Panoramic Radiography in the Evaluation of the Relationship of Maxillary Molar Teeth and Maxillary Sinuses on the Deep Learning Models Improved with the Findings Obtained by Cone Beam Computed Tomography.

BACKGROUND: Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used. AIM: The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT). METHODS: A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods. RESULTS: DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively. CONCLUSION: DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.

Evaluation of localisation of mandibular foramen in patients with mandibular third molar teeth using cone-beam computed tomography.

BACKGROUND: It is important to know the correct anatomical location of the mandibular foramen to obtain successful anaesthesia of inferior alveolar nerve and to prevent injury to the mandibular vessels and nerve, during a variety of oral and maxillofacial surgical procedures. The aim of this study is to evaluate localisation of the mandibular foramen in patients with the third molars using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Cone-beam computed tomography was used to determine the location of the mandibular foramen in 67 patients (totally 99 sides) with unilateral or bilateral impacted mandibular third molars. RESULTS: The distance from the posterior border of the mandibular ramus to mandibular foramen did not differ significantly among the other angulations. But the difference between vertical and horizontal angulation of the impacted mandibular third molars according to 'fd' values (the shortest distance between mandibular foramen and the posterior border of mandibular ramus) was found to be statistically significant (p < 0.05). CONCLUSIONS: The present study provides new information to the literature concerning relationship between the location of the mandibular foramen and the mandibular third molars.

Ponticulus posticus in a cohort of orthodontic children and adolescent patients with different sagittal skeletal anomalies: a comparative cone beam computed tomography investigation.

BACKGROUND: The objective of this study was to evaluate the prevalence and characteristics of ponticulus posticus (PP) in groups with sagittal skeletal anomalies in a Turkish population using cone beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 181 CBCT images were evaluated according to gender, side and characteristics of PP in the three different sagittal skeletal groups. RESULTS: The average age of the patients was 13.88 ± 2.99 years (ranging 8-18 years). The study population consisted of 104 (57.5%) females and 77 (42.5%) males. PP was detected in 66 (36.5%) patients. Unilateral and bilateral PP was identified in 29 (43.9%) and 37 (56.1%) patients, respectively. The prevalence of PP in the atlas vertebrae was found to be higher in males than in females and this was statistically significant (p ≤ 0.05). PP was most frequently detected in class III patients (25, 13.8%). Statistically significant differences between the different sagittal skeletal groups were observed (p ≤ 0.05). CONCLUSIONS: Ponticulus posticus is a common anomaly in Turkish populations and is associated with different sagittal skeletal patterns. The highest frequency of PP was found in angle class III patients. (Folia Morphol 2018; 77, 1: 65-71).

Ultrasonography in the evaluation of the mid-palatal suture in rapid palatal expansion.

OBJECTIVES: Orthodontists usually evaluate the mid-palatal sutural opening with occlusal radiography. The purpose of this article is to evaluate the sutural opening with ultrasonography (USG) in a series of patients undergoing rapid palatal expansion (RPE). METHODS: The study included 87 USG images and 87 occlusal radiographs from 29 healthy patients (mean age, 13.9 years; range, 11-20 years; boys, 12; girls, 17) who required RPE treatment. The sutural opening was assessed with USG, and the amount of sutural expansion as mesiodistal length was measured immediately after appliance practice (T0), 10 turns (T1) and 20 turns (T2) during the expansion period. Sutural expansion evaluated by occlusal radiographs was scored at every stage. Measurements obtained by USG and scores observed in the occlusal radiographs were compared by non-parametric Kendall's tau test. RESULTS: Both USG and radiographic images revealed normal anatomical structure during pre-expansion (stage T0). On USG, sutural expansion was seen in 19 patients at stage T1. There was no expansion at this stage in ten patients. At stage T2, on USG and radiography, an increase in the amount of expansion was observed in 19 patients with sutural expansion at stage T1 and sutural expansion was observed in 5 patients without sutural expansion at stage T1. No expansion was observed at both stages T1 and T2 in five patients. USG measurements and occlusal scores in both T1 and T2 turns showed statistically significant correlation (p < 0.001). CONCLUSIONS: The results indicate that USG might be a useful method to assess mid-palatal sutural opening in patients undergoing RPE.

Identification of the mandibular landmarks in a pediatric population.

