Temporomandibular joint disorders and associated factors in a Turkish pediatric population.

OBJECTIVE: To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. METHODS: A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis. RESULTS: One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16). CONCLUSIONS: Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.

Investigation of the clinical efficacy of CGF and ozone in the management of alveolar osteitis: a randomized controlled trial.

OBJECTIVES: To investigate the efficacy of concentrated growth factors (CGF) and ozone in the treatment of alveolar osteitis (AO). MATERIALS AND METHODS: Patients admitted for the treatment of AO and eligible for the study were included and divided into control, ozone, and CGF + ozone groups. For the treatment of AO alveogyl, ozone, and CGF + ozone were applied to control, ozone, and CGF + ozone groups, respectively, and repeated on 3rd day. Demographic data and oral hygiene were recorded at the initial visit. Pain with visual analog scale (VAS) and analgesic consumption were evaluated at the 6th and 24th h, and on 2nd-7th days. Granulation tissue health and inflammation severity were evaluated on the 1st, 3rd, and 7th days. Quality of life was evaluated with the postoperative symptom severity scale (Posse) on the 7th day. RESULTS: A total of 60 patients (43 females/17 males; mean age 42.7 ± 13.76 years), 20 patients per group were included. Among the groups, pain scores on the 7th day (p = 0.042), granulation tissue health on the 3rd (p = 0.003) and 7th (p = 0.015) days showed a significant difference while analgesic consumption, Posse scores, and inflammation severity showed no significant differences (p > 0.05). Between genders analgesic consumption at 6 h (p = 0.027), 24 h (p = 0.033), and on the 2nd day (p = 0.034) and inflammation severity on the 7th day (p = 0.012) showed significant differences while Posse scores and granulation tissue health showed no significant differences (p > 0.05). CONCLUSIONS: This study demonstrates that regenerative treatment which modulates angiogenesis, and tissue regeneration by stimulating stem cells, growth factors, and cytokines with CGF + ozone are more effective than conventional treatment regarding AO. CLINICAL RELEVANCE: Usage of CGF and ozone together provides faster and more satisfactory management of AO.

Does Modifying the Consent Process Based on the Dominant Intelligence Type Reduce Anxiety During 3rd Molar Operations?

PURPOSE: Third molar surgery is one of the most commonly performed operations, usually associated with high anxiety. The purpose of this study was to determine if patients' anxiety would reduce if consent was modified to match their dominant intelligence type (DIT). METHODS AND MATERIALS: A single center, prospective randomized clinical study was conducted in the Maxillofacial Surgery Clinic of Ordu University on patients admitted for lower third molar removal between October 2020 and June 2021. The participants were randomly assigned to a study group where consent was based on DIT or a control group where consent was obtained in the standard fashion. DIT was determined using the multiple intelligence test and was further categorized as visual/spatial, verbal/linguistic, and bodily/kinesthetic. The consent method was the primary and the type of DIT was the secondary predictor variable. The primary and secondary outcome variables were the salivary cortisol level and Modified Dental Anxiety Scale (MDAS) scores measured before and after the consent, and after the operation. Mann-Whitney U, Friedman, Kruskal Wallis, Pearson correlation, and χ2 tests were conducted for statistical analysis. RESULTS: Eighty patients (55 females and 25 males; mean age 23.5 ± 6.2) were included. No significant difference was observed between the study and control groups for the change in cortisol levels and MDAS scores before-after consent (-11.15 ± 62.64; -6.84 ± 32.9) (P = .389), (-0.6 ± 3.46; -0.7 ± 2.49) (P = .832) and before consent-after operation (-39.80 ± 108.2; -39.72 ± 77.04) (P = .987), (-4.31 ± 5.97; -3 ± 4.34) (P = .867). The change in MDAS scores and cortisol levels was not correlated after consent (P = .587, r = 0.62) and operation (P = .406, r = 0.94). CONCLUSION: Providing consent based on DIT is not statistically different than providing consent in the standard fashion. The role of consent strategy in managing anxiety and lack of correlation between salivary cortisol and MDAS requires further investigation.

Comparative evaluation of the trabecular structure of the mandibular condyle, the levels of salivary cortisol, MMP-3, TNF-α, IL-1ß in individuals with and without temporomandibular joint disorder.

