Academic literature on the topic 'Orthopantomogramme'

Background: Mandibular asymmetries are commonly seen as asymmetric traits among orthodontic and orthognathic patients which require bilateral mandibular assessment for diagnosis and treatment. An orthopantomogram can be used to measure and compare right and left sides of mandible. The objective of this study was to investigate the reliability of left and right sides of orthopantomogram for determining the linear mandibular measurements and to check whether these values are identical with the values of linear mandibular measurements determined from lateral cephalogram. Methods: Orthopantomogram and lateral cephalogram were taken from 118 patients of age group 12–35 years from Orthodontic department, Liaquat College of Medicine & Dentistry and Darul Sehat Hospital, Karachi, Pakistan. Linear mandibular measurements were detected and compared between orthopantomograms and lateral cephalograms. Right and the left sides of orthopantomograms were compared for all of the linear mandibular parameters by using paired t-test. Independent sample t-test was performed for the comparison between orthopantomogram and lateral cephalogram using SPSS version 26.0. Results: Statistically significant differences were observed when orthopantomograms were compared with lateral cephalograms for mandibular body length (p=0.000) and total mandibular length (p=0.000). No statistically significant difference was found between orthopantomograms and lateral cephalograms for ramus height (p=0.226, p=0.177). Neither any significant difference was observed between right and left sides of an orthopantomogram. Conclusion: An orthopantomogram can be used to evaluate vertical mandibular measurements as reliably as a lateral cephalogram. However, it is required for clinicians to be vigilant when determining horizontal mandibular measurements from orthopantomograms as they are unpredictable.

Orthopantomogram is a radiographic technique that improves the possibility of early detection of dental anomalies.This study was representing a base line diagnostic information which obtained from each patient utilizes orthopantomogram in x-ray clinic at hospital of Surgeries Specialization (ALshaheed Addnan previously).Data was collected from randomly chosen 696 dentate patients who were radiographed for different reasons. The age range was between 5-45years.Results revealed that, the main reason for taking orthopantomograms was to investigate different orthodontic problems (41.4%), then impacted teeth (25%), facial fractures due to trauma (13.7%), mixed dentition development (11.5%), and finally periodontal diseases (8.3%). High percentage of patients was in range of age group between (5-15) (51.1%).This study focuses on the importance of using orthopantomograms as a most indispensable method on achieving complete diagnostic information.

Background: Among various replacement options available for maxillary molars, implants necessitate the need to examine available ridge height and width. Panoramic radiographs (orthopantomograms) are routinely used for preliminary determination of ridge height which is helpful in communicating with patients regarding treatment needs and options. This study was designed with the aim to assess the sub sinus ridge height at dentulous and edentulous first molar sites.Methods: A cross-sectional study was conducted from March to November 2019 among patients visiting the dental college. The orthopantomograms of 455 patients were prospectively collected and analysed using Carestream imaging software (version 7.0.0). Distance from alveolar crest to maxillary sinus was measured in first molar region. Results: Mean minimal sub sinus ridge height at non-missing maxillary first molar site was 8.16 ± 2.6 mm, whereas for missing maxillary first molar site it was 5.25 ± 2.28 mm and the difference was statistically significant (p<0.001). Statistically significant difference among the age groups and minimum subsinus ridge height (p<0.001) was observed. Conclusions: Missing maxillary first molar sites may often require vertical bone augmentation with direct sinus lifting procedures if it has to undergo replacement with dental implants in the representative Nepalese population.Keywords: Implant; Nepalese; orthopantomogram; panoramic radiography; sinus augmentation

Objective: To find the inter-rater reliability to the assessment of ramus relationship of mandibular impacted third molar among denitsts. Methodology: A cross sectional comparative study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore after obtaining ethical clearance from ethical committee of Sharif Medical Research Centre (SMRC) in which dentists from three different specialties namely; Oral Pathology, Endodontics and Prosthodontics were included as raters. The study was conducted from December 2020 to February 2021. A total of 21 Orthopantomograms were assigned to each rater for assessing the ramus relationship of impacted third molar. The classification for angle of impaction used was Winter`s classification. The raters were provided with the OPGs and a proforma for recording their observations. Results: The level of agreement regarding the ramus relationship of impacted third molars observed on the Orthopantomograms between rater 1 and rater 2 was fair (κ=0.366 ,p=0.022). The agreement was also fair between rater 1 and rater 3 (κ=0.300, p=0.094). Conclusion: There was a fair agreement in assessment of ramus relation of the impacted mandibular molars of rater 1 with rater 2 and 3 where majority of the class 2 and class 3 relations were rated similarly by both the raters as Keywords: Inter-rater reliability, Cohen Kappa, Impacted third molar, Orthopantomogram, Ramus relationship

