Evaluation of Clinical and Oral Findings in Patients with Epidermolysis bullosa.

Introduction: Epidermolysis bullosa (EB) is a genetically inherited disease characterized by recurrent bullae and erosions on the skin with numerous signs of dental caries and poor oral hygiene. The aim of this study was to investigate the general clinical and oral findings of patients with EB. Materials and Methods: In this prospective study, the clinical and oral findings and family history of 26 cases with EB were evaluated. The type of EB, gender, age, parental consanguinity, dental caries, oral findings, distribution of lesions and presence of associated anomalies, clinical and oral findings correlated with gender were recorded. Results: All 26 patients with EB had a history of consanguinity and siblings with EB to varying degrees. In our study, malnutrition, anemia and growth retardation, gastrointestinal system complications, hair thinning, hand and nail deformity, ocular problems and renal disease (in one case) were observed with variable frequencies. When the intraoral findings of the patients were investigated, extensive dental caries in all EB types, enamel hypoplasia in junctional EB (JEB) and the presence of tooth-root to be extracted in dystrophic EB (DEB), intraoral bullae and lesions, ankyloglossia, vestibular sulcus insufficiency, microstomia and maxillary atrophy were observed. Three cases had restorative treatment and one case had prosthetic rehabilitation. Conclusions: Oral involvement can be seen with varying frequencies depending on the type of EB and the severity of the disease. It may result from delayed oral and dental rehabilitation due to physical disabilities, limitations and more pressing medical problems. Microstomy, pain from mucosal lesions, and restricted access to the mouth can be caused by poor oral hygiene. Oral complications and caloric needs of individuals with EB should be determined, and individual prophylaxis should be applied to prevent caries formation and protect teeth.

Can the Density of Mineralized Dental Tissues (Dentin and Enamel) Be Measured and Compared with 3D Cone Beam Computed Tomography in Cases of Ectodermal Dysplasia?

BACKGROUND Since 3-dimensional cone beam computed tomography (CBCT) started to be used in dentistry, mineral density can now be examined with computer software from the data on the images obtained. Detailed and clear images at different slice intervals can be obtained with CBCT, and mineral density can be measured from the image data on a computer with a Hounsfield unit (HU) scale. In addition to the broad opportunities presented by CBCT, this feature has presented a wider perspective to researchers. MATERIAL AND METHODS In this study, the CBCT images obtained from patients with the genetic disorder of ectodermal dysplasia were compared with the images of a control group to determine differences in mineralization of the teeth and to show that these could be compared by measuring the mineral density of dentin and enamel tissues using the HU scale on data from CBCT images. This opens new opportunities for cognitive and implementation research. RESULTS In the study, CBCT images of 14 ectodermal dysplasia and 14 control group cases previously obtained for various reasons were used. Mineral density measurements were made from 4 different regions of the teeth of the ectodermal dysplasia and control groups (incisor edge of the crown, the center buccal, cervicale line, and apex of the teeth), and the groups were compared. CONCLUSIONS The aim of this study was to provide a new overview of the feasibility and suitability of mineralization measurement of dentin and enamel dental tissues with CBCT in ectodermal dysplasia and control groups.

Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT.

AIM: Sinus maxillaris is an important anatomical formation in many branches of dentistry due to its proximity to the field of work. Various methods have been used in literature to measure the maxillary sinus volume (MSV) such as cadavers, stereology, two-dimensional conventional radiographs, computed tomography (CT), magnetic resonance imaging (MRI). The aim of this study is to evaluate the change of maxillary sinus volume according to age and gender with MIMICS 19.0 (Materialise HQ Technologielaan, Leuven, Belgium) which is one of three-dimensional modeling software. MATERIALS AND METHODS: This study was performed in 200 patients selected by a retrospective review of the archives of the Dicle University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology. Patients were divided into five age groups (18-24 years, 25-34 years, 35-44 years, 45-54 years, and ≥ 55 years) and by sex. Cone-beam computed tomography (CBCT) images of the patients were transferred to the MIMICS software and the MSV was measured. All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software. RESULTS: There was no statistically significant difference between the right and left maxillary sinus volume according to the findings obtained from our study, and maxillary sinus volume in males was found to be significantly higher than that of females. Another finding of our study is that the maxillary sinus volume decreases with age increase. Especially it was also found that the sinus volume in males in the 18-24 age group was statistically significantly higher than females. CONCLUSION: Consequently, maxillary sinus volume measurements can be made on CT, CBCT, MRI scans using reconstruction software.

