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Background and purpose: Assessment of tooth length has an important role in success and failure of dental treatments. As yet periapical radiography has been used for the assessment of tooth length causing high x-ray exposure, long time and patient discomfort. Using panoramic radiography can resolve these problems. The major disadvantage of panoramic radiography is monotonous magnification. The aim of this study was to assess the relationship between real and panoramic tooth lengths. Materials and methods: In an analytical study, 89 teeth consisting 59 maxillary first premolars and 30 maxillary second premolars from patients referring to orthodontic clinics of babol were selected. According to universal numbering system the teeth were divided into four groups: T14, T24, T15, T25. Measurements of real and panoramic tooth length were accomplished by a digital caliper. Length linear regression model analysis was used for the prediction of tooth. Results: Real and panoramic tooth lengths and their magnification showed significant differences between two sexes (P< 0.05). For each gender regression models were produced: (male first premolar tooth length= 0.818X+3.017) (female first premolar tooth length= 0.852X+1.875) (male second premolar tooth length= 1.030X-2.028) (female second premolar tooth length= 1.020X-2.246). Conclusion: Using panoramic radiography for estimation of maxillary premolar real tooth length in studied machine is practical and reliable.

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Background and purpose: Elongated styloid process and mineralization of stylohyoid ligament were ‎seen in 2 – 28% of patients on panoramic radiograph.This condition can create pain in head and neck region ‎or Eagle syndrome in some cases. The aim of this study was to assess the length of stylohyoidligament on ‎panoramic radiographs.‎ Materials and methods: In this cross -sectional study, panoramic radiographs of 800 patients ‎referring to oral and maxillofacial radiology department of Babol dental school were examined for ‎measurement of styloid process. Length of the styloid process was measured as the distance from the point ‎where the styloid process left the tympanic plate to the tip of the process. Processes measuring more than 30 ‎mm were considered as elongated. The collected data was analyzed using statistical analysis software, SPSS ‎‎18. The T-test, Spearman rho and one-way ANOVA were used for analysis. For all tests the p-value of <0.05 ‎was considered significant.‎ Results: The average length of the right styloid was 24.74(±6.99) mm and that of theleft styloid was ‎‎23.86(± 6.45) mm. The length of both styloids increased with age and males had longer styloids than ‎females.Elongated styloids were present in 19.8% of the panoramic radiographs, that 80(10%) showed ‎bilateral elongation of the styloid. Elongated styloid processes were more prevalent in the age-group of 30 – ‎‎50 years.‎ Conclusion: The results of this study was similar to previous studies. So,with considering the ‎relatively high prevalence of this lesion, the clinician must be pay attention to this lesion for diagnosis and ‎treatment of neck and head pain.‎

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Angina bullosa Haemorrhagica (ABH) is a term that was first introduced by Badham in 1967 to describe a bullous disorder in which recurrent oral blood blisters appear in the absence of any identifiable systemic disorder. It is a disorder restricted to the oral mucosa characterized by the formation of blood blisters on slight trauma in the absence of blood dyscrasia, vesiculobullous disease or other systemic diseases. The incidence of the disease is not known. Pathological studies did not reveal new information about these lesions so the etiology of this disease is not fully understood. However, the use of inhaled corticosteroids is a factor for the onset or exacerbation. The incidence of hemorrhagic bullae in primary and secondary amyloidosis is known. The condition runs a benign course. The aim of this paper is to report a case of Angina bullosa haemorrhagica in a 65-year-old man with a medical history of minor thalassemia with the following clinical manifestations: formation of bullas containing blood on the lateral surfaces of the tongue and the hard palate with the recurrence of 2 to 3 months.

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Abstract Background and purpose: Extensive application of x-ray as a diagnostic tool has created a global concern. Repeating a radiograph doubles radiation dose to the patient and staff. It was expected that development of digital facilities could decrease the rate of re-take of radiographs. The aim of this study was to investigate the causes for repeating digital panoramic radiographs. Materials and methods: A descriptive cross sectional study was performed in patients attending digital maxillofacial digital radiography centers. Rejected radiographs were classified into four main groups based on the causes of rejection. The findings were then recorded in a check list designed by authors. Results: There were 2751 panoramic radiographs, of which 153 were repeated. The most important causes of re-taking radiographs were incorrect positioning (47.7%) and not sticking the tongue to the hard palate (28.8%). Conclusion: The results showed an acceptable rate of radiograph re-take compared to the rate found in literature. Digital systems did not affect incorrect positioning, but proper positioning is depended on the operator abilities.

