ABSTRACT Dental anomalies may occur due to the complex interactions among genetic, epigenetic, and environmental factors during dental development. The current study aimed to determine the prevalence and gender significance of developmental dental anomalies (DDA) in dental patients. This was a cross-sectional study of 260 subjects (123 males and 137 females) with an age range of 6–35 years old. Clinical and radiographic examinations were performed to determine the prevalence of anomalies in tooth number, shape, size, position, and structure. Descriptive statistics was performed, the chi-square test was used for analysis and p-value was set at 0.05. The findings showed that 203 subjects (78.1%) had DDA, which included 86 males (33.1%) and 117 females (45%). A significant gender difference was found regarding the prevalence of two anomalies (p < 0.05). The most prevalent anomaly was displacement 51.2%, followed by dilaceration 24.2%. A significant gender difference (p < 0.05) was found regarding hypodontia 16.5% and impaction 14.6%, with more predominant in females. Some anomalies were not observed such as microdontia, dentin dysplasia, ectopic eruption, gemination, and taurodontism. The study concluded that displacement and dilacerations were the common abnormalities. These findings may lead to various dental complications. Therefore, early diagnosis and follow-up observation are required to reduce the potential dental problems. In addition, it is helpful to increase the knowledge of practitioners with regards to DDA and its occurrence. Furthermore, it is good to highlight the importance of early diagnosis of DDA, especially in the mixed dentition, which can lead to reducing the complication of an orthodontic treatment plan.
Tooth Abnormalities ; Radiography, Dental, Digital ; Libya

OBJECTIVE: To compare the effects of different imaging methods on radio-opacity. Digital imaging and traditional film imaging were used to determine the radio-opacity of dental composite resin materials. METHODS: Fourteen dental composite resins commonly used in clinic were prepared for disc samples with thickness of 1 mm and diameter of 15 mm respectively. The aluminum step wedge was used as the reference and the disc samples were irradiated with X-rays by the traditional film imaging, phosphor imaging plate and charge-coupled device(CCD) intra-oral X-ray sensor respectively. Exposure was set at 65 kV and 7 mA, with 300 mm focus to film distance and the exposure time was 0.25 s. After developing and fixing the film, the optical density of the image of the sample and that of each step of the aluminum step wedge were measured using the densitometer. The digital image file was exported to grey scale analysis software of Adobe Photoshop^® to measure the average grey value in the sample image and aluminum step wedge image. The curves were drawn corresponding to the optical density/gray value of each step of the aluminum step wedge and its thickness, and the equivalent thickness of the aluminum plate was calculated according to the optical density/gray value of the actual measured thickness of the sample, so as to evaluate the radio-opacity of dental composite resin material. RESULTS: For the same sample, the aluminum equivalent measured by traditional film imaging and two other digital imagings had significant differences among the 14 composite resins (P < 0.05), and the aluminum equivalent measured by the two digital imagings were greater than that of the traditional film. Moreover the aluminum equivalent measured by the two digital imagings was also different, and the aluminum equivalent measured by the CCD intra-oral X-ray sensor in most composite resins was larger than that measured by phosphor imaging plate. The same sample was photographed with the same imaging method, and the aluminum equivalent was different after three exposures. The standard deviation of aluminum equivalent measured by phosphor imaging plate was the largest, while that measured by CCD intra-oral X-ray sensor was the smallest. Among the 14 dental composite resin materials, the aluminum equivalent of Tetric N-Ceram and Te-Econom Plus measured by traditional film imaging and phosphor imaging plate was significantly higher than other composite resins. CONCLUSION Based on clinical significance, three kinds of sensors designed to measure the radio-opacity of dental composite resin, the value of aluminum equivalent will change according to different types of sensors. The aluminum equivalent measured by CCD intra-oral X-ray sensor was higher than that measured by phosphor imaging plate, and the aluminum equivalent measured by phosphor imaging plate was higher than that measured by traditional film imaging. Moreover, even though the same sensor was used, the aluminum equivalent measured by multiple exposures was different. The standard deviation of the aluminum equivalent measured by phosphor imaging plate was greater than that measured by traditional film imaging and CCD intra-oral X-ray sensor. The three sensors in this study could be used for evaluating the radio-opacity of dental composite resin materials. But no matter what kind of sensor was used to measure the radio-opacity of dental composite resin, it complied to ISO 4049: 2019 standard, the materials were suitable for clinical use.
Aluminum ; Composite Resins ; Radiography, Dental, Digital

