Analysis of photostimulable phosphor image plate artifacts and their prevalence.

BACKGROUND: Digital radiography has recently been used in dentistry as a substitute for conventional film radiography worldwide. Digital imaging has many advantages and provides new possibilities for recording and interpreting radiographic data. This system uses different types of digital receptors. AIM: To detect the frequency, type, and reasons behind the appearance of intraoral image artifacts acquired by photostimulable phosphor plates (PSP). METHODS: This retrospective descriptive study was conducted in the oral and maxillofacial radiology unit of the dental clinics of the College of Dentistry, Princess Nourah University (PNU). All intraoral digital radiographs were acquired using (Gendex Expert DC., United States) an intraoral X-ray machine with 7 -mA, 65-kVP using a PSP system (Soredex DIGORA Optime imaging plate) and laser scanners (Soredex DIGORA Optime), which can house all sizes of reusable intraoral PSP sensor plates with image acquisition software (MIPACS Dental Enterprise viewer 3.2.2). A total of 50000 intraoral radiographs were retrieved from the clinical database from April 2018 to April 2020 to evaluate the reason, type, and solutions to these image artifacts. RESULTS: Overall, 50000 intraoral digital radiographs were acquired in a two-year-period; that is, from April 2018 to April 2020. Of these, 3550 (7.1%) retakes were performed due to the presence of image artifacts. Periapical radiographs were the most common image type of intraoral retakes (80.8%). Imaging artifacts were divided into three categories: operator, plate and scanning errors. Out of 3550 retakes, 5%, 1.37%, and 0.73% were related to operator, plate, and scanning errors, respectively. The cone cut was the most common operator error (988 images), Bite marks were the most common plate error (276 images), and delayed scanning artifacts were the most common scanning errors (145 images). The calculated kappa value for interobserver reliability was 0.99, indicating almost perfect interobserver agreement. CONCLUSION: Our study discussed intraoral image artifacts that were characteristic of PSP, where the most common artifacts were bitemarks, image size reduction, scratches, and delayed scanning.

Assessment of dens invaginatus and its characteristics in maxillary anterior teeth using cone-beam computed tomography.

This cone-beam computed tomographic (CBCT) study aimed to evaluate the prevalence of dens invaginatus (DI) and its characteristics in maxillary anterior teeth in a Saudi population. A total of 505 CBCT scans were evaluated, including a total of 2790 maxillary anterior teeth. The patients' demographic data, including age and sex, were recorded. The presence of DI and the related characteristics including bilateral occurrence; DI type according to Oehlers classification; and presence of periapical radiolucency, open apex, and/or nearby impacted teeth were analyzed. The associations between DI and the other factors were analyzed using the chi-square and fisher exact tests. DI was detected in 7.3% of the patients and 1.6% of the teeth examined. Most of the DI-affected teeth were maxillary lateral incisors (76.1%), followed by mesiodens (19.6%) and maxillary central incisors (4.3%), while no DI was observed in the maxillary canines. Bilateral DI was found in 24.3% of the affected patients. Oehlers type I DI was the most frequent (80%). Periapical radiolucencies, open apices, and nearby impacted teeth were observed in 10.9%, 4.3%, and 30% of the invaginated teeth, respectively. DI was significantly associated with tooth type (P < 0.0001) but not with sex (P > 0.05). Although most of the DI cases are limited to the crown, CBCT imaging is essential for DI evaluation and management.

Occupational and patients effective radiation doses in dental imaging.

Ionizing radiation exposure from medical applications is increasing annually worldwide. It was estimated that 325 million dental procedures were performed in the United States. Radiation exposure from dental radiography consists of intraoral, panoramic, and 3D imaging cone-beam computed tomography (CBCT) imaging. Recent studies reported an association between dental imaging procedures and increased cancer probability of brain and thyroid. Previous studies showed that some dental imaging practices exposed patients and staff to unnecessary radiation doses due to incorrect image acquisition and insufficient radiation protection measures. This study aims to (i) measure the occupational and patients doses during dental procedures and (ii) assess the current imaging techniques and radiation protection practices. Two hundred fourteen patients were evaluated for periapical, bitewing, cephalometric, occlusal, and panoramic procedures. Organ equivalent doses were quantified for the breast, eye lens, and thyroid gland during CBCT procedure. Occupational and ambient dose assessment were assessed using calibrated thermoluminescent dosimeters (TLD-100(LiF: Mg. Ti). Ambient doses were measure at different locations at the department using TLDs. Patients' radiation doses were quantified using kerma area product (PKA (mGy.cm) and the entrance surface air kerma (ESAK (mGy). Fixed tube voltage (65 kVp) and tube current-time product (7 mAs) were used. The overall mean, sd, and range of patients dose values during intraoral (mGy), panoramic and CBCT examinations were 4.6 ± 0.7 (1.4-7.1), 135 ± 45 (75.2-168.5), and 215 ± 165 (186-2115), respectively. The mean and range of the annual occupational doses (mSv) were 1.4 (0.6-3.7), which below the annual dose limits for radiation workers (20 mSv/y). The study showed that inadequate radiation protection for patients existed in terms of the use of the thyroid shield, the technologist's presence inside the room during radiation exposure. Patients' radiation doses were comparable with the international diagnostic reference level (DRL). Staff education and training in radiation protection aspects are highly recommended.

Intramuscular hemangioma in the zygomaticus muscle: A rare case report presentation and diagnosis.