Purpose: to determine the peculiarities of the dynamics of the roentgenomorphometric indices of the jaws in children during the period of mixed bite. Materials and methods. The study assessed the dynamics of radiological indices (mental index (MI), gonial index (GI), upper and lower panoramic mandibular indices (PMI-S and PMI-i)). The study used orthopantomograms of 107 children (65 boys and 42 girls) aged 6–13 years from Lvov and Lviv region. All children were divided into age groups with the preservation of a proportional and harmonious distribution, both by sex and by age. Results. After evaluating the results of the study, the age periods of active restructuring of the bone structure of the child's jaws were identified. A characteristic feature of variations in index indicators is different age phases of active changes for boys and girls. The only common period for both sexes is the age of 9–10 years, when there is an increase in almost all index indicators, which coincides with the beginning of the eruption of multi-rooted teeth. Conclusions. Evaluation of index indicators using orthopantomograms in children during the period of mixed bite is an important diagnostic criterion for detecting active morphometric changes in the bone structures of the maxillofacial region, as well as an auxiliary diagnostic criterion when planning the timing of dental or orthodontic intervention. Key words: orthopantomogram, radiological indices, mental index, gonial index, upper and lower panoramic mandibular indices.

Introduction: Gonial angle is an important parameter of the craniofacial complex which is generally used to evaluate the vertical parameters and symmetry of the facial skeleton. Gonial angle can be measured in both orthopantomogram (OPG) and lateral cephalograms. Due to the superimpositions seen while measuring the bilateral strucuture on lateral cephalograms, reliable measurement of the gonial angle becomes difficult. This study is done to clarify the possible application of orthopantomogram (OPG) for evaluating angular measurement of the mandible specifically gonial angle by comparing with lateral cephalogram. Materials and Method: All the patients (104) being treated from January 2018 to August 2020 in department of Orthodontics in Nepal Medical College were included in the study. Gonial angle measurements were made on lateral cephalograms and orthopantomograms of 104 patients – 54 males and 50 females with mean age of 22.20 ± 3.25 years. Patients aged 15-35 years were included in the study. Data was processed in SPSS version 16.0. Result: Mean Gonial angle in lateral cephalogram was greater than mean gonial angle in OPG and this difference was found to be statistically significant (p-value < 0.05). The difference in mean gonial angle was found to be statistically significant when compared between right gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05) and also between left gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05). Conclusion: When gonial angle values obtained from both sides of OPG were compared, no statistically significant difference was found. Significant differences were found when gonial angle values obtained from OPG right and left sides were compared with that of lateral cephalogram.

An inferior alveolar nerve block is a usual practice by a dental practitioner. Panoramic radiography is a widely used technique in dentistry to get a clear and comprehensive view before planning any treatment. The study aimed to compare the morphometric localization of mandibular foramen (MF) on dry bones and orthopantomogram. The study was designed in two phases: a morphometric study on dry human mandibles (phase I) and orthopantomograms of the same dry human mandibles (phase II). The study materials were 200 dry north Indian human mandibles belonging to unknown sex obtained from the Department of Anatomy. Descriptive statistics, including range, mean±standard deviation, paired t-test to compare dry bones and orthopantomogram, Pearson's correlation coefficient, and measurement error, were used. T-test was applied separately to compare the right and left sides of dry bones. The distance of mandibular foramen from the posterior border and lower border is shorter on the right side than on the left. Its distance from the anterior border and the mandibular notch was greater on the right side. On panoramic radiographs, the distance of MF from nearby anatomical landmarks on the mandible was highly unreliable except for the mandibular notch. Our findings demonstrate a statistically significant difference between distances on dry bone and OPG but no statistically significant difference between MF-notch on both sides and MF-AB on the right side. As a result, a surgeon can rely upon a mandibular notch to locate mandibular foramen during clinical procedures. Magnification is an inbuilt property of OPG; for precise localization of MF, it is advisable to proceed with advanced three-dimensional techniques to protect viable anatomical structures.

