Strut and radio-morphometric analysis of mandibular trabecular structure in pre-and post-menopausal women to aid in the diagnosis of osteoporosis.

Purpose: The purpose of the study is to evaluate the mandibular trabecular pattern in pre- and postmenopausal age women. By analysing the strut, fractal, grey level co-occurrence matrix, and radio-morphometric indices in the panoramic radiograph. Method: Panoramic radiographs from 2019 to 2022 were used to assess pre- and postmenopausal women's bone mineral density. A total of 272 panoramic radiographs, which exhibited clear visibility of the mental foramen on both sides without any blurring, motion artefacts, surgical errors, overlapping hyoid bone, or inferior mandibular cortex, were divided into two groups. Group A (136 premenopausal women) and Group B (136 postmenopausal women). It is a retrospective study that is non-interventional/observational in design. Strut features, fractal dimensions, a grey-level co-occurrence matrix, and radio morphometric indices were used to investigate bone texture in an image processing program. The mean difference between group variables was calculated using an independent sample t-test/unpaired t-test. Results: Pre-menopausal women had a mean age of 38.83 ± 6.01 years, while postmenopausal women had a mean age of 68.26 ± 8.31 In the postmenopausal group Four regions of interest exhibited fractal dimensions with a P value of less than 0.01 and GLCM features including contrast (0.812), correlation (0.230), energy (0.215), and homogeneity (0.322). Strut features of the four regions showed that 15 of 19 characteristics were significantly different. Conclusion: Orthopantomogram is useful in screening for osteoporosis. Strut, radio-morphometric indices, and fractal analysis can assess bone texture and quality. Future research incorporating artificial intelligence can revolutionize image analysis and support clinical decision-making.

Mandibular Osteoblastoma: A Case Report of a Rare Entity.

Osteoblastoma, an uncommon bone neoplasm characterized by the formation of osteoid tissue, constitutes a rare subset of bone tumors, representing only a negligible percentage of cases. While extensive research on the condition has identified a predilection for long bones and vertebrae, occurrences in facial bones are infrequent. This case report discusses a unique presentation in a nine-year-old female diagnosed with a tumor located in the mandibular parasymphysis region. Radiological examination revealed distinctive irregular contours surrounding the lesion, prompting a comprehensive investigation involving biopsy and subsequent histological analysis. The ensuing evaluation definitively confirmed the diagnosis of a typical benign osteoblastoma. This report highlights the novelty of an unresected benign osteoblastoma situated in the mandible, currently undergoing periodic review, with the option of surgery also on the table.

Deep learning methods for fully automated dental age estimation on orthopantomograms.

OBJECTIVES: This study aimed to use all permanent teeth as the target and establish an automated dental age estimation method across all developmental stages of permanent teeth, accomplishing all the essential steps of tooth determination, tooth development staging, and dental age assessment. METHODS: A three-step framework for automatically estimating dental age was developed for children aged 3 to 15. First, a YOLOv3 network was employed to complete the tasks of tooth localization and numbering on a digital orthopantomogram. Second, a novel network named SOS-Net was established for accurate tooth development staging based on a modified Demirjian method. Finally, the dental age assessment procedure was carried out through a single-group meta-analysis utilizing the statistical data derived from our reference dataset. RESULTS: The performance tests showed that the one-stage YOLOv3 detection network attained an overall mean average precision 50 of 97.50 for tooth determination. The proposed SOS-Net method achieved an average tooth development staging accuracy of 82.97% for a full dentition. The dental age assessment validation test yielded an MAE of 0.72 years with a full dentition (excluding the third molars) as its input. CONCLUSIONS: The proposed automated framework enhances the dental age estimation process in a fast and standard manner, enabling the reference of any accessible population. CLINICAL RELEVANCE: The tooth development staging network can facilitate the precise identification of permanent teeth with abnormal growth, improving the effectiveness and comprehensiveness of dental diagnoses using pediatric orthopantomograms.

Radiological assessment of periodontal ligament space visibility on third molars for forensic age assessment - a comparison study of three different staging scales.

