Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review

Histological Evidences of Autograft of Dentin/Cementum Granules into Unhealed Socket at 5 Months after Tooth Extraction for Implant Placement

The aim of this clinical case study was to observe biopsy tissues at 5 months after an autograft of a partially demineralized dentin/cementum matrix (pDDM) into a tooth-extracted socket exhibiting healing failure. A 66-year-old female presented with healing failure in the cavity for 2 months after the extraction (#36). Initial X-ray photos showed a clear remainder of lamina dura (#36), a residual root (#37), and a horizontal impaction (#38). The vital tooth (#38) was selected for pDDM. The third molar crushed by electric mill was decalcified in 1.0 L of 2.0% HNO₃ for 20 min and rinsed in cold distilled water. The pDDM granules (size: 0.5–2.0 mm) were grafted immediately into the treated socket. X-ray views just after pDDM graft showed radio-opaque granules. At 5 months after pDDM graft, the surface of regenerated bone was harmonized with the mandibular line, and bone-like radio-opacity was found in the graft region. The biopsy tissue (diameter: 3.0 mm) at 5 months after pDDM graft showed that mature bone was interconnected with the remaining pDDM. The novel histological evidence highlighted that newly formed bone was connected directly with both dentin-area and cementum-area matrix of pDDM. We concluded that pDDM contributed to the regeneration of bone in the unhealed socket, and this regeneration prepared the socket for implant placement. Autogenous pDDM could be immediately recycled as an innovative biomaterial for local bone regeneration.

Development of a Visualisation Approach for Analysing Incipient and Clinically Unrecorded Enamel Fissure Caries Using Laser-Induced Contrast Imaging, MicroRaman Spectroscopy and Biomimetic Composites: A Pilot Study

This pilot study presents a practical approach to detecting and visualising the initial forms of caries that are not clinically registered. The use of a laser-induced contrast visualisation (LICV) technique was shown to provide detection of the originating caries based on the separation of emissions from sound tissue, areas with destroyed tissue and regions of bacterial invasion. Adding microRaman spectroscopy to the measuring system enables reliable detection of the transformation of the organic–mineral component in the dental tissue and the spread of bacterial microflora in the affected region. Further laboratory and clinical studies of the comprehensive use of LICV and microRaman spectroscopy enable data extension on the application of this approach for accurate determination of the boundaries in the changed dental tissue as a result of initial caries. The obtained data has the potential to develop an effective preventive medical diagnostic approach and as a result, further personalised medical treatment can be specified.

Rapid Apical Healing with Simple Obturation Technique in Response to a Calcium Silicate-Based Filling Material

Background

Root canal sealers with high alkaline (pH more than 11) and bioactive properties (release ions) are more effective for healing the apical area and preventing reinfection in root canals. Pure calcium silicate-based bioceramic premixed injectable sealers lead to change the obturation technique because it depends on maximizing amount of sealer and single cone gutta-percha as a carrier. This retrospective clinical study aimed at demonstrating the effect of single cone gutta-percha with a calcium silicate-based filling, used to fill the root canal in a single visit, on the apical healing with different lesion size.

Materials and Methods

195 patients needing root canal treatment were treated at the Al-Jazaer private clinic in southern Iraq. Cases were obtained during the 2017–2021 period (retrospective study). All patients were treated with a simple hydraulic condensation technique that used calcium silicate-based filling materials as the sealer with single cone gutta-percha as the carrier, with a minimum follow-up period of approximately one year. Both treatment- and patient-related factors were evaluated. The clinical outcomes depended on classification with respect to complete (success) or incomplete (failure) healing. Statistical analysis was performed using a chi-square test to compare different related factors.

Results

Radiographs for 195 patients were examined, and the average follow-up time was 20.44 months. The complete healing success rate was 164 (84.1%), and 31(15.9%) patients were not healed. The highly significant success rate was 88.7% for the initial treatment compared with 63.9% for retreatment. Small and medium lesions (<5 mm diameter) had a significant success rate compared to large lesions (>5 mm diameter). Sealer extrusion was found in 68.7% of cases, but it did not have any significant effect on the treatment result.

Conclusions

The bioceramic calcium silicate-based filling sealer used with single-cone gutta-percha led to increased success of apical healing with a simple hydraulic condensation technique without multiple visit treatments and premedication material.

