Awareness of patients with impacted teeth about impacted teeth in Turkey: A questionnaire study.

Objective: The aim of this study is to evaluate the knowledge and awareness levels of patients who have at least one impacted tooth and who had previously applied to the dentist. Study design: This study was conducted in patients aged 15 years and older who applied to Ordu University Faculty of Dentistry for routine examination and agreed to fill out the questionnaire form. A total of 325 people participated in the survey conducted to determine the awareness of patients applying to the faculty of dentistry about their existing impacted teeth. A Pearson's chi-square test was used for hypothesis testing when expected frequencies exceeded 5. Results: It was determined that 56.9 % (185) of the participants were aware of their existing teeth, while 43.1 % (140) were not aware. When the patients were evaluated according to the institutions they had visited, it was seen that the group who were most aware of the presence of impacted tooth were those who apply to the faculty of dentistry (74.4 %). The rate of being informed by dentists in the institutions that they had previously visited was higher in patients with university or post-university graduates (p < 0.05). The most common information given by the dentists to the patients about their impacted dental problems was that the tooth should be followed up (40.4 %), while the removal of the tooth constituted 28.4 % of the information given. Conclusion: This study showed that although patients are aware of their existing impacted teeth, their level of knowledge about the risks it may pose is low. For a healthy oral care and health, patients should be adequately informed about impacted teeth.

An enhanced tooth segmentation and numbering according to FDI notation in bitewing radiographs.

Bitewing radiographic imaging is an excellent diagnostic tool for detecting caries and restorations that are difficult to view in the mouth, particularly at the molar surfaces. Labeling radiological images by an expert is a labor-intensive, time-consuming, and meticulous process. A deep learning-based approach has been applied in this study so that experts can perform dental analyzes successfully, quickly, and efficiently. Computer-aided applications can now detect teeth and number classes in bitewing radiographic images automatically. In the deep learning-based approach of the study, the neural network has a structure that works according to regions. A region-based automatic segmentation system that segments each tooth using masks to help to assist analysis as given to lessen the effort of experts. To acquire precision and recall on a test dataset, Intersection Over Union value is determined by comparing the model's classified and ground-truth boxes. The chosen IOU value was set to 0.9 to allocate bounding boxes to the class scores. Mask R-CNN is a method that serves as instance segmentation and predicts a pixel-to-pixel segmentation mask when applied to each Region of Interest. The tooth numbering module uses the FDI notation, which is widely used by dentists, to classify and number dental items found as a result of segmentation. According to the experimental results were reached 100% precision and 97.49% mAP value. In the tooth numbering, were obtained 94.35% precision and 91.51% as an mAP value. The performance of the Mask R-CNN method used has been proven by comparing it with other state-of-the-art methods.

Deep-learning approach for caries detection and segmentation on dental bitewing radiographs.

OBJECTIVES: The aim of this study is to recommend an automatic caries detection and segmentation model based on the Convolutional Neural Network (CNN) algorithms in dental bitewing radiographs using VGG-16 and U-Net architecture and evaluate the clinical performance of the model comparing to human observer. METHODS: A total of 621 anonymized bitewing radiographs were used to progress the Artificial Intelligence (AI) system (CranioCatch, Eskisehir, Turkey) for the detection and segmentation of caries lesions. The radiographs were obtained from the Radiology Archive of the Department of Oral and Maxillofacial Radiology of the Faculty of Dentistry of Ordu University. VGG-16 and U-Net implemented with PyTorch models were used for the detection and segmentation of caries lesions, respectively. RESULTS: The sensitivity, precision, and F-measure rates for caries detection and caries segmentation were 0.84, 0.81; 0.84, 0.86; and 0.84, 0.84, respectively. Comparing to 5 different experienced observers and AI models on external radiographic dataset, AI models showed superiority to assistant specialists. CONCLUSION: CNN-based AI algorithms can have the potential to detect and segmentation of dental caries accurately and effectively in bitewing radiographs. AI algorithms based on the deep-learning method have the potential to assist clinicians in routine clinical practice for quickly and reliably detecting the tooth caries. The use of these algorithms in clinical practice can provide to important benefit to physicians as a clinical decision support system in dentistry.

