Is it safe and effective to extract impacted maxillary tooth adjacent to maxillary sinus via submaxillary sinus membrane space approach?-a randomized controlled trial

OBJECTIVE

To evaluate the clinical outcomes following extraction of impacted maxillary tooth adjacent to maxillary via submaxillary sinus membrane space approach.

MATERIALS AND METHODS

Seventy-two patients were enrolled in our study. The positions of the maxillary impacted tooth were confirmed by cone-beam computed tomography (CBCT). Cases were randomly divided into two groups: the "submaxillary sinus membrane space approach" was applied in the new method (NM) group, and the conventional "avoid maxillary sinus membrane exposure" strategy was executed in the traditional method (TM) group. The clinical and follow-up data were recorded.

RESULTS

The duration of the procedure in the TM group was significantly longer than those in the NM group (P < 0.05). Four teeth were accidentally displaced into the maxillary sinus with MSM perforation. The MSM perforation rate was slightly higher in the TM group than in the NM group, however, without significant difference between the two groups (8/36 vs. 3/36, P = 0.19). The maxillary sinus membrane perforation was associated with the displacement of tooth into the maxillary sinus (OR = 16.2, P = 0.026). The root tip exposure of the adjacent tooth was significantly higher in the TM group than in the NM group (10/36 vs. 1/36, P = 0.006). The incidence of reduced pulp vitality of the adjacent tooth was significantly higher in the TM group (10/36 vs. 1/36, P = 0.006), and it was associated with the exposure of the root tip intraoperatively (OR = 456.5, P < 0.001). The incidence of external root resorption was significantly lower in the NM group, and there was no significant association with the root exposure intraoperatively (OR = 3.7, P = 0.47).

CONCLUSIONS

Submaxillary sinus membrane space approach is a safe and efficient approach in extraction of impacted maxillary tooth. It is an alternative way for cases which are in close proximity to the maxillary sinus.

CLINICAL RELEVANCE

A novel method to extract impacted maxillary tooth adjacent to maxillary sinus.

Anterior tooth autotransplantation: a case series

Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. It is relatively common for the anterior segment of the mouth to be affected by traumatic tooth injuries, impacted and/or congenitally missing permanent teeth. Autotransplantation of teeth into the anterior dental arch can provide unrivalled biological solutions when such issues arise in this critical aesthetic zone, particularly for adolescent patients. The combination of meticulous pre-surgical assessment, synergistic interdisciplinary collaboration and carefully performed anterior tooth autotransplantation has been demonstrated to achieve impressive outcomes, with respect to both transplant survival and clinical success. © 2023 Australian Dental Association.

The efficacy of supervised learning and semi-supervised learning in diagnosis of impacted third molar on panoramic radiographs through artificial intelligence model

OBJECTIVES

The aim of the study was to evaluate the efficacy of traditional supervised learning (SL) and semi-supervised learning (SSL) in the classification of mandibular third molars (Mn3s) on panoramic images. The simplicity of preprocessing step and the outcome of the performance of SL and SSL were analyzed.

METHODS

Total 1625 Mn3s cropped images from 1000 panoramic images were labeled for classifications of the depth of impaction (D class), spatial relation with adjacent second molar (S class), and relationship with inferior alveolar nerve canal (N class). For the SL model, WideResNet (WRN) was applicated and for the SSL model, LaplaceNet (LN) was utilized.

RESULTS

In the WRN model, 300 labeled images for D and S classes, and 360 labeled images for N class were used for training and validation. In the LN model, only 40 labeled images for D, S, and N classes were used for learning. The F1 score were 0.87, 0.87, and 0.83 in WRN model, 0.84, 0.94, and 0.80 for D class, S class, and N class in the LN model, respectively.

CONCLUSIONS

These results confirmed that the LN model applied as SSL, even utilizing a small number of labeled images, demonstrated the satisfactory of the prediction accuracy similar to that of the WRN model as SL.

Large erupted complex odontoma mimicking maxillary osteomyelitis

Odontoma is the most common benign odontogenic hamartoma. Odontomas are of two types, such as viz compound and complex odontoma. The complex type is a conglomeration of hard tissues of dental origin. They are primarily intraosseous and usually present in the second decade of life. Most odontomas are asymptomatic, but those erupting in the oral cavity may cause severe infection. They are often associated with impacted teeth and are present with the anterior maxilla showing the highest propensity.The present case report is of a male patient in his early 60s with a substantial solitary sclerotic odontoma of the middle and posterior segments of the maxilla erupted into the oral cavity communicating with the right maxillary sinus. The delayed presentation, size, location and active suppuration can misguide clinicians.

