Traumatic Ulcerative Granuloma with Stromal Eosinophilia on the Tongue.

BACKGROUND: Traumatic Ulcerative Granuloma with Stromal Eosinophilia, commonly known as Eosinophilic Ulcer, is a reactive solitary and self-limiting benign lesion. It manifests as a punched-out ulcer with a distinct surrounding indurated border, often raising concerns about malignancy. METHODS: A 44-year-old male presented with a painless, indurated tongue ulcer evolving over three months. Despite being asymptomatic, the patient underwent an incisional biopsy due to suspicions of oral squamous cell carcinoma. RESULTS: Histological analysis revealed a disrupted epithelial lining, dense necrotic connective tissue, and a fibrino-purulent pseudomembrane. Proximal to the ulcer, a collar-like projection of reactive epithelial tissue hyperplasia was noted, accompanied by mononuclear cells and a predominantly histiocytic infiltrate in the submucosal layer surrounding skeletal muscle fibers. The final diagnosis was Traumatic Ulcerative Granuloma with Stromal Eosinophilia. Remarkably, the lesion spontaneously healed within 2 weeks post-biopsy, with no recurrence over 6 months. CONCLUSION: This case emphasizes considering this benign condition in the differential diagnosis of oral ulcers, highlighting the importance of accurate histopathological evaluation to rule out cancer.

Prevalence of oral manifestations of leprosy: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the prevalence of oral manifestations of leprosy. STUDY DESIGN: This systematic review with meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included cross-sectional studies by 2 independent reviewers in 2 phases, who reported bacilloscopic-confirmed oral manifestations of leprosy. Studies were selected based on predetermined eligibility criteria. Searches in 6 main databases were performed, such as PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS/BVS, and LIVIVO, in addition to the gray literature. The risk of bias was assessed using the JBI Checklist for Analytical Cross-Sectional Studies, and the quantitative synthesis of the data was performed using the Jamovi 2.3 application. RESULTS: Ten studies were included, and the meta-analysis was performed with 917 patients with different types of leprosy. The overall prevalence of oral alterations was 6.0% (95% IC, 0.02-0.11; I2 = 97.01%; Q = 75.56), with plaques (27.2%), infiltrations (18.1%), and macules (15.1%) being the most prevalent fundamental lesions, especially in multibacillary patients. CONCLUSIONS: Even though there is no oral pathognomonic lesion of leprosy, this infectious disease can manifest in oral tissues in different ways, depending mainly on the leprosy type and stage of treatment.

Risk and prevalence of oral cancer in patients with different types of lupus erythematosus: a systematic review and meta-analysis.

OBJECTIVE: The objective of this study was to assess the risk and prevalence of oral cancer in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). STUDY DESIGN: The review included observational cohort and cross-sectional studies that investigated the incidence or prevalence of oral cancer in adults with confirmed diagnoses of SLE or DLE. Studies were selected based on predefined eligibility criteria, including the use of specific diagnostic criteria for SLE and DLE. After searches in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, LILACS, and LIVIVO databases and gray literature for relevant studies, the selection process was conducted by independent reviewers. RESULTS: A total of 5,545 articles were identified. After screening, 8 studies met the inclusion criteria. The pooled risk estimate indicated a significantly increased risk of oral cancer in patients with SLE (risk ratio = 2.69; 95% confidence interval, 1.75 to 4.16; I2 = 0%; P = .78) compared with the general population. The pooled prevalence of oral cancer in patients with DLE was 10% (95% ci, 0.03 to 0.13; I2 = 59%; P = .12). CONCLUSIONS: This review provides evidence supporting an elevated risk for individuals with SLE or DLE developing oral cancer. The findings highlight the importance of monitoring oral mucosa in patients with these conditions.

Accuracy of cone-beam computed tomography in determining gingival thickness: a systematic review and meta-analysis.