Various staging scales have been proposed for the assessment of the visibility of the periodontal ligament space of mandibular third molars on dental panoramic radiographs (PANs) for forensic age assessment in living individuals. However, up to now, there has been no systematic comparison between these staging scales available. We directly compared the 2010 staging scale proposed by Olze et al. with the 2017 staging by Lucas et al. and the 2020 staging by Guo et al. in a German study population. We evaluated 233 PANs from 115 females and 118 males aged 20.0 to 40.9 years using three independent examiners, with one examiner conducting two assessments. We examined the correlation between age and stage, as well as the inter- and intra-rater reliabilities. While the point estimates for the correlation coefficient and the reliability measures were lowest for the Guo scale and highest for the Olze scale, confidence intervals showed a large overlap, particularly for the scales of Olze et al. and Lucas et al. The correlation coefficients between stage and age were consistently lower in females than in males across all methods. In summary, we showed that the staging scales of Olze et al. and Lucas et al. were very similar. The Olze method showed higher point estimates across all analyses, and because there are more reference data available for this method, we argue that it should be preferred as the method of choice for further studies in the field. However, Guo method could be considered for instances, in which the inter-radicular periodontal ligament is not evaluable.

Impact of dental state and surgical factors on postoperative neck infection in oral cancer patients.

Postoperative neck infection (PONI) is a known complication of neck dissection. In this study we explored the impact of dental status on the development of PONI, using orthopantomograms to assess edentulism, periodontal health, and caries status. Retrospective analysis was performed for all new oral cancer patients who had neck dissection between January 2008 and January 2020 in a tertiary head and neck centre. PONI risk factors assessed included patient characteristics, dental status, tumour, and surgical factors. Development of PONI was the primary outcome. Edentulous patients had lower risk of PONI (OR 0.06, p = 0.026) compared to those with 21 or more teeth. Periodontitis and dental caries were not statistically significant. Current smokers (OR 2.09, p = 0.044) and free flap reconstruction (OR 5.41, p < 0.001) were also significant predictors for development of PONI. This study highlights the presence of teeth as a potential source of infection post neck dissection and that orthopantomogram assessment may be inadequate to identify at risk patients. Future studies are required on direct clinical assessment of dentition to evaluate the impact of dental optimisation in prevention of PONI.

Dental age assessment in the living: a comparison of two common stage classifications for assessing radiographic visibility of the root canals in mandibular third molars.

After dentition is complete, degenerative tooth characteristics can be used for dental age assessment. Radiological assessment of the visibility of the root canals of the mandibular third molars in dental panoramic radiographs (DPRs) is known to be one such suitable feature. Essentially, two different stage classifications are available for evaluating the visibility of the root canals of mandibular third molars in the DPR. The aim of this study was to determine if one method outperforms the other. Therefore, the 2010 method of Olze et al. was directly compared to the 2017 method of Lucas et al. in the 2020 modification of Al Qattan et al. To this end, 233 DPRs from 116 females and 117 males aged 20.0 to 40.9 years were evaluated by three independent experienced examiners. In addition, one examiner ran two independent evaluations. Correlation between age and stage was investigated, and the inter- and intra-rater reliability was estimated for both methods. Correlation between age and stage was higher with the Olze method (Spearman rho 0.388 [95% CI 0.309, 0.462], males and 0.283 [95% CI 0.216, 0.357], females) than the Lucas method (0.212 [95% CI 0.141, 0.284], males and 0.265 [95% CI 0.193, 0.340], females). The intra-rater repeatability of the Olze method (Krippendorff's α = 0.576 [95% CI 0.508, 0.644], males and α = 0.592 [95% CI 0.523, 0.661], females) was greater than that for the Lucas method (intra-rater α = 0.422 [95% CI 0.382, 0.502], males and α = 0.516 [95% CI 0.523, 0.661], females). Inter-rater reproducibility was also greater for the Olze method (α = 0.542 [95% CI 0.463, 0.620], males and α = 0.533 [95% CI 0.451, 0.615], females) compared to the Lucas method (α = 0.374 [95% CI 0.304, 0.443], males and α = 0.432 [95% CI 0.359, 0.505], females). The method of Olze et al. was found to present marginal advantages to the Lucas et al. method across all examinations and may be a more appropriate method for application in future studies.

