Radiologic assessment and frequency of idiopathic osteosclerosis of jawbones: an interpopulation comparison

Performance evaluation of a deep learning model for automatic detection and localization of idiopathic osteosclerosis on dental panoramic radiographs

Idiopathic osteosclerosis (IO) are focal radiopacities of unknown etiology observed in the jaws. These radiopacities are incidentally detected on dental panoramic radiographs taken for other reasons. In this study, we investigated the performance of a deep learning model in detecting IO using a small dataset of dental panoramic radiographs with varying contrasts and features. Two radiologists collected 175 IO-diagnosed dental panoramic radiographs from the dental school database. The dataset size is limited due to the rarity of IO, with its incidence in the Turkish population reported as 2.7% in studies. To overcome this limitation, data augmentation was performed by horizontally flipping the images, resulting in an augmented dataset of 350 panoramic radiographs. The images were annotated by two radiologists and divided into approximately 70% for training (245 radiographs), 15% for validation (53 radiographs), and 15% for testing (52 radiographs). The study employing the YOLOv5 deep learning model evaluated the results using precision, recall, F1-score, mAP (mean Average Precision), and average inference time score metrics. The training and testing processes were conducted on the Google Colab Pro virtual machine. The test process's performance criteria were obtained with a precision value of 0.981, a recall value of 0.929, an F1-score value of 0.954, and an average inference time of 25.4 ms. Although radiographs diagnosed with IO have a small dataset and exhibit different contrasts and features, it has been observed that the deep learning model provides high detection speed, accuracy, and localization results. The automatic identification of IO lesions using artificial intelligence algorithms, with high success rates, can contribute to the clinical workflow of dentists by preventing unnecessary biopsy procedure.

Idiopathic Osteosclerosis in Orthodontic Patients: A Report of Two Cases

Idiopathic osteosclerosis (IO) is described as a localized radiopacity of unknown etiology. Also known as dense bone islands, enostoses, bone scar, or focal periapical osteopetrosis, it is generally clinically asymptomatic and appears round, elliptical, or irregular in shape on a radiograph. The internal structure is usually homogenous. It should be distinguished from condensing osteitis and other alveolar bone-related radiopacities. This condition may cause changes in tooth position or interfere with orthodontic treatment. Two cases of IO involving the maxilla and mandible are highlighted. Both patients were females and presented with complaints of malocclusion and desired orthodontic correction. One case was detected incidentally on routine radiographic examination of the patient. In contrast, the other case presented as an expansile lesion lingual to the left mandibular first molar and second premolar. Radiographically, both lesions appeared as well-defined radiopaque masses with no surrounding radiolucent rim; the maxillary lesion was irregular in shape, while the mandibular lesion was elliptical. Both patients underwent orthodontic treatment without any adverse sequelae. The clinical and radiographic findings are discussed to facilitate the diagnosis of radiopacities of jaws. Usually asymptomatic and of no clinical significance, IO may occasionally induce root resorption, traumatic occlusion, traumatic/pathologic migration of teeth, and inhibit eruption of teeth. Though orthodontic tooth movement through areas of IO can be undertaken, the rate of tooth movement may be slower due to higher trabecular bone density. Lower force levels are warranted to avoid adverse effects like root resorption and bone hyalinization.

Longitudinal investigation of idiopathic osteosclerosis lesions of the jaws in a group of Chinese orthodontically-treated patients using digital panoramic radiography

Background/purpose

Idiopathic osteosclerosis (IO) is an intraosseous lesion of asymptomatic, non-expansive, radiopaque. The study aimed to investigate the prevalence and morphometric parameters of IO in orthodontic patients and variations in longitudinal observations and to assess the relationship between IO and orthodontic treatment.

Materials and methods

Five hundred and seventy-one orthodontically-treated patients were reviewed. A cross-sectional study was performed with the evaluated parameters, including the age and sex of patients, as well as the number, shape, location and morphometric data of IO observed in panoramic radiography. Long-term behaviour of IO and orthodontic tooth movement were also observed. Also, a control group was set up for comparisons.

Results

Sixty-eight (11.3%) patients had 78 lesions all in the mandible with premolar/molar preference and no sex predilection. Lesions were located more commonly at apical and separate sites related to teeth. A large majority of lesions enlarged in the 10–19 years old group, while most lesions had no change in the 30–39 years old group. Hindrances of tooth movement and external root resorption around IO were not found in affected patients.

Conclusion

IO is labile lesion that may develop in early stages of life, with little change occurring once the affected individual is mature and being relatively stable in the middle stage of life. Our study supports the hypothesis that IO may be developmental anatomic variations of normal bone. However, no obvious association between IO and orthodontic treatment was found in patients, which may be due to the limitations of two-dimensional shooting of panoramic radiography and the sample size.

[Prevalence of idiopathic osteosclerosis in patients cared for at a radiological center in Ayacucho from 2016-2018]

Objective

The objective of this study was to determine, describe and identify the prevalence of radiopaque images compatible with idiopathic osteosclerosis in digital panoramic radiographs taken in patients between the ages of 18 and 50.

Materials and methods

The study design was descriptive, cross-sectional and retrospective. The sample consisted of 500 digital panoramic radiographs taken between January 1, 2016 and December 31, 2018, in the target population aged between 18 and 50 years from Ayacucho - Peru, attended at a private radiological center. The radiographs obtained were analyzed using the Romexis viewer version 5.3 program, and the results were recorded on a data collection sheet. The Chi-square test was used to establish associations among the variables evaluated. A P <0.05 was considered significant.

