UNASSIGNED: The canine plays a vital role in dentofacial aesthetics and function. It supports the base of the alar and upper lip, which are crucial for smile aesthetics. When impacted, these functions are lost, leading to low self-esteem and overall poor health-related quality of life. The present study was conducted to find the prevalence of impacted and transmigrated canines in orthodontic patients and also to find the most prevalent type of canine impaction.
UNASSIGNED: This retrospective study was conducted in a hospital setting at Dental College. A total of 3050 OPGs (Orthopantomagram) of patients who visited dental hospitals for orthodontic treatment constituted the final sample. Demographic details regarding age, gender, and place of residence were collected from the patients. Evaluation of sample radiographs on the standard light box was performed to collect data regarding impacted and transmigrated canines. Statistical analysis was performed using descriptive statistics and Chi-square test.
UNASSIGNED: Prevalence of impacted canine was found to be 2.46%. Impacted canine prevalence of 1.53% and 2.85% was reported in males and females, respectively. Only two female patients had transmigrated mandibular impacted canines. Comparison of arch showed a statistically significant (P value 0.02) higher prevalence in the maxillary arch, which was 1.54%, and in the mandibular arch, it was 0.92%. The present study reported significantly more unilateral impactions (P value 0.00) than bilateral impactions.
UNASSIGNED: The overall prevalence for impacted canine was 2.46%. Prevalence was higher in female patients. Early diagnosis of impacted canines is vital for planning orthodontic treatment in such patients.

Background/Objectives: The purpose of this preliminary study was to evaluate the diagnostic performance of an AI-driven platform, Diagnocat (Diagnocat Ltd., San Francisco, CA, USA), for assessing endodontic treatment outcomes using panoramic radiographs (PANs). Materials and Methods: The study included 55 PAN images of 55 patients (15 males and 40 females, aged 12-70) who underwent imaging at a private dental center. All images were acquired using a Hyperion X9 PRO digital cephalometer and were evaluated using Diagnocat, a cloud-based AI platform. The AI system assessed the following endodontic treatment features: filling probability, obturation adequacy, density, overfilling, voids in filling, and short filling. Two human observers independently evaluated the images, and their consensus served as the reference standard. The diagnostic accuracy metrics were calculated. Results: The AI system demonstrated high accuracy (90.72%) and a strong F1 score (95.12%) in detecting the probability of endodontic filling. However, the system showed variable performance in other categories, with lower accuracy metrics and unacceptable F1 scores for short filling and voids in filling assessments (8.33% and 14.29%, respectively). The accuracy for detecting adequate obturation and density was 55.81% and 62.79%, respectively. Conclusions: The AI-based system showed very high accuracy in identifying endodontically treated teeth but exhibited variable diagnostic accuracy for other qualitative features of endodontic treatment.

OBJECTIVE: To investigate the prevalence of tooth agenesis and associated dental anomalies in Latvian adolescent dental patients and compare it to other European countries.
METHODS: Cross-sectional study of 2692 11-to-14-year-old patients (39.9% males and 60.1% females) attending Riga Stradins University Institute of Stomatology with panoramic radiographs taken between August 2020 and September 2021. Patients with any genetic syndromes were excluded. Data on tooth agenesis (excluding third molars) and other dental anomalies were recorded.
RESULTS: The prevalence of tooth agenesis in Latvian adolescent dental patients was 9.3% with no statistically significant difference between genders (χ2 test, p = 0.472). The most commonly missing teeth were mandibular second premolars, followed by upper lateral incisors and upper second premolars. There was a statistically significant association with the presence of other dental anomalies in tooth agenesis patients (p < 0.001).
CONCLUSIONS: This study found that the prevalence of non-syndromic tooth agenesis in Latvian adolescent dental patients was 9.3% with no statistically significant differences between the genders. Patients with tooth agenesis have a statistically significant possibility of the presence of other dental anomalies (p < 0.001).