Unusual presentation of non-inflamed glandular odontogenic cyst presenting with cholesterol clefts

Glandular odontogenic cysts (GOCs) are relatively rare among odontogenic cysts but are widely discussed owing to their multifaceted nature. We present a case of a women in her late 30s with a large radiolucency of right posterior ramus area and an associated impacted third molar. Histopathology confirmed GOC; although it presented with unusual presence of cholesterol clefts in absence of inflammation. This report emphasises the novelty and significance of the aforementioned finding.

Maxillary unicystic ameloblastoma: a rare presentation

Unicystic ameloblastoma (UAM), a rare variant of ameloblastoma, is an odontogenic epithelial neoplasm typically appearing in the mandible. We report an extremely rare case of maxillary UAM with an impacted canine and supernumerary tooth. The patient was a woman in her late 30s who presented with a slight expansion of the left anterior maxilla due to a cystic lesion with impacted teeth. Under a clinical diagnosis of dentigerous cyst, the cystic lesion was completely enucleated by extracting the impacted teeth. Based on the clinical features and pathological findings, the final diagnosis was intraluminal UAM in the anterior maxilla. In the present case, despite the rarity of UAM with impacted teeth in the anterior maxilla, it should be considered during differential diagnosis. Careful clinical examination is required for diagnostic accuracy since the clinical findings of tooth-containing ameloblastoma and dentigerous cyst are very similar.

The usefulness of cone beam computed tomography according to age in cleft lip and palate

The current study aimed to evaluate the usefulness of cone beam computed tomography (CBCT) examination in cleft children and adolescents, the age of the first CBCT exposure, and the criteria that justified the first CBCT exposure. A number of 229 non-syndromic cleft subjects aged between 0–22 years receiving treatment in the same specialized surgical center in orofacial cleft treatment were studied. A cleft group of 64 cleft lip and palate (CLP) children with at least one CBCT exposure was identified based on CBCT records. Parameters related to diagnosis and treatment planning in cleft deformity were considered dental anomalies and bone morphology changes. The examiners assessed whether the treatment option was necessary, not necessary, or could not be evaluated at the age of CBCT exposure. A number of thirty-nine unilateral clefts and fifteen bilateral clefts were identified. Posterior palatal cleft was present in six children (mean age: 15.03±5.55 years; male/female ratio: 1/0.8). Alveolar bone morphology changes were found in 90.58% of cases; jaw relationship changes in 71.82%; nasal fossa morphology changes in 74.99%; airway obstruction in 49.98% and maxillary asymmetry in 87.48%. Orthodontic planning was necessary for 85.93% of CLP patients, and orthognathic surgery in 39.05%. The usefulness of CBCT in patients with CLP varied with age, with reduced value for the evaluation of impaction and root resorption under the age of ten.

[Early orthodontic treatment of malocclusion in the mixed dentition]

Children in the mixed dentition grow rapidly, and various types of malocclusion often appear in this period. At the same time, there are many environmental factors affecting the development of the occlusion at this stage. Functional abnormalities related to lip, tongue, articulation and breathing, and impacted teeth should be actively intervened and blocked to avoid the continued development of the deformity. Appropriate orthopedic devices should be used in patients with skeletal malocclusion, if necessary, for growth modification and the influence of congenital factors and the prognosis of treatment should be fully evaluated. Over-intervention of the temporary malocclusions in the mixed dentition should be avoided. In conclusion, early orthodontic treatment in the mixed dentition requires a comprehensive assessment of the treatment need, risks, timing, cost and the ultimate benefit of the patient. The timing of orthodontic treatment is not the sooner the better. The indications must be strictly controlled, and the necessity and limitations must be carefully considered.

