Generalized root agenesis in permanent dentition of a young adolescent patient with rhabdomyosarcoma: a case report.

BACKGROUND: Parameningeal rhabdomyosarcoma (PM-RMS) is a rare and aggressive soft tissue malignancy that primarily occurs in the head and neck region. The standard treatment approach for RMS involves a multimodal therapy regimen, which includes surgery, chemotherapy, and radiotherapy. However, the routine use of radiotherapy and chemotherapy in young patients with RMS in the head and neck region can lead to adverse effects on dental development and thereby, pose a challenge in planning dental intervention. CASE PRESENTATION: This case report outlines the dental and facial developmental consequences in a 13-year-old child, who received chemo-radiotherapeutic intervention at the age of 7 years for the management of PM-RMS. Following treatment, the child exhibited significant dental complications, including arrested root growth and restricted mouth opening. CONCLUSIONS: This case highlights the necessity for interdisciplinary collaboration between oncologists, dentists, and other healthcare professionals to mitigate the adverse effects on dental health and overall quality of life in patients undergoing chemo-radiotherapy for rhabdomyosarcoma.

Clinical and radiographic evaluation of regenerative endodontic procedures (REPs) with or without concentrated growth factor (CGF) as scaffolds for non-vital immature mandibular premolars.

This study aimed to perform clinical and radiographic investigations of the effect of regenerative endodontic procedures (REPs) with and without concentrated growth factor (CGF). Fifty-six non-vital and immature teeth from 56 patients were randomly categorized into two groups. Following chemical and mechanical preparation, REPs with and without CGF as a scaffold was induced in the blood clot (BLC) group and the CGF group. All patients were clinically and radiographically evaluated at 6-month and 12-month intervals to monitor their progress and treatment outcomes. When considering the total number of patients, the follow-up rate was 96.4% (54 out of 56 patients) over a 12-month period. Favorable clinical and radiographic outcomes were observed in 92.6% of patients (25 out of 27) in both the CGF and BLC groups; there were no significant differences between the two groups in these respects (p > 0.05). Notable differences were, however, observed in radiographic measurements relating to the development of root length and radiographic root area when compared between the CGF and BLC groups at both the 6-month and 12-month follow-up intervals (p < 0.05). REPs have been proven to represent a conservative and effective approach for promoting maturogenesis in non-vital and immature teeth. Furthermore, the incorporation of CGF as scaffolds holds promising potential for enhancing the desired biological outcomes of this regenerative technique. These findings highlight the clinical significance and potential benefits of CGF supplementation in REPs, further supporting its application in the field of endodontics.

Prevalence of Isthmi and Root Canal Configurations in Mandibular Permanent Teeth Using Cone-Beam Computed Tomography.

While root canal anatomy in Middle Eastern populations is well-studied, research on isthmi in mandibular permanent teeth from this region is limited. This retrospective study used cone-beam computed tomography (CBCT) to examine isthmi prevalence and location, as well as root canal morphologies (per Vertucci's classification) in mandibular permanent teeth from a subpopulation in Ardabil, Iran. The study is aimed at enhancing our understanding of dental anatomical variations in Middle Eastern populations. A total of 3566 teeth from 384 CBCT scans were evaluated in this retrospective study. Mandibular teeth were evaluated on sagittal, coronal, and axial sections regarding the presence of isthmus and root morphology (Vertucci's classification). CBCT scans of 197 males (51.3%) and 187 females (48.7%) were evaluated, with a mean age of 41.1 ± 11.4 years. Isthmi were most prevalent in molar mesial roots, typically located in the middle third for anterior teeth and first premolars and cervical third for posterior teeth. While gender did not play a significant role, the presence of an isthmus in the mesial root of the left second molars was associated with a younger mean patient age (p < 0.05). Root morphology varied across tooth types. Central and lateral incisors predominantly showed Vertucci's Types I and III. Canines and premolars were mostly Type I, with some variation. Molar mesial roots frequently exhibited Types IV and II, while distal roots were predominantly Type I. Statistically significant differences were found between morphology and gender in the first left premolar (Type I more common in women; Type V in men; p < 0.001) and in the right canine (Type I more prevalent in men; Types III and V more prevalent in women; p < 0.001). The results revealed wide variations in root canal morphology and a relatively high prevalence of isthmi in the study population. Our findings suggest a potential difference in tooth anatomy based on sex and a relationship between age and the presence of isthmi.

