Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study.

OBJECTIVE: This retrospective study compared changes in periapical trabecular patterns using fractal analysis and the periapical index (PAI) on the periapical radiographs of patients who underwent multivisit nonsurgical endodontic retreatment of persistent periapical disease. STUDY DESIGN: In total, 50 participants were included in the study. For each patient, baseline periapical radiographs were acquired just before retreatment and postoperative radiographs were acquired 1 year later. The region of interest, located in the abnormal tissue around the root apex, was selected from each of the paired radiographs and the fractal dimension (FD) was calculated. Periapical status was classified using the PAI as "healed" (PAI <3) or "unhealed" (PAI ≥3). RESULTS: According to the PAI scores, retreatment after 1 year had a healing rate of 70%. In healed cases, the FD values increased significantly (P < .001), whereas FD decreased significantly in unhealed cases (P = .021). Change in FD was significantly different between healed and unhealed cases (P < .001). However, change in FD did not have a significant correlation with PAI in either healed or unhealed cases (P > .05). There was no significant effect of sex on the change in FD values in either healed or unhealed cases (P ≥ .690). CONCLUSIONS: The significant differences in FD suggest that this parameter may be useful in detecting increased trabeculation and estimating retreatment prognosis.

Retrospective fractal analyses of one-year follow-up data obtained after single-visit nonsurgical endodontic retreatment on periapical radiographs.

OBJECTIVES: The aim of retrospective study was to evaluate the changes to the periapical bone sites after non-surgical endodontic retreatment by using fractal analysis on periapical radiographs. MATERIALS AND METHODS: Thirty patients whose teeth had periapical lesions and underwent primary endodontic treatment were selected for nonsurgical single-visit endodontic retreatment. Two radiographs were taken, the first immediately after retreatment and the second at the 1-year follow-up. An identical region of interest close to the infected root apex was selected from each radiograph. FD was measured using the box-counting method. Periapical status was evaluated using the periapical index (PAI). Treatment outcomes were categorized into healed (PAI < 3), or not healed (PAI ≥ 3) based on radiographic criteria. RESULTS: The mean FD value significantly increased at the 1-year follow-up compared to baseline. No significant sex biases were apparent. According to the PAI, retreatment after 1 year resulted in a 63.3% healed. CONCLUSION: The extent of periapical trabecular bone evident radiographically increased, as revealed by FD data, 1 year after endodontic retreatment. Clinical relevance The use of fractal analysis as a quantitative method to evaluate changes in periapical trabecular bone (such as healing and inflammation) after endodontic retreatment can be an important marker in determining the prognosis of endodontic retreatment.

Examination of oral hemangiomas by intraoral ultrasonography.

OBJECTIVES: Oral hemangioma is a benign vascular tumor characterized by the presence of numerous blood vessels. We aimed to examine the clinical and ultrasonographic findings of patients diagnosed with oral hemangioma in our ultrasonography (USG) archive, retrospectively. METHODS: This study was conducted by examining 20 patients diagnosed with oral hemangioma and underwent USG examination in the Department of Oral and Maxillofacial Radiology of Atatürk University Faculty of Dentistry from 2016 to 2020. All patients had intraoral and radiographic examinations. Patients pre-diagnosed clinically oral hemangioma were evaluated as intraoral with USG. The intraoral USG examinations were performed using both the B-mode and the color Doppler mode. RESULTS: The mean age of the patients was 42.4 ± 19.14 years; 16 patients were female and four were male. The lesions were mostly observed on the alveolar mucosa (30%), followed by the buccal mucosa (25%), the lower lip (15%), the mouth floor (15%), the tongue (15%). In intraoral USG examinations of all oral hemangiomas, we detected submucosal located, well-defined, lobulated, non-capsule, hypo-isoechoic, heterogeneous lesion areas. Additionally, while we detected only peripheral blood flow in 6 (30%) of 20 patients, we detected both internal and peripheral blood flow in 14 (70%). CONCLUSIONS: In our study, the examination of the oral hemangiomas with the intraoral probe and the color Doppler mode was very helpful in the differential diagnosis. Although histopathology has an important place in definitive diagnosis, particularly intraoral USG can provide sufficient information for the diagnosis of oral hemangiomas.

