Evaluation of osteomeatal complex by cone-beam computed tomography in patients with maxillary sinus pathology and nasal septum deviation.

BACKGROUND: This study aimed to determine if there is a relationship between the presence of maxillary sinus pathology, nasal septum deviation and various lengths of the osteomeatal complex. METHODS: A total of 223 CBCT images were included in the study. The lengths of the osteomeatal complex (maxillary sinus ostium width, infundibulum length, maxillary sinus ostium height) were analyzed. The presence of maxillary sinus pathology, nasal septum deviation, age, sex, right-left, septum deviation level, and the relationship between pathology level and all variables were evaluated. RESULTS: The average maxillary sinus ostium width, ostium height and infundibulum length were 3.06 ± 0.70 mm, 30.10 ± 5.43 mm and 8.82 ± 1.86 mm, respectively. Ostium width was significantly higher in the healthy group than in the groups evaluated in the presence of deviation and pathology. A significant difference was found in infundibulum length only between the healthy condition and the condition evaluated in the presence of deviation. No significant difference was observed between the groups in terms of ostium height. In all groups, ostium height and infundibulum length were significantly higher in men than in women. The age group with the highest average ostium height was found in the 35-44 age group (p < 0.001). CONCLUSION: Identifying normal and abnormal conditions in the osteomeatal complex area is important for diagnosing the cause of a patient's complaint, guiding the surgical procedures to be performed, and preventing possible complications that may arise during surgical procedures.

Evaluation of Optic Canal and Surrounding Structures Using Cone Beam Computed Tomography: Considerations for Maxillofacial Surgery.

The optic canal connects the anterior cranial fossa and the orbit and maintains the optic nerve and the ophthalmic artery. Within the extent of the surgical approach of the region, risk of iatrogenic injury of the neural and vascular structures increases. The aim of this retrospective morphometric study is to investigate the radiological anatomy of orbita, optic canal, and its surrounding using cone beam computed tomography (CBCT) scans in a group of Turkish population.Cone beam computed tomography images of a total of 182 patients were evaluated by 2 observers. Anatomical parameters regarding optic canal and orbita were measured for all patients from axial, sagittal, and three-dimensional reconstructed images. To assess intraobserver reliability, the Wilcoxon matched-pairs test was used. Pearson χ test and Student t test were performed for statistical analysis of differences, sex, localization, and measurements (P < 0.05).Repeated CBCT evaluation and measurements indicated no significant inter and intra-observer difference were found (P > 0.05). The orbita width and height were larger for the males than females (P < 0.05). No significant difference was observed for optic canal shape, dimensions of infraorbital foramen (IOF) and supraorbital foramen (SOF), SOF-midline distance, and SOF-IOF distance according to sex and location (P > 0.05). Examination CBCT scans revealed that the shape of the optic canal was 70% funnel and 28% Hourglass shape, 2% amorph type round.These results provide detailed knowledge of the anatomical characteristics in the orbital area which may be of assistance for surgeons preoperatively. Cone beam computed tomography scans can be an alternative modality for multislice computed tomography with submillimeter resolution and lower dose in preoperative imaging of the orbit.

Volatile sulphur compound levels and related factors in patients with chronic renal failure.

