Marcela Lima Gurgel

To map and critically synthesize the methodological approaches used for the CBCT‐based evaluation of maxillary and mandibular impacted canines (ICs), with emphasis on imaging protocols, anatomical variables, and diagnostic frameworks. This scoping review followed PRISMA‐ScR guidelines. A three‐step search strategy was applied across PubMed, Embase, Web of Science, Scopus, LIVIVO, Cochrane Library, LILACS, and Google Scholar, using MeSH terms and free‐text keywords related to ICs and CBCT. Data on sample characteristics, CBCT acquisition parameters, anatomical assessment criteria, classification systems, segmentation software, and examiner calibration were extracted and synthesized narratively. Forty‐nine observational studies met the inclusion criteria. Substantial heterogeneity was observed in CBCT equipment, voxel size, field of view, exposure settings, image orientation, segmentation tools, and calibration procedures. Most studies evaluated maxillary canines, whereas mandibular impactions were rarely assessed (6.12%). The most frequently analysed characteristics were the impacted canine's position within the alveolar bone, its involvement in adjacent tooth resorption, and its spatial relationship to surrounding teeth. Major methodological gaps were identified in CBCT acquisition protocols, image orientation, examiner reliability, classification systems, and the assessment of follicular and impacted canine morphology, volume, shape, and anatomical relationships to adjacent structures widely used classification systems, particularly Ericson–Kurol, showed variable adaptations and limited standardization. Most studies evaluated maxillary canines, focusing on bucco‐palatal position, root resorption, and the Ericson and Kurol classification, although CBCT methodologies were inconsistently reported. Standardized acquisition, orientation, and measurement protocols may improve diagnostic consistency and support more reliable orthodontic treatment planning and clinical decision‐making for impacted canines.

Sex estimation plays a critical role in the reconstruction of the biological profile in forensic contexts. The paranasal sinuses, owing to their structural complexity and resistance to postmortem degradation, have emerged as valuable anatomical regions for this purpose. This observational, retrospective study assessed the accuracy of sex estimation in Brazilian adults using linear and volumetric measurements of the frontal, maxillary, and sphenoidal sinuses obtained from multislice computed tomography (MSCT). A total of 220 MSCT scans (113 males, 107 females) from three imaging centers were analyzed. Semiautomatic segmentation was performed using ITK-SNAP and 3D Slicer to extract craniometric features. Statistical analyses and supervised machine learning models, including logistic regression, linear support vector machine (SVM), random forest, and k-nearest neighbors, were employed for classification. Males showed significantly larger anteroposterior, supero-anterior, and volumetric dimensions (p < 0.05). The highest classification accuracy was achieved by logistic regression and linear SVM models, both reaching 84%. These models outperformed conventional discriminant analysis. The study supports the forensic utility of CT-derived morphometric parameters of the paranasal sinuses for sex estimation and highlights the potential of machine learning as a robust complementary tool in forensic investigations. Findings also underscore the relevance of broader validation in multiethnic forensic contexts.

Introduction This study aimed to validate an artificial intelligence (AI)-based automated image analysis for three-dimensional (3D) characterization of impacted canine position. In addition, it compared clinical treatment plans developed using conventional orthodontic records versus with the aid of the AI-generated diagnostic report. Methods A sample of 228 cone-beam computed tomography (CBCT) scans for patients with impacted maxillary canines was retrospectively collected. AI models were used to automatically orient scans and identify anatomical landmarks to quantify impaction severity. The accuracy of the AI approach was validated by comparing its assessments with manual measurements performed by expert clinicians. Clinical applicability was assessed by comparing diagnoses made by clinicians using conventional records to those made using AI-based diagnostic system. Results A total of 316 impacted canines were assessed, with 20.9% classified as buccal, 31.3% as bicortical, and 47.8% as palatal. The AI-based diagnostic system accurately identified the position of impacted canines, achieving a mean detection success rate of 96.2%. Palatally impacted canines tend to have the crown closer to the midpalatal plane, reduced vertical distance to the occlusal plane, and greater pitch and roll angles compared to bicortically and buccally impacted canines (P<0.001). Overlap with adjacent teeth was the primary contributor to the AI-generated severity index (81.11%). The AI-based diagnostic system report significantly influenced clinicians' decisions, particularly patient education (72.31%) and biomechanics (51.15%). Conclusions The AI-based diagnostic system accurately characterized impacted canine position and severity, demonstrating the effectiveness of AI in enhancing diagnosis for impacted canine. Clinical relevance The automated diagnostic report provides objective measurements that enhance clinicians’ understanding of impaction complexity, improve patient communication, and support more informed biomechanical and treatment-planning decisions.