Comprehensive Analysis of Mandibular First Molar Root and Canal Morphology in Saudi Patients Using Cone Beam Computed Tomography (CBCT).

BACKGROUND The goal of conventional endodontic therapy is to clean the root canal system thoroughly, restore tooth function, and prevent re-infection. Success depends on understanding root canal morphology, resolving apical periodontitis, and using proper techniques. Studies highlight variations in root canal anatomy, with cone-beam computed tomography (CBCT) being crucial for accurate diagnosis despite its high cost and limited availability. MATERIAL AND METHODS This retrospective study reviewed CBCT images of 1820 (907 male, 913 female) patients aged 18 to 78 years. Analysis included 2081 mandibular first molars for variations in root and canal morphology and right- and left-side symmetry. Inter-orifice distance was measured, along with distance from the cementoenamel junction (CEJ) to the level of canal bifurcation. RESULTS In this study, 96.01% of teeth had 2 roots and 3.89% had 3 roots. The percentages of canal configuration were 77.70% for 3 canals, 21.58% for 4 canals, 0.67% for 2 canals, and 0.05% for 1 canal. The inter-orifice distance was 2.07 mm for 2 canals in 1 root and 2.86 mm for 2 canals in separate distal roots. Distance from the CEJ to canal bifurcation varied significantly between 2 canals within 1 distal root (3.35 mm), 2 canals in separate distal roots (1.60 mm), as well as between distal (3.35 mm) and mesial roots (1.10 mm). CONCLUSIONS In mandibular first molars, only 3.89% have additional distolingual roots. Sex and ethnicity showed no influence on number of roots and canals. Distal canals showed a deeper bifurcation and greater inter-orifice distance than did mesial canals.

Morphological study of distal furcation in mandibular first molars based on cone beam computed tomography images in Beijing population.

OBJECTIVES: This retrospective study explored the incidence of independent distal-lingual root (DLR) in mandibular first molars and the morphologic features of distal furcations through cone beam computed tomography (CBCT) in Beijing population. METHODS: A total of 401 CBCT images of both mandibular first molars existed were included. The sex of the patients, the incidence of DLR, the distal root trunk length (DRT), the locations of distal furcation entrance (DFE), and the separation angle of distal furcation (ADF) were recorded. RESULTS: The incidence rates of DLR were 33.2% on the subject level and 26.8% on the tooth level. The incidence of DLR was not different between genders but was higher on the right sides. The DRT values were 4.15 mm±1.02 mm. The ADF was 65.56°±11.56°. The DFE was located lingually, and 97.2% DFE was located more apically than buccal/lingual furcations. CONCLUSIONS: A high incidence of DLR was found in the Beijing population. The DRT was longer than buccal and lingual sites. The DFE was located lingually with a wide separation. Understanding the morphological features of distal furcation can help clinicians to make proper treatment plans.

Regenerative potential of mesoporous silica nanoparticles scaffold on dental pulp and root maturation in immature dog's teeth: a histologic and radiographic study.

OBJECTIVE: To evaluate histologically and radiographically the potential of dog's immature roots with apical periodontitis to regenerate after regenerative endodontic treatment using mesoporous silica nanoparticles (MSNs) with/without bone morphogenic protein (BMP-2) as scaffolds. METHODS: In 4 mongrel dogs, 56 immature teeth with 96 roots were infected, resulting in necrotic pulps and periapical pathosis. According to the evaluation time (Group I = 30 days and Group II = 90 days), 90 roots were divided into two equal groups (45 roots each) and 6 roots used to replace any lost root during the procedure. The two main groups were further divided according to treatment protocol into 5 subgroups (9 roots each): blood clot (BC subgroup), mesoporous silica nanoparticles scaffold only (MSNs subgroup), mesoporous silica nanoparticles impregnated with BMP2 (MSNs + BMP2 subgroup), infected teeth without treatment (+ ve control subgroup) and normal untouched teeth (-ve control subgroup). All teeth surfaces were coated with Tincture iodine and calcium hydroxide was applied prior to treatment protocols. Then, teeth were restored with glass ionomer filling to seal the remaining part of the access cavity. Radiography evaluation of the increase in root length, root thickness and occurrence of apical closure were performed. Following the sacrifice of the two dogs at each time of evaluation, histopathological analysis was performed and included the inflammatory cells count, bone resorption, tissue ingrowth, deposition of hard tissue, and closure of the apical part. All data were statistically analyzed. RESULTS: Compared to BC subgroup, MSNs and MSNs + BMP-2 subgroups exhibited significant higher increase in root length and thickness as well as higher vital tissue in-growth and new hard tissue formation in group II (P < 0.05). MSNs + BMP-2 subgroup had significant higher increase in root length and thickness as well as significant lower inflammatory cell count than MSNs subgroup in both groups (P < 0.05). There were no significant differences between MSNs and MSNs + BMP-2 subgroups regarding new hard tissue formation in both groups and apical closure in group I (P > 0.05). CONCLUSION: MSNs with/without BMP-2 scaffolds enabled the continuing growth of roots in immature teeth with necrotic pulps and periapical pathosis. Addition of BMP-2 to MSNs scaffold improved its outcome in regenerative endodontics. CLINICAL RELEVANCE: MSNs with/without BMP-2 scaffolds may alternate blood clot for regenerative endodontic treatment of immature teeth with necrotic pulps.

