Anatomic variations and lesions in mandibular first molar region detected with cone beam computerized tomography

Year 2022, Volume: 2 Issue: 2, 87 - 94, 25.08.2022

Faruk Öztekin , Tuba Talo Yıldırım , Osman Ataş , Melek Didem Tozum

Abstract

Background: The aim of the present study was to evaluate the submandibular fossa (SF) depth, periodontal bone loss (PBL), furcation defects (FD) and periapical (PA) status in mandibular first molar region with cone beam computerized tomography.
Materials and Methods: The retrospective study consisted of CBCT images of 402 mandibular posterior regions from 201 patients. The CBCT scans were assessed to detect the prevalence of SF depth, PBL, FD and periapical status. X2-test was used to detect whether there were significant differences in the prevalence of PBL, PA status, FD, and SF by gender and by age, by occlusion. Pearson’s coefficient was applied to evaluate the correlation between variables.
Result: 90 females, 111 males, mean age of 30.5213.08) were examined. There were significant associations between age and SF depth, PBL, FD, PA status at both right and left sides (p<0.05).There were statistically significant difference among the FD and PBL with regard to occlusal contact at right side (p<0.05). Also, age was correlated with SF depth, PBL, FD, PA and gender was correlated with PBL, FD.
Conclusion: CBCT should be preferred after a detailed and careful clinical evaluation, especially in complex cases where invasive treatment approaches such as regenerative and dental implant surgery are considered as conventional 2D radiography is not sufficient.

