Journal of Clinical Medicine

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11 pages, 8340 KiB

Open AccessArticle

The Diagnostic Value of CEUS in Assessing Non-Ossified Thyroid Cartilage Invasion in Patients with Laryngeal Squamous Cell Carcinoma

by Milda Pucėtaitė, Davide Farina, Silvija Ryškienė, Dalia Mitraitė, Rytis Tarasevičius, Saulius Lukoševičius, Evaldas Padervinskis and Saulius Vaitkus

J. Clin. Med. 2024, 13(3), 891; https://doi.org/10.3390/jcm13030891 - 3 Feb 2024

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Abstract

Background: Accurate assessment of thyroid cartilage invasion in squamous cell carcinoma (SCC) of the larynx remains a challenge in clinical practice. The aim of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and magnetic resonance [...] Read more.

Background: Accurate assessment of thyroid cartilage invasion in squamous cell carcinoma (SCC) of the larynx remains a challenge in clinical practice. The aim of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), and magnetic resonance imaging (MRI) in the detection of non-ossified thyroid cartilage invasion in patients with SCC. Methods: CEUS, CECT, and MRI scans of 27 male patients with histologically proven SCC were evaluated and compared. A total of 31 cases were assessed via CEUS and CECT. The MR images of five patients and six cases were excluded (one patient had two suspected sites), leaving twenty-five cases for analysis via MRI. Results: CEUS showed the highest accuracy and specificity compared with CECT and MRI (87.1% vs. 64.5% and 76.0% as well as 84.0% vs. 64.0% and 72.7%, respectively). The sensitivity and negative predictive value of CEUS and MRI were the same (100%). CEUS yielded four false-positive findings. However, there were no statistically significant differences among the imaging modalities (p > 0.05). Conclusions: CEUS showed better diagnostic performance than CECT and MRI. Therefore, CEUS has the potential to accurately assess non-ossified thyroid cartilage invasion and guide appropriate treatment decisions, hopefully leading to improved patient outcomes. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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14 pages, 2986 KiB

Open AccessArticle

Influence of the Tube Angle on the Measurement Accuracy of Peri-Implant Bone Defects in Rectangular Intraoral X-ray Imaging

by Petra Rugani, Katharina Weingartner and Norbert Jakse

J. Clin. Med. 2024, 13(2), 391; https://doi.org/10.3390/jcm13020391 - 10 Jan 2024

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Abstract

Background: Intraoral radiography in the right-angle technique is the standard procedure to examine the peri-implant bone level in implant follow-up and implant-related studies. For the implementation of the right-angle or parallel technique, mostly ready-made image receptor holders are used. The aim of this [...] Read more.

Background: Intraoral radiography in the right-angle technique is the standard procedure to examine the peri-implant bone level in implant follow-up and implant-related studies. For the implementation of the right-angle or parallel technique, mostly ready-made image receptor holders are used. The aim of this experimental study is to analyze changes in the measurement of standardized peri-implant defects caused by a deviation in the position of the image receptor. Methods: Eleven Xive^® implants (Dentsply Sirona, Bensheim, Germany) were placed in bovine bone, and peri-implant defects of varying depths were created. The preparations were fixed in a specially made test stand, and intraoral radiographs were taken using the right-angle technique with standard film holders at various horizontal and vertical projection angles. Defect measurement was carried out with the imaging software Sidexis 4 V 4.3 (Dentsply Sirona, Bensheim, Germany). Results: With increasing angular deviation, larger deviations between the measured and the real extent of the defect occurred. Vertical tilting caused significant distortion, while horizontal rotation showed less effect. Conclusion: Intraoral radiography only provides a valid representation of the peri-implant bone level for follow-up or as a tool in implant-related studies if a reproducible projection direction is assured. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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13 pages, 3148 KiB

Open AccessArticle

Evaluating a Periapical Lesion Detection CNN on a Clinically Representative CBCT Dataset—A Validation Study

by Arnela Hadzic, Martin Urschler, Jan-Niclas Aaron Press, Regina Riedl, Petra Rugani, Darko Štern and Barbara Kirnbauer

J. Clin. Med. 2024, 13(1), 197; https://doi.org/10.3390/jcm13010197 - 29 Dec 2023

Cited by 3 | Viewed by 1512

Abstract

The aim of this validation study was to comprehensively evaluate the performance and generalization capability of a deep learning-based periapical lesion detection algorithm on a clinically representative cone-beam computed tomography (CBCT) dataset and test for non-inferiority. The evaluation involved 195 CBCT images of [...] Read more.