BACKGROUND: Accurate bracket positioning remains challenging. To avoid angulation errors, some recommend examining the panoramic radiograph during bonding. However, it can cause distortions. Cone-beam computed tomography (CBCT) provides a more precise panoramic reconstruction but with higher radiation doses. The main objective of this study is to compare the accuracy of axial positioning between direct bonding without radiography, with conventional panoramic radiograph, and with panoramic reconstruction from CBCT. The secondary objectives are to evaluate positioning accuracy of each tooth and to assess the influence of practitioner level of experience.
METHODS: Thirty practitioners, divided into two groups based on their experience performed direct bonding on a model thrice: without radiography, then with the conventional panoramic radiograph, then with the panoramic reconstruction from CBCT. Models were scanned, and angulation errors were measured using OrthoAnalyzer. Values were compared using the Friedman\'s test followed by the Bonferroni correction for multiple comparisons (P-value = 0.05).
RESULTS: For the low level of experience group, angulation errors were significantly greater than the accepted limit without radiographic reference, and significantly lower with CBCT reconstruction. For the high level of experience group, angulation errors were significantly lower than the accepted limit for the three bonding methods. For every tooth, using the panoramic reconstruction from CBCT as a reference, was the most accurate method, regardless of the level of experience. More experienced practitioners made fewer errors for the three methods.
CONCLUSIONS: Panoramic reconstruction from CBCT is the most accurate method to limit angulation errors during direct bonding. Conventional panoramic radiography remains a reliable tool if used with caution. Bonding without any radiographic reference should be avoided especially for less experienced practitioners.

OBJECTIVE: The styloid process (SP) becomes clinically relevant when it shows enlargement (>30 mm) in the sense of an elongated SP (ESP) and/or increasing calcification leading to Eagle Syndrome (ES). Panoramic radiograph (PR) or computed tomography (CT) are part of the routine diagnostics in ES. Currently, CT is considered the gold standard. The aim of this study was to investigate the accuracy in the diagnostics/measurements of SP/ESP throughout a comparative study between PR and CT. Furthermore, in addition to measuring established parameters, this study aimed to determine the currently unexamined width in the base and tip of the SP.
METHODS: The present study examined the radiological findings of bilateral SP in 100 patients who received both PR and CT on the same day. Measurements of the length of the SP and width at the basis and tip were performed. Furthermore, calcification patterns, Langlais classification and the prevalence of ESP were analyzed.
RESULTS: There was a highly significant correlation between PR and CT measuring SP for every parameter. Males showed significantly longer SP than females among the age group between 18-75 years. The results of the length measurements of the SP (male: right SP=32.98 mm; left SP=35.21 mm; female: right SP=30.31 mm; left SP=30.92 mm) significantly exceeded the values of comparable studies.
CONCLUSIONS: Consequently, it can be concluded that PR provides accurate measurements when compared to CT for measuring and diagnosing SP/ESP/Eagle syndrome. This study was one of the first to examine the width of the SP in the base and tip, thus these measurements can serve as a baseline for further studies. Since the mean lengths of SP exceeded 30.0 mm in the present study, these findings raise the question of whether the cut-off of 30.0 mm is adequate for the diagnosis of ESP.

OBJECTIVE: This study aims to investigate the incidence and clinical characteristics of concomitant hypodontia and hyperdontia (CHH) by performing panoramic radiographs.
METHODS: A total of 41 648 panoramic radiographs of pediatric patients who were admitted to the hospitals from January 2019 to May 2021 were reviewed, and 145 CHH patients were included in the study. The presence of CHH was recorded. SPSS 24.0 software was used for statistical analysis.
RESULTS: The prevalence of CHH was 0.35% (145/41 648). Males (102 cases) were obviously more than females (43 cases), and the difference between genders was statistically significant (P<0.001). The features of congenital permanent tooth loss in this group were predominantly 1 and 2 teeth missing and preferably mandibular lateral incisors and mandibular second premolars missing. The incidence of congenital permanent teeth loss was higher in the mandible than in the maxilla (P<0.001), but no difference was found in the distribution between left and right (P=0.84). The features of supernumerary teeth in this group were 1 and 2 teeth, mostly in the maxillary anterior area, mostly conical, mostly vertical inversion and orthotopic growth.
CONCLUSIONS: CHH is a rare mixed numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. CHH cases are higher in men than in women. The characteristics of their hypodontia and hyperdontia are similar to those of patients with congenital permanent tooth absence or supernumerary teeth. Early diagnosis of the condition and a multidisciplinary approach for management of such case is recommended.
目的: 应用曲面体层技术探讨少牙多牙症（CHH）的发生率和临床特征。方法: 收集2019年1月—2021年5月就诊的41 648例儿童口腔科患者的曲面体层片，纳入CHH患者145例，观察记录CHH的发生情况。应用SPSS 24.0软件统计分析所得的数据。结果: CHH的发生率为0.35%（145/41 648），男性（102例）多于女性（43例），性别间差异有统计学意义（P<0.001）。恒牙先天缺失特征：缺失1~2颗为主；最好发下颌侧切牙和下颌第二前磨牙；下颌恒牙先天缺失多于上颌恒牙先天缺失，二者差异有统计学意义（P<0.001）；左侧先天缺失与右侧先天缺失差异无统计学意义（P=0.84）。多生牙特征：数目1~2颗；多见于上颌前牙区；多为圆锥形；垂直倒置生长和垂直正位生长为主。结论: CHH是一种少见的混合牙齿数目异常，男性多于女性，恒牙先天缺失和多生牙的特征与单独发生的恒牙先天缺失/多生牙的特征相似，建议早期诊断和多学科治疗。.

