Anastasia Mitsea

AI methods (machine learning and deep learning methods) presented promising results concerning the accuracy of dental age estimation and sex determination. Therefore, this pilot study aims to evaluate the efficacy of an artificial intelligence system to estimate age and determine sex in a Greek population sample. Panoramic radiographs from 110 adult subjects comprised this study’s sample. Males and females were equally distributed (1/1) in the sample. The dental status of each patient was different. The sample’s age ranged from 9 to 84 years of age, with a mean age of 48.87 years (±16.14 yrs). The methodology employed beta versions of convolutional neural networks (CNNs) developed by the University of Zagreb. Separate CNNs were trained on 4000 panoramic radiographs: one for sex estimation and another for age estimation. The AI program overestimated the subjects’ age on average by 4.16 years. A statistically significant correlation was found between true and estimated sex (p-value < 0.001). In males, the rate of agreement was 56.36%, while for females it was 89.47% (z-test for two proportions; p-value < 0.001). For the overall sample, Kappa = 73.21%, indicating a very good agreement. The results concerning age estimation are not quite satisfactory and further research is needed.

The objective of this study was to evaluate the reliability and predictive ability of specific anthropometric mandibular measurements on three-dimensional (3D) reconstructed surfaces of cone-beam computed tomography (CBCT) records for sex determination. The study sample analyzed volumetric data from cone-beam computed tomography (CBCT) records of 204 Greek individuals aged 18-70 years, who sought general dental treatment at the School of Dentistry, National and Kapodistrian University of Athens, Greece. Patient records were screened for eligibility based on predefined inclusion criteria. The sample was distributed by sex and further categorized into four distinct age groups. Volumetric data of 204 patients (equally distributed between sexes) were reprocessed with the ViewBox 4 software, according to inclusion-exclusion criteria. Ten anatomical landmarks visible on three-dimensional CBCT reconstructions were digitally traced using the ViewBox 4 software, including superior points of the right and left condyles, the most proximal points of the inner poles of the right and left condyles, the inferior points of the right and left sigmoid notches, the superior points of the right and left coronoid processes and the right and left Gonion. This cross-sectional study employed a binary logistic regression (BLR) model for statistical analysis. All linear parameters exhibited statistically significant differences between sexes whereas angular measurements did not demonstrate a statistically significant difference. The developed model yielded an accuracy of 83.4% in predicting sex. Specific linear measurements are reliable predictors of sex and may be applied in forensic science as a supplementary method.

Sex determination is a fundamental component of forensic identification and medicolegal investigations. Several studies have investigated sexual dimorphism through mandibular osteometric measurements, including the position of anatomical foramina such as the mandibular and mental foramen (MF), reporting population-specific discrepancies. This study assessed the reliability and predictive ability of specific anthropometric mandibular measurements for sex estimation using three-dimensional (3D) cone beam computed tomography (CBCT) surface reconstructions. Methods: CBCT scans from 204 Greek individuals (18–70 years) were analyzed. Records were categorized by sex and age. Five linear measurements were traced on 3D reconstructions using ViewBox 4 software: projections of the inferior points of the right and left mental and mandibular foramina and the linear distance between mental foramina projections. A binary logistic regression (BLR) model was employed. All measurements showed statistically significant sex differences, with males presenting higher mean values. The final model achieved accuracy of 66.7% in sex prediction, with two vertical measurements—distances from the right mandibular foramen and the left mental foramen—identified as the strongest predictors of sex. The positions of the mandibular and mental foramina demonstrate sex-related dimorphism in this Greek sample, supporting their forensic relevance in population-specific applications.

