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Background This study aimed to provide the frequency and demographic data of non-endodontic periapical lesions clinically misdiagnosed as endodontic periapical lesions from a Southeast Asian population over a 15-year period. Material and Methods A retrospective study was conducted from departmental archives between 2005 and 2019. Cases clinically diagnosed as endodontic periapical lesions were retrieved. Then, cases with a histopathological diagnosis of non-endodontic periapical lesion were selected. Demographic data of non-endodontic periapical lesions were recorded. Radiographic features of cases with available radiographs were analyzed. Results Of 1,566 cases clinically diagnosed as endodontic periapical lesion, 157 cases received a histopathological diagnosis of non-endodontic origin. Eighteen different histopathological diagnoses were identified. The most frequent lesion was dentigerous cyst (n= 51, 32.48%) followed by odontogenic keratocyst (n=31, 19.75%), nasopalatine duct cyst (n=18, 11.46%) and ameloblastoma (n=15, 9.56%). Three cases of malignant tumors, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and metastatic papillary thyroid carcinoma were observed. Conclusions Non-endodontic periapical lesions constituted 10.03% of cases clinically diagnosed as endodontic periapical lesions. Histopathological examinations of non-endodontic periapical lesions revealed a variety of lesions ranging from foreign body reaction, cysts, fibro-osseous lesions, benign tumors and primary or metastatic malignant tumors. Of clinical significance is that some non-endodontic periapical lesions had different treatment modalities and prognoses compared with endodontic lesions. Therefore, dentists must be aware that periapical radiolucent lesions are not always a consequence of pulpal necrosis. Key words: Ameloblastoma, dentigerous cyst, endodontic periapical lesions, non-endodontic periapical lesions, odontogenic keratocyst.

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Purpose Placement of one-piece ceramic dental implants requires precision, which can be enhanced by using a computer-guided system. This prospective clinical study examines the accuracy of partially guided implantation in the placement of one-piece ceramic implants in the anterior region. Materials and methods One-piece ceramic dental implants were placed in 20 patients who were missing a central or lateral incisor. Partially guided dental implant placements were performed in all cases. The deviations in the implant positions were analyzed by superimposing post-operative cone beam computed tomography images over pre-operative treatment planning images. The results were reported as deviations (mean ± standard deviation) for three aspects (3D offset, mesio-distal, labio-lingual, and apico-coronal) and in three dimensions (the angle, coronal, and apical parts). Results Implants were successfully placed in 20 patients. The mean angular deviation was 4.23±1.84°, whereas the mean coronal 3D offset was 0.98±0.48 mm, and the mean apical 3D offset was 1.57±0.46 mm. Conclusions A prospective clinical study involving 20 patients was conducted to measure the accuracy of computer-guided implantation of one-piece ceramic dental implants. Accuracy was determined by comparing the planned implant position to the actual position. Greater accuracy can be expected at the coronal part than at the apical part. The coronal 3D offset was found to be the most accurate.

Odontogenic keratocyst is regarded as a relatively common developmental odontogenic lesion representing 12% to 14% of all odontogenic cyst of the jaw. The lesion is of important interest for its potentially destructive behaviour and relatively high recurrence rate from 21.1% to as high as 35.4% in patients associated with Nevoid basal cell carcinoma syndrome. This study aim to determine the radiographic characteristic of odontogenic keratocyst (OKC) using conventional radiographs and cone beam computed tomography images. Patients histopathologically diagnosed as OKC from 2003 to 2016 by Oral and Maxillofacial Pathology Department were retrospectively reviewed. Radiographs of these cases from the archives of the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry Mahidol University were retrieved. Assessment of the location, shape, border, cortication, locularity, relationship of lesion to embedded tooth, displacement of adjacent tooth, root resorption and bony expansion of the lesion were conducted. Radiographs of 89 patients with the mean age of 31.5 years old were analysed. A total of 100 OKCs were studied. The most common location was at the ramus of mandible followed by posterior maxilla. Most cases presented as a well-defined unilocular radiolucency with smooth and corticated border. The lesions were in association with embedded tooth in 42 lesions. The lesions might relate to an embedded tooth by surrounding an entire tooth, attached to the CEJ level or extending to part of root. Bony expansion and teeth displacement could be found and root resorption were not common. These features facilitate in guiding the clinicians to formulate the differential diagnosis.