Soft tissue simulant materials in X-ray-based imaging in dentomaxillofacial radiology: a scoping review.

INTRODUCTION: In in-vitro dental radiographic research, simulation of soft tissue is required to replicate the clinical condition as close as possible. This study aimed to find out which soft tissue simulation material have been studied to use in dentomaxillofacial radiology and showed similarity in radiodensity to the soft tissues of the maxillofacial region. METHODS: In this scoping review, Web of Science, Embase, Scopus, Google scholar and PubMed databases were searched on April 9, 2023, considering the following PICOS: Population: soft tissue simulants, Intervention: X-ray-based imaging, Comparison: -, Outcome: properties of the soft tissue simulants, Study design: in-vitro studies. Screening, study selection, and data extraction were performed by two independent researchers. A third team member was consulted in the case of disagreement. Quality assessment of the included studies was made using Quality Assessment Tool For In-Vitro Studies (QUIN Tool). RESULTS: Of the initial 1172 articles retrieved in the database search, 13 studies were included in the review. Seven studies had a low risk of bias. In 8 studies, computed tomography (CT) or cone beam computed tomography (CBCT), in 4 studies intraoral radiography, and in 2 studies panoramic radiography was used (one study has used CT/CBCT and panoramic radiography). The studies varied in the radiographic modality, acquisition parameters, selected outcomes, and gold standard. In the majority of the studies (n = 10, 77%), acrylic resin derivatives were used in the soft tissue simulant formula alone or as a major component. Wax was used in the simulant material in 8 studies (62%). In addition, in 3 studies (23%) ice/water was used as the main simulant. CONCLUSION: Ballistic gelatin, expanded 2-cm thick polystyrene with or without 1-cm utility wax, and 0.5 cm of acrylic resin were shown to have a radiographic density similar to soft tissue in standardized studies employing CBCT scanning. For intraoral radiographs, using self-polymerizing acrylic resin, utility wax, and wood, as well as a polymethylmethacrylate box filled with water in thicknesses ranging from 4 to 45 mm, provides suitable radiographic contrast. However, for 4 and 8 mm of wax and 4 mm of water, the radiographic contrast is not appropriate. In addition, 13-17 mm wax and 14.5 mm acrylic resin showed acceptable soft tissue densities in intraoral radiography. Further studies using different imaging modalities with standardized conditions and objective metrics are required to confirm the most appropriate soft tissue simulant material for in-vitro dental radiographic research.

Cone-beam computed tomography imaging of dentoalveolar and mandibular fractures.

Three-dimensional imaging methods have an important role in the diagnosis of dentomaxillofacial fractures that can not be seen on the plain films. Cone-beam computed tomography (CBCT) is one of the three-dimensional imaging methods and has facilitated dental professionals' access to cross-sectional imaging. CBCT units allow different technical parameters and the data acquired by CBCT, can be reformatted. Osseous structures are correctly examined with this technique but the technique is not useful for the examination of soft tissues. Therefore, the purpose of its use should be based on the expected diagnostic gain. The aim of this review is to present the use of CBCT with different multi-planar reformatted sections and three-dimensional reconstructions of dentoalveolar and mandibular fractures.

Subpontic osseous hyperplasia: Three case reports and literature review.

Subpontic osseous hyperplasia (SOH) is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture. The aim of this article is to present three patients with SOH with long-term follow-up and to make a current overview of the literature. Presented maxillary SOH is the second case in the dental literature. Intraorally the lesions were bone-hard and painless swellings in the subpontic space. Radiographically, the maxillary case was a nodular bone growth having similar radiodensity and trabeculation to the adjacent bone with a thin radiopaque border. Mandibular cases were bony growths, which were more radiopaque than the adjacent alveolar ridge. Follow-up radiographs revealed regression in two of the cases. Clinicians should take care not to cause the possible etiologies of SOH such as functional stresses and chronic irritation by the prosthetic treatments and be aware of SOH does not usually require treatment or a biopsy.

Multiple calcifying hyperplastic dental follicles: A case report.

This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made.

Incidence of cystic changes in radiographically normal impacted lower third molar follicles.

OBJECTIVE: The objective of this study was to investigate the cystic changes in radiographically normal follicles associated with impacted lower third molars (ILTM). The relation between the cystic changes and both the angular position and the contact of ILTM with the adjacent tooth was also evaluated. STUDY DESIGN: Follicular spaces of patients who were referred to our clinic for removal of ILTM for a variety of reasons were measured from panoramic radiographs by each author independently. Pericoronal tissues of radiographically normal impacted third molars were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with the second molar. RESULTS: There were 30 male and 64 female patients, ages ranging from 14 to 45 years (mean = 21.11). Forty-seven (50%) of the 94 specimens showed cystic changes as the only pathological condition other than inflammation. Most of the cystic changes occurred in the 20-25 year age range. The relation between cystic changes and angular position was statistically significant (chi 2 = 7.46, P < .05). The higher probability of cystic changes was found in the vertically positioned ILTM. The relation between the cystic changes and communication of ILTM with the second molar was not statistically significant (chi 2 = 2.068, P > .05). CONCLUSIONS: Cystic changes may be encountered in the histopathologic examination of asymptomatic third molars, especially in patients older than 20 years. Vertically positioned ILTM especially may be suspected for the higher possibility of cystic changes.

Examiner agreement in the replacement decision of Class I amalgam restorations.

The aim of this study was to investigate interexaminer and intraexaminer agreement in the replacement decision for Class I amalgam restorations. Three examiners evaluated the restorations clinically and with bitewing radiographs. One hundred and twelve restorations were evaluated for secondary caries, body fracture, deficient anatomic form (contour), ditched margins, and marginal overhangs. After one month, the assessments were repeated by the same examiners under the same conditions. Cohen's Kappa analysis was used to analyze the data. The number of replacement decisions varied from 12 to 27 and from 6 to 14 at the first and second evaluations, respectively. The Kappa statistics indicated "moderate" to "substantial" consistency for interexaminer and intraexaminer agreement in the replacement decisions based on clinical and radiographical examinations. Restorations with deficient anatomic form and marginal overhangs presented the most frequent diagnostic difficulties and lead to disagreement among examiners. The most frequently mentioned reasons for replacement were the restorations had ditched margins at both clinical evaluation periods and secondary caries was detected during radiographical evaluations. In the absence of agreement among examiners, clinical and radiographic guidelines are necessary for replacing Class I amalgam restorations.

Prevalence of internet usage and access to health information among dental school outpatients.

The aim of this study was to investigate the prevalence of Internet access and use among dental school outpatients to evaluate the type of information they seek and their views regarding health-related information. A total of 400 consecutive outpatients were surveyed. A questionnaire was used to collect data on demographic characteristics and Internet use. Users were asked about the frequency and location of their Internet access. Access to health-related information and medical and dental topics of interest was recorded. Participants expressed their opinions on the usefulness of the information and the improvements that might be needed. A total of 33.0% of the participants were Internet users. Those in the 15- to 24-year age group were male, unmarried, and at school and were much more likely to use the Internet than their counterparts. Twelve percent of the users were seeking online health information. Dental information was sought by 16.7% (n = 8) of online health seekers. Those in the 25- to 34-year age group were married, employed, and who have a university degree and were much more likely to seek health information on the Internet than their counterparts. Currently, persons seeking online health information in this population in Turkey are a small minority. It is important to respond to the specific health needs of the Internet users to post accurate information.