The aim of this study is to compare a technique using Convolutional Neural Network (CNN) with the Demirjian\'s method for chronological age estimation of living individuals based on tooth age from panoramic radiographs. This research used 5898 panoramic X-ray images collected for diagnostic from pediatric patients aged 4-17 who sought treatment at Antalya Oral and Dental Health Hospital between 2015 and 2020. The Demirjian\'s method\'s grading was executed by researchers who possessed appropriate training and experience. In the CNN method, various CNN architectures including Alexnet, VGG16, ResNet152, DenseNet201, InceptionV3, Xception, NASNetLarge, InceptionResNetV2, and MobieNetV2 have been evaluated. Densenet201 exhibited the lowest MAE value of 0.73 years, emphasizing its superior accuracy in age estimation compared to other architectures. In most age categories, the predicted age closely matches the actual age. The most inconsistent results are observed at ages 12 and 13. The results highlight correspondence between the age predicted by CNN and the Demirjian\'s approach. In conclusion, the results show that the CNN method is adequate to be an alternative to the Demirjian\'s age estimation method. We suggest that convolutional neural network can effectively optimize the accuracy of age estimation and can be faster than traditional methods, eliminating the need for additional learning from experts.

The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies.
Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies.
No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively).
While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.

Artificial intelligence (AI) has been introduced to interpret the panoramic radiographs (PRs). The aim of this study was to develop an AI framework to diagnose multiple dental diseases on PRs, and to initially evaluate its performance.
The AI framework was developed based on 2 deep convolutional neural networks (CNNs), BDU-Net and nnU-Net. 1996 PRs were used for training. Diagnostic evaluation was performed on a separate evaluation dataset including 282 PRs. Sensitivity, specificity, Youden\'s index, the area under the curve (AUC), and diagnostic time were calculated. Dentists with 3 different levels of seniority (H: high, M: medium, L: low) diagnosed the same evaluation dataset independently. Mann-Whitney U test and Delong test were conducted for statistical analysis (ɑ=0.05).
Sensitivity, specificity, and Youden\'s index of the framework for diagnosing 5 diseases were 0.964, 0.996, 0.960 (impacted teeth), 0.953, 0.998, 0.951 (full crowns), 0.871, 0.999, 0.870 (residual roots), 0.885, 0.994, 0.879 (missing teeth), and 0.554, 0.990, 0.544 (caries), respectively. AUC of the framework for the diseases were 0.980 (95%CI: 0.976-0.983, impacted teeth), 0.975 (95%CI: 0.972-0.978, full crowns), and 0.935 (95%CI: 0.929-0.940, residual roots), 0.939 (95%CI: 0.934-0.944, missing teeth), and 0.772 (95%CI: 0.764-0.781, caries), respectively. AUC of the AI framework was comparable to that of all dentists in diagnosing residual roots (p > 0.05), and its AUC values were similar to (p > 0.05) or better than (p < 0.05) that of M-level dentists for diagnosing 5 diseases. But AUC of the framework was statistically lower than some of H-level dentists for diagnosing impacted teeth, missing teeth, and caries (p < 0.05). The mean diagnostic time of the framework was significantly shorter than that of all dentists (p < 0.001).
The AI framework based on BDU-Net and nnU-Net demonstrated high specificity on diagnosing impacted teeth, full crowns, missing teeth, residual roots, and caries with high efficiency. The clinical feasibility of AI framework was preliminary verified since its performance was similar to or even better than the dentists with 3-10 years of experience. However, the AI framework for caries diagnosis should be improved.

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower-upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t-test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t-test and one-way ANOVA were used for normally distributed data, while the Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula.