Evaluation of anatomical structures and variations in the maxilla and the mandible before dental implant treatment.

BACKGROUND: Cone beam computed tomography (CBCT) allows a detailed visualization of the anatomic structures of the jaw. There have been presented variations of the anatomic structures between genders after evaluating the structures in detail. OBJECTIVES: The aim of this study was to investigate the anatomic variations of the jaws according to gender and age in an effort to avoid complications during implant surgeries. MATERIAL AND METHODS: In this retrospective study, a total of 159 scans (87 of the maxilla, 72 of the mandible) were evaluated in order to analyze the effect of age and gender on these anatomic variations. RESULTS: According to statistical analysis, gender affected the crestal dimensions above the mandibular canal and sinus mucosal thickening. The mean value of the width of the mandibular canal, the distance between the mandibular canal and the superior border of the mandible, the distance between the mandibular canal and the inferior border of the mandible, the diameter of the mental foramen, the distance between the mental foramen and the inferior border of the mandible, and the distance between the lingual foramen and the inferior border of the mandible were significantly greater in female patients than in male subjects (p < 0.001). However, sinus mucosal thickening and the diameter of the posterior superior alveolar artery (PSAA) were significantly greater in males as compared to females (p < 0.001). While the configuration of the nasopalatine canal was funnel-shaped in female patients, this configuration was found to be cylinder-shaped in male subjects. A high prevalence of sinus septa (43.7%) and PSAA (87.4%) was detected in the scans. CONCLUSIONS: When planning dental implants, radiographic examinations, alongside clinical examinations, have become necessary to reduce the risk of implant surgery failure and complications. The CBCT imaging is a valuable tool to determine the anatomic structures before carrying out any surgeries, including implant surgery. Gender affects anatomical variations and dimensions significantly, even when they are not affected by age. Large population focused and multicenter studies may provide a better understanding of the need to evaluate the anatomical structures in detail.

Oxidative Stress and Periodontal Disease in Obesity.

Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women.Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated.Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers.Our results suggest that young obese, otherwise healthy, women show findings of early periodontal disease (gingival inflammation) compared with age-matched healthy lean women, and that local/periodontal oxidative stress generated by obesity seems to be associated with periodontal disease.