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26: QUALITATIVE AND QUANTITATIVE ANALYSIS OF THE MOST COMMON MINI-PLATES PLACEMENT SITES IN ADULT PATIENTS: A COMPARATIVE CROSS-SECTIONAL STUDY

A. Almashraqi1, M. Alhammadi2, A. Khadhi2, K. Arishi2, A. Alamir2, E. Beleges2

1Qatar University, College of Dental Medicine, Doha, Qatar, 2Jazan University, College of Dentistry, Gizan, Saudi Arabia

Aim: This study aimed to analyze the quality and quantity of the bone to recommend the most suitable miniplates placement sites of adults with normodivergent facial pattern of both genders.

Material and Methods: This retrospective cross-sectional comparative study retrieved and analyzed 60 CBCT scans of adult patients who fulfilled the selection criteria. The analysis included measurements of Cortical Bone Thickness (CBT) and Cortical Bone Density (CBD) at different levels in the most common position of miniplates: maxillary anterior (MA), infra-zygomatic (IZ), para-symphyseal (PS) and buccal ridge (BR).

Results: The CBT and CBD ranged 1.27-1.83 mm and 635-821 gray-scale (GS), 1.99-2.23 mm and 508-779 GS, 1.88 -2.74 mm and 1074-1307 GS, and 2.64-3.69 mm and 883-1181 GS for MA at 16 and 18 mm, IZ at 4 mm from root apex, PS at 8 and 12 mm, and BR at 8 and 10 mm, respectively. For gender comparison of the recommended sites, females showed significantly higher values of CBD of left IZ area, CBT in PS area, CBT in BR area, while males showed significantly higher values of CBT of the right MA area.

Conclusion: Within the limitations of this study, the recommended miniplate insertion sites for both males and females are at:

1- 16 and 18 mm from alveolar crest for the maxillary anterior miniplates.

2- 4 mm from maxillary first molars for infra-zygomatic miniplates.

3- 8 and 12 mm from alveolar crest for the para-symphyseal miniplates.

4- 8 and 10 mm from alveolar crest for the buccal ridge miniplates.

32: ODONTOMA ASSOCIATED WITH UNERUPTED LOWER THIRD MOLAR IN AN YOUNG ADULT PATIENT – CASE REPORT

A. Reis Durao1, A. Morosolli2, F. Barros dos Santos3, R. Chies Hartmann2

1University Fernando Pessoa, Health Sciences, Porto, Portugal, 2Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, discipline of Radiology – Dentistry Course – School of Health and Life Science, Rio Grande do Sul, Brazil, 3Private pratice, Porto, Portugal

Odontomas are malformations not neoplasms. It is considered to be a congenital development abnormality that causes proliferation of epithelial and mesenchymal cells, as well as completely differentiated tissues, in the tooth cavity.

Aim: Report an unusual case of unerupted lower third molar with simultaneous root malformation associated with an odontoma-like lesion.

Material and Methods: A 25-year-old Caucasian male patient sought care, due to discomfort at the posterior right mandible. Clinical extraoral examination did not detect, facial asymmetry, although a slight enlargement was seen. Small FOV Cone Beam Computed Tomography (CBCT) of the region was performed. We could observe, that the third molar was unerupted, as well as the presence of a hyperdense mass with hypo/hyperdense fragments in the interior, surrounded by a well-defined hypodense halo. The lesion, measured approximately 17.62mm x 13.46mm in the vertical and horizontal directions, respectively. We could depict a modification in the mesial root format, and close contact with the inferior alveolar nerve canal. This indicates, a probable diagnosis of a compound odontoma.

Conclusions: Detailed and careful assessment in imaging exams, such as CBCT, should be considered for surgical planning. Information regarding size, exact location and relationship of the lesion with adjacent structures. The presence of asymptomatic odontomas, as occasional findings on imaging exams can lead to late diagnosis of the lesion. The correct diagnosis allows for greater chances of successful surgical interventions, avoiding complications, preservation of noble vascular-nervous structures, such as the mandibular canal, as well as an adequate healing process for the patient.

105: CURRENT STATUS OF TELERADIOLOGY SERVICES IN JAPAN BASED ON MEDICAL FEE CLAIMS FROM THE NATIONAL HEALTH INSURANCE

K. Ejima1, S. Asakura1, T. Amemiya1, Y. Arai1

1Nihon University School of Dentistry, Oral and Maxillofacial Radiology, Tokyo, Japan

Aim: Claiming medical fees from the National Health Insurance for dental teleradiology became possible approximately 10 years ago. Our dental university hospital has been providing teleradiological services in dentistry for some time now. This study aimed to analyze the cases examined to date and discussed the future direction of teleradiology in dentistry.