An artificial intelligence proposal to automatic teeth detection and numbering in dental bite-wing radiographs.

OBJECTIVES: Radiological examination has an important place in dental practice, and it is frequently used in intraoral imaging. The correct numbering of teeth on radiographs is a routine practice that takes time for the dentist. This study aimed to propose an automatic detection system for the numbering of teeth in bitewing images using a faster Region-based Convolutional Neural Networks (R-CNN) method. METHODS: The study included 1125 bite-wing radiographs of patients who attended the Faculty of Dentistry of Ordu University from 2018 to 2019. A faster R-CNN an advanced object identification method was used to identify the teeth. The confusion matrix was used as a metric and to evaluate the success of the model. RESULTS: The deep CNN system (CranioCatch, Eskisehir, Turkey) was used to detect and number teeth in bitewing radiographs. Of 715 teeth in 109 bite-wing images, 697 were correctly numbered in the test data set. The F1 score, precision and sensitivity were 0.9515, 0.9293 and 0.9748, respectively. CONCLUSIONS: A CNN approach for the analysis of bitewing images shows promise for detecting and numbering teeth. This method can save dentists time by automatically preparing dental charts.

Cone-Beam Computed Tomography Evaluation of the Eustachian Tube in Patients With Cleft Lip and Palate Compared With Normal Controls.

The authors compared the morphological features of the Eustachian tube (ET) between patients with cleft lip and palate (CL/P) and normal controls using cone-beam computed tomography (CBCT). CBCT images of 51 CL/P patients (28 males and 23 females, mean age: 18.5 ±â€Š8.0 years) and a control group of 52 patients (22 males and 30 females, mean age: 25.23 ±â€Š10.65 years) were retrospectively evaluated. The Eustachian tube angle (ETA), Eustachian tube length (EL), and auditory tube angle (ATA) were measured on CBCT images. The ETA, EL, and ATA in the CL/P and normal control groups were 30.4 ±â€Š6.2 and 36.7 ±â€Š7.5°; 24.7 ±â€Š3.7 and 27.7 ±â€Š4.3 mm; and 142.4 ±â€Š7.8 and 136.3 ±â€Š4.1°, respectively. All between-group differences were statistically significant (all P < 0.05). There were no significant between-gender differences in either group (all P > 0.05). Continuous variables were compared using the Mann-Whitney U-test. The morphological features of the ET, measured via multiplanar reconstruction CBCT, differed between CL/P patients and normal controls. CBCT can be used to evaluate ET morphological features.

Evaluation of radix entomolaris in mandibular first and second molars using cone-beam computed tomography and review of the literature.

OBJECTIVES: The aim of the present study is to identify the prevalence of radix entomolaris in mandibular first and second molars and to determine morphological classifications and associations with other root and canals. METHODS: Mandibular first and second molar teeth of 850 Turkish patients were evaluated using cone-beam computed tomography. A total of 2800 mandibular first molars and second molars were screened. The CBCT examination was performed at five different axial levels. The prevalence of total radix entomolaris, unilateral-bilateral, right-left side and gender distributions, and the classification of radix entomolaris's canal configurations were measured. RESULTS: Radix entomolaris was found in 2.9% (n = 25) of the patients and 1.2% (n = 34) of the teeth. The prevalence of radix entomolaris in mandibular first molars was higher than in mandibular second molars (p < 0.01), in males than in females (p < 0.05) and in right side than left side. An additional tubercle was found in 23% of the teeth with radix entomolaris. For buccolingual orientation, Type A canal variation was the highest and Type C canal variation was the lowest. Regarding locations of cervical parts, Type III canal variation was the highest while Type I canal variation was the lowest. CONCLUSIONS: The prevalence of radix entomolaris was lower in the Turkish population than in other Asian populations but, in multiethnic societies, it needs attention. Before starting endodontic treatment, the clinician should examine the radiography thoroughly and apply advanced radiography methods when necessary. Cone-beam computed tomography is a valuable advanced radiography method for assessing such anatomical variations in vivo.