AIMS: To analyse specific volatile sulphur compound(VSC) levels in a group of chronic renal failure (CRF) patients and determine the relationship between these VSC levels and organoleptic measurements, blood urea nitrogen (BUN) levels, dental and periodontal conditions, salivary flow rate, and tongue coating scores. MATERIALS AND METHODS: One examiner performed organoleptic and VSC measurements on fifty patients with CRF before and after haemodialysis (HD) and controls. DMFT and CPITN indexes, tongue coating scores, salivary flow rates were measured. Comparisons were performed using the Mann-Whitney U, Wilcoxon signed-ranks, and chi-square tests. Spearman correlation coefficient was used to analyse correlations. RESULTS: Before HD, the mean dimethyl sulphide level was 1.04 ± 1.20 in the CRF patients and 0.51 ± 0.65 in controls, with a significant difference. The mean hydrogen sulphide, methyl mercaptan and dimethyl sulphide levels in CRF patients were 1.47 ± 3.04, 1.03 ± 1.85, and 1.04 ± 1.20, respectively, before HD; and 0.53 ± 1.65, 0.48 ± 1.27, and 0.56 ± 0.85, respectively, after HD; with the differences being significant. Methyl mercaptan levels increased with an increase in HD duration. Tongue coating and organoleptic measurements were significantly correlated with methyl mercaptan. CONCLUSIONS: Dimethyl sulphide is the main VSC in extraoral blood-borne halitosis; but methyl mercaptan may also contribute to this type of halitosis. A decreased salivary flow rate and an increased pH of the biofilm matrix may be a significant parameter for VSC levels in CRF patients.

Florid osseous dysplasia in a middle-aged Turkish woman: A case report.

Florid osseous dysplasia (FOD) is an uncommon, benign, cemento-osseous lesion of the jaws. The etiology of FOD is still unknown. It is often asymptomatic and may be identified on routine dental radiographs. The classic radiographic appearance of FOD is amorphous, lobulated, mixed radiolucent/radiopaque masses of cotton-wool appearance with a sclerotic border in the jaws. In our case the lesion was found incidentally on routine periapical radiographs taken for restored teeth and edentulous areas. For further and detailed examination, a panoramic radiograph and cone-beam computed tomograph (CBCT) were taken. The panoramic radiograph and CBCT revealed maxillary bilateral and symmetrical, non-expansile, well-defined, round, radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth. Our aim in presenting this case report was to highlight the importance of imaging in diagnosis of FOD.

The visibility of secondary caries under bonding agents with two different imaging modalities.

This study investigated the visibility of secondary caries lesions associated with two different adhesive systems of composite restorations (Optibond Solo Plus and Clearfil SE Bond) using a conventional dental x-ray film (Kodak D Speed) and a digital system (Digora) based on storage phosphor-plate technology for detection of secondary caries. For imaging techniques and adhesive systems, false positive scores were high. Intraobserver agreements ranged between 0.432 and 0.778, while interobserver agreements for the readings ranged 0.321-0.731 and 0.411-0.701, respectively. No statistical difference was found between the Az (area under curve) values obtained from PSP (photostimulable storage phosphor) and film images with the exception of the second observer's first reading for total etch adhesive system (Optibond Solo Plus) (p=0.0258). Furthermore, no statistical difference was found between both the bonding systems assessed (p>0.05). Adhesive materials should also have enough radiopacity to facilitate diagnosis of secondary caries.

Radiopacity evaluation of composite restorative resins and bonding agents using digital and film x-ray systems.

OBJECTIVE: The purpose of this in vitro study was to explore the radiopacity of composite resins and bonding materials using film and phosphor plates. METHODS: Nine composite dental resin specimens and human tooth slices were exposed together with an aluminium stepwedge using dental film and phosphor plates. Eight dentin bonding specimens were prepared and exposed in a similar manner. Their radiopacity on film was assessed using a transmission densitometer, and the radiopacity with phosphor plates was assessed digitally using the system's own software (Digora). Data were analysed using one-way analysis of variance (ANOVA) and post-hoc Tukey tests (P<.05). Film and phosphor plate radiopacity values were compared using simple regression analysis. RESULTS: Excellent linear correlation was found between film and phosphor plates for both composite resins and bonding agents. The composite materials Spectrum Tph and Natural Look exhibited the highest radiopacity with film and with phosphor plates, respectively. All the dentin bonding agents tested exhibited lower radiopacity than dentin. CONCLUSION: Synergy, Ice, Filtek Silorane, Filtek Z250, Clearfil Majesty Posterior, Herculite Classic, Spectrum Tph, and Natural Look composite materials exhibited greater radiopacity than dentin, and all the dentin bonding agents tested exhibited lower radiopacity than either enamel or dentin.

Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs.

AIM: This study examined and classified patients who were treated at the Faculty of Dentistry at Ankara University Dentistry to determine the incidence of different types of stylohyoid ligament calcification (SLC) using panoramic radiographs. In addition, it also assessed the possible causative symptoms and Eagle's syndrome in cases of styloid process elongation. METHODS: The study consisted of 2000 patients (1161 females and 839 males), aged 3-88 years, who were treated at our clinic. The panoramic radiographs were evaluated as part of this study. RESULTS: Panoramic radiography examination revealed SLC in 1350 patients. Both-sided (right and left), type 1 SLC was observed in 345 patients, while types 2-4 were found in 203, 418, and 384 patients, respectively. CONCLUSION: The incidence of SLC was found to be higher in female patients when compared to male patients. In addition, calcifications were seen more often at age 50-59 years, and the incidence of calcification was found to increase with age. Two Eagle's syndrome cases were diagnosed among a total of 2000 patients. Finally, it was determined that the incidence of calcified stylohyoid ligament is higher in patients with systemic diseases.

Delayed diagnosis of oral squamous cell carcinoma: a case series.

INTRODUCTION: In malign neoplasms, oral cancer is one of the important causes of mortality and morbidity. Squamous cell carcinoma is the most common form of oral cancers in adults and is related to risk factors such as smoking and alcohol consumption. CASE PRESENTATION: In this article, we present three case reports of oral squamous cell carcinomas with delayed diagnosis. The first patient was a 52-year-old Turkish man, the second patient was a 61-year-old Turkish man and the third patient was a 60-year-old Turkish woman. All were referred to the Ankara University Faculty of Dentistry with pain, swelling and various complaints in their jaws. CONCLUSION: Early diagnosis is of vital importance for the prognosis of the patients with oral squamous cell carcinomas. For this reason, dentists play a crucial role in the early detection and prevention of oral cancers.

Observer ability to detect ex vivo simulated internal or external cervical root resorption.

INTRODUCTION: The objective of this study was to assess observer ability to detect ex vivo simulated internal and external cervical root resorption. METHODS: A total of 90 single-rooted mandibular anterior teeth were split along the coronal plane. By using a 0.5-mm diameter round bur, 50 of the teeth were drilled to simulate resorptive cavities (25 internal and 25 external cervical resorption), and the remaining 40 teeth were left without surface defects. The sectioned teeth were rejoined and placed in the alveolar sockets of a dry human mandible in groups of 6 and imaged with intraoral film by using 3 different angulations and with a cone-beam computed tomography (CBCT) unit. Film and CBCT image sets were evaluated twice by 3 separate observers. Teeth were scored for the presence and location of resorption by using a 5-point scale. Intraobserver and interobserver kappa coefficients and Az values were calculated for each observer and image set. Differences between modalities were compared by using z statistics, with the significance level set at α = 0.05. RESULTS: Both intraobserver and interobserver agreements were statistically higher (p < .05) for the Iluma CBCT images than for the intraoral images. Az values for CBCT images were also statistically higher (p < .05) than for film images for all observers and readings. In addition, kappa and Az values of external cervical resorption cavities were statistically higher (p < .05) than those of internal cervical resorption cavities for all observers, image types, and readings. CONCLUSIONS: High-resolution Iluma CBCT images performed better than film in the ex vivo detection and localization of simulated internal and external cervical root resorption.

Occlusal caries depth measurements obtained by five different imaging modalities.

