The quality of root canal treatment and periapical status of permanent teeth in Turkish children and teens: a retrospective CBCT study.

OBJECTIVE: This study aimed to assess the quality of root canal fillings and the prevalence of periapical radiolucencies in the permanent teeth of 6-18 year-old Turkish children. METHODS: CBCT images of 150 patients' 235 teeth with a mean age of 16.0 ± 2.06 years were included. Root development stage, quality of root canal filling, the presence and severity of periapical radiolucencies, and their relationship with anatomical structures were recorded. Correlations between the quality of root canal filling, periapical lesion, and lesion size were assessed using regression analyses. RESULTS: A total of 235 teeth (528 root canals) were evaluated. 65.5% of root canals had periapical lesions. Immature roots and mandibular teeth had the highest prevalence and the largest size of periapical radiolucencies (p < 0.05). Overfilling (n = 52), underfilling (n = 93), unfilled (n = 46), inhomogeneously filled (n = 113) root canals and poor coronal restoration (n = 85 teeth) were observed in terms of technical failures of endodontic treatment. The quality of endodontic treatment was associated with the presence of periapical lesion and lesion size (p < 0.05). Teeth with under-filled, overfilled or inhomogeneously filled root canals and poor coronal restoration had a periapical lesion larger than 5 mm (p < 0.05). Immature teeth were most associated with the presence of lesion (OR = 4.07) and the lesion size > 5 mm (OR = 3.71). CONCLUSION: The prevalence of periapical radiolucencies in young permanent teeth showed an increase when the tooth was an incisor, had incomplete root development, or the root filling had technical errors.

Assessment of dental anxiety levels among dental emergency patients during the COVID­19 pandemic through the Modified Dental Anxiety Scale.

BACKGROUND: Coronavirus disease 2019 (COVID­19) continues to affect dental emergency services worldwide. Dental anxiety (DA) is described as a common and distressing problem in terms of oral health maintenance. OBJECTIVES: The present study aimed to evaluate DA levels as well as the COVID­19 fear and perception of control (COVID­19 FPC) in patients attending dental emergency clinics during the COVID­19 pandemic. MATERIAL AND METHODS: Sociodemographic, dental and medical data was obtained from the participants. A face-to-face questionnaire with questions referring to the reasons for the emergency dental visit, the visual pain scale, the Modified Dental Anxiety Scale (MDAS), and the COVID­19 Fear and Perception of Control Scale (COVID­19 FPCS) as well as additional questions concerning bruxism and a previous diagnosis of anxiety/panic attacks or depression was administered. The χ2 test was used to analyze the data. RESULTS: A total of 1,439 patients were included in the study. The most common reason for the dental visit was pain (47.5%). The prevalence of DA was 5.1% (74/1,439). A significant association was found between DA and gender (p = 0.020). The incidence of severe pain was higher in patients with DA than in those without DA (p = 0.002). No significant differences in the MDAS scores were found between patients with and without a chronic disease (p = 0.804), with regard to the educational status (p = 0.364), or between the age groups (p = 0.600). The prevalence of a 'strongly agree' response to all questions in COVID­19 FPCS was higher in patients with DA as compared to those without DA. CONCLUSIONS: Females and patients with severe pain were more likely to exhibit DA. In general, patients with DA strongly agreed with the statements of COVID­19 FPCS, which may indicate a correlation between the 2 scales.

Invasive squamous cell carcinoma arising in an inverted papilloma involving oral cavity.

Inverted papilloma (IP) is a benign tumour characterized by the growth of epithelial cells downward into the underlying supportive tissue. The tumour derives from the lining mucosa of the nasal cavity and paranasal sinuses. IP typically arises as a unilateral lesion from the lateral wall of the nasal cavity and extends secondarily to the paranasal sinuses. The aggressive behaviour of IP causing local invasion, its tendency for local recurrence, and its propensity to be associated with carcinoma constitute serious complications. This paper describes a very rare case of IP associated with squamous cell carcinoma, extending into paranasal sinuses, causing destruction of the bony wall of maxillary sinus and involvement of the oral cavity.

Evaluation of radiomorphometric indices and bone findings on panoramic images in patients with scleroderma.