Potential role of active decompression and distraction sugosteogenesis for the management of ameloblastomas: Report of two cases and review of the literature

Ameloblastomas are aggressive odontogenic entities well-known for their high tendency to recur. Clinical presentation includes lesions discovered on routine examination or radiographs, pathologies causing facial swelling, pain, cortical expansion, tooth mobility, root resorption, and paresthesia. Radiographic findings comprise large unilocular or multilocular radiolucencies with well-defined borders associated to an impacted tooth. Ameloblastomas are classified as unicystic, multicystic/solid, and peripheral. Treatment options include marsupialization, decompression, enucleation, or curettage with or without adjuvant measures such as Carnoy's solution, marginal resection, and segmental resection. Recently, active decompression with distraction sugosteogenesis (ADDS) was introduced for the conservative management of odontogenic cystic conditions. The purpose of this paper is to present 2 cases of a conventional ameloblastoma treated by means of ADDS. The purpose of this novel approach is to significantly reduce the amount of time required to decompress cystic-like lesions. In these cases, ADDS proved to be a viable treatment because it demonstrated a reduction in size of the initial lesion by new osseous formation within 2 weeks of placement of the device. The cases presented in this paper demonstrate that ADDS could be a valuable treatment modality for this type of ameloblastoma, although further research is necessary to validate this philosophy.

Orthodontic traction of an impacted maxillary third molar through a miniscrew-anchored cantilever spring to substitute the adjacent second molar with severe root resorption

BACKGROUND

An orthodontic traction technique with a miniscrew-anchored cantilever spring was used for the traction of a deeply impacted maxillary third molar to substitute its adjacent second molar with severe root resorption.

CASE DESCRIPTION

A 30-year-old woman sought multidisciplinary treatment planning for a second molar with severe root resorption caused by a deeply impacted third molar. Panoramic radiographs and cone-beam computed tomographic images showed that the third molar was located on the apical and palatal side of the second molar and that the second molar had severe root resorption. The second molar was removed, and the impacted third molar was orthodontically tractioned occlusally with the aid of a miniscrew-anchored cantilever spring. After 12 months of orthodontic treatment, the maxillary left third molar was successfully tractioned occlusally and well aligned with adjacent teeth for the substitution of the second molar. The patient was satisfied with the treatment outcome.

PRACTICAL IMPLICATIONS

A palatal miniscrew-anchored cantilever spring is an effective and viable technique for the orthodontic traction of deeply impacted third molars to substitute second molars with severe root resorption.

Autotransplantation: a lost art worthy of revival in the era of implants

While synthetic implants represent a significant contribution to the advancement of dental medicine, they are associated with high costs, potential complications, and time delays. With autotransplantation, the patient is both donor and recipient of a living tooth; in the ideal case, this procedure transfers a healthy, nonfunctional tooth to a functional position. The aim of this article is to review the literature surrounding autotransplantation and present a successful case with the hope of increasing awareness of this approach to tooth replacement. A 20-year-old patient presented with a maxillary right second molar showing poor prognosis for restoration, and the patient's financial difficulties rendered extraction the only treatment option. The patient's fully soft tissue-impacted maxillary right third molar was atraumatically extracted and transplanted as a replacement for the second molar. The autotransplantation technique was enhanced via use of bone allograft to adapt the distal portion of the socket to the transplant, immediately reestablishing a healthy bony anatomy. In addition to reviewing the biologic basis, high success rate, and advantages of tooth autotransplantation, this article introduces a naming convention for transplanted teeth.

RUNX2 Nonsense Mutation Associated with Cleidocranial Dysplasia with Unusual Dental Features

Purpose: The purpose of this case report is to describe a RUNX2 nonsense mutation associated with cleidocranial dysplasia (CCD) with unusual dental features. The patient was a 12-year-old Brazilian girl who sought dental care due to over-retention of primary teeth and absence of erupted permanent teeth. Clinical and radiographic examinations revealed multiple impacted permanent teeth, a prominent cingulum of the permanent impacted maxillary incisors and enamel defects (hypoplasia and hypomineralization) in addition to skeletal abnormalities. No supernumerary teeth were present. The diagnostic hypothesis of CCD was raised and the patient was refer- red to the genetic medical service, where the diagnosis was cofirmed. After RUNX2 genetic screening, including polymerase chain reaction and sequencing of both DNA strands, a heterozygous nonsense mutation was identified in exon 2 (c.193 C>T [Q65X]). This article reports unusual dental features in a patient with CCD.

Compression of the Inferior Alveolar Canal by Mandibular Third Molar among Images Taken from Patients Visiting Dental Imaging Centres of Kathmandu: A Descriptive Cross-sectional Study

INTRODUCTION

Third molars are common teeth to be impacted. The position of mandibular third molar is such that it is in close contact with inferior alveolar canal which may lead to nerve damage during its removal. So, this study was conducted to find out the prevalence of compression of inferior alveolar canal by mandibular third molars.