OBJECTIVE: Temporomandibular disorder (TMD) is still a challenge in terms of diagnosis and management. The aim of this study is to explore if the evaluation of salivary biomarkers and fractal dimension (FD) of mandibular condyle could be useful for interpreting early degenerative changes and the effectiveness of salivary cortisol in determining the stress levels of TMD patients. MATERIALS AND METHODS: 34 patients with TMD, and 34 healthy controls were included in this study. Saliva samples were obtained from all participants between 09:00-12:00 am. Salivary cortisol, IL-1ß, TNF-α, and MMP-3 levels were evaluated with ELISA method. FD of the mandibular condyle was determined by means of box-counting method. Depression and anxiety were determined with PHQ-9 and GAD-7 questionnaires. RESULTS: The salivary cortisol and depression/anxiety were higher in study group; however, not significant (p>0.05). FD of the study group was found significantly lower than the control group (p<0.01). Salivary TNF-α, IL-1ß and MMP-3 levels were showed no significant difference between the two groups (p>0.05). There were no significant correlations between the evaluated parameters. CONCLUSION: Salivary cortisol seems to be a non-invasive way of measuring physiological stress of TMD patients. Fractal analysis may be a useful tool in detecting early structural changes in mandibular condyle. Salivary TNF-α. IL-1ß and MMP-3 have not a diagnostic value in terms of interpreting early degenerative changes.

Temporomandibular disorder severity and its association with psychosocial and sociodemographic factors in Turkish adults.

BACKGROUND: There is a lack of awareness regarding temporomandibular disorder (TMD) and its association with psychological and sociodemographic factors in the Turkish population. This study aimed to evaluate the relationship between signs/symptoms of anxiety-depression, sociodemographic factors, parafunctional habits, bruxism, and the presence and severity of the symptoms of TMD in Turkish adults. METHODS: The participants completed an online questionnaire consisting of sociodemographic questions, the Fonseca Anamnestic Index, and the Patient Health Questionnaire-4. RESULTS: The mean age of the 2580 participants was 35.29 ± 12.70 years, and 63.3% were women. The frequency of the participants who showed symptoms of TMD was 69.8%. The severity of TMD symptoms was significantly greater in participants who had signs/symptoms of anxiety and depression (p < 0.05). Sociodemographic and psychological data showed an association between the presence and severity of the symptoms of TMD and sex (OR 1.52, 95% confidence interval (CI) 1.26-1.85), parafunctional habits (OR 2.64, 95% CI 2.36-2.99), bruxism (OR 3.14, 95% CI 1.78-4.90), signs/symptoms of anxiety (OR 2.30, 95% CI 1.76-3.00), and signs/symptoms of depression (OR 1.90, 95% CI 1.48-2.42). CONCLUSIONS: The results of the present study suggest that females and those who report bruxism, parafunctional habits, and signs/symptoms of anxiety-depression are more likely to show symptoms of TMD with different severity.

Investigation of the biomechanical stability of Cfr-PEEK in the treatment of mandibular angulus fractures by finite element analysis.

The purpose of this study is to explore the effectiveness of Cfr-PEEK, in the fixation of unfavorable fractures of mandibular angulus by comparing it with the titanium and resorbable biomaterials. 8 different fixation models were created. In the first 4 groups, a single mini plate was applied to the upper edge of the fracture line by the Champy method. In the other 4 groups, an additional plate was placed on the lower edge of the fracture line. In these models, titanium, resorbable and Cfr-PEEK plate/screw systems were investigated by the finite element analysis method. The highest Von Mises stress was observed on the upper plate in the group 5 while the lowest was seen in the lower plate in the group 7. The highest stress values on the screws were observed on the screws placed closer to the fracture line. Considering the stresses on the bone around the screws, the highest Pmax and Pmin values were seen in group 5, and the lowest values were seen in the group 7. The highest displacement was observed in the group 3, while the lowest was observed in the group 5. According to the results it can be said that Cfr-PEEK plate/screw systems may provide advantages by decreasing the stresses on the fixation systems over the titanium plates and providing more stable fixation over the resorbable systems. Cfr-PEEK plates of 2 mm thickness seems to be a potential alternative to 1 mm thick titanium plates.

Is Teledentistry a Feasible Alternative for People Who Need Special Care?