OBJECTIVE: The aim of this study was to determine and compare the reliability to accomplish of common mandibular landmarks and to determine the incidence of incisive canals, anterior looping, and lingual foramina in children from panoramic and CBCT images. DESIGN: Panoramic and CBCT images from 100 children and adolescent patients were randomly selected. In order to grade the visibility of mandibular anatomical landmarks, a four-point rating scale was used. RESULTS: In panoramic images, the mandibular canal could be observed in 92.5% of cases, with good visibility in 12.0%. The mental foramen could be observed in 44.5% of cases, while none had good visibility. Anterior looping of the mental nerve was present in 16.5% of the cases, and none had good visibility. An incisive canal could be identified in 22.5% of cases, with only 1.5% showing good visibility. The lingual foramen could be visualized in 61.0% of cases, with good visibility in 6%. In CBCT images, the mandibular canal, the mental foramen, and the lingual foramen could be observed in 100% of the cases, with good visibility in 51.0%, 98.5%, and 45.0% of cases, respectively. Anterior looping of the mental nerve was present in 26% of cases, with 2% having good visibility. An incisive canal could be identified in 49.5% of cases, with only 75% showing good visibility. CONCLUSIONS: This study confirms the applicability of CBCT images to visualize critical structures in children.

Prevalence and intra-oral distribution of agenesis of permanent teeth among Eastern Turkish children.

AIM: The aim of this study was to describe agenesis of permanent teeth, excluding the third molars, in a sample of children in Eastern Turkey. MATERIALS AND METHODS: This retrospective study assessed 1,291 digital orthopantomograms (OPT) (678 males and 613 females), taken at the Faculty of Dentistry, Ataturk University, Erzurum. The chi-square test was used to compare maxillary and mandibular hypodontia in males and females. RESULTS: Eighty children were found to have at least one tooth absent from their permanent set of teeth. The prevalence of tooth agenesis was 6.2%. A total of 135 permanent teeth were missing as a result of the congenital condition. Tooth agenesis was found more frequently in females than in males. Although there was no significant difference between genders in the prevalence of hypodontia among the children (p>0.05), the difference between genders in children who had congenitally missing teeth (CMT) reached a statistically significant level (p<0.05). CONCLUSION: When hypodontia in a Turkish paediatric population was compared to other populations, the characteristics were found to be similar to the Western population. However, the population in Eastern Turkey differs from the population in Asia, where there is less incisor tooth agenesis and more second molar tooth agenesis.

Radiographic evaluation on prevalence of Stafne bone defect: a study from two centres in Turkey.

OBJECTIVES: The aim of this study was to investigate the frequency of Stafne bone defect (SBD) and to describe the clinical and radiological characteristics of detected cases. METHODS: A retrospective study was performed using panoramic radiographs from 34 221 patients undergoing dental treatment in the Department of Oral and Maxillofacial Radiology at Erciyes University and Ataturk University, Turkey. After finding an image compatible with SBD in the radiographs, multislice CT (MSCT) on seven patients and cone beam CT (CBCT) on six patients were performed to confirm the diagnosis. RESULTS: Of the 34 221 patients, 29 (0.08 %) had SBDs, of whom 4 were female (13.8%) and 25 were male (86.2 %). The age range of patients with SBD was 18-77 years (mean age 49.6 years). SBD was found in the lingual molar region in 28 patients and in the lingual canine-premolar region of the mandible in 1 patient. The contour of the concavities on CT images (MSCT and CBCT) was detected. The MSCT revealed glandular tissue within the defects. CONCLUSIONS: According to our results, SBD is an uncommon anomaly. Examination of MSCT images supports the presence of aberrant submandibular glands within these mandibular defects, suggesting that pressure from submandibular gland tissue had caused the SBD, as generally thought. Both CBCT and MSCT can provide adequate support for the detection of SBDs. The CBCT could be suggested as the most suitable non-invasive diagnostic modality for this bony configuration of the mandible since it provides a lower radiation exposure dose than MSCT.

Pneumatization of the articular eminence on cone beam computed tomography: prevalence, characteristics and a review of the literature.

OBJECTIVES: The aim of this study was to determine the prevalence and characteristics of pneumatized articular eminence (PAT) by cone beam CT (CBCT) and to present a review of the PAT literature. METHODS: A retrospective study was performed using sagittal and coronal CBCT images of 514 patients in the Department of Oral and Maxillofacial Radiology, Ataturk University, Turkey. Age and gender were recorded for all patients and, for the cases of PAT, laterality and types were also recorded. The χ(2) test was used. RESULTS: Of the 514 patients, 41 (8.0%) had PAT, of whom 25 were female (61.0%) and 16 were male (39.0%). This difference was not statistically significant (P > 0.05). The age range of the patients with PAT was 15-62 years (mean 30.6 ± 11.4). Of the 41 patients, 31 (75.6%) had unilateral and 10 (24.4%) had bilateral PAT. 17 (41.5%) PATs were unilocular and 24 (58.5%) were multilocular. CONCLUSIONS: It is possible that PAT is a more frequent condition than is commonly perceived. In differential diagnosis of suspected cases or in cases for which surgical treatment is planned, panoramic radiographs should be supplemented with CBCT.

