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1.
Sud Med Ekspert ; 67(4): 42-46, 2024.
Artículo en Ruso | MEDLINE | ID: mdl-39189494

RESUMEN

The assessment of majority age is important for determining legal responsibility. The definition of the 3rd molar maturity index (Im3) have proven to be a simple and effective method of majority age establishment, the accuracy of which has been tested in different populations. There is a clear lack of studies in this scientific area in Russia. OBJECTIVE: To test diagnostic accuracy of majority age assessment method by 3rd molar (Cameriere index) in the Ufa sample. MATERIAL AND METHODS: The number of orthopantomograms equal 120 from males and females aged from 14 to 23 years without apparent pathological changes of the pulp of teeth 38 and 48 was examined. The measures were conducted using the standard R. Cameriere method. The method of logistic regression, determination of predictive values of sensitivity and specificity were used. RESULTS: The Im3 cut-off point, that was equal 0.08, had a sensitivity of 89% and specificity of 95% in the male sample, accuracy of age group determination was 93%. In the female sample the method sensitivity was 93%, specificity - 97%, accuracy - 97%. CONCLUSION: The study results confirmed the absence of population variability of the Cameriere index value, that makes it possible to use the majority age determination method by 3rd molar for practical application in the examination of a living person at the territory of the Russian Federation.


Asunto(s)
Determinación de la Edad por los Dientes , Tercer Molar , Radiografía Panorámica , Humanos , Determinación de la Edad por los Dientes/métodos , Masculino , Femenino , Adolescente , Federación de Rusia , Tercer Molar/crecimiento & desarrollo , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica/métodos , Adulto Joven , Adulto , Sensibilidad y Especificidad , Odontología Forense/métodos
3.
Clin Oral Investig ; 28(8): 427, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38992326

RESUMEN

OBJECTIVES: The aim of this study was to explore inflammation of soft tissue around the upper third molar as a prevalent cause of limited mouth opening, identify the clinical and radiographic features, and summarize the therapeutic effectiveness of tooth extraction. MATERIALS AND METHODS: A retrospective analysis of data from 264 patients with limited mouth opening over the last five years was performed. RESULTS: Among the 264 patients, 24 (9.1%) had inflammation of the soft tissue around the upper third molar, which was the second most common cause of limited mouth opening. Twenty-one of the twenty-four affected patients, with an average mouth opening of 19.1 ± 7.6 mm, underwent upper third molar extraction. Gingival tenderness around the upper third molar or maxillary tuberosity mucosa was a characteristic clinical manifestation (p < 0.05). The characteristic features on maxillofacial CT included soft tissue swelling around the upper third molar and gap narrowing between the maxillary nodules and the mandibular ascending branch. Post extraction, the average mouth opening increased to 31.4 ± 4.9 mm (p < 0.05), and follow-up CT demonstrated regression of the inflammatory soft tissue around the upper third molar. CONCLUSIONS: Inflammation of soft tissue around the upper third molar is a common cause of limited mouth opening. Symptoms of pain associated with the upper third molar and distinctive findings on enhanced maxillofacial CT scans are crucial for diagnosis. Upper third molar extraction yields favorable therapeutic outcomes. CLINICAL RELEVANCE: Inflammation of the soft tissue around the maxillary third molar commonly causes limited mouth opening, but this phenomenon has long been overlooked. Clarifying this etiology can reduce the number of misdiagnosed patients with restricted mouth opening and enable more efficient treatment for patients.


Asunto(s)
Tercer Molar , Extracción Dental , Humanos , Tercer Molar/cirugía , Tercer Molar/diagnóstico por imagen , Femenino , Masculino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Inflamación , Adolescente
4.
Clin Oral Investig ; 28(8): 443, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39046553

