Evaluation of accessory mental foramina morphology with cone-beam computed tomography.

BACKGROUND: Accessory mental foramen (AMF) is the extra mental foramen (MF) located in the mandible. The recognition of AMF is important to avoid complications during surgical procedures involving MF and cheeks. AIM: This study aimed to determine the prevalence, localization, and size of AMF by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of 645 patients over 13-14 years (male 281; female 364) were retrospectively evaluated. The CBCT images were obtained using Promax 3D® (Planmeca, Helsinki, Finland) device with automated exposure parameters varying depending on the cases. Statistical analysis was performed using descriptive statistics, chi-square test and t-test. RESULTS: AMF was detected in 75 (11.6%) patients. There was no significant difference between the presence of AMF and gender (P = 0.57, P > 0.05). Majority of the cases (n = 67, 88.8%) consisted of single AMF, while double AMF was observed in 6 (10%) and triple AMF in 2 (1.2%) patients. The most common location of AMF with respect to MF was posterio-inferior (n = 57, 67.1%), and AMF placed at the root line of first molar tooth in 45 cases (52.9%). CONCLUSION: AMF can be seen in the mandible one in every ten patients being single in most cases. Considering the high prevalence and present morphological features, AMF should be detected by CBCT before surgical operations, particularly in implant planning for the prevention of possible complications.

Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers

Recurrent aphthous ulcer (RAU) is an inflammatory condition of the oral mucosa characterized by painful, well-circumscribed, single or multiple round or ovoid ulcerations. The exact etiologic factor(s) of these ulcerations are not yet understood. The objective of this study was to evaluate inflammatory processes and free radical metabolism of 25 patients with RAUs compared to 25 healthy controls. The levels of malondialdehyde (MDA) and glutathione (GSH) were determined by high-performance liquid chromatography. Tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), IL-10, and IL-12 were determined by ELISA. Nitric oxide (NO), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidant status (TOS) levels were measured spectroscopically in serum. The levels of MDA, GSH, TNF-α, IL-2, IL-12, MPO, and TOS, and oxidative stress index (OSI) were higher, and the levels of NO, IL-10, and TAS were lower in patients with RAU than in controls. Statistical analysis showed that GSH, TNF-α, IL-2, IL-10, and OSI differed significantly in patients with RAU compared to controls. These parameters have important roles in oxidant/antioxidant defense.

Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers.

Recurrent aphthous ulcer (RAU) is an inflammatory condition of the oral mucosa characterized by painful, well-circumscribed, single or multiple round or ovoid ulcerations. The exact etiologic factor(s) of these ulcerations are not yet understood. The objective of this study was to evaluate inflammatory processes and free radical metabolism of 25 patients with RAUs compared to 25 healthy controls. The levels of malondialdehyde (MDA) and glutathione (GSH) were determined by high-performance liquid chromatography. Tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), IL-10, and IL-12 were determined by ELISA. Nitric oxide (NO), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidant status (TOS) levels were measured spectroscopically in serum. The levels of MDA, GSH, TNF-α, IL-2, IL-12, MPO, and TOS, and oxidative stress index (OSI) were higher, and the levels of NO, IL-10, and TAS were lower in patients with RAU than in controls. Statistical analysis showed that GSH, TNF-α, IL-2, IL-10, and OSI differed significantly in patients with RAU compared to controls. These parameters have important roles in oxidant/antioxidant defense.

Influence of gag reflex on dental attendance, dental anxiety, self-reported temporomandibular disorders and prosthetic restorations.

