PURPOSE: To evaluate the effect of deviation of mandibular positioning, by changing the mandibular plane inclination, on the measured height and width of mandible in spiral conventional tomography. MATERIALS AND METHODS: By means of the Scanora multifunctional unit, cross-sectional tomograms were taken from two human dried mandibles at the mandibular angulations: -15 degrees, -10 degrees, -5 degrees, and 0 degree. Twenty-eight sites in two dried mandibles were imaged. One examiner measured the bone heights and widths at selected sites on the images and the actual bone heights were recorded. RESULTS: The bone heights at the four mandibular inclinations overestimated real bone heights and the mean difference between actual heights and image heights on 0 degree was the smallest (P< 0.01). The bone widths on -15 degrees were narrowest and there were significant differences between bone widths measured at the four mandibular inclinations (P< 0.001). We found statistically significant differences between both bone heights and widths as measured according to the mandibular plane angle for the posterior region (P< 0.01). CONCLUSION: The use of different mandibular positioning may result in discrepancies in heights and widths when measured from the cross-sectional tomographic images. It is suggested that the mandibular positioning may play a significant role in the measurement of mandibular heights and widths.
Dental Implants ; Humans ; Mandible ; Radiography, Dental, Digital

PURPOSE: The purpose of this study was to investigate whether the fractal dimension of successive panoramic radiographs of bone after implant placement is useful in the characterization of structural change in alveolar bone. MATERIALS AND METHODS: Twelve subjects with thirty-five implants were retrospectively followed-up from one week to six months after implantation. Thirty-six panoramic radiographs from twelve patients were classified into 1 week, 1-2 months and 3-6 months after implantation and digitized. The windows of bone apical and mesial or distal to the implant were defined as periapical region of interest (ROI) and interdental ROI; the fractal dimension of the image was calculated. RESULTS: There was not a statistically significant difference in fractal dimensions during the period up to 6 months after implantation. The fractal dimensions were higher in 13 and 15 mm than 10 and 11.5 mm implant length at interdental ROIs in 3-6 months after implantation (P< 0.01). CONCLUSION: Longer fixtures showed the higher fractal dimension of bone around implant. This investigation needs further exploration with large numbers of implants for longer follow-up periods.
Dental Implants ; Follow-Up Studies ; Fractals* ; Humans ; Radiography, Panoramic ; Retrospective Studies

PURPOSE: To study the intra- and interobserver agreement of multidetector row computed tomography (MDCT) in interpretation of degenerative changes of the mandibular condyle. MATERIALS AND METHODS: Five observers independently evaluated one hundred temporomandibular joint MDCT images for signs of osteophytes, erosion, sclerosis and flattening. The intra- and interobserver agreements were calculated by using Kappa statistics. RESULTS: The intraobserver agreement was substantial for erosion (k=0.75), flattening (k=0.74) and sclerosis (k=0.72) and almost perfect for osteophytes (k=0.84). The interobserver agreement was fair for flattening (k=0.39), moderate for erosion (k=0.58) and sclerosis (k=0.48) and substantial for osteophytes (k=0.75). CONCLUSION: This study shows that we can expect good agreement for the presence of osteophytes, but not for flattening in the interpretation of MDCT images of the condyle.
Mandibular Condyle* ; Multidetector Computed Tomography ; Observer Variation ; Osteophyte ; Sclerosis ; Temporomandibular Joint ; Tomography, Spiral Computed

PURPOSE: This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. MATERIALS AND METHODS: The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. RESULTS: In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. CONCLUSION: The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate.
Bone and Bones ; Cone-Beam Computed Tomography ; Floors and Floorcoverings ; Humans ; Maxillary Sinus ; Molar

PURPOSE: The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. MATERIALS AND METHODS: The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. RESULTS: A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. CONCLUSION: The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health.
Adult* ; Alveolar Bone Loss ; Dental Caries ; Diagnosis, Oral ; Female ; Humans ; Incidence ; Male ; Molar ; Molar, Third* ; Prevalence* ; Radiography, Panoramic ; Tooth, Impacted