Background: The evaluation of the chronological age is a practical method in crime investigation field that assists in identifying individuals to treat them as underage or adult. This study aimed to assess the stages of third molars mineralization in relation to chronological age of Iraqi individuals, determine the gender differences and arches (maxillary/mandibular) differences. Materials and Methods: A total of 300 orthopantomograms of orthodontic patients were collected according to specific criteria and evaluated visually. The developmental stages of maxillary and mandibular third molars were determined according to Demirjian method. The chronological age was recorded according to the particular mineralization stages at which it reached considering genders, sides and jaws. Comparisons were done using paired sample and independent sample t-tests. Results: Results showed that there was no statistically significant difference (P>0.05) between maxillary and mandibular third molars. The maxillary third molars reached earlier than mandibular one in stages F and G. There was no significant difference between the mean ages of males and females at each given developmental stage in the maxillary and mandibular third molars except for the stage D in the maxilla and stages D and E in the mandible. The development of third molar teeth on the right and left sides was similar except for the maxillary arch in males when there was a significant difference in stage C and D and stage E in the mandibular arch. Conclusion: The Demirjian method is an excellent approach for age assessment using Orthopantomogram. All of the differences between the current study and other studies could be because of the difference in the populations who were chosen from different geographical areas. Keywords: Age estimation, Demirjian method, third molar, Orthopantomogram, chronological age.

Background: Growing individuals not only differ in the timing of the maturational events, but also in the sequence of these events. Age is one of the essential factors, which play an important role in every aspect of life like in clinical, medico-legal, forensic and anthropological applications and in planning treatment of orthodontic and pedodontic patients. The aim of the study was to determine dental age from orthopantomogram using Demirjian’s method and Nolla’s method and to evaluate the interrelationship between chronological and dental age according to both these methods. Materials and Methods: A cross sectional study was carried out in 177 orthopantomograms of the patient aged between 5 to 15 years. Dental age estimation was done with Demirjian’s and Nolla’s method. Results: The mean chronological age 10.14 + 3.16 compared with the mean Demirjian age 9.58 + 3.39 was statistically non significant p > 0.05 whereas comparision with mean Nolla age 7.88+ 1.56 was significant statistically. Conclusions: Both methods showed delayed dental age compared to chronological age. Demirjian’s method was more applicable to assess the dental age in Nepalese children compared to Nolla’s method.Keywords: chronological age; dental age; Demirjian’s method; Nolla’s method.