OBJECTIVES: The aim of this study was to make radiomorphometric measurements on panoramic images and evaluate the radiologic findings of bones and teeth in patients with scleroderma. STUDY DESIGN: Panoramic images of 49 patients with scleroderma and 51 healthy controls were assessed. Mandibular radiomorphometric indices, including mandibular cortical index (MCI), mental index (MI), panoramic mandibular index (PMI), gonial index (GI), and antegonial index (AI), were determined. Furthermore, mandibular osteolysis, changes of periodontal ligament (PDL) space and changes in the lamina dura were recorded for the scleroderma group. RESULTS: Statistically significant differences were found for MCI (P = .003), MI (P = .001), and PMI (P < .001) between the scleroderma and control groups, but not for GI or AI (P > .05). Widening of the PDL space (79.6%), thickening of the lamina dura (44.9%), limited mouth opening (71.4%), and osseous resorption of the mandible (8%) were detected in the scleroderma group. CONCLUSIONS: The radiomorphometric indices determined in the present study can be used on panoramic images to identify the existence of a porous structure in the mandibular cortical bone in patients with scleroderma. The most common prevalent oral radiographic manifestations of scleroderma were widening of the PDL space and of the lamina dura.

Oral health status in patients with mucopolysaccharidoses.

Ballikaya E, Eymirli PS, Yildiz Y, Avcu N, Sivri HS, Uzamis-Tekçiçek M. Oral health status in patients with mucopolysaccharidoses. Turk J Pediatr 2018; 60: 400-406. The aim of this study is to assess oral clinical and radiological findings of patients with mucopolysaccharidoses (MPS) which are a group of rare inherited disorders of glycosaminoglycan catabolism. In this retrospective and descriptive study, records of all patients with MPS over 3 years of age managed at Division of Pediatric Metabolism, who were all referred to Department of Pediatric Dentistry for evaluation of their oral health status were assessed. Oral examinations were performed in 30 patients with determination of DMFT/S, dmft/s, dental plaque and gingival indices and panoramic radiological assessment was performed in 12 patients. Twenty-seven (90.0%) patients had dental caries and 19/21 (90.5%) had gingival inflammation. Radiological examination in 12 patients with panoramic image showed short mandibular ramus (100.0%), enlarged dental follicles (83.3%), taurodontism (75.0%), flat mandibular notch (66.7%). In association with the bone structure and morphology of the jaws, 11 patients (91.7%) had trabecular variation similar to osteoporotic disease. Condylar defect was observed in all patients, which might lead to temporomandibular joint disorders. Pulp chamber with three horns, which had never been reported in MPS before, was observed in panoramic images of 2 of 7 patients with MPS-VI. Oral clinical and radiological changes are very common in this population of MPS patients. These changes may impair opening of the mouth, eating and chewing and thus affect their quality of life. Regular dental counseling, preventive applications and dental treatments must be included in multidisciplinary team approach of MPS patients to provide better oral health.

Investigation of hemorheological parameters in periodontal diseases.

Periodontal diseases are frequently associated with cardiovascular diseases (CVD). On the other hand, occurrence of CVD has also been related with increased blood viscosity. This study was planned to investigate four main hemorheological parameters contributing to blood viscosity - hematocrit, erythrocyte deformability, erythrocyte aggregation and plasma viscosity - and also some biochemical parameters (hs-CRP, fibrinogen, globulin etc.) in patients with periodontal disease. We hypothesized that poor periodontal health would be associated with deterioration of hemorheological properties. According to periodontal health status, subjects were divided into three groups as control (healthy), with plaque induced gingivitis and with chronic periodontitis. All groups included 15 males who had not received periodontal therapy in the last six months before the study, were non-smokers, had no systemic diseases and were not on any medication. Erythrocyte deformability and erythrocyte aggregation were measured with laser-assisted optical rotational cell analyzer (LORCA). Plasma viscosity was measured by a cone-plate viscometer. Data were analyzed with Kruskal-Wallis, Mann-Whitney U Test and Spearman Correlation Coefficient. Plasma viscosity (1.36 ± 0.01 mPa.s in the control group and 1.43 ± 0.02 mPa.s in the chronic periodontitis group, P <  0.01), erythrocyte aggregation tendency (aggregation index, amplitude and t½ were 58.82 ± 1.78% , 20.22 ± 0.40 au, 2.80 ± 0.25 s respectively in the control group, and 67.05 ± 1.47% , 22.19 ± 0.50 au, 1.84 ± 0.15 s in the chronic periodontitis group, P <  0.01), hs-CRP, fibrinogen and globulin levels were significantly higher, whereas HDL level was significantly lower in the chronic periodontitis group (P <  0.05) compared to the control group. All of these conditions may contribute to cardiovascular morbidity and mortality observed in people with periodontal disease, via increasing blood viscosity.

