Anatomical landmarks of mandibular interforaminal region related to dental implant placement with 3D CBCT: comparison between edentulous and dental mandibles.

BACKGROUND: Anterior mandibular (interforaminal) region is important in implant applications as it serves a basis for neurovascular bedding and holds the prosthesis for patients. Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the neurovascular bundle. Anatomical structures including mandibular incisive canal (MIC) and lingual foramen (LF) should also be examined as part of the detailed analysis for their neurovascular structures. This study aimed to detect the positions of LF and MIC as well as the prolongation of interforaminal region in Anatolian population to supply the reference data of the surgical safe zone in chin for the clinicians. MATERIALS AND METHODS: Mandibles of 70 adult specimens (35 edentulous + 35 dentate) were retrieved from the Department of Anatomy, Ege University. Images of the dry mandibles were obtained using a cone beam computed tomography unit applying a standardized exposure protocol. Afterwards, mandibles were sawn into vertical sections according to the respective tomographic cross-sections. Images were evaluated for the absence/presence of the MIC, its dimensions and antero-posterior length for both edentulous and dentate groups. In addition; the presence, number, location, labial canal and LF diameter and height of the LF were determined for both groups. RESULTS: The MIC was observed in 80 and 68.6% of the dentate and edentulous groups, consecutively (p > 0.05). The MIC continued towards the incisor region in a slightly downward direction. The LF was observed in all dentate mandibles (100%), while it was present in 94.3% of the edentulous mandibles (p > 0.05). For the dentate group, 62.9% of the specimens had two foramens and 20% had three foramens in the mandibular midline. Mean length of the MIC in dentate groups and edentulous groups was measured as 2.55 ± 0.809 and 3.08 ± 1.745 mm, respectively. Well-defined MIC mean diameter in dentate groups and edentulous groups were measured as 2.44 ± 0.702 and 2.35 ± 0.652 mm, respectively. Significant difference was found between dentate and edentulous group in most of the parameters except for the LF and the diameter of the MIC (p > 0.05). The correlation between observers' measurements ranged between 0.742 and 0.993 for all anatomical landmarks and mandible groups. CONCLUSION: The MIC and LF are associated with neurovascular bundle variations in number, location and size. Therefore, clinicians should determine each of these anatomical structures on a case-by-case basis to recognize their presence and to take measures for the possible implications of various treatment options. These guidelines included leaving a 2 mm safety zone between an implant and the coronal aspect of the neurovascular bundle. To avoid neurovascular injury during surgery in the interforaminal area, guidelines were developed with respect to validating the presence of an anterior loop of the neurovascular bundle.

Does the state of dentition effect the type of stylohyoid chain calcification pattern?

INTRODUCTION: The human stylohyoid chain calcification patterns (SCP) present considerable anatomic variability. This study was performed to investigate the calcification on SCP in the dentate and total edentulous population and its relation to mandibular protrusive movement. MATERIALS AND METHODS: The study analyzed 1.234 SCP in digital panoramic radiographs of 617 subjects. The SCP were classified according to Mac Donald-Jankowski. The amount of mandibular protrusion movement limitation was evaluated for each subject. The data were analyzed using one-way Anova, Kruskall Wallis, Mann-Whitney U, and Chi-squared tests with significance set at p = 0.05. RESULTS: Among the 617 subjects evaluated there was symmetry of the SCP between the left and right sides in 87.3 % of the cases. In the study population 501 subjects were dentate (Class I, Class II, Class III molar relationship) and 116 subjects were total edentulous. There were significant differences among dentate and total edentulous patients for the distribution of SCP (p < 0.05). Elongated group was more prevalent in total edentulous subjects while in subjects with Class I occlusion normal SCP was observed. Although mandibular protrusive movement range was within normal limits for all the groups, calcified and elongated groups have numerically less protrusive movement compared to normal groups (p < 0.05). CONCLUSION: Among dentate and total edentulous subjects, similarity in SCP for right and left side was observed. The elongation of SCP was more common in the total edentulous group. Further studies conducted on larger populations are necessary to establish the effect of the state of dentition on the SCP.

Effects of surface-finishing protocols on the roughness, color change, and translucency of different ceramic systems.

