Investigation of the determinants of the mandibular cortical morphology.

BACKGROUND: The mandibular cortical index (MCI) is a measurement based on the visual assessment of changes in the morphology of the mandibular cortex on panoramic radiographs. OBJECTIVES: The present study aimed to investigate age, gender, dental status (DS), occlusal function, and presence of torus mandibularis (TM) as variables that might have a possible effect on MCI. MATERIAL AND METHODS: A total of 381 patients (155 men and 226 women) aged 21-84 years (mean age: 43.8 ±14.5 years) were included in this study. Age, gender and DS were recorded for each patient. The occlusal function was evaluated using the Eichner index (EI). The presence of tori was assessed by visual inspection and digital palpation. The MCI assessments were done based on Klemetti's classification (C1-C3). Statistical comparisons were performed using the χ2 test, independent samples t-test and multiple logistic regression analysis (p < 0.05). RESULTS: Significant differences were observed between the MCI categories regarding age, gender, DS, EI, and TM. The likelihood of the MCI categories C2 and C3 was increased in males (odds ratio (OR) 9.33; p < 0.001), when TM was absent (OR 2.73; p < 0.001), in EI Class B (OR 2.68; p = 0.027), and in the age group 50-70 years (OR 2.5; p = 0.018). CONCLUSIONS: Morphological changes of the mandibular cortical bone are related to gender, presence of TM, occlusal function expressed as EI, and age.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

PURPOSE: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. MATERIALS AND METHODS: A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. RESULTS: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. CONCLUSION: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

Sequential test selection by quantifying of the reduction in diagnostic uncertainty for the diagnosis of proximal caries.

BACKGROUND: In order to determine the presence or absence of a certain disease, multiple diagnostic tests may be necessary. Performance of these tests can be sequentially evaluated. AIMS: The aim of the study is to determine the contribution of the test in each step, in reducing diagnostic uncertainty when multiple tests are sequentially used for the diagnosis. STUDY DESIGN: Diagnostic accuracy study. METHODS: Radiographs of seventy-three patients of the Department of Dento-Maxillofacial Radiology of Hacettepe University Faculty of Dentistry were assessed. Panoramic (PAN), full mouth intraoral (FM), and bitewing (BW) radiographs were used for the diagnosis of proximal caries in the maxillary and mandibular molar regions. Diagnostic performance of radiography was sequentially evaluated by using the reduction in diagnostic uncertainty. RESULTS: FM provided maximum diagnostic information for ruling in potential in the maxillary and mandibular molar regions in the first step. FM provided more diagnostic information than BW radiographs for ruling in the mandibular region in the second step. In the mandibular region, BW radiographs provided more diagnostic information than FM for ruling out in the first step. CONCLUSION: The presented method in this study provides the clinicians with a solution for the decision of the sequential selection of diagnostic tests for the correct diagnosis of the presence or absence of a certain disease.

An accessory mental foramen: a case report.

AIM: The aim of this article is to present a case of an accessory mental foramen (AMF). BACKGROUND: The mental foramen is an important anatomical structure of particular importance in local anesthesia and surgical procedures in terms of achieving effective mandibular nerve blocks and avoiding injuries to the neurovascular bundles. Although rare, multiple mental foramina have been described in humans. In these cases one foramen is termed the mental foramen and the others are referred to as an AMF. REPORT: A 62-year-old woman presented for a routine dental examination. In addition to the normal radiographic image of the mental foramen, periapical radiographs of the left mandibular premolar and molar region revealed a round-shaped radiolucency with distinct borders along with an inferior extension below the apex of the mesial root of the first molar. This image was considered to be an AMF. SUMMARY: Although no surgical operation was planned, the patient was informed about the existence and importance of the anatomical variation with regard to the need for local anesthesia, diagnosis of periapical disease, and the prevention of nerve damage during surgery in that area of the mandible.

Does menstrual cycle effect buffer capacity of stimulated saliva?

The present study was performed to analyze buffer capacity (BC) and flow rate of stimulated saliva during menstrual cycle. Two salivary samples were taken from 17 subjects during the menstrual cycle. BC was determined according to electrometric method. Both variables showed no hormone dependency. The results suggest that the salivary protection against acid attacks is constant in healthy nonpregnant women.

Localized epidermolysis bullosa simplex with generalized enamel hypoplasia in a child.

Epidermolysis bullosa is an uncommon disease characterized by the formation of blisters following minor trauma. The three major types are simplex, junctional, and dystrophic. Generalized enamel hypoplasia is accepted as a feature of the junctional type. Teeth with enamel hypoplasia are liable to destruction in the form of caries and/or gingivitis. In this report, a patient with epidermolysis bullosa simplex and severe enamel hypoplasia is described and the importance of early dental consultation for all children with this disease is stressed.

Is torus palatinus a feature of a well-developed maxilla?

Torus palatinus (TP) is an exostosis of the hard palate. The biologic significance of TP is unknown. Our hypothesis was that the presence of a TP reflects the development of the maxilla. It has been proven that tooth agenesis is associated with small maxillary size. We investigated whether there is a relationship between maxillary third molar agenesis and the presence or absence of TP. The study was carried out on 253 Turkish patients. It showed a lower prevalence of third molar agenesis in female subjects with TP (P < 0.001). This study provides indirect evidence that development of the maxilla may be greater in female subjects with TP.