RESUMEN

OBJECTIVES: The study aimed to examine the authenticity of the often-mentioned statement that the third molar is the most frequently extracted tooth. This finding has not been shown previously in a large population-based sample. MATERIALS AND METHODS: Data comprised a nationally representative sample of 6082 panoramic radiographs taken from adults in the cross-sectional Health 2000 Survey. From the radiographs, all missing teeth were recorded. Information on congenital agenesis of individual teeth was retrieved from two published meta-analyses. Primary outcome was the frequency of missing teeth by tooth type. Explanatory variables were age, sex, and the jaw (maxilla/mandible). Statistical analyses included χ2 test and binomial logistic regression. RESULTS: Mean age of participants (46% men, 54% women) was 53 years (SD 14.6; range 30‒97 years). Missing teeth occurred more often in women than in men (P < 0.001). The third molar was most frequently missing and the canine least frequently. In the maxilla and mandible, the third molar was missing more often than each of the other tooth types up to the age of 80 years (P < 0.01). CONCLUSIONS: When considering the rates of congenital agenesis of individual teeth, it is concluded that the third molar remained the most common tooth extracted up till the age of 80 years. CLINICAL RELEVANCE: The third molar is the most common target for extraction, but also the most common tooth associated with malpractice claims, and therefore, calls for skills, adequate equipment, and other resources for a successful extraction.


Asunto(s)
Tercer Molar , Radiografía Panorámica , Extracción Dental , Humanos , Masculino , Femenino , Tercer Molar/diagnóstico por imagen , Tercer Molar/anomalías , Estudios Transversales , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Extracción Dental/estadística & datos numéricos , Anodoncia/diagnóstico por imagen , Anodoncia/epidemiología
5.
J Dent ; 148: 105131, 2024 09.
Artículo en Inglés | MEDLINE | ID: mdl-38950765

RESUMEN

OBJECTIVES: Digital protocols and bioactive materials may reduce complications and improve tooth autotransplantation (ATT) success and survival rates. This prospective study assesses the performance of a fully digital autotransplantation protocol of close-apex molars with the adjunctive application of Enamel Matrix Derivatives (EMD). METHODS: Twelve adult patients with 13 hopeless molar teeth were replaced with autotransplantation of closed apex third molars. Outcomes, including success and survival rates, clinical, endodontic, radiographic, patient-reported outcome measures (PROMs), and digital image assessments, were conducted over a two-year follow-up period. RESULTS: Survival and success rates were 100% and 91.2%, respectively, with no progressive inflammatory or replacement root resorption (ankylosis) except for one tooth presenting radiographic furcation involvement. A significant probing depth reduction of 2.4 ± 2.58 mm and CAL gains of 2.8 ± 3.03 mm were observed in transplanted teeth compared to the hopeless receptor teeth. Radiographic bone levels remained stable throughout the study period (-0.37 ± 0.66 mm), and digital image assessments showed minimal alveolar ridge width changes (-0.32 to -0.7 mm) and gingival margin changes (-0.95 to -1.27 mm) from baseline to last visit. PROMs indicated very high patient satisfaction. CONCLUSION: The use of a digital ATT protocol with adjunctive use of EMD in closed-apex third molars demonstrated promising short-term high success and survival rates. Additionally, this type of therapy adequately preserves the dimensions of the alveolar ridge in the receptor site. CLINICAL SIGNIFICANCE: This is the first prospective clinical study examining the effect of a digital tooth autotransplantation protocol combined with the application of EMD. It demonstrates that this approach is an effective treatment for replacing hopeless teeth and also validates the digital assessment of ATT alveolar ridge preservation at the recipient site.


Asunto(s)
Proteínas del Esmalte Dental , Trasplante Autólogo , Humanos , Estudios Prospectivos , Femenino , Adulto , Masculino , Persona de Mediana Edad , Proteínas del Esmalte Dental/uso terapéutico , Resultado del Tratamiento , Tercer Molar/trasplante , Tercer Molar/diagnóstico por imagen , Flujo de Trabajo , Adulto Joven , Tomografía Computarizada de Haz Cónico , Medición de Resultados Informados por el Paciente , Diente Molar
6.
Niger J Clin Pract ; 27(7): 837-843, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39082908