Accuracy of Age Estimation Using Three Dental Age Estimation Methods in a Young, Large, and Multiethnic Patient Sample.

European countries have become host countries for migrants and unaccompanied minors. However, many migrants arrive without identity documents. Many methods exist to estimate age; among them, several methods using dental age have been proposed. Our objective was to evaluate the accuracy of biological age determination in a multiethnic sample using dental age estimated using three methods: Nolla, Demirjian, and the London Atlas. Orthopantomograms collected for 324 patients of various ethnicities aged from 4 to 20 years old were included. Then, for each orthopantomogram, a blind trained examiner used the three methods of age estimation. For each method, the estimated mean age was greater than the real mean age (p < 0.0001). The accuracy after 18 years old with a 1-year margin was under 50%. Demirjian's method gave a less accurate estimated age than Nolla's method (p < 0.0001) or the London Atlas (p < 0.001). The most accurate methods were those of Nolla and the London Atlas, with average absolute deviations of 1.3 and 1.2 years, respectively. Demirjian's method was much less accurate, with a deviation of around 2 years. The evaluated methods are unable to provide reliable information to determine if an individual is a minor.

Third Molar Eruption in Dental Panoramic Radiographs as a Feature for Forensic Age Assessment-Presentation of a New Non-Staging Method Based on Measurements.

The evaluation of third molar eruption in dental panoramic radiographs (DPRs) constitutes an evidence-based approach for forensic age assessment in living individuals. Existing methodologies involve staging morphological radiographic findings and comparing them to reference populations. Conversely, the existing literature presents an alternative method where the distance between third molars and the occlusal plane is measured on dental plaster models. The aim of this study was to adapt this measurement principle for DPRs and to determine correlation between eruption and chronological age. A total of 423 DPRs, encompassing 220 females and 203 males aged 15 to 25 years, were examined, including teeth 38 [FDI] and 48. Two independent examiners conducted the measurements, with one examiner providing dual assessments. Ultimately, a quotient was derived by comparing orthogonal distances from the mesial cementoenamel junctions of the second and third molars to a simplified radiological occlusal plane. This quotient was subsequently correlated with the individual's age. We estimated correlations between age and quotients, as well as inter- and intra-rater reliability. Correlation coefficients (Spearman's rho) between measurements and individuals' ages ranged from 0.555 to 0.597, conditional on sex and tooth. Intra-rater agreement (Krippendorf's alpha) ranged from 0.932 to 0.991, varying according to the tooth and sex. Inter-rater agreement ranged from 0.984 to 0.992, with distinctions drawn for different teeth and sex. Notably, all observer agreement values fell within the "very good" range. In summary, assessing the distance of third molars from a simplified occlusal plane in DPRs emerges as a new and promising method for evaluating eruption status in forensic age assessment. Subsequent reference studies should validate these findings.

Effectiveness of Orthopantomograms as a Screening Tool for Osteoporosis: A Case-Control Study.

Introduction Osteoporosis is a disease that is characterised by low bone mineral density (BMD), and loss of structural and biomechanical properties that are essential in maintaining bone homeostasis. Osteoporosis is diagnosed by clinical measurement of BMD and is the best predictor of osteoporosis. The study was conducted with the aim of assessing the effectiveness of orthopantomogram (OPG) as a screening tool for osteoporosis in postmenopausal women and chronic drug users. Objectives The primary objective of the current study was to assess the mandibular cortical width and antegonial index in postmenopausal women and chronic drug users, the secondary objective was to compare the mandibular cortical width and antegonial index of postmenopausal women and chronic drug users with that of the control group (healthy individual). Methods Three groups were taken in this study with a sample size of 300 with 100 OPG in each group. The groups categorised in the study were postmenopausal women, patients under drugs (glucocorticoids, proton pump inhibitor, anti-epileptic drugs, selective serotonin reuptake inhibitor) and the control group and the parameters assessed were antegonial index and mandibular cortical width. Results Results were tabulated and analysed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). The normality tests Kolmogorov-Smirnov and Shapiro-Wilks test results reveal that the variables (both indices) follow the normal distribution. The mandibular cortical width was 3.44, 2.66 and 2.96 in the normal, postmenopausal women and women on drugs respectively. The antegonial index was 163.5, 157.2 and 158.8 in the normal, postmenopausal women and women on drugs respectively. Conclusion From the above results, it is evident that there is a statistically significant reduction in antegonial index and mandibular cortical width in postmenopausal women compared to normal individuals. Alterations of this value are suggestive that early pre-clinical changes of osteoporosis can be detected in the high-risk group using OPG.

