Medial sigmoid depression as a radiographic finding in patients visiting the Dr. René Puig Bentz Dental Clinic at the Pedro Henríquez Ureña National University

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.