Radiographic examination in the diagnosis of a curious case associating odontoma to agenesis and supernumerary teeth / O exame radiográfico no diagnóstico de um caso curioso associando odontoma à agenesia e dente supranumerário

ABSTRACT Developmental disorders of human dentition may result in various abnormalities according to etiologic agents and the developmental period involved. The size, shape and number of teeth may be affected. Dental abnormalities can occur singly or in multiples in an individual and may or may not be associated with syndromes. Complementary radiographic examinations are valuable for diagnosis, especially in lesions that are asymptomatic and detected only through examination. The present study is intended to report a case of an incidental finding in panoramic radiography of an odontoma, a supernumerary tooth and permanent tooth agenesis in the same non-syndromic individual. According to the literature, the association of hypodontia and hyperdontia (called concomitant hypo-hyperdontia) is most common. The association of hyperdontia and odontoma is uncommon but still reported. However, regarding the association of hypodontia and odontoma no reports were found, as well as the association of the three pathologies.

RESUMO Os distúrbios de desenvolvimento da dentição humana podem resultar em diferentes anomalias dependendo do agente etiológico e do período do desenvolvimento acometido. O tamanho, a forma e o número dos dentes, dentre outros, podem ser afetados. Podem ocorrer isoladamente ou em conjunto num mesmo indivíduo, bem como estarem ou não associados a síndromes. Os exames radiográficos complementares são valiosos para o diagnóstico, sobretudo quando as lesões são assintomáticas e detectadas incidentalmente no exame. O presente trabalho relata o caso de achado incidental, em radiografia panorâmica, de odontoma, dente supranumerário e agenesia de dente permanente num mesmo indivíduo não sindrômico. Segundo relatos da literatura, a associação de hipodontia e hiperdontia, denominada hipo-hiperdontia concomitante, é a mais comumente encontrada. A associação de hiperdontia e odontoma é incomum, mas ainda é relatada. No entanto, a respeito da associação de hipodontia e odontoma não foram encontrados relatos, bem como da associação das três patologias.

Association between imaging and clinical findings in mandibular third molar surgeries

Objective: it is important to evaluate the position andestablish the third molar relationship with the mandibularcanal to minimize the risk of nerve injury and assistin planning the extraction of this tooth. The panoramicradiograph is the standard diagnostic tool for this purpose.However, if it indicates a close relationship betweenthe third molar and the mandibular canal, furtherinvestigation using cone beam computed tomography(CBCT) may be recommended to check the three-dimensionalrelationship between the tooth and the mandibularcanal. Thus, this study aimed to correlate the clinicalfindings (observed in third molar surgeries) to imagingfindings (observed in panoramic radiographs andCBCT). Subjects and method: after the extraction of 20mandibular third molars, the panoramic radiograph andthe cone beam computed tomography were analyzed.Then, the surgical findings were correlated to the imagefindings. Results: It was observed that the radiographicfinding type 2 (darkening of roots) observed in the panoramicradiograph presented a greater relation to theabsence of cortical bone between the mandibular canaland the third molar (CBCT finding), with statistical significance(p<0.05). Conclusions: Based on the findingsobtained in this study, it may be concluded that CBCTwould be best used in the surgical planning, when thepanoramic radiograph clearly suggests a risk. Moreover,the panoramic radiograph may continue to be used forthe planning of third molar extractions.

Zoledronic Acid Induces Site-Specific Structural Changes and Decreases Vascular Area in the Alveolar Bone.

