Evaluation of the effects of periodontal status according to 2017 classifications on oral health-related quality of life and quality of life-related to general health: A cross-sectional study.

BACKGROUND: In patients with periodontal disease, various symptoms are observed along with inflammation. The impact of local and systemic inflammation on periodontal tissue is well-known; however, the impact of periodontal disease on the individual's quality of life is unclear. This study aimed to assess oral health-related and general health-related quality of life in patients undergoing maintenance treatment following treatment for periodontitis (RP-CPH), patients with gingivitis (G) and patients with Stage I periodontitis (SI-P) and to compare this with individuals with clinical periodontal health (IP-CPH). METHOD: This study was comprised of cross-sectional periodontal assessment along with questionnaires. Oral health-related quality of life and general health-related quality of life were assessed using, respectively, the Oral Health Impact Profile-14 (OHIP-14) and Short-Form-36 (SF-36) questionnaires. Study participants were classified according to the classification of periodontal and peri-implant diseases and conditions established by the 2017 World Workshop. RESULTS: The OHIP-14 total scores for the 166 study participants (age range: 22-57) of the G (11.61 ± 3.21) and SI-P (13.03 ± 3.47) groups were significantly higher than the OHIP-14 total scores of the IP-CPH (1.09 ± 1.58) and RP-CPH (2.95 ± 2.58) groups. SF-36 scores were found to be significantly lower in the SI-P group in all subgroups compared to the G and IP-CPH groups. CONCLUSIONS: A correlation was found between early-stage periodontal disease and low levels of OHRQoL and GHRQoL. The health of periodontal tissues may have a positive effect on the quality of life.

Evaluation of use of cone beam computed tomography in paediatric patients: A cross-sectional study.

BACKGROUND: Cone beam computed tomography (CBCT) is widely used in paediatric dentistry. Appropriate use of CBCT is important because children are more vulnerable to ionizing radiation than adults. AIM: To investigate the use of CBCT in children by describing reasons for requesting it and its distribution according to age, oral region, and department. DESIGN: Cone beam computed tomography scans of patients (age < 19 years) who presented to our dental clinic were investigated retrospectively according to sex, age (6-12 [Group 1] and 13-18 [Group 2] years based on dentition), referring department, imaging area (anterior/posterior, mandible/maxilla), and indication. Indications were grouped under five headings according to 2011 SEDENTEXCT guidelines: dental anomalies, impacted teeth, endodontics, bone pathosis, and others. RESULTS: Overall, 334 CBCT scans at different times and for different reasons in 319 patients were evaluated. In recent years, CBCT requests increased in both age groups. Eighty-five CBCT scans (25.44%) of 78 patients (24.45%) with a mean age of 10.37 ± 1.60 years were examined in Group 1, whereas 249 CBCT scans (%74.55) of 241 patients (75.54%) with a mean age of 15.66 ± 1.70 years were examined in Group 2. The most frequent indication was the assessment of impacted teeth (46.1%). The anterior maxilla was the most frequently monitored region (41.6%). The oral and maxillofacial radiology department was the department that made the most CBCT requests in all the years considered (53.6%). CONCLUSIONS: The most common indications were the assessment of dentigerous cysts and impacted teeth. There was an increase in the number of referrals to paediatric dentistry.

Pre-eruptive intracoronal resorption of permanent dentition: A new classification and a multidisciplinary study.

The aims of this study were to develop a new classification for pre-eruptive intracoronal resorption(PIR) with different resorption areas and sizes and to compare the new classification scores among observers from different specialities and professional experience. The PIR was evaluated according to the new classification by two dentomaxillofacial radiologists and two endodontists. Information regarding the patient's age, gender, systemic diseases, the number of PIR, the affected tooth area and the size of the PIR was recorded. The new classification system showed that PIR six and seven defects were the most detected. Regarding jaw regions, the highest reliability was seen in the maxillary central teeth between observers I and IV, and maxillary premolar-molar teeth between observers II and III. This study revealed that PIR can be found in both root and crown dentine. Professional experience and specialty and awareness of the PIR defect may affect the diagnosis.

Gingival crevicular fluid CSF-1 and IL-34 levels in patients with stage III grade C periodontitis and uncontrolled type 2 diabetes mellitus.

PURPOSE: Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD). METHODS: In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay. RESULTS: All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05). CONCLUSIONS: These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04891627.

A rare case of a nasal cavity fungus ball due to Aspergillus niger.