Assessment of Bone Conduction Thresholds After Surgical Treatment in Patients with Labyrinthine Fistula.

OBJECTIVE: This study aimed to analyze the bone conduction thresholds before and after surgery in chronic otitis media patients with cholesteatoma who had labyrinthine fistula and whose cholesteatoma matrix had been completely cleaned. METHODS: The study was performed between 2013 to 2017 with 23 chronic otitis media patients who had labyrinthine fistula with cholesteatoma and who were operated at the Department of Otorhinolaryngology of Dicle University School of Medicine. Patients were assessed by anamnesis and examination and when necessary, by temporal computerized tomography and diffusion magnetic resonance imaging. Bone conduction thresholds at frequencies of 500, 1000, 2000, and 4000 Hz were determined by audiometric examination and they were compared before and after surgery. RESULTS: Of the 23 patients, 12 were female and 11 were male; their age range was 10-55 (26.04±14.13) years. In the post-operative period, it was possible to conduct audiological follow-up on 20 patients. In these follow-ups, 16 patients showed no change in bone conduction thresholds, two patients showed worsening, and two showed improvement. When pre- and post-operative bone conduction thresholds at each frequency were compared separately, no significant difference was found (p=0.937). No statistically significant difference was found between the pre- and post-operative means at the four frequencies (p=0.712). CONCLUSION: In this study, we found that to reduce complications relating to cholesteatoma, it might be necessary to completely remove the matrix especially in the case of type 1 and 2 labyrinthine fistulas.

Maxillary Cortical Bone Thickness in a South-Eastern Anatolian Population: A Cone-Beam Computed Tomography Study.

BACKGROUND The aim of this study was to measure the distance between the maxillary premolar and molar teeth apices to the buccal cortical bone and evaluate differences in gender and age group, using cone beam computed tomography (CBCT). MATERIAL AND METHODS This retrospective study comprised of 451 premolar and molar teeth of one hundred and thirteen patients who were admitted to Dicle University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology for different reasons. Data were analyzed using Student's t-tests and Tukey HSD tests. RESULTS There was significant difference in buccal bone thickness by gender (p<0.05). The thinnest point of the maxillary buccal bone was measured in women as 2.11 mm and in men as 2.02 mm in the first premolar teeth. The thickest point of maxillary buccal bone was measured in women as 9.87 mm and in men 10.71 mm palatinal root of the first molar. A comparison of buccal bone thickness between age showed a statistically significant difference at the distobuccal and palatinal roots of the first molar, at the mesiobuccal root of the second molar (p<0.05). CONCLUSIONS The measurements of maxillar buccal bone thickness using CBCT for various dental procedures especially in endodontic surgery, orthodontic mini implant treatment, dental implant procedures, and healing after tooth extraction that are important knowledge.

Effect of electromagnetic fields and antioxidants on the trace element content of rat teeth.

The purpose of this study was to examine the possible effect of extremely low-frequency electromagnetic fields (ELF-EMFs), from a high-voltage source, on rat teeth in terms of changes in trace elements (TEs) and the effect of antioxidants (melatonin [MLT] and Ganoderma lucidum [GL]) in counteracting these effects. We used adult male Wistar albino rats with a mean weight of 250-300 g and divided the rats into eight groups. The groups were subjected to an ELF-EMF that was applied with a high-voltage line for 8 hours/day for 26 days (Groups I, II, and III) or 52 days (Groups V, VI, and VII). Groups IV and VIII were the 26- and 52-day control/sham groups, respectively. Groups II and VI were treated with GL, and Groups III and VII were treated with MLT. MLT and GL were administered daily based on the weight of the animals and appropriate standards. At the end of the study, the rats were euthanized, and their anterior teeth were extracted. The teeth were preserved in pure water before evaluating the major TEs. At the end of the study, TE concentrations (in mg/kg) were assessed in the control and test groups. Compared with Group V, statistically significant differences in the concentrations of zinc (Zn) and strontium (Sr) were found for Group VII (ELF-EMF + MLT) (P<0.05). Therefore, ELF-EMF exposure can change the content of certain TEs in teeth and, after administering MLT and GL, the values of some of the TEs return to normal.

