Dental radiographsmakalenin revize son hali ve hakeme cevap mektubu

Medical and dental radiographic information of the COVID-19 patients was collected using the Nucleus Medical Information System (Monad software, Istanbul, Turkey), a hospital information and automation system. An experienced endodontist evaluated their panoramic radiographs retrospectively twice at different times. The radiographs were downloaded from the Extreme Pacs version 4.3 (Ankara, Turkey), the official medical image and archiving system, and were produced in a dim room using contrast, density, zoom and measurement settings on a 20-inch wide LCD TFT monitor (HP, Houston, USA).

The number of dental caries (NDC), the number of root canal treatment (NRCT), the number of tooth filling (NTF), the number of dental implant (NDI), the number of crown (NC) and the number of missing tooth (NMT) were determined for the patients using available dental radiographic images and reports. Then, their PAI scores and % RBL measurements were found. The teeth with AP detected in radiographs were scored according to the APGS based on PAI (Fig. 1). The patients were divided into 4 groups (APGS group 0, 1, 2 and 3) according to the severity of AP. These APGSP groups were scored as 0, 1, 3 and 5 according to the severity of their AP. The computer-aided diagnoses (CAD) method was used for the RBL measurements [16, 17]. Based on the patients’ radiological data, the radiologic alveolar bone loss (RBL) was calculated in percentage (%) by a computer program (ExtremePacs Client × 64 Software, Ankara, Turkey) (Fig. 2). The patients were divided into 4 groups (RBL group 1, 2, 3, and 4) according to the severity of RBL, including RBL 0%, < 15%, 1–33%, and > 33%. These RBL groups were scored as 0, 1, 3 and 5 according to the severity of their RBL. The classification of PPDC was based on dental caries, where by the lack of dentine caries was classified as PPDC group 0; the presence of only one dental caries was categorized as PPDC group 1 as the first dentine caries was considered to be the beginning; and the presence of more than one dentine caries, which is an indication of dental caries progression, was considered PPDC group 2. These PPDC groups were scored as 0, 1 and 3 according to their severity.

APGS scoring based on PAI on dental radiographic images. a Since PAI 3 was detected in tooth number 48, the patient was included in the APGS group 1. b Since PAI 3 was detected in tooth number 17 and PAI 4 in teeth 36 and 37, the patient was included in the APSG group 2. c Since PAI 3 was detected in tooth number 18 and PAI 5 in teeth 36 and 46, the patient was included in the APSG group 3

RBL measurements made using computer-aided diagnosis (CAD) method. The figure shows the radiographic image of a patient whose RBL measurement was 43.47% and was included in RBL group 4

Oral and dental health status of the patients were scored based on their APGS, RBL and PPDC values. Using this scoring, their Dental Damage Stage (DD Stg) was determined as an indicator of their oral and dental health status (Fig. 3). Accordingly, those who scored 0–1 for dental health were classified in DD Stg 0 (healthy), those who scored 2–4 in DD Stg 1 (mild), those who scored 5–8 in DD Stg 2 (moderate), and those who scored 9–13 in DD Stg 3 (severe).

Algorithm of Dental Damage Stage. Dental Damage Stage calculated on the basis of scores from APGS, RBL and PPDC. APGS Apical periodontitis grading scale, RBL Radiologic alveolar bone loss, PPDC Pathophysiological process of dental caries

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