Identification of various orthodontic materials as foreign bodies via panoramic radiography, cone beam computed tomography, magnetic resonance imaging, and ultrasonography: an in vitro study.

OBJECTIVES: We evaluated the in vitro detection sensitivity of orthodontic materials (serving as foreign bodies) using panoramic radiography, cone beam computed tomography (CBCT), magnetic resonance imaging (MRI), and ultrasonography. METHODS: Five different orthodontic materials served as foreign bodies: titanium-molybdenum alloy wire (TMA; ORMCO, Orange, CA, USA; 0.017 × 0.025 in in cross-sectional dimensions and 1 cm long); stainless steel bracket tooth #34 (American Orthodontics, Sheboygan, WI, USA); a monocrystalline, sapphire ceramic bracket tooth #34 (Skyortho Dental Supplies Medical, China); a polycrystalline alumina clear bracket, Damon clear bracket tooth #34 (ORMCO); and a 1 × 1 × 0.1 cm polyurethane-based thermoplastic material, Invisalign clear aligner (Align Technology, San Jose, CA, USA). Panoramic radiography, CBCT, MRI, and ultrasonography were used, and four observers scored all findings independently. RESULTS: The TMA and stainless steel bracket were visualised in all fields by panoramic radiography and CBCT. The sapphire and Damon brackets were very clear on CBCT. The Invisalign in air was evident only on CBCT. MRI was unable to identify any material in muscle. Ultrasonography detected the TMA, sapphire bracket, and the Invisalign in muscle but only the TMA on bone. CONCLUSIONS: Panoramic radiography does not reveal nonmetallic orthodontic equipment in air and reveals them only poorly in muscle. CBCT was the optimal imaging modality for all materials in all fields except for the Invisalign in muscle and bone. CBCT was the only method that revealed the Invisalign in air. MRI and ultrasonography should be used to detect orthodontic materials in muscle.

Evaluation of jaw bone density and morphology in bruxers using panoramic radiography.

BACKGROUND/PURPOSE: Bruxism affects the stomatognathic system and causes tissue damage by the excessive jaw movements. The purpose of this study was to evaluate the effects of sleep bruxism on jaw bone density, mineralisation and morphology by comparing bruxers and non-bruxers. MATERIALS AND METHODS: 60 bruxers and 60 non-bruxers (control) patients were included in the analysis. Cortical width at the gonion (GI), at the mental foramen (MI), at the antegonion (AI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) and antegonial notch depth (AND) were measured bilaterally on 120 panoramic radiographs. The measurements were evaluated for repeatability, correlation with age, gender and correlation between the variables. RESULTS: A significant association was observed between cortical shape (MCI) and bruxism status (p = 0.012). The MI was significantly different between the bruxers and non-bruxers (p = 0.006). There was a significant but weak correlation between the MI value and age in bruxers and the control (p = 0.003, p = 0.04). The AI was not associated with bruxism status and did not vary by age or gender (p > 0.05). The AND was higher in bruxers than non-bruxers (p = 0.001). Male bruxers had a significantly higher AND value than female bruxers (p = 0.001). The GI was higher in male bruxers (p = 0.001). CONCLUSION: Defects in the endosteal margin of the cortex and cortical thickening in the mental region were detected in bruxer patients. Furthermore, AND was increased in bruxers. Tiny bone peaks accompanied the cortical thickening seen in the gonial region. Male bruxer patients had higher GI and AND values than female bruxers.

In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth.

OBJECTIVE: The purpose of this in vivo study was to confirm the detection of proximal caries using near-infrared light transillumination (NILTI) (DIAGNOcam) device, and to compare the diagnostic performance of the device with other caries detection methods, including visual examination using the International Caries Detection and Assessment System (ICDAS), bitewing radiography (BW), an LED-based device (Midwest Caries I.D.), and a laser fluorescence device (LFpen). METHODS: A total of 974 proximal surface of permanent posterior teeth from 34 patients (19 females and 15 males between the ages of 22-55) were evaluated in the present study. After clinical examination of each proximal surface by an experienced examiner, they were coded according to the ICDAS criteria and subsequently with BW, the NILTI, LED, and LFpen. The proximal dentin caries of 106 were opened based on the combination of visual, NILTI and radiographic assessment and validated; and were treated with restorative materials. The data were analyzed with descriptive statistics and calculation of the sensitivity, specificity, and area under curve (AUC). RESULTS: The highest sensitivity values were recorded from NILTI readings (99.1%), followed by BW scores (86.8%). The highest specificity values were recorded from ICDAS (100%). The best AUC values were found from the NILTI readings (0.97), followed by BW (0.93) and ICDAS (0.87). CONCLUSION: The NILTI device exhibited the best performance in terms of detecting proximal dentin caries.

