Sequential test selection by quantifying of the reduction in diagnostic uncertainty for the diagnosis of proximal caries.

BACKGROUND: In order to determine the presence or absence of a certain disease, multiple diagnostic tests may be necessary. Performance of these tests can be sequentially evaluated. AIMS: The aim of the study is to determine the contribution of the test in each step, in reducing diagnostic uncertainty when multiple tests are sequentially used for the diagnosis. STUDY DESIGN: Diagnostic accuracy study. METHODS: Radiographs of seventy-three patients of the Department of Dento-Maxillofacial Radiology of Hacettepe University Faculty of Dentistry were assessed. Panoramic (PAN), full mouth intraoral (FM), and bitewing (BW) radiographs were used for the diagnosis of proximal caries in the maxillary and mandibular molar regions. Diagnostic performance of radiography was sequentially evaluated by using the reduction in diagnostic uncertainty. RESULTS: FM provided maximum diagnostic information for ruling in potential in the maxillary and mandibular molar regions in the first step. FM provided more diagnostic information than BW radiographs for ruling in the mandibular region in the second step. In the mandibular region, BW radiographs provided more diagnostic information than FM for ruling out in the first step. CONCLUSION: The presented method in this study provides the clinicians with a solution for the decision of the sequential selection of diagnostic tests for the correct diagnosis of the presence or absence of a certain disease.

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.

An accessory mental foramen: a case report.

AIM: The aim of this article is to present a case of an accessory mental foramen (AMF). BACKGROUND: The mental foramen is an important anatomical structure of particular importance in local anesthesia and surgical procedures in terms of achieving effective mandibular nerve blocks and avoiding injuries to the neurovascular bundles. Although rare, multiple mental foramina have been described in humans. In these cases one foramen is termed the mental foramen and the others are referred to as an AMF. REPORT: A 62-year-old woman presented for a routine dental examination. In addition to the normal radiographic image of the mental foramen, periapical radiographs of the left mandibular premolar and molar region revealed a round-shaped radiolucency with distinct borders along with an inferior extension below the apex of the mesial root of the first molar. This image was considered to be an AMF. SUMMARY: Although no surgical operation was planned, the patient was informed about the existence and importance of the anatomical variation with regard to the need for local anesthesia, diagnosis of periapical disease, and the prevention of nerve damage during surgery in that area of the mandible.

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.

Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation.

OBJECTIVE: This study aimed to compare ultrasonography (US) with magnetic resonance imaging (MRI) with respect to the diagnosis of temporomandibular joint (TMJ) internal derangements. STUDY DESIGN: The study group consisted of 23 patients with a chief complaint of TMJ discomfort who were tentatively diagnosed by means of head-neck examination as having TMJ internal derangements and a control group of 9 volunteers who had no sign of TMJ internal derangements. All the patients were then examined by means of MRI and US. RESULTS: The results showed perfect agreement between MRI and US in the diagnosis of TMJ internal derangements (kappa = 1.000; P =.0001). CONCLUSION: MRI and US can be used to define the disk and its position, as well as the presence of TMJ internal derangements.