Have conventional dental radiographs lost its charm to modern techniques?

For any dental implant procedure that is being carried out, the success will depend on a thorough pre-operative investigation. The quality, quantity and the volume of available bone at the planned implant site has to be assessed properly when planning a dental implant placement. When we speak of the fore-mentioned aspects pre-surgical imaging and its co-relation to clinical findings help assess the relation to the amount of bone available from underlying vital parts namely the sinus cavities, nasal floor, nerves, teeth and vessels. Different radiographic modalities have been advocated for its assessment. Intra Oral Peri-apical radiograph (two-dimensional) is one such modality that has lost its importance after the introduction of more advanced techniques like Cone Beam Tomography (three-dimensional). This article will help us understand how two-dimensional and three-dimensional imaging modalities go hand in hand while treating dental patients. It will also explain why the conventional imaging technologies are still required in this era of modern methods of imaging.

Prevalence and Configuration of C-shaped Canals in Lower Molars from a Chilean Subpopulation

Objective: To determine the prevalence of C-shaped canals in lower molars (first and second molars) in a Chilean subpopulation, and to identify root configuration and demographic characteristics using cone beam tomography. Materials and method: 912 molars (456 first and 456 second molars) resulting from the analysis of 228 mandibular CBCT scans (89 men and 139 women between 15 and 80 years old) were evaluated. Through panoramic reconstruction and axial tomographic sections, the root configuration was established, and the presence and type of C-shaped canal were classified, analyzing 5 levels along the root canal. Data were statistically analyzed with a 5% significance level. Results: Of the 912 molars analyzed, 69 were classified as C-shaped (7.57%), constituting 65.72% of those molars that presented fused roots. 100% of this configuration of canals was observed in lower second molars, presenting a higher prevalence in women (n = 49, 71.01%). 40.82% of the cases that presented a C-shaped configuration manifested bilaterally. The most frequent C-shaped canal configuration was C3 (n = 347, 66.10%), according to Melton's classification. Conclusion: The C-shaped canals in the studied population were observed entirely in lower second molars, showing a clear predilection for the female sex and a high rate of bilaterality. Keywords Anatomy; Cone beam computed tomography; Dental pulp cavity; Endodontics.

Comparative Analysis of Capabilities of Different Types of Cone-Beam Tomography in an Experimental Study of Root Canals of Teeth Filled with High-Density Materials (part 2)

During the course of this experimental study tomograms of extracted teeth were analyzed before and after filling the root canals with an endodontic material and fragments of broken metal instruments for root canal treatment. During the first stage of the experiment, untreated extracted teeth were scanned using conebeam computed tomography and microfocus cone-beam computed tomography. A comparative assessment of capabilities of the two methods of cone-beam computed tomography based on examination of untreated root canals was carried out. The second part of the study is dedicated to visualization of root canals that contain foreign high-density materials.

An updated review of idiopathic osteosclerosis of the jaws

Objective: The aim of this study was to update the concepts of the diagnosis of idiopathic osteosclerosis (IO) of the jaws by digital panoramic radiographs and cone beam tomography and describe the impact of this disease on oral and general health. Methods: A search of the main databases of dental medical research was carried out using the search terms “osteosclerosis, panoramic radiography, cone beam computed tomography, jaws”. Articles without language restriction until September 30, 2020 were identified. The prevalence and clinical and radiographic characteristics of IO of the jaws were examined in 2D and 3D imaging studies, as well as the interaction during treatments in the various dental specialties. Results: We analyzed the current situation regarding the diagnosis of IO, with an update of the diagnostic criteria used to accurately identify IO in the latest generation imaging studies, as well determine its possible interactions in oral an general health. Conclusions: It is important to have a clear differential diagnosis of IO and be able to distinguish different radiopacities in the maxilla. Accurate reporting and monitoring of the morphometric characteristics are necessary taking into account the impact the presence of IO of the jaws has on future dental treatments.

Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature

Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.