OBJECTIVE: The aim of this study is to explore the feasibility and acceptability of teledentistry as a vehicle that provides enhanced delivery of oral care for the people who need special care (PNSC). METHODS: Between January 2018 and September 2020, PNSC who were admitted in the study were either waiting for a follow-up (F) appointment or on a waiting list. An examination via video call was carried out for initial examination (IE) and F purposes. The virtual examination was scored by the clinician who performed the examinations. The experience of the participants was evaluated with a satisfaction questionnaire. RESULTS: Forty PNSC (26 females, 14 males) between ages 7 and 48 years (21.17 ± 10.62) participated in the study. According to the clinician ratings, the accuracy of the examination was rated as the lowest. The F group had higher scores when compared to the IE group regarding clinician rating. No significant differences were found in terms of the scoring of the clinician and patient/parent satisfaction regarding cooperation status and type of examination (P ≥ 0.05). CONCLUSIONS: Through adequate adaptation of the technology into clinical practice and overcoming the barriers for wider implementation, the teledentistry approach could be a reliable and feasible alternative in triaging, treatment planning, and F purposes for PNSC.

The influence of education and gender on the esthetic perception of facial profile.

PURPOSE: The aim of the present study was to evaluate the facial esthetic perception of dental students, non-dental students, and laypersons with respect to digitally altered profile photographs in the vertical and sagittal dimensions. MATERIALS AND METHODS: Colored profile photographs of a male subject and a female subject were digitally altered in the sagittal and vertical dimensions. Preclinical and clinical dental students, clinical medical students, senior art and engineering students, and laypersons with various occupations were invited to rate the profile photographs and their treatment need by means of a questionnaire created on Google Forms. RESULTS: The study involved 574 participants (378 females, 196 males). Male and female straight normal profiles were found to be the most attractive facial profiles by all groups, followed by convex profiles. Concave profiles were rated as the least attractive and in need of more treatment. No significant difference was observed between the ratings of the preclinical and clinical dental students. The ratings of dental students showed significant differences in terms of esthetic perception compared with the engineering students and laypersons. Regarding the gender of the participants, there were significant differences between males and females. CONCLUSION: The perception of facial esthetics was influenced by education, and students whose study curriculum was esthetic in nature or clinically based were more critical in their judgment. The gender of the participants significantly influenced their esthetic judgment.

Retrospective Evaluation of Two-Implant-Supported Mandibular Overdentures with Radiographic and Clinical Aspects.

PURPOSE: The aim of this retrospective study was to evaluate the clinical performance of two implants supporting mandibular overdentures by means of clinical and radiologic parameters, and also to explore the relationship of marginal bone loss with implant-/patient-related factors and soft tissue parameters. MATERIALS AND METHODS: Data of patients who had undergone insertion of two implants into the interforaminal region between November 2012 and December 2016 using three different implant systems were retrieved from the archival records. Age, sex, implant length, implant diameter, observation period, mobility, and soft tissue parameters were recorded. Marginal bone levels and interimplant distances were measured with computer software on panoramic radiographs obtained at 3 months and at the recall session. RESULTS: A total of 43 patients with 86 implants were included in the study. Patients were evaluated with an average observation period of 41.79 months. Among the evaluated parameters, Gingival Index, Bleeding Index, and implant diameter were found to have significant effects on the marginal bone loss (P < .05). However, no significant effects of sex, age, implant length, observation period, and interimplant distance were observed on the marginal bone loss. No implants showed peri-implantitis or mobility, while eight implants showed peri-implant mucositis. CONCLUSION: Within the limitations of this study, it can be concluded that peri-implant soft tissue health and the diameter of the implant have an important effect on the marginal bone loss as well as the success of two-implant-supported mandibular overdentures.

Is saliva a reliable biofluid for the detection of COVID-19?

This review aimed to assess the current evidence on the diagnostic potential of saliva regarding the detection of coronavirus disease 2019 (COVID-19). The literature published until May 24, 2020 was searched in the Web of Science, PubMed and Google Scholar databases with the keywords "COVID-19", "SARS-CoV-2", "2019-nCoV", "oral fluid", "saliva", and "diagnosis", individually and in combination, and 11 studies that explored the efficacy of saliva in the diagnosis of COVID-19 in different patient groups were found. Together, these studies suggest that saliva is a safe and reliable tool for the diagnosis of COVID-19. Further, saliva offers enhanced safety as well as logistical and economic benefits as compared to the current methods used to diagnose COVID-19. However, there is still limited evidence in the literature to make a definitive, clinically appropriate decision. The ideal specimen for the detection of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still an issue under investigation. Thus, new studies with large sample sets for the validation of easy, safe and reliable methods applicable for large-scale testing are immediately required.