Digital Panoramic Radiographs for Age Prediction Utilizing the Tooth Coronal Index of First Mandibular Bicuspids Among the South Indian Population.

Introduction Age estimation holds significant importance within the realm of forensic science, serving as a crucial tool for various purposes such as validating birth certificates, aiding immigration processes, and determining eligibility for retirement benefits. Additionally, age estimation carries significant implications in situations involving human trafficking, offering insights into matters such as legal culpability, adult classification, and marriage age assessment. Aim The purpose of this research was to assess the precision of the Tooth Coronal Index (TCI) in the estimation of age, a key component of forensic odontology. Materials and methods The research employed a retrospective approach, analyzing 700 digital panoramic radiographs of the mandibular first bicuspids. The study population was categorized into five age groups viz. 20-30, 31-40, 41-50, 51-60, and above 61 years respectively. Statistical methods were applied to investigate the relation between TCI and age. Additionally, one-way ANOVA was utilized to compare the groups. Results Findings revealed that males aged between 20-30 years exhibited underestimation, while males above 60 years displayed overestimation. Among females, the smallest disparity between existent and calculated age was observed in the 31-40 age group. Notably, ANOVA analysis for females indicated highly significant differences between the calculated and actual ages across all age segments (P<0.01). Regarding the mean TCI, inter-group comparisons showed statistically insignificant differences in males, while in females, the distinctions were statistically extremely noteworthy (P<0.01). Conclusion The utilization of TCI for age estimation based on mandibular first bicuspids is recommended as a convenient, non-invasive, and time-efficient approach.

Maxillary canine position of patients with non-syndromic craniofacial disorder: a retrospective evaluation of panoramic radiographs.

BACKGROUND: The study evaluates the position and displacement tendency of unerupted maxillary canines in orthodontic patients with non-syndromic craniofacial disorders (CD) compared to a control (C) group. METHODS: Canine position and displacement tendency were evaluated using panoramic radiographs (PAN) examined with parameters such as sector classification (sectors 1-5) and inclination angles (α and ß). The displacement tendency was defined as the positioning of the tip in sectors 1 or 2, as well as its combination with increased angles (α > 30° and ß > 39°). In addition, the correlation of the tooth position and agenesis, cleft side, and sex was assessed. RESULTS: A total of 116 pre-treatment PAN, divided into the CD group (n = 50; mean age 8.32 ± 2.27 years) and the C group (n = 66; mean age 10.80 ± 2.82 years), were evaluated in this study. The sector classification showed no displacement tendency in both groups. Inclination angles α/ß showed a statistically significant higher displacement tendency (p = 0.01) of the CD group (n = 5) on the right side, compared to healthy subjects (n = 1). Male CD patients had a statistically significant higher displacement tendency on the right side (p = 0.03). A statistically significant correlation between cleft and non-cleft-side (p = 0.03) was found. CONCLUSION: Patients with CD showed a statistically significant higher displacement tendency of the maxillary canine affected by the cleft side. The inclination angle was found to be the better predictor compared to the sector classification which should be considered in the orthodontic treatment planning.

Prevalence and Characteristics of Eagle's Syndrome in a Syrian Population: A Cross-Sectional Descriptive Study.