Comparison of mandibular cortical bone among obese, overweight, and normal weight adolescents using panoramic mandibular index and mental index.

OBJECTIVE: The objective of this study is to evaluate the mental index (MI) and panoramic mandibular index (PMI) of a group of adolescent patients in different body mass index (BMI) percentile. MATERIAL AND METHODS: Subjects were divided into three different groups in accordance to their BMI percentile status: normal weight (35 subjects; mean age, 14.81 ± 2.12 years), overweight (32 subjects; mean age, 14.77 ± 2.56 years), and obese (33 subjects; mean age, 14.06 ± 2.59 years) groups. Mental index (MI) and panoramic mandibular index (PMI) were assessed on panoramic radiographs. RESULTS: There were statistically significant differences in PMI and MI that were observed among groups (p < 0.0001 and p < 0.001, respectivel). MI and PMI are higher in overweight and obese individuals than in normal-weight. CONCLUSIONS: Mandibular cortex was found thicker in patients who are obese and overweight compared to normal weight patients. We can suggest that young obese individuals' bone structure can be take in consideration in orthodontic or dental surgical treatment planning. CLINICAL RELEVANCE: Dense cortical bone may cause some difficulties in orthodontic and surgical treatment. Clinicians should understand obesity and overweight-related jaw bone changes and consider these factors to treat their patients.

Relationship between sella turcica bridging and cephalometric parameters in adolescents and young adults.

OBJECTIVES: Sella turcica bridging occurs with fusion or calcification of the anterior and posterior clinoid processes in the middle cranial region. This study aimed to compare the cephalometric parameters among normal shape, partial bridge, and total bridge of the sella turcica in adolescent and young adult subjects. METHODS: This retrospective study was performed on the lateral cephalometric radiographs of 410 Turkish adolescent and young adult subjects. The subjects were divided into three groups: normal sella turcica shape (128 females, 32 males; mean age: 17.7 ± 1.54 years), partial sella turcica bridge (129 females, 32 males; mean age: 17.8 ± 2.15 years), and total sella turcica bridge (66 females, 23 males; mean age: 18.2 ± 1.82 years). Thirteen angular and eight linear cephalometric measurements were performed using a cephalometric software program. The data were analyzed by one-way analysis of variance, and the Kruskal-Wallis test with the Bonferroni correction. RESULTS: Significant differences were found for Nperp-A distance, Nperp-Pg distance, and palatal plane-to-anterior cranial base angle among the groups (p < 0.016). There were no significant differences in the cephalometric parameters between the partial and total sella turcica bridging groups (p > 0.05). CONCLUSIONS: This study evaluated a large amount of data for cephalometric measurements focusing on the degree of calcification of the sella turcica in adolescent and young adult subjects. The maxilla and mandible were located in a sagittally retrusive position in the partial and total sella turcica bridge subjects compared with the normal sella turcica shape subjects.

Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals.

OBJECTIVE: We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT). METHODS: Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints. RESULTS: The eminence inclination (P < 0.05), eminence height (P < 0.0001), mediolateral width of condyle (P < 0.0001), and anterior joint space (P < 0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P < 0.0001), ratio of anterior joint space to posterior joint space (P < 0.001), posterior joint space (P < 0.05), eminence inclination (P < 0.05), eminence height (P < 0.05), condyle shape (P < 0.0001), and fossa shape (P < 0.05). CONCLUSIONS: As a result of our analysis, we concluded that a low eminence angle may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.

Correction to: Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals.

In the original publication of the article in "Abstract", the sentence that reads as "The present analyses suggest that a steeper articular eminence inclination may be risk factor" should read as "As a result of our analysis, we concluded that a low eminence angle may be risk factor".

Cone beam computed tomography imaging of superior semicircular canal morphology: a retrospective comparison of cleft lip/palate patients and normal controls.