The study aimed to assess the accuracy and reproducibility of occlusal caries depth measurements obtained from different imaging modalities. The study comprised 21 human mandibular molar teeth with occlusal caries. Teeth were imaged using film, CCD, two different cone-beam computerized tomography (CBCT) units and a microcomputer tomography (micro-CT). Thereafter, each tooth was serially sectioned, and the section with the deepest carious lesion was scanned using a high-resolution scanner. Each image set was separately viewed by three oral radiologists. Images were viewed randomly, and each set was viewed twice. Lesion depth was measured on film images using a digital caliper, on CCD and CBCT images using built-in measurement tools, on micro-CT images using the Mimics software program, and on histological images using AxioVision Rel. 4.7. Intra- and inter-rater reliabilities were assessed according to the Bland/Altman method by calculating Intraclass Correlation Coefficients (ICCs). Mean/median values obtained with intraoral systems were lower than those obtained with 3-D and histological images for all observers and both readings. Intra-observer ICC values for all observers were highest for histology and micro-CT. In addition, intra-observer ICC values were higher for histology and CBCT than for histology and intra-oral methods. Inter-observer ICC values for first and second readings were high for all observers. No differences in repeatability were found between Accuitomo and Iluma CBCT images or between intra-oral film and CCD images. Micro-CT was found to be the best imaging method for the ex vivo measurement of occlusal caries depth. In addition, both CBCT units performed similarly and better than intra-oral modalities.

Submandibular displacement of a mandibular third molar root during extraction: a case report.

A 46-year-old female patient with complaints of pain and swelling on right submandibular region and limitation on mouth opening was reported. She had undergone an unsuccessful surgical procedure under local anesthesia performed by a general practitioner for removal of impacted mandibuler right third molar 1 week earlier. On clinical examination floor of the mouth was tender to palpation. Panoramic and the periapical radiographs showed presence of a radiopaque mass similar to that of a tooth root. Computed tomography scans were obtained for detailed radiographic examination, thereby the presence of a high density area in the submandibular region was detected. Under general anesthesia the displaced root was removed and the postoperative course was uneventful.

Prevalence and distribution of oral mucosal lesions in an adult Turkish population.

OBJECTIVES: The purpose of this study was to assess the prevalence and distribution of oral mucosal lesions in a Turkish adult population. MATERIAL AND METHODS: Five thousand consecutive patients were examined during routine dental treatment. Some of the mucosal changes were diagnosed solely by clinical examination. When clinical features were not diagnostic, a biopsy was undertaken. Chi-square test was used to analyze the data. RESULTS: The overall incidence of oral mucosal changes or lesions was 15.5%. The lesions were classified as anatomic changes, ulcerated lesions, tongue lesions, white lesions, benign lesions, color alterations, and malignant lesions. Anatomic changes (7%), ulcerated lesions (6.6%), and tongue lesions (4.6%) were the most common lesions. White lesions were observed in 2.2% of all patients. Among the white lesions, leukoplakia was identified in men 4 times more frequently than it was in women. Benign lesions and color alterations were identified in 1.6% and 1.2% of all patients, respectively. In addition, 3 patients (0.06%) were diagnosed as having squamous cell carcinoma, and 1 patient (0.02%) was diagnosed as having adenocarcinoma. There was a statistically significant relation between smoking and the occurrence of mucosal lesions whereas no relation was found between alcohol consumption and mucosal lesion occurrence. Besides, no relation was found between systemic diseases and oral mucosal lesion occurrence. CONCLUSIONS: This study has provided information about the epidemiologic aspects of oral mucosal lesions that may prove valuable in planning of future oral health studies.

Diffuse sclerosing osteomyelitis in the maxilla: case report.

A case of diffuse sclerosing osteomyelitis (DSO) in the maxilla of a 25-year-old male is presented. His chief complaint was recurrent painless swelling in the maxillary right molar region over a 3-year-period. The periapical and panoramic radiographs of the right maxilla showed diffuse sclerotic areas. Computed tomography (CT) indicated a high density area in the right maxilla. Although the tentative diagnosis was fibrous dysplasia on the basis of history, clinical symptoms and radiologic examination, the biopsy results supported chronic diffuse sclerosing osteomyelitis. The maxillary location and the painless course of the lesion in a male patient is a rare occurrence.