Evaluation of the fungiform papillae number in Behçet's disease.

OBJECTIVES: The aim of this study was to evaluate the number, area, circumference, and circularity of lingual fungiform papillae and taste sensitivity in Behçet's disease (BD) and the correlation with the disease. MATERIALS AND METHODS: Eighty-six Behçet's patients and 78 healthy control subjects were examined. After taking digital photographs from the tongue, the fungiform papillae evaluations were performed for the right and left tongue tip sites separately. Taste sense was evaluated with an electrogustometer (EG) from the same sites. RESULTS: The ANOVA test was used to evaluate the fungiform papillae number difference between BD and control groups, and the difference was statistically significant. The fungiform papillae number was significantly reduced in BD, 37.93% at the left site and 40.13% at the right site compared to controls. There was no significant difference in papillae area, circumference, circularity, and EG measurements between BD and control group. CONCLUSION: According to these findings, it is conceivable that the reduction of the fungiform papillae number could be a sign of BD. CLINICAL RELEVANCE: BD has different clinical features that are used for the diagnosis. This study provided a new possible clinical feature. Further studies should be carried out to investigate the usability of this new clinical feature for the diagnosis of BD.

Evaluation of the radiopacity of different root canal sealers.

OBJECTIVE: The aims of this study were to compare the radiopacity of 8 root canal sealers relative to gutta-percha and dentin in standard discs and to evaluate the effect of these sealers on the radiopacity of root canal fillings in simulated canals. STUDY DESIGN: Radiographs were taken of 1-mm-thick specimens of 8 root canal sealers (Diaket, Endion, MTA, Endofil, Roeko Seal, Sealite, AH26, AH Plus) and gutta-percha, a 1-mm-thick human tooth slice, and aluminum stepwedge.Simulated canals were used to evaluate the effect of the sealer on radiopacity of the root fillings. After enlargement of the simulated canals with ProTaper instrument, root canals were filled with these 8 sealers alone and with single ProTaper gutta-percha cone. Radiographs of all filled simulated canals were taken with an aluminum stepwedge. RESULTS: All the sealers demonstrated greater radiopacity than dentin (0.7940 mm Al) (P < .001). AH Plus showed the highest radiopacity in the standard disc group (Group 1) (8.9881 mm Al) (P < .001), and in the sealer group in simulated canals (Group 2) (9.2100 mm Al) (P < .001). In the sealer plus gutta-percha group in simulated canals (Group 3), Sealite plus gutta-percha showed greater radiopacity (8.4460 mm Al) (P < .001). CONCLUSION: Whether the opacity of the sealers alone is more or less than 3 mm Al, their radiopacity is increased when they are used in combination with gutta-percha, because of its higher radiopacity. However, when sealers are used in conjunction with gutta-percha, they can affect the radiopacity of the root canal filling according to their type and thickness.

Cranio-orbital-temporal neurofibromatosis with cerebral hemiatrophy presenting as an intraoral mass: a case report.

Neurofibromatosis, NF, is a group of genetic disorders that primarily affect the cell growth of neural tissues. Cranio-orbital-temporal neurofibromatosis is an uncommon subtype of neurofibromatosis characterized by neurofibromas, cranial defects, and specific bone lesions. This case report presents the signs of cranial defects in a 24-year-old Caucasian woman with type 1 NF. Mandibular malformations due to NF and dental defects caused by intraoral masses and radiographic images are presented.

Spontaneously healed root fractures: two case reports.