OBJECTIVE: This study evaluated the prevalence and morphological characteristics of the superior semicircular canal (SSCC) in cleft lip and palate (CL/P) patients using cone beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of 53 CL/P patients (28 males and 25 females) and a control group of 76 patients (42 males and 34 females) were evaluated. Retrospectively, 258 temporal bone images from 129 patients were evaluated in terms of SSCC morphology and divided into a normal pattern (0.6-1.7 mm in thickness), a papyraceous pattern (<0.5 mm), a thick pattern (>1.8 mm), a pneumatized pattern and dehiscent. The chi-squared test was used to compare differences among semicircular canal dehiscence (SSCD) patterns in the CL/P and control groups; p ≤ .05 was taken to reflect statistical significance. RESULTS: The characteristics of the SSCC were evaluated on CBCT images in patients with CL/P and controls. In total, 158 (61%) cases were normal (0.6-1.7 mm in thickness), 31 (12%) papyraceous (<0.5 mm), 8 (3%) thick, and 34 (13%) pneumatized. SSCD was observed in 27 (11%) cases. Statistically significant differences between the CL/P and control groups were evident in terms of SSCC morphology (p < .001). CONCLUSIONS: SSCD should be considered if a CL/P patient exhibits a vestibular system deficiency. Oral and maxillofacial radiologists should pay attention to SSCD when interpreting CBCT images. Future studies should use high-level spatial resolution CBCT to focus on cleft site and SSCC morphology in larger patient populations.

Association between frontal sinus morphology and craniofacial parameters: A forensic view.

The aim of this study was to evaluate the morphologic structure of the frontal sinuses with postero-anterior cephalometric radiographs in Turkish adolescents and to compare the findings between genders. The study sample consisted of 148 subjects divided into two groups (74 male subjects; mean age: 14.55 ± 1.42 years-74 female subjects; mean age: 14.95 ± 1.80 years). The right and left maximum height and width of the frontal sinus, maxillary width, nasal width, cranial width, antegonial width parameters were measured in 148 postero-anterior cephalometric radiographs. The data were analyzed using independent t and Mann Whitney U test. Spearman correlation analyses were used to evaluate the relationships of the frontal sinus measurements and transversal cephalometric parameters. The mean values of the right and left frontal sinus width, maxillary width, antegonial width, and cranial width were larger in males than females (P < 0.05). The right frontal sinus height were positively correlated with antegonial width (r = 0.243; P < 0.05) and the right frontal sinus width were positively correlated with antegonial width (r = 0.327; P < 0.01) in males. The right frontal sinus width were positively correlated with nasal width (r = 0.244; P < 0.05) and the left frontal sinus width were positively correlated with nasal width (r = 0.231; P < 0.05) in females. Frontal sinuses were unique to each individual due to their morphological structures, and in forensic science, taking advantage of these features was very important for personal identification.

Morphometric Analysis of Sella Turcica Using Cone Beam Computed Tomography.

OBJECTIVE: The purpose of this study was to assess morphological shape and morphometric analysis of the sella turcica using cone beam computed tomography (CBCT) in different planes of section (coronal and sagittal). MATERIALS AND METHODS: CBCT images of 177 subjects of which 51 males and 126 females in the age group of 11 to 73 years were included in the study population. Linear dimensions which include the length, depth, diameter, and interclinoid distance were measured and the shape of sella turcica was analyzed. RESULTS: Sella turcica had circular morphology in 69.5% of the subjects while flattened shape of sella turcica was observed in 16.4%, oval shape of sella turcica in 14%. There was no significant difference in the all measurements of sella turcica between males and females (P > 0.05). Diameter (P < 0.01), depth (P < 0.001), length (P < 0.05), and interclinoid distance (P < 0.05) of the sella turcica differed significantly with age. CONCLUSIONS: The anatomical structure of sella turcica can be studied effectively in CBCT images. Linear dimensions and shape of sella turcica in the current study can be used as reference standards for further investigations.

Evaluation of Sella Turcica Shape and Dimensions in Cleft Subjects Using Cone-Beam Computed Tomography.