RESUMEN

OBJECTIVE: The aim of this retrospective study was to determine the prevalence and patterns of impacted third molars in a Trinidadian population. METHODS: A total of 1500 orthopantomograms (OPG) taken at the School of Dentistry, University of the West Indies, from 2008 to 2019 in patients between 15 and 67 years old were evaluated. From the data collected, the prevalence of third molar impaction, the parameters of gender, angulation, level of impaction, and associated pathologies were evaluated. Other types of impacted teeth were also recorded. RESULTS: Of the 1500 OPG viewed, 408 (27.2%) of the study sample presented with at least one impacted third molar. 161 (39.5%) were males and 247 (60.5%) were females, with a male-to-female ratio of 1:1.5. There was a greater incidence of mandibular third molars versus maxillary third molars, which had a frequency of 77.9% and 22.1%, respectively. The most common type of impaction (Winter's classification) was horizontal in the mandible and distoangular in the maxilla. The most common level of impaction in the mandible (Pell and Gregory classification) was level 1A. The total number of impacted teeth was 775, and of these, 75 (9.7%) showed other impacted teeth besides the third molars. Canines and second premolars were the most prevalent with 7.6% and 1.5%, respectively. Caries on the second molar (49.3%) and third molars (40%) were the most frequently associated pathologies identified. CONCLUSION: The prevalence of impacted wisdom teeth in this study was 27%. These results raise awareness and provide insight among dental professionals in Trinidad as to the prevalence of impacted third molars, their patterns, as well as commonly associated pathologies, and the need for screening within the population.


Asunto(s)
Tercer Molar , Radiografía Panorámica , Diente Impactado , Humanos , Femenino , Masculino , Trinidad y Tobago/epidemiología , Prevalencia , Diente Impactado/epidemiología , Diente Impactado/diagnóstico por imagen , Adulto , Estudios Retrospectivos , Persona de Mediana Edad , Adolescente , Tercer Molar/diagnóstico por imagen , Anciano , Adulto Joven , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen
7.
J Stomatol Oral Maxillofac Surg ; 125(4S): 101946, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38857691

RESUMEN

PURPOSE: This study aims to develop a deep learning framework for the automatic detection of the position relationship between the mandibular third molar (M3) and the mandibular canal (MC) on panoramic radiographs (PRs), to assist doctors in assessing and planning appropriate surgical interventions. METHODS: Datasets D1 and D2 were obtained by collecting 253 PRs from a hospitals and 197 PRs from online platforms. The RPIFormer model proposed in this study was trained and validated on D1 to create a segmentation model. The CycleGAN model was trained and validated on both D1 and D2 to develop an image enhancement model. Ultimately, the segmentation and enhancement models were integrated with an object detection model to create a fully automated framework for M3 and MC detection in PRs. Experimental evaluation included calculating Dice coefficient, IoU, Recall, and Precision during the process. RESULTS: The RPIFormer model proposed in this study achieved an average Dice coefficient of 92.56 % for segmenting M3 and MC, representing a 3.06 % improvement over the previous best study. The deep learning framework developed in this research enables automatic detection of M3 and MC in PRs without manual cropping, demonstrating superior detection accuracy and generalization capability. CONCLUSION: The framework developed in this study can be applied to PRs captured in different hospitals without the need for model fine-tuning. This feature is significant for aiding doctors in accurately assessing the spatial relationship between M3 and MC, thereby determining the optimal treatment plan to ensure patients' oral health and surgical safety.


Asunto(s)
Aprendizaje Profundo , Mandíbula , Tercer Molar , Radiografía Panorámica , Humanos , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica/métodos , Mandíbula/diagnóstico por imagen , Femenino , Masculino , Adulto
8.
Fa Yi Xue Za Zhi ; 40(2): 149-153, 2024 Apr 25.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-38847029

RESUMEN

OBJECTIVES: To investigate the age-related changes of the mandibular third molar root pulp visibility in individuals in East China, and to explore the feasibility of applying this method to determine whether an individual is 18 years or older. METHODS: A total of 1 280 oral panoramic images were collected from the 15-30 years old East China population, and the mandibular third molar root pulp visibility in all oral panoramic images was evaluated using OLZE 0-3 four-stage method, and the age distribution of the samples at each stage was analyzed using descriptive statistics. RESULTS: Stages 0, 1, 2 and 3 first appeared in 16.88, 19.18, 21.91 and 25.44 years for males and in 17.47, 20.91, 22.01 and 26.01 years for females. In all samples, individuals at stages 1 to 3 were over 18 years old. CONCLUSIONS: It is feasible to determine whether an individual in East China is 18 years or older based on the mandibular third molar root pulp visibility on oral panoramic images.