PURPOSE: The aim was to assess the effect of a relevant regimen of zoledronic acid (ZA) treatment for the study of bisphosphonate-related osteonecrosis of the jaw on alveolar bone microstructure and vasculature. A sub-objective was to use 3-dimensional imaging to describe site-specific changes induced by ZA in the alveolar bone. MATERIALS AND METHODS: Five Wistar rats received ZA (0.6 mg/kg) and five (controls) received saline solution in the same volume. The compounds were administered intraperitoneally in 5 doses every 28 days. The rats were euthanized 150 days after therapy onset. The mandibles were scanned using high-resolution (14-µm) micro-computed tomography (micro-CT), decalcified, cut into slices for histologic analysis (5 µm), and stained with hematoxylin-eosin. Bone quality parameters were calculated using CT-Analyser software (Bruker, Kontich, Belgium) in 2 different volumes of interest (VOIs): the region between the first molar roots (VOI-1) and the periapical region under the first and second molars' apex (VOI-2). Blood vessel density and bone histomorphometric parameters were calculated only for the region between the roots of the first molar using AxioVision Imaging software (version 4.8; Carl Zeiss, Gottingen, Germany). RESULTS: ZA-treated rats showed a significant increase in percentage of bone volume and density (P < .05), with thicker and more connected trabeculae. Furthermore, the ZA group showed a significant decrease in the size of the marrow spaces and nutritive canals and in blood vessel density (P < .05). In the micro-CT evaluation, VOI-2 showed better outcomes in measuring the effect of ZA on alveolar bone. CONCLUSIONS: ZA treatment induced bone corticalization and decreased alveolar bone vascularization. VOI-2 should be preferred for micro-CT evaluation of the effect of bisphosphonates on alveolar bone. This analysis allowed the effect of ZA on alveolar bone and its vascularization to be characterized. The results of this analysis may add further knowledge to the understanding of the physiopathology of osteonecrosis of the jaw.

CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: Importance to sagittal split osteotomy

Background: Mandibular Sagittal Split Osteotomy (MSSO) is a popular technique in orthognathic surgery used both to advance and to retreat the mandible. However, MSSO may incur in important complications, such as bad splits and sensorineural injuries. Knowing the location of the fusion between the buccal and lingual cortical (FBLC) in the mandibular ramus and the bone thickness in the region where osteotomies will be performed is determinant in MSSO planning to avoid complications. The aim of this study was to document and evaluate possible differences between sexes regarding the location of the FBLC in relation to the superior cortical of mandibular foramen (MF) and bone thickness in the region of interest for MSSO in a Brazilian population. Material and Methods: Eighty five cone-beam Computed Tomography (CBCT) scans were used to perform linear measurements to determine the location of the FBLC. Bone thickness from the mandibular canal (MC) to the cortical external surfaces and the diameter of the MC were measured at three different points: mandibular ramus (A), mandibular angle (B) and mesial of the second molar (C). Results: The FBLC was located at a mean distance of 8.3 mm from the superior cortical of the MF in males and 8.1 mm in females. There was no difference between males and females regarding the mean bone thickness from the MC to the buccal external surface at all the points investigated (p>0.05). Bone thickness from the lingual external surface to the MC was bigger among females than males in regions B and C (p < 0.05). The diameter of the MC was bigger among males in regions B and C. Conclusions: Sexual dimorphism regarding mandibular bone thickness but not regarding the location of FBLC was present. This fundamental knowledge may assist to the panning of MSSO (AU)

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Evaluation of Interforaminal Mandible Region of Individuals With Pierre Robin Sequence and Treacher Collins Syndrome Through the Cone-Beam Computed Tomography.

The Pierre Robin sequence (PRS) and the Treacher Collins syndrome (TCS) are conditions that cause significant abnormalities of jaw. This study was conducted in anticipation of evaluating the morphology of interforaminal region and identify the anatomic variations: anterior loop and mandibular incisive canal, in individuals with PRS and TCS by cone-beam computed tomography and compare them with individuals without craniofacial anomalies. By applying the t-test, the results showed no statistically significant difference, allowing to infer that there are no significant differences in interforaminal mandible morphology between groups and indicated that the prevalence and location of the studied anatomic variations are consistent with those described in literature.

Accuracy of linear measurements using three imaging modalities: two lateral cephalograms and one 3D model from CBCT data.