The aim of this validation study was to comprehensively evaluate the performance and generalization capability of a deep learning-based periapical lesion detection algorithm on a clinically representative cone-beam computed tomography (CBCT) dataset and test for non-inferiority. The evaluation involved 195 CBCT images of adult upper and lower jaws, where sensitivity and specificity metrics were calculated for all teeth, stratified by jaw, and stratified by tooth type. Furthermore, each lesion was assigned a periapical index score based on its size to enable a score-based evaluation. Non-inferiority tests were conducted with proportions of 90% for sensitivity and 82% for specificity. The algorithm achieved an overall sensitivity of 86.7% and a specificity of 84.3%. The non-inferiority test indicated the rejection of the null hypothesis for specificity but not for sensitivity. However, when excluding lesions with a periapical index score of one (i.e., very small lesions), the sensitivity improved to 90.4%. Despite the challenges posed by the dataset, the algorithm demonstrated promising results. Nevertheless, further improvements are needed to enhance the algorithm’s robustness, particularly in detecting very small lesions and the handling of artifacts and outliers commonly encountered in real-world clinical scenarios. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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11 pages, 1017 KiB

Open AccessArticle

Bismuth Shielding in Head Computed Tomography—Still Necessary?

by Jana Di Rosso, Andreas Krasser, Sebastian Tschauner, Helmuth Guss and Erich Sorantin

J. Clin. Med. 2024, 13(1), 25; https://doi.org/10.3390/jcm13010025 - 20 Dec 2023

Cited by 1 | Viewed by 1379

Abstract

Introduction: Cranial CT scans are associated with radiation exposure to the eye lens, which is a particularly radiosensitive organ. Children are more vulnerable to radiation than adults. Therefore, it is essential to use the available dose reduction techniques to minimize radiation exposure. According [...] Read more.

Introduction: Cranial CT scans are associated with radiation exposure to the eye lens, which is a particularly radiosensitive organ. Children are more vulnerable to radiation than adults. Therefore, it is essential to use the available dose reduction techniques to minimize radiation exposure. According to the European Consensus on patient contact shielding by the IRCP from 2021, shielding is not recommended in most body areas anymore. This study aims to evaluate whether bismuth shielding as well as its combination with other dose-saving technologies could still be useful. Methods: Cranial CT scans of a pediatric anthropomorphic phantom were performed on two up-to-date MDCT scanners. Eye lens dose measurements were performed using thermoluminescent dosimeters. Furthermore, the impact of BS and of the additional placement of standoff foam between the patient and BS on image quality was also assessed. Results: Bismuth shielding showed a significant lens dose reduction in both CT scanners (GE: 41.50 ± 4.04%, p < 0.001; Siemens: 29.75 ± 6.55%, p = 0.00). When combined with AEC, the dose was lowered even more (GE: 60.75 ± 3.30%, p < 0.001; Siemens: 41.25 ± 8.02%, p = 0.00). The highest eye dose reduction was achieved using BS + AEC + OBTCM (GE: 71.25 ± 2.98%, p < 0.001; Siemens: 58.75 ± 5.85%, p < 0.001). BS caused increased image noise in the orbital region, which could be mitigated by foam placement. Eye shielding had no effect on the image noise in the cranium. Conclusions: The use of BS in cranial CT can lead to a significant dose reduction, which can be further enhanced by its combination with other modern dose reduction methods. BS causes increase in image noise in the orbital region but not in the cranium. The additional use of standoff foam reduces image noise in the orbital region. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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14 pages, 2789 KiB

Open AccessArticle

Relationship between the Status of Third Molars and the Occurrence of Dental and Periodontal Lesions in Adjacent Second Molars in the Polish Population: A Radiological Retrospective Observational Study

by Daniel Poszytek and Bartłomiej Górski

J. Clin. Med. 2024, 13(1), 20; https://doi.org/10.3390/jcm13010020 - 19 Dec 2023

Cited by 1 | Viewed by 1790

Abstract

The aim of this study was to evaluate the effect of third molars on caries, external root resorption, and alveolar bone loss on the distal surface of adjacent second molars. A total of 2488 panoramic radiographs of adult Poles were evaluated. Third molars [...] Read more.