Asunto(s)
Determinación de la Edad por los Dientes , Pulpa Dental , Tercer Molar , Radiografía Panorámica , Raíz del Diente , Humanos , Tercer Molar/diagnóstico por imagen , Masculino , Adolescente , Femenino , Adulto , Adulto Joven , China , Raíz del Diente/diagnóstico por imagen , Determinación de la Edad por los Dientes/métodos , Pulpa Dental/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Odontología Forense/métodos , Factores de Edad
9.
Clin Oral Investig ; 28(7): 401, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38940883

RESUMEN

OBJECTIVES: This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS: Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS: The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS: Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE: The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Electromiografía , Tercer Molar , Resorción Radicular , Diente Impactado , Humanos , Tercer Molar/diagnóstico por imagen , Tercer Molar/fisiopatología , Femenino , Masculino , Diente Impactado/fisiopatología , Diente Impactado/diagnóstico por imagen , Adulto , Resorción Radicular/fisiopatología , Resorción Radicular/diagnóstico por imagen , Diente Molar/fisiopatología , Bruxismo/fisiopatología , Músculos Masticadores/fisiopatología , Mandíbula/fisiopatología , Mandíbula/diagnóstico por imagen
10.
Comput Biol Med ; 178: 108755, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38897151

RESUMEN

PURPOSE: Impacted teeth are abnormal tooth disorders under the gums or jawbone that cannot take their normal position even though it is time to erupt. This study aims to detect all impacted teeth and to classify impacted third molars according to the Winter method with an artificial intelligence model on panoramic radiographs. METHODS: In this study, 1197 panoramic radiographs from the dentistry faculty database were collected for all impacted teeth, and 1000 panoramic radiographs were collected for Winter classification. Some pre-processing methods were performed and the images were doubled with data augmentation. Both datasets were randomly divided into 80% training, 10% validation, and 10% testing. After transfer learning and fine-tuning processes, the two datasets were trained with the YOLOv8 deep learning algorithm, a high-performance artificial intelligence model, and the detection of impacted teeth was carried out. The results were evaluated with precision, recall, mAP, and F1-score performance metrics. A graphical user interface was designed for clinical use with the artificial intelligence weights obtained as a result of the training. RESULTS: For the detection of impacted third molar teeth according to Winter classification, the average precision, average recall, and average F1 score were obtained to be 0.972, 0.967, and 0.969, respectively. For the detection of all impacted teeth, the average precision, average recall, and average F1 score were obtained as 0.991, 0.995, and 0.993, respectively. CONCLUSION: According to the results, the artificial intelligence-based YOLOv8 deep learning model successfully detected all impacted teeth and the impacted third molar teeth according to the Winter classification system.


Asunto(s)
Tercer Molar , Radiografía Panorámica , Diente Impactado , Humanos , Diente Impactado/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Inteligencia Artificial , Interfaz Usuario-Computador , Femenino , Masculino , Aprendizaje Profundo
11.
Sci Rep ; 14(1): 13082, 2024 06 07.
Artículo en Inglés | MEDLINE | ID: mdl-38844566

RESUMEN

Accurate classification of tooth development stages from orthopantomograms (OPG) is crucial for dental diagnosis, treatment planning, age assessment, and forensic applications. This study aims to develop an automated method for classifying third molar development stages using OPGs. Initially, our data consisted of 3422 OPG images, each classified and curated by expert evaluators. The dataset includes images from both Q3 (lower jaw left side) and Q4 (lower right side) regions extracted from panoramic images, resulting in a total of 6624 images for analysis. Following data collection, the methodology employs region of interest extraction, pre-filtering, and extensive data augmentation techniques to enhance classification accuracy. The deep neural network model, including architectures such as EfficientNet, EfficientNetV2, MobileNet Large, MobileNet Small, ResNet18, and ShuffleNet, is optimized for this task. Our findings indicate that EfficientNet achieved the highest classification accuracy at 83.7%. Other architectures achieved accuracies ranging from 71.57 to 82.03%. The variation in performance across architectures highlights the influence of model complexity and task-specific features on classification accuracy. This research introduces a novel machine learning model designed to accurately estimate the development stages of lower wisdom teeth in OPG images, contributing to the fields of dental diagnostics and treatment planning.