OBJECTIVE: The aim of this study was to assess the morphology of the sella turcica and measure its size in cleft and noncleft subjects. MATERIAL AND METHODS: Cone-beam computed tomography (CBCT) images of 54 individuals (29 males; 25 females) with cleft and 85 (22 males; 63 females) without cleft were used for this study. Syndromic patients with cleft(s) were not included because of possible additional endocrinological and/or morphological disorders. Linear measurements included length, depth, and diameter. The shape of the sella turcica was analyzed in the cleft and noncleft groups. An independent t test was conducted to evaluate differences between genders and groups. One-way ANOVA was used to compare age groups. RESULTS: The length (p < 0.001) of the sella turcica was smaller in noncleft subjects than in cleft subjects. Diameter (p = 0.014) and depth (p = 0.005) showed as constantly increasing from an age <15 to >25 years in the overall assessment. The distribution of the shape of the sella turcica differed significantly between groups (p < 0.001). CONCLUSIONS: In this study, CBCT was used to assess the morphology of the sella turcica. A majority of the subjects with cleft had a flattened sella turcica compared to that of the control group. A shorter length of the sella turcica was more evident in the cleft subjects than in the control group.

Correlation Between Tinnitus and Petrotympanic Fissure Status Among Patients With Temporomandibular Joint Dysfunction.

PURPOSE: The objective of this study was to evaluate the correlation between tinnitus and petrotympanic fissure (PTF) subtypes in patients diagnosed with temporomandibular joint dysfunction (TMD). MATERIALS AND METHODS: One hundred patients with TMD (50 with tinnitus, 50 without tinnitus) were evaluated retrospectively using cone-beam computed tomography (CBCT). CBCT images were analyzed according to PTF subtype diagnosis (types 1 to 3). PTF structure was classified as type 1 (wide tubular formation), type 2 (double conical structure), or type 3 (single conical structure). RESULTS: Although there was a negative correlation between tinnitus and PTF type (P < .001), there was no correlation between age and tinnitus or between age and subtype of PTF. There was no significant association between gender and tinnitus or PTF type (P > .05). CONCLUSIONS: A short, wide PTF (type 1) might be associated with an increased incidence of tinnitus in patients with TMD.

Unilateral bone cavities situated near the angle of the mandibula.

Stafne bone defects (SBDs) are asymptomatic radiolucent lingual/buccal bone lesions of the lower jaw and are frequently caused by soft tissue inclusion. These defects have a cystlike appearance on plain radiographs. The diagnosis of this defect is incidental because patients do not usually present clinical symptoms. The common variant of SBD exists at the third molar region of the mandible below the inferior alveolar canal. To date, only 1 case of multilocular SBD has been reported in the literature, including both clinical cases and archaeological specimens. The purpose of the current study was to describe a new case of multilocular appearance of SBD near the angle of the mandibula that was diagnosed with the aid of a three-dimensional cone beam computed tomographic scan.

Odontogenic tumors: a collaborative study of 218 cases diagnosed over 12 years and comprehensive review of the literature

OBJECTIVES: The objective of this study was to analyze the frequency and distribution of odontogenic tumors (OTs)in the Cappadocia region of Turkey, and to compare the findings with those reported in the literature. Study DESIGN: The records of the Oral and Maxillofacial Surgery and Pathology Departments at Erciyes University, with histologic diagnosis of odontogenic tumors (based on the World Health Organization classification,2005), over a 12-year period, were analyzed. The relative frequency of different types of tumors was also analyzed and compared with the literature. RESULTS: OTs in the present study constituted 2.74% of all the 7,942 registered biopsies. A total of 218 cases of OTs were collected and reviewed. Of these, (94.04%) were benign and (5.96%) were malignant. The mandible was the most commonly affected anatomic location, with 170 cases (77.9%). Ameloblastoma with a predilection for the posterior mandible was the most frequent odontogenic tumor (30.28%), followed by keratocystic odontogenictumor (19.5%), odontoma (13.4%), and odontogenic myxoma (8.5%).CONCLUSIONS: OTs are rare neoplasms and appear to show geographic variations in the world. In Cappadocia, Turkey, they are more common in the mandible, with ameloblastoma followed by keratocystic odontogenic tumors with the incidences observed in the present study being similar to those of previous studies from Asia and Africa, and in contrast to those reported from American countries