLUSIONS: Improvements were observed in substantial cardiorespiratory parameters such as the ODI and HRVI of the participants wearing dentures nocturnally.

Temporomandibular joint MR images: Incidental head and neck findings and pathologies.

OBJECTIVE: To report the number and frequency of incidental findings (IFs) detected during magnetic resonance (MR) imaging screening of the temporomandibular joint (TMJ) and to define related diseases. METHODS: Bilateral TMJ MR images in the sagittal and coronal sections, from 518 patients with TMJ symptoms were evaluated retrospectively. Patients who were diagnosed with IFs were sent for consultation and clarification of the findings. Patient age, gender, IFs, locations, and diseases were classified and noted.  Results: Seventy-eight (15%) patients were diagnosed with 117 IFs. Of them, 43 were diagnosed with a single IF, and 35 were diagnosed with more than one IF. The most frequent locations were paranasal sinuses and mastoid air cells. The most frequent diseases were inflammatory and cystic lesions.  Discussion: While examining TMJ MR images, it is important to check for evidence of IFs or pathologies that may have mimicked signs and symptoms of TMJ disorders.

A DETAILED CBCT STUDY OF 'CORONOID FORAMINA' AND ACCESSORY FORAMINA OF THE MANDIBLE: A UNIQUE ANATOMIC VARIATION.

The aim of the study was to evaluate accessory foramina (AF) located on the medial aspect and to present a unique finding of 'coronoid foramina' (CF) along with AF on the mandible. The cone beam computed tomography images of the mandible in 979 patients were retrospectively evaluated for the presence of CF and AF. AF was found in 39 (3.98%) patients. AF located on the medial surface below and above mandibular foramen was found in 15.38% and 84.62% of patients, respectively. CF was confirmed in 20 (2.04%) patients. Mandibular AF is important for surgical procedures in the posterior region of the mandible and for mandibular nerve anesthesia. This study including CF will be useful for further studies due to the lack of literature on the issue.

Prevalence and characteristics of pneumatizations of the articular eminence and roof of the glenoid fossa on cone-beam computed tomography.

OBJECTIVE: The aim of this study was to determine the prevalence and characteristics of pneumatization of the articular tubercle (PAT) and pneumatization of the roof of the glenoid fossa (PRGF) in a large population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This study was designed to evaluate the CBCT images of 1000 patients. The prevalences of the pneumatizations by age, sex, locularity, and laterality were determined. The significance of differences between variables was evaluated by the Chi-square test and analysis of variance. RESULTS: PAT was detected in 28.4% of the zygomatic bone sides and PRGF in 29.6%. Bilateral PAT was detected in 176 (17.6%) patients and bilateral PRGF in 195 (19.5%). The mean age of patients with PAT was 47.33 years and that of patients with PRGF was 45.62 years. Multilocular appearance was observed significantly more often than unilocular type for both pneumatizations (p < 0.01). Unilateral PAT cases were slightly, but significantly, higher than bilateral PAT cases (p = 0.047), while no significant difference was observed between unilateral and bilateral PRGF cases. CONCLUSIONS: In conclusion, PAT and PRGF can be assessed more accurately on CBCT images than on plain radiographs. During routine radiological investigations, maxillofacial radiologists should be aware of zygomatic air cells.

Incidental findings on cone-beam computed tomographic images: paranasal sinus findings and nasal septum variations.

OBJECTIVE: CBCT applications have received widespread acceptance in dentistry. CBCT scans provide three-dimensional information on anatomic structures and characteristics of pathologies, rather than the two-dimensional information obtained with the conventional techniques. The purpose of this study was to evaluate incidental findings in out-of-interest areas on CBCT images and to reveal their frequency and characteristics. METHODS: A total of 691 CBCT scans from 691 patients were assessed. Demographic data, CBCT indications, and incidental findings outside the primary area of interest, such as anatomical variations and pathologies, were noted. The incidental findings were categorized and analyzed using descriptive statistics. RESULTS: In total, 1109 incidental findings in paranasal sinuses were noted on 548 of the 691 CBCT scans. The highest rate of incidental findings was maxillary sinus findings, followed by concha bullosa and septum deviation. The most frequently observed pathology was mucosal thickening, followed by polypoid mucosal thickening in the maxillary sinus. CONCLUSIONS: While most incidental findings require no treatment, some conditions will necessitate modification of the treatment plan. Therefore, dental practitioners should be aware of incidental findings and anatomical variations. Correct identification of these findings will reduce unnecessary further diagnostic assessments and allow selection of more appropriate treatment plans.

Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions.

OBJECTIVE: This study assessed the use of different voxel resolutions in a cone beam computed tomography (CBCT) unit for the detection of artificially induced periodontal bone defects created using burr, burr and chemicals, and only chemicals. STUDY DESIGN: Seven dry skulls were used in this study. In total, 65 dehiscence defects, 43 fenestration defects, and 76 control sites with no periodontal defects were examined. Images were obtained from a CBCT unit (3 D Accuitomo; J Morita Mfg. Corp., Kyoto, Japan), using 3 field-of-view (FOV) sizes (4 × 4 cm; 6 × 6 cm; and 8 × 8 cm) and 4 scan modes (standard, high-definition, high-fidelity, and low-dose). RESULTS: Overall, κ coefficients for interobserver agreement on burr-induced periodontal defects ranged from 0.336 to 0.795, with the lowest κ value (indicating a fair degree of agreement) obtained for images acquired in standard mode with a voxel size of 0.160 mm3. κ coefficients for the detection of periodontal defects were highest (indicating moderate to high degrees of interobserver agreement) for smaller voxel sizes and high-resolution images. Statistical comparison among groups (burr, burr + chemicals, and chemicals only) was performed using 1-way analysis of variance with post hoc tests. CONCLUSIONS: The CBCT scan mode may affect the diagnosis of periodontal defects. The technique used to create periodontal defects also affected diagnosis. For this kind of experiment, burr-induced or burr + chemical-induced defects should be used, rather than those induced solely using a chemical technique.

Can nocturnal use of implant-retained overdenture improve cardiorespiratory stability of a patient with obstructive sleep apnea? A clinical report.

Few studies have evaluated the interaction between conventional complete dentures (CCD) and the respiratory system and the authors are unaware of any that evaluated the interaction between implant-retained overdentures (IROs) and the respiratory system. This clinical report documented the effects of wearing an IRO on the cardiorespiratory stability of an edentulous patient with obstructive sleep apnea (OSA). A 64-year-old woman was referred to the department of otolaryngology because of daytime sleepiness and morning headaches. The patient refused polysomnographic evaluation because of claustrophobia. Overnight pulse oximetry (PO) was performed to detect cardiorespiratory stability during sleep, and the oxygen desaturation index (ODI) of the patient was found to be 20.9. A mandibular advancement device (MAD) was fabricated; however, the patient did not comply with the treatment and stopped using the MAD because of intraoral discomfort. Therefore, the patient started to wear the conventional complete dentures (CCDs) nocturnally to prevent upper airway collapses. Despite the significant drop in ODI score to 12.6, because of displacement, the mandibular denture was converted to an IRO. The PO tests performed after another 6 months revealed an ODI score of 7.8. Wearing CCDs might improve respiratory stability of patients with edentulism during sleep; however, more favorable results could be obtained with IROs.

The Effects of Desferroxamine on Bone and Bone Graft Healing in Critical-Size Bone Defects.

