Correlations with clinical and radiologic findings and prevalence of osteopenia/osteoporosis in the patients with bilateral temporomandibular joint osteoarthritis.

This study aimed to evaluate the prevalence of osteopenia/osteoporosis in patients with bilateral temporomandibular joint osteoarthritis (TMJ-OA) and its correlations with clinical and radiological findings. A total of 95 patients with bilateral TMJ-OA diagnosed by CBCT were included in the study. Clinical and radiological findings and bone mineral density (BMD) scores were recorded. Descriptive statistics and the Spearman rho correlation tests were performed. Osteopenia/osteoporosis was found in 44 of 95 patients (46.32 %) (30, osteopenia; 14 osteoporosis). Osteopenia/osteoporosis is significantly associated with postmenopausal status and age over 40 years, but it is not associated with clinical and radiological findings of TMJ-OA. Patients with bilateral TMJ-OA have a high prevalence of osteopenia/osteoporosis.

An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube.

OBJECTIVES: To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). MATERIALS AND METHODS: The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. RESULTS: In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P > .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P < .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). CONCLUSIONS: The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.

Cone Beam Computed Tomography Assessment of Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate Alone or in Combination with Platelet-Rich Plasma: A Randomized Clinical Trial.

PURPOSE: The aim of this study was to evaluate and compare the long-term clinical and radiographic outcomes between a bone graft substitute mixture (beta-tricalcium phosphate [ß-TCP] and plateletrich plasma [PRP]) and ß-TCP bone graft substitute alone used for sinus floor elevation. MATERIALS AND METHODS: This randomized clinical trial included patients with an atrophic maxilla referred for maxillary sinus floor elevation. The elevated sinus cavities of patients were randomly filled with ß-TCP plus PRP (study group) or ß-TCP alone (control group). Residual bone crest height, vertical bone height gain, and bone graft resorption were measured on cone beam computed tomography (CBCT) images at 10 days and 6 months postoperatively. Incidence of sinus membrane perforations and maxillary sinus infections were recorded. Paired t and Student t tests were used for intragroup and intergroup comparisons, respectively. RESULTS: The sample was composed of 18 subjects: nine subjects in the control group (mean age, 31.51 years) and nine subjects in the study group (mean age, 34.01 years). The mean residual bone crest height was found to be < 5 mm in both groups (4.88 mm in the control group and 2.70 mm in the study group, with no significant difference). From the 10-day to 6-month postoperative visit, mean vertical bone height gains were changed from 12.48 to 11.59 mm in the study group and from 14.77 to 13.19 mm in the control group, with no significant difference. The mean vertical bone graft resorption was -1.58 mm in the study group and -0.89 mm in the control group, with no significant difference. Sinus membrane perforation was observed in 3 of 18 patients. CONCLUSION: In this study, PRP plus ß-TCP graft substitute did not produce significantly more vertical bone height gain or significantly less vertical bone graft resorption compared with ß-TCP graft substitute alone. Within the limitations of this study, however, it can be concluded that both grafting materials produced sufficient vertical bone height gain for safe implant placement.

Rapid maxillary expansion versus middle ear tube placement: Comparison of hearing improvements in children with resistance otitis media with effusion.

OBJECTIVE: To test the null hypothesis that there are significant differences in hearing improvements of children with resistance otitis media with effusion (OME) who undergo a rapid maxillary expansion (RME) procedure or ventilation tube placement. METHODS: Forty-two children between 4.5 and 15 years old were divided into three groups: RME, ventilation tube, and control groups. The RME group consisted of 15 children with maxillary constriction and resistance OME that indicated ventilation tube placement. The ventilation tube group consisted of 16 children for whom ventilation tube placement was indicated but no maxillary constriction. The control group consisted of 11 children with no orthodontic and/or rhinologic problems. Hearing thresholds were evaluated with three audiometric records: (1) before RME/ventilation tube placement (T0); (2) after RME/ventilation tube placement (T1), and (3) after an observation period of 10 months (T2). The control group was matched to these periods, except T1. RESULTS: Hearing thresholds decreased significantly in both the RME and ventilation tube groups (P < .001). Hearing thresholds decreased approximately 15 and 17 decibels in the RME and ventilation tube groups, respectively, but differences in improvements were insignificant between the two study groups (P > .05). Slight changes were observed in the control groups. CONCLUSION: The null hypothesis was rejected. RME showed similar effects as ventilation tube placement for release of otitis media and improvement of hearing thresholds levels. RME should be preferred as a first treatment option for children with maxillary constriction and resistance OME.

Facial asymmetry in subjects with class III malocclusion.

BACKGROUND: Facial skeletal asymmetries in Class III subjects seeking orthognathic surgery may complicate subsequent treatment. OBJECTIVE: The purpose of this study was to investigate facial asymmetry in orthognathic surgery patients with Class III malocclusion. METHODS: The Class III group consisted of 29 orthognathic surgery patients 114 female, 15 male; Mean age: 21.44 years) with Class III malocclusions. The Control group consisted of 32 subjects (16 female, 16 male; Mean age: 19.20 years) with excellent Class I occlusal relationships. Facial skeletal asymmetry, based on the skeletal midline, was measured on posteroanterior radiographs. In the Class III group, the chin point deviated to the ipsilateral side. The side-to-side and between group differences were compared. RESULTS: In the Class III group, the antegonial notch--skeletal midline distance was significantly larger (p < 0.05) and menton-antegonial notch distance was significantly different (p < 0.05). There were no statistically significant differences between the right and left side measurements in the Control group. Between-group comparisons showed that subjects in the Class III group had greater skeletal asymmetries in lower face. In 78 per cent of the subjects in the Class III group the chin point was displaced more than 2 mm to one side. CONCLUSIONS: Subjects with Class III malocclusion may have facial skeletal asymmetries, predominantly in the lower face. Frontal asymmetries should be considered during diagnosis and treatment planning.