Are maxillary sinus variations related to maxillary sinus diameters?

OBJECTIVES: The reasons why the maxillary posterior region is challenging for dentists are its structure and anatomical variations. For this reason, it is necessary to have complete knowledge about the anatomy of this region. In dentistry, necessary information for the desired evaluation in this region can be provided by CBCT. The fact that it provides a three-dimensional evaluation and has measurement reliability emphasizes its importance in surgical applications. The septa, haller cell, and accessory ostium are variations of the maxillary sinus. There are few studies in the literature examining the relationship between maxillary sinus diameters and its variations. The aims of this study are to determine the prevalence of maxillary sinus variations and the average of maxillary sinus diameters, to examine their relationships according to age and gender, and to evaluate the effects of maxillary sinus diameters on variations. METHODS: In this retrospective study, CBCT images of 212 patients were examined. The examined CBCT images were analysed and recorded in more than one section. Descriptive statistics, chi-square tests, independent t test, one-way Anova tests were used to evaluate the data. RESULTS: As a result, a statistically significant difference was observed between the variations, gender and age groups in terms of morphometric characteristics of the maxillary sinus. The most common variation was observed to be accessory ostium. CONCLUSIONS: The rate of patients with at least one anatomical variation was 77.8%. For this reason, a detailed analysis should be performed to avoid complications before surgical procedures are performed in the area.

Radiographic evaluation of periapical status and frequency of endodontic treatment in a turkish population: a retrospective study.

PURPOSE: The aim of this study was to determine the frequencies of apical periodontitis and endodontic treatment in a Turkish population using a retrospective analysis of orthopantomograms. MATERIALS AND METHODS: The sample consisted of orthopantomographs of 250 subjects who had been referred to our clinic for an initial visit between the years of 2013 and 2014. The periapical status of all teeth (with the exception of third molars) was examined using periapical index scoring system (PAI). Data were analyzed statistically using the Chi-squared test at the significance level of p<0.05. RESULTS: The study sample comprised 6196 teeth belonging to 250 patients. Out of 6196 examined teeth, the frequencies of apical periodontitis and endodontic treatment was 1.8% and 3.7%, respectively. Gender had no effect on the presence of apical periodontitis or the frequency of endodontic treatment. The frequency of apical periodontitis and endodontic treatment increased with age, but it did not show statistical significance among different age groups. CONCLUSION: This study provides epidemiological data about apical periodontitis and endodontic treatment in a Turkish population.

Comparison of the delay in processing time and protective plastic cases in two phosphor plate systems.

OBJECTIVE: The purpose of this study was to analyze two phosphor plate systems (PSPs) (Dürr Dental, Digora Optime) according to their scanning delay and protective plastic case performances. METHODS: Two PSPs using an aluminum step wedge were exposed. These plates were placed in three different protective plastic cases (manufacturers' original cases, black case, and white case) before obtaining the radiographs and were then processed immediately and 1, 5, 10, 30, 60, 120, 240, and 480 min after exposure. Mean gray values (MGVs) of the 3rd, 5th, 7th, and 9th steps of the wedges were compared using ANOVA. RESULTS: Statistically significant differences were found between the two PSPs (P < 0.001). ANOVA revealed that the MGVs of four steps of the wedges were significantly different from each other for all scan delays (P < 0.001). MGVs increased with increasing scanning delay, except the group with Dürr plates in their original cases. Reduction in image quality began 5 min after exposure in the other Dürr plate groups. CONCLUSIONS: Within the limitations of the current study, it can be concluded that scanning delay causes a reduction in image quality, and using the manufacturer's original protective case will result in better performance of PSPs.

Sociodemographic comparison in patients with subjective and objective clinical findings of temporomandibular dysfunctions.