PURPOSE: To determine whether calcified carotid atherosclerotic plaques (CCAPs) and mineralized laryngeal cartilages (MLCs) were more frequently detected on digital or film-based panoramic radiographs. The clinical relevance of this question is that some radiopacities seen on digital radiographs may correspond to medium-density tissues that are not necessarily mineralized. MATERIALS AND METHODS: Data were collected from panoramic radiographs and the respective reports issued by 2 private oral radiology centers. A total of 388 radiographs and reports were divided into film-based (group A) and digital (group D) radiographs. The frequencies of CCAPs and MLCs were analyzed using the Fisher exact test, and odds ratios were also calculated (α=1%). RESULTS: The mean age of patients whose reports and radiographs showed CCAPs and/or MLCs ranged from 50.1 to 54.1 years. There was a predominance of females. A higher frequency of CCAPs and MLCs was observed in group D than in group A at both centers (P<0.01). CCAPs and MLCs were detected 4 times more frequently in group D than in group A at one of the centers. CONCLUSION: CCAPs and MLCs were more frequently detected on digital than on film-based panoramic radiographs. Further studies are needed to determine whether such radiopacities do indeed correspond to mineralized, rather than medium-density, tissues.
Atherosclerosis ; Female ; Humans ; Incidental Findings ; Laryngeal Cartilages ; Miners ; Odds Ratio ; Plaque, Atherosclerotic ; Radiography, Dental, Digital ; Radiography, Panoramic

PURPOSE: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) with that of parallel (PPA) and oblique projected periapical (OPA) radiography for the detection of different types of peri-implant bone defects.MATERIALS AND METHODS: Forty implants inserted into bovine rib blocks were used. Thirty had standardized bone defects (10 each of angular, fenestration, and dehiscence defects), and 10 were defect-free controls. CBCT, PPA, and OPA images of the samples were acquired. The images were evaluated twice by each of 2 blinded observers regarding the presence or absence and the type of the defects. The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were determined for each radiographic technique. The 3 modalities were compared using the Fisher exact and chi-square tests, with P<0.05 considered as statistical significance.RESULTS: High inter-examiner reliability was observed for the 3 techniques. Angular defects were detected with high sensitivity and specificity by all 3 modalities. CBCT and OPA showed similar AUC and sensitivity in the detection of fenestration defects. In the identification of dehiscence defects, CBCT showed the highest sensitivity, followed by OPA and PPA, respectively. CBCT and OPA had a significantly greater ability than PPA to detect fenestration and dehiscence defects (P<0.05).CONCLUSION: The application of OPA radiography in addition to routine PPA imaging as a radiographic follow-up method for dental implantation greatly enhances the visualization of fenestration and dehiscence defects. CBCT properly depicted all defect types studied, but it involves a relatively high dose of radiation and cost.
Area Under Curve ; Cone-Beam Computed Tomography ; Dental Implantation ; Dental Implants ; Follow-Up Studies ; Methods ; Peri-Implantitis ; Radiography ; Radiography, Dental, Digital ; Ribs ; ROC Curve ; Sensitivity and Specificity

PURPOSE: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. MATERIALS AND METHODS: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. RESULTS: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. CONCLUSION: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients.
Calibration ; Gutta-Percha ; Health Services ; Humans ; Prevalence ; Radiation Protection ; Radiographic Image Enhancement ; Radiography, Dental, Digital ; Retrospective Studies ; Semiconductors* ; Students, Dental

PURPOSE: The aim of this study was to compare the diagnostic accuracy of previously trained endodontists in the detection of artificially created periapical lesions using cone-beam computed tomography (CBCT) and digital periapical radiography (DPR). MATERIALS AND METHODS: An ex vivo model using dry skulls was used, in which simulated apical lesions were created and then progressively enlarged using #1/2, #2, #4, and #6 round burs. A total of 11 teeth were included in the study, and 110 images were obtained with CBCT and with an intraoral digital periapical radiographic sensor (Instrumentarium dental, Tuusula, Finland) initially and after each bur was used. Specificity and sensitivity were calculated. All images were evaluated by 10 previously trained, certified endodontists. Agreement was calculated using the kappa coefficient. The accuracy of each method in detecting apical lesions was calculated using the chi-square test. RESULTS: The kappa coefficient between examiners showed low agreement (range, 0.17-0.64). No statistical difference was found between CBCT and DPR in teeth without apical lesions (P=.15). The accuracy for CBCT was significantly higher than for DPR in all corresponding simulated lesions (P<.001). The correct diagnostic rate for CBCT ranged between 56.9% and 73.6%. The greatest difference between CBCT and DPR was seen in the maxillary teeth (CBCT, 71.4%; DPR, 28.6%; P<.01) and multi-rooted teeth (CBCT, 83.3%; DPR, 33.3%; P<.01). CONCLUSION: CBCT allowed higher accuracy than DPR in detecting simulated lesions for all simulated lesions tested. Endodontists need to be properly trained in interpreting CBCT scans to achieve higher diagnostic accuracy.
Cone-Beam Computed Tomography* ; Dentists* ; Humans ; Methods ; Periapical Periodontitis ; Pilot Projects* ; Radiography* ; Radiography, Dental, Digital ; Sensitivity and Specificity ; Skull ; Tooth