INTRODUCTION: intramuscular hemangioma (IMH) is a relatively rare benign vascular tumor of the skeletal muscles. It shows less than 1% of all soft tissue hemangiomas. In the head and neck area, it occurs usually in the masseter muscle followed by temporalis and sternocleidomastoid muscles. PRESENTATION OF CASE: we present a case of 25-year-old male patient with a chief complaint of slowly growing facial swelling in the left zygomatic area. Clinical, imaging and histopathological evaluation lead to the diagnosis of intramuscular hemangioma in the zygomaticus major muscle. DISCUSSION: IMH in the zygomaticus muscle is very rare; hence, the clinical diagnosis of IMH is challenging. Different diagnostic procedures can be used such as CT and MRI. In addition, the ideal therapy for esthetic disfiguring IMH in the head are is the complete surgical excision of the lesion. Through the review of literature and to our knowledge this case is the first report of intramuscular hemangioma in the zygomaticus muscle. CONCLUSION: IMHs are rare in the head and neck area and must be considered in differential diagnosis of isolated muscle mass in this region.

Case Report: Bilateral mandibular buccal bifurcation cysts.

Buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst, which commonly affects children in the first decade of life. We report a case of a seven-year-old healthy boy with bilateral BBC, which involved unerupted incomplete permanent mandibular first molars. A review of the literature in English language revealed few similar cases. We reviewed 16 manuscripts of bilateral mandibular BBC, reporting a total of 20 cases since 1970. The clinical features of bilateral mandibular BBC summarized here could assist specialists with an accurate diagnosis and provide patients with optimal management.

Role of problem-based learning in undergraduate dental education: a questionnaire-based study.

BACKGROUND: There is a debate regarding the significance of problem-based learning (PBL) model in educational systems. The aim of this study was to assess the awareness of dental students at the Princess Nourah Bint Abdulrahman University (PNU), Saudi Arabia, toward PBL. METHODS: The present cross-sectional study was performed at the College of Dentistry, PNU, Riyadh, Saudi Arabia. An anonymous, standardized and self-administered questionnaire (based on nine items) coded as 1, 2, 3 and 4 was distributed to the first-, second-, third- and fourth-year undergraduate students, respectively, after a seminar that focused on the perceptions of PBL among the students at the end of the academic year 2017. The questionnaire was developed following an exhaustive search of indexed databases. Based on the students' responses (yes/no) to the questions, group mean differences (95% CI) were computed and Pearson's chi-squared test was used for data analysis. Cronbach's alpha coefficient was also determined. The level of significance was set at P<0.05. RESULTS: In total, 238 female undergraduate dental students (61 first-year, 59 second-year, 60 third-year and 58 fourth-year students) were included. The Cronbach's alpha coefficient ranged between 0.82 and 0.93. Group comparisons (95% CI) showed no statistically significant difference in the responses (yes) of students in the first, second, third and fourth year of academic years related to the perceptions listed earlier (P>0.05). CONCLUSION: Perception of female undergraduate dental students at the PNU was inconclusive. Further studies are warranted in this regard.

Melanotic neuroectodermal tumour of infancy: A report of two cases.

INTRODUCTION: Melanotic neuroectodermal tumour of infancy (MNTI) is a benign tumour of infancy, most commonly affecting the head and neck region. First described in 1918, less than 500 cases have been reported in the literature. MNTI is aggressive in nature & has a high rate of recurrence. PRESENTATION OF CASES: In this retrospective case series, we report two cases of MNTI that presented at our unit; both cases were managed by wide excision and have been followed up uneventfully for over two years. DISCUSSION: MNTI has a recurrence rate of up to 20%. Patient's age can play a significant role in recurrence rate. Although this neural crest tumour is somewhat rare in the literature, there is a consensus with regards to surgical management; the gold standard remains to be wide excision with safety margin. Select cases may benefit from adjuvant and neoadjuvant therapy. CONCLUSION: Owing to its locally aggressive nature and high recurrence rate, prompt diagnosis and surgical intervention is advised in cases of MNTI. Further understanding of this tumour is needed on a microscopic level in order to determine clear prognostic factors.

Panoramic radiomorphometric indices as reliable parameters in predicting osteoporosis.

BACKGROUND: The purpose was to evaluate the significance of panoramic radiomorphometric indices (mandibular cortical index [MCI], mental index [MI] and panoramic mandibular index [PMI]) as useful tools for identifying osteoporosis. METHODS: One hundred healthy women aged ≥ 30 years were included. Digital panoramic images and bone mineral density (BMD) of the lumbar spines were recorded. Radiomorphometric indices (MCI, MI and PMI) were measured and categorized. RESULTS: Interobserver agreements were kappa = 0.922 for the MCI and alpha = 0.902 and 0.702 for the PMI and MI, respectively. The indices MI, PMI and BMD showed a statistically significant positive correlation with the t score (r = 0.47, 0.36 and 0.96, respectively). The MI showed a statistically significant positive correlation with the PMI (r = 0.72). Sensitivity, specificity and diagnostic accuracy of the MI at a cutoff point of 4.5 mm were 76.9%, 54.1% and 63%, respectively, whereas for the MCI were 66.7%, 75.4% and 72%, respectively. CONCLUSIONS: Panoramic indices (MI, PMI and MCI) were positively correlated with the t score and BMD of the lumbar spines. The MCI was found to be the most reproducible index.