METHODS

This descriptive cross-sectional study was conducted on images collected from Dental Imaging Centers of Nepal from 25th June 2020 to 15th February 2021 after obtaining ethical clearance from Nepal Health Research Council (Reference number: 2100). A convenience sampling method was used to collect 433 cone-beam computed tomography images showing the relation between the third molars and inferior alveolar canal. Data were analyzed using the Statistical Package for the Social Sciences version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for the binary data.

RESULTS

Out of 433 images, 135 (31.17%) (26.80-35.53 at 95% Confidence Interval) images showed compression of inferior alveolar nerve by mandibular third molar. The study result indicated that 16 (11.85%) buccally placed, 50 (37.03%) lingually placed and 69 (51.11%) inferiorly placed inferior alveolar canal were compressed by apices of mandibular third molars.

CONCLUSIONS

The prevalence of compression of inferior alveolar canal by mandibular third molar was found to be similar to other studies done in similar settings. Compression of the canal was more evident when inferior alveolar canal is situated lingually.

Alveolar bone changes after molar protraction in young adults with missing mandibular second premolars or first molars

OBJECTIVES

To assess the changes in alveolar bone of the mandibular second molars following molar protraction and investigate the factors associated with the alveolar bone changes.

MATERIALS AND METHODS

Cone-beam computed tomography of 29 patients (mean age 22.0 ± 4.2 years) who had missing mandibular premolars or first molars and underwent molar protraction were reviewed. Alveolar bone level was measured as the distance from the cementoenamel junction at six points, buccal, lingual, mesiobuccal (MB), mesiolingual (ML), distobuccal (DB), and distolingual (DL), of the second molars at pretreatment (T0) and after molar protraction (T1). Factors associated with alveolar bone changes at the distal and mesial of the second molars were assessed.

RESULTS

Mean alveolar bone changes ranged from -1.2 mm (bone apposition) to 0.8 mm (bone resorption). The presence of a third molar impaction at T0 (P < .001), third molar angulation at T0 (P < .001), and Nolla's stage of third molar at T0 (P = .005) were significantly associated with alveolar bone level changes distal to the second molars. Treatment duration (P = .028) was significantly associated with alveolar bone level changes mesial to the second molar.

CONCLUSIONS

Patients with impacted third molars, third molars at an earlier stage of development, and mesially angulated third molars at pretreatment may have less alveolar bone resorption distal to the second molars following protraction. Patients with increased treatment time may have reduced alveolar bone resorption mesial to the second molars.

Navigation in bone-impacted premaxillary supernumerary tooth removal: a preliminary clinical trial

AIM

The present clinical trial aimed to preliminarily assess whether navigation could help to position impacted supernumerary teeth (STs) and reduce surgical trauma.

MATERIALS AND METHODS

Subjects with an impacted supernumerary tooth (ST) in the premaxillary area were enrolled in the study and randomly distributed into a navigation group and a control group. In the navigation group, STs were positioned and extracted under real-time optic navigation. In the control group, STs were extracted depending on the surgeon's experience. Subjects were followed up for 12 to 24 weeks postsurgery. Operating time, futile bony trauma, and the positioning precision of the STs were the major outcomes assessed. Multivariate correlation analysis was performed.

RESULTS

In 24 subjects, 32 STs were removed and no severe complications occurred in either group. The proportion of ST exposure at the planned access point was 100% in the navigation group and 68.75% in the control group (χ² = 5.926, P = 0.015). Futile length, futile width, and the distance between the point where the ST was initially exposed and the bony point planned for accessing it were related to both navigation/control grouping and bone thickness in the access side. For challenging STs with bone thickness of > 0.5 mm in the access side (N = 22), the futile length in the navigation group (0.0 [0.0, 4.0] mm) was significantly smaller than that in the control group (3.0 [0.0, 8.0] mm, P = 0.028). Similarly, the futile width in the navigation group (0.0 [0.0, 2.0] mm) was significantly smaller than that in the control group (2.0 [0.0, 4.0] mm, P = 0.018).

CONCLUSIONS

Navigation helped to position impacted STs precisely and reduced surgical bony trauma to some extent, especially in challenging cases in which the bone in the access side was thicker than 0.5 mm.