PURPOSE: The objective of this study was to compare the accuracy of digital models from 3 dimentional (3D) optical scanner and cone beam computed tomography (CBCT). MATERIALS AND METHODS: We obtained digital models from 11 pairs of stone casts using a 3D optical scanner and a CBCT, and compared the accuracy of the models. RESULTS: The error range of average positive distance was 0.059 - 0.117 mm and negative distance was 0.066 - 0.146 mm. Statistically (P < 0.05), average positive distance was larger than 70 µm and shorter than 100 µm, and that of negative distance was larger than 100 µm and shorter than 120 µm. CONCLUSION: We concluded that the accuracy of digital models generated from CBCT is not appropriate to make final prostheses. However, it may be acceptable for provisional restorations and orthodontic diagnoses with respect to the accuracy of the digitalization.
Cone-Beam Computed Tomography* ; Dental Casting Technique ; Dental Models ; Diagnosis ; Prostheses and Implants ; Radiography, Dental, Digital

PURPOSE: The aim of this study was to compare the radiopacity of 6 modern resin cements with that of human enamel and dentine using the Digora digital radiography system, to verify whether they meet the requirements of ANSI/ADA specification no. 27/1993 and the ISO 4049/2000 standard and assess whether their radiopacity is influenced by the thickness of the cement employed. MATERIALS AND METHODS: Three 3-thickness samples (0.5, 1 and 1.5 mm) were fabricated for each material. The individual cement samples were radiographed on the CCD sensor next to the aluminium wedge and the tooth samples. Five radiographs were made of each sample and therefore five readings of radiographic density were taken for each thickness of the materials. The radiopacity was measured in pixels using Digora 2.6 software. The calibration curve obtained from the mean values of each step of the wedge made it possible to obtain the equivalent in mm of aluminium for each mm of the luting material. RESULTS: With the exception of Variolink Veneer Medium Value 0, all the cements studied were more radiopaque than enamel and dentin (P<.05) and complied with the ISO and ANSI/ADA requirements (P<.001). The radiopacity of all the cements examined depended on their thickness: the thicker the material, the greater its radiopacity. CONCLUSION: All materials except Variolink Veneer Medium Value 0 yielded radiopacity values that complied with the recommendations of the ISO and ANSI/ADA. Variolink Veneer Medium Value 0 showed less radiopacity than enamel and dentin.
Calibration ; Dental Enamel ; Dentin ; Dentistry* ; Humans ; Radiographic Image Enhancement ; Radiography, Dental, Digital ; Reading ; Resin Cements* ; Tooth

PURPOSE: In the present study, we coined the term 'alveolar dome' and aimed to demonstrate the prevalence of alveolar domes through digital periapical radiographs. MATERIALS AND METHODS: This study examined 800 digital periapical radiographs in regard to the presence of alveolar domes. The periapical radiographs were acquired by a digital system using a photostimulable phosphor (PSP) plate. The χ2 test, with a significance level of 5%, was used to compare the prevalence of alveolar domes in the maxillary posterior teeth and, considering the same teeth, to verify the difference in the prevalence of dome-shaped phenomena between the roots. RESULTS: The prevalence of alveolar domes present in the first pre-molars was statistically lower as compared to the other maxillary posterior teeth (p<0.05). No statistically significant difference was observed in the prevalence of alveolar domes between the maxillary first and second molars. Considering the maxillary first and second molars, it was observed that the palatal root presented a lower prevalence of alveolar domes when compared to the distobuccal and mesiobuccal roots (p<0.05). CONCLUSION: The present study coined the term 'alveolar dome', referring to the anatomical projection of the root into the floor of the maxillary sinus. The maxillary first and second molars presented a greater prevalence of alveolar domes, especially in the buccal roots, followed by the third molars and second pre-molars. Although the periapical radiograph is a two-dimensional method, it can provide dentists with the auxiliary information necessary to identify alveolar domes, thus improving diagnosis, planning, and treatment.
Dentists ; Diagnosis ; Humans ; Maxillary Sinus ; Methods ; Molar ; Molar, Third ; Numismatics ; Prevalence* ; Radiography, Dental, Digital ; Tooth ; Tooth Root

PURPOSE: This study was performed to evaluate the reliability of the identification of anatomical landmarks in panoramic and lateral cephalometric radiographs on a standard medical grade picture archiving communication system (PACS) monitor and a tablet computer (iPad 5). MATERIALS AND METHODS: A total of 1000 radiographs, including 500 panoramic and 500 lateral cephalometric radiographs, were retrieved from the de-identified dataset of the archive of the Section of Oral and Maxillofacial Radiology of the University Of Connecticut School Of Dental Medicine. Major radiographic anatomical landmarks were independently reviewed by two examiners on both displays. The examiners initially reviewed ten panoramic and ten lateral cephalometric radiographs using each imaging system, in order to verify interoperator agreement in landmark identification. The images were scored on a four-point scale reflecting the diagnostic image quality and exposure level of the images. RESULTS: Statistical analysis showed no significant difference between the two displays regarding the visibility and clarity of the landmarks in either the panoramic or cephalometric radiographs. CONCLUSION: Tablet computers can reliably show anatomical landmarks in panoramic and lateral cephalometric radiographs.
Archives ; Connecticut ; Dataset ; Humans ; Radiography, Dental, Digital ; Radiography, Panoramic ; Radiology Information Systems