Asunto(s)
Aprendizaje Profundo , Tercer Molar , Radiografía Panorámica , Tercer Molar/crecimiento & desarrollo , Tercer Molar/diagnóstico por imagen , Humanos , Redes Neurales de la Computación , Procesamiento de Imagen Asistido por Computador/métodos , Femenino , Masculino
12.
Med Oral Patol Oral Cir Bucal ; 29(5): e634-e643, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-38794934

RESUMEN

BACKGROUND: Assess the correlation between the position of the third molar (M3) and fractures of the mandibular angle and condyle using panoramic radiographs to offer valuable data references for oral clinical research. MATERIAL AND METHODS: A retrospective cross-sectional study was undertaken, involving the collection of 409 cases of mandibular fracture in the Yanbian University Hospital. The case records and panoramic radiographs of mandibular angle fracture (78 cases) and condylar fracture (106 cases) were evaluated. RESULTS: In the comparative analysis between the mandibular angle fracture group and the condylar fracture group, statistical significance was observed in the variables of M3 existence (P = 0.002), eruption of M3 from the alveolar cavity (P = 0.003), P&G position classification (P = 0.001), deep impactions (Classes IC, IIC, IIIB, and IIIC) (P < 0.001), and the presence of impacted M3 in both groups (P < 0.001).Regarding M3 roots, the mandibular angle fracture group exhibited the highest prevalence of multiple roots at 75.4%, surpassing the 64.6% observed in the condylar fracture group. The prevalence of proximal angles in the mandibular angle group and the condyle group was the highest, accounting for 64.6% and 61.5%, respectively. The percentage of M3 in the two groups was 80% and 43.1%, respectively, with a significant difference (P < 0.001). CONCLUSIONS: Impacted mandibular third molars (M3) elevate the risk of mandibular angle fractures, while their absence or normal eruption reduces this risk and protects against condylar process fractures. The fracture risk is influenced by the M3's position: P&G Class II and Class B impactions, where M3s emerge partially from the alveolar bone, are significantly associated with mandibular angle fractures. In contrast, the absence of M3 or its placement in P&G Class I and Class A positions tends to correlate with a higher incidence of condylar process fractures.


Asunto(s)
Cóndilo Mandibular , Fracturas Mandibulares , Tercer Molar , Humanos , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/epidemiología , Tercer Molar/diagnóstico por imagen , Estudios Transversales , Estudios Retrospectivos , Cóndilo Mandibular/lesiones , Cóndilo Mandibular/diagnóstico por imagen , Masculino , Femenino , Adulto , Adulto Joven , Persona de Mediana Edad , Mandíbula/diagnóstico por imagen , Adolescente , Radiografía Panorámica
13.
Int J Legal Med ; 138(5): 1873-1880, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38730060

RESUMEN

INTRODUCTION: Evaluation of the eruption of mandibular third molars in orthopantomograms (OPGs) is a method of forensic age assessment. The objective of our study was to provide valid reference data for this trait within a population of black South Africans. The study was guided by the criteria for reference studies in age assessment. MATERIALS AND METHODS: A study population from Pretoria, South Africa comprising 670 OPGs obtained from 338 black females and 332 black males aged between 15.00 and 25.97 years was analysed. All OPGs were performed for medical indication during the period from 2011 to 2022 and were retrospectively evaluated. From the 670 OPGs, a total of 1021 mandibular third molars were evaluated. The assessment of mandibular third molars was conducted using the staging scale presented by Olze et al. in 2012. Two experienced dentists evaluated the OPGs independently of each other. If the two examiners diverged in their assessments, a consensus stage was assigned. RESULTS: As expected, the mean, median and minimal age increased with higher stages for both teeth and both sexes. The minimum age recorded for stage D, indicating complete tooth eruption, was 15.79 years in females and 16.62 years in males. CONCLUSION: As it is the case for previous reference studies in other countries, placing exclusive reliance on the evaluation of mandibular third molar eruption is inadequate for ascertaining the age of majority among Black South Africans. Future studies need to examine if our results are transferable to other countries in Sub-Saharan Africa.


Asunto(s)
Determinación de la Edad por los Dientes , Población Negra , Mandíbula , Tercer Molar , Radiografía Panorámica , Erupción Dental , Humanos , Tercer Molar/diagnóstico por imagen , Tercer Molar/crecimiento & desarrollo , Determinación de la Edad por los Dientes/métodos , Sudáfrica , Masculino , Adolescente , Femenino , Adulto , Adulto Joven , Mandíbula/diagnóstico por imagen , Estudios Retrospectivos , Valores de Referencia , Pueblo Africano
14.
J Clin Pediatr Dent ; 48(3): 139-145, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38755992