OBJECTIVE: To assess the accuracy of cone-beam computed tomography (CBCT) for determining gingival thickness. MATERIAL AND METHODS: Searches were undertaken in PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO, and gray literature (Google Scholar and ProQuest) for studies considered eligible according to the following criteria: cross-sectional observational studies, which compared CBCT accuracy with that of transgingival probing when determining gingival thickness, in adult patients with good periodontal health. No language or time restrictions were applied in this systematic review. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for analytical cross-sectional studies. RESULTS: Six articles were included for qualitative synthesis, involving a pooled sample of 132 patients with a mean age of 29 years (18-51 years). Of these 6 studies, 5 were eligible for quantitative analysis. The meta-analysis showed no statistically significant difference between CBCT and transgingival probing measures of gingival tissue (mean difference of 0.10 (95% CI-0.17-0.38). No significant level of heterogeneity was detected (Tau2-P = 0.0662; I2 = 0%; H2-P = 1.000; Q-P = 1.134). According to the GRADE criterion, confidence in the cumulative evidence was considered low. CONCLUSIONS: CBCT is an accurate method for determining gingival tissue thickness, comparable to the reference standard (transgingival probing). CLINICAL RELEVANCE: CBCT could be considered for gingival thickness measurement when bone thickness is also needed, and thereby aid in the assessment of gingival biotype without the discomfort and anesthesia needed in transgingival probing. TRIAL REGISTRATION: This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42022326970. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022326970 .

Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF). MATERIAL AND METHODS: Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6. RESULTS: A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively). CONCLUSIONS: Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT. CLINICAL RELEVANCE: This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis. Registration This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.

Accuracy of artificial intelligence for tooth extraction decision-making in orthodontics: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to analyze the accuracy of artificial intelligence (AI) for orthodontic tooth extraction decision-making. MATERIALS AND METHODS: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO, Computers & Applied Science, ACM Digital Library, Compendex, and gray literature (OpenGrey, ProQuest, and Google Scholar) were electronically searched. Three independent reviewers selected the studies and extracted and analyzed the data. Risk of bias, methodological quality, and certainty of evidence were assessed by QUADAS-2, checklist for AI research, and GRADE, respectively. RESULTS: The search identified 1810 studies. After 2 phases of selection, six studies were included, showing an unclear risk of bias of patient selection. Two studies showed a high risk of bias in the index test, while two others presented an unclear risk of bias in the diagnostic test. Data were pooled in a random model and yielded an accuracy value of 0.87 (95% CI = 0.75-0.96) for all studies, 0.89 (95% CI = 0.70-1.00) for multilayer perceptron, and 0.88 (95% CI = 0.73-0.98) for back propagation models. Sensitivity, specificity, and area under the curve of the multilayer perceptron model yielded 0.84 (95% CI = 0.58-1.00), 0.89 (95% CI = 0.74-0.98), and 0.92 (95% CI = 0.72-1.00) scores, respectively. Sagittal discrepancy, upper crowding, and protrusion showed the highest ranks weighted in the models. CONCLUSIONS: Orthodontic tooth extraction decision-making using AI presented promising accuracy but should be considered with caution due to the very low certainty of evidence. CLINICAL RELEVANCE: AI models for tooth extraction decision in orthodontics cannot yet be considered a substitute for a final human decision.

Risk of oral cancer in patients with graft-vs-host disease: A systematic review and meta-analysis.

OBJECTIVE: This systematic review was undertaken to determine the risk of oral cancer in patients with chronic graft-vs-host disease (cGvHD). STUDY DESIGN: The search was conducted in 6 electronic databases (PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO) and gray literature (Google Scholar, Open Gray, and ProQuest) for studies published up to November 2021. RESULTS: Of the 13 cohorts included in qualitative synthesis, 9 were eligible for the quantitative analysis. The meta-analysis showed that the presence of cGvHD increased the risk of developing oral cancer (risk ratio [RR] = 2.78; 95% CI, 1.27-6.08; I2 = 46%; P = .01). A subgroup meta-analysis revealed a higher risk of oral cancer in Asian samples exposed to cGvHD (RR = 2.50; 95% CI, 1.54-4.04; I2 = 0%; P = .0002), which was not seen in the pooled analysis of European samples (P = .24). The overall methodological quality of most studies included was "good." The cumulative evidence (Grading of Recommendations Assessment, Development and Evaluation) was considered moderate and of very low confidence for Asian and European studies, respectively. CONCLUSIONS: Patients with cGvHD resulting from allogenic hematopoietic stem cell transplantation run an increased risk of developing oral cancer. Hence, it is recommended that patients with cGvHD be monitored to allow for the early detection and treatment of secondary malignant disease.