BACKGROUND: Autogenous bone grafts are still the criterion standard treatment option in critical-size bone defect reconstructions, and many therapies can affect its incorporation. In this study, it was aimed to research the effects of desferroxamine (DFO) application on bone and bone graft healing due to the effects of osteoblast and osteoclast regulation and stimulation of angiogenesis. METHODS: Rat zygomatic arch critical-size bone defect model (5 mm) was used as the experimental model. Thirty-two Sprague-Dawley rats (64 zygomatic arches) were divided into 4 groups (16 zygomatic arches in each). In groups 1 and 2, defects were reconstructed with the bone grafts harvested from the other side, and the right arc was named as group 1, and the left was group 2. At group 1, 200 µM/300 µL dosage of DFO was injected at the zygomatic arch region starting at the seventh day preoperatively and lasting until the 45th day postoperatively. Group 2 animals were defined as the control group of group 1, and 0.9% NaCl injection was applied. In groups 3 and 4, there was no repair after the formation of defects, and the right arc region was treated with DFO, and left was treated with 0.9% NaCl for postoperative 45 days, respectively. Radiological (computed tomography), histological (hematoxylin-eosin), and biomechanical (3-point bending test) tests were used for the evaluation. RESULTS: In radiological evaluation, there was a statistically significant decrease (P < 0.05) in bone defect size in group 3 animals at the 4th, 8th, and 12th weeks, and bone graft volume showed a statistical difference at all weeks (P < 0.05). In histological evaluation, it was observed that there was an increase in osteoblast number and vascularity rates (P < 0.05) in the DFO-treated groups at all weeks. Biomechanical evaluation of the subjects showed increase in bone strength in group 1 animals at 12 weeks. CONCLUSIONS: In this study, it was shown that DFO treatment increased bone graft incorporation and healing in critical-size bone defects. In this aspect, we suggest that DFO can be used to increase graft incorporation in risky areas and reduce the defect size in patients who are not suitable for vascularized bone graft transfer.

Comparing the Effect of Different Voxel Resolutions for Assessment of Vertical Root Fracture of Permanent Teeth.

BACKGROUND: The teeth with undiagnosed vertical root fractures (VRFs) are likely to receive endodontic treatment or retreatment, leading to frustration and inappropriate endodontic therapies. Moreover, many cases of VRFs cannot be diagnosed definitively until the extraction of tooth. OBJECTIVES: This study aimed to assess the use of different voxel resolutions of two different cone beam computerized tomography (CBCT) units in the detection VRFs in vitro. MATERIALS AND METHODS: The study material comprised 74 extracted human mandibular single rooted premolar teeth without root fractures that had not undergone any root-canal treatment. Images were obtained by two different CBCT units. Four image sets were obtained as follows: 1) 3D Accuitomo 170, 4 × 4 cm field of view (FOV) (0.080 mm(3)); 2) 3D Accuitomo 170. 6 × 6 cm FOV (0.125 mm(3)); 3) NewTom 3G, 6˝ (0.16 mm(3)) and 4) NewTom 3G, 9˝ FOV (0.25 mm(3)). Kappa coefficients were calculated to assess both intra- and inter-observer agreements for each image set. RESULTS: No significant differences were found among observers or voxel sizes, with high average Z (Az) results being reported for all groups. Both intra- and inter-observer agreement values were relatively better for 3D Accuitomo 170 images than the images from NewTom 3G. The highest Az and kappa values were obtained with 3D Accuitomo 170, 4 × 4 cm FOV (0.080 mm(3)) images. CONCLUSION: No significant differences were found among observers or voxel sizes, with high Az results reported for all groups.

A multi-centre evaluation of multiple supernumerary premolar prevalence.

AIM: The occurrence of multiple supernumerary teeth is rare and often found in association with syndromes such as cleidocranial dysplasia, Gardner's syndrome or cleft lip and palate. Few examples of non-syndromal multiple supernumerary teeth have been reported. The aim of this multi-centre study was to investigate the prevalence of supernumerary premolar teeth in non-syndromic patients and to investigate the association between the presence of supernumerary premolar teeth and malocclusion type in a Turkish population. MATERIALS AND METHODS: The clinical records and panoramic radiographs of 10,700 patients (referred to three different university hospitals) were retrospectively examined for the presence of supernumerary premolars. Age, gender, orthodontic malocclusion type, the number of supernumerary premolars (two or more), the distribution, location, position (vertical, horizontal, inverted, mesio-angular), surgical approach, and related complications (pain, cystic changes, root resorption, or eruption disturbance of adjacent teeth) were recorded. RESULTS: Forty-two cases (13 Class I, 17 Class II, 12 Class III) of multiple mandibular supernumerary premolars in patients without an associated syndrome were detected. A total of 97 (27 Class I, 41 Class II, 29 Class III) supernumerary premolar teeth were found, with a prevalence of 0.39%. No statistical difference was found related to gender, malocclusion type and supernumerary premolars (p > 0.05). The majority of the extra premolars were located in the mandible, which was statistically significant (p < 0.05). CONCLUSION: The present study revealed that the prevalence of multiple supernumerary teeth was 0.39%. The most frequently impacted premolars were found in the mandible and more often associated with Class II malocclusions in the examined Turkish population.