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Multiple myeloma is a monoclonal malignant proliferation of plasma cells that causes osteolytic lesions in the vertebrae, ribs, pelvic bone, skull and jaw. We report a case of a 66 year-old-woman with pain and right facial swelling. Radiographic examination showed a well-defined radiolucent lesion in left posterior mandible. An incisional biopsy was performed and histopathological examination revealed proliferation of malignant plasma cell with off-center and hyper chrome nucleus. The results of biopsy, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This maxillofacial manifestation of multiple myeloma is not that rare, but dentist knowledge about maxillofacial manifestation can help in early diagnosis and consequently better prognosis of the disease.

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Background and purpose: Pulp stones are calcified masses in the pulp chamber or root canals. Cone-beam computed tomography (CBCT) can identify crown and root anatomy and also detect calcifications which may help to achieve a better diagnosis. The goal of this study was to determine the frequency of pulp stones in CBCT images.
Materials and methods: In this cross-sectional study, 500 CBCT images in Babol, north of Iran were included. Pulp stones were detected by NNT viewer software in axial, coronal and sagittal dimensions by the presence of a round or oval appearance of a single dense mass in the pulp cavity or root canals. Parameters such as age, sex, type of tooth and jaw and side involved, condition of the tooth (healthy, decayed/repaired), and location of pulp stone (crown and cervical, middle, apical one third of the root) were identified and recorded in a checklist. Data were analyzed by SPSS V22 applying Independent Samples T-test and Chi-square test.
Results: The mean age of participants was 38.80±14.35 years. Pulp stones were reported in 71 individuals (14.2%) and 119 teeth (0.93%). The frequency of pulp stones was significantly higher in women, maxilla, molars, healthy teeth, and crown pulp (P< 0.05). The frequency of pulp stones was not significantly different between the left and right sides (P= 0.343). Findings showed no significant difference in mean age between people with and without pulp stones (P= 0.334).
Conclusion: In this study, the prevalence of pulp stone was low and they were more common in women, maxillary, molars, healthy teeth, and crown pulp.

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 Background and purpose: This study was conducted to investigate the relationship between the position of impacted canine and associated follicular width.
Materials and methods: This cross-sectional descriptive study, included CBCT archival images (n=70) in a maxillofacial imaging center in Sari, Iran. The images were studied by Planmeca Romexis Viewer ver. 3.8.2. Variables were determined and any relationship was investigated. Data analysis was carried out in SPSS V22.
Results: Findings showed that 61.43% of the canines were in palatal position, 28.57% were in central position of the alveolar process and 10% were in buccal position. Also, the frequencies of vertical position of the canine cusp tip impacted in coronal 1/3, apical 2/3, and cervical region of the lateral incisor root were 50.86%, 40%, and 7.14%, respectively, and there were mild and severe root resorption in 28.57% and 2.86% of the cases, respectively.
Conclusion: Canine impaction often occurs in the palatal position relative to the bone crest and the risk of its occurrence increases with increase in the distance of the canine from the midline and increase in the size of the follicle. This phenomenon, which is reported more in women, can eventually lead to root resorption of the lateral incisor tooth.
 

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Background and purpose: Early diagnosis of jaw lesions is of great importance, especially in children. The aim of the present study was to investigate the frequency of jaw lesions in panoramic radiography of children (5-12 years old) in north of Iran.
Materials and methods: In this study, 1000 panoramic images of children attending oral radiology centers (2012-2019) in north of Iran were studied during one year. Information, including the age, gender, and presence or absence of any jaw lesion were extracted from the radiographic images of patients. Data analysis was carried out in SPSS V22 applying Chi-square.
Results: Out of 1000 panoramic images, 188 (18.8%) were found with jaw lesions. The mean age of children with these lesions was 8.64±2 years. Radiolucent lesions (in 185 images) were more frequent than radiopaque lesions.
Conclusion: Radiolucent lesions were more of periapical lesions.