We report on two undiagnosed horizontal root fractures of two maxillary right central incisors in two different patients caused by dental trauma which occurred several years ago. These fractures were discovered during a routine full-mouth radiographic examination. While, in case one, the fracture was located in the middle-third of the root, it was in the cervical-third of the root in case two. The fractured teeth were observed to have healed spontaneously without any sign or symptom, and tested as vital to electric pulp test.

Cytotoxic effects of four different endodontic materials in human periodontal ligament fibroblasts.

The purpose of this study was to compare the cytotoxicity, induced apoptosis and/or necrosis, and apoptotic mechanisms in human periodontal ligament (PDL) fibroblasts treated with four different endodontic materials: White ProRoot mineral trioxide aggregate (MTA) (MTA/Dentsply; Tulsa Dental, Memphis, TN), Diaket (ESPE, Seefeld, Germany), Endion (VOCO, Cuxhaven, Germany), and CYMED 8410 (NANO, Kaohsiung, Taiwan). The effects of these four materials on the viability of PDL fibroblasts were determined by MTT (3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-SH-tetrazolium bromide) assay. Apoptotic pathways were evaluated via several mechanisms. Exposure to MTA for 24, 48, and 72 hours resulted in no significant differences in MTT reduction and viable cell number compared with controls. However, treatment of PDL fibroblasts with Diaket, Endion, and CYMED 8410 for 24, 48, and 72 hours resulted in cytotoxicity with MTT and a reduction of viable cell number with trypan blue dye exclusion test compared with controls (from p < 0.05 to p < 0.001). Annexin V-FITC/PI staining showed that Diaket, Endion, and CYMED 8410 induced higher percentages of apoptosis and/or necrosis than in controls (45.6%, 25.5%, and 6.3%, respectively). Results of cell-cycle analyses were concordant with annexin V-FITC/PI staining findings. These results suggest that MTA is a very biocompatible filling material. However, Diaket, Endion, and CYMED 8410 are toxic to PDL fibroblasts in vitro. The main form of cell death induced by these filling materials was determined to be apoptosis and/or necrosis.

Mandibular lateral incisor-canine transposition associated with dental anomalies.

Tooth transposition is a rare positional anomaly that may create many orthodontic problems. Its etiology is an enigma. The occurrence of mandibular canine/lateral incisor transposition is a relatively rare anomaly. Two rooted canine/rotated incisor transposition has not been reported previously in the clinical dental literature. We describe a case with transposition of a mandibular two rooted canine and a lateral incisor with 180 degrees rotation. Possible causes such as trauma and tooth agenesis were absent in this case. Due to the root anomaly, we consider that our case may have a genetic etiology. Although the mandibular lateral incisor and canine were not in their normal anatomic positions, there were no functional or esthetic problems.

Oral findings and health status among hospitalized patients with physical disabilities, aged 60 or above.

The purpose of the study was to determine oral health status and the prevalence of oral mucosal lesions among hospitalized elderly patients with physical disabilities. The study group consisted of 111 (43 male and 68 female) elderly patients with physical disabilities. Clinical examination and interview methods were employed. Clinical examination revealed that 45.9% of the elderly patients had one or more oral mucosal lesions. Xerostomia (58.6%), coated-hairy tongue (54.1%) and halitosis (46.8%) were the most frequently encountered oral findings and mucosal lesions. As the most interesting finding discovered in elderly patients, macroglossia (30.6%) seems to depend on physical disability. Coated or hairy tongue was commonly related to poor oral hygiene, with both crude odds ratio (OR) of 3.25 (95% CI: 1.26-8.36) (P=0.021) and the logistic regression OR of 3.36 (95% CI: 1.21-9.33) (P=0.020). Halitosis and bruxism were commonly related to dentate patients [logistic regression OR of 0.29 (95% CI: 1.12-0.74) (P=0.009) and 0.21 (95% CI: 0.06-0.74) (P=0.016); respectively]. Increase in dental problems may have negative impacts on chewing, nutrition, aesthetics and phonation in elderly patients. It is particularly noteworthy that physical disability in elderly patients limits their ability to effectively follow oral hygiene procedures.

Severe hypodontia and asymptomatic bilaterally ectopic impacted teeth in the coronoid processes: a case report.

An asymptomatic case in which severe hypodontia and mandibular ectopic impacted teeth in the coronoid processes are visualized through panoramic radiographs, is presented.