Radiologic study of the distance between the maxillary central incisor root and the incisive canal according to skeletal malocclusion classification.

The aim of this study was to evaluate the distance between the maxillary central incisor root and the incisive canal based on skeletal malocclusion classification and to analyze the morphology of the incisive canal using cone-beam computed tomography (CBCT). Skeletal malocclusion was categorized into Class I, II, and III using lateral cephalometric analysis. Measurements of the distance between the maxillary central incisor root and the incisive canal were taken at two levels: 2 mm (L1) and 4 mm (L2) superior to the labial cementoenamel junction of the maxillary central incisor. At L1, the distance was found to be closer in the Class II group compared to the Class I or Class III groups. Similarly, at L2, the Class II group exhibited a closer distance than the Class III group. Interestingly, females showed a closer distance compared to males at both L1 and L2. Further analysis revealed a significant gender difference in the Class I and III groups, but not in the Class II group. These findings emphasize the significance of evaluating the distance between the maxillary central incisor root and the incisive canal in patients with skeletal Class II malocclusion, regardless of gender.

Nomogram to predict radicular grooves in maxillary lateral incisors in preoperative orthodontic population.

OBJECTIVES: This study aimed to develop and validate a predictive nomogram for diagnosing radicular grooves (RG) in maxillary lateral incisors (MLIs), integrating demographic information, anatomical measurements, and Cone Beam Computed Tomography (CBCT) data to diagnose the RG in MLIs based on the clinical observation before resorting to the CBCT scan. MATERIALS AND METHODS: A retrospective cohort of orthodontic patients from the School and Hospital of Stomatology, Wuhan University, was analyzed, including demographic characteristics, photographic anatomical assessments, and CBCT diagnoses. The cohort was divided into development and validation groups. Univariate and multivariate logistic regression analyses identified significant predictors of RG, which informed the development of a nomogram. This nomogram's performance was validated using receiver operating characteristic analysis. RESULTS: The study included 381 patients (64.3% female) and evaluated 760 MLIs, with RG present in 26.25% of MLIs. The nomogram incorporated four significant anatomical predictors of RG presence, demonstrating substantial predictive efficacy with an area under the curve of 0.75 in the development cohort and 0.71 in the validation cohort. CONCLUSIONS: A nomogram for the diagnosis of RG in MLIs was successfully developed. This tool offers a practical checklist of anatomical predictors to improve the diagnostic process in clinical practice. CLINICAL RELEVANCE: The developed nomogram provides a novel, evidence-based tool to enhance the detection and treatment planning of MLIs with RG in diagnostic and therapeutic strategies.

Recommendations to minimize tooth root remodeling in patients undergoing maxillary osteotomies.

The purpose of this study was to report root remodeling/resorption percentages of maxillary teeth following the different maxillary osteotomies; i.e. one-piece, two-pieces, three-pieces Le Fort I, surgically assisted rapid palatal expansion (SARPE). The possibility of relationships between root remodeling and various patient- and/or treatment-related factors were further investigated. A total of 110 patients (1075 teeth) who underwent combined orthodontic and orthognathic surgery were studied retrospectively. The sample size was divided into: 30 patients in one-piece Le Fort I group, 30 patients in multi-pieces Le Fort I group, 20 patients in SARPE group and 30 patients in orthodontic group. Preoperative and 1 year postoperative cone beam computed tomography (CBCT) scans were obtained. A validated and automated method for evaluating root remodeling and resorption in three dimensions (3D) was applied. SARPE group showed the highest percentage of root remodeling. Spearman correlation coefficient revealed a positive relationship between maxillary advancement and root remodeling, with more advancement contributing to more root remodeling. On the other hand, the orthodontic group showed a negative correlation with age indicating increased root remodeling in younger patients. Based on the reported results of linear, volumetric and morphological changes of the root after 1 year, clinical recommendations were provided in the form of decision tree flowchart and tables. These recommendations can serve as a valuable resource for surgeons in estimating and managing root remodeling and resorption associated with different maxillary surgical techniques.