The human neurocranium exhibits significant sexual dimorphism, making it a valuable resource for anthropological studies. This systematic review aggregated and analyzed data from literature on sex differences in neurocranial dimensions as measured by computed tomography (CT). Following registration of the review protocol with PROSPERO (#CRD 42023442451), comprehensive searches were conducted in six databases and gray literature. From an initial pool of 1,499 articles, 14 met the inclusion criteria and were analyzed for data extraction, meta-analysis of linear measurements, risk of bias (RoB), and certainty of evidence (GRADE) evaluation. In the meta-analysis (Sample size- 1726 female and 1837 male), the inverse variance method and a random-effects model were employed using Review Manager (version 5.4.1). Statistical heterogeneity was quantified using the I² coefficient. The studies primarily involved linear measurements between specific cranial landmarks, manually delineated using imaging software. Measurements analyzed included Maximum Cranial Length (G-Op), Cranial Base Length (N-Ba and N-Pfm), Cranial Height (Ba-Br), Frontal Chord (N-Br), Maximum Cranial Breadth (Eu–Eu), Minimum Frontal Breadth (Ft-Ft), Upper Facial Breadth (Fmt-Fmt), and Bimastoid Breadth (Ms–Ms). Results indicated that the mean values were significantly lower in females (p < 0.001), with no differences between the subgroups of dry skulls and living patients. The largest differences between sexes were observed in G-Op [-8.64 (-9.69, -7.59) mm] and N-Pfm [-8.83 mm (-12.75, -4.91)]. Our meta-analysis showed a low risk of bias, and measurements of N-Ba, Ba-Br, N-Br, and Ms–Ms demonstrated high certainty of evidence according to the GRADE approach. This research underscores the reliability of specific neurocranial measurements for sex differentiation in CT scans, with smaller dimensions consistently found in females.

Objectives To evaluate the temporomandibular joint (TMJ), condylar and mandibular movements in obstructive sleep apnea (OSA) patients treated with mandibular advancement device (MAD) and to identify the influence of these anatomic factors on upper airway (UA) volume and polysomnographic outcomes after treatment. Materials and methods Twenty OSA patients were prospectively treated with MAD. Clinical examinations, cone-beam computed tomography, and polysomnography were performed before MAD treatment and after achieving therapeutic protrusion. Polysomnographic variables and three-dimensional measurements of the TMJ, mandible, and upper airway were statistically analyzed. Results Condylar rotation, anterior translation, and anterior mandibular displacement were directly correlated with total UA volume, while vertical mandibular translation was inversely correlated with the volume of the inferior oropharynx. MAD treatment resulted in an increase in the volume and area of the superior oropharynx. There was no statistically significant correlation between condylar rotation and translation and polysomnographic variables. With MAD, there was a significant increase in vertical dimension, changes in condylar position (rotation and translation), and mandibular displacement. The central and medial lengths of the articular eminence were inversely correlated with condylar rotation and translation, respectively. The lateral length of the eminence was directly correlated with condylar translation, and the lateral height was directly correlated with condylar rotation and translation. Conclusion Condylar and mandibular movements influenced UA volume. The articular eminence played a role in the amount of condylar rotation and translation. Clinical relevance Individualized anatomical evaluation of the TMJ proves to be important in the therapy of OSA with MAD.

This study explored the effects of L-PRF on pain, soft tissue healing, periodontal condition, and post-extraction bone repair of mandibular third molars (3Ms). A randomized, prospective, triple-blind, split-mouth clinical trial was conducted with 34 volunteers. Eligible patients were randomly allocated into two treatments: G1 (without L-PRF), G2 (alveoli filled with L-PRF), in which the removal of bilateral 3Ms was performed at the same surgical time. Outcomes were assessed according to a visual analogue scale (pain), soft tissue scoring system (wound healing), periodontal probing of mandibular second molar. Bone repair was determined by volumetric analysis (ITK-SNAP software) and fractal analysis (ImageJ software). An intention-to-treat approach to Statistical analysis was used. L-PRF reduced pain in the 7-day postoperative follow-up (p = 0.019) and not only improved soft tissue healing after 1 month of follow-up (p = 0.021), but also probing depth (distal face) in 3 months postoperatively (p = 0.011). Significant alveolar reduction occurred in 3 months after surgery in both treatments (p < 0.05), however, this was more significant in G1 (p = 0.016). The fractal dimension showed no statistical differences. L-PRF improved postoperative clinical parameters of pain, soft tissue healing, and periodontal condition, suggesting that it has a beneficial effect on preserving the alveolar ridge and accelerating the initial repair process.

Objective(s): This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)‐automated tools.Materials and Methods: Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI‐automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial‐distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared.Results: The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth.Conclusion: The open source‐automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.