An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases.

BACKGROUND: This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clinical examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. MATERIAL AND METHODS: In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. RESULTS: The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. CONCLUSIONS: Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved.

The relationship between pneumatized middle turbinate and the anterior ethmoid roof dimensions: a radiologic study.

The development of pneumatized middle turbinate may affect anterior ethmoid roof formation. The aim of this study was to investigate the relationship between the pneumatized middle turbinate and the dimensions of the anterior skull base structures using computed tomography scans. The coronal reconstructed images of the computed tomography scans were evaluated retrospectively. The lateral and medial ethmoid roof points, the width of the cribriform plate (CP), and the anterior ethmoid roof were identified at the first coronal cut, which was determined by the infraorbital nerve. The pneumatized middle turbinates were measured on the axial, vertical, and sagittal planes. The images of 101 patients were evaluated. The mean axial diameters of the pneumatized middle turbinate on the right and left sides were between 6.93 and 4.95 mm, respectively. The correlation between the axial diameters of the pneumatized middle turbinate and the width of the anterior ethmoid roof (termed AER width) was significant for both sides and gender (p < 0.05). There was a higher correlation on the right side where the pneumatized middle turbinate was observed more frequently (r = 0.357). The relationship between CP width and the diameters of the pneumatized middle turbinate was not significant (p > 0.05) for both sides. Iatrogenic lesions of the skull base occur predominantly in the lateral lamella of the CP. The risk of this complication may decrease with increasing of the AER width. Pneumatized middle turbinate may cause an increase in the width of the anterior ethmoid roof and provide more reliable endoscopic intervention of the anterior skull base and frontal sinus.

Patient-specific factors in the proximity of the inferior alveolar nerve to the tooth apex.

OBJECTIVES: To evaluate whether age and gender differences are predictive factors for inferior alveolar nerve position with respect to mandibular first molar roots. STUDY DESIGN: Cone-beam computed tomography scans [0.2-mm3 voxel size; n = 200 (100 males, 100 females)] of patients aged 15-65 years showing mandibular first and second molars were included in this study. Patients with pathoses that might affect inferior alveolar nerve position, including second molar and/or first premolar extraction, were excluded. Fourteen measurements (mm) were taken from the inferior alveolar nerve to the mesial and distal root apices. Subjects were grouped by age and gender. Data were analysed using two-way analyses of variance with post hoc Bonferroni corrections. RESULTS: The distance from the inferior alveolar nerve to the root apices was smaller in females than males, regardless of age (p < 0.01). Distal roots were closer to the nerve than mesial roots in both genders (p < 0.05). Total buccolingual mandibular length (at 3-mm apical level) was shorter in females than males (p < 0.01) but mean buccolingual mandibular width at the level of the inferior alveolar canal did not differ. Nerve-root apex distances were significantly shorter in males and females aged 16-25 and 56-65 years than in other age groups (p < 0.01). CONCLUSIONS: The distance between inferior alveolar nerve and mandibular first molar roots depends upon the age and gender: it is shorter in females than in males and in subjects aged 16-25 years and >55 years than in other age groups.

An evaluation of preoperative computed tomography on patients with chronic otitis media.