Results

500 digital panoramic radiographs were analyzed, showing a prevalence of idiopathic osteosclerosis of 17.4%, of which 12% were female and 5.4% male, and according to age, the presence of idiopathic osteosclerosis was more prevalent in the second decade of life.

Conclusions

It is important to have a clear differential diagnostic criterion when distinguishing the different radiopacities such as idiopathic osteosclerosis, which can occur in the jaws, making a precise record of the morphometric characteristics and monitoring over time, taking into account their existence and implication in dental treatments.

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.

The imaging role for diagnosis of idiopathic osteosclerosis: a retrospective approach based on records of 33,550 cases

OBJECTIVE

The study aimed to describe the diagnostic imaging features of idiopathic osteosclerosis (IO) to aid in differential diagnosis of similar dentomaxillomandibular conditions.

MATERIALS AND METHODS

An archive of 550 dentomaxillofacial radiographic (panoramic radiography (PR) and cone beam computed tomography (CBCT)) images and 33,000 histopathological records were reviewed to identify IO cases. Chi-square, Student's t test, and ANOVA tests, with a significance of p < 0.05, were applied for comparative analysis. In addition, we analyzed various studies to present a short review.

RESULTS

After meticulous observation, 36 images of 34 patients revealed 60 IO lesions in 31 PR and 5 CBCT. Sex, age group, anatomical site, shape, regularity, and root relationship showed statistical significance: sex and age group (p = 0.046), sex and IO regularity (p = 0.007), age group and IO regularity (p = 0.014), anatomical site and IO shape (p = 0.010), anatomical site and IO regularity (p = 0.003), and IO shape and IO regularity (p = 0.002). We presented a short review from 26 articles, including retrospective, cross-sectional, and longitudinal studies, documenting 2307 patients with 2435 IO lesions from 51,160 imagiological examinations.

CONCLUSIONS

A radiographic diagnostic profile of IO may guide the clinical practitioners in differentiating an incidental radiopacity. PR is a preliminary examination, with CBCT facilitating the IO diagnosis.

CLINICAL RELEVANCE

Knowledge of imaging characteristics variability of idiopathic osteosclerosis is crucial for accurate diagnosis process when incidental radiopacities are found in the panoramic radiographs, thus avoiding unnecessary biopsies. CBCT scans facilitate the interpretation of idiopathic osteosclerosis overlapping the mandibular canal.

Idiopathic Osteosclerosis of the Jaw in a Brazilian Population: a Retrospective Study

OBJECTIVES

To report cases of idiopathic osteosclerosis (IO), to review the literature on the subject, and to discuss its main characteristics, diagnosis, differential diagnosis, and treatment.

MATERIAL AND METHODS

Retrospective analysis of 354 panoramic radiographs, searching for IO, its size, shape, location, and noting patients' demographic information. Literature review used Medline and Lilacs databases and the terms idiopathic osteosclerosis OR bone sclerosis OR dense bone island AND jaws.

RESULTS

IO was identified in 5.6% of the radiographs (n=20 patients, 22 foci). Patients were healthy, with an age ranging from 5 to 51 years (mean=29.8), with male-female ratio of 3:2. IOs were found mainly in the premolar/molar region, at root apices, between roots, away from the teeth, laterally to the tooth, and in edentulous areas. The distribution between right and left sides of the jaw was equal for the 22 foci, with only one case in the maxilla. IOs were localized, well-defined, radiopaque, mostly round or ovoid in shape, but sometimes irregular. In some cases, IOs were similar to condensing osteitis, but differential diagnosis also considered complex odontoma, focal cemento-osseous dysplasia, and residual roots. Twenty studies on the topic were reviewed.

CONCLUSIONS

Incidence of IO in the Brazilian sample was 5.6%, with age ranging from 5 to 51 years (mean=29.8), and male-female ratio of 3:2. The radiopacities occurred in different locations, with significant prevalence in the mandible. The findings and the literature review corroborate the hypothesis that IO should be considered developmental variation of normal bone that does not require treatment.

Frequency and pattern of idiopathic osteosclerosis and condensing osteitis lesions in panoramic radiography of Iranian patients

Background:

The purpose of this study was to investigate of radiographic pattern and relative frequency of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in panoramic radiographs.

Materials and Methods:

Totally 411 panoramic radiographies were randomly selected from patients referred to Radiology Department of Faculty of Dentistry, Tabriz University of Medical Sciences. Descriptive characteristics of radiopacities, including shape, border, localization, and dental relationship, were recorded. The Chi-squared test was used.

Results:

IO was detected in 31 (7.5%) patients and 22 (68.8%) lesions had exact border while their shape was mostly irregular. About 17 (53.1%) lesions were apical, and 13 (40.6%) lesions had no relation to the teeth. The most involved teeth were the second premolar (28.1%) and first molar (25%). Moreover, CO was detected in 32 (7.8%) patients. 17 (53.1%) lesions had an ill-defined border, and their shape was mostly irregular (65.6%) with ill-defined border. Around 18 (56.3%) lesions were apical, and 11 (34.4) lesions were apical and interradicular. The most involved teeth were the second premolar (59.4%) and the first molar (21.9%).

Conclusion:

The results demonstrated that relative frequency of IO in the selected population was 7.5% and for CO, it was 7.8%.