Introduction: Cone-beam computed tomography (CBCT) is widely used in the preoperative qualitative and quantitative assessment of dental implant sites, offering dimensional accuracy, spatial resolution, gray density, and contrast comparable to those of classical CT scan, yet with disputable ability to determine bone mass density. Materials and methods: A systematic review of the literature was performed using the PubMed and SCOPUS databases, with terms referring to low bone mass and cone-beam computed tomography (CBCT). Results: Sixteen studies were included in the review. The results show different perspectives, but the evidence favors the use of CBCT, combined with dual-energy X-ray absorptiometry bone density scan (DXA) evaluation, for the assessment of the osteoporosis status of the aging population and, more specifically, in postmenopausal women. Radiographic density (RD) values of the dens and the left part of the first cervical vertebra show the strongest correlation coefficients and the highest sensitivity, specificity, and accuracy for predicting osteoporosis (OP) in the lumbar vertebrae and the femoral neck. Conclusions: Our review suggests the potential of CBCT as a screening tool for patients with low bone mass using different radiomorphometric indices. Linear measurements of the inferior mandibular cortex were lower in osteoporotic individuals, indicating the perspective of CBCT also as a diagnostic tool for this disease.

Objective. This study examined the potential use of computed tomography panoramic mandibular indices on cone beam CT (CBCT) for assessing bone density in postmenopausal women with low bone mass. Study design. The study enrolled 104 postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen region CBCT alongside the NewTom VGi EVO Cone Beam 3D system. We assessed the relationship between the following DXA parameters: lumbar, femoral neck, and total hip T score, bone mineral density (BMD), and lumbar trabecular bone score (TBS). The following panoramic mandibular indices were also considered: the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography mental index (CTMI). Results. The study revealed moderate correlations between CBCT indices and BMD/TBS scores: CTMI showed the highest correlation with the femoral neck T-score (r = 0.551, p < 0.0001). TBS scores were also moderately correlated with CBCT indices: CTMI showed a moderate positive correlation with TBS (r = 0.431, p < 0.0001); CTI(S) had a similar moderate positive correlation with TBS (r = 0.421, p < 0.0001). AUC values ranged from 0.697 to 0.733 for osteoporosis versus the osteopenia/normal group and from 0.734 to 0.744 for low versus normal bone quality groups, p < 0.0001. The comparison of the values of the studied indices between low versus normal bone quality (quantified with TBS) groups showed high sensitivity but low specificity. Conclusions. CBCT-measured indices CTI(S), CTI(I), and CTMI are useful in assessing patients with low bone mass to improve, by specific treatment, the prognosis of dental implants.

Background: The present study examined the potential use of computed tomography radiomorphometric mandibular indices on cone beam CT (CBCT) for the assessment of bone density in postmenopausal women with low bone mass. Methods: We included 104 postmenopausal women who received dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen (MF) region CBCT using a NewTom VGi EVO Cone Beam 3D system. We assessed the relationships between the following DXA parameters: lumbar, femoral neck, and total hip T-scores, bone mineral density (BMD), lumbar trabecular bone score (TBS), and mandibular inferior cortical bone thickness at 4 sites. The cross-sectional images were obtained, as follows: anterior (A)—10 mm anterior from the MF; molar (M)—10 mm posterior from the MF; posterior (P)—25 mm posterior from the MF; symphysis (S)—equidistant from the centers of the right and left MF. Results: We found that A and M indices showed statistically significant moderate positive correlations with lumbar spine, femoral neck, and total hip BMD, as well as TBS. The P index demonstrated moderate positive correlations with these measurements, while the S index did not show significant correlations with BMD or TBS in postmenopausal women. Conclusions: These findings support the potential usefulness of CBCT-derived radiomorphometric mandibular indices for non-invasive bone health assessment in clinical practice.

Background: As implant treatment cases increase, many cases of failure/side effects also occur. Generally, dental clinics determine the density of the jawbone using cone beam CT (CBCT). Considering the known potential role of this tool for bone assessment in primary osteoporosis, this study evaluated patients with secondary endocrine causes of low bone mass. Methods: The study included 83 patients with endocrine causes of osteoporosis who were evaluated by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and mental foramen (MF) region CBCT. The following CBCT indices were measured: anterior (A)—thickness of inferior mandibular cortex 10 mm anterior from MF; molar (M)—thickness of inferior mandibular cortex 10 mm posterior from MF; posterior (P)—thickness of inferior mandibular cortex 25 mm posterior from MF; symphysis (S)—thickness of inferior mandibular cortex equidistant from the centers of right and left MF. Results: The highest correlation coefficient in the secondary causes group was between the A index and the lumbar BMD (r = 0.375, p = 0.001) and the P index and the femoral neck BMD (r = 0.38, p = 0.001). Hypercortisolism seems to be the most predictable cause of secondary osteoporosis using the A, M, and P indices. The A, M, and P indices showed predictive values of the bone micro-architecture that was evaluated using TBS score, and were statistically significant. The symphysis index does not significantly predict osteoporosis or impaired bone micro-architecture. Conclusions: These findings support the potential usefulness of A, M, and P CBCT-derived radiomorphometric mandibular indices in secondary osteoporosis, underlining the well-known effects of these pathologies on bone micro-architecture rather than bone quantity.

Chronic sclerosing sialadenitis (CSS), currently included in the group of immunoglobulin G4 (IgG4)-related diseases, is an under-recognized inflammatory lesion that afflicts mostly the submandibular gland of 40-60 years adults. To our knowledge, only one case of CSS located in the submandibular gland has been reported in childhood to date. We present a case of CSS in a 5-year-old male child. He presented with bilateral submandibular swellings that clinically resembled discrete lumps, suspected to be tumors. The completely resected tumors composed predominantly of dense lymphoplasmacytic inflammatory infiltrate rich in IgG4-positive cells [77-90 IgG(+) cells per high-power field; IgG4(+)/IgG(+) cells ratio of 42.77%]. We discuss the peculiarities of this case, and we also review the literature on CSS.

Sebaceous adenoma is an extremely rare tumor located in the parotid gland. In the English literature, less than 10 cases have been reported. Sebaceous adenoma represents 0.5% of all monomorphic adenomas. The authors are presenting a case of sebaceous adenoma of the parotid gland in a 65-year-old female who presented a mass on the left parotid area that had been gradually enlarging for one year without symptoms of pain. On imaging (ultrasound), a well-defined mass lesion in the left parotid area was seen. Histopathological findings were consistent with sebaceous adenoma. Surgical excision is curative. The prognosis is excellent, with a low recurrence rate. The present case report will increase the awareness and possibility of this rare tumor occurring at an unusual site, thereby avoiding any chance of misdiagnosis.