Keywords

Anatomy, radiology, CBCT, dental implants, furcation defect

References

• 1) White SC, Pharoah MJ. The evolution and application of dental maxillofacial imaging modalities. Dent Clin North Am 2008; 52(4):689-705.
• 2) Erickson M, Caruso J, Leggitt L. Newtom QR-DVT 9000 imaging used to confirm a clinical diagnosis of iatrogenic mandibular nerve paresthesia. J Calif Dent Assoc 2003; 31(11):843-5.
• 3) Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006; 72(1):75-80.
• 4) Borahan APMO, Pekiner FN. Assesment of submandibular fossa depth using cone beam computed tomography. Therapy 2018; 14(2):51-6.
• 5) Sato S, Arai Y, Shinoda K, Ito K. Clinical application of a new cone-beam computerized tomography system to assess multiple two-dimensional images for the preoperative treatment planning of maxillary implants. Quintessence Int 2004; 35(7):525-8.
• 6) Ito K, Gomi Y, Sato S, Arai Y, Shinoda K. Clinical application of a new compact CT system to assess 3‐D images for the preoperative treatment planning of implants in the posterior mandible: A case report. Clin Oral Implants Res 2001; 12(5):539-42.
• 7) Cattabriga M, Pedrazzoli V, Wilson Jr TG. The conservative approach in the treatment of furcation lesions. Periodontol 2000 2000; 22(1):133-53.
• 8) Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura H. Effectiveness of dental computed tomography in diagnostic imaging of periradicular lesion of each root of a multirooted tooth: a case report. J Endod 2006; 32(6):583-7.
• 9) Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007; 40(10):818-30.
• 10) Low KM, Dula K, Bürgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod 2008; 34(5):557-62.
• 11) Parnia F, Fard EM, Mahboub F, Hafezeqoran A, Gavgani FE. Tomographic volume evaluation of submandibular fossa in patients requiring dental implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(1):e32-e6.
• 12) Yildirim TT, Güncü GN, Colak M, Tözüm TF. The Relationship between Maxillary Sinus Lateral Wall Thickness, Alveolar Bone Loss, and Demographic Variables: A Cross-Sectional Cone-Beam Computerized Tomography Study. Med Princ Pract 2019; 28(2):109-14.
• 13) Zhang W, Foss K, Wang B-Y. A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography. BMC oral health 2018; 18(1):75.
• 14) Yildirim TT, Güncü GN, Göksülük D, Tözüm MD, Colak M, Tözüm TF. The effect of demographic and disease variables on Schneiderian membrane thickness and appearance. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2017; 124(6):568-76.
• 15) Noujeim M, Prihoda T, Langlais R, Nummikoski P. Evaluation of high-resolution cone beam computed tomography in the detection of simulated interradicular bone lesions. Dentomaxillofac Radiol 2009; 38(3):156-62.
• 16) Yildirim YD, Güncü GN, Galindo-Moreno P, Velasco-Torres M, Juodzbalys G, Kubilius M, et al. Evaluation of mandibular lingual foramina related to dental implant treatment with computerized tomography: a multicenter clinical study. Implant Dent 2014; 23(1):57-63.
• 17) Chan HL, Brooks SL, Fu JH, Yeh CY, Rudek I, Wang HL. Cross‐sectional analysis of the mandibular lingual concavity using cone beam computed tomography. Clin Oral Implants Res 2011; 22(2):201-6.
• 18) Froum S, Casanova L, Byrne S, Cho SC. Risk assessment before extraction for immediate implant placement in the posterior mandible: a computerized tomographic scan study. J Periodontol 2011; 82(3):395-402.
• 19) de Souza LA, Assis NMSP, Ribeiro RA, Carvalho ACP, Devito KL. Assessment of mandibular posterior regional landmarks using cone-beam computed tomography in dental implant surgery. Ann Ana 2016; 205:53-9.
• 20) Chan HL, Benavides E, Yeh CY, Fu JH, Rudek IE, Wang HL. Risk assessment of lingual plate perforation in posterior mandibular region: a virtual implant placement study using cone‐beam computed tomography. J Periodontol 2011; 82(1):129-35.
• 21) Pelayo JL, Diago MP, Bowen EM, Diago MP. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal 2008; 13(4):239-43.
• 22) Tugnait A, Clerehugh V, Hirschmann P. The usefulness of radiographs in diagnosis and management of periodontal diseases: a review. J. Dent 2000; 28(4):219-26.
• 23) Braun X, Ritter L, Jervøe-Storm P-M, Frentzen M. Diagnostic accuracy of CBCT for periodontal lesions. Clin Oral Investig 2014; 18(4):1229-36.
• 24) Helmi MF, Huang H, Goodson JM, Hasturk H, Tavares M, Natto ZS. Prevalence of periodontitis and alveolar bone loss in a patient population at Harvard School of Dental Medicine. BMC oral health 2019; 19(1):254.
• 25) Eke PI, Dye B, Wei L, Thornton-Evans G, Genco R. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res 2012; 91(10):914-20.
• 26) Natto ZS, Hameedaldain A. Methodological quality assessment of meta-analyses and systematic reviews of the relationship between periodontal and systemic diseases. J Evid Based Dent Pract 2019; 19(2):131-9.
• 27) Mohan R, Singh A, Gundappa M. Three-dimensional imaging in periodontal diagnosis–Utilization of cone beam computed tomography. J Indian Soc Periodontol 2011; 15(1):11.
• 28) de Faria Vasconcelos K, Evangelista K, Rodrigues C, Estrela C, De Sousa T, Silva M. Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Radiol 2012; 41(1):64-9.
• 29) Mol A. Imaging methods in periodontology. Periodontol 2000. 2004;34(1):34-48.
• 30) Hou GL, Tsai CC. Relationship between periodontal furcation involvement and molar cervical enamel projections. J Periodontol 1987; 58(10):715-21.
• 31) Tal H, Lemmer J. Furcal Defects in Dry Mandibles: Part II: Severity of Furcal Defects. J Periodontol 1982; 53(6):364-7.
• 32) Ozcan G, Sekerci A. Classification of alveolar bone destruction patterns on maxillary molars by using cone-beam computed tomography. Niger J Clin Pract 2017; 20(8):1010-9.
• 33) Bender I. Factors influencing the radiographic appearance of bony lesions. J Endod 1982; 8(4):161-70.
• 34) Borahan M, Dumlu A, Pekiner F. Diş hekimliğinde yeni bir çağın başlangıcı: Dental Volumetrik Tomografi. İstanbul Dişhekimleri Odası Dergisi. 2012; 143:32-5.
• 35) Patel S. New dimensions in endodontic imaging: Part 2. Cone beam computed tomography. Int Endod J 2009; 42(6):463-75.
• 36) Keser G, Pekiner FN. Comparative Evaluation of Periapical Lesions Using Periapical Index Adapted for Panoramic Radiography and Cone Beam Computed Tomography. Clin Exp Health Sci 2018; 8(1):50-5.
• 37) Ramis-Alario A, Tarazona-Alvarez B, Cervera-Ballester J, Soto-Peñaloza D, Peñarrocha-Diago M, Peñarrocha-Oltra D, et al. Comparison of diagnostic accuracy between periapical and panoramic radiographs and cone beam computed tomography in measuring the periapical area of teeth scheduled for periapical surgery. A cross-sectional study. J Clin Exp Dent 2019; 11(8):e732.