Classification of alveolar bone destruction patterns on maxillary molars by using cone-beam computed tomography.

OBJECTIVE: The defective diagnosis of alveolar structures is one of most serious handicaps when assessing available periodontal treatment options for the prevention of tooth loss. The aim of this research was to classify alveolar bone defects in the maxillary molar region which is a challenging area for dental implant applications. To our knowledge, this is the first study of periodontal bone defect prevalence by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: In this study, the remaining alveolar bone patterns of 669 maxillary molars of 243 patients with periodontal bone loss were investigated on four aspects and the furcation areas of teeth, and then they were classified into six main groups. Combined periodontal-endodontic lesions (CPELs) were also reported in another category. RESULTS: Following exclusion of 39 (5.8%) teeth with CPEL, the most common group was horizontal bone defects (71.4%) and the least seen group was three-walled vertical bone defects (1.9%) in all alveolar bone sides of teeth. Osseous crater was found at the rate of 6.7% on interdental alveolar bone. Dehiscence and fenestration were detected at rates of 2.7% and 3.3%, respectively. In the assessment of furcation areas, there was no furcation involvement in 61.4% of all teeth and the rate of Grade-II involvements was 26.2%. CONCLUSIONS: The most appropriate treatment option may be decided through accurate imaging of periodontal defect morphology. CBCT can provide comprehensive information about the remaining alveolar bone structures. In this way, the need for dental implant can be prevented in many cases and be replaced with a more conservative approach on the maxillary molar region.

Clinical and radiographic evaluation of double teeth in primary dentition and associated anomalies in the permanent successors.

OBJECTIVE: Understanding potential problems associated with primary double teeth (PDT) are important to provide prophylactic measures, thereby preventing or minimizing possible complications. The purposes of this study were to investigate the prevalence of PDT in a group of Turkish children and to compare the distribution of the different types of double primary teeth and their relationship to permanent successors. MATERIALS AND METHODS: A total of 17,268 children underwent a clinical examination to determine the presence of PDT. One hundred fifty-two PDT of 128 children were included in this study. All the 128 children with PDT underwent a clinical examination and had photographs taken at the time of the examination. The children underwent a further periapical or panoramic radiographic examination to determine the status of the underlying permanent successors. The PDT was classified according to Aguilo's classification. RESULTS: The prevalence of PDT was 0.74%, with no significant statistical difference between the sexes. PDT was most frequently observed between the mandibular lateral incisors and canines. Of the 152 PDT, 10.7% were Type I, 15.3% were Type II, 26.1% were Type III, and 47.9% were Type IV. Dental anomalies on the succedaneous permanent teeth were diagnosed in 69.4% of the children with affected primary dentition. Aplasia of the permanent lateral incisor was observed most frequently in association with Type I (52.7%) PDT. Caries involvement was observed most frequently in Type III (56.2%) PDT. CONCLUSION: The findings of this study have clinical relevance for the diagnosis of children with PDT. Early clinical and radiographic identification of PDT can help the clinician to evaluate the number and condition of permanent successors and draw up a proper treatment plan.

A survey of ponticulus posticus: Radiological analysis of atlas in an orthodontic population based on cone-beam computed tomography.

BACKGROUND: The ponticulus posticus (PP; Latin for little posterior bridge) has become an important anomaly of the atlas, as the use of the C1 lateral mass screw has become common in treating atlantoaxial instability. AIM: The purpose of this study was to retrospectively determine the prevalence and morphologic characteristics of PP in an orthodontic patient population using cervical three-dimensional (3-D) cone beam computed tomography (CBCT) images. MATERIAL AND METHODS: A retrospective study was conducted by selecting cervical 3-D CBCT images of 374 adolescent population and examining them for the presence and type of PP. RESULTS: 161 patients with 298 complete or partial or bilateral or unilateral PPs were identified based on the 374 cervical 3-D CBCT scans. The prevalence of posticulus ponticus was founded 43.04% in adolescent population. CONCLUSION: Our results show that the presence of this anomaly should be carefully examined using preoperative lateral radiographs before lateral mass screw placement. If a PP is suspected or confirmed on radiographs, 3-D CBCT scanning should be considered before lateral mass screw placement into the posterior arch because of the variation in the size and shape of PPs and the possibility of injury.

Maxillary dental anomalies in patients with cleft lip and palate: a cone beam computed tomography study.