STATEMENT OF PROBLEM: Surface-finishing protocols have a mechanical impact on ceramic surfaces that could eventually affect surface topography and light scattering. An optimum protocol is needed to avoid damaging the optical properties of ceramics. PURPOSE: The purpose of this study was to determine the effects of different surface-finishing protocols on the surface roughness, color change, and translucency of ceramic and metal ceramic restorations. MATERIAL AND METHODS: Standardized disk-shaped specimens (1.5 × 10 mm, n=128) were fabricated from 3 different ceramic core materials (aluminum oxide [Al2O3]-AL, zirconium oxide [ZrO2]-ZR, lithium disilicate [Li2Si2O5]-LIT), veneered (V) with dentin ceramics (n=32 per group), and placed in the following groups: ALV, ZRV, and LITV. The metal ceramic group acted as the control (n=32). Four different surface-finishing methods were tested. Airborne-particle abrasion with 50 µm Al2O3, polishing with adjustment kit, polishing with adjustment kit plus diamond polishing paste, and autoglazing (n=8 subgroup) were applied on the veneering ceramics. The specimens were analyzed with a profilometer for surface roughness, and color change and translucency were measured with a clinical spectrophotometer. Statistical analyses were performed with 1-way ANOVA and the Tukey honest significant difference tests (α=.05). RESULTS: Specimens treated with the airborne particle abrasion method showed significantly higher mean profilometer for surface roughness values in all groups (P<.05). The polishing with adjustment kit and autoglazing methods revealed statistically similar surface roughness values in all groups (P>.05). With the diamond polishing paste method, lower surface roughness values were achieved in the ZRV and metal ceramic groups acted as the control groups. Different surface-finishing methods affected the color change of the ceramic systems, except for ZRV. Surface-finishing protocols significantly affected the translucency values of the ALV, LITV, and metal ceramic groups (P<.05). CONCLUSIONS: No single surface-finishing protocol can be recommended to obtain the smoothest surface and the least color change without affecting translucency for the ceramics tested. The airborne-particle abrasion protocol created rougher surfaces and decreased translucency, and color change in zirconia was not affected by the finishing protocols.

Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population.

OBJECTIVE: The calcified stylohyoid ligament and the elongated styloid process (SP) are identified radiographically, are associated with several syndromes and symptoms. The aim of this study was to classify and determine the incidence of different types of stylohyoid chain patterns in Turkish population to provide a guide for the dentist and maxillofacial surgeon. The effect of menopause, on the elongation of SP was also investigated. METHOD: 1,600 patients, who visited Ege University Faculty of Dentistry, were enrolled. Images were evaluated for the pattern of stylohyoid chain complex according to O'Carroll's classification. The difference between age and gender was evaluated using χ(2) and ANOVA tests. RESULTS: Normal SP (Patterns A, B, C, D) 68.3 %, elongated SP (Pattern E) 27.1 %, calcified stylohyoid ligament (Patterns F, G, H, I, J, K) 1.7 % and absent stylohyoid chain 2.5 % ratios were encountered. Pattern D (52.5 %) was the most prevalent stylohyoid chain pattern followed by Pattern E (27.1 %) and Pattern C (10.7 %), respectively. Among the calcified stylohyoid ligament groups studied, Pattern G (2.6 %) was most frequently observed. There was no difference in gender for the type of stylohyoid chain complex pattern (p > 0.05). No statistically significant difference was found between menopause and non-menopause group (p > 0.05). CONCLUSIONS: According to the results of the present study, styloid process elongation is more common in older adults with no correlation to gender. In addition, menopause had no effect on the calcification or elongation of the stylohyoid chain. The sum of the elongated SP and the calcified stylohyoid ligament was 28.8 %.

Systemic consequences of poor oral health in chronic kidney disease patients.

Changes in the oral cavity, such as periodontitis and other manifestations of poor oral health, are common in patients with chronic kidney disease (CKD) and may contribute to increased morbidity and mortality because of systemic consequences such as inflammation, infections, protein-energy wasting, and atherosclerotic complications. Poor oral health in CKD patients may thus represent an important, but often overlooked, problem. Several studies show that uremic patients have higher rates of decayed, missing, and filled teeth, loss of attachment, and periapical and mucosal lesions than the general population. The consequences of poor oral health may be more severe in CKD patients because of advanced age, common comorbidities such as diabetes, concurrent medications, and a state of immune dysfunction that may increase the risk for systemic consequences of periodontitis and other oral and dental pathologic conditions. Poor dentition and other signs of poor oral health should be an alarm clock also at early stages of CKD. However, it remains to be determined whether more successful management of poor oral health and periodontitis will reduce the risk of inflammation, infection, protein-energy wasting, and atherosclerotic complications in CKD patients. This review explores etiological factors and potential systemic consequences of poor oral health in CKD patients as well as possible preventive and therapeutic strategies.