Mirror-image phenomenon in Turkish monozygotic twins: A report of 3 cases.

Due to the special circumstances and the pre-natal environment in twin gestations, disruptions in the development of the embryo are more frequently observed in twin births as compared to singleton births. Twin research provides an excellent model to explore the etiology of disruptions in craniofacial biology. Mirror imaging (MI) is a special manifestation of twinning, and the elucidation of the etiology of this phenomenon is important to understand the biological mechanisms which underlie congenital defects, like orofacial clefts, and to provide insight into left-right asymmetry. The aim of this paper was, therefore, to present 3 pairs of Turkish monozygotic (MZ) twins with MI dental features, and to contribute to the knowledge of the MI phenomenon in the literature. We examined 2 male and 1 female MZ twin pairs clinically and radiographically in terms of their MI features. Mirrorimage features in dental and other ectodermal structures were detected in all the twins. Understanding the biological mechanisms of MI provides broad insight into preventive measures and treatment protocols. Furthermore, the presence of MI features may lead to the detection of other MI pathologies in twins.

Persistent palatal hypertrophy associated with rapid maxillary expansion procedure: Report of a rare case.

Maxillary transversal deficiency (MTD) is a common skeletal problem. If not treated on time, MTD evolve to a more complex malocclusion. This problem can affect facial growth and development. Rapid maxillary expansion (RME) procedure frequently used for the management. This technique is usually successful in young individuals but as the age advances and the articulations of the maxilla with surrounding facial bones get more rigid, it becomes ineffective. Undesirable side effects or results have been reported after use of RME in skeletally mature patients such as buccal tipping of posterior teeth, extrusion, periodontal tissue recession, fenestration of buccal cortex, necrosis of palatal tissue, failure in opening of midpalatal suture, pain, and relapse of expansion. Side effects of RME are often temporary and permanent damages are rarely seen. The aim of this report is to present the management of a permanent side effect of the RME procedure in a 13-year-old child.

Does Watching Videos Increase the Perioperative Anxiety in Patients Undergoing Third Molar Surgery? A Randomized Trial.

PURPOSE: The extraction of third molar teeth has usually been associated with a high level of anxiety, mainly from a lack of knowledge. We compared the effect of different informed consent formats on the perioperative anxiety level of patients scheduled for third molar surgery and explored the effects of watching a video about the surgical procedure from the Internet before the procedure on the patients' anxiety level. PATIENTS AND METHODS: A total of 113 patients who had been admitted for the removal of impacted third molars were randomly divided into control (verbal information) and study (video plus verbal information) groups. The anxiety level was assessed using the Amsterdam Preoperative Anxiety and Information Scale, Modified Dental Anxiety Scale, and Spielberger's State-Trait Anxiety Inventory. Pain was evaluated using the visual analog scale (VAS). RESULTS: The results showed that the study group had higher anxiety scores than the control group immediately after the consent process (P < .05). In all groups, the anxiety levels showed a decreasing trend after surgery. The VAS scores did not show significant differences when stratified by gender or educational level. No correlation was observed between age and the other variables. CONCLUSIONS: According to our results, the patients who watched the procedural video in an uncontrolled situation from websites before the operation were prone to high anxiety. The verbal and written consent format resulted in satisfactory anxiety management. Further studies are needed to clarify whether the use of video consent with different formats, such as animation, would be more effective in managing anxiety when applied carefully and under the control of a clinician.

Metastatic Prostate Adenocarcinoma of the Mandible Diagnosed With Oral Manifestations.

Metastasis from the prostate gland to the mandible is rarely encountered and commonly present with non-specific features like unexplained pain, swelling, and numb chin syndrome. Here we present a case with metastatic prostate adenocarcinoma detected secondary to oral manifestations. Patients present with unexplained facial pain and numbness should alert clinicians to the presence of malignant disease, and appropriate hematological, radiological and or histological investigations should be performed. Thereby, clinicians can prevent the overlook of the first signs of metastasis, accelerate the early diagnosis and positively orientate the prognosis of the disease, especially in a patient without known malignancy.

Buccal vascular malformation with multiple giant phleboliths: a rare case presentation and review of the literature.