OBJECTIVES: To investigate the differences in healthy persons and patients with myofacial pain without limitation, objective signs of temporomandibular dysfunctions (TMDs), and both subjective and objective features with respect to age, gender, effects of TMDs on daily life, economic condition, smoking habit, marital status, and education. METHODS: Sociodemographic information of 296 persons (212 females and 84 males) was evaluated. Subjects were categorized into 4 groups according to clinical findings: no TMD symptoms (control, C); myofacial pain without limitation (MP); objective signs (PWOS); or both subjective and objective features (MP/PWOS). RESULTS: The C, MP, PWOS, and MP/PWOS groups comprised 64 (22%), 66 (22%), 68 (23%), and 98 (33%) subjects. PWOS and MP/PWOS differed significantly between the 15-30 and 30-45 year age groups. Although patients with PWOS were significantly higher in the 15-30 year age group, patients with MP/PWOS were significantly higher in the 30-45 year age group. A significant difference was observed with respect to gender in all groups except the control group. The effects of TMD symptoms on daily life differed statistically among the groups. CONCLUSIONS: Female gender is a risk factor for TMDs. Females are more vulnerable to subjective and objective signs than males. During general dental examinations, females should be checked for TMD symptoms. PWOS manifest before MP. Moreover, mechanical derangements can cause myofacial pain. MP can mostly affect daily life, but PWOS tend to be prohibitive.

Correlation between the Condyle Position and Intra-Extraarticular Clinical Findings of Temporomandibular Dysfunction.

OBJECTIVES: To investigate the relationship between different clinical findings and condyle position. METHODS: Tenderness on masseter (MM), temporal (TM), lateral pyterigoid (LPM), medial pyterigoid (MPM) and posterior cervical (PSM) muscles, limitation, deviation and deflection in opening of mouth, clicking, crepitating, tenderness on lateral palpation of temporomandibular joint (TMJ) area for each side of 85 patients were evaluated. Each side of patients was categorized into the clinical findings: no sign and/or symptom of temporomandibular dysfunctions (TMDs), only extraarticular findings and only intraarticular findings, extra and intraarticular findings. Condyle positions of 170 TMJs were determined the narrowest anterior (a) and posterior interarticular distance (p) on mid-sagittal MRIs of condyles and expressed as p/a ratio and these ratio were transformed into logarithmic base e. Spearman's Correlation was used to investigate the relationship between the condyle position and the clinical findings. The difference between the condyle positions of different groups was tested by T test. Reliability statistic was used to determine intra-observer concordance of two measurements of condylar position. RESULTS: A significant relationship was found between the condyle position and tenderness of PSM. There was no significant difference between the groups in aspect of the condyle position. Occlusion and condyle position correlated with significantly. CONCLUSIONS: The inclination of the upper cervical spine and craniocervical angulations can cause the signs and symptoms of TMD and condyle position is not main cause of TMDs alone but it may be effective together with other possible etiological factors synergistically.

The incidence of canine transmigration and tooth impaction in a Turkish subpopulation.

The purpose of this study was to determine the incidence of transmigrated maxillary and mandibular canine teeth and also of the other impacted teeth in a Turkish subpopulation. Five thousand consecutive panoramic radiographs taken of patients who attended the Department of Oral Diagnosis and Radiology, Selcuk University, for routine examination between 2005 and 2007 were examined to identify incidences of transmigrated and impacted teeth. Demographic information of all patients was also recorded. Transmigrations were categorized according to the classification of Mupparapu. The effect of age, gender, and sidedness (left or right side) on the recorded abnormality was evaluated using a t-test. The incidence of transmigrated upper and lower canine teeth was found to be 0.34 per cent [17 patients, 12 females/5 males, with a mean age of 34 years (range 16-76 years)] and 0.14 per cent [7 patients, 4 females/3 males, with a mean age of 37.1 years (range 17-62 years)]. The incidence of tooth impaction was 2.94 per cent [147 patients, 101 females/46 males, with a mean age of 29.7 years (range 15-80 years)]. The most frequently impacted tooth was the upper canine followed by the lower canine, lower second premolar, and upper second premolar. No incidence of maxillary first molar impaction was found. Gender and sidedness did not show a statistical significance on the recorded abnormality (P = 0.22 and P = 0.48, respectively). However, in the 15-29 year age group, this was statistically different (P < 0.05). The incidence of transmigration of impacted mandibular canine teeth was greater than other teeth. With the increased use of panoramic radiographs, it is inevitable that diagnosis of such anomalies will increase.

Alveolar bone changes under overhanging restorations.

The aim of this study was to investigate changes in the trabecular architecture of the alveolar bone beneath overhanging restorations with bitewing radiographs in patients having no radiographically visible vertical bone loss. Twenty-eight digital bitewing radiographs with overhanging restorations and 28 digital bitewing radiographs without any restorations belonging to the contralateral side of the same patient were included in the study. Regions of interests (ROI) were created in the alveolar bone along the interproximal regions. These ROIs were segmented to binary images with ImageJ, and, within these binary images, the number of radiographically visible trabecular bone islands per unit area was counted; in addition, the Feret diameter and fractal dimension (FD) were measured. It was found that the mean number of objects per unit area was statistically different in alveolar bone with overhanging restorations from control sites (p < 0.0001). However, the FeD (p = 0.179) and FD (p = 0.963) did not show statistically significant differences between alveolar bone with and without overhanging restorations.