Exposé du problème : Chez l'individu vivant, l'estimation de l'âge dentaire est un paramètre utilisé en orthopédie ou en orthodontie dentofaciale, ou en pédiatrie pour situer l'individu sur sa courbe de croissance. En médecine légale l'estimation de l'âge dentaire permet d'inférer l'âge chronologique sous forme d'une régression ou d'une classification par rapport à un âge clé. Il existe des méthodes physiques et radiologiques. Si ces dernières sont plus précises, il n'existe pas de méthode universelle. Demirjian a créé il y a presque 50 ans la méthode radiologique la plus utilisée, mais elle est critiquée pour sa précision et pour l'utilisation de tables de références basées sur un échantillon de population franco-canadien. Objectif : L'intelligence artificielle et plus particulièrement l'apprentissage machine a permis le développement de différents outils ayant une capacité d'apprentissage sur une base de données annotées. L'objectif de cette thèse a été de comparer la performance de différents algorithmes d'apprentissage machine ; dans un premier temps par rapport à deux méthodes classiques d'estimation de l'âge dentaire, puis entre elles en ajoutant des prédicteurs supplémentaires. Matériel et méthode : Dans une première partie, les différentes méthodes d'estimation de l'âge dentaire sur des individus vivants enfants et jeunes adultes sont présentées. Les limites de ces méthodes sont exposées et les possibilités d'y répondre avec l'utilisation de l'apprentissage machine sont proposées. A partir d'une base de données de 3605 radiographies panoramiques d'individus âgés de 2 à 24 ans (1734 filles et 1871 garçons), différentes méthodes d'apprentissage machine ont été testées pour estimer l'âge dentaire. Les précisions de ces méthodes ont été comparées entre elles et par rapport à deux méthodes classiques de Demirjian et Willems. Ce travail a abouti à la parution d'un article dans l'International Journal of Legal Medicine. Dans une deuxième partie, les différentes méthodes d'apprentissage machine sont décrites et discutées. Puis les résultats obtenus dans l'article sont remis en perspective avec les publications sur le sujet en 2021. Enfin une mise en perspective des résultats des méthodes d'apprentissage machine par rapport à leur utilisation dans l'estimation de l'âge dentaire est réalisée. Résultats : Les résultats montrent que toutes les méthodes d'apprentissage machine présentent une meilleure précision que les méthodes classiques testées pour l'estimation de l'âge dentaire dans les conditions d'utilisation de ces dernières. Elles montrent également que l'utilisation du stade de maturation des troisièmes molaires sur une plage d'utilisation étendue à 24 ans ne permet pas l'estimation de l'âge dentaire pour une question légale. Conclusion : Les méthodes d'apprentissage machine s'intègrent dans le processus global d'automatisation de la détermination de l'âge dentaire. La partie spécifique d'apprentissage profond semble intéressante à investiguer pour des tâches de classification de l'âge dentaire
Statement of the problem: In the living individual, the estimation of dental age is a parameter used in orthopedics or dentofacial orthodontics or in pediatrics to locate the individual on its growth curve. In forensic medicine, the estimation of dental age allows to infer the chronological age for a regression or a classification task. There are physical and radiological methods. While the latter are more accurate, there is no universal method. Demirjian created the most widely used radiological method almost 50 years ago, but it is criticized for its accuracy and for using reference tables based on a French-Canadian population sample. Objective: Artificial intelligence, and more particularly machine learning, has allowed the development of various tools with a learning capacity on an annotated database. The objective of this thesis was to compare the performance of different machine learning algorithms first against two classical methods of dental age estimation, and then between them by adding additional predictors. Material and method: In a first part, the different methods of dental age estimation on living children and young adults are