To assess the influence of gag reflex severity, assessed according to the short form of the patient part of Gagging Problem Assessment Questionnaire (GPA-pa SF), on the dental attendance, dental anxiety, self-reported temporomandibular disorder (TMD) symptoms and presence of prosthetic restorations among patients requiring prosthodontic treatment in Turkey. A total of 505 patients (305 women; mean age: 46·35 years, SD: 28·2 years) undergoing dental examination were administered a questionnaire containing questions regarding their age, gender, education level, dental attendance, TMD symptoms (limitation in jaw opening, muscle pain, pain/sounds in the temporomandibular jaw), the Turkish version of the Modified Dental Anxiety Scale (MDAS) and the GPA-pa SF. Subsequently, any prosthetic restoration was recorded by a dentist. Descriptive statistics, one-way analysis of variance (anova) and the chi-square test were used for statistical analysis. Differences were found between GPA-pa SF scores 0, 1 and 2 for education level (P = 0·001), MDAS scores (P = 0·003), self-reported TMD (P = 0·000) and prosthesis wear (P = 0·000), but not for attendance patterns (P = 0·826). Patients with gag reflex had lower education levels, higher levels of dental anxiety, more self-reported TMD symptoms and fewer fixed or removable prosthetic restorations than patients without gag reflex. Gag reflex has impacts on dental anxiety, self-reported TMD and prosthetic restorations, but not on dental attendance patterns, according to the results of the GPA-pa SF.

Utility of the gagging problem assessment questionnaire in assessing patient sensitivity to dental treatments.

Although the Gagging Problem Assessment Questionnaire (GPA) can be used to identify patients with gag reflex, it does not provide information about patient sensitivity to dental procedures. The aim of this study was to assess the utility of GPA in determining patient sensitivity (i.e. gag reflex) in response to intra-oral radiography and impression-taking procedures. The study included 95 patients (65 women; mean age, 44·2 ± 13·4 years) undergoing dental treatment at a Turkish dental school. Patients completed the patient section of the GPA before their dental examination. An observing dentist monitored and scored the gag reflex of patients during each step of intra-oral radiographic examination and impression taking. The overall sensitivity of the patient to the entire process was also recorded. Descriptive statistics, one-way analysis of variance and the Tukey's test were used for statistical analysis. Patients with GPA scores of 1·00-1·74 did not show any gagging or displayed only mild discomfort during the procedures. Patients with GPA scores of 1·75-3·24 showed moderate gagging, which was managed with prophylactic and suppressive precautions. Patients with GPA scores of 3·25-4·00 were unable to complete the procedures because of gagging. Differences (all P < 0·001) were found between the three groups for the observed responses of patients during radiography (F, 203·343), impression (F, 175·035) and radiography + impression procedures (F, 228·319), with no significant difference between women and men. In conclusion, GPA may be helpful for the prediction of patient sensitivity to dental treatments.

Dental students' knowledge and attitudes towards cone beam computed tomography in Turkey.

OBJECTIVE: The aim of this study was to evaluate students' knowledge and attitudes regarding cone beam CT (CBCT). METHODS: A questionnaire consisting of 11 questions was given to 472 dental students (280 pre-graduate and 192 post-graduate) at two institutions located in Ankara, Turkey (Ankara University, Faculty of Dentistry, and Gazi University, Faculty of Dentistry). Differences in responses by institution, education level and sex were statistically assessed with the χ(2) test. RESULTS: Statistical results showed that only 63.3% of students had heard of CBCT. Of these, 59.9% said they had learned about CBCT in their classes, 31.0% in seminars and 20.9% from the internet; 76.8% felt that CBCT was not given adequate coverage in their courses; 69% thought that CBCT should be taught as part of their clinical education; 91% thought it essential for CBCT to be available at dental faculties; 53.5% believed that the use of CBCT would become more widespread in the near future; and 84.9% wished to use CBCT technology in their future careers. CONCLUSION: This research suggests that efforts should be made to improve students' knowledge base regarding CBCT and that the dental school curriculum should devote more curriculum time to this promising new technology.

Relationship between trait anxiety, dental anxiety and DMFT indexes of Turkish patients attending a dental school clinic.

