Introduction Children with clefts have been shown to have various nutrient deficiencies including protein energy malnutrition but the levels of vitamin D as compared to normal population have seldom been researched. Materials and Methods Serum levels of Vitamin D in children with clefts (12 years and less), belonging to the Sub-Himalayan and Gangetic Plain regions were compared with age matched normal population using non-parametric tests. Bivariate Logistic regression for estimation of odds ratio for cleft versus control were performed for risk estimation of vitamin D insufficiency (less than 30 ng/mL). Results Serum Vitamin D levels of cleft group was significantly lower than control group significantly (P = 0.02) and the age adjusted odds ratio was 2.819 compared to controls. Conclusion The study reveals Vitamin Deficiency in the general population of the sub-Himalayan region, albeit, the levels in the population of clefts are significantly less as compared to the control population. Hence it is imperative to consider prospective trials and if proven then to recommend alterations in the existing vitamin D supplementation for children in this age group belonging to this belt in general. The normalization of vitamin D levels in children with cleft can help in wound healing after surgeries in addition to their normal growth and development.

This study compared cone-beam computed tomography (CBCT) and photon-counting detector computed tomography (PCD-CT) for detecting simulated mandibular osseous lesions, emphasizing lesion detectability, quantitative accuracy, and inter-reader reliability at equivalent radiation doses. Three types of simulated osseous lesions (sequestrum/fracture, cystic lesion, and extended periodontal gap) were evaluated by two readers, across three radiation dose levels: high (360 μSv), standard (122 μSv), and low (20 μSv). Image quality, artifact presence, and lesion detectability were qualitatively evaluated using a 5-point Likert scale (5 = highest to 1 = lowest rating). Lesion dimensions were quantitatively measured. Statistical analysis included descriptive statistics and weighted kappa for interobserver reliability. High-dose PCD-CT consistently provided the highest image quality, lesion detectability, and minimal artifacts across all lesion types (5 ± 0), achieving perfect inter-reader agreement (100 %). PCD-CT outperformed CBCT in lesion detectability, with the greatest difference at lower doses (3.87 ± 0.35 to 4.83 ± 0.39 vs. 3.13 ± 0.53 to 4.5 ± 0.52). PCD-CT demonstrated superior inter-reader reliability, with perfect agreement for high-dose (κ = 1.0; p < 0.001) and good agreement for standard- and low-dose protocols (κ = 0.909 and κ = 0.744; p < 0.001). Quantitative measurements showed minimal intermodal differences ranging from 0.15 to 0.34 mm, confirming PCD-CT's clinical precision even at low-dose protocols. These findings highlight PCD-CT's potential in dentomaxillofacial imaging, enhancing diagnostic capabilities and reducing radiation exposure.

To compare cone-beam computed tomography (CBCT) with photon-counting detector computed tomography (PCD-CT) at equivalent radiation doses, focusing on qualitative and quantitative parameters relevant to dental implant surgery. This ex vivo comparative study of porcine specimens assessed five imaging protocols with both CBCT and PCD-CT at three effective radiation dose levels (high: 360µSv, standard: 145µSv, low: 20µSv) to evaluate image quality, artifact burden, metal artifact susceptibility, and quantitative bone measurements in the mandibular region. Three blinded readers analyzed the data using a 5-point Likert scale (5 = highest to 1 = lowest rating) and performed linear bone measurements at implant planning sites. Statistical analysis included descriptive statistics and inter-reader reliability assessment using intraclass correlation coefficients (ICC). Each reader evaluated 30 data sets (12 CBCT, 18 PCD-CT), with 24 implant planning sites per imaging protocol. High-dose PCD-CT demonstrated the best image quality and diagnostic interpretability (4.89 ± 0.27), followed by standard-dose PCD-CT and CBCT (4.50 ± 0.73; 4.33 ± 0.61), with low-dose protocols showing intermediate quality with higher artifact burden. In comparison to CBCT, PCD-CT demonstrated superior performance in reducing implant-induced artifacts across all protocols. Quantitative bone measurements showed minimal variability, meeting clinical precision requirements for computer-assisted implant surgery. Both qualitative (ICCs:0.70–0.89; p < 0.001) and quantitative (ICCs:0.79–1; p < 0.001) analyses demonstrated high reliability, regardless of the reader’s experience. PCD-CT demonstrated superior image quality and reduced artifacts compared with CBCT at all radiation dose levels. These findings highlight PCD-CT’s potential to enhance implant planning and improve clinical outcomes with reduced radiation exposure while maintaining diagnostic accuracy.