RESUMEN

The endodontic treatment of immature permanent teeth with necrotic pulp is a significant clinical challenge. The success of regenerative endodontic procedure is highly dependent on disinfection of the root canal and an accurate anatomical knowledge of the root canal. The aim of this study was to use micro-computed tomography (micro-CT) analysis to investigate the configuration of root canals in the upper permanent third maxillary molars with incomplete root development in their coronal, apical and middle third portions. Thirty immature third permanent maxillary molars were scanned using a micro-CT system. Then, we measured the diameters and areas of the root canal in the coronal, middle and apical third of the roots. The ratio between the long and short diameter of each root canal was then calculated and the canals were divided into several groups: round, oval, long oval, flat and irregular. The round configuration was not observed in the distobuccal and mesiobuccal roots in any of their anatomical regions. Oval and long oval canals predominated in the distobuccal root. The greatest variations were observed in the mesiobuccal root, with the ribbon-shaped canal predominating in the middle region and an irregular shape in the apical region. In the coronal region of the palatal canal, the round configuration predominated; in the middle third, we observed an almost equivalent distribution between round and oval configurations; apically, the oval shape predominated. In conclusion, we observed significant complexity and variation in the morphology and configuration of root canals in immature permanent molars, thus generating additional obstacles for the success of regenerative endodontics.


Asunto(s)
Cavidad Pulpar , Maxilar , Tercer Molar , Microtomografía por Rayos X , Humanos , Microtomografía por Rayos X/métodos , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/anatomía & histología , Maxilar/diagnóstico por imagen , Maxilar/anatomía & histología , Tercer Molar/diagnóstico por imagen , Tercer Molar/anatomía & histología , Niño , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/anatomía & histología
15.
Head Face Med ; 20(1): 29, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730394

RESUMEN

Forensic age assessment in the living can provide legal certainty when an individual's chronological age is unknown or when age-related information is questionable. An established method involves assessing the eruption of mandibular third molars through dental panoramic radiographs (PAN). In age assessment procedures, the respective findings are compared to reference data. The objective of this study was to generate new reference data in line with the required standards for mandibular third molar eruption within a German population. For this purpose, 605 PANs from 302 females and 303 males aged 15.04 to 25.99 years were examined. The PANs were acquired between 2013 and 2020, and the development of the mandibular third molars was rated independently by two experienced examiners using the Olze et al. staging scale from 2012. In case of disagreement in the assigned ratings, a consensus was reached through arbitration. While the mean, median and minimum ages were observed to increase with each stage of mandibular third molar eruption according to the Olze method, there was considerable overlap in the distribution of age between the stages. The minimum age for stage D, which corresponds to complete tooth eruption, was 16.1 years for females and 17.1 years for males. Thus, the completion of mandibular third molar eruption was found in both sexes before reaching the age of 18. In all individuals who had at least one tooth with completed eruption and who were younger than 17.4 years of age (n = 10), mineralization of the teeth in question was not complete. Based on our findings, the feature of assessing mandibular third molar eruption in PAN cannot be relied upon for determining age of majority.


Asunto(s)
Determinación de la Edad por los Dientes , Tercer Molar , Radiografía Panorámica , Erupción Dental , Humanos , Radiografía Panorámica/métodos , Tercer Molar/diagnóstico por imagen , Masculino , Femenino , Determinación de la Edad por los Dientes/métodos , Adolescente , Erupción Dental/fisiología , Alemania , Adulto , Adulto Joven , Valores de Referencia
16.
Clin Oral Investig ; 28(6): 307, 2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-38733524

RESUMEN

PURPOSE: The factors related to pericoronitis severity are unclear, and this study aimed to address this knowledge gap. MATERIALS AND METHODS: In total, 113 patients with pericoronitis were included, and their demographic, clinical, and radiographic characteristics were recorded. The Patient-Clinician Pericoronitis Classification was used to score and categorize the severity of pericoronitis. Statistical analysis was conducted to examine the participants' characteristics, validity of the Patient-Clinician Pericoronitis Classification, and risk factors associated with the severity of pericoronitis. RESULTS: The demographic, clinical, and radiographic characteristics of males and females were similar, except for Winter's classification, pain, and intraoral swelling. The constructive validity of the Patient-Clinician Pericoronitis Classification was confirmed with three latent factors, including infection level, patient discomfort, and social interference. Ordinal logistic multivariate regression analysis revealed that upper respiratory tract infection was the sole risk factor associated with pericoronitis severity in males (odds ratio = 4.838). In females, pericoronitis on the right side (odds ratio = 2.486), distal radiolucency (odds ratio = 5.203), and menstruation (odds ratio = 3.416) were significant risk factors. CONCLUSION: This study demonstrated the constructive validity of the Patient-Clinician Pericoronitis Classification. Among females, pericoronitis in mandibular third molars on the right side with radiolucency in menstruating individuals was more severe. In males, upper respiratory tract infection was the sole risk factor associated with pericoronitis severity. CLINICAL RELEVANCE: Individuals with risk factors should be aware of severe pericoronitis in the coming future.