Incidence, Size and Orientation of Maxillary Sinus Septa—A Retrospective Clinical Study

Background: The purpose of this study is to analyze if there is any statistical correlation between the surgery’s complexity (easy to difficult—depending on the anatomical conditions) and the patient’s sex, type of edentulism, and left or right side of the maxilla. Methods: Cone beam computed tomography records of 1192 maxillary sinuses were evaluated, measured, and statistically analyzed with respect to patient sex, type of edentulism, and left or right side, taking into consideration Wen’s proposed sinus septum classification. Results: Our research suggests that most sinus augmentation procedures in patients presenting antral septum fall into the Moderate A category (31.94%) and that there is not a correlation between the surgery’s complexity (easy to difficult) and the patient’s sex, type of edentulism and left or right side of the maxilla. Conclusion: We suggest a minor modification to Wen’s classification in view of the fact that our findings revealed a combination of medio-lateral and antero-posterior septa that we could not classify in one of the existing categories.

Value of FDG-PET/MR in Oral Focus Assessment in Head and Neck Cancer Patients-A Feasibility Study

FDG-PET/MR is a hybrid imaging modality used for the staging and restaging of advanced head & neck cancer (HNC) patients. Their treatment typically involves radiation therapy, which requires previous dental focus assessment. The aim of this study was to analyze if staging FDG-PET/MR is a valuable tool for oral focus assessment. For this purpose, FDG-PET/MR findings, such as metabolic activity of periapical radiolucencies and marginal periodontitis, were retrospectively compared with conventional standardized dental focus assessment, including dental radiographs and clinical assessment of 124 teeth in seven patients. Increased FDG uptake of periapical lesions was found in one out of 23 lesions. Increased FDG uptake of the marginal periodontium was recorded in one out of 34 lesions. In summary, standardized dental focus assessment by panoramic radiography and periapical radiographs may be enriched by information from FDG-PET/MR, showing active inflammation in dental foci. However, many dental foci have no correlate in FDG-PET/MR. The treatment decision for oral foci may benefit from the visualized presence or absence of metabolic activity on FDG-PET/MR.

Applications and Clinical Behavior of BioHPP in Prosthetic Dentistry: A Short Review

(1) Background: BioHPP® (Bredent, UK) is a partially crystalline poly ether ether ketone (PEEK) that is strengthened using ceramic. PEEK and its various formulations represent a very interesting alternative, and has been in-depth with its literature in recent years; (2) Methods: A PubMed and Scopus search for the term “BioHPP” yielded 73 results and 42 articles which were included in this short review. Considering the scarce literature on the subject, each article was considered in this review; (3) Results: the articles analyzed are very recent, all published in the last 5 years. Their clinical evaluation of BioHPP® highlights many positive aspects, and few articles have highlighted critical issues in its multiple clinical applications; (4) Conclusions: this material is not only extremely interesting for the future, but possesses characteristics suitable for clinical application today, for endocrowns, small adhesive bridges, temporary prostheses and for immediate loads on implant restorations. The excellent aesthetics and the possibility of simple reprocessing of the restorations made with this material invite its clinical application.

Anatomical Positions of Mesially/Horizontally Impacted Mandibular Third Molars are Significant Predictors for Distal Caries in Adjacent Second Molars

Background

Prevalence of distal caries in mandibular second molars (M2Ms) and its relationship with impacted condition of the adjacent mandibular third molars (M3Ms) have been reported in some studies. The results, however, were ambiguous because of including all impaction types and using univariate analysis for statistics.

Aim

This study aimed to determine anatomical features of mesially/horizontally impacted mandibular third molars (M3Ms) that could predict distal caries in the adjacent mandibular second molars (M2Ms) using multivariable analysis.

Materials and Methods

The study sample consisted of 300 digital panoramic radiographs of patients who underwent impacted M3Ms extraction. Two independent researchers collected the following variables from 446 pairs of M2M-M3M: sex, age, status of distal caries in M2Ms, mesial angulation, and Pell–Gregory classification of M3Ms.

Results

The prevalence of distal caries was 50.67%. Multivariable Firth's logistic regression analysis showed that age (β = 0.066, 95% CI = 0.023–0.113), mesial angulation (<30°: β = −1.205, 95% CI = −1.955 to −0.499; >70°: β = −0.730, 95% CI = −1.184 to −0.282), vertical position (level B: β = 2.275; 95% CI = 0.015–7.175; level A: β = 3.008; 95% CI = 0.755–7.905), and horizontal position (level II: β = 1.515; 95% CI = 0.444–2.874; level I: β = 1.423; 95% CI = 0.283–2.825) were significant variables after adjusting for sex in the final model for predicting distal caries (p < 0.05).