The effects of orthodontic materials on the accuracy of periapical radiography-based caries detection.

OBJECTIVES: To investigate the influence of orthodontic materials on the assessment of proximal caries using periapical radiography. METHODS: Forty non-cavitated and restoration-free human premolars and molars ranging from sound teeth to teeth containing various grades of lesions were embedded with approximal contacts into silicon blocks. Periapical radiographs were obtained using combinations of two orthodontic materials (three bracket and two archwires). Images were obtained using a Planmeca ProX™ (Planmeca®, Helsinki, Finland). Two observers assessed the images. Intraobserver and interobserver agreement was computed using an intraclass correlation coefficient. Receiver operating characteristic (ROC) analysis was used to calculate the true positive value, true negative value, and the area under the ROC curve (AUC). RESULTS: Intraobserver agreement ranged from 0.483 to 0.768. Interobserver agreement ranged from 0.383 to 0.718. The AUC, sensitivity and specificity were 0.792, 71.23% and 87.10% in the control group (without bracketing), respectively. The highest area under the curve (AUC) value (0.792) was obtained from the without bracket group. The lowest AUC value (0.659) belonged to the stainless steel bracket and steel wire group. A decrease in the AUC values was observed for the control group (without bracketing) compared to the stainless steel bracket and steel wire group (P = 0.040). CONCLUSIONS: The addition of a stainless steel bracket with stainless steel wire combination makes it difficult to the diagnose the interproximal tooth caries by periapical radiography.

Evaluating the effects of orthodontic materials, field of view, and artifact reduction mode on accuracy of CBCT-based caries detection.

OBJECTIVES: To investigate the influence of orthodontic materials, field of view (FOV), and artifact reduction (AR) on the assessment of approximal caries using cone beam computed tomography. MATERIALS AND METHODS: Forty non-cavitated and restoration-free human premolars and molars ranging from sound to various grades of lesions without cavitations were assigned to 13 groups with different combination of fix appliance equipment. CBCT (cone beam computed tomography) (Planmeca ProMax 3D Mid, Helsinki, Finland) images were obtained using combinations of three orthodontic bracket materials and two orthodontic archwire with small and large FOVs and with and without AR activation. Receiver operating characteristic (ROC) analysis was used to calculate the area under the ROC curve (AUC). RESULTS: Interobserver agreement ranged from 0.44 to 0.92 and intraobserver agreement ranged from 0.50 to 0.99. Teeth lacking orthodontic materials had the highest Az values at 0.84. FOV and AR activation did not significantly affect AUC values (P > 0.05). The AUC data were significantly reduced by the addition of stainless steel wire, NT wire, or a combination of a stainless steel bracket with stainless steel wire (P < 0.05). CONCLUSIONS: The addition of stainless steel wire, NT wire, or a stainless steel bracket with stainless steel wire combination prevented the diagnosis of non-cavitated interproximal tooth caries by CBCT. With and without AR modes and different FOVs did not influence the diagnosis of interproximal caries lesions with different types of orthodontic equipment. CLINICAL RELEVANCE: A wide variety of brackets and wire combinations are used in the clinic; however, the extent to which these combinations impact the diagnosis of caries by CBCT as the effects of FOV and AR algorithms are unknown.

Indications for cone beam computed tomography in children and young patients in a Turkish subpopulation.