Material and Methods: We reviewed a total of 400 cases in which dental clinics and hospitals claimed medical fees for using our dental hospital’s teleradiology service over the past 5 years. Specifically, the age, sex, disease, and modality used, as well as the name and modality of the imaging diagnosis, of the extracted cases were analyzed.

Results: In dental clinics, cone-beam computed tomography (CBCT) was the most commonly used modality, and most cases were chronic apical periodontitis, supernumerary teeth, and impacted wisdom teeth. Conversely, the modalities used in our hospital were CBCT, CT, and MRI, with tumors, cysts, and inflammatory diseases found in most cases. The number of cases sent to the teleradiology service showed a declining trend in dental practices.

Conclusion: The analysis revealed a wide division between dental clinics and hospitals in the number of lesions transmitted. Regarding teleradiology based on claims for medical fees from the National Health Insurance, the low number of cases sent by dental clinics was because of problems with the insurance system and incentives, etc. Dental teleradiology in Japan was expected to remain polarized.

221: DRAMATIC BONE LESION WITH MINOR RADIOGRAPHIC FEATURES IN 2D IMAGING

H. Ackam1, A. Novikov1, A. Maly2, Y. Fleissig3, J. Abu-Tair3, C. Nadler1

1Hebrew University of Jerusalem, Hadassah Medical Center, Maxillofacial Imaging, Department of Oral medicine, Sedation and Imaging, Jerusalem, Israel, 2Hebrew University of Jerusalem, Hadassah Medical Center, Department of Pathology, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel, 3Hebrew University of Jerusalem, Hadassah Medical Center, Oral and Maxillofacial Surgery Department, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel

Aim: We present an extensive right maxillary lesion with subtle radiographic features.

Case presentation: A 51-year-old man, otherwise healthy, presented with a one-month swelling in his right jaw, which did not improve following root canal treatment of the 1st and 2nd molars, thus he was referred to our tertiary center. Periapical radiograph demonstrated disappearance of the lamina dura in the periapical region of the adjacent teeth. Panoramic image demonstrated a lesion with subtle cortical borders causing opacification of the right maxillary sinus, resembling pneumatization. CBCT scan revealed an extensive maxillary lesion causing antral expansion and effacement of the nasal, antral and orbital borders. Histopathologic diagnosed the lesion as adenoid cystic carcinoma with perineural invasion. Treatment included surgical maxillectomy and neck dissection, followed by external radiation.

Conclusion: Radiographic changes causing asymmetry of anatomical structures should serve as an alarming sign in order to diagnose pathological lesions in their initial stages.

147: AN UNUSUAL CBCT RING ARTIFACT NOT PREVIOUSLY NOTED IN THE LITERATURE. A TECHNICAL REPORT.

A. Delantoni1, E. Papanastasiou2

1Aristotle University of Thessaloniki, Dentoalveolar Surgery, Implant Surgery and Radiology, Thessaloniki, Greece, 2Aristotle University of Thessaloniki, Dept. of Medical Physics, School of Medicine, Thessaloniki, Greece

Aim: This presentation demonstrates an unusual ring artifact produced upon a CBCT exam and to our knowledge not yet observed in the literature.

Materials and Methods: We present an unusual case of multiple ring artifacts, which occurred during a patient examination performed on a NEWTOM VGI EVO CBCT scanner (NEWTOM/CEFLA S.C., Imola, Italy). The CBCT unit was installed in 2019 and is routinely serviced and calibrated by the vendor’s authorized technician, every 6 months. The 74 year old male patient was referenced for a routine implant placement. The scan was reconstructed using the manufacturer’s proprietary software.

Results: The artifact was seen in the lateral and frontal scout view, There are two intense nearly vertical lines on either side of both images, giving rise to the intense large ring artifact There are also at least six point-like spots at three different levels of the scout viewsgiving rise to two smaller and one larger ring artefact at three different cross-sectional planes, At a subsequent communication,the authorized technician and the vendor’s application specialist postulated that there must have been a mechanical issue with the movement of the collimator, stating that “one curtain did not move to the correct position blocking the x-ray beam”.

Conclusions: Although this might have caused the intense nearly vertical lines on the scout views and the corresponding large outer ring artifact, it does not explain the inner smaller artifacts. In our opinion, there are still technical issues dentists performing CBCT should be aware of and note.