This study aimed to compare the veracity of computed tomography findings on patients undergoing surgery for chronic otitis media (COM) with the surgical findings, and to determine to what extent the preoperative computerized tomography (CT) findings are useful to the surgeon. A series of 56 patients with COM undergoing preoperative CT scanning followed by surgical exploration of the middle ear and mastoid. Operative notes were recorded and data collected on the nature of soft tissue masses, the status of the ossicles, presence or absence of facial canal dehiscence and semicircular canal (SCC) dehiscence and the presence or absence of dural plate erosion, and sigmoid sinus thrombosis. Fifty-six patients were recruited in the study, 30 males and 26 females. The age range was from 16 to 67 years with a mean of 26.51 ± 1.4 years. The preoperative CT scan imaging in cases of cholesteatoma, ossicular chain erosion and SCC dehiscence have good correlation with the intraoperative findings. The specificity of preoperative CT scan in detecting facial canal dehiscence, dural plate erosion and sigmoid sinus thrombosis in patient of COM were weak. Preoperative computed tomography evaluation is fairly useful especially in cases of cholesteatoma. According to the results of this study, CT is of value particularly in the definition of cholesteatoma, and in determining ossicular chain erosion and semicircular canal fistula.

Measuring bone density in healing periapical lesions by using cone beam computed tomography: a clinical investigation.

INTRODUCTION: Differences in bone density before and after endodontic treatment were examined in teeth with periapical lesions in Hounsfield units (HUs) by using cone beam computed tomography (CBCT). METHODS: Sixteen patients requiring endodontic treatment for periapical lesions underwent CBCT scan before and after treatment. Their bone densities were calculated in HUs. The study included 16 lesions measuring 8-10 mm in diameter. HU measurements were taken from an area of 2.25 mm(2) on the CBCT images where the bone density was lowest, before and after treatment. RESULTS: The initial and final measurements were compared statistically by using paired samples statistics at the 5% significance level. CONCLUSIONS: The results of this study support the use of CBCT to measure bone density before and after endodontic treatment.

Effectiveness of ethylenediaminetetraacetic acid (EDTA) and MTAD on debris and smear layer removal using a self-adjusting file.

OBJECTIVE: The aim of this study was to investigate the cleaning ability of a self-adjusting file (SAF) system regarding debris and smear layer removal using ethylenediaminetetraacetic acid (EDTA) or MTAD. STUDY DESIGN: In total, 45 maxillary incisor teeth were randomly divided into 2 different irrigation groups of 20 canals each and a negative control group of 5 canals. The canals in each of the irrigation groups were irrigated using sodium hypochlorite (1.3%) as an initial irrigant during the first 2 minutes of operation, followed by 2 minutes continuous irrigation with either 17% EDTA or MTAD in a closed system. The negative control group was irrigated using 1.3% sodium hypochlorite. The roots were split longitudinally and subjected to scanning electron microscopy (SEM). The presence of debris and smear layer in the coronal, middle, and apical thirds of the canal was evaluated using a 5-grade scoring system with ×200 and ×2,000 magnification, respectively. RESULTS: The SAF operation with 2-minute continuous irrigation using MTAD resulted in root canal walls that were free of smear layer in 85%, 70%, and 60% and of debris in 95%, 90%, and 95% of the coronal, middle, and apical thirds of the root canals, respectively. The SAF operation with continuous irrigation using EDTA resulted in root canal walls that were free of smear layer in 85%, 60%, and 50% and of debris in 95%, 90%, and 85% of the coronal, middle, and apical thirds of the root canals, respectively. Teeth in the negative control group were totally covered with debris. Evaluation by SEM showed no significant difference between the tested irrigants in removing the smear layer and debris among the different regions of the root canal. Both groups were significantly different from the negative control group. CONCLUSIONS: When using the SAF, the protocols used in this study were effective for debridement for all regions of the root canal even for the apical thirds.