Calcifications of the pulp chamber: prevalence and implicated factors.

The objectives of this study were to describe the prevalence of pulp chamber calcifications in a sample of Turkish dental patients and to report associations between presence of pulp chamber calcifications and dental status, gender, age, and cardiovascular diseases (CVDs). Data were collected through radiographic examination of periapical and bitewing radiographs of 15,326 teeth from 536 dental patients, comprising 270 male and 266 female patients aged between 13 and 65 years. Definite radiopaque focuses inside the radiolucent pulp chamber were defined as pulp chamber calcifications. When the pulp chamber was completely radiolucent, that tooth was scored as tooth without pulp chamber calcification. The dental status was scored as intact, carious, restored, or restored + carious. Pulp chamber calcifications were identified in 204 (38%) patients examined. Of the 15,326 teeth, 747 (4.8%) had pulp chamber calcifications. Gender and dental status were found to be correlated with the presence of pulp chamber calcifications. The high prevalence of pulp chamber calcifications in carious, restored, and restored + carious teeth support the view that the occurrence of pulp chamber calcifications can be a response to long-standing irritants. However, to report any associations between occurrence of pulp chamber calcifications and different dental or clinical status, further studies are still needed.

Prevalence of styloid process elongation on panoramic radiography in the Turkey population from cappadocia region.

OBJECTIVES: The aim of this study is to determine the prevalence of styloid process elongation (SPE) detected on panoramic radiographs (PRs) in Cappadocia region population in Turkey and to investigate the SPE incidences in relation to the age subgroups. METHODS: Between 2004 to 2007 years, a random sample of 750 PRs was collected from the data files and any questionable PR was excluded. Therefore, 698 PRs were included in the present study. The subjects were divided into six age subgroups: 10-19, 20-29, 30-39, 40-49, 50-59 and 60 years and older. Fifty-four (7.7%) patients demonstrated SPE at least one side. RESULTS: There were statistical differences between 10-19, 20-29 age subgroups and 30-39, 50-59 age subgroups in terms of the SPE prevalence, but not other subgroups. CONCLUSIONS: According to our knowledge, this is the highest prevalence in comparison to the other Turkish reports and the first study in terms of the SPE prevalence in Cappadocia region population. Also, the subgroup analyse suggested that the age may not have a role in the elongation of the SP.

Unusual cases of the transmigrated mandibular canines: report of 4 cases.

The canine impaction is not uncommon in dental literature, but the transmigration of mandibular canine is a rare phenomenon, and some of them are far more extreme than others. In this study, we aimed to present the more extreme cases of the four transmigrated mandibular canine cases with special emphasis on their classification.

Prevalence of torus palatinus in cappadocia region population of Turkey.

OBJECTIVES: The objectives of this study were to determine the prevalence, size, shape and location of the torus palatinus (TP) in dental outpatients in Cappadocia region of Turkey and to investigate the relationship between the findings in relation to age and gender. METHODS: The present study included 2660 patients, who attended the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry at Erciyes University for their dental problems between December 2005 and May 2007. The presence or absence of TP was examined by clinical inspection and palpation. RESULTS: The prevalence of TP in our large sample was low (4.1%) in comparison to other Turkish population. It was found to be significantly higher (P<.001) in females (5.7%) than in males (1.8%). Most TP were found in flat shape (62.7%), smaller than 2 cm (75.4%) and located at premolar-molar region (66.4%). CONCLUSIONS: This study indicated that the prevalence of TP in Turkish population was low. Our results showed a significant relationship between the occurrence of TP and gender. According to the literature, it was firstly showed that flat TP was the most common type in our large population.

Evaluating mandibular cortical index quantitatively.