The frequency of bifid mandibular condyle in a Turkish patient population.

OBJECTIVE: The objective of this study was to investigate the frequency and pattern of bifid mandibular condyles (BMCs). METHODS: A retrospective study was performed using panoramic radiographs from 10 200 patients undergoing dental treatment in the Department of Oral and Maxillofacial Radiology (Erzurum, Turkey) between 1996 and 2008. RESULTS: Of the 10 200 patients, 32 (0.3%) had BMCs, of whom 17 were female (53.1%) and 15 were male (46.9%). The age range of the patients with BMCs was 5 to 71 years (mean age 30.0+/-0.40). Of these 32 patients, 24 (75.0%) had unilateral and 8 (25.0%) had bilateral BMCs, none of the patients had a history of trauma. No symptoms associated with bifid condyles were observed in any of the patients with BMCs. CONCLUSIONS: It is possible that BMC is a more frequent condition than is commonly perceived. However, because of the minimal symptoms associated with this condition, the authors believe that it will remain an incidental finding upon routine radiographic examination, rather than a clinical observation. Nevertheless, in symptomatic cases or in cases where surgical treatment is planned, panoramic radiographs should be supplemented with CT.

Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography.

OBJECTIVE: The purpose of this study was to compare the sensitivity for detecting foreign bodies among conventional plain radiography, CT and ultrasonography in in vitro models. METHODS: Seven different materials were selected as foreign bodies with dimensions of approximately 1 x 1 x 0.1 cm. These materials were metal, glass, wood, stone, acrylic, graphite and Bakelite. These foreign bodies were placed into a sheep's head between the corpus mandible and muscle, in the tongue and in the maxillary sinus. Conventional plain radiography, CT and ultrasonography imaging methods were compared to investigate their sensitivity for detecting these foreign bodies. RESULTS: Metal, glass and stone can be detected with all the visualization techniques used in the study in all of the zones. In contrast to this, foreign bodies with low radiopacity, which could be detected in air with CT, became less visible or almost invisible in muscle tissue and between bone and muscle tissue. The performance of ultrasonography for visualizing foreign bodies with low radiopacity is relatively better than CT. CONCLUSIONS: Ultrasonography detects and localizes superficial foreign bodies with low radiopacity in the tissues of the body more effectively than CT and conventional plain radiography. However, CT is a more effective technique for visualization of foreign bodies in air than ultrasound and conventional plain radiography.

Dentigerous cyst associated with an ectopic tooth in the maxillary sinus: a report of 3 cases and review of the literature.

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. Dentigerous cysts surrounding impacted teeth often displace teeth into ectopic positions. In the maxilla, these teeth are often displaced into the maxillary sinus. We report 3 cases of dentigerous cysts associated with an ectopic tooth in the maxillary sinus and review the literature reports of this condition over the past 29 years.

Dental panoramic radiography in the diagnosis of osteoporosis.

Osteoporosis is common in the elderly and the dentist is often the only healthcare professional that they visit regularly. Since dental panoramic radiographs (DPRs) are widely used for routine examinations when planning treatment, this study evaluated whether the presence of osteoporosis might be apparent in a population of patients who underwent DPR. The mandibular cortical index (MCI) and a new method of measuring the mandibular radiographic density (m-RD), which used DPR that incorporated an aluminium step-wedge, were compared with the total vertebral bone mineral density (v-BMD) of the lumbar vertebrae measured using dual energy X-ray absorptiometry (DXA) in 25 osteoporotic women. Although there was only a weak correlation between m-RD and v-BMD, significant correlation was found between MCI and v-BMD. Since both m-RD and MCI were related to vBMD, dental radiographic density and MCI may be useful in clinical dental practice to identify osteoporotic women with previously undetected low BMD.

Oxidative stress and myeloperoxidase levels in saliva of patients with recurrent aphthous stomatitis.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is the most common oral ulcerative condition affecting 5-25% of the general population. The aim of this study was to evaluate the oxidative stress parameters in saliva of patients with RAS and to investigate the relationship among these parameters in either group. MATERIALS AND METHODS: The study involved 50 patients with RAS of whom 24 were male and 26 were female, and 25 healthy controls of whom 13 were male and 12 were female. RESULTS: There was no statistically significant difference in the salivary total antioxidant capacity, total oxidant status, oxidative stress index levels, and myeloperoxidase activity between patients with RAS and those in the control group. CONCLUSIONS: The results show that reactive oxygen species may not play a role in the etiology of RAS.