Objective: To investigate significant differences in selected radiomic parameters when classifying periapical lesions based on volumetric size, cortical expansion, erosion, and shape using Cone Beam Computed Tomography (CBCT).Methods: A retrospective analytical and comparative study was conducted on 100 small field of view (FOV) 50×50 mm CBCT scans collected between the years 2018 and 2023. The study involved qualitative classification of periapical lesions, followed by segmentation and extraction of radiomic parameters. The extracted parameters included first-order features such as energy, entropy, total energy, and uniformity; texture features like grey-level co-occurrence matrix contrast (GLCMC) and neighbouring grey tone difference matrix contrast (NGTDMC); and shape features including elongation, flatness, sphericity, and mesh volume, utilising 3D Slicer and Pyradiomics. The normal distribution of the variables was determined using the Shapiro-Wilk test. Various tests were used to assess significant differences, including Student’s t-test, Mann-Whitney U test, ANOVA, and Tukey’s post hoc analysis. Results: Significant differences were observed in the following parameters among the classification levels when classifying periapical lesions according to their volumetric size. There were significant differences in energy with a p-value of 0.001 and total energy with a p-value of 0.02. NGTDMC also showed a significant difference with a p-value of 0.001. A larger volumetric size is associated with greater energy and lower contrast. Significant differences in periapical lesions with erosion were found in shape sphericity (mean 0.34, SD 0.10, p=0.01), energy (mean 3.73×10¹⁰, SD 4.52×10¹⁰, p=0.002), and NGTDMC (mean 0.05, SD 0.02, p=0.001) compared to lesions without erosion. GLCMC was lower in erosive lesions (mean 18.94, SD 6.81, p=0.03) than in non-erosive ones (mean 22.28, SD 8.48). Regular-shaped periapical lesions demonstrated significantly greater elongation (mean 0.794, SD 0.115, p=0.006) and flatness (mean 0.614, SD 0.107, p=0.005) than irregular-shaped lesions. These findings suggest that regular-shaped periapical lesions are more elongated and flatter than irregular ones. No significant differences were found in radiomic features depending on the presence or absence of expansion in the periapical lesion.Conclusion: There are significant differences in texture and first-order radiomic features in periapical lesions classified based on size, erosion, and shape. This research's relevance lies in its potential to improve the quantitative characterisation of periapical lesions, leading to an objective interpretation. (EEJ-2023-11-159)

This systematic review and meta-analysis aim to synthesize the current evidence from randomized clinical trials (RCTs) comparing the anesthetic success of mental/incisive nerve block (MINB) versus inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis affecting mandibular premolars. A thorough literature search was performed using databases such as PubMed, Web of Science, Science Direct, Cochrane Database, and Google Scholar. The search covered publications up to June 2025. The focused PICOTT question for this review was: “What is the anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block in mandibular premolars with symptomatic irreversible pulpitis?”. The included studies were evaluated for quality using the ROB 2 tool for non-randomized designs, while the certainty of the evidence was assessed through the GRADE approach. A meta-analysis was performed using a random-effects model to address potential variability among studies. Three RCTs were included. Overall, the risk of bias was considered low to moderate using the ROB 2 tool. The GRADE assessment indicated that the certainty of evidence was rated as very low. The overall pooled analysis showed no statistically significant difference in success rates between the MINB and IANB techniques (OR = 1.25; 95% CI: 0.74 to 2.12; P = 0.40), with low heterogeneity (I² = 0%). Subgroup analysis by premolar type showed no significant differences between techniques for either first (OR = 1.03; 95% CI: 0.64-1.65; P = 0.90; I² = 0%) or second premolars (OR = 1.23; 95% CI: 0.76-1.98; P = 0.40; I² = 0%). In conclusion, the findings of this systematic review and meta-analysis indicate no clear difference in anesthetic efficacy between MINB and IANB techniques. However, most studies suggest that achieving adequate pulpal anesthesia requires the use of supplemental anesthesia.

Sinus pathologies of odontogenic origin (SPO) are common in the clinical consultation; however, the dentist has some complications to detect them because their discovery is usually incidental and through imaging studies that, in most cases, are of low quality. The objective of this review is to describe the pertinent imaging resources that allow the detection of the most frequent SPO and, at the same time, carry out an updated review of the scientific literature in order to recognize the imaging of both the maxillary sinus and the dental organs. The scientific literature focused on this topic, published between 2014 and 2020, was consulted. The review showed two important results: the first is that Cone Beam Tomography (CBCT) represents the imaging modality with the best performance for the detection of SPO by what can be considered the gold standard for this purpose. The second is that the most frequent SPO is sinus mucositis, which is related to odontogenic conditions such as periapical lesions and periodontal affectations. Although Cone Beam Computed Tomography (CBCT) is the most appropriate tool to detect SPO compared to images obtained by 2D devices, there are also other alternatives such as magnetic resonance imaging and ultrasonography, which seem to have a promising future.