PURPOSE: The purpose of this study was to examine the patient- and treatment-related etiologic factors of external root resorption. MATERIALS AND METHODS: This study consisted of 163 patients who had completed orthodontic treatments and taken the pre- and post-treatment panoramic and lateral cephalometric radiographs. The length of tooth was measured from the tooth apex to the incisal edge or cusp tip on the panoramic radiograph. Overbite and overjet were measured from the pre- and post-treatment lateral cephalometric radiographs. The root resorption of each tooth and the factors of malocclusion were analyzed with an analysis of variance. A paired t test was performed to compare the mean amount of root resorption between male and female, between extraction and non-extraction cases, and between surgery and non-surgery groups. Correlation coefficients were measured to assess the relationship between the amount of root resorption and the age in which the orthodontic treatment started, the degree of changes in overbite and overjet, and the duration of treatment. RESULTS: Maxillary central incisor was the most resorbed tooth, followed by the maxillary lateral incisor, the mandibular central incisor, and the mandibular lateral incisor. The history of tooth extraction was significantly associated with the root resorption. The duration of orthodontic treatment was positively correlated with the amount of root resorption. CONCLUSION: These findings show that orthodontic treatment should be carefully performed in patients who need the treatment for a long period and with a pre-treatment extraction of teeth.
Female ; Humans ; Incisor ; Male ; Malocclusion ; Orthodontics ; Overbite ; Radiography, Panoramic ; Root Resorption ; Tooth ; Tooth Apex ; Tooth Extraction

PURPOSE: This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. MATERIALS AND METHODS: A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. RESULTS: Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). CONCLUSION: BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.
Cone-Beam Computed Tomography ; Female ; Humans ; Incidental Findings ; Male ; Mandibular Condyle ; Noise ; Osteophyte ; Prevalence ; Temporomandibular Joint

PURPOSE: This study was performed to investigate the course of the mandibular canal on panoramic radiography and the visibility of this canal on both panoramic radiography and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The study consisted of panoramic radiographs and CBCT images from 262 patients. The course of the mandibular canal, as seen in panoramic radiographs, was classified into four types: linear, elliptical, spoon-shaped, and turning curves. The visibility of this canal from the first to the third molar region was evaluated by visually determining whether the mandibular canal was clearly visible, probably visible, or invisible. The visibihlity of the canal on panoramic radiographs was compared with that on CBCT images. RESULTS: Elliptical curves were most frequently observed along the course of the mandibular canal. The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves and the lowest among the linear curves. On panoramic radiographs, invisible mandibular canals were found in 22.7% of the examined sites in the first molar region, 11.8% in the second molar region, and 1.3% in the third molar region. On CBCT cross-sectional images, the mandibular canal was invisible in 8.2% of the examined sites in the first molar region, 5.7% in the second molar region, and 0.2% in the third molar region. CONCLUSION: The visibility of this canal was lower in the first molar region than in the third molar region. The mandibular canal presented better visibility on CBCT images than on panoramic radiographs.
Cone-Beam Computed Tomography ; Humans ; Mandible ; Mandibular Nerve ; Molar ; Molar, Third ; Radiography, Panoramic

PURPOSE: This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. MATERIALS AND METHODS: A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. RESULTS: The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. CONCLUSION: The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.
Classification ; Crowns ; Female ; Humans ; Linear Models ; Male ; Molar, Third* ; Radiography, Panoramic ; Retrospective Studies ; Young Adult*

PURPOSE: To describe the MRI findings of the antero-superior attachment of the disc in patients with internal derangement. MATERIALS AND METHODS: One hundred fifty-six MR images from 40 normal subjects and 55 abnormal subjects were classified into three study groups of normal, anterior disc displacement with reduction and anterior disc displacement without reduction. On both closed- and open-mouth proton density sagittal images, the depiction of the antero-superior attachment of the disc and its demarcation from the disc were evaluated in three cuts of lateral, central and medial one thirds of the condyle. RESULTS: The depiction of antero-superior attachment was more frequent by the order of normal, anterior disc displacement with reduction and anterior disc displacement without reduction groups, and the significant differences were found on lateral cut of the closed images and lateral and central cuts of the open images. In study for the demarcation between the antero-superior attachment and the disc the lateral cut of the closed images and all three cuts of the open images showed significant differences. CONCLUSION: Open images are useful to show the difference in depiction of the antero-superior attachment of the disc among the TMJ groups.
Humans ; Magnetic Resonance Imaging* ; Protons ; Temporomandibular Joint Disorders ; Temporomandibular Joint*