Background/Objectives: The aim of this retrospective study was to investigate the supernumerary teeth located in the anterior region of the maxilla of non-syndromic Greek children and adolescents, as well as their possible correlation with demographic characteristics and radiographic findings. Methods: The study sample comprised cone-beam computed tomography (CBCT) scans from 224 children and adolescents aged up to 18 years. The following parameters were studied: location of supernumerary teeth in the anterior maxillary area, their morphology, their relationship to adjacent anatomical structures and adjacent teeth, and potential implications. Results: Out of the 224 cases 26 (11.6%) presented supernumerary teeth. There was higher prevalence in males than females (61.5% versus 38.5%, respectively). Among the 26 participants diagnosed with supernumerary teeth, one supernumerary tooth was found in 80.8% of children/adolescents, while 19.2% had two supernumerary teeth. The vast majority of supernumerary teeth were impacted (92.3%), and their morphology in 57.7% of cases was conical. A total of 38.5% of cases had normal orientation, 26.9% inverted orientation, 19.2% horizontal orientation, and 15.4% other. The localization was palatal in 84.6%, and the area of localization for 50% of cases was the midline. Conclusions: The prevalence of supernumerary teeth in the studied sample of Greek children and adolescents was 11.6% and tended to appear as single, impacted, conical, and with normal orientation. However, these results should be interpreted with caution, due to the limitations in the sampling strategy and the restricted generalizability of this study. The need for further research to enhance broader applicability for different populations is highlighted. These findings are instrumental for a more comprehensive understanding of the prevalence of supernumerary teeth, contributing to more accurate and individualized dental treatment planning in children and adolescents. This will help to avoid future issues in the patient’s dentition.

Purpose The present study aims to systematically review the literature on the effect of combined surgical-orthodontic treatment on the periodontal health of labially maxillary impacted canines, comparing the results between the three available surgical approaches, open and closed eruption technique and apically positioned flap. Methods Seven electronic databases and three registers were searched until September 2024 and lists of references from relevant publications were screened to identify studies (randomised (RCTs) / controlled clinical trials (CCTs) and observational) assessing the periodontal status of labially maxillary impacted canines after combined surgical-orthodontic treatment. Participants consisted of medically and periodontally healthy individuals with labially impacted canines and their untreated contralaterals as comparison. The outcomes assessed were plaque accumulation, gingival inflammation, gingival recession, probing pocket depth, keratinised gingiva width, attached gingiva width, and crestal bone loss. The risk of bias was evaluated using the ROBINS-I tool for the CCTs and Newcastle-Otawa tool for the observational studies. Results A total of 1829 studies were identified, and seven were included in the review (one CCT and six observational studies). All evaluated soft tissue periodontal parameters had the most negative outcomes after excisional uncovering, however these findings did not reach clinical significance. When closed eruption technique or an apically positioned flap was performed, the periodontal outcomes were similar to those of untreated teeth. Conclusions This review found no clinically significant adverse effects on the periodontium after combined surgical-orthodontic treatment of labially impacted maxillary canines. Further high-quality, low-bias clinical trials are needed to assess post-treatment periodontal status.

Background/Objectives: Emerging hybrid imaging modalities, like Positron Emission Tomography/Computed Tomography (PET/CT) and Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI), are useful for assessing head and neck cancer (HNC) and its prognosis during follow-up. PET/MRI systems enable simultaneous PET and MRI scans within a single session. These combined PET/MRI scanners merge MRI’s better soft tissue contrast and the molecular metabolic information offered by PET. Aim: To review scientific articles on the use of hybrid PET/MRI techniques in diagnosing dentomaxillofacial malignancies. Method: The available literature on the use of PET/MRI for the diagnosis of dentomaxillofacial malignancies in four online databases (Scopus, PubMed, Web of Science, and the Cochrane Library) was searched. Eligible for this review were original full-text articles on PET/MRI imaging, published between January 2010 and November 2024, based on experimental or clinical research involving humans. Results: Out of the 783 articles retrieved, only twelve articles were included in this systematic review. Nearly half of the articles (5 out of 12) concluded that PET/MRI is superior to PET, MRI, and PET/CT imaging in relation to defining malignancies’ size. Six articles found no statistically significant results and the diagnostic accuracy presented was similar in PET/MRI versus MRI and PET/CT images. Regarding the overall risk of bias, most articles had a moderate risk. Conclusions: The use of PET/MRI in HNC cases provides a more accurate diagnosis regarding dimensions of the tumor and thus a more accurate surgical approach if needed. Further prospective studies on a larger cohort of patients are required to obtain more accurate results on the application of hybrid PET/MRI.