Imaging technologies for the detection of sinus pathologies of odontogenic origin. A review

Sinus pathologies of odontogenic origin (SPO) are common in the clinical consultation; however, the dentist has some complications to detect them because their discovery is usually incidental and through imaging studies that, in most cases, are of low quality. The objective of this review is to describe the pertinent imaging resources that allow the detection of the most frequent SPO and, at the same time, carry out an updated review of the scientific literature in order to recognize the imaging of both the maxillary sinus and the dental organs. The scientific literature focused on this topic, published between 2014 and 2020, was consulted. The review showed two important results: the first is that Cone Beam Tomography (CBCT) represents the imaging modality with the best performance for the detection of SPO by what can be considered the gold standard for this purpose. The second is that the most frequent SPO is sinus mucositis, which is related to odontogenic conditions such as periapical lesions and periodontal affectations. Although Cone Beam Computed Tomography (CBCT) is the most appropriate tool to detect SPO compared to images obtained by 2D devices, there are also other alternatives such as magnetic resonance imaging and ultrasonography, which seem to have a promising future.

Cone beam tomography and panoramic radiography in localization of impacted maxillary canine and detection of root resorption

ntroduction The aim of this study was to evaluate cases of impacted maxillary canines (IMC) using cone beam tomography (CBCT) and panoramic images in an attempt to assess if panoramic radiographs can provide information compatible with CBCT results regarding canine position and root resorption. Methodology Fifty-six impacted maxillary canines from 48 patients were radiographically evaluated. The positions of the canine teeth were classified by Sector localization on panoramic radiographs and the same teeth were also analyzed by KPG on CBCT. Root resorptions in maxillary lateral incisors were also evaluated on CBCT. The relationships between panoramic and CBCT findings were compared by Chi-square test and Fischer’s exact test. Results Statistically significant correlations were found between panoramic Sectors and KPG indexes (p<0.001). KPG index values of 1, 3 and 4 corresponded to the panoramic Sectors 1, 4 and 5, respectively; but KPG index 2 matched the panoramic Sectors 3 and more often 2. Mid-alveolar impaction generally coincided with score 1 for both KPG index and panoramic Sector. In palatally IMC, this score value was generally 2 or 3 for the KPG index and 4 for the panoramic Sector (p≤0.001). Root resorptions in maxillary lateral incisors showed significant differences according to Sector localization and KPG index (p<0.05), namely they coincided with 2 and 3 in Sector evaluation and 2, 3 and 4 in KPG index. Conclusions Sector location on OPG is found to be related to KPG index on CBCT, and it can help evaluate mainly certain positions of impacted canines; thus, unnecessary CBCT scans are not requested.

THE POSSIBILITIES OF CONE-BEAM COMPUTER TOMOGRAPHY IN THE DIAGNOSTIC OF FRACTURES OF THE MANDIBLE WITHIN THE DENTAL ROW

The aim: To establish the possibilities and advantages of cone-beam tomography in the primary diagnostic of mandibular fractures within the dental row compared with traditional methods of radiation diagnosis. Materials and methods: The research was performed involving of 28 patients who had traumatic injuries of the maxillofacial area. The age of the victims was 18-56 years. The injured people were selected who were examinated by traditional radiological methods of diagnosis in the first hours after injury, and for final diagnostic in hospital were used cone-beam tomography of the mandible. The comparison of the results obtained with the help of traditional X-ray examinations with the data of cone-beam tomography allowed to conduct a comparative analysis of the diagnostic capabilities of these methods and to determine the advantage of the last one. Results: A comparative analysis of the results of the examination of injured people, which were obtained by using of traditional methods and cone-beam tomography of the mandible, shows the diagnostic advantages of the last one, which allows to determine the extent of traumatic injuries of the mandible and identify hidden fractures that were not determined by traditional X-ray methods. Conclusions: For the primary diagnostics of traumatic mandibular injuries, traditional X-ray examinations may be informative, but for complex, combined injuries, as well as fractures that raise doubts,it is advisable to use cone-beam computed tomography. The use of cone-beam computed tomography in mandibular fractures makes it possible to better assess the degree of damage and determine the displacement of fragments.