PURPOSE: The purpose of this study was to describe a case and to review the diameters, symptoms, locations, and treatment methods for vascular malformations (VMs) with phleboliths. Our case report is probably the first to mention this observation because of sizes and large number of phleboliths in buccal region. CASE PRESENTATION: A 26-year-old male patient was referred to Ordu University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery for the evaluation and management of a painless tender swelling in the left buccal region. Clinically, a bluish mucosal lesion of the posterior region of the left buccal mucosa and lip is apparent. Panoramic radiography and CT were obtained for radiographical examinations. Multiple giant phleboliths with the largest dimension of 32 mm were seen in this region. Left maxillary first molar teeth extraction was indicated. An aspiration was performed and revealed that there is a risk of severe hemorrhage. The patient did not want to take MRI and stated that he only wanted to have dental treatment. Therefore, it was decided that the maxillary first molar should be retained in the region and endodontic treatment should be done, if necessary. CONCLUSIONS: The clinic of phlebolith patients is painless swelling and can reach up to 6 cm. The localization is not specific but is found in the masseter and parotid regions generally. Treatment may be invasive or non-invasive depending on, location, accessibility, depth of invasion, age, cosmetic issues, and risk of severe hemorrhage, as with the current case.

Results of Combined, Single-Session Arthrocentesis and Dextrose Prolotherapy for Symptomatic Temporomandibular Joint Syndrome: A Case Series.

OBJECTIVE: Arthrocentesis and prolotherapy are nonsurgical treatments for temporomandibular joint (TMJ) diseases. This study aimed to evaluate the treatment of hypermobility, pain, and displacement of the TMJ by consecutively performing arthrocentesis and prolotherapy in the same session. MATERIALS AND METHODS: In this study, 10 adults with disc displacement and painful, hypermobile TMJ were selected. Arthrocentesis and prolotherapy were consecutively performed using a 30% dextrose solution that was simultaneously injected into five areas: posterior disc attachment, superior joint space, superior and inferior capsular attachments, and stylomandibular ligament. Paired t-test, McNemar test, and chi-square test were used to assess the maximum mouth opening, clicking sounds, pain, and subluxation of the TMJ. Patients with rheumatoid arthritis and parafunctional habits such as teeth clenching and grinding and biting of the cheeks or any other objects and those who had undergone surgery were excluded from this study. RESULTS: A total of 10 participants (36.20 ± 7.06 years old, 7 women and 3 men) received a single treatment session of combined arthrocentesis and prolotherapy at the same office visit. Subluxation frequency and pain significantly decreased after the first week of treatment (p < 0.05). Subluxation also decreased at the 3-month follow-up (p < 0.05). Clicking sound values did not significantly change at any of the follow-up time points. Maximum mouth opening values decreased at all follow-up time points compared to baseline (p < 0.05). CONCLUSION: A single session of combined arthrocentesis and prolotherapy to treat symptomatic TMJ safely and significantly improved the subluxation and pain after 1 week and subluxation after 3 months compared to baseline status. The maximum mouth opening significantly decreased at all follow-up time points. Future studies assessing multiple treatment sessions are warranted.

Mind Conduct disorders in children with poor oral hygiene habits and attention deficit hyperactivity disorder in children with excessive tooth decay.

INTRODUCTION: Dental caries and poor oral hygiene are among the major childhood public health problems. Although dental research frequently refers to the link between these conditions and behavioural issues, little attention has been paid to understanding the reason for oral health problems from a psychiatric point of view. The aim of this study was to examine the relationship between poor oral health and hygiene and parental attitudes towards child rearing, parents' and children's oral hygiene behaviours, and childhood psychiatric disorders. MATERIAL AND METHODS: This study included 323 children aged 3-15 years. Decayed, missing, filled and decayed, extracted, filled indices, the Simplified Oral Hygiene Index, the Strengths and Difficulties Questionnaire, and the Parent Attitude Research Instrument were used in the study. RESULTS: We found that the subjects' hyperactivity/inattention scores were positively correlated with poor oral health (p = 0.001) and heavy cariogenic food consumption (p = 0.040). Tooth brushing frequency was found to be significantly lower in children who have a risk for conduct/oppositional disorders than in their non-problematic peers (p = 0.001). CONCLUSIONS: Dental health and oral hygiene behaviours have close links with psychiatric disorders and psychosocial issues. Improving cooperation between child psychiatrists and dentists seems to be important in the prevention of paediatric dental problems.

The prevalence of foreign bodies in jaw bones on panoramic radiography.