Cone beam computed tomography in the detection of reactional osteogenesis of the maxillary sinus: a case report.

This report describes a case of reactional osteogenesis associated with the residual roots of the maxillary left first molar (tooth 14) in a 42-year-old woman. During intraoral examination, an extensive carious lesion was observed in the residual roots of tooth 14. On the periapical radiograph, a radiolucent area with well-defined limits and regular shape was observed in association with these roots. The 3-dimensional cone beam computed tomographic evaluation revealed that the hyperdense mass was homogenous, not corticated, of defined limits, and irregular in shape and had the density of bone tissue. The mass was clearly associated with an inflammatory periapical lesion. In this clinical case, volumetric analysis established a diagnosis of reactional osteogenesis and facilitated removal of the focus of infection associated with its development. Three-dimensional examination of possible changes in the maxillary sinus is crucial when infectious processes are present in the posterior region of the maxilla.

Complications in intraoral versus external approach for surgical treatment of Eagle syndrome: A systematic review and meta-analysis.

OBJECTIVE: The surgical treatment of Eagle syndrome involves an intra- or extraoral approach. This systematic review set out to consolidate current knowledge on the prevalence of complications associated with intraoral and external approaches. METHODS: Seven main electronic and two gray literature databases were searched. Studies were blindly selected by two reviewers based on pre-defined eligibility criteria. Studies evaluating any type of complication in the treatment of Eagle syndrome were considered eligible. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for studies reporting prevalence data, case reports, and case series. The Comprehensive Meta-Analysis software (Software version 3.0 - Biostat, Englewood, NJ, USA) was used to perform all meta-analyses. RESULTS: Out of 1728 articles found on all databases, 36 were included for qualitative analysis. Twenty were included for quantitative analysis and meta-analysis. CONCLUSION: In this study, the highest rate of complications was found in the intraoral approach.

Experiência de estudantes na divulgação da imagem de pacientes odontológicos / Student experience in the images' dissemination of dental patients

As implicações éticas do uso de redes sociais por profissionais da saúde têm ocupado espaço na agenda da Bioética quando se considera os direitos do paciente e o risco de exposição de sua imagem. Este estudo buscou conhecer a percepção de estudantesde Odontologia sobre a exposição da imagem de pacientes em redes sociais. Trata-se de estudo observacional transversal, quantitativo, com aplicação de questionário a estudantes de um curso de Odontologia. Os dados foram tabulados e analisados por meio de estatísticas descritivas. A taxa de resposta foi de 73,5% (n=247), todos utilizando redes sociais e 33,1% (n=82) declararam já ter realizado fotografia de paciente na clínica de ensino. Muitos estudantes ainda não têm clareza sobre as questões éticas que envolvem a divulgação de imagem de pacientes em rede social. Isso revela a importância de se ater a esse tópico nos cursos brasileiros de graduação em Odontologia (AU).

The ethical implications of social networks use by health professionals have occupied space on the Bioethics' agenda, when considering the rights of patients and the risk of exposing their image. This study aimed to understand the perception of dentistry students about the exposure of patients image in social networks. This is a cross-sectional, quantitative, observational study, with the application of a questionnaire to students of a Dentistry course. It was used the descriptive statistics for tabulating and analyzing the data. The response rate was 73.5% (n=247), all using social networks, and 33.1% (n=82) reported having already taken a patient photograph at the training clinic. Many students are still unclear about the ethical issues surrounding the dissemination of patient images on social media. The ethical implications of social networks use by health professionals haveoccupied space on the Bioethics' agenda, when considering the rights of patients and the risk of exposing their image (AU).

Gender differences among dentistry conference speakers in Brazil / Diferenças de gênero entre palestrantes de congressos odontológicos no Brasil

ABSTRACT This study aimed to evaluate possible gender differences among the invited speakers of Brazilian dentistry meetings. The selected meetings (n=15) were held in different states distributed among the five Brazilian regions. The conference programs were manually reviewed, and a database was constructed. Data analysis was performed using descriptive statistics, chi-square and Mann-Whitney tests. A total of 1,195 speakers was identified, 19.7% (n= 235) of which were women. The results of this study provide an overview of the trends of gender disparity in dentistry conferences in Brazil. These findings suggest disseminated gender-discriminatory practices in the promotion of women participation as speakers in such events. This requires more effective approaches to promote gender balance among conference organizing committees and encourage greater visibility and promotion of equity and diversity policies in dental professional societies to ensure more equitable conference programs.