Comparison of intraoral radiography and cone-beam computed tomography for the detection of horizontal root fractures: an in vitro study.

OBJECTIVES: This study aimed to compare the diagnostic accuracy of two different cone-beam computed tomography (CBCT) units with several intraoral radiography techniques for detecting horizontal root fractures. METHODS: The study material comprised 82 extracted human maxillary incisors without root fractures that had not undergone any root canal treatment. Root fractures were created in the horizontal plane in 31 teeth by a mechanical force using a hammer with the tooth placed on a soft foundation as described in a previous study. The teeth were divided into two groups: a control group with no fractures and a test group with fractures. These were randomized to the empty maxillary anterior sockets of a dry human maxilla. Each tooth was imaged at various vertical angles using each of the following modalities: a 3D Accuitomo 170 CBCT, a NewTom 3G CBCT, a VistaScan PSP, a CCD sensor, and conventional film. Specificity and sensitivity for assessing horizontal root fracture by each radiographic technique were calculated. Chi-square statistics were used to evaluate differences between modalities. Kappa statistics assessed the agreement between observers. Results were considered significant at P < 0.05. RESULTS: The kappa values for inter-observer agreement between observers ranged between 0.88 and 0.98 for the 3D Accuitomo 170, 0.82 and 0.91 for the NewTom 3G, and 0.61 and 0.72 for the different types of intraoral images. The diagnostic accuracy for detecting fracture lines in 3D Accuitomo 170 (0.93) was significantly higher than NewTom 3G (0.87), VistaScan (0.71), CCD (0.70), and CF (0.68). CONCLUSIONS: 3D Accuitomo 170 has the highest sensitivity and diagnostic accuracy for detecting horizontal root fracture among the 5 radiographic modalities examined. CBCT should be considered as the most reliable imaging modality of choice for the diagnosis of horizontal root fracture. CLINICAL RELEVANCE: CBCT imaging offers the clear advantage over conventional imaging that traumatized teeth can be visualized in all three dimensions--especially the oro-facial dimension.

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Part I: relationship of radiographic gray density and implant stability.

PURPOSE: The relationship of conventional multi-slice computed tomography (CT)- and cone beam CT (CBCT)-based gray density values and the primary stability parameters of implants that were placed by stereolithographic surgical guides were analyzed in this study. MATERIALS AND METHODS: Eighteen edentulous jaws were randomly scanned by a CT (CT group) or a CBCT scanner (CBCT group) and radiographic gray density was measured from the planned implants. A total of 108 implants were placed, and primary stability parameters were measured by insertion torque value (ITV) and resonance frequency analysis (RFA). Radiographic and subjective bone quality classification (BQC) was also classified. Results were analyzed by correlation tests and multiple regressions (p < .05). RESULTS: CBCT-based gray density values (765 ± 97.32 voxel value) outside the implants were significantly higher than those of CT-based values (668.4 ± 110 Hounsfield unit, p < .001). Significant relations were found among the gray density values outside the implants, ITV (adjusted r(2) = 0.6142, p = .001 and adjusted r(2) = 0.5166, p = .0021), and RFA (adjusted r(2) = 0.5642, p = .0017 and adjusted r(2) = 0.5423, p = .0031 for CT and CBCT groups, respectively). Data from radiographic and subjective BQC were also in agreement. CONCLUSIONS: Similar to the gray density values of CT, that of CBCT could also be predictive for the subjective BQC and primary implant stability. Results should be confirmed on different CBCT scanners.

Large arteriovenous malformation of the oromaxillofacial region with multiple phleboliths.