Objectives Elongation of the styloid process causes different symptoms with varying degrees of severity in some people. This elongation can be detected haply during routine reading of panoramic X-ray. The aim of this study is to determine the prevalence rate of Eagle's syndrome among a population from Damascus, Syria, and to evaluate the accompanying clinical symptoms. Methods This is a descriptive epidemiological study including 3,962 patients who attended one of the many dental clinics of educational and/or healthcare institutions in Damascus. All digital panoramic radiographs were reviewed, and the styloid processes were measured and assessed for elongation. Patients with styloid process of more than 3 cm in length were contacted and their consents were obtained to participate in the study to assess the presence of clinical symptoms. Results Radiographic elongation of the styloid process was found in 179 out of the 3,962 assessed dental records (prevalence rate was 4.5%). Length ranged from 30 to 90 mm, with an average of 55.9 mm. Of the patients with elongated styloid process, 10.2% had undergone tonsillectomy. All patients who underwent tonsil surgeries were symptomatic with at least three of the studied symptoms. Symptoms included peri-orbital pain (40.9%), orbital pain (35.2%), neck and shoulders pain (52.3%), ipsilateral headache (58%), earache (30.7%), tinnitus (37.5%), articular clicking (29.5%), throat pain (31.8%), globus sensation (22.7%), and dysphagia (21.6%). Conclusions The prevalence of Eagle's syndrome according to this study was 4.5%. Patients who had undergone tonsillectomy were more likely to be more symptomatic. The most common symptom was severe headache (migraine) on the same side of styloid elongation. Panoramic radiography is a low-cost means that can be helpful in the diagnosis of vague pain and symptoms caused by Eagle's syndrome in the head and neck regions.

The location of the permanent mandibular canine as identified in orthopantomograms from children younger than 5 years of age: a case series study.

AIM: The aim of this case series study is to describe where the crowns of the permanent mandibular canines are located in early childhood in relation to the preceding primary canines. MATERIALS AND METHODS: From a sample of 31 orthopantomograms from children, younger than 5 years of age, the location of the mandibular canines was analysed by visual inspection. The radiographs were taken due to different deviations in the dentition and forwarded during a period of 28 years for elucidating different diagnostic questions. From an embryological point of view, the primary canine was considered as a stable structure in the jawbone. A longitudinal axis through the primary canine was named the canine axis. The initial site of the permanent crown was the site, where the permanent lamina "placed" the tooth bud for final development. A normal site was determined when the canine axis passed though the permanent crown and a pathological site was determined when this did not happen. RESULTS: Normal sites for the permanent crowns were observed in 19 cases and abnormal sites in 8 cases. In four cases, the interrelationship between the canine axis and the permanent crown could not be decided. The study demonstrated that the tooth germ for the permanent canine can start initial formation misplaced distally or mesially to the preceding primary tooth. CONCLUSION: The study demonstrates different malpositions of the initial crowns of the permanent mandibular canines in children younger than 5 years of age. The results are considered of importance for future understanding of the aetiology behind ectopic mandibular canines.

Normal pre-eruptive inclinations of maxillary canine, lateral incisor, and first premolar in children aged 6-14 years.

BACKGROUND: Maxillary canine is the second most common tooth that gets impacted after III molars. Early pre-eruptive inclination changes of first premolar and its associative changes with canine inclination are an important factor that predicts the fate of maxillary canines. Hence, a cross-sectional study was planned to evaluate the normal pre-eruptive mesiodistal inclinations of maxillary permanent canine, first premolar, and lateral incisor in children aged 6-14 years using orthopantomogram. MATERIALS AND METHODS: The total number of participants was 296. Each group of boys and girls consisted of 37 participants in each of the age groups 6-8 years, 8-10 years, 10-12 years, and 13-14 years, making up a total of 148 boys and 148 girls. Routine clinical examination was conducted, and orthopantomograph was taken for radiographic examination. Orthopantomographs of all these participants were collected. Inclination of lateral incisor, inclination of canine, and inclination of premolar with midline were measured on the orthopantomogram. Also, the angles between the canine with lateral incisor and canine with first premolar were measured. Pearson correlation was also evaluated between the movement of canine with lateral incisor and canine with first premolar. RESULTS: All the mean angles related to lateral incisor, canine, and first premolar with midline were recorded. Also, the angles between the canine with lateral incisor and the canine with first premolar were recorded. The movements between lateral incisor, canine, and first premolar were moderately correlated from 6 to 12 years of age. CONCLUSION: The eruption of canine from the floor of the nose till it erupts has its synchronized influence on the lateral incisor and the first premolar.