OBJECTIVES: The aim was to assess whether Fractal Dimension and Lacunarity analysis can discriminate patients having different mandibular cortical shape. METHODS: Panoramic radiographs of 52 patients were evaluated for mandibular cortical index. Weighted Kappa between the observations were varying between 0.718-0.805. These radiographs were scanned and converted to binary images. Fractal Dimension and Lacunarity were calculated from the regions where best represents the cortical morphology. RESULTS: It was found that there were statistically significant difference between the Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 1 and Cl 2 (Fractal Dimension P:0.000; Lacunarity P:0.003); and Cl 1 and Cl 3 cortical morphology (Fractal Dimension P:0.008; Lacunarity P:0.001); but there was no statistically significant difference between Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 2 and Cl 3 cortical morphology (Fractal Dimension P:1.000; Lacunarity P:0.758). CONCLUSIONS: FD and L can differentiate Cl 1 mandibular cortical shape from both Cl 2 and Cl 3 mandibular cortical shape but cannot differentiate Cl 2 from Cl 3 mandibular cortical shape on panoramic radiographs.

Osteosarcoma: a case report.

Although osteosarcoma of the head and neck is a relatively rare disease, it is a highly malignant bone tumor. Diagnosis of the tumor is important especially in early stages for improving prognosis. The patients with orofacial pain firstly prefer to go to dentists. Such kind of pain may be associated with an oral or maxillofacial cancer. The dentists must be careful for evaluating the clinical and radiologic clues. These clues determine the biopsy necessity, type and management plan. The aim of this case presentation is to emphasize the importance of dentists on diagnosis and prognosis of oral malignancies.

The Prevalence of Carotid Artery Calcification on the Panoramic Radiographs in Cappadocia RegionPopulation.

OBJECTIVES: The aim of this study is to determine retrospectively the presence of carotid artery calcifications (CACs) detected on panoramic radiographs (PRs) in a group of Turkish population. Further, the relationships between CACs and gender, life style, and medical history were evaluated. METHODS: During the years 2004 to 2006, a random sample of 1282 PRs was collected from patients older than 40 years who were being treated by the School of Dentistry, Erciyes University. Of these 1282 PRs, 750 PRs were included in this study. Medical data was collected from the archival records of the dental school. RESULTS: About 38 (5.06%) CACs were found on the PRs of 12 (4.5%) males and 26 (5.4%) females. The CAC prevalence was not significantly different between the males and females (P=0.583). These calcifications were unilateral in 26 (68.4%) and bilateral in 12 (31.6%) subjects. Of those in the positive group, there were 12 subjects (31.58%) with hyperlipidemia, 12 subjects (31.58%) with hypertension, 7 subjects (18.4%) with diabetes mellitus, 6 subjects (15.8%) with cardiovascular disease, and 6 subjects (15.8%) with smoking history. CONCLUSIONS: This study has the highest CACs prevalence in comparison to the other studies. Therefore, dentists caring for subjects with dental problems should carefully evaluate their PRs for the evidence of CACs, and refer them for medical evaluation as indicated. So, incidental findings could provide life-saving information.

Correlation of different MRI characteristics of anterior disc displacement with reduction and without reduction.

The aim of this study was to evaluate the correlations between magnetic resonance imaging (MRI) findings in anterior displacement with reduction (ADDR) and anterior displacement without reduction (ADDWR). Two hundred patients with temporomandibular disorder (TMD) symptoms were examined clinically by a clinician experienced with this disorder. There were 130 joints with ADDR and 45 joints with ADDWR; 88 patients were identified according to the clinical and MRI diagnoses of both observers. The MRI characteristics such as position, signal intensity, morphology of disc, degenerative changes, effusion, scar tissue, avascular necrosis, and condylar hypermobility were evaluated in the individual with ADDR and ADDWR. The Chi-square test was used to determine the correlation between MRI characteristics in the ADDR and the ADDWR. There were significant relationships between degenerative changes and increased signal intensity, degenerative changes and side-way displacement, effusion and the deformation of the disc, effusion and subluxation, increased signal intensity and subluxation, elongation deformation and increased signal intensity, and elongation deformation and side-way displacement in ADDR. There were significant relationships between degenerative changes and effusion, degenerative changes and decreased signal intensity, scar tissue and avascular necrosis, deformation of disc and increased signal intensity, as well as deformation of disc and decreased signal intensity in ADDWR. These MRI findings also correlated with the clinical findings, however, this correlation appears to be a synergistic pattern rather than a set of clear-cut relationships. The correlations between these MRIs and different clinical findings such as pain and dysfunction also must be evaluated. Existing correlations must be considered in the diagnosis and treatment planning of TMD, and signs and symptoms of TMD should be monitored after treatment.