BACKGROUND: Cone beam computed tomography (CBCT) imaging is widely used in children; however, it remains controversial because of the health effects of radiation. AIM: This retrospective study investigated the indications for CBCT and dentomaxillofacial pathologies in paediatric patients. MATERIALS AND METHODS: CBCT images of 329 paediatric patients (i.e., aged <18 years) were investigated retrospectively. CBCT images were obtained with five fields of view (FOV). CBCT indications were categorised as surgery and orthodontics. The effects of age, sex, and FOV were evaluated. The level of significance was P = 0.05. RESULTS: The most common orthodontic indications were malocclusion and dentomaxillofacial anomalies (38.5%), followed by the localisation of impacted teeth (33.1%). There was no relationship between sex and indications. There were significant associations between age groups and malocclusion and dentomaxillofacial anomalies, localisation of impacted teeth, and trauma. The face was the most frequently imaged region, followed by the jaws (maxilla and mandible). CONCLUSION: The most common indication for CBCT was malocclusion and dentomaxillofacial anomalies in the primary and permanent dentition age groups, whereas the localisation of impacted teeth was the most common indication in the mixed dentition age group. Generally, CBCT was indicated in orthodontics and surgery.

Cephalometric comparison of cesarean and normal births.

OBJECTIVE: The aim of this study was to compare cephalometric variables of subjects with normal and cesarean births. MATERIALS AND METHODS: Ninety age- and gender-matched patients, who were treated in Gaziantep University, Faculty of Dentistry Orthodontics Department were equally divided into normal and cesarean groups according to the birth methods reported by their mothers. To eliminate the negative effects of being different in terms of age and gender among parameters, control, and patient groups were matched in the present study. Pretreatment cephalometrics radiographs were used. Six measurements representing sagittal and vertical relationships were evaluated from pretreatment cephalograms using Dolphin Imaging Orthodontics Software was used in this issue by an orthodontist. Kolmogorov-Smirnov test, Student's t-test, and Mann-Whitney U-test were used for statistical comparisons. RESULTS: A point-nasion-B point angle (ANB) and Wits values were higher in the normal group, while sella-nasion-A point angle, sella-nasion-B point angle, Frankfort horizontal-mandibular plane angle, and gonion-gnathion-SN plane angle values were higher in the cesarean group. However, the groups showed no significant differences (P > 0.05). ANB angle and Wits values showed high correlation. CONCLUSIONS: Within the study limitations, the results suggest that the birth method may not have a considerable effect on the development of the craniofacial skeletal system.

Relationship between CBCT and panoramic images of the morphology and angulation of the posterior mandibular jaw bone.

PURPOSE: We determined actual bucco-lingual angulation values and morphological variations of residual bone in the mandibular posterior edentulous region using cone-beam computed tomography (CBCT) and panoramic radiography. A second aim was to investigate whether it was possible to predict bone morphology from panoramic radiographs. METHODS: Data were collected from 77 consecutive patients referred for both CBCT and panoramic radiography in our department. Two-dimensional and three-dimensional images of the probable implant placement region were investigated. The bucco-lingual angulation values and crest type were determined directly from the cross-sectional images of the posterior edentulous region. The edentulous region was divided into three groups: second premolar, first molar, or second molar region. The observations were evaluated by the computer software, SPSS 22.0 (SPSS Inc. Chicago, USA). The crest type was classified into three groups: type U, type C, or type P. Kappa statistics, Kolmogorov-Smirnov tests, ANOVA, and Kruskal-Wallis tests were used in statistical analyses. The significance level was set at p < 0.05. RESULTS: Type C was more frequent in the second premolar region and the crest type had changed to type U in the second molar region. The predictability of the type U was highest in the second molar region. Moderate agreement was found in the predictability of type U in the molars (κ = 0.602). The mean value of bucco-lingual angulation was highest in the second molar region, followed by the first molar region. There were statistically significant differences between the bucco-lingual angulation of the crest types in the second premolar and first molar regions (p < 0.05). CONCLUSIONS: Bucco-lingual angulation values and morphology change through the posterior mandible. Type U was predicted at a higher rate in the second molar region from panoramic radiographs. These results demonstrate predicting high-risk areas in the posterior mandible for implant therapy from panoramic radiography.