Early replacement of ankylosed first molar via mesial root movement facilitates bone formation and normal eruption of the third molar

Ankylosis of a molar during active growth leads to a significant vertical bone defect, extrusion of the opposing molar, and inclination of adjacent teeth. Treatment timing is an essential factor for the patient's quality of life. Early extraction of the ankylosed molar and protraction of the second molar is challenging because of the difficulty of tooth movement and the uncertainty of the normal eruption of the third molar. In view of the uncertainty of eruption of the mandibular third molar, it is essential to assess the potential for eruption according to the developmental stage of the third molar and to secure sufficient space for eruption. In this case report, a girl with an ankylosed right mandibular first molar and an advanced vertical bone defect was treated via early extraction of the ankylosed molar along with the intrusion of the maxillary molar and mesial root movement of the second molar before the initiation of third molar root formation. Restoration of the vertical bone defect was noted at the end of treatment. In addition, spontaneous eruption of the third molar was observed, which was in contrast to the mesioangular impaction of the contralateral third molar. This case emphasizes the importance of treatment timing to increase the chance of utilization of the third molar.

Dentigerous cyst in a young child: a case report

Dentigerous cysts are one of the most common developmental types of odontogenic cysts occurring in the oral cavity and often manifest as incidental findings on dental radiographs and/or as asymptomatic swellings. These cysts develop from remnants of reduced enamel epithelium around the crown of an unerupted or impacted tooth, attached at the level of the cementoenamel junction. Most are considered developmental. However, in young clients they may be inflammatory in origin, the result of caries in the primary dentition. This short communication highlights a case of an asymptomatic dentigerous cyst identified in a 4-year-old child and subsequent enucleation under general anesthesia. A thorough clinical and radiographic assessment of the oral cavity in pediatric clients merits a review of dentigerous cysts by the dental hygienist.

Do anatomical variations of the mandibular canal pose an increased risk of inferior alveolar nerve injury after third molar removal?

OBJECTIVES

The present study aimed to assess whether anatomical variations of the mandibular canal are associated with neurosensory disturbances of the inferior alveolar nerve (IAN) following mandibular third molar removal.

METHODS

Two observers compared the detection of third molar root-nerve relations and bifurcations of the mandibular canal on panoramic radiographs and CBCT images of 201 patients undergoing removal of 357 mandibular third molars. Potential neurosensory disturbances of the IAN were surveyed ten days after surgery. Fisher's Exact was performed to correlate presence of canal variations to postoperative neurosensory disturbances. Positive and negative predictive values (PPV, NPV) and likelihood ratios (LR + , LR-) were calculated.

RESULTS

Thirteen patients reported postoperative altered sensation of the lower lip, with 2 of them having mandibular canal bifurcations on the ipsilateral side of the injury. Fisher's Exact showed that the studied mandibular canal variations were not related to postoperative neurosensory disturbances. CBCT was superior in visualization of anatomical variations of the mandibular canal. Prevalence of bifurcations was 14% on CBCT and 7% on panoramic radiographs. In both imaging modalities and for all parameters, PPVs were low (0.04 - 0.06) and NPVs were high (0.92 - 0.98), with LR ranging around 1.

CONCLUSION

In the present study, the assessed mandibular canal variations had limited predictive value for IAN neurosensory disturbances following third molar removal.

CLINICAL RELEVANCE

While a close relation between the third molar and the mandibular canal remains a high risk factor, mandibular canal variations did not pose an increased risk of postoperative IAN injury after third molar removal.

IMPREGNATION OF ORAL MUCOSA OVER IMPACTED TEETH BY SUBPOPULATIONS OF MACROPHAGES M1 AND M2

OBJECTIVE

The aim: Of the study is to research quantitative parameters of mucous membrane macrophages populations M1 (CD68+) and M2 (CD163+) over vestibularly and palatally impacted teeth.

PATIENTS AND METHODS

Materials and methods: A group of 21 people aged from 10 to 16 years was formed to conduct the research. Clinical situation according to diagnostic criteria was identical in all the patients. The group was divided into two groups - control and experimental, which in their turn were fragmented into two subgroups. Immunohistochemical studies of mucosal biopsies were performed in accordance with the recommendations for selection.