presented. The limitations of these methods are exposed and the possibilities to address them with the use of machine learning are proposed. Using a database of 3605 panoramic radiographs of individuals aged 2 to 24 years (1734 girls and 1871 boys), different machine learning methods were tested to estimate dental age. The accuracies of these methods were compared with each other and with two classical methods by Demirjian and Willems. This work resulted in an article published in the International Journal of Legal Medicine. In a second part, the different machine learning methods are described and discussed. Then, the results obtained in the article are put in perspective with the publications on the subject in 2021. Finally, a perspective of the results of the machine learning methods in relation to their use in dental age estimation is made. Results: The results show that all machine learning methods have better accuracy than the conventional methods tested for dental age estimation under the conditions of their use. They also show that the use of the maturation stage of third molars over an extended range of use to 24 years does not allow the estimation of dental age for a legal issue. Conclusion: Machine learning methods fit into the overall process of automating dental age determination. The specific part of deep learning seems interesting to investigate for dental age classification tasks

Zusammenfassung Ziel: Pathomorphologische Veränderungen der Kiefergelenke treten im Rahmen einer JIA häufig auf. In dieser Arbeit sollten anhand von einer kieferorthopädischen zweidimensionalen Röntgenbildgebung (Orthopantomographie - OPG) pathologische Veränderungen der Kiefergelenke bei JIA-Patienten differenziert und Asymmetrien des Unterkiefers in Abhängigkeit vom Grad der Kondylendestruktion bestimmt werden. Darüber hinaus sollte geprüft werden, wie sich die Krankheitsdauer auf den Befall der Kiefergelenke auswirkt. Zusätzlich wurden zur differenziellen Analyse der Pathomorphologie die klinische Funktionsanalyse (FAL), die Joint Vibration Analysis (JVA) sowie die 3D-Stereophotogrammetrie (3d-Scan) eingesetzt. Ziel war mittels non-invasiver, kostengünstiger und schnell verfügbarer Untersuchungsmethoden eindeutige Parameter zum Befall der Kiefergelenke zu detektieren. Patienten und Methodik: In dieser Arbeit wurden 46 Patientin (28 weiblich; 18 männlich) kaukasischer Herkunft mit diagnostizierter JIA eingeschlossen. Die Kiefergelenke (n = 92) wurden einzeln nach dem Grad ihrer Kondylendestruktion (Grad 0 - 4 nach Billiau et. al. [78]) befundet und in eine leicht betroffene Gruppe 1 (Grad 0, 1 und 2 nach Billiau: röntgenologisch unauffällig, Kondylenerosionen, Kondylenabflachungen) und in eine schwer betroffene Gruppe 2 (Grad 3 und 4 nach Billiau: Kondylusabflachungen mit Erosionen, Komplettverlust des Kondylus) eingeteilt. Zur Quantifizierung von Unterkieferasymmetrien wurde das Seitenverhältnis aus Kondylus-, Ramus- und Mandibulahöhe bestimmt. Der Vergleich der einzelnen klinischen, instrumentellen und bildgebenden Untersuchungsverfahren (OPG, FAL, JVA, 3d-Scan) erfolgte jeweils durch die Gegenüberstellung der schwer betroffenen und der leicht betroffenen Patientengruppe. � Ergebnisse: Erkrankungsdauer: Anhand des Grades der Kondylendestruktion wurden 36 Patienten in die leicht betroffene Gruppe 1 und 10 Patienten in die schwer betroffenen Gruppe 2 eingeteilt. Dabei war die Erkrankungsdauer in der schwer betroffenen Patientengruppe (8,9 ± 5,2 Jahre) signifikant länger, als in der leicht betroffenen Patientengruppe (4,6 ± 4,7; Jahre) (p = 0,031). FAL: Die Ergebnisse der FAL zeigten ausgeprägtere funktionelle Abweichungen in der schwer betroffenen Patientengruppe (Gruppe 2). Es wurde jedoch kein signifikanter Unterschied zur Gruppe 1 ermittelt. Die schwer betroffene Patientengruppe zeigten einen höheren Prozentsatz an von Schmerzen bei Palpation der Kiefergelenke (Gruppe 2: 70,0 % vs. Gruppe 1: 61,1 %) oder Schmerzen bei Mundöffnung (Gruppe 2: 10,0% vs. Gruppe 1: 8,3 %), Deflexionen des Unterkiefers (Gruppe 2: 50,0% vs. Gruppe 1: 33,3 %), Gelenkgeräuschen (Gruppe 2: 80,0 % vs. Gruppe 1: 63,9 %) und Mundöffnungseinschränkungen (Gruppe 2: 60,0 % vs. Gruppe 