Cone-beam dental computerize tomography for evaluating changes of agingin the dimensions central superior incisor root canals

Objectives: Cone-beam dental computerize tomography (CBCT), a noninvasive imaging method, was used to imagethe pulp-dentin complex. Pulp changes histologically with aging. While many studies have investigated thehistological changes in pulp, few studies have focused on the changes in the shape of the root canals. This studyevaluated the changes in the root canals with aging of central superior teeth using CBCT.Study Design: The study examined 100 non-carious maxillary central teeth. These teeth were divided into five groupsaccording to the age of the patients: Group A:15‑24, Group B: 25‑34, Group C: 35‑44, Group D: 45‑54 and Group E: 55years and older. CBCT was used to determine root length, and pulp width at the cervical, apical 1/2, and apical 1/3.Results: On comparing the groups using one-way analysis of variance (ANOVA), the root length did not differ (P >0.05), while the pulp width at the cervical, apical 1/2, and apical 1/3 differed between the groups (P < 0.001).Conclusions: The pulp length did not change with aging, while the pulp width did change. CBCT can be used todetermine the precise root length and width, to prevent iatrogenic exposure of the apex, complementing existingmethods. This will improve the prediction of the prognosis of root canal treatment (AU)

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Extremely low-frequency magnetic field decreased calcium, zinc and magnesium levels in costa of rat.

Electromagnetic field (EMF) can affect cells due to biochemical change followed by a change in level of ions trafficking through membrane. We aimed to investigate possible changes in some elements in costa of rats exposed to long-term extremely low-frequency magnetic field (ELF-MF). Rats were exposed to 100 and 500 µT ELF-MF, which are the safety standards of public and occupational exposure for 2 h/day during 10 months. At the end of the exposure period, the samples of costa were taken from the rats exposed to ELF-MF and sham. The levels of elements were measured by using atomic absorption spectrophotometry (AAS) and ultraviolet (UV) spectrophotometry. Ca levels decreased in the ELF-500 exposure group in comparison to sham group (p < 0.05). Statistically significant decrease was found in Mg levels in the ELF-500 exposure group in comparison to sham and ELF-100 exposure groups (p < 0.05). Zn levels were found to be lower in the ELF-500 exposure group than those in the sham and ELF-100 exposure groups (p < 0.05). No significant differences were determined between groups in terms of the levels of P, Cu and Fe. In conclusion, it can be maintained that long-term ELF-MF exposure can affect the chemical structure and metabolism of bone by changing the levels of some important elements such as Ca, Zn and Mg in rats.

Cone-beam dental computerized tomography for evaluating changes of aging in the dimensions central superior incisor root canals.

OBJECTIVES: Cone-beam dental computerize tomography (CBCT), a noninvasive imaging method, was used to image the pulp-dentin complex. Pulp changes histologically with aging. While many studies have investigated the histological changes in pulp, few studies have focused on the changes in the shape of the root canals. This study evaluated the changes in the root canals with aging of central superior teeth using CBCT. STUDY DESIGN: The study examined 100 non-carious maxillary central teeth. These teeth were divided into five groups according to the age of the patients: Group A:15-24, Group B: 25-34, Group C: 35-44, Group D: 45-54 and Group E: 55 years and older. CBCT was used to determine root length, and pulp width at the cervical, apical 1/2, and apical 1/3. RESULTS: On comparing the groups using one-way analysis of variance (ANOVA), the root length did not differ (P>0.05), while the pulp width at the cervical, apical 1/2, and apical 1/3 differed between the groups (P<0.001). CONCLUSIONS: The pulp length did not change with aging, while the pulp width did change. CBCT can be used to determine the precise root length and width, to prevent iatrogenic exposure of the apex, complementing existing methods. This will improve the prediction of the prognosis of root canal treatment.

Intermaxillary Bolton tooth size discrepancies among different malocclusion groups.

The orthodontic "finishing" phase is recognized for the many details necessary to accomplish an excellent result. A high percentage of finishing-phase difficulties arise because of tooth size imbalances that could have been discovered and considered during the initial diagnosis and treatment planning. The aim of our study was to determine whether there is a prevalent tendency for intermaxillary tooth size discrepancies among different malocclusion groups. This study involved 60 subjects who served as the normal occlusion group and 300 patients divided into five malocclusion groups (ie, Class I, Class II, Class II division 1, Class II division 2, and Class III). Tooth size measurements were performed on the models of the normal occlusion group and the pretreatment models of the patients. The tooth size ratios and the one-way analysis of variance test showed no sexual dimorphism for these ratios in each of five groups, so the sexes were combined for each group. Then, these ratios were compared among different malocclusion groups. The results showed no significant difference between subcategories of malocclusion, so these groups were combined as Class I, Class II, and Class III. No significant difference was found for all the ratios between the groups.