RESULTS

Results: Study of ratio of CD68+/CD163+ cells revealed imbalance in individuals with vestibularly impacted teeth due to higher infiltration density of CD163+ (p<0,05), compared to CD68+ of control group. In individuals with palatally impacted teeth, ratio of CD68+/CD163+ increased 3,6 times, as well as compared with control group, but due increased infiltration density of CD68+.

CONCLUSION

Conclusions: In the epithelium of oral mucosa located over impacted teeth, both on vestibular and palatal surface, number of CD 68+ and CD163+ cells had no significant differences compared to control group. In biopsies of the lamina propria of mucosa over vestibularly impacted teeth, the ratio M1/M2=0,91±0,11 (p<0,05) decreases, with predominance of macrophages CD163+ subpopulation activity, and over palatally impacted teeth balance of M1/ M2 macrophages elevated (M1/M2= 2,10 ± 0,32, p<0,05), due to increased infiltration density of CD68+.

Is the extraction of third molars a risk factor for the temporomandibular disorders? A systematic review

BACKGROUND

The aim of this study was to evaluate through a systematic review the extraction of third molars as a risk factor for temporomandibular disorders (TMDs).

TYPES OF STUDIES REVIEWED

Randomized and nonrandomized controlled clinical trials where patients underwent third molar extraction and with qualitative evaluation of TMDs before and after extraction were included.

RESULTS

After applying the inclusion criteria, seven nonrandomized clinical studies were included. QUIPS tool showed that four articles presented a moderate and three a high risk of bias (RoB). Six studies reported that TMDs presented higher level after removal of third molars ranging from OR, 1.81 to 2.15/RR, 2.1. However, one study showed no significant association. GRADE showed heterogeneity in relation to general results, which means that confidence in the estimated effects varied from low to moderate GRADE. The quality of clinical recommendations decreased especially due to the risk of bias in some of the included studies evaluated with the QUIPS tool.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Third molar extraction can be associated with the development of TMD signs and symptoms. Furthermore, TMD can be aggravated according to the third molar location, the degree of impaction and surgical difficulty, age, and gender. This systematic review highlights the need to perform randomized clinical trials with diagnostic criteria and standardized surgical procedures.

Complex odontoma at the upper right maxilla: Surgical management and histomorphological profile

BACKGROUND

Odontomas are hamartomatous developmental malformations of the dental tissues. Usually asymptomatic, their presence is often revealed on routine radiographs. The study aimed to establish the efficacy of this conventional approach in treating odontomas, analysing clinical outcome, follow-up, and histomorphological profile.

CASE REPORT

A case is presented with a review of the international literature. The patient, aged 8 years, had a complex odontoma localised on the front upper jaw. She was treated following the conventional surgical procedure. Post-operative course and healing were uneventful. Orthodontic treatment was necessary to realign the teeth. At the 12-month follow-up there was no recurrence or failure. Healing was excellent.

CONCLUSION

Variations in normal tooth eruption are a common finding, but significant deviations from established norms should alert the clinician to further investigate the patient's health and development.

Pixel gray measurement for the diagnosis of dental ankylosis in cone beam computed tomography images

OBJECTIVE

The aim of this study was to investigate dental ankylosis in unerupted or partially erupted teeth by using cone beam computed tomography (CBCT) to quantify pixel intensity.

STUDY DESIGN

In total, 157 CBCT images from individuals with a total of 206 unerupted or partially erupted teeth with suspected ankylosis were evaluated. CBCT images were analyzed for the presence of ankylosis by 2 oral radiologists by quantifying mean pixel intensities (analysis 1) and variations in pixel intensities (analysis 2) in normal and ankylosed regions. The association between ankylosis and demographic and tooth-related factors was also examined.

RESULTS

Ankylosis was diagnosed in 57 teeth (27.7%). The diagnosis was established with all 3 multiplanar reconstruction views in 22 of these teeth (38.6%). In analysis 1, a higher pixel intensity was observed in areas with ankylosis compared with normal periodontal ligament (PDL) density as a result of bone deposition in this region, which is characteristic of ankylosis (P < .001). In analysis 2, reductions in pixel intensity were greater in the PDL areas than in the ankylosed areas. Ankylosis was significantly associated with the anterior teeth, the maxillary arch, single-rooted teeth, and impacted teeth (P ≤ .026).

CONCLUSIONS

Our results suggest that CBCT measurement of pixel intensity may be useful for the diagnosis of ankylosis.