OBJECTIVE: To compare the frequency of maxillary dental anomalies in patients affected by unilateral (UCLP) and bilateral (BCLP) cleft lip with palate and to determine whether statistical differences were present or not between cleft and normal sides in UCLP group by using cone beam computed tomography (CBCT). In addition, the frequency of those dental anomalies was compared with previous studies presenting the same population without cleft Study Design: Fifty non-syndromic patients affected by UCLP (28 patients) and BCLP (22 patients) were selected for analysis of dental anomalies by means of CBCT. The frequency of maxillary dental anomalies including tooth agenesis, microdontia of lateral incisor, ectopic eruption and impaction of canine and supernumerary tooth were examined. Pearson chi-square and Fisher's exact tests were performed for statistical comparisons. RESULTS: All patients affected by UCLP and BCLP were found to have at least one maxillary dental anomaly. The most frequently observed dental anomaly was tooth agenesis (92.5% and 86.4%, respectively) in UCLP and BCLP groups. Tooth agenesis and canine impaction were observed more commonly in the cleft side (75.0% and 35.7%, respectively) than in the normal side (57.1% and 14.3%, respectively) in UCLP group (p≯0.05). All dental anomalies were found to be higher in both cleft groups than in general populations not affected by cleft. CONCLUSION: Since patients affected by UCLP and BCLP had at least one dental anomaly and higher dental anomaly frequency as compared to patients without cleft, those patients should be examined carefully prior to orthodontic treatment.

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.

Comparison of chemotherapy and hematopoietic stem cell transplantation pre and postterm DMFT scores: a preliminary study.

AIMS: Chemotherapy is frequently used as a conditioning regimen to destroy malignant marrow cells before transplantation. Xerostomia, dysphagia, altered taste perception, mucositis, soft-tissue ulceration, and infection are common adverse oral effects of chemotherapy. The study was aimed to compare decayed, missing, filled teeth (DMFT) scores before and after hematopoietic stem cell transplantation (HSCT) and chemotherapy. MATERIALS AND METHODS: Thirty-six patients undergoing HSCT were included in the study. A pre-HSCT dental treatment protocol was implemented that consisted of restoration of all active carious lesions, treatment of periodontal infections, and extraction of all teeth with advanced periodontal disease. Upon completion of dental treatment, the importance of rigorous and effective oral hygiene was reemphasized, and patients were recalled 6 months later. DMFT scores were calculated prior to the initiation of HSCT treatment and 6 months after transplantation. STATISTICAL ANALYSIS USED: Regression analysis was used to evaluate the effects of HSCT and chemotherapy on DMFT scores. RESULTS: Wilcoxon T test showed a statistically significant difference in DMFT scores before and after HSCT ( P < 0.001). CONCLUSIONS: DMFT scores were found to increase after chemotherapy and HSCT, suggesting that the risk of infection is higher among HSCT patients when compared to other individuals. The results emphasize the need for dental examinations as an integral part of examination and treatment planning for patients undergoing HSCT and chemotherapy.

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.

The prevalence of pulp stones in a Turkish population. A radiographic survey.

OBJECTIVES: The goal of this retrospective study was to determine the prevalence of pulp stones in a Turkish population. Any possible associations between pulp stones and gender, tooth type and dental arch were also evaluated. STUDY DESIGN: Four hundred and sixty nine patients' bitewing radiographs which were reached through the patient database of Erciyes University Dentistry School, Department of Oral Diagnosis and Radiology were examined. Of these 469 subjects whose mean age was 24( ± 10.7), 302 were females and 167 were males. A total of 6,926 teeth were examined during this study. Pulp stones were recorded as present or absent and any relations with gender, tooth type and dental arch were noted. RESULTS: Pulp stones were identified in 270 (57.6 %) of the subjects and in 1,038 (15 %) of the teeth examined. Their presence were seldom found in the premolars (9.07%) but was much higher in the molars (90.92 %). Pulp stone occurrence was significantly more common in the first molars than in the second molars, and in the first premolars than in the second premolars in each dental arch. Their occurrence was higher in the maxilla than in the mandible for each tooth type. No difference between the two genders could be identified. CONCLUSION: Pulp stones are not only incidental radiographic findings of the pulp tissue but may also be an indicator of some serious underlying disease. On the other hand, they may provide useful information to predict about the susceptibility of patients for other dystrophic soft tissue calcifications such as urinary calculi and calcified atheromas. However, further study on this issue is needed.

An unusual case of multilocular Stafne bone cavity.

Stafne bone defects (SBDs) are asymptomatic lingual bone depressions of the lower jaw that are frequently caused by soft-tissue inclusion. The common variant of SBD exists at the third molar region of the mandible below the inferior dental canal is an and ovoid-shaped homogeneous well-defined radiolucency. In this report, an unusual occurrence of SBD with multilocular appearance is presented. Asymptomatic lingual bone defects may represent various radiographic features. Detailed radiographic evaluation with CT scans should be performed to differentiate SBDs from other pathologies.

Tetrafid mandibular condyle: a unique case report and review of the literature.

Morphological changes such as bifid and trifid mandibular condyle are rare entities. The aim of the present report is to describe a unique morphological variation of the mandibular condyle which has four separate condylar heads (tetrafid mandibular condyle) and to discuss clinical and radiological differential diagnosis of tetrafid mandibular condyle with advanced imaging techniques.