Purpose: This ex vivo study was performed to determine the optimal energy level for virtual monoenergetic images (VMIs) generated with photon-counting detector computed tomography (PCD-CT) to minimize metal artifacts from dental implants. Materials and Methods: Twelve implants from various manufacturers were placed in 6 pig mandibles and scanned with PCD-CT. VMIs were reconstructed at energy levels from 70 keV to 150 keV in 20-keV increments. Three readers with varying experience qualitatively assessed the image quality, artifact burden, and diagnostic interpretability of peri-implant soft and hard tissues using a 5-point discrete visual scale. Objective analyses included quantitative line profileanalysis of implant-induced artifacts. Descriptive statistics were calculated, and inter-reader agreement was assessedusing percentage agreement and the Krippendorff alpha coefficient. Results: Qualitative analysis demonstrated excellent image quality for VMIs at ≥110 keV (median = 5), with minimal artifacts observed at 130-150 keV. In contrast, lower-energy VMIs (70-90 keV) showed inferior performance due to artifact-related limitations in diagnostic interpretability. Inter-reader agreement ranged from moderate to perfect, with perfect reliability (α = 1) for VMIs ≥110 keV. Quantitative line-profile analysis confirmed reduced artifact burden at higher energy levels, particularly for VMIs ≥110 keV. Conclusion VMI at energy levels ≥110 keV on PCD-CT reduced dental implant-related metal artifacts and offeredexcellent image quality, including assessment of both peri-implant soft and hard tissues. These findings suggest thatoptimized PCD-CT VMI may enhance postoperative follow-up imaging. Future in vivo studies are warranted tovalidate these findings in clinical practice.

Nasopalatine duct cysts (NPDCs), the most common non-odontogenic cysts of maxilla, are often incidental findings on diagnostic imaging. When symptomatic, they usually present as a painless swelling with possible fistula. Conventional radiography shows a round-to-ovoid or heart-shaped radiolucency between the roots of central maxillary incisors. While the radiographic features of NPDCs in X-ray-based modalities have been well described, their magnetic resonance imaging (MRI) features have rarely been reported. Developments in dental MRI in recent years and the introduction of various dental MRI protocols now allow a wide range of applications in dental medicine. MRI is becoming an important tool for the detection and diagnosis of incidental or non-incidental dentomaxillofacial cysts. This report presented and discussed the characteristics of 2 NPDC cases visualized on MRI using both conventional and newly implemented specific dental MRI protocols with a novel 15-channel mandibular coil, demonstrating the use of these protocols for radiation-free maxillofacial diagnoses.

Supernumerary teeth that are present in the molar region may be evident based on crowding and impaction, but most cases are asymptomatic and discovered as incidental findings during routine radiological examinations. This article reports the case of a 29-year-old woman who presented with a severe feeling of pressure in the region of the maxillary third molars that had been increasing in intensity for weeks. A clinical examination revealed crowding of the maxillary anterior teeth despite the completion of orthodontic treatment and an erupted third molar with localized gingivitis in the second quadrant. A radiographic examination revealed bilateral supernumerary maxillary fourth and fifth molars, so cone-beam computed tomography was performed to locate the supernumerary teeth precisely for a preoperative diagnosis and comprehensive treatment planning. This report presents the radiological and surgical case management of a rare case of bilateral supernumerary molars and reviews the literature regarding epidemiology and treatment options.