BACKGROUND: The aim of this study was to evaluate the accuracy of linear measurements on three imaging modalities: lateral cephalograms from a cephalometric machine with a 3 m source-to-mid-sagittal-plane distance (SMD), from a machine with 1.5 m SMD and 3D models from cone-beam computed tomography (CBCT) data. METHODS: Twenty-one dry human skulls were used. Lateral cephalograms were taken, using two cephalometric devices: one with a 3 m SMD and one with a 1.5 m SMD. CBCT scans were taken by 3D Accuitomo® 170, and 3D surface models were created in Maxilim® software. Thirteen linear measurements were completed twice by two observers with a 4 week interval. Direct physical measurements by a digital calliper were defined as the gold standard. Statistical analysis was performed. RESULTS: Nasion-Point A was significantly different from the gold standard in all methods. More statistically significant differences were found on the measurements of the 3 m SMD cephalograms in comparison to the other methods. Intra- and inter-observer agreement based on 3D measurements was slightly better than others. LIMITATIONS: Dry human skulls without soft tissues were used. Therefore, the results have to be interpreted with caution, as they do not fully represent clinical conditions. CONCLUSIONS: 3D measurements resulted in a better observer agreement. The accuracy of the measurements based on CBCT and 1.5 m SMD cephalogram was better than a 3 m SMD cephalogram. These findings demonstrated the linear measurements accuracy and reliability of 3D measurements based on CBCT data when compared to 2D techniques. Future studies should focus on the implementation of 3D cephalometry in clinical practice.

Cisto radicular inflamatório extenso envolvendo seio maxilar / Large radicular cyst involving the maxillary sinus

O cisto radicular é o cisto odontogênico de maior significado clínico para o cirurgião-dentista. Por ser a lesão cística inflamatória mais frequentemente encontrada dos maxilares, é a mais tratada. Ocorre nos ápices de dentes infectados em decorrência à necrose pulpar. Embora o cisto radicular faça parte do cotidiano do clínico, há poucos trabalhos descrevendo as suas características clínicas e tomográficas. Assim, o objetivo deste trabalho é o de apresentar um cisto radicular extenso com envolvimento do seio maxilar e cavidade nasal cujo exame de tomografia computadorizada por feixe cônico foi essencial para o delineamento do plano de tratamento...

The radicular cyst is the odontogenic lesion with major clinical significance for the dental surgeon. Once this is the most common inflammatory cystic lesion, the radicular cyst is the most treated one. It affects the apical portion of infected teeth after the pulp necrosis. Although the radicular cyst is part of the routine of the dental practice, there are only few studies describing its clinical and thomographic features. Thus, the aim of this work is to report an extensive radicular cyst involving the maxillary sinus and nasal cavity which cone bean computerized tomography was essential for the surgical planning...

O efeito do ácido zoledrônico na microestrutura óssea analisado pela micro-CT em mandíbulas de ratos wistar / Zoledronic acid effect on the bone microarchitecture of the jaw of rats by Micro-CT

Os bisfosfonatos são medicamentos amplamente e efetivamente utilizados para o tratamento de doenças osteolíticas. Entretanto, na cavidade oral, é de particular relevância, pois possuem como efeito adverso a osteonecrose dos maxilares induzida pelo uso de bisfosfonatos. Sua etiopatogenia ainda não é bem estabelecida, os métodos de detecção são insatisfatórios e as terapias recomendadas são por vezes, medidas paliativas e ineficazes. Pouco ainda é sabido sobre o efeito do Ácido Zoledrônico na microestrutura óssea, portanto, propusemo-nos a realizar um estudo em modelo animal que analisasse o trabeculado ósseo da mandíbula através da Micro-CT. Foram utilizados 24 ratos machos (Rattus novergicus, albinus, Wistar), com 12 semanas de vida, divididos em 2 grupos: grupo controle (cloreto de sódio 0,9%) e grupo ácido zoledrônico (ácido zoledrônico 0,6mg/kg). As substâncias foram administradas via intraperitoneal a cada 28 dias em um total de 5 doses. Após 150 dias do início do experimento, foi realizada a eutanásia dos animais e então as amostras foram preparadas e escaneadas (Skyscan 1174) para análise da microestrutura óssea através da Micro- CT. O teste t-student demonstrou diferença estatisticamente significativa (p<0,05) em todos os fatores: volume ósseo, densidade óssea, fator de padrão trabecular, índice de modelo estrutural, espessura trabecular, separação trabecular, porosidade total exceção de número de trabéculas e volume tecidual, demonstrando que há alterações significativas na estrutura trabecular pelo uso de bisfosfonatos. O grupo medicado com ácido zoledrônico comparado ao grupo controle demonstrou trabéculas mais espessas, menos separadas e com menores ligações...