The aims of this study were to evaluate possible relationships between trait anxiety, dental anxiety and the total number of decayed, missing and filled teeth (DMFT) index of patients attending a dental school clinic. A sample of 558 patients was surveyed with the Turkish version of the Spielberger Trait Anxiety Inventory and Dental Anxiety Scale. DMFT index was calculated by clinical and radiographic examination. A significant linear correlation was observed between trait and dental anxiety, but there was no correlation between DMFT index, trait anxiety and dental anxiety. Trait anxiety has an impact on dental anxiety, but does not affect the DMFT index.

Reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire.

The aim of this study was to evaluate the reliability and validity of the Turkish version of the shorter form of the gagging problem assessment questionnaire. Forty-three patients with gagging problems and 89 patients who showed no signs of gagging during dental examination were included in the study. The patients completed the patient portion of the gagging problem assessment questionnaire, as well as the modified dental anxiety scale, dental fear scale and Spielberger trait anxiety scale for comparison. Two experienced dentists subsequently completed the dentist portion of the gagging problem assessment questionnaire by performing clinical examinations with a dental mirror. The results indicate that patients with gagging problems had significantly higher mean scores than the control group (P < 0.001). The internal consistency of the questionnaire was found to be adequate, and good intra- and inter-observer reliability was present. Patients with a gagging reflex had significantly higher anxiety scores, indicating the validity of the questionnaire. The Turkish translation of the shorter form of the gagging problem assessment questionnaire was found to be reliable and valid for distinguishing among patients with and without a gagging reflex.

Relationship between trait anxiety, dental anxiety and DMFT indexes of Turkish patients attending a dental school clinic

The aims of this study were to evaluate possible relationships between trait anxiety, dental anxiety and the total number of decayed, missing and filled teeth [DMFT] index of patients attending a dental school clinic. A sample of 558 patients was surveyed with the Turkish version of the Spielberger Trait Anxiety Inventory and Dental Anxiety Scale. DMFT index was calculated by clinical and radiographic examination. A significant linear correlation was observed between trait and dental anxiety, but there was no correlation between DMFT index, trait anxiety and dental anxiety. Trait anxiety has an impact on dental anxiety, but does not affect the DMFT index

A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximal caries detection in posterior teeth.

OBJECTIVES: The aim of this study was to investigate the diagnostic accuracy of conventional bitewing, periapical radiographs, unfiltered and filtered digital panoramic images for the assessment of approximal carious lesions in posterior teeth. METHODS: 20 patients who required bitewing, periapical and panoramic radiographs participated in the study. The digital panoramic images were treated with the "sharpen", "smooth" and "emboss" filters. Three experienced observers evaluated the bitewing and periapical radiographs, and the unfiltered and filtered digital panoramic images for the presence or absence of approximal carious lesions according to a 5-point confidence scale. Intra- and interobserver reliability was analysed with the Cronbach alpha test and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: According to the results, the intra- and interobserver agreement levels were found to be almost perfect. The highest diagnostic accuracy was found for the bitewing, followed by the periapical and panoramic images. Compared with the unfiltered panoramic images, the filtered images had an almost equal or slightly higher diagnostic accuracy. The largest increase in diagnostic accuracy was observed for those images filtered with the emboss filter. CONCLUSIONS: The accuracy of unfiltered and filtered digital panoramic images is lower than conventional bitewing and periapical radiographs. The filtration of the digital panoramic images, especially the emboss filter, may have some value for the detection of approximal carious lesions.

A fatty tissue lesion of the floor of the mouth mimicking an odontogenic lesion.

The floor of the mouth is a rare location for fatty tissue lesions. These lesions could cause resorption of the adjacent bone and lead to a radiolucent appearance on radiographs. In this case report, a non-capsulated lesion composed of mature adipose tissue located on the floor of the mouth causing a well-circumscribed oval radiolucent lesion close to the roots of the molar teeth due to resorption of mandible in a 33-year-old woman is reported.