Prosthetic rehabilitation of hemimandibular hyperplasia: five-year follow-up.

Hemimandibular hyperplasia is a rare asymmetrical mandibular malformation, characterized by enlargement of the condyle, the condylar neck, the ramus, and the body of the mandible. This condition results in laterognathia, dental articulation disorders, and functional defects. Therapy largely depends on the patient's age and the desired esthetic and functional results. This clinical report describes the prosthetic rehabilitation of a 50-year-old woman with hemimandibular hyperplasia. During the diagnostic phase, facial asymmetry was observed, as was the chin midline shifting to the unaffected side and three-dimensional enlargement of one side of the mandible, the condyle, the condylar neck, and the ramus. No biomechanical or functional problems were seen at a five-year follow-up visit, except for physiological wear to the artificial teeth.

Reliability and validity of the Geriatric Oral Health Assessment Index in Turkey.

The purpose of this study was to test the reliability and validity of the Turkish version of the Geriatric Oral Health Assessment Index (GOHAI). Data were obtained from a cross-sectional survey of 101 older adults living at a residential home in the Izmir municipality of Turkey. The Turkish version of the GOHAI showed acceptable reliability and validity. The Cronbach's alpha coefficient was 0.75, and item-scale (Pearson's) correlations varied between 0.30 and 0.67. Low GOHAI scores were associated with perceived poor oral health (p < 0.01) and dissatisfaction with oral health status (p < 0.05). Factor analyses of the index indicated a two-factor solution. It was concluded that the Turkish version of the GOHAI is a reliable and valid measure for use with Turkish adults age 65 and older.

The oral hygiene and denture status among residential home residents.

The aim of this study was to investigate the oral hygiene practices and denture status of elderly people living in a residential home. One hundred one elderly people living in Gurcesme Zubeyde Hanim Residential Home, Izmir-52 women (mean age 75.5 +/- 7.8) and 49 men (mean age 75.3 +/- 8.8)-participated in an interview. Their oral hygiene practices, self-perceived oral health, denture status, and needs of denture were noted down. Self-perceived oral health was very bad in 9.9%, bad in 47.5%, good in 33.7%, and very good in 8.9%. From 69 people who reported maintaining oral hygiene, the incidence of oral hygiene practice was 36.2% once a day, 31.9% three times a day, 21.8% once a week, and 10.1% seldom. The majority, 60 people (59.4%), were dentate. Among the dentate, 47 people (78.3%) had full denture, 4 (6.6%) removable partial denture, 2 (3.3%) fixed/removable partial denture, 5 (8.3%) full/removable partial denture, and 2 (3.3%) one or more fixed partial dentures. By gender, 57.6% female and 61.2% male subjects were dentate. The relationship between having a social security and having a denture was significant (p = 0.02); having a denture and needing a denture was also significantly related (p = 0.00). The high prevalence of needs for denture pointed to the requirement for frequent dental check ups. The most important need within the residents of the residential home was daily oral hygiene. Nurses trained on this subject are required.

Conservative rehabilitation of missing teeth before placement of implant dentures: clinical reports.

Although implant-supported restorations often are preferred for the replacement of missing teeth, their high cost means that they can be given only to patients who can afford them. The clinical reports in this article describe interim conservative restorations made after orthodontic treatment to achieve esthetics, phonation, and function until implant-supported dentures were made. In all cases, the patients who received fiber-reinforced resin composite fixed partial dentures returned for follow-up visits at three-month intervals and reported no complaints during a year of follow-up visits. The desired esthetics can be achieved with temporary conservative treatment until the implant dentures are applied; if this treatment meets the patient's esthetic expectations, the final restoration can be fabricated according to these contours.

Treatment of localized anterior tooth wear with a glass-fiber-reinforced composite resin: a clinical report.

Developments in adhesive dentistry have provided the dental profession with new restorative materials and technology to restore esthetics and function to the worn anterior dentition. This clinical report describes treatment of localized anterior tooth wear with fiber-reinforced composite resin restorations as an alternative treatment method.