Automatic sex estimation using deep convolutional neural network based on orthopantomogram images.

Sex estimation is very important in forensic applications as part of individual identification. Morphological sex estimation methods predominantly focus on anatomical measurements. Based on the close relationship between sex chromosome genes and facial characterization, craniofacial hard tissues morphology shows sex dimorphism. In order to establish a more labor-saving, rapid, and accurate reference for sex estimation, the study investigated a deep learning network-based artificial intelligence (AI) model using orthopantomograms (OPG) to estimate sex in northern Chinese subjects. In total, 10703 OPG images were divided into training (80%), validation (10%), and test sets (10%). At the same time, different age thresholds were selected to compare the accuracy differences between adults and minors. The accuracy of sex estimation using CNN (convolutional neural network) model was higher for adults (90.97%) compared with minors (82.64%). This work demonstrated that the proposed model trained with a large dataset could be used in automatic morphological sex-related identification with favorable performance and practical significance in forensic science for adults in northern China, while also providing a reference for minors to some extent.

Third molar eruption in orthopantomograms as a feature for forensic age assessment-a comparison study of different classification systems.

Evaluation of third molar eruption represents an established method for age assessment of living individuals. Different classification systems are available for the radiological assessment of third molar eruption. The aim of this study was to identify the most accurate and reliable classification system for the mandibular third molar eruption on orthopantomograms (OPG). We compared the method of Olze et al. (2012) with the method of Willmot et al. (2018) and a newly derived classification system using OPGs from 211 individuals aged 15-25 years. The assessments were performed by three experienced examiners. One examiner evaluated all radiographs twice. The correlation between age and stage was investigated and the inter- and intra-rater reliability was estimated for all three methods. Correlation between stage and age was similar between classification systems, although higher in the data from males (Spearman's rho ranging from 0.568 to 0.583) than from females (0.440 to 0.446). Inter- and intra-rater reliability measures were similar across methods and invariant on sex, with overlapping confidence intervals, although the highest point estimates for both intra- and inter-rater reliability were for the method by Olze et al. with Krippendorf's alpha values of 0.904 (95% confidence interval 0.854, 0.954) and 0.797 (95% confidence interval 0.744, 0.850). It was concluded that the method of Olze et al. from 2012 is a reliable method for practical application and future studies.

A population-based study to assess two convolutional neural networks for dental age estimation.

BACKGROUND: Dental age (DA) estimation using two convolutional neural networks (CNNs), VGG16 and ResNet101, remains unexplored. In this study, we aimed to investigate the possibility of using artificial intelligence-based methods in an eastern Chinese population. METHODS: A total of 9586 orthopantomograms (OPGs) (4054 boys and 5532 girls) of the Chinese Han population aged from 6 to 20 years were collected. DAs were automatically calculated using the two CNN model strategies. Accuracy, recall, precision, and F1 score of the models were used to evaluate VGG16 and ResNet101 for age estimation. An age threshold was also employed to evaluate the two CNN models. RESULTS: The VGG16 network outperformed the ResNet101 network in terms of prediction performance. However, the model effect of VGG16 was less favorable than that in other age ranges in the 15-17 age group. The VGG16 network model prediction results for the younger age groups were acceptable. In the 6-to 8-year-old group, the accuracy of the VGG16 model can reach up to 93.63%, which was higher than the 88.73% accuracy of the ResNet101 network. The age threshold also implies that VGG16 has a smaller age-difference error. CONCLUSIONS: This study demonstrated that VGG16 performed better when dealing with DA estimation via OPGs than the ResNet101 network on a wholescale. CNNs such as VGG16 hold great promise for future use in clinical practice and forensic sciences.

Reference values of Orthopantomographic indices for early detection of low bone mineral density in Indian population.

