Ocak, Ali; Akyüz, Mehmet

Background: This study aimed to evaluate and compare the periradicular trabecular bone density (BD) and microarchitecture of dilacerated and non-dilacerated mandibular third molars using gray values (GVs) and fractal dimension (FD) derived from cone-beam computed tomography (CBCT) images. Methods: This retrospective cross-sectional study included CBCT scans of 54 patients with dilacerated mandibular third molars and 60 controls without dilaceration. Root dilaceration was defined as deviation > 20° from the long axis. The dilaceration group was further divided into subgroups based on severity (angle of dilaceration > 60° vs. ≤60°). Standardized regions of interest were selected adjacent to the curvature of the roots, excluding cortical bones. GVs were automatically measured by Romexis 6.2.1 (R®software, Planmeca, Helsinki, Finland), and FD was calculated via ImageJ using the box-counting method. Appropriate statistical analyses were performed, with significance set at p < 0.05. Results: No significant differences were found between dilacerated and non-dilacerated groups in GV (437.12 ± 184.83 vs. 439.25 ± 148.90, p = 0.645) or FD (1.07 ± 0.15 vs. 1.04 ± 0.17, p = 0.204). However, when dilacerated teeth were stratified by severity, roots with > 60° curvature exhibited significantly higher FD values than those ≤ 60° (p = 0.040), whereas GV values did not differ between curvature groups (p > 0.05). Spearman’s correlation revealed no significant association between dilaceration angle and GV or FD (p > 0.05). Conclusion: Within the limitations of this study, fractal analysis was used as a quantitative method to assess periradicular trabecular bone changes adjacent to dilacerated root apices. Although overall GV- and FD-based metrics did not differ between dilacerated and non-dilacerated teeth, the higher FD observed in severely dilacerated roots (> 60°) suggests increased trabecular complexity in the apical region, reflecting a potential biological bone response associated with pronounced root curvature.

Bingol, Koray; Ozdemir, Hatice Kubra

Background: Pediatric cerebral sinovenous thrombosis (CSVT) is an uncommon yet serious cause of stroke in children. Although cerebral venous anatomical variations (AVs) are frequently encountered on MR venography (MRV), their potential contribution to CSVT remains unclear. Only one prior study has explored the relationship between AVs and CSVT, highlighting the need for larger population-based investigations. This study aimed to examine the prevalence of AVs in pediatric CSVT and non-CSVT populations and to assess their potential association with thrombosis and CSVT-related complications. Methods: This retrospective study included 124 children who underwent MRV between January 2020 and November 2025. Sixty-two patients diagnosed with CSVT were age- and sex-matched with 62 controls. MRV examinations were evaluated for the presence and subtype of AVs. Clinical presentation, complications, and demographic characteristics were recorded. Results: AV prevalence did not differ significantly between CSVT and control groups (46.7% vs. 50%, p = 0.67). The most common variation in both groups was left hypoplastic transverse sinus. AV rates were also similar between complicated and uncomplicated CSVT cases (44.4% vs. 47.1%, p = 0.92). Headache was the predominant presenting symptom (70.1%). Complications—including papilledema, elevated intracranial pressure, and venous infarction—were more common in younger patients (p = 0.01). Conclusions: AVs are common findings on pediatric MRV; however, their presence does not appear to influence CSVT development or complication risk. This study represents the largest cohort evaluating AVs in pediatric CSVT and contributes valuable evidence suggesting that AVs are incidental rather than pathogenic in this context.