RESUMO Este estudo objetivou avaliar possíveis disparidades de gênero entre palestrantes de congressos de odontologia. Os congressos selecionados (n=15) aconteceram em diferentes estados, distribuídos entre as cinco regiões do País. A programação dos congressos foi avaliada, e um banco de dados foi construído. Os dados foram analisados por estatística descritiva (testes qui-quadrado e Mann-Whitney). Foram identificados 1.195 palestrantes, dos quais 19,7% (n=235) eram mulheres. Os resultados deste estudo fornecem uma visão geral das tendências de disparidade de gênero em conferências odontológicas no Brasil. Sugerem disseminação de prática discriminatória na participação de mulheres como palestrantes nesses eventos. São necessárias abordagens mais eficazes para promover o equilíbrio de gênero entre os comitês organizadores dos congressos, encorajando e promovendo políticas de equidade e diversidade, ampliando a participação e o protagonismo das mulheres nesses eventos.

A three-dimensional finite element analysis of permanent maxillary central incisors in different stages of root development and trauma settings.

BACKGROUND AND OBJECTIVES: Differences in dental maturation may affect the prognosis and clinical management of traumatized teeth. However, evaluation of the outcomes of dental trauma to the tooth and support structures in an in vivo model involves major methodological and ethical implications. Thus, the aim of the present study was to perform a three-dimensional finite element analysis of permanent maxillary central incisors in different stages of root development under different trauma settings. METHODS: The study factors included two trauma conditions (B, buccal; I, incisal) on upper permanent central incisors showing three different stages of root development (CR, complete rhizogenesis; IRA; incomplete rhizogenesis in the apical third of the root; and IRM, incomplete rhizogenesis in the middle third of the root) to yield six models. The complete rhizogenesis model was obtained with a cone-beam computed tomography examination of an extracted tooth. The two incomplete rhizogenesis models were modeled on the basis of similar examinations of patients. Trauma was simulated by applying a 300 N static surface to surface load on the incisal edge or perpendicular to the buccal surface of the tooth. The displacement and equivalent von Mises (σvM) stress values were obtained for alveolar bone, periodontal ligament, apical papilla, and dentin for the quantitative analysis. A σvM color-coded scale was used for qualitative analysis. RESULTS: The force direction had a greater influence on the stress than the root-formation stage. Buccal forces resulted in higher stress concentration in the bone and periodontal ligament, especially in B-CR. Lower stress was found on the periodontal ligament as the root formation progressed (decrease of 8% from B-IRA to B-CR and 11% from B-IRM to B-CR). The incomplete rhizogenesis models showed higher σvM stress peak values in dentin in comparison with complete rhizogenesis (increase of 52% from B-CR to B-IRA and 56% from B-CR to B-IRM). CONCLUSIONS: Buccal forces yielded greater stress values regardless of the stage of rhizogenesis. Teeth with fully formed roots showed a higher stress concentration in the alveolar bone and periodontal ligament in comparison with immature teeth, with the latter presenting high stresses in the tooth crown.

Binary and WHO dysplasia grading systems for the prediction of malignant transformation of oral leukoplakia and erythroplakia: a systematic review and meta-analysis.