Determining Whether an Individual is 18 Years or Older Based on the Third Molar Root Pulp Visibility in East China.

OBJECTIVES: To investigate the age-related changes of the mandibular third molar root pulp visibility in individuals in East China, and to explore the feasibility of applying this method to determine whether an individual is 18 years or older. METHODS: A total of 1 280 oral panoramic images were collected from the 15-30 years old East China population, and the mandibular third molar root pulp visibility in all oral panoramic images was evaluated using OLZE 0-3 four-stage method, and the age distribution of the samples at each stage was analyzed using descriptive statistics. RESULTS: Stages 0, 1, 2 and 3 first appeared in 16.88, 19.18, 21.91 and 25.44 years for males and in 17.47, 20.91, 22.01 and 26.01 years for females. In all samples, individuals at stages 1 to 3 were over 18 years old. CONCLUSIONS: It is feasible to determine whether an individual in East China is 18 years or older based on the mandibular third molar root pulp visibility on oral panoramic images.

Systematic review and meta-analysis of root morphology and canal configuration of permanent premolars using cone-beam computed tomography.

INTRODUCTION: The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY: A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS: Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS: The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.

Evaluation of the relationship between periodontal bone destruction and mesial root concavity of the maxillary first premolar.

BACKGROUND: The purpose of this study was to investigate the morphology of maxillary first premolar mesial root concavity and to analyse its relation to periodontal bone loss (BL) using cone beam computed tomography (CBCT) and panoramic radiographs. METHODS: The mesial root concavity of maxillary premolar teeth was analysed via CBCT. The sex and age of the patients, starting position and depth of the root concavity, apicocoronal length of the concavity on the crown or root starting from the cementoenamel junction (CEJ), total apicocoronal length of the concavity, amount of bone loss both in CBCT images and panoramic radiographs, location of the furcation, length of the buccal and palatinal roots, and buccopalatinal cervical root width were measured. RESULTS: A total of 610 patients' CBCT images were examined, and 100 were included in the study. The total number of upper premolar teeth was 200. The patients were aged between 18 and 65 years, with a mean age of 45.21 ± 13.13 years. All the teeth in the study presented mesial root concavity (100%, n = 200). The starting point of concavity was mostly on the cervical third of the root (58.5%). The mean depth and buccolingual length measurements were 0.96 mm and 4.32 mm, respectively. Depth was significantly related to the amount of alveolar bone loss (F = 5.834, p = 0.001). The highest average concavity depth was 1.29 mm in the group with 50% bone loss. The data indicated a significant relationship between the location of the furcation and bone loss (X2 = 25.215, p = 0.003). Bone loss exceeded 50% in 100% of patients in whom the furcation was in the cervical third and in only 9.5% of patients in whom the furcation was in the apical third (p = 0.003). CONCLUSIONS: According to the results of this study, the depth of the mesial root concavity and the coronal position of the furcation may increase the amount of alveolar bone loss. Clinicians should be aware of these anatomical factors to ensure accurate treatment planning and successful patient management.

Effect of mineralized dentin matrix on the prognosis of bone defect and retained root after coronectomy.

OBJECTIVE: To investigate the impact of mineralized dentin matrix (MDM) on the prognosis on bone regeneration and migration of retained roots after coronectomy. MATERIALS AND METHODS: Patients were divided into three groups based on the type of bone graft after coronectomy: Group C (n = 20, collagen), Group T (n = 20, tricalcium phosphate (TCP) + collagen), and Group D (n = 20, MDM + collagen). CBCT scans, conducted immediately and 6 months after surgery, were analyzed using digital software. Primary outcomes, including changes in bone defect depth and retained root migration distance, were evaluated 6 months after surgery. RESULTS: After 6 months, both Groups D and T exhibited greater reduction of the bone defect and lesser retained root migration than Group C (p < 0.001). Group D had greater regenerated bone volume in the distal 2 mm (73 mm3 vs. 57 mm3, p = 0.011) and lesser root migration (2.18 mm vs. 2.96 mm, p < 0.001) than Group T. The proportion of completely bone embedded retained roots was also greater in Group D than in Group C (70.0% vs. 42.1%, p = 0.003). CONCLUSIONS: MDM is an appropriate graft material for improving bone defect healing and reducing retained root migration after coronectomy. CLINICAL RELEVANCE: MDM is an autogenous material prepared chairside, which can significantly improve bone healing and reduce the risk of retained root re-eruption. MDM holds promise as a routine bone substitute material after M3M coronectomy.