Bisphosphonates are widely and effectively drugs used for the treatment of osteolytic disorders. However, in the oral cavity, this situation is of particular relevance as it can lead to bisphosphonate related osteonecrosis of the jaws. Its etiopathogenesis is still not established, detection methods are unsatisfactory and recommended therapies are sometimes palliative and often ineffective. Little is known about the effect of zoledronic acid on the quality of trabecular bone, therefore, we proposed to conduct a study in an animal model to examine the trabecular bone of the jaw through the Micro-CT. 24 male rats were used (Rattus norvegicus, Albinus, Wistar), with 12 weeks old, divided into 2 groups: control group (sodium chloride 0.9%) and group with zoledronic acid (zoledronic acid 0.6 mg / kg). The substances were administered intraperitoneally every 28 days for a total of 5 doses. After 150 days from the beginning of the experiment, the animals were sacrificed and then the samples were prepared and scanned (Skyscan 1174) for analysis of the bone microstructure through Micro-CT. The "t-student" test demonstrated statistically significant differences (p<0.05) in all factors: bone volume, osseous density, trabecular pattern, structure model index, trabecular thickness, trabecular separation, total porosity except trabecular number and tissue volume, demonstrating that there are significant changes in the trabecular structure of the bisphosphonates. Zoledronic Acid compared to control group shows thicker, less separate and lower connected trabeculae...

Unusual bilateral dentigerous cysts in a nonsyndromic patient assessed by cone beam computed tomography.

In the absence of syndromes, bilateral dentigerous cysts (DC) located on the jaws are unusual. In English based language literature review, we only found eight reports of nonsyndromic bilateral dentigerous cyst associated with mandibular third molars. Therefore, we report the unusual occurrence of sizable nonsyndromic bilateral DC associated with mandibular impacted third molars in a 42-year-old Caucasian woman. The lesions were assessed by cone beam computed tomography (CBCT) the right lesion showed approximately 23.64 mm and the left one, 16.57 mm diameter, both located intimately next to the mandibular canal. Bilateral surgical enucleation, related teeth excision of both third molars and plate for fixation placement on the right and bigger lesion, under general anesthesia was the final treatment choice. Clinical, radiographic and histopathological features confirmed diagnose of bilateral dentigerous cyst. Now-a-days, the patient is on 18 months radiograph follow-up with favorable osseous formation with no evidence of recurrence of the cysts.

Surgical management of palatine Torus - case series / Tratamento cirúrgico de Tórus palatino - série de casos

Introduction: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. Objective: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. Case Report: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. Final Consideration: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications. .

Introdução: Torus palatinus é um nome específico usado para identificar exostoses no palato duro ao longo da sutura palatina mediana. Apesar de não ser considerado uma condição patológica, sua presença requer atenção e conhecimento no que diz respeito ao seu tratamento. A remoção cirúrgica de exostoses é indicada quando o paciente traumatiza frequentemente a área do Torus palatinus durante a mastigação e a fala, ou quando for necessária a reabilitação da arcada dentária superior com próteses totais. Objetivo: O objetivo deste trabalho é apresentar três casos de Torus palatinus e discutir os seus respectivos tratamentos. Caso Clínico: O primeiro caso era de um homem leucoderma e com maxila edêntula que procurou reabilitação dentária, porém apresentou um nódulo no palato duro. O segundo caso era de uma mulher, leucoderma e de 40 anos que foi encaminhada devido ao trauma frequente na mucosa do palato durante a mastigação, insatisfação com a estética e desconforto causado pelo trauma na língua. O terceiro caso era de uma mulher de 45 anos de idade, leucoderma com uma lesão no palato e dificuldade pra engolir. Uma vez que o Torus palatinus estava prejudicando as funções fisiológicas básicas dos pacientes, todos os casos foram cirurgicamente tratados, melhorando a qualidade de vida dos mesmos. Consideração final: O dentista deve estar preparado para selecionar a técnica cirúrgica mais indicada para cada caso buscando o melhor resultado e evitando possíveis complicações. .