The aim of this study was to evaluate the effect of third molars on caries, external root resorption, and alveolar bone loss on the distal surface of adjacent second molars. A total of 2488 panoramic radiographs of adult Poles were evaluated. Third molars were classified, according to eruption status, into non-impacted, partially, or completely impacted, and according to angulation into horizontal, mesioangular, vertical, and distoangular. Completely impacted third molars were assigned as reference group. The odds ratios (ORs) and 95% confidence intervals for the occurrence of the above-mentioned pathologies were 1.39 (1.09–2.21), 6.51 (3.72–10.11), and 2.42 (1.22–4.09), respectively, for second molars with adjacent erupted third molars and 1.54 (1.11–2.82), 10.65 (7.81–20.19), and 5.21 (3.38–10.81), respectively, when partially impacted third molars were next to second molars. The ORs of lesions were significantly higher for horizontally and mesioangularly impacted third molars. Within the limitation of a radiological study, it might be concluded that the presence of erupted third molars is a risk factor for caries, while the presence of impacted third molars increases the risk of root resorption and bone loss on the distal surface of second molars. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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12 pages, 2626 KiB

Open AccessArticle

Neurosensory Deficits of the Mandibular Nerve Following Extraction of Impacted Lower Third Molars—A Retrospective Study

by Marcus Rieder, Bernhard Remschmidt, Vera Schrempf, Matthäus Schwaiger, Norbert Jakse and Barbara Kirnbauer

J. Clin. Med. 2023, 12(24), 7661; https://doi.org/10.3390/jcm12247661 - 13 Dec 2023

Cited by 5 | Viewed by 1574

Abstract

Background: Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient’s quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to [...] Read more.

Background: Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient’s quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to the corresponding position of the inferior alveolar nerve. Methods: In a retrospective study, all patients who underwent impacted lower third molar extraction between January and December 2019 were compiled. Therefore, clinical data as well as preoperative radiological imaging were assessed. Results: In total, 418 patients who underwent lower third molar extractions (n = 555) were included in this study. Of these, 33 (5.9%) had short-term (i.e., within the initial 7 postoperative days) and 12 (1.3%) long-term (i.e., persisting after 12 months) neurosensory deficits documented. The inferior alveolar nerve position in relation to the tooth roots showed apical position in 27%, buccal position in 30.8%, lingual position in 35.4%, and interradicular position in 6.9%. Conclusions: A statistically significant increased incidence of neurosensory deficits occurs when the inferior alveolar nerve is directly positioned lingually to the tooth roots (p = 0.01). Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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11 pages, 6874 KiB

Open AccessArticle

Accuracy of Palatal Orthodontic Mini-Implants Placed Using Fully Digital Planned Insertion Guides: A Cadaver Study

by Lea Stursa, Brigitte Wendl, Norbert Jakse, Margit Pichelmayer, Frank Weiland, Veronica Antipova and Barbara Kirnbauer

J. Clin. Med. 2023, 12(21), 6782; https://doi.org/10.3390/jcm12216782 - 26 Oct 2023

Cited by 4 | Viewed by 1414

Abstract

Digital workflows have become integral in orthodontic diagnosis and therapy, reducing risk factors and chair time with one-visit protocols. This study assessed the transfer accuracy of fully digital planned insertion guides for orthodontic mini-implants (OMIs) compared with freehanded insertion. Cone-beam computed tomography (CBCT) [...] Read more.