Evaluation of saliva glutathione, glutathione peroxidase, and malondialdehyde levels in head-neck radiotherapy patients

Background/aim: It is believed that radiotherapy has important effects on oxidant/antioxidant systems. Oxidative stress occurs when the balance between oxidant formation and antioxidant defense is disrupted in favor of oxidants. The aim of this study was to determine the biochemical changes in saliva pre- and postradiotherapy in head-neck radiotherapy patients and to find out the effects of radiation on glutathione (GSH), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels in saliva. Materials and methods: This study included 16 patients undergoing head-neck radiotherapy in Atatürk University Research Hospital. The levels of GSH, GSH-Px, and MDA were measured in saliva samples taken from the patients pre- and postradiotherapy. The same biochemical parameters were also measured in saliva samples from 30 healthy individuals who did not undergo head-neck radiotherapy. The data obtained were analyzed using the paired t-test and the Mann­Whitney U test. Results: When the levels of GSH (P > 0.05), GSH-Px (P > 0.05), and MDA (P < 0.05) in saliva were compared pre- and postradiotherapy in the patient group, the only significant increase was detected in the MDA level postradiotherapy. When the pre- and postradiotherapy levels of saliva GSH (P < 0.01, P < 0.001, respectively), GSH-Px (P > 0.05, P < 0.05, respectively), and MDA (P < 0.01, P < 0.001, respectively) were compared with those of the control group, it was revealed that the GSH level was significantly lower and the MDA level was significantly higher in both pre- and postradiotherapy compared to the control group. Also, only the postradiotherapy saliva GSH-Px level was found to be significantly lower than the control group. Conclusion: These findings show that the changes in saliva GSH, GSH-Px, and MDA levels in patients with head-neck malignity intensified due to radiation.

Buccal bifurcation cyst (paradental cyst) defined by ultrasonography and cone-beam computed tomography.

Buccal bifurcation cyst (BBC) is an uncommon inflammatory odontogenic cyst that generally occurs at the buccal region of the permanent mandibular first molars in children aged 6-8 years. The diagnosis of BBC cannot be made from the histopathologic features; therefore, diagnosis is primarily based on specific clinical and radiographic findings. In this case report, we present the clinical and radiological findings, including ultrasonography (USG) and cone-beam computed tomography (CBCT) images, of a 10-year-old boy who was referred with a complaint of swelling on the lower right jaw. According to the radiographic and clinical findings, the differential diagnosis of this lesion included lateral radicular cyst, lateral periodontal cyst, dentigerous cyst, eruption cyst, and others. Recently, in addition to classical radiographies and CBCT, USG has been considered important for diagnosis. In particular, if a cyst produces a perforation in the cortical bone, it is helpful to make a pre-diagnosis with USG.

Garre's Osteomyelitis of the Mandible Caused by Infected Tooth.

AIM: Garre's osteomyelitis is a local thickening of the periosteum caused by a slight irritation or infection. We aimed to present the extraoral, intraoral, and radiographic findings and postoperative pursuits of two patients diagnosed with Garre's osteomyelitis. In this case report, although clinical findings indicate infection source, these clinical findings are strongly supported by cone-beam computed tomography images. In addition, it can be seen that when we have followed the case I, we have chosen the right path in treatment. CASE REPORTS: Two patients presented to our clinic due to severe swelling and facial asymmetry in the right and left mandibular region. As a result of the clinical and radiological examinations, the patients were diagnosed with Garre's osteomyelitis. Infected teeth that were responsible for the formation of Garre's osteomyelitis were extracted under antibiotic treatment in both cases. A complete improvement in postoperative control was observed in case I. On the other hand, the other case could not be followed up postoperatively. CONCLUSION: In Garre's osteomyelitis, new bone formation can occur in many pathological conditions. Therefore, it should be distinguished from other pathologies that cause new bone formation, such as Ewing's sarcoma, Caffey disease, and fibrous dysplasia.