Accessory mental foramina: prevalence, position and diameter assessed by cone-beam computed tomography and digital panoramic radiographs.

OBJECTIVE: To investigate the presentation of accessory mental foramina (AMF) on cone-beam computed tomography (CBCT) and digital panoramic examinations (PAN). STUDY DESIGN: Imaging examinations (i.e., CBCT and PAN) of 100 patients (200 hemi-mandibles) were assessed. AMF prevalence, diameter, and location related to adjacent teeth and to the mental foramen (MF) were analyzed. RESULTS: On CBCT images, the AMF was observed in 3% of the patients: two unilateral cases and one bilateral case, with mean diameter of 0.93 mm (±0.3); no AMF was identified on PAN. Most AMF were located between the premolars, either superiorly (two cases) or mesially (two cases) to the MF. The mean horizontal distance to the corresponding MF was 2.3 mm (±1.0) and the mean vertical distance was 4.0 mm (±0.7). CONCLUSIONS: The results of this study suggest that CBCT is an effective tool for presurgical tridimensional assessment of the neurovascular structures, such as MF and its variations; On the other hand, PAN examinations were not able to show the AMF cases assessed on CBCT.

Panorâmica versus TCFC para interpretação de ateromas calcificados da carótida / Panoramic versus CBCT exams to suggest carotid artery calcifications

Objetivo: o objetivo deste estudo foi avaliar a prevalência das calcificações na artéria carótida – CACs – em imagens digitais panorâmicas (PD) e de tomografia computadorizada de feixe cônico (TCFC) dos mesmos pacientes. A CAC é uma doença vascular que acomete os pacientes acima dos 50 anos, coincidindo com uma grande maioria de pacientes que procura reabilitação por implantes. Assim sendo, é importante que o implantodontista esteja atento à interpretação da CAC, uma vez que detectada requer encaminhamento do paciente a um cardiologista para confirmação do diagnóstico. Material e métodos: foram avaliadas 100 imagens (200 lados) de panorâmicas digitais (idade média de 48 anos) e a imagem TCFC dos mesmos pacientes. O re-exame das imagens panorâmicas foi realizado com o objetivo de identificar os CACs falso-positivos e falso-negativos em relação à TCFC. Resultados: considerando 200 lados analisadas, 3,5% (n=7/200) foram interpretadas como CACs em radiografias panorâmicas, e 2,5% (n=5/200) em imagens de TCFC. Dos sete casos CACs positivos em radiografias panorâmicas, três foram falso-positivos quando comparados à correspondente TCFC. Quanto aos cinco casos CACs positivos em TCFC, um era falso-negativo, comparado à imagem panorâmica respectiva. Conclusão: calcificações artéria carótida – CACs – podem ser vistas nas imagens panorâmicas e/ou TCFC, no entanto, a panorâmica tendeu a mostrar casos falso-positivos da CAC. A CAC surge como um achado incidental nos exames de panorâmica e de TCFC, mas ainda assim o dentista tem como obrigação encaminhar o paciente para um cardiologista para a confirmação do diagnóstico, uma vez detectada a sua suposta presença.

Avaliação da alça anterior do nervo mentual por meio de tomografia computadorizada de feixe cônico / Evaluation of anterior loop of mental nerve by means of cone beam computed tomography

O forâmen mentual é um importante ponto de referência cirúrgico, sua localização e a possibilidade da existência de uma alça anterior do nervo mentual deve ser levada em consideração no planejamento cirúrgico para evitar traumas ao nervo. Nesse trabalho, avaliamos a presença da alça anterior do nervo mentual em 70 pacientes por meio de tomografia computadorizada de feixe cônico (TCFC). Os resultados revelaram uma prevalência de 32,8% da alça anterior. Nossos resultados e os encontrados na literatura atentam para uma imprevisibilidade das variações anatômicas na região do forâmen mentual. Assim, um planejamento individualizado para cada paciente deveria ser feito para minimizar os riscos de complicações pós-operatórias. A TCFC poderia ser indicada para os pacientes nos quais a anatomia da região do forâmen mentual não possa ser claramente visualizada em outros exames