1: 25,0 %). Die durchschnittliche Mundöffnung betrug in Gruppe 2 40,6 mm, während sie in Gruppe 1 43,5 mm betrug. Bei Patienten mit einer Mundöffnung < 40 mm wurde in Gruppe 2 eine durchschnittliche Mundöffnung von 35,3 mm und in Gruppe 1 von 34,1 mm gemessen. JVA: Sowohl in der gelenkbezogenen, als auch in der patientengruppenbezogenen Analyse der JVA deuteten die Messparameter in der schwer betroffenen Patientengruppe vermehrt auf chronisch-degenerative oder bestehende Ergüsse im Kiefergelenk hin. In der gelenkbezogenen Auswertung zeigte sich dies insbesondere durch eine reduzierte Signalstärke in der schwer betroffenen Patientengruppe (Total power: p = 0,005; Power < 300 Hz: p = 0,006; Power > 300 Hz: 0,003;) sowie in einer signifikant erhöhten Peak Frequenz (p = 0,036). OPG: In der Auswertung der OPGs war die Ratio von Kondylus-, Ramus- und Mandibulahöhe in der schwer Patientengruppe (Ratio 79,6 %, 85,9 %, 86,5 %) signifikant kleiner (Kondylushöhe: p = 0,0005; Ramushöhe: p = 0,0030; Mandibulahöhe: p = 0,0002), als in der leicht betroffenen Patientengruppe (Ratio 93,8 %, Ratio 96,0 %, 95,6 %). Somit ergaben sich in der schwer betroffenen Patientengruppe signifikant stärker ausgeprägte Unterkieferasymmetrien, als in der leicht betroffenen Patientengruppe. 3d-Scan: Im 3d-Scan kam es bei Patienten mit schwer betroffenen Kiefergelenken signifikant häufiger zu Abweichungen des Weichteilkinns von der Medianebene (Gruppe 2: 3,0 mm vs. Gruppe 1: 1,2 mm; p = 0,041) und zu Asymmetrien des Unterkiefers (Gruppe 2: 62,5 % vs. Gruppe 1: 14,8 %; p = 0,015) als bei Patienten mit leicht betroffenem Kiefergelenk. Schlussfolgerung: Es zeigte sich, dass mittels einfacher und schnell verfügbarer Untersuchungsmethoden wie der klinischen Funktionsanalyse, der Joint Vibration Analysis und der OPG-Aufnahme eine Pathologie im Kiefergelenk dargestellt werden kann. Die Methoden können als wichtige Referenz zur Kontrolle der Krankheitsprogression bei Patienten mit JIA dienen. Darüber hinaus ist eine Klassifikation der Kondylen in schwer und leicht betroffene Kiefergelenke mittels pathomorphologischer Analyse möglich. Dabei ist von einem direkten Zusammenhang zwischen Grad der Destruktion, Ausmaß der Unterkieferasymmetrie und Dauer der Erkrankung bei Patienten mit JIA auszugehen. Insgesamt konnte die Wertigkeit klinischer, instrumenteller und bildgebender Untersuchungsverfahren der Kiefergelenksdiagnostik bei Patienten mit juveniler idiopathischer Arthritis dargestellt werden
Summary Aim: Pathomorphological changes of the temporomandibular joints occur frequently in patients with JIA. In this study, orthodontic two-dimensional X-ray imaging (orthopantomography - OPG) was used to differentiate pathological changes of the temporomandibular joints in JIA patients and to determine asymmetries of the mandible in accordance to the degree of condyle destruction. In addition, it should be examined how the disease duration affects the involvement of the temporomandibular joints. In addition, clinical analysis (FAL), joint vibration analysis (JVA) and 3D stereophotogrammetry (3d-scan) were used for the specific analysis of pathomorphology. The aim was to detect unambiguous parameters for affected temporomandibular joints by means of non-invasive, cost-effective and rapidly available examination methods. Patients and methods: In this study, 46 patients (28 female, 18 male) of Caucasian origin were diagnosed with JIA. The temporomandibular joints (n = 92) were individually evaluated based on the degree of their condylar destruction (Grades 0 - 4 according to Billiau et al. [78]) and divided into a slightly affected group 1 (Grades 0, 1 and 2 according to Billiau: radiologically unremarkable, Condylar erosions, condyle flattening) and into a severely affected group 2 (grade 3 and 4 according to Billiau: condyle flattening with erosions, complete loss of the condyle). To quantify mandibular asymmetries, the ratio of condyle, ramus and mandibular height was determined. The comparison of the individual clinical, instrumental and imaging examination procedures (OPG, FAL, JVA, 3d-Scan) was performed by comparing the severely affected and the slightly affected patient group. Results: Disease duration: Based on the degree of condylar destruction, 36 patients were divided into the slightly affected group 1 and 10 patients to the severely affected group 2. The disease duration was significantly longer in the severely affected patient group (8.9 ± 5.2 years) than in the slightly affected patient group (4.6 ± 4.7 years) (p = 0.031). FAL: The results of the FAL showed more functional deviations in the severely affected patient group (group 2). However, no significant difference to Group 1 was found. The severely affected patients showed a higher percentage of pain in palpation of the temporomandibular joints (group 2: 70.0% vs. group 1: 61.1%) or mouth opening pain (group 2: 10.0% vs. group 1: 8.3%), mandibular deflections (group 2: 50.0% vs. group 1: 33.3%), joint noises (group 2: 80.0% vs. group 1: 63.9%) and mouth opening restrictions (Group 2: 60.0% vs. Group 1: 25.0%). The average mouth opening in group 2 was 40.6 mm, while in group 1 it was 43.5 mm. In patients with a mouth opening <40 mm, an average mouth opening of 35.3 mm was measured in group 2 and 34.1 mm in group 1. JVA: In the joint-related as well as in the patient-group-related analysis of the JVA, the measurement parameters in the severely affected patient group increasingly pointed to chronic degenerative or existing effusions in the temporomandibular joint. In the joint-related evaluation, this was demonstrated in particular by a reduced signal strength in the severely affected patient group (total power: p = 0.005, power <300 Hz: p = 0.006, power> 300 Hz: 0.003;) and in a significantly increased peak frequency (p = 0.036). OPG: In the evaluation of the OPGs, the ratio of condyle, ramus and mandibular height was significantly lower in the severe patient group (ratio 79.6%, 85.9%, 86.5%) (condyle height: p = 0.0005; p = 0.0030, mandibular height: p = 0.0002), than in the slightly affected Patient group (ratio 93.8%, ratio 96.0%, 95.6%). Thus, significantly more pronounced mandibular asymmetries were found in the severely affected patient group than in the slightly affected patient group. 3d scan: In the 3d scan, deviations of the soft tissue chin from the median plane (group 2: 3.0 mm vs. group 1: 1.2 mm, p = 0.041) and mandibular asymmetry were significantly more frequent in patients with severely affected temporomandibular joints (group 2: 62.5% vs. Group 1: 14.8%, p = 0.015) than in patients with slightly affected temporomandibular joints. Conclusion: It has been shown that it is possible to visualize pathology in the temporomandibular joint by means of simple and easily available examination methods such as clinical functional analysis, joint vibration analysis and OPG imaging. The methods can serve as an important reference for controlling disease progression in patients with JIA. In addition, a classification of the condyles in severe and slightly affected temporomandibular joints by means of pathomorphological analysis is possible. There is a direct correlation between the degree of destruction, the extent of mandibular asymmetry and the duration of the disease in patients with JIA. Overall, the value of clinical, instrumental and imaging examination methods of temporomandibular joint diagnosis in patients with juvenile idiopathic arthritis was demonstrated

Dental radiology occupies a pivotal role in pediatric dentistry and acts as an aid in the diagnosis of oral health and disease states. It is used in conjunction with clinical examination for the final diagnosis. It includes the intraoral radiograph, extra-oral radiograph, and specialized radiographs like Cone Beam Computed Tomography (CBCT), computed tomography (CT) etc. The Intra Oral Periapical Radiograph (IOPA) and orthopantomogram (OPG) are commonly used in the dental setting owing to the low exposure and broad coverage of the areas. Radiation protection includes many entities, which must be provided for both the patient and the accompanying person. The radiographic requirements differ for neonates, children, and adolescents. This chapter emphasizes the importance of dental radiology in pediatric dentistry and the various aspects of radiology from the perspective of the pediatric population.