OBJECTIVES: The aim of this systematic review was to examine the evidence of the binary histologic grading system capacity for predicting malignant transformation and to compare it with that of the WHO systems. MATERIAL AND METHODS: A systematic review was conducted, using PubMed, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO databases without any language or timeframe restrictions. Studies were included if they compared the binary and the WHO histologic grading systems in the prediction of malignant transformation of oral epithelial dysplasia (OED). RESULTS: The capacity of the WHO and binary grading systems to predict malignant transformation ranged from 16 to 80% and from 5 to 80%, respectively. The pooled malignant transformation rate of lesions classified as severe dysplasia or carcinoma in situ by the WHO grading was 40% (95% confidence interval (CI), 0.02-0.87; I2 = 92%; P = 0.00), while the corresponding value for lesions classified as high-risk by the binary grading system was 31% (95% CI, 0.00-0.84; I2 = 97%; P = 0.00). Overall, there was no significant difference in prognostication accuracy between the WHO and the binary systems (odds ratio = 2.02; 95% CI, 0.88-4.64). CONCLUSIONS: Although some studies suggest that the binary system is associated with lower inter-rater variability when grading OED, the evidence remains inconclusive on whether this system is superior to that of the WHO at predicting malignant transformation. CLINICAL RELEVANCE: The reproducibility of the binary system has the potential to be better for prognostic purposes. However, there is no high-quality evidence to confirm if this advantage may assist clinicians in decision-making.

Dentin thickness as a risk factor for vertical root fracture in endodontically treated teeth: a case-control study.

OBJECTIVES: This study evaluated factors associated with vertical root fracture in endodontically treated teeth, using a cone-beam computed tomography (CBCT) image database. MATERIALS AND METHODS: The sample for this case-control study consisted of 81 CBCT scans of teeth with vertical root fracture (VRF) and 81 CBCT scans of non-fractured teeth, matched by age, sex, and tooth position. The analyzed variables included dentin thickness, an intraradicular post, an adjacent implant, and a missing adjacent tooth. Student's t test test was used to compare the quantitative variables. The chi-square test was used to compare the categorical variables. Logistic regression was performed to evaluate the association between the presence of VRF and the independent factors assessed. RESULTS: The mean dentin thickness of fractured teeth was 1.3 mm, whereas that of non-fractured ones was 1.5 mm (p < 0.001). There was no difference between the fractured and non-fractured groups, regarding implant frequency or missing adjacent tooth (p > 0.05). There were a significantly larger number of teeth with posts in the fractured versus non-fractured group (p = 0.007). However, dentin thickness ≤ 1.3 mm was the only factor associated with VRF in the multiple regression model (OR = 3.60, 95%CI = 1.76-7.37). CONCLUSIONS: Dentin thickness may influence the development of VRF. Dentin thickness ≤ 1.3 mm is associated with a greater likelihood of fracture than ≥ 1.4 mm. CLINICAL RELEVANCE: This study suggests there may be a minimum amount of safe dentin thickness that should be preserved after endodontic instrumentation.

Prevalence of hyposalivation in older people: A systematic review and meta-analysis.

BACKGROUND: The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. OBJECTIVE: To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). METHODS: The review was registered at Prospero - International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. RESULTS: Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90 - 43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08 - 46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. CONCLUSION: This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).

SOX2 and BCL-2 Expressions in Odontogenic Keratocyst and Ameloblastoma

BACKGROUND: The purpose of this experimental study was to compare the immunohistochemical expression of SOX2 and BCL-2 in Odontogenic Keratocyst (OKC) and Ameloblastoma (AB) specimens, and to identify a possible correlation in their expression.MATERIAL AND METHODS: Immunohistochemical analysis was performed to evaluate SOX2 and BCL-2 expression in OKC (n = 20) and AB (n = 20). The immunoexpression was analyzed by a quantitative and qualitative scoring system. The comparison between the immunoexpression of SOX 2 and BCL-2 was assessed by the Mann-Whitney U-test. Spearman's correlation coefficient evaluated the correlation between SOX2 and BCL-2 expressions.RESULTS: SOX2 and BCL-2 expression was observed in all specimens of OKC in the full thickness of the epithelium lining. SOX2 immunostaining was higher in OKC, in comparison with AB samples (P<0.05). BCL-2 immunostaining between OKC and AB was not statistically significant. There was no significant correlation between SOX2 and BCL-2 in OKC and AB specimens.CONCLUSIONS: SOX2 and BCL-2 expressions in OKC may suggest their relationship with the biological behavior of this lesion, and the higher expression of SOX2 might be an upstream influence on the Hh signaling pathway

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CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study.

OBJECTIVE: The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. METHODOLOGY: In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). RESULTS: The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). CONCLUSIONS: The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.

CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study

Abstract The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. Objective To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. Methodology In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). Results The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). Conclusions The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.