The mental foramen is a surgical strategically landmark its location and the possibility of an anterior loop of the mental nerve exists mesial to the mental foramen needs to be take in consideration before implant placement to avoid nerve injury. We studied the presence of the anterior loop of mental nerve by means of CBCT in 70 patients. The results revealed a prevalence of 32,8%. Our findings together with the literature reviewed draw attention to the unpredictability of anatomical variations. Therefore, individualized anatomic assessment for each patient should be performed to minimized surgical complications. CBCT can be indicated in the cases where the anatomy of the mental foramen region is not clearly depicted in other exams

Estudo do canal incisivo por meio da tomografia volumétrica / Study of the incisive mandibular canal by means of cone beam computed tomography

Considerada uma área segura, a região anterior da mandíbula, entre os forames mentuais, abriga muitas estruturas vitais e é passível de muitas intervenções cirúrgicas como colocação de implantes osseointegrados e alguns procedimentos da Cirurgia Ortognática. O Canal Incisivo (CI) é um importante reparo anatômico localizado nessa região e é muitas vezes desconsiderado e nesses casos pode acarretar complicações cirúrgicas. O planejamento radiográfico é um dos mais importantes aspectos pré-cirúrgicos para que não haja injúria dessas importantes estruturas, entretanto, as radiografias convencionais usadas atualmente (intraorais e panorâmica) apresentam uma grande limitação no que se trata da interpretação do CI. A Tomografia Computadorizada Volumétrica de Feixe Cônico (TCFC) oferece a obtenção da imagem do canal incisivo em três dimensões permitindo um completo estudo do seu trajeto e morfologia. Objetivo: Estabelecer as taxas de visibilidade, o comprimento, a localização, o diâmetro e o curso do CI por meio da TCFC e Panorâmica Digital. Material e Métodos: O grupo de estudo consistiu em 100 exames de mandíbula de pacientes adultos realizados por meio da TCFC com protocolo de aquisição padronizado e Panorâmica Digital dos mesmos pacientes obtidos dos arquivos de imagem do Departamento de Estomatologia da Faculdade de Odontologia de Bauru. As imagens foram obtidas pelo dispositivo i-CAT Classic e analisadas pelo i-CAT Vision software em sala adequada. As taxas de visibilidade do CI nas reformatações panorâmicas, digitais e coronais, seu comprimento e localização foram analisando bilateralmente a partir dos forames mentuais até a linha média mandibular. Posteriormente foi feita uma comparação da visibilidade do CI com a radiografia panorâmica digital dos mesmos pacientes. Resultados: Na Panorâmica Digital a visualização do CI foi em média de 20,5% enquanto que na reformatação panorâmica da TCFC a visibilidade foi em torno de 45%...

The mandibular interforaminal region is usually considered a safe area. It heldsvital anatomical structures and common surgical interventions such as placement of dental implants and procedures of orthognathic surgery are performed in this area. The Mandibular Incisive Canal (MIC) is a significant anatomical feature located in this region, often overlooked and that can cause surgical complications.The radiographic planning is one of the most important aspects of presurgical assessment to avoid injuries to these important structures, however, conventional radiographs (intraoral and panoramic) used nowadays remains limited when it comes to interpretation of the incisive canal. Cone beam computed tomography (CBCT) offers tridimensional image of the incisive canal allowing a comprehensive study of its course and morphology Objective: To establish the rate of visibility, length, location and course of CI by means of cone beam computed tomography and on digital panoramic. Material and Methods: The study group consisted of 100 CBCT random scans obtained from the Department of Stomatology of Bauru Dental Schools files. The images were taken using i-Cat CBCT device, applying a standardized exposure protocol and analyzed by i-Cat Vision software. The visibility of IC was studied at panoramic, cross-section and coronal scans. Its length and location were also analyzed from mentual foramen to the mandible midline. Subsequently, a comparison was made with the rates of visibility at the digital panoramic radiography from the same patients. Results: The visualization of the incisive canal at digital panoramic averaged 20.5% while the reconstruction of the CBCT panoramic visibility was around 45%. The McNemar test showed statistical difference, indicating the superiority of CBCT over panoramic radiograph for CI visualization. In crossectional reformatation, the average between the sides in the postforament area was...