Purpose: Orthopantomographic (OPG) indices are considered tools for early screening for low Bone Mineral Density and Osteoporosis. This tool is being used in the western population, and they have developed their reference values for all the OPG indices. The current study aimed to check the validity of the reference values for OPG indices in the Indian population. Material and methods: A cross-sectional study was conducted on 325 participants, and they were recruited in two sets. Dataset one of 130 aged 20-30 years and dataset two of 195 participants aged 40-60 years. OPG was performed, and indices such as Mental Index (MI), Panoramic Mandibular Index (PMI), Gonial Index (GI) and Antegonial Index (AI) were measured. Values obtained in our study were compared with the established OPG indices for the Indian and Western populations. Results: The mean age of participants in dataset one to develop references was 23.5 ± 2.5 years. Females had a significantly lower MI, PMI, and AI than males (p < 0.05). MI was significantly higher in validation dataset one males than females (p < 0.05). A good agreement was found in MI and PMI of the two references (p < 0.05). Conclusions: The reference values derived from this study for MI, PMI, GI and AI are 3.50,0.27,1.10, 2.50, respectively. Compared with previous studies in Indian and western populations, these references were significantly lower.

A Cephalometric Study of Sella Turcica: Correlation of Its Size with Different Skeletal Malocclusions.

Introduction: The present study was done to determine the size of the sella turcica in different skeletal type subjects and to evaluate if any significant difference exists between them, which could be the basis for early diagnosis. Materials and methods: A total of 60 lateral cephalograms of patients above 15 years of age were selected and distributed according to skeletal malocclusion into class I (n = 20), class II (n = 20), and 20 class III (n = 20). Syndromic patients (physically/mentally/both) or patients with major illnesses were not included. Two linear measurements of the sella turcica, that is, length and depth in mid-sagittal plane, were obtained in accordance with Silverman and Kisling method. Unpaired t-test and one-way analysis of variance (ANOVA) were performed. Results: The mean length of sella turcica in class I, class II, and class III subjects was 3.81, 3.37, and 3.9, respectively. Similarly, the mean depth of sella turcica in class I, class II, and class III subjects was 7.6, 6.83, and 9.075, respectively. Conclusion: No significant difference in length of the sella turcica could be found between different skeletal types. Maximum depth of sella turcica was found to be in subjects with class III and minimum with class II skeletal types. Clinical significance: The linear dimensions of sella turcica can be used to approximate the pituitary gland size. The pedodontist should be familiar with different morphologies of the sella turcica to differentiate normal from abnormal appearance so that treatment can be diagnosed and treated early. How to cite this article: Grover N, Khan DUZ, Bhagchandani J, et al. A Cephalometric Study of Sella Turcica: Correlation of Its Size with Different Skeletal Malocclusions. Int J Clin Pediatr Dent 2023;16(S-3):S229-S232.

Reliability Of Orthopantomogram In Comparison To Lateral Cephalogram For Linear Mandibular Measurements.

Background: Mandibular asymmetries are commonly seen as asymmetric traits among orthodontic and orthognathic patients which require bilateral mandibular assessment for diagnosis and treatment. An orthopantomogram can be used to measure and compare right and left sides of mandible. The objective of this study was to investigate the reliability of left and right sides of orthopantomogram for determining the linear mandibular measurements and to check whether these values are identical with the values of linear mandibular measurements determined from lateral cephalogram. Methods: Orthopantomogram and lateral cephalogram were taken from 118 patients of age group 12-35 years from Orthodontic department, Liaquat College of Medicine & Dentistry and Darul Sehat Hospital, Karachi, Pakistan. Linear mandibular measurements were detected and compared between orthopantomograms and lateral cephalograms. Right and the left sides of orthopantomograms were compared for all of the linear mandibular parameters by using paired t-test. Independent sample t-test was performed for the comparison between orthopantomogram and lateral cephalogram using SPSS version 26.0. Results: Statistically significant differences were observed when orthopantomograms were compared with lateral cephalograms for mandibular body length (p=0.000) and total mandibular length (p=0.000). No statistically significant difference was found between orthopantomograms and lateral cephalograms for ramus height (p=0.226, p=0.177). Neither any significant difference was observed between right and left sides of an orthopantomogram. Conclusion: An orthopantomogram can be used to evaluate vertical mandibular measurements as reliably as a lateral cephalogram. However, it is required for clinicians to be vigilant when determining horizontal mandibular measurements from orthopantomograms as they are unpredictable.