Assessment of sealing efficacy, radiopacity, and surface topography of a bioinspired polymer for perforation repair.

Background: Root perforation repair presents a significant challenge in dentistry due to inherent limitations of existing materials. This study explored the potential of a novel polydopamine-based composite as a root repair material by evaluating its sealing efficacy, radiopacity, and surface topography. Methods: Confocal microscopy assessed sealing ability, comparing the polydopamine-based composite to the gold standard, mineral trioxide aggregate (MTA). Radiopacity was evaluated using the aluminium step wedge technique conforming to ISO standards. Surface roughness analysis utilized atomic force microscopy (AFM), while field emission scanning electron microscopy (FESEM) visualized morphology. Results: The polydopamine-based composite exhibited significantly superior sealing efficacy compared to MTA (P < 0.001). Radiopacity reached 3 mm aluminium equivalent, exceeding minimum clinical requirements. AFM analysis revealed a smooth surface topography, and FESEM confirmed successful composite synthesis. Conclusion: This study demonstrates promising properties of the polydopamine-based composite for root perforation repair, including superior sealing efficacy, clinically relevant radiopacity, and smooth surface topography. Further investigation is warranted to assess its clinical viability and potential translation to endodontic practice.

Micro-computed tomography (micro-CT) evaluation of root canal morphology in immature maxillary third molars.

The endodontic treatment of immature permanent teeth with necrotic pulp is a significant clinical challenge. The success of regenerative endodontic procedure is highly dependent on disinfection of the root canal and an accurate anatomical knowledge of the root canal. The aim of this study was to use micro-computed tomography (micro-CT) analysis to investigate the configuration of root canals in the upper permanent third maxillary molars with incomplete root development in their coronal, apical and middle third portions. Thirty immature third permanent maxillary molars were scanned using a micro-CT system. Then, we measured the diameters and areas of the root canal in the coronal, middle and apical third of the roots. The ratio between the long and short diameter of each root canal was then calculated and the canals were divided into several groups: round, oval, long oval, flat and irregular. The round configuration was not observed in the distobuccal and mesiobuccal roots in any of their anatomical regions. Oval and long oval canals predominated in the distobuccal root. The greatest variations were observed in the mesiobuccal root, with the ribbon-shaped canal predominating in the middle region and an irregular shape in the apical region. In the coronal region of the palatal canal, the round configuration predominated; in the middle third, we observed an almost equivalent distribution between round and oval configurations; apically, the oval shape predominated. In conclusion, we observed significant complexity and variation in the morphology and configuration of root canals in immature permanent molars, thus generating additional obstacles for the success of regenerative endodontics.

Three-dimensional evaluation of dental characteristics in patients with Cleidocranial dysplasia.

BACKGROUND: Cleidocranial dysplasia (CCD) is an autosomal dominant hereditary disorder. Besides skeletal abnormalities, CCD is often associated with dental complications, such as multiple supernumerary teeth and permanent teeth impaction or delayed eruption. METHODS: Supernumerary teeth of axial, sagittal and coronal CBCT view was characterized in detail and 3D image reconstruction was performed. Number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth, direction of supernumerary teeth in CCD patients were analyzed. RESULTS: The mean age of the 3 CCD patients in this study was 16.7 years. Among 36 supernumerary teeth, the majority of them were identified as apical side located and lingual side located. Normal orientation was the most common type in this study, followed by sagittal orientation, and horizontal orientation. Horizontal orientation teeth were all distributed in the mandible. Supernumerary teeth exhibited significantly shorter crown and dental-root lengths, as well as smaller crown mesiodistal and buccolingual diameters (P < 0.01). There was no difference in the number of supernumerary teeth between the maxilla and mandible, and the premolars region had the largest number of supernumerary teeth and the incisor region had the smallest number. CONCLUSIONS: This study compares number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth and direction of supernumerary teeth, this study also provides a reference for the comprehensive evaluation of CCD patients before surgery.

Influence of root shape on canal complexity at the mandibular molar apical surgical resection level: A micro-CT study.