Conclusions

In conclusion, anatomical positions of impacted M3Ms, such as mesial angulation and Pell–Gregory classification were significant predictors of distal caries in M2Ms.

Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study

Background: Fibro-osseous lesions (FOL) of the jaw represent a rare, benign group of lesions that share similar clinical, radiological, and histopathological features and are characterized by progressive, variable replacement of healthy bone tissue by fibrous connective tissue. Methods: This retrospective study aimed to evaluate the incidence of fibro-osseous lesions and to reassess the efficacy of case-specific treatment management from a clinical, radiological, and histopathological perspective based on 14 years of data. Results: Forty-four patients with a radiological and/or histopathological diagnosis of benign FOLs were identified and re-evaluated. Cemento-osseous dysplasia was the most common group of FOLs present in our patient cohort (45%), followed by ossifying fibroma (39%) and fibrous dysplasia (16%). The diagnostic imaging technique of choice was CBCT (68%), followed by PAN (18%), with most patients (95 %) additionally undergoing biopsy. The mean age of the patients at the time of diagnosis was 40.54 ± 13.7 years, with most lesions being located in the mandible (86%), with females being predominantly affected (73%). Conclusion: An interdisciplinary approach that analyzes all case-specific factors, including demographic data, medical history, intraoperative findings, and, most importantly, histopathological and radiological features, is essential for an accurate diagnosis and key to avoiding inappropriate treatment.

Modern Approaches and Innovations on Methods and Imaging Protocols of the Maxillofacial District

In recent years, improvements in imaging techniques have profoundly changed the diagnosis of pathologies of the maxillofacial district [...].

Ultrasound Imaging in Dentistry: A Literature Overview

(1) Background: the frequency with which diagnostic tests are prescribed with exposure to ionizing radiation, a cause of biological damage, has been studied, and with much more attention, patients are subjected to these diagnostic tests for diagnosis and follow-up. This review aimed, given the recent developments of this technology, to evaluate the possible use of ultrasound in different branches of dentistry. The possibility of applying ionizing-radiation-free diagnostic exams in dentistry, overcoming the limits of this application, has led scientific research in this area to obtain interesting results that bode well for the future. (2) Methods: a search for articles on the application of ultrasounds in dentistry was performed using the PubMed electronic database. (3) Results: only 32 studies were included, and these clearly stated that this examination is widely usable and in great progress. (4) Conclusions: regarding the modern application techniques of this diagnostic test, it is essential to consider technological evolution as an objective to reduce the damage and side effects of necessary diagnostic tests. The use of ultrasound in dentistry can represent a valid radiation-free alternative, in certain contexts, to the other most used exams.

Diagnostic Accuracy of Cystic Lesions Using a Pre-Programmed Low-Dose and Standard-Dose Dental Cone-Beam Computed Tomography Protocol: An Ex Vivo Comparison Study

Background: This study aimed to analyze the diagnostic reliability of radiographic assessment of cystic lesions using a pre-set, manufacturer-specific, low-dose mode compared to a standard-dose dental cone-beam computed tomography (CBCT) imaging protocol. Methods: Forty pig mandible models were prepared with cystic lesions and underwent both CBCT protocols on an Orthophos SL Unit (Dentsply-Sirona, Bensheim, Germany). Qualitative and quantitative analysis of CBCT data was performed by twelve investigators independently in SIDEXIS 4 (Dentsply-Sirona) using a trial-specific digital examination software tool. Thereby, the effect of the two dose types on overall detectability rate, the visibility on a scale of 1 (very low) to 10 (very high) and the difference between measured radiographic and actual lesion size was assessed. Results: Low-dose CBCT imaging showed no significant differences considering detectability (78.8% vs. 81.6%) and visibility (9.16 vs. 9.19) of cystic lesions compared to the standard protocol. Both imaging protocols performed very similarly in lesion size assessment, with an apparent underestimation of the actual size. Conclusion: Low-dose protocols providing confidential diagnostic evaluation with an improved benefit–risk ratio according to the ALADA principle could become a promising alternative as a primary diagnostic tool as well as for radiological follow-up in the treatment of cystic lesions.