Asunto(s)
Tercer Molar , Pericoronitis , Índice de Severidad de la Enfermedad , Humanos , Masculino , Femenino , Factores de Riesgo , Tercer Molar/diagnóstico por imagen , Pericoronitis/complicaciones , Adulto , Adolescente , Mandíbula/diagnóstico por imagen
17.
Med Oral Patol Oral Cir Bucal ; 29(4): e537-e544, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38794938

RESUMEN

BACKGROUND: A quantification of the residual bone mass of the mandible (B/A) was utilized in this study to examine the correlation between mandibular fracture and residual bone mass. To improve the clinical utilization rate and reduce the incidence of iatrogenic mandibular fractures, the B/A ratio calculation should be simplified. MATERIAL AND METHODS: Data were collected from the Yanbian University Hospital on 175 cases of mandibular fracture with third molar (M3), 67 normal cases without fractures and 20 cases of impacted teeth extraction. Twenty cases of iatrogenic mandibular fracture were collected, and the case records and panoramic radiographs of the patients were recorded. RESULTS: The average B/A ratio of mandibular angle fracture group was 0.61±0.10.The value of B/A was found to be statistically significant in terms of whether M3 emerged from alveolar bone (P = 0.001), location (horizontal P < 0.001, vertical P < 0.001), the degree of impaction (P < 0.001), the number of roots (P < 0.001), the difference in impaction (P < 0.001), and the fracture type (P = 0.002). The average B/A ratio of normal group was 0.62±0.10. In the statistical results of the B/A value of normal patients, M3 involving alveolar bone (P < 0.001), position classification (P < 0.05), degree of impaction (P < 0.001) and presence or absence of a root (P < 0.05) were statistically significant. The average B/A ratio of iatrogenic mandibular angle fracture group was 0.28±0.08. The average B/A ratio of the extraction group for impacted teeth was 0.62 ± 0.09. CONCLUSIONS: There is a high risk of mandibular angle fracture when the (B/A) value of the residual bone height (B) in the mandibular M3 area compared to the mandibular bone height (A) in the M3 area is less than 0.4.


Asunto(s)
Fracturas Mandibulares , Tercer Molar , Humanos , Tercer Molar/diagnóstico por imagen , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/etiología , Fracturas Mandibulares/epidemiología , Femenino , Masculino , Adulto , Adulto Joven , Persona de Mediana Edad , Mandíbula/diagnóstico por imagen , Adolescente , Densidad Ósea , Medición de Riesgo
18.
Acta Odontol Scand ; 83: 174-179, 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38651519

RESUMEN

OBJECTIVE: We examined whether dental panoramic radiography (PAN) can be used to identify the clinical stage of eruption of mandibular third molars at the time of radiological examination. MATERIALS AND METHODS: Cross-sectional data included records from clinical oral examination and PANs of university students. In the retrospective analysis of 345 mandibular third molars in 189 participants (20% men, 80% women; mean age 20.7 years; standard deviation [SD] ± 0.6), clinical stages of eruption were compared with their radiographic depth in bone, inclination, and root development. Statistics included χ2, Mann-Whitney U tests, and logistic regression. RESULTS: Significant (p < 0.001) predictor variables for assessing the clinical stage of eruption were radiographic depth in bone and inclination. All teeth radiologically at a depth of the cementoenamel (CE) junction of the neighbouring second molar or deeper were clinically unerupted. Above the CE junction, 80% of vertical and 97% of distoangular teeth were connected to the oral cavity, and 82% of mesioangular and 69% of horizontal teeth were clinically unerupted. CONCLUSION: All teeth below or at the CE junction are clinically unerupted. Above the CE junction, stage of eruption should be assessed together with the inclination, but horizontally inclined teeth are recommended to be verified clinically.