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 Background and purpose: Condensing osteitis is the local reaction of bone to a pulp inflammatory stimulus with low intensity and long duration and is the most common radiopaque pathogen lesion in the jaw. The aim of the present study was to evaluate the frequency of condensing osteitis in apex of teeth with deep caries and restorations in panoramic radiographs.
Materials and methods: This cross-sectional study evaluated panoramic radiographs of 2039 patients attending Sari Dental School clinic for dental treatments during 2018-19. Demographic information, including age and sex were recorded. All panoramic radiographs were taken with Cranex D (soredex, Finland) panoramic device and Ortho CP-G Plus films. Lesions in the area of teeth with extensive restoration or deep caries (condensing osteitis) were examined in both jaws. Data were analyzed in SPSS V21 using Kolmogorov-Smirnov test, Fisher's exact test and Chi-square.
Results: According to findings, 364 panoramic radiographs had condensing osteitis. The frequency of radiopacity at the apex of teeth with condensing osteitis was significantly higher in women than men (P=0.042). But there was no significant association between condensing osteitis and border, shape, jaw type, tooth type, and age (P<0.05).
Conclusion: This study showed a relatively high prevalence of condensing osteitis in our patients in dental clinic at Mazandaran University of Medical Sciences. Current findings support the theory that condensing osteitis lesions may form a reaction associated with severely decayed, restored, or pulpitized teeth.

 

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Background and purpose: The anatomy of the great palatine canal is important for dentists and maxillofacial surgeons in terms of performing various surgical procedures such as local anesthesia, dental implant placement, and paranasal sinus surgery. In the axial view, the great palatal foramen (GPF) is usually seen in the alignment of the second molar and is hidden by the thick mucosa, which is important to determine its clinical position according to the anatomical signs. The present study aimed to investigate and evaluate the anatomical variations of the large palatine foramen and canal, the large and small palatine foramen, and the location of the large palatine foramen by CBCT technique.
Materials and methods: In this retrospective cross-sectional study, 316 CBCT images related to the maxilla were analyzed to identify the large and small palatal foramen and the palatal canal and their positions. In this cross-sectional study, CBCT images obtained from patients were evaluated in terms of morphology and diameter of the large palatal foramen and large palatal canal. The anatomical shape of the large palatal canal in the sagittal plane and the position of the large palatal foramen in the axial plane relative to the second molar tooth in the upper jaw were investigated. The required information was collected in the checklist prepared for this purpose. With the help of two observers specializing in maxillofacial radiology, the CBCT images were examined and gave their opinion, and 20% of the data were repeated for the observer's error. In this study, the samples were divided into three age groups for statistical analysis. The relationship between age groups, GPF, and large palatal canal was investigated. After collecting the data and information, it was analyzed by SPSS V.23 software, and the data was described using number and percentage indicators and central and dispersion indicators. The significance level was considered to be P<0.05.
Results: Results showed that large palatal holes are seen in 63.9% of the distal second molar and 36.1% flush with the second molar in CBCT images. In terms of foramen morphology, the most common shape was oval in 107 patients (33.9%). Also, according to the surveys, the most common morphology of the large palatal canal was cascade in 120 people (38%). Additionally, the results showed that there is a significant relationship between the morphology of the large palatal foramen and gender, so that the round and oval shapes are more common in men, and the round, split, and teardrop shapes are more common in women. The number of small palatal foramen was less than 3 in 88.8% of cases. According to statistical tests, there is a significant relationship between the diameter of the small palatal foramen with sex, age, and jaw direction (P=0.046).
Conclusion: Considering that the large palatal foramen is located in the distal second molar in most cases a significant relationship was found between the shape of the GPF and its position. Therefore,  to avoid surgical problems, it is necessary to evaluate the anatomical variations of the hole and the large palatal canal, especially before the maxillary wisdom tooth surgery.