189: THE EFFECT OF RADIOGRAPHIC VARIABLES DEMONSTRATED IN CBCT ON IMPACTED ROOT DEVELOPMENT

S. Chaushu1, R. Abdalla-Aslan2,3, T. Weill1, E. Dekel1, A. Becker1, C. Nadler2

1Hebrew University of Jerusalem, Hadassah Medical Center, Department of Orthodontics, Jerusalem, Israel, 2Hebrew University of Jerusalem, Hadassah Medical Center, Maxillofacial Imaging, Department of Oral Medicine, Sedation and Imaging, Jerusalem, Israel, 3Rambam Health Care Campus, Department of Oral and Maxillofacial Surgery, Haifa, Israel

Aim: In this analysis we aimed to study the effect of different variables on the morphology of impacted central maxillary incisors.

Materials and Methods: We conducted a retrospective split-mouth study involving 30 patients, aged 8-30 years, with unilateral impacted maxillary incisor, observed in CBCT scans. Demographic, clinical (dental age) and radiographic data were collected. Two calibrated observers, blinded to the clinical data, evaluated anonymized CBCT scans using an objective survey tool. Radiographic measurements included: obstruction location and type, root length and volume of impacted and erupted teeth, as well as presence and angle of dilacerations, vertical location (distance to occlusal plane), tooth axis angle to ANS-PNS (sagittal inclination) and to midline (coronal inclination) of the impacted tooth. Statistical analysis was performed to compare incisor measurements and assess the impact of different variables on these measurements.

Results: The impacted incisors demonstrated significantly shorter roots (10.2±1.8mm versus 13.7±1.8mm) and significantly higher incidence of dilacerations (40% of cases), with minimal impact on root volume. A more advanced dental age correlated with shorter roots and more dilacerations. Odontomes had a greater effect on root volume than supernumeraries. A less angulated position of the impacted tooth in sagittal and coronal planes with superior position of the impacted toot resulted in shorter roots with more dilacerations.

Conclusion: Impacted incisors, supinely located, may result in root malformation, possible due to its cortical bone proximity. Therefore, the volumetric location and the dental age of the impacted incisor may dictate the time for surgical intervention.

215: THE ROLE OF CBCT IN EVALUATING THE PERIAPICAL LESION SIZE: CASE REPORT

A. Cristina1, H. Danisia2, M. Anca1, S. Mihaela1, P. Roxana2, H. Tudor1, C. Corina1, G. Cristian1, D. Yllka1, C. Radu Eduard3

1UMF GR T POPA, Endodontology, Iasi, Romania, 2UMF GR T POPA, Radiology, Iasi, Romania, 3UMF GR T POPA, Surgery, Iasi, Romania

Aim: Highlighting the importance of using CBCT (cone beam computed tomography) in evaluating the size of periapical lesions after endodontic treatment. A follow up at 6 months.

Material and Methods: The 20 years old patient presents with periapical lesions at the level of teeth 4.1 and 4.2 caused by trauma. She benefited from rotary instrumentation taper 30/04, sodium hipochorite irrigation 2.5% followed by laser canal sterilization 1.2 W 4 x times through circular movements after that we do root canal filling. In order to assess the size of the periapical lesions as concretely as possible we preformed a CBCT examination before and after treatment the last one was made at 6 moths after treatment.

Results: CBCT reconstructions highlighted the reduction in the size of the periapical lesions so that definitive crowns could be placed.

Conclusion: In the case of periapical lesions it is necessary to use CBCT examination for a correct evaluation of the dimension of the lesions.

185: ANALYSIS OF SPHENO-OCCIPITAL SYNCHONDROSIS FOR AGE ESTIMATION USING CONE-BEAM COMPUTED TOMOGRAPHY IN LATVIAN INDIVIDUALS

Z. Bokvalde1, Z. Vasermane1, L. Neimane1

1Riga Stradinš University, Rīga, Latvia

Introduction: Spheno-occipital synchondrosis is a point of interest for forensic age estimation because of its relative late ossification in comparison to other cranial synchondroses. In literature it is reported that spheno-occipital synchondrosis fusion occur between 17 to 20 years of age. As its ossification reaches into adolescence, it has potential application for estimating 18 years of age which in many countries is the legal age. Ossification of spheno-occipital syndrondrosis could be used as additional method together with evaluation of the person-of-interest teeth deveploment and condyle deveploment.

Aim: to assess and evaluate spheno-occipital synchonsis fusion stage in relation to the real age in 14-21 year old individuals.

Materials and methods: CBCT data of 92 patients were retrospectively evaluated. CBCT were retrieved from database of RSU Stomatology institute clinic, images were taken for different clinical purposes. Spheno-occipital synchondrosis fusion was graded in 4 stages (0-3) – from completely open with no evidence of fusion till completely fused appereance of bone. Futher it was evaluated in relation to age and sex.

Results: In this study it was observed that there could be potential connection between spheno-occipital synchondrosis fusion stage and chronological age.