Asunto(s)
Mandíbula , Tercer Molar , Radiografía Panorámica , Erupción Dental , Humanos , Tercer Molar/diagnóstico por imagen , Erupción Dental/fisiología , Masculino , Femenino , Estudios Transversales , Mandíbula/diagnóstico por imagen , Adulto Joven , Estudios Retrospectivos , Adulto
19.
IEEE J Biomed Health Inform ; 28(6): 3523-3533, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38557613

RESUMEN

Germectomy is a common surgery in pediatric dentistry to prevent the potential dangers caused by impacted mandibular wisdom teeth. Segmentation of mandibular wisdom teeth is a crucial step in surgery planning. However, manually segmenting teeth and bones from 3D volumes is time-consuming and may cause delays in treatment. Deep learning based medical image segmentation methods have demonstrated the potential to reduce the burden of manual annotations, but they still require a lot of well-annotated data for training. In this paper, we initially curated a Cone Beam Computed Tomography (CBCT) dataset, NKUT, for the segmentation of pediatric mandibular wisdom teeth. This marks the first publicly available dataset in this domain. Second, we propose a semantic separation scale-specific feature fusion network named WTNet, which introduces two branches to address the teeth and bones segmentation tasks. In WTNet, We design a Input Enhancement (IE) block and a Teeth-Bones Feature Separation (TBFS) block to solve the feature confusions and semantic-blur problems in our task. Experimental results suggest that WTNet performs better on NKUT compared to previous state-of-the-art segmentation methods (such as TransUnet), with a maximum DSC lead of nearly 16%.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Bases de Datos Factuales , Aprendizaje Profundo , Tercer Molar , Niño , Humanos , Algoritmos , Benchmarking/métodos , Tomografía Computarizada de Haz Cónico/métodos , Imagenología Tridimensional/métodos , Mandíbula/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Conjuntos de Datos como Asunto
20.
Clin Oral Investig ; 28(5): 256, 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38630324

RESUMEN

OBJECTIVES: To investigate the feasibility of MRI nerve-bone fusion imaging in assessing the relationship between inferior alveolar nerve (IAN) / mandibular canal (MC) and mandibular third molar (MTM) compared with MRI-CBCT fusion. MATERIALS AND METHODS: The MRI nerve-bone fusion and MRI-CBCT fusion imaging were performed in 20 subjects with 37 MTMs. The Hausdorff distance (HD) value and dice similarity coefficient (DSC) was calculated. The relationship between IAN/MC and MTM roots, inflammatory, and fusion patterns were compared between these two fused images. The reliability was assessed using a weighted κ statistic. RESULTS: The mean HD and DSC ranged from 0.62 ~ 1.35 and 0.83 ~ 0.88 for MRI nerve-bone fusion, 0.98 ~ 1.50 and 0.76 ~ 0.83 for MRI-CBCT fusion. MR nerve-bone fusion had considerable reproducibility compared to MRI-CBCT fusion in relation classification (MR nerve-bone fusion κ = 0.694, MRI-CBCT fusion κ = 0.644), direct contact (MR nerve-bone fusion κ = 0.729, MRI-CBCT fusion κ = 0.720), and moderate to good agreement for inflammation detection (MR nerve-bone fusion κ = 0.603, MRI-CBCT fusion κ = 0.532, average). The MR nerve-bone fusion imaging showed a lower ratio of larger pattern compared to MR-CBCT fusion (16.2% VS 27.3% in the molar region, and 2.7% VS 5.4% in the retromolar region). And the average time spent on MR nerve-bone fusion and MRI-CBCT fusion was 1 min and 3 min, respectively. CONCLUSIONS: Both MR nerve-bone fusion and MRI-CBCT fusion exhibited good consistency in evaluating the spatial relationship between IAN/MC and MTM, fusion effect, and inflammation detection. CLINICAL RELEVANCE: MR nerve-bone fusion imaging can be a preoperative one-stop radiation-free examination for patients at high risk for MTM surgery.


Asunto(s)
Tercer Molar , Tomografía Computarizada de Haz Cónico Espiral , Humanos , Reproducibilidad de los Resultados , Tercer Molar/diagnóstico por imagen , Imagen por Resonancia Magnética , Diente Molar/diagnóstico por imagen , Inflamación , Nervio Mandibular/diagnóstico por imagen
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