OBJECTIVE: Foreign bodies can be deposited in the oral cavity either by traumatic or iatrogenic injury. The most common foreign bodies of iatrogenic origin encountered are restorative materials, like amalgam, and root canal fillings. The aim of this study was to determine the prevalence of foreign bodies detected with panoramic radiography in the jawbones, as well as to evaluate the etiology and characteristics of these pathologies. MATERIALS AND METHODS: From March 2012 to January 2014, 11,144 panoramic radiographs were taken and retrospectively reviewed. The number, characteristics, location of the foreign bodies, age, and gender of the patients were recorded. RESULTS: Of the 11,144 patients reviewed, 62 of them have a foreign body with a frequency of 0.6%. The patients who had a foreign body were between 14 and 81 years old. Female patients showed more foreign bodies than male patients. Among the 62 patients, 63 filling materials, one stapler, and five shrapnel were detected. Only 8 patients had symptoms associated with foreign bodies and these foreign bodies excised surgically. CONCLUSION: If possible, these pathologies must be removed at the time of detection to prevent further complications; however, in asymptomatic cases, according to location and the characteristic of the foreign body, they can be kept under observation without performing any operations.

The Effect of Alendronate on Various Graft Materials Used in Maxillary Sinus Augmentation: A Rabbit Study.

BACKGROUND: Increasing sinus pneumatization and the accompanying alveolar bone resorption complicate dental implant placement. This problem can be overcome today by raising the maxillary sinus floor with graft materials. Bisphosphonates are commonly used to accelerate the recovery of the graft materials and to prevent resorption. OBJECTIVES: The purpose of this study is to investigate whether systemic administration of a bisphosphonate (alendronate) would improve new bone formation and reduce fibrous tissue formation over a 6-week follow-up in rabbits treated with two different grafting materials for maxillary sinus floor augmentation. MATERIALS AND METHODS: This experimental animal study was conducted at the Experimental Medical Application and Research Center at Erzurum/ Turkey. Twelve New Zealand rabbits, each weighing between 2.7 and 3.3 kg, were used. Twenty-four maxillary sinus floor elevation operations were performed, two on each animal (n = 24). Each elevation was repaired with either deproteinized bovine bone (xenograft) or autogenous bone graft obtained from the iliac crest. Both groups were divided into 2 subgroups: saline-treated and alendronate-treated. All groups underwent the same surgical procedures and evaluation, and were sacrificed at the 6th postoperative week. Sinuses augmented with deproteinized bovine bone (xenograft) and autogenous bone graft were examined histopathologically and histomorphometrically. RESULTS: At 6 weeks, the bone area was significantly larger in the Xenograft-Alendronate group (33.0% ± 5.0%) than in the Xenograft-Saline group (20.8% ± 4.9%) and the bone area was significantly larger in the Autogenous-Alendronate group (43.3% ± 3.8%) than in the Autogenous-Saline group (37.5% ± 6.6%) (P = 0.001). The histomorphometric and histopathological results consistently showed that alendronate stimulated bone formation and reduced fibrous tissue formation in maxillary sinus augmentation grafts, especially in the deproteinized bovine bone group (xenograft). CONCLUSIONS: Alendronate may be considered a therapeutic option for improving the bone formation process and reducing resorption in different bone grafting procedures. Further detailed studies should focus on dosage and time-dependent effects of alendronate on bone remodeling.

Non-syndromic supernumerary premolars

Objective: The objective of this study was to estimate the incidence of non-syndromic supernumerary premolars,to classify them and to identify the complications related to them.Study Design: This retrospective cohort study was composed of 8400 panoramic radiographs of patients whopresented at our Oral and Maxillofacial Surgery Services from January 1998 to May 2008. The number of supernumerarypremolars, their localization, the ages and the sex of the patients, any associated complications andtreatment methods were estimated.Results and Conclusion: A total of 20 supernumerary premolar teeth were found in 10 of the 8400 patients (0.24%) with7 of those being females and three males. Three patients had pain localized to the mental foramen and one patient hadresorption in the root of the adjacent tooth. In these series, 18 supernumerary premolar teeth were extracted. In contrastwith previous studies, this study suggested that this phenomenon is more frequently encountered in females than inmales. The presence of complications associated with the supernumerary premolars in 4 patients necessitated considerationof surgical intervention as a treatment choice for these teeth. Otherwise, they should be kept under observation (AU)