Journal of Dental Medicine

Background and Aims: Pulpal exposures originated from the external cervical root resorptions have major effects on the treatment and prognosis. Therefore, the aim of this study was performed to compare the two different imaging systems-digital radiography with PSP (Photostimulable Phosphor) sensor in three horizontal different views and CBCT (cone beam computed tomography) images to assess the pulpal exposure in simulated cavity of external cervical root resorptions that was performed in 1398 in the School of Dentistry of Azad University.
Materials and Methods: 40 intact maxilla anterior teeth with straight roots were included. Teeth were randomly divided to two groups (20 teeth with and 20 without pulpal exposures). Each sample was assessed using PSP digital radiography (in 3 horizontal angles) and CBCT image system, to detect the presence of pulpal exposures. False negative and false positive results in 2 imaging procedures were judged with ratio test.
Results: The results showed in CBCT (P.P.V=85.7%) and (N.P.V=89.5%), and in digital intraoral radiography (P.P.V=80%) and (N.P.V=80%) in proximal defects. Ratio test showed that there were no significant differences in the proximal defects (P<0.4).
Conclusion: The results showed that there were no significant differences in detection of exposure in the proximal surfaces between two imaging systems.

Background and Aims: In impacted third molar surgery, panoramic radiography is a preliminary technique for assessing the consequences associated with inferior alveolar nerve injury. However, this technique cannot provide enough information to determine the true risk in all cases. The aim of this study was to compare the accuracy of panoramic and CBCT radiographs in evaluating the relationship between the mandibular impacted third molars and the inferior alveolar nerve.
Materials and Methods: In this cross-sectional study, the relationship between mandibular third molar and inferior alveolar nerve in 15 patients referred to the oral and maxillofacial radiology department of Birjand dental school including 20 mandibular third molars were evaluated using two panoramic and CBCT radiographs. Data were analyzed using descriptive statistics and chi-square test and sensitivity analysis in SPSS22.
Results: In the evaluation of the teeth using panoramic radiography, the highest frequency was related to root darkening (65%) and root deflection (65%), and the lowest frequency was related to root narrowing (20%) and canal deviation (5%). The highest sensitivity of panoramic criteria was related to the root darkening with 100% sensitivity and the lowest sensitivity was related to the canal deviation with 17% sensitivity. On the other hand, the highest specificity of panoramic criteria between the mandibular third molars with the inferior alveolar nervewas was related to the two criteria of bifid apex and canal deviation with 100% specificity. The lowest specificity was related to the root deflection with 21% of specificity.
Conclusion: According to the results of this study, the probability of observing relationship between the mandibular third molars with the inferior alveolar nerve in CBCT radiography was very high.

Background and Aims: Knowing the depth and type of the teeth impaction with radiographic approaches can guide the clinicians into selecting the most appropriate treatment and prevent surgical complications. Therefore, the purpose of this article was to evaluate the prevalence of canine and premolar impaction in the digital panoramic view of patients referred to Rasht dental school in 2019.
Materials and Methods: This annalistic-descriptive cross-sectional study comprised patients who attended the Faculty of Dentistry, Rasht, Iran in 2019. Dental records and panoramic radiographs of 500 patients were reviewed retrospectively. Demographic information as well as the type and depth of impaction, involved jaw, and also, the associated pathological lesions were recorded. Data were analyzed with SPSS24 version with significant level of P<0.05.
Results: The findings revealed that among 500 individuals (300 (60%) were females and 200 (40%) were males), 35 individuals (7%) had at least one impacted tooth, 80% of impacted teeth were canines and the others were premolars. The most common impaction type, impaction level, and pathological lesion were mesioangular, B, and carries of the adjacent tooth, respectively. A significant relation was not observed between the type and level of impaction with the involved jaw (P=0.15, P=0.99) and also, the relation between the type of pathological lesion and gender was insignificant (P=0.85).
Conclusion: Functional and esthetic complications of impacted tooth can be prevented or declined by on-time radiographic screening.

Background and Aims: Achieving non-invasive methods for the proper detection of secondary caries adjacent to dental restorations has a great importance. As alterations in horizontal and vertical angles of X-ray beam would affect the detection of dental caries on radiographs, this study was designed to evaluate the effect of changing the horizontal angle of X- ray on detection of dental caries adjacent to class II amalgam restorations in posterior teeth on periapical radiographs.
Materials and Methods: In this in vitro study, artificial carious lesions were prepared in axial walls of the amalgam restoration cavities in interproximal surfaces of 27 human extracted premolar teeth. Periapical radiographies with different horizontal X- ray angles were obtained, observed, and rated by 5 maxillofacial radiologists for detection of carious lesions. For each observer, the sensitivity, specificity, accuracy, PPV, and NPV of radiographs in the individual horizontal angles were calculated and compared by nonparametric Kruskal Wallis test. Interobserver agreement was assessed by fleiss’ kappa coefficient.
Results: The highest accuracy of periapical radiographs for the detection of secondary caries of mesial dental surfaces was in 5-degree of mesial and distal X- ray angle (86.66%) and for the distal dental surfaces was allocated to 10-degree of distal X- ray angle (85.90%). Also, there was a significant difference in the accuracy between different horizontal angles (mesial and distal 0, 5, 10, 15-degree) (P=0.01). The higher agreement between observers in detecting mesial surface caries was in 10-degree of distal angle (0.86) and in detecting distal caries was in 5-degree of distal angle (0.89).
Conclusion: In the case of doubt in the existence of recurrent caries in the interproximal tooth surface, if the carious lesion is not visible on standard radiographic image with direct angle of X- ray, A 5- 10 degree of x- ray horizontal angle can improve the detection of secondary caries under amalgam restorations in interproximal dental surfaces.

Background and Aims: Idiopathic osteosclerosis is an asymptomatic local growth of cortical bone and is discovered incidentally on panoramic radiographs. The purpose of this study is to evaluate the frequency of idiopathic osteosclerosis and its radiographic features in panoramic images of patients referred to the Department of Maxillofacial Radiology, Faculty of Dentistry, Arak University of Medical Sciences (Iran) in 2022-2023.
Materials and Methods: In this cross-sectional study, 460 panoramic images from the radiology department of Arak Faculty of Dentistry were randomly selected and analyzed. The demographic information of patients, frequency of idiopathic osteosclerosis, location, and also its relationship with adjacent teeth in terms of proximity to lamina dura and periodontal ligament and radiographic features in terms of size and morphology were evaluated. The data were analyzed using the SPSS24 software.
Results: Panoramic images of 460 patients (266 men and 194 women) with an average age of 38.12 (11.75) years were evaluated. The frequency of idiopathic osteosclerosis was 6.1% (28 images). 92.9% of the lesions were in the lower jaw and 46.4% of them were near the premolar teeth. In 39.3% of the cases, the lesion was adjacent to the periodontal ligament and laminadora of the tooth. In 3.6% of the cases, it was associated with a small displacement of the adjacent tooth, and 17.9% was associated with tooth root resorption. According to the results, there was no correlation between the incidence of this lesion with age and gender (P>0.05).
Conclusion: According to the findings of this study, the frequency of idiopathic osteosclerosis in the patients referred to Arak dental school was reported as 6.1%. Most of these lesions were observed in the back of the lower jaw and thus, it is important to be able to distinguish this lesion from the radiopaque lesions of the jaw which need treatment.