Vascular tumors are the most common benign tumors of the head and neck in infancy and childhood. Vascular anomalies of the head and neck were divided into 2 categories including hemangiomas and vascular malformations. Oral and maxillofacial hemangiomas and vascular malformations are congenital lesions with various clinical characteristics, manifestations, indications, and possibilities for treatment. This paper reports a case of large arteriovenous malformations including a description of the features demonstrated by panoramic radiography, cone beam computed tomography, and magnetic resonance imaging. The differential diagnosis and treatment modalities (including embolization with N-butylcyanoacrylate in this case) are also discussed following the case presentation, along with the available literature review.

Cross-sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of Turkey.

BACKGROUND: To determine the prevalence of periapical lesions in root canal-treated teeth in a rural, male adult, Turkish population and to investigate the influence of the quality of root canal fillings on prevalence of periapical lesions. METHODS: The sample for this cross-sectional study consisted of 552 adult male patients, 18-32 years of age, presenting consecutively as new patients seeking routine dental care at the Dental Sciences of Gulhane Military Medicine, Ankara. The radiographs of the 1014 root canal-treated teeth were evaluated. The teeth were grouped according to the radiographic quality of the root canal filling and the coronal restoration. The criteria used for the examination were slightly modified from those described by De Moor. Periapical status was assessed by the Periapical Index scores (PAI) proposed by Orstavik. RESULTS: The overall success rate of root canal treatment was 32.1%. The success rates of adequately root canal treatment were significantly higher than inadequately root canal treatment, regardless of the quality or presence of the coronal restoration (P < .001). In addition, the success rate of inadequate root canal treatment was also significantly affected by the quality of coronal restorations. CONCLUSIONS: Our results revealed a high prevalence of periapical lesions in root canal treatment, which is comparable to that reported in other methodologically compatible studies from diverse geographical locations. In addition, the results from the present study confirm the findings of other studies that found the quality of the root canal treatment to be a key factor for prognosis with or without adequate coronal restoration.

Bilateral bifid condylar process / Proceso condilar bífido bilateral

The bifid condylar process is a rare alteration that is usually diagnosed as an incidental finding in a panoramic radiograph. The etiology of bifid condylar process is unknown, although the most tenable theory is that of traumatic origin. A 46-year-old woman was referred to our dental department with a complaint of pain and clicking on her temporomandibular joints. A panoramic radiograph showed bilateral bifid condyles Described with bifid condylar process varies from case to case, however in most cases are asymptomatic. The most common and predominant symptoms are temporomandibular joints sounds. The diagnosis of bifid condylar process is based on its radiographic appearance. Some researchers have indicated the necessity of imaging the anomaly by a second imaging method obtained in a different plane, in addition to orthopantomograph, and they have employed different techniques such as CT and magnetic resonance imaging. The bifid condylar process, and particularly the bilateral bifid condylar process, is a rare finding, the etiology of which remains uncertain. It is predominately an asymptomatic condition, discovered by chance on routine radiographic survey. The diagnosis is based on the radiographic manifestations and the treatment is usually conservative.

El proceso condilar bífido es una alteración rara que usualmente se diagnostica como un hallazgo incidental en una radiografía panorámica. La etiología de proceso condilar bífido es desconocida, aunque la teoría más aceptable es la de origen traumático. Una mujer de 46 años de edad, fue remitida a nuestro servicio dental con presencia de dolor y clic en sus articulaciones temporomandibulares. Una radiografía panorámica mostró procesos condilares bífidos bilaterales. La descripción del proceso condilar mandibular bífido varía de caso a caso, sin embargo en la mayoría de los casos son asintomáticos. Los síntomas más comunes y predominantes son los sonidos en las articulaciones temporomandibulares. El diagnóstico de proceso condilar bífido se basa en su aspecto radiográfico. Algunos investigadores han indicado la necesidad de proyección de imagen de la anomalía por un segundo método de imagen obtenida en un plano diferente, además de ortopantomografía, y han empleado diferentes técnicas como la tomografía computarizada y resonancia magnética. El proceso condilar bífido, y en particular bilateral, es un hallazgo poco frecuente, cuya etiología sigue siendo incierta. Es predominantemente una enfermedad asintomática, descubierta por casualidad en examen radiográfico de rutina. El diagnóstico se basa en las manifestaciones radiográficas y el tratamiento suele ser conservador.