Determination of osteoporosis risk factors using a multiple logistic regression model in postmenopausal Turkish women.

OBJECTIVE: To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. METHODS: We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. RESULTS: We classified 80.1% (281/351) of the participants using the regression model. Furthermore, the specificity value of the model was 67% (84/126) of the control group while the sensitivity value was 88% (197/225) of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test (p=0.193). The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. CONCLUSION: Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation.

Potential atherogenic roles of lipids, lipoprotein(a) and lipid peroxidation in preeclampsia.

AIMS: To evaluate changes in lipid profile, serum levels of malondialdehyde (MDA) and lipoprotein(a) (Lp(a)) and placental MDA in preeclamptic women, and to evaluate the atherogenic role of these changes in the pathophysiology of pre-eclampsia. METHOD: A cross-sectional study was performed in 20 normal pregnant women, 25 women with mild preeclampsia and 28 women with severe preeclampsia in the third trimester. MDA, which is the endproduct of lipid peroxidation, was measured in placental tissue by the thiobarbituric acid (TBA) method of Ohkawa and colleagues and in serum by the TBA method of Asakawa and Matsushita. Serum lipid levels were measured by with an autoanalyzer, serum apolipoprotein (Apo) A-I and Apo B were measured by nephelometric assay and serum Lp(a) level using a nephelometric agglutination assay method. In preeclamptic and normal pregnant women, multiple comparisons between groups were performed by one-way analysis of variance supplemented with Tukey's HSD post hoc test. The association between placental and serum concentrations among groups was analyzed using the Pearson correlation test. RESULTS: Serum levels of MDA, Lp(a), total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and placental MDA were significantly higher, and high-density lipoprotein cholesterol (HDL-C) and Apo A-I levels were significantly lower, in severely preeclamptic and mildly preeclamptic women than in the normal pregnant women, but no difference was observed in Apo B among groups. Serum level of Lp(a) was positively correlated with body mass index in severely preeclamptic women (r=0.489, p=0.008). A significant positive correlation was also found between serum level of MDA and systolic blood pressure in women with severe preeclampsia (r=0.375, p=0.049). CONCLUSIONS: Our findings suggest that high Lp(a), lipid peroxidation, LDL-C and TG, and low HDL-C and Apo A-I levels, are important risk factors for atherosclerosis among preeclamptic women.

Effects of extracorporeal shock-wave lithotripsy on intrarenal resistive index.

OBJECTIVE: This prospective study was performed to determine whether extracorporeal shock-wave lithotripsy (ESWL), widely used for treating renal and ureteral stones, affects the kidney interlobar artery resistive index (RI). MATERIAL AND METHODS: A total of 43 patients (30 with renal and 13 with ureteral stones) underwent color Doppler examination before and 30 min and 3 h after ESWL. Seventeen patients with renal and nine with ureteral stones underwent Doppler examination 2 weeks later. Measurements were made near the stones (nearby region), at least 2 cm from the stones (remote region) and in the contralateral kidney for renal stones, and in the ipsilateral and contralateral kidneys for ureteral stones. RESULTS: In patients with renal stones, the RI was increased 30 min and 3 h after ESWL in the nearby and remote regions, and more markedly in the former. In the contralateral kidney, there was an increase in RI only at 3 h, which was less than that in the ipsilateral kidney. The RI at 2 weeks post-ESWL in the nearby region and contralateral kidney did not differ from the pre-ESWL values. ESWL performed for ureteral stones caused no increase in RI in the ipsilateral kidney. CONCLUSION: Patients with renal stones had a temporary increase in RI in the hours following ESWL in both the ipsilateral and contralateral kidneys, which was highest in the region near the stones and lowest in the contralateral kidney. Two weeks later, the RI in both areas had returned to pre-ESWL levels.