This systematic review evaluates the current literature on state-of-the-art radiation-free MRI techniques for managing dental, oral, and maxillofacial trauma, comparing their diagnostic performance to conventional X-ray-based imaging. Two reviewers conducted an investigation using the PICOS search strategy across multiple databases, including MEDLINE, EMBASE, BIOSIS, Web of Science, Cochrane Library, LILACS, and BBO Dentistry. Twenty-nine studies were included: 12 on orbital trauma, 10 on condylar, subcondylar, or TMJ trauma, five on mandibular fractures, and one each on temporal bone and dental trauma. MRI was performed at post-traumatic, postoperative, or both stages. Despite variability in scan parameters, field strengths, and coil configurations, the results highlight MRI's growing potential in trauma assessment. CT-like and Black Bone MRI sequences enable simultaneous visualization of hard and soft tissues at trauma sites, providing diagnostic insights comparable to X-ray-based techniques. However, despite their superior soft-tissue assessment, they remain less effective at depicting intricate bony pathoanatomical conditions. This diagnostic approach can improve the long-term benefit-to-risk ratio, particularly for younger, radio-sensitive patients requiring repeated imaging and long-term follow-up. However, a modality- and protocol-oriented approach is essential to balance clinical conditions, radiation exposure, and diagnostic accuracy and efficiency, to ensure optimal patient outcomes in comprehensive trauma management.

To assess postoperative fracture reduction and visualization of titanium-based and bioresorbable osteosynthesis materials in maxillofacial trauma surgery using ultra-high-resolution photon-counting detector computed tomography (PCD-CT) compared with cone-beam computed tomography (CBCT). Fractures were induced in six cadaveric pig mandibles at the angle, body, and parasymphysis and were stabilized using various titanium and bioresorbable plate systems. Specimens were scanned with CBCT and dose-matched PCD-CT in the ultra-high resolution mode, applying standard and low-dose protocols. Two observers assessed fracture reduction and implant delineation using a 5-point visual analog scale. Fracture gap and osteosynthesis materials were quantitatively measured and compared to ground-truth values. Descriptive statistics and inter-reader agreement (weighted κ) were calculated. PCD-CT enabled excellent assessment of fracture reduction and visualization of osteosynthesis materials, with perfect inter-observer agreement (Median = 5, IQR, 5–5; κ = 1.0, p < 0.001), whereas low-dose CBCT showed reduced image quality and lower reproducibility (Median = 4, IQR, 4–4; κ = 0.92; p < 0.001). Bioresorbable plates were not directly visible using either scanner, but the associated screw drill holes were reliably delineated. PCD-CT achieved the smallest measurement deviations of fracture gap and osteosynthesis materials compared with ground truth, and with superior reproducibility (κ = 0.74–0.84; ICC = 0.95–0.99; all p < 0.001), outperforming CBCT across most parameters. Ultra-high resolution PCD-CT combines superior visualization and precise measurements compared with CBCT even at low radiation dose. With further clinical validation, these findings highlight PCD-CT’s strong potential for perioperative imaging in maxillofacial trauma, particularly benefiting younger patients who require repeated scans.

To assess the effectiveness and feasibility of MRI-based delineation of fracture-prone regions in the oral and maxillofacial region using Black Bone and CT-like MRI protocols optimized for dentomaxillofacial imaging with a dedicated 15-channel mandibular coil. In this prospective study, healthy volunteers underwent 3T MRI using five protocols: DESS, SPACE STIR, SPACE SPAIR, T1-VIBE Dixon, and UTE. Eight trauma-prone regions, including the nasal septum, orbit, naso-orbito-ethmoidal (NOE) complex, zygomaticomaxillary complex, Le Fort regions, mandible, condyle, and dentoalveolar complex, were assessed. Image quality, artifacts, anatomical delineation, and bone-to-soft-tissue contrast were rated on a five-point Likert scale by three independent observers. Descriptive statistics and inter-rater agreement (intraclass correlation coefficients (ICCs)) were calculated. Sixteen participants (37.2 ± 12.9 years; 12 males, 4 females) were included, resulting in 80 MRI volumes and 640 regions for evaluation. UTE and VIBE-DIXON sequences achieved the highest ratings for image quality, artifact susceptibility, and anatomical delineation across most fracture-prone regions (ICC: 0.793–1; all p < 0.001). UTE excelled in visualizing NOE and Le Fort regions, while VIBE-DIXON performed best in mandibular and orbital imaging. Bone-to-soft-tissue contrast was highest in UTE and VIBE-DIXON, highlighting their diagnostic potential in simultaneous soft and hard tissue imaging. Inter-rater agreement was consistently high (ICC: 0.772–0.976; all p < 0.001). Dedicated trauma-specific MRI protocols show promising potential as a radiation-free modality for maxillofacial trauma imaging, particularly in young adults and pediatric patients. The strengths of each protocol highlight the need for tailored sequence selection to optimize diagnostic accuracy and personalized care. Trial registration number: Swiss National Clinical Trials Portal: SNCTP000005246.

BACKGROUND:Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials.OBJECTIVES:This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation.METHODS:The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction.RESULTS:Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'.CONCLUSIONS:Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.