La coagulation intravasculaire disséminée (CIVD) est une pathologie rare correspondant à l’activation systémique de la cascade de coagulation. Les thrombi fibrineux formés, auxquels s’ajoute un éventuel vasospasme, conduisent à l’ischémie et à la nécrose des tissus. La CIVD est fréquemment associée à un traumatisme, une blessure, une complication obstétrique ou à un choc septique. De nombreux cas d’ostéonécrose dus à une CIVD ont été décrits dans la littérature orthopédique (principalement concernant la tête fémorale), mais très peu de cas sont retrouvés concernant la région maxillo-mandibulaire. Une patiente de 83 ans se présente en consultation pour l’apparition récente de mobilités au niveau du bloc incisivo-canin maxillaire. L’interrogatoire révèle le diagnostic deux mois auparavant d’une leucémie myéloïde aigue, découverte de manière fortuite suite à un choc septique à E. Coli. Les bilans biologiques réalisés au moment du sepsis étaient en faveur d’une coagulation intravasculaire disséminée (CIVD). Quelques jours après, la patiente se plaignait de douleurs et de mobilités anormales localisées sur les dents antérieures maxillaires. Les examens cliniques et radiographiques (orthopantomogramme et cone beam) objectivent une nécrose osseuse du prémaxillaire limitée par les canines, avec un séquestre indépendant du reste du maxillaire. L’étude d’imputabilité conclut à la responsabilité de la CIVD en l’absence d’autres facteurs déclenchants et en raison d’une chronologie concordante. Le diagnostic de nécrose consécutive à une CIVD est alors posé. La prise en charge consiste en une séquestrotomie sous anesthésie générale et fermeture muqueuse. Un suivi régulier est mis en place avec une évolution favorable. Le prémaxillaire possède une vascularisation très riche assurée par les branches terminales de l’artère carotide externe, et par l’artère maxillaire. Les nécroses avasculaires sont par conséquent rares dans cette région. Cette vascularisation abondante explique le peu de cas décrits dans la littérature. On retrouve deux cas de nécrose consécutive à une CIVD au niveau de la mandibule et deux cas pour le prémaxillaire.

Autotransplantation de germes dentaires au centre hospitalier de Pau : une série de cas Alande C1, Landric C2 1. Interne en Chirurgie Orale, UFR Odontologie, Service ORL et Stomatologie CH Pau 2. Spécialiste en Chirurgie Orale, Assistante hospitalière, CH Pau. INTRODUCTION : L’autotransplantation correspond au déplacement d’un organe fonctionnel (transplant) d’un site donneur vers un site receveur, sur un même patient. Dans le cadre de l’organe dentaire, le transplant est placé dans une alvéole osseuse intrabuccale naturelle ou préparée chirurgicalement. Les indications sont nombreuses : délabrement carieux, expulsion traumatique, défaut d’éruption, agénésie. C’est une technique chirurgicale peu utilisée, pourtant les métaanalyses les plus récentes font état d’un taux de succès compris entre 75 et 91% (1). Ce travail expose une série de 07 transplantations. OBSERVATION : Les 7 transplantations ont été réalisées au Centre Hospitalier de Pau entre aout 2017 et janvier 2018. Les patients étaient initialement adressés par leur dentiste ou leur othodontiste pour des avulsions. Les indications résultaient toutes d’un délabrement carieux de premières molaires maxillaires ou mandibulaires, ces dernières étant non restaurables. Les patients étaient âgés de 17 à 23 ans. Les transplants étaient tous des germes de 3ème molaire incluse situées au stade 7-8 de Nolla. Le même protocole chirurgical a été systématiquement utilisée pour chacun des patients, à savoir : avulsion de la dent délabrée, révision et rinçage alvéolaire, préparation du site receveur, avulsion du germe, temps extra-alvéolaire le plus court possible, positionnement dans le site receveur avec ajustement si nécessaire, mise en sous occlusion par améloplastie, contention. Un soin tout particulier était accordé à la préservation des cellules desmodontales du transplant. Les patients n’ont pas présenté de complication per ou postopératoire. Leur suivi post-opératoire est en cours et est réalisé de façon systématique à 1 semaine, 1 mois, 2 mois avec orthopantomogramme et 6 mois. Pour être considérées comme un succès, les transplantations devaient présenter les critères suivants : poursuite de l’édification radiculaire, absence de mobilité du transplant, absence de signes infectieux cliniques et radiologiques, visualisation radiologique d’un ligament alvéolo-dentaire sans signe d’ankylose. DISCUSSION : De plus en plus d’études tendent à montrer que la préservation des cellules desmodontales est un des facteurs majeurs pour la réussite du traitement (2). Avec l’avènement de la planification 3D (3), ce paramètre pourra être d’avantage contrôlé. Les taux de succès de cette thérapeutique, déjà élevés, pourraient être amenés à augmenter d’avantage. Les transplantations sont aujourd’hui une alternative de choix au traitement implantaire chez les jeunes patients.