Ibrahim Nasseh

Number of basis images effect on detection of root fractures in endodontically treated teeth using a cone beam computed tomography machine: an in vitro study

OBJECTIVES The objective of this study was to compare the accuracy of root fracture detection in endodontically treated teeth using scans acquired with a 180° rotation motion compared with a 360° after which the patient exposure and number of basis images are doubled. METHODS Sixty-six roots were collected and decoronated. All were treated endodontically. One-half of the roots were fractured, resulting in 2 root fragments which were then glued together. The roots were placed randomly in 8 prepared beef rib fragments. Five reviewers independently reviewed the scans twice, at different times. RESULTS The specificity of the 360° scan was significantly higher than the 180° scan; doubling the basis images leads to a significant decrease in false-positive rates. Accuracy and sensitivity were not significantly different. CONCLUSIONS Only the specificity is improved by the increased rotation and doubling of images. The accuracy and sensitivity are not improved.

Evaluation of the oral component of Sjögren's syndrome: An overview

Sjögren′s syndrome is a chronic autoimmune disorder characterized by lymphocytic infiltration, and consequently hypofunction of lacrimal and salivary glands. The loss of salivary function induces oral dryness (xerostomia). This review focuses on methods for determining salivary gland function including clinical signs, salivary flow rate measurements (sialometry), analysis of salivary composition (sialochemistry), histopathological and radiologic examinations, and other recent advanced techniques.

Radiolucency in the mandible: a seventeen-year follow-up

CLINICAL PRESENTATION In 2009, a 43-year-old white woman was referred to the Department of Oral and Maxillofacial Imaging at the Lebanese University with an approximately 1 year history of a slowly expanding, painless mass along the left inferior part of the mandible in the premolar region. The patient initially consulted her dentist in 2007, and a panoramic radiograph was acquired at that time (Figure 1). The practitioner told her that there is nothing to worry about, and he scheduled a follow-up appointment. Sixteen months later, the patient went to the dental school for a second opinion. She was referred to our department, where a panoramic radiograph was taken (Figure 2). It showed a well-circumscribed, round, radiolucent area extending from the inferior border of the mandible in the premolar region and overlapping the mandibular canal. Cone beam computed tomography imaging (using i-CAT (Imaging Sciences International, USA) with voxel size 0.3 mm (field of volume 6 cm), tube voltage of 120 kV, current of 23.87 mA, and exposure time of 20 s) demonstrated a 13 11 mm lytic lesion in the left mandibular premolar region. The lesion was situated on the buccal aspect in the inferior third of the mandible. The lesion was irregular in shape, noncorticated, but fairly well demarcated. The alveolar process was interrupted, with the presence of what seemed to be a communication between the buccal and lingual aspect and a bone structure connecting the mesial and distal sides. The mandibular canal was displaced to the lingual side; the lingual cortex was intact (Figure 3). During the clinical examination, the patient complained of mild pain over the swollen area; however, she reported that chewing, swallowing, and speech were normal. On clinical examination, there was a slightly firm swelling in the region, slightly painful on pressure. Skin and the oral mucosa over the swelling were normal; however, the swelling could not be

Analysis of the greater palatine foramen in a Lebanese population using cone-beam computed tomography technology

Objective: The aim of this study was to describe the diameter and the position of the greater palatine foramen (GPF) in relation to adjacent anatomical landmarks in the maxilla in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 58 Lebanese adult patients were included in this study and a total of 116 GPF were evaluated bilaterally. The diameter of the GPF and its position relative to the maxillary molars, and distances to the midline maxillary suture and to the anterior nasal spine were analyzed. Results: Of all foramina assessed, 41.38% were located opposite to the third molar, 29.31% were distal to it, 27.59% were between the second and the third, and only 1.72% were opposite to the second. The average diameter was 5.633 mm on the right and 5.723 mm on the left, and the average distances to midline maxillary suture and anterior nasal spine were 16.228 mm and 48.294 mm on the right and 14.907 mm and 48.122 mm on the left, respectively. Conclusion: Within the limits of this study, we conclude that in Lebanese patients, the GPF location is variable, very rarely opposite to the second molar, and more closely related to the third, but may present mesial or distal to it in one-fourth of patients.

Cone Beam Computed Tomography

In the last several decades, the need for 3D images in dentistry have developed. Computerized tomography was first introduced mainly with the advent of implantology, but its use remained limited to a small number of specialists, due to its indications, access and dose radiation. In the late 90s, a new technology using a cone-shaped beam and a reciprocating detector, which rotates around the patient 360 degrees and acquires projected data in a single rotation, namely the cone beam computerized tomography (CBCT), invaded dentistry, making the perception of 3D easily acceptable to dentists and their patients.

Assessment of the Nasopalatine Canal: an Anatomical Study

Objective: The aim of this study was to evaluate the anatomy of the nasopalatine canal in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 63 Lebanese adult patients were included in this study. The length, shape, diameter of the oral opening corresponding to the incisive foramen and inclination in relation to the hard palate of the nasopalatine canal were analyzed. Results: Of all canals assessed, 13 were hourglass-shaped, 23 were cylindrical-shaped, 23 were funnel-shaped and 4 were spindle-shaped. The mean canal length and the incisive foramen anteroposterior diameter were respectively 11.52 mm and 4.91 mm. The average canal inclination related to the hard palate was 17.09 degrees. Conclusion: Within the limits of this study, we conclude that in Lebanese patients, the shape of the nasopalatine canal is variable. No statistical significance was noticed between genders except for the canal length which was found shorter in our female sample.

Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block

Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF), in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males) were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides); however, the GPC-PPF length does not significantly vary according to gender and side.

Mesiodens within the nasopalatine canal: an exceptional entity

A supernumerary tooth is one that is supplementary to the normal dentition. It can be found anywhere at the dental arch. A mesiodens is a supernumerary tooth located between the two maxillary central incisors usually palatally or within the alveolar process. Less frequently, the mesiodens is in relation with the nasal floor and the nasopalatine canal walls. This paper presents a very rare case of an impacted inverted mesiodens located inside the nasopalatine canal and found incidentally with a cone-beam computed tomography examination.

Location of Posterosuperior Alveolar Artery and Correlation with Maxillary Sinus Anatomy.

The blood supply to both the lateral wall of the maxillary sinus and the overlying membrane originates from the posterosuperior alveolar artery (PSAA) and the infraorbital artery. The purpose of the present study was to evaluate the anatomic characteristics of the PSAA in a large number of subjects of the Lebanese population. Images of 696 sinuses were analyzed using cone beam computed tomography (CT). Coronal, axial, and sagittal CT images were evaluated for the presence of an osseous canal in the lateral wall of the sinus, and the prevalence, position, and location of the canal were studied and presented.

Residual cyst with a misleading clinical and radiological appearance

A case report of a 45-year-old male who presented with a deep defect in the alveolar crest at the buccal side of the upper right 1 st molar strongly suggesting a perforation of the floor of the maxillary sinus and an oro-antral communication. Clinical signs and symptoms supported this diagnosis. After radiographic evaluation with Cone Beam Computed Tomography (CBCT), the diagnosis was shifting away from oro-antral communication. The diagnosis of a residual cyst was established after surgical exploration and removal, and histopathologic evaluation. The maxillary sinus membrane was intact.