Digital workflows have become integral in orthodontic diagnosis and therapy, reducing risk factors and chair time with one-visit protocols. This study assessed the transfer accuracy of fully digital planned insertion guides for orthodontic mini-implants (OMIs) compared with freehanded insertion. Cone-beam computed tomography (CBCT) datasets and intraoral surface scans of 32 cadaver maxillae were used to place 64 miniscrews in the anterior palate. Three groups were formed, two using printed insertion guides (A and B) and one with freehand insertion (C). Group A used commercially available customized surgical templates and Group B in-house planned and fabricated insertion guides. Postoperative CBCT datasets were superimposed with the planning model, and accuracy measurements were performed using orthodontic software. Statistical differences were found for transverse angular deviations (4.81° in A vs. 12.66° in B and 5.02° in C, p = 0.003) and sagittal angular deviations (2.26° in A vs. 2.20° in B and 5.34° in C, p = 0.007). However, accurate insertion depth was not achieved in either guide group; Group A insertion was too shallow (−0.17 mm), whereas Group B insertion was deeper (+0.65 mm) than planned. Outsourcing the planning and fabrication of computer-aided design and computer-aided manufacturing insertion guides may be beneficial for certain indications; particularly, in this study, commercial templates demonstrated superior accuracy than our in-house–fabricated insertion guides. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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14 pages, 3466 KiB

Open AccessArticle

Correlation Analysis of Nasal Septum Deviation and Results of AI-Driven Automated 3D Cephalometric Analysis

by Natalia Kazimierczak, Wojciech Kazimierczak, Zbigniew Serafin, Paweł Nowicki, Adam Lemanowicz, Katarzyna Nadolska and Joanna Janiszewska-Olszowska

J. Clin. Med. 2023, 12(20), 6621; https://doi.org/10.3390/jcm12206621 - 19 Oct 2023

Cited by 7 | Viewed by 1829

Abstract

The nasal septum is believed to play a crucial role in the development of the craniofacial skeleton. Nasal septum deviation (NSD) is a common condition, affecting 18–65% of individuals. This study aimed to assess the prevalence of NSD and its potential association with [...] Read more.

The nasal septum is believed to play a crucial role in the development of the craniofacial skeleton. Nasal septum deviation (NSD) is a common condition, affecting 18–65% of individuals. This study aimed to assess the prevalence of NSD and its potential association with abnormalities detected through cephalometric analysis using artificial intelligence (AI) algorithms. The study included CT scans of 120 consecutive, post-traumatic patients aged 18–30. Cephalometric analysis was performed using an AI web-based software, CephX. The automatic analysis comprised all the available cephalometric analyses. NSD was assessed using two methods: maximum deviation from an ideal non-deviated septum and septal deviation angle (SDA). The concordance of repeated manual measurements and automatic analyses was assessed. Of the 120 cases, 90 met the inclusion criteria. The AI-based cephalometric analysis provided comprehensive reports with over 100 measurements. Only the hinge axis angle (HAA) and SDA showed significant (p = 0.039) negative correlations. The rest of the cephalometric analyses showed no correlation with the NSD indicators. The analysis of the agreement between repeated manual measurements and automatic analyses showed good-to-excellent concordance, except in the case of two angular measurements: LI-N-B and Pr-N-A. The CephX AI platform showed high repeatability in automatic cephalometric analyses, demonstrating the reliability of the AI model for most cephalometric analyses. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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12 pages, 1703 KiB

Open AccessArticle

Scattered Radiation Distribution Utilizing Three Different Cone-Beam Computed Tomography Devices for Maxillofacial Diagnostics: A Research Study

by Sotirios Petsaros, Emmanouil Chatzipetros, Catherine Donta, Pantelis Karaiskos, Argiro Boziari, Evangelos Papadakis and Christos Angelopoulos

J. Clin. Med. 2023, 12(19), 6199; https://doi.org/10.3390/jcm12196199 - 26 Sep 2023

Cited by 1 | Viewed by 1111

Abstract

This study aimed to estimate scattered radiation and its spatial distribution around three cone-beam computed tomography (CBCT) devices, in order to determine potential positions for an operator to stand if they needed to be inside the CBCT room. The following devices were tested: [...] Read more.