Aims: The Education Committee of the European Academy of DentoMaxilloFacial Radiology should ‘ encourage and support high levels of graduate and postgraduate education in dentomaxillofacial radiology ( DMFR ) all over Europe ’. For this reason, the committee aimed to formulate a document describing resources allocated for undergraduate education within oral radiology in Europe today that can serve as a benchmark against which dental schools and/or countries with dentistry programmes can relate their undergraduate education. Materials and Methods: A questionnaire addressing resources allocated for learning oral radiology was distributed to colleagues involved in oral radiology education in 117 dental schools in 29 countries in Europe. Results: The answers represent approximately 13% of the dental schools in 40% of the countries providing dental education in Europe. There was a large variation regarding qualifications among teachers. There were also large differences in reported time dedicated to oral radiology courses, within some parts the allocated time differed by a factor 16. Discussion: An ambition to achieve high standards in oral radiology all over Europe should, based on the results of this survey, start with an effort to attain consensus regarding the role of oral radiology in dental education. The involvement of dentists with DMFR specialist training, would support high levels of undergraduate education. Conclusion: The results of this survey include information that educators and authorities can relate to in planning and implementation of new or revised curriculum. The ambition should be to increase teachers' competence and to work towards more harmonised and extensive courses in oral radiology.

Incidental findings (IFs) depicted in imaging tests during the diagnostic evaluation of patients with cleft lip and/or palate (CL/P) can guide clinicians during treatment planning procedures for effective, comprehensive cleft care. Evidence regarding IFs in different anatomical regions distant from the dentition is scarce. The aim of this study was to compare the prevalence of IFs in various anatomical areas between patients with non-syndromic CL/P and unaffected subjects. Orthopantomographs (OPTs), lateral cephalometric (LC) radiographs, and cone beam computed tomography (CBCT) scans of 120 subjects (case group: n = 40, 18 females, age 14.5 ± 5.0 years; control group: n = 80, 36 females, age 14.6 ± 4.9 years) were examined, and IFs were assessed by four observers. A significantly higher prevalence of IFs (p < 0.001) was reported in the case group (97.5%) compared with the control group (62.5%). The most prevalent location of IFs in the case group was the maxilla (92.5%), followed by the nasal cavity (75.8%) and the mandible (63.2%), while in the control group, the highest rates of IFs occurred in the maxilla (43.8%), mandible (41.3%), and temporomandibular joint (TMJ) (14.7%). No gender-dependent pattern for IF occurrence was detected overall. Orofacial clefts may affect the mandible. However, the reported IFs were limited compared to those in the maxilla. In conclusion, individuals with CL/P are more likely to present with a range of IFs than their unaffected peers. Understanding the association between CL/P and IFs is critical for successful interdisciplinary treatment, raising awareness of the potential need for future dental care for cleft patients, and managing extra-dental aberrations. A systematic assessment of diagnostic records is required to eliminate the risk of overlooking clinically significant IFs.

Incidental findings (IFs) depicted in imaging tests during diagnostic evaluation of patients with cleft lip and/or palate (CL/P) can guide clinicians during treatment-planning procedures for effective, comprehensive cleft care. Evidence regarding IFs in different anatomical regions distant from the dentition are scarce. The aim of this study was to compare the prevalence of IFs in various anatomical areas between patients with non-syndromic CL/P and unaffected subjects. Orthopantomographs (OPT), lateral cephalometric (LC) radiographs and cone-beam computed tomography (CBCT) scans of 120 subjects (case group: n = 40, 18 females, age 14.5 ± 5.0 years; control group: n = 80, 36 females, age 14.6 ± 4.9 years) were examined and IFs were assessed by four observers. Significantly higher prevalence of IFs (p < 0.001) was reported in the case group (97.5%) compared with the control group (62.5%). The most prevalent location of IFs in the case group was the maxilla (92.5%), followed by the nasal cavity (75.8%) and the mandible (63.2%), while in the control group, the highest rates of IFs occurred in the maxilla (43.8%), mandible (41.3%) and temporomandibular joint (TMJ) (14.7%). No gender-dependent pattern for IF occurrence was detected overall. Orofacial clefts may affect the mandible. However, the reported IFs were limited compared to those in the maxilla. In conclusion, individuals with CL/P are more likely to present with a range of IFs than their unaffected peers. Understanding the association between CL/P and IFs is critical for successful interdisciplinary treatment, raising awareness of the potential need for future dental care for cleft patients, and managing extra-dental aberrations. A systematic assessment of diagnostic records is required to eliminate the risk of overlooking clinically significant IFs.