Medial sigmoid depression as a radiographic finding in patients visiting the Dr. René Puig Bentz Dental Clinic at the Pedro Henríquez Ureña National University
Description
This study was based on the premise that the medial sigmoid depression is a common anatomical variant of the mandibular ramus, identifiable on panoramic radiographs, and that its proper recognition is essential for preventing errors in dental diagnosis. Similarly, it was considered that this structure may exhibit variations in shape and location within the evaluated population. The medial sigmoid depression (MSD) is an anatomical variant located in the sigmoid notch of the ascending ramus of the mandible. It presents as a bony concavity that appears as a radiolucent image on X-rays, which can lead to confusion with pathological processes. The purpose of this study was to evaluate the MSD as a radiographic finding in patients treated at the Dr. René Puig Bentz Dental Clinic of the Pedro Henríquez Ureña National University. A descriptive and observational study was conducted using a sample of 362 panoramic radiographs selected based on availability. A Google Forms questionnaire designed specifically for radiographic analysis was used to collect the data. This questionnaire recorded variables such as the presence or absence of the DSM, its location, its shape, and the patients’ sex.The results indicated that 60.22% of the radiographs did not show this anatomical variant, while 39.78% did. Among the identified cases, the triangular shape was the most common, followed by the teardrop shape. Regarding location, the left side predominated, followed by the right side, and, to a lesser extent, bilateral presentation. When analyzing the relationship between the presence, shape, and location of the DSM and the patients’ sex, as well as between shape and location, no statistically significant associations were found. In conclusion, medial sigmoid depression is a relatively common radiographic finding, and its recognition is essential to avoid misinterpretations that could lead to confusion with pathological lesions in dental practice.
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The data for this study were obtained through a systematic review of panoramic X-rays of patients treated at the Dr. René Puig Bentz Dental Clinic at the Pedro Henríquez Ureña National University. Prior to data collection, authorization was obtained from the relevant departments, ensuring compliance with ethical principles and the confidentiality of patient information. A descriptive and observational methodological design was employed. The sample consisted of 362 panoramic radiographs, selected through non- probabilistic convenience sampling based on the availability of the studies in the radiographic archive. Inclusion criteria included radiographs with adequate diagnostic quality and clear visualization of the mandibular ramus; images with distortions, low quality, or poorly defined anatomical structures were excluded. Data were collected using a structured form (Google Forms) designed specifically for this study, in which the variables of interest were recorded: presence or absence of the medial sigmoid depression, its shape (triangular, teardrop-shaped, or other), its location (right, left, or bilateral), and the patient’s sex. The evaluation of the radiographs was performed through direct observation, following a standardized radiographic analysis protocol that ensured consistency in the identification criteria. The radiographs were viewed using the Romexis software on standard computers, which allowed for adequate observation of the anatomical structures for analysis. The data obtained were organized into a digital database and subsequently processed using descriptive statistical analysis tools to calculate frequencies and percentages of the variables studied, as well as to evaluate possible associations among them. This methodological approach ensures that the study can be replicated by other researchers, provided that similar criteria are followed for sample selection, the use of diagnostic-quality panoramic radiographs, and the application of a standardized protocol for the assessment of the medial sigmoid depression.
Institutions
- Universidad Nacional Pedro Henríquez UreñaNacional, Santo Domingo