This study aimed to estimate scattered radiation and its spatial distribution around three cone-beam computed tomography (CBCT) devices, in order to determine potential positions for an operator to stand if they needed to be inside the CBCT room. The following devices were tested: Morita Accuitomo (CBCT1), Newtom Giano HR (CBCT2), Newtom VGi (CBCT3). Scattered radiation measurements were performed using different kVp, mA, and Field of View (FOV) options. An anthropomorphic phantom (NATHANIA) was placed inside the X-ray gantry to simulate clinical conditions. Scattered measurements were taken with the Inovision model 451P Victoreen ionization chamber once placed at fixed distances from each irradiation isocenter, away from the primary beam. A statistically significant (p < 0.001) difference was found in the mean value of the scattered radiation estimations between the CBCT devices. Scattered radiation was reduced with a different rate for each CBCT device as distance was increased. For CBCT1 the reduction was 0.047 μGy, for CBCT2 it was 0.036 μGy, and for CBCT3 it was 0.079 μGy, for every one meter from the X-ray gantry. Therefore, at certain distances from the central X-ray, the scattered radiation was below the critical level of 1 mGy, which is defined by the radiation protection guidelines as the exposure radiation limit of the general population. Consequently, an operator could stay inside the room accompanying the patient being scanned, if necessary. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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12 pages, 3671 KiB

Open AccessArticle

Evaluation of Artifact Appearance and Burden in Pediatric Brain Tumor MR Imaging with Compressed Sensing in Comparison to Conventional Parallel Imaging Acceleration

by Rieke Lisa Meister, Michael Groth, Shuo Zhang, Jan-Hendrik Buhk and Jochen Herrmann

J. Clin. Med. 2023, 12(17), 5732; https://doi.org/10.3390/jcm12175732 - 3 Sep 2023

Cited by 1 | Viewed by 1539

Abstract

Clinical magnetic resonance imaging (MRI) aims for the highest possible image quality, while balancing the need for acceptable examination time, reasonable signal-to-noise ratio (SNR), and lowest artifact burden. With a recently introduced imaging acceleration technique, compressed sensing, the acquisition speed and image quality [...] Read more.

Clinical magnetic resonance imaging (MRI) aims for the highest possible image quality, while balancing the need for acceptable examination time, reasonable signal-to-noise ratio (SNR), and lowest artifact burden. With a recently introduced imaging acceleration technique, compressed sensing, the acquisition speed and image quality of pediatric brain tumor exams can be improved. However, little attention has been paid to its impact on method-related artifacts in pediatric brain MRI. This study assessed the overall artifact burden and artifact appearances in a standardized pediatric brain tumor MRI by comparing conventional parallel imaging acceleration with compressed sensing. This showed that compressed sensing resulted in fewer physiological artifacts in the FLAIR sequence, and a reduction in technical artifacts in the 3D T1 TFE sequences. Only a slight difference was noted in the T2 TSE sequence. A relatively new range of artifacts, which are likely technique-related, was noted in the 3D T1 TFE sequences. In conclusion, by equipping a basic pediatric brain tumor protocol for 3T MRI with compressed sensing, the overall burden of common artifacts can be reduced. However, attention should be paid to novel compressed-sensing-specific artifacts. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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Review

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23 pages, 16343 KiB

Open AccessReview

CT and MR Appearance of Teeth: Analysis of Anatomy and Embryology and Implications for Disease

by Zachary Abramson, Chris Oh, Martha Wells, Asim F. Choudhri and Matthew T. Whitehead

J. Clin. Med. 2024, 13(5), 1187; https://doi.org/10.3390/jcm13051187 - 20 Feb 2024

Viewed by 2468

Abstract

Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various [...] Read more.

Abnormalities of dental development and anatomy may suggest the presence of congenital or acquired anomalies. The detection of abnormalities, therefore, is an important skill for radiologists to achieve. Knowledge of dental embryology and an understanding of the radiologic appearances of teeth at various stages of maturation are required for the appreciation of abnormal dental development. While many tooth abnormalities are well-depicted on dedicated dental radiographs, the first encounter with a dental anomaly may be by a radiologist on a computed tomographic (CT) or magnetic resonance (MR) exam performed for other reasons. This article depicts normal dental anatomy and development, describing the appearance of the neonatal dentition on CT and MRI, the modalities most often encountered by clinical radiologists. The radiology and dental literature are reviewed, and key concepts are illustrated with supplemental cases from our institution. The value of knowledge of dental development is investigated using the analysis of consecutive MR brain examinations. Finally, the anatomical principles are applied to the diagnosis of odontogenic infection on CT. Through analysis of the literature and case data, the contrast of dental pathology with normal anatomy and development facilitates the detection and characterization of both congenital and acquired dental disease. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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19 pages, 1753 KiB

Open AccessReview

AI in Orthodontics: Revolutionizing Diagnostics and Treatment Planning—A Comprehensive Review

by Natalia Kazimierczak, Wojciech Kazimierczak, Zbigniew Serafin, Paweł Nowicki, Jakub Nożewski and Joanna Janiszewska-Olszowska

J. Clin. Med. 2024, 13(2), 344; https://doi.org/10.3390/jcm13020344 - 7 Jan 2024

Cited by 16 | Viewed by 10099

Abstract

The advent of artificial intelligence (AI) in medicine has transformed various medical specialties, including orthodontics. AI has shown promising results in enhancing the accuracy of diagnoses, treatment planning, and predicting treatment outcomes. Its usage in orthodontic practices worldwide has increased with the availability [...] Read more.

The advent of artificial intelligence (AI) in medicine has transformed various medical specialties, including orthodontics. AI has shown promising results in enhancing the accuracy of diagnoses, treatment planning, and predicting treatment outcomes. Its usage in orthodontic practices worldwide has increased with the availability of various AI applications and tools. This review explores the principles of AI, its applications in orthodontics, and its implementation in clinical practice. A comprehensive literature review was conducted, focusing on AI applications in dental diagnostics, cephalometric evaluation, skeletal age determination, temporomandibular joint (TMJ) evaluation, decision making, and patient telemonitoring. Due to study heterogeneity, no meta-analysis was possible. AI has demonstrated high efficacy in all these areas, but variations in performance and the need for manual supervision suggest caution in clinical settings. The complexity and unpredictability of AI algorithms call for cautious implementation and regular manual validation. Continuous AI learning, proper governance, and addressing privacy and ethical concerns are crucial for successful integration into orthodontic practice. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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12 pages, 13220 KiB

Open AccessCase Report

Pulp Revascularization in an Autotransplanted Mature Tooth: Visualization with Magnetic Resonance Imaging and Histopathologic Correlation

by Petra Rugani, Iva Brcic, Marton Magyar, Uwe Yacine Schwarze, Norbert Jakse and Kurt Ebeleseder

J. Clin. Med. 2023, 12(18), 6008; https://doi.org/10.3390/jcm12186008 - 16 Sep 2023

Cited by 2 | Viewed by 1646

Abstract

Autotransplantation of a mature tooth usually leads to pulpal necrosis. Root canal treatment is recommended to prevent related inflammatory complications a few weeks after surgery. Extraoral root-end resection may facilitate reperfusion and obviate root canal treatment, but cannot be pictured with conventional dental [...] Read more.

Autotransplantation of a mature tooth usually leads to pulpal necrosis. Root canal treatment is recommended to prevent related inflammatory complications a few weeks after surgery. Extraoral root-end resection may facilitate reperfusion and obviate root canal treatment, but cannot be pictured with conventional dental radiography at this point in time. In the case of a lower mature transplanted molar, contrast-enhanced magnetic resonance imaging proved to be a feasible method for visualizing pulp revascularization just 4 weeks after autotransplantation. Consequently, root canal treatment was obviated. Nevertheless, the tooth had to be extracted 18 months postoperatively due to external cervical root resorption, probably caused by the extraction trauma. This allowed the histological processing and examination of the newly generated intracanal tissue. Uninflamed fibrovascular connective tissue was found, while odontoblasts or cementoblast-like cells were absent. These findings indicated that it was most likely stem cells from the bone marrow and the periodontal ligament that drove the regeneration. Full article

(This article belongs to the Special Issue Clinical Advances in Head and Neck Imaging including Dentistry)

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