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Extraoral profile photographs are crucial for orthodontic diagnosis, documentation, and treatment planning. The purpose of this study was to evaluate classifications made on extraoral patient photographs by deep learning algorithms trained using grouped patient pictures based on cephalometric measurements. Cephalometric radiographs and profile photographs of 990 patients from the archives of Kocaeli University Faculty of Dentistry Department of Orthodontics were used for the study. FH-NA, FH-NPog, FMA and N-A-Pog measurements on patient cephalometric radiographs were carried out utilizing Webceph. 3 groups for every parameter were formed according to cephalometric values. Deep learning algorithms were trained using extraoral photographs of the patients which were grouped according to respective cephalometric measurements. 14 deep learning models were trained and tested for accuracy of prediction in classifying patient images. Accuracy rates of up to 96.67% for FH-NA groups, 97.33% for FH-NPog groups, 97.67% for FMA groups and 97.00% for N-A-Pog groups were obtained. This is a pioneering study where an attempt was made to classify clinical photographs using artificial intelligence architectures that were trained according to actual cephalometric values, thus eliminating or reducing the need for cephalometric X-rays in future applications for orthodontic diagnosis.

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OBJECTIVES: The aim of this study was to assess the reliability of panoramic radiography (OPG) using age estimation method using cone beam computed tomography (CBCT) verification in the evaluation of radiographic visibility of root pulp (RPV) of mandibular third molars for age estimation. METHODS: CBCT and OPG images of 429 mandibular third molars from 290 patients were evaluated. RPV of fully mineralized mandibular third molars was evaluated as stages 0, 1, 2, and 3 for both imaging methods. Descriptive statistics were performed separately for stages by age for both genders. The consistency of these scores with chronological age was evaluated for both imaging methods. The reliability of OPG evaluation was also analyzed with CBCT scores.Results Spearman's rho correlation demonstrated a positive correlation between RPV and chronological age for both genders and for OPG and CBCT evaluation. Considering the minimum ages of both imaging methods, all stages were above the age of 18 except for the female group of Stage 2 and all Stage 0. For the comparison of OPG and CBCT RPV Staging scores, the κ score was found to be 0.312 (p < 0.001), indicating a fair agreement. CONCLUSION: In conclusion, the absence of Stage 3 at age of 18 and under might have a forensic value for RPV age estimation method. Considering the fair agreement in the verification of OPG scores, it is not possible to determine the exact age with the RPV detected in OPG images, the use of CBCT for the RPV evaluation is recommended to available cases.

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OBJECTIVE: This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients. METHODS: In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs. RESULTS: The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively). CONCLUSIONS: The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.

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OBJECTIVES:: The aim of this study was to assess the visibility of discomallear ligament and anterior mallear ligament together with anatomical morphometric measurements of petrotympanic fissure, and to determine whether the mallear ligaments correlate with the bone compartment changes of temporomandibular joint. METHODS:: Cone beam CT images of 275 patients were evaluated retrospectively. The visibility of discomallear and anterior mallear ligaments were evaluated by two observers. The petrotympanic fissure was classified into four groups. Morphologic features of petrotympanic fissure and mandibular fossa were also measured in sagittal, axial and three-dimensional cone beam CT reconstructed images. Pearson's χ2 test and Student's t-test were performed for statistical analysis of differences voxel sizes, age, gender, localization, temporomandibular joint and measurements (p < 0.05). Intra- and interobserver reliability was also performed. RESULTS:: Type 3 petrotympanic fissure was more frequent in male, whereas females showed Type 1 and Type 2 petrotympanic fissure structures (p < 0.05). Anterior mallear ligament visibility on cone beam CT images was statistically higher in bone compartment changes of temporomandibular joint. In cone beam CT images, petrotympanic fissure tunnel types 1, 2, 3 and 4 were seen in 11.5, 35.63, 51.34 and 1.53% of patients, respectively. CONCLUSIONS:: Knowledge of the anatomy may help in identifying temporomandibular joint pain and auditory symptoms due to temporomandibular disorder. Further cross-sectional studies with larger populations are needed to investigate the physiopathological relation of both disorders.

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En coup de sabre is a type of linear scleroderma which presents on the frontal or frontoparietal scalp. En coup de sabre in children is associated with asymmetric growth and progressive facial disfigurement. The purpose of this report was to present the case of a 4-year-old girl with a 2-year history of en coup de sabre. The clinical presentation and radiographic findings are discussed.

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