OBJECTIVES: This study aimed to investigate the relationship between the aspect ratios of mandibular molar roots at the apical 3-mm level and their root canal complexity. DESIGN: This study used micro-CT imaging to analyze 163 two-rooted mandibular molars. The aspect ratios of the roots at the apical 3-mm level were categorized as "< 2.75" or "≥ 2.75" (mesial) and "< 1.75" or "≥ 1.75" (distal). A two-dimensional (2D) analysis focused on four apical axial cross-section levels to determine the presence of main and accessory canals and isthmus. Additionally, a three-dimensional (3D) assessment of the apical 4-mm of both roots examined main and accessory canals, apical foramina, apical deltas, and middle mesial canals. RESULTS: Mesial roots with aspect ratios ≥ 2.75 showed a higher number of main canals at all levels compared to those with aspect ratios < 2.75 at the 3-mm level. Additionally, the ≥ 2.75 group exhibited more accessory canals and a higher average number of accessory canals. The 3D assessment confirmed significantly more accessory canals and apical foramina in the ≥ 2.75 group. The prevalence of roots with apical deltas was nearly double in the ≥ 2.75 group, and middle mesial canals were exclusively found in this group. In the distal root, the ≥ 1.75 group showed a significantly higher number of main canals at all axial levels. No significant differences were observed between groups in terms of accessory canals, apical foramina, or deltas. CONCLUSIONS: A higher root aspect ratio is related to higher anatomical complexity.

A retrospective clinical study to compare the ability of cone-beam computed tomographic images and periapical radiographs to reveal cracked teeth, split teeth, and teeth with vertical root fractures.

BACKGROUND: This retrospective clinical study aimed to compare the sensitivity of cone-beam computed tomographic (CBCT) images and periapical (PA) radiographs to reveal cracked teeth, split teeth, and teeth with vertical root fractures (VRFs). METHODS: The authors included 98 patients (98 teeth) diagnosed with a longitudinal tooth fracture (LTF) (cracked tooth, split tooth, VRF) through direct visualization after extraction and with comprehensive clinical and radiographic records. They collected demographic, clinical, and radiographic data. The authors evaluated PA radiographs and CBCT images to identify fractures, fracture lines, and the different patterns of bone loss associated with these teeth. They used the McNemar test to compare PA radiographs and CBCT scans when assessing bone loss. They used the Fisher test to determine statistical relationships between fracture types and demographic, clinical, and radiologic traits. They used an analysis of variance test to compare patient age with fracture types. RESULTS: CBCT images were significantly more effective (P < .05) in detecting bone loss patterns associated with LTFs than with PA radiographs, with 71% of cases detected via CBCT images compared with 42% via radiographs. Mean age was significantly greater (P < .05) in patients with teeth with VRFs than in patients with split teeth. A significant relationship was observed between the type of fracture and the following variables: root canal treatment (split, VRF, P = .002), deep probing depth (≥ 5 mm) (VRF, P = .026), and having more than 8 teeth extracted from the mouth (VRF, P = .032). Overall, there was a significant difference (P < .001) between the visualization of fracture lines (45% on PA radiographs, 65% on CBCT images). CONCLUSIONS: CBCT scans provided more information on LTFs than PA radiographs, particularly in the identification of periradicular bone changes. PRACTICAL IMPLICATIONS: CBCT imaging can assist in making the clinical diagnosis of LTFs through observation of bone loss patterns, providing more information than PA radiographs.

Canine sexual dimorphism in crown and root dimensions: a cone-beam computed tomographic study.

The primary step in forensic odontological analysis is sex determination. The present study is one of the few studies that evaluated the accuracy of the combination of canine tooth root length and crown measurements for sex determination. The study sample comprised 196 cone-be am computed tomographic scans of individuals aged 20-80 years distributed in five age categories: 20-29, 30-39, 40-49, 50-59, and 60+ years old. Different parameters, such as width, length, and ratio measurements for the crown and root of each maxillary and mandibular canine tooth, were examined and recorded. The findings indicated that maxillary canines had greater sex dimorphism ability (87.3%) than mandibular canines (80.6%). Total tooth length and root length of maxillary canine were the most pronounced variables in the differentiation of sex groups. When the combination of the mandibular and maxillary measurements was considered, the accuracy for sex dimorphism was 85.7%. By using ratio variables, the accuracy was reduced to 68.9%. According to the findings of this study, total tooth length and root length are the most discriminant variables of canine teeth. These variables are more reliable sex indicators than crown measurements.