Background and Purpose: Fungus Ball (FB) is a non-invasive fungal infection caused mainly by Aspergillus species. It can occur after root canal treatments are applied to the teeth adjacent to the maxillary sinus. These balls are commonly seen in the paranasal sinuses and rarely observed in the nasal cavity. This report attempted in to highlight such a rare case of fungal infection which requires accurate observation. Moreover, it highlights the importance of careful microbiological and histopathological examinations that were combined with imaging and can lead to a definitive diagnosis. Case report: Herein, we report a rare case of a FB found in the vicinity of the nasal cavity of a 73-year-old male patient. Microbiological examination supported by radiographic and histopathological results indicated that the FB is due to Aspergillus niger. Excised surgery was done to the FB area, and the patient was referred to the post-operation room with the proper recommendations. After the wound healed, the total denture was performed as requested by the patient, and his overall oral health was improved. Conclusion: In this article, we report the first case of a rare FB in the vicinity of the nasal cavity of a 73-year-old male patient. The appropriate investigation is an essential step in the diagnostic process for these infections and requires effective communication and collaboration.

Assessment of intravertebral pneumatocysts, degenerative joint disease, and ponticulus posticus in the cervical spine through cone beam computed tomography examination.

OBJECTIVE: To identify the prevalence rates and radiologic characteristics of intravertebral pneumatocysts (IVP), degenerative joint disease (DJD), and ponticulus posticus (PP) in the cervical spine by using cone beam computed tomography (CBCT) images. The correlations of the lesions with patient age and sex, as well as the correlations among the lesions, were also evaluated. STUDY DESIGN: CBCT images obtained from 440 patients were assessed retrospectively. Correlations between patient demographic characteristics and IVP, DJD, and PP in the cervical vertebrae were analyzed by using χ2 tests and logistic regression analysis. A difference of P < .05 was considered statistically significant. RESULTS: IVP occurred in 22 of 1792 vertebrae (1.2%) and in 17 of 440 patients (3.9%). DJD findings were observed in the cervical vertebrae of 260 patients (59.1%). PPs were found in 245 patients (55.7%). The prevalence rate of DJD varied significantly by age group (P = .002), whereas the prevalence rates of IVP and PP did not. There was a significant correlation between both DJD and PP with demographic characteristics (P < .001) and between DJD and PP in patients without IVPs (P = .038). CONCLUSIONS: Although DJD is common, radiologists should carefully examine CBCT scans of vertebrae for IVP and PP. Patients with DJD should be evaluated for the presence of PP.

Review on the applications of ultrasonography in dentomaxillofacial region.

Use of ultrasonography (US) in dentomaxillofacial region became popular in recent years owing to increasing radiation dose concerns and economic limitations. It helps to visualize fine detail of the surface structure of the oral and maxillofacial tissues without ionizing radiation. In diagnostic ultrasound, high frequency sound waves are transmitted into the body by a transducer and echoes from tissue interface are detected and displayed on a screen. Sound waves are emitted via piezoelectric crystals from the ultrasound transducer. US technique can be used in dentomaxillofacial region for the examination of bone and superficial soft tissue, detection of major salivary gland lesions, temporomandibular joint imaging, assessment of fractures and vascular lesions, lymph node examination, measurement of the thickness of muscles and visualization of vessels of the neck. It has the potential to be used in the evaluation of periapical lesions and follow up of periapical bone healing. Also, it may be used for the evaluation of periodontal pocket depth and for the determination of gingival thickness before dental implantology.

Volatile sulphur compound levels and related factors in patients with chronic renal failure.

AIMS: To analyse specific volatile sulphur compound(VSC) levels in a group of chronic renal failure (CRF) patients and determine the relationship between these VSC levels and organoleptic measurements, blood urea nitrogen (BUN) levels, dental and periodontal conditions, salivary flow rate, and tongue coating scores. MATERIALS AND METHODS: One examiner performed organoleptic and VSC measurements on fifty patients with CRF before and after haemodialysis (HD) and controls. DMFT and CPITN indexes, tongue coating scores, salivary flow rates were measured. Comparisons were performed using the Mann-Whitney U, Wilcoxon signed-ranks, and chi-square tests. Spearman correlation coefficient was used to analyse correlations. RESULTS: Before HD, the mean dimethyl sulphide level was 1.04 ± 1.20 in the CRF patients and 0.51 ± 0.65 in controls, with a significant difference. The mean hydrogen sulphide, methyl mercaptan and dimethyl sulphide levels in CRF patients were 1.47 ± 3.04, 1.03 ± 1.85, and 1.04 ± 1.20, respectively, before HD; and 0.53 ± 1.65, 0.48 ± 1.27, and 0.56 ± 0.85, respectively, after HD; with the differences being significant. Methyl mercaptan levels increased with an increase in HD duration. Tongue coating and organoleptic measurements were significantly correlated with methyl mercaptan. CONCLUSIONS: Dimethyl sulphide is the main VSC in extraoral blood-borne halitosis; but methyl mercaptan may also contribute to this type of halitosis. A decreased salivary flow rate and an increased pH of the biofilm matrix may be a significant parameter for VSC levels in CRF patients.

Effect of clinician's experience, age, gender and calibration on the assessment of halitosis.

PURPOSE: To evaluate the diagnosis of halitosis in relation to the oral malodour judge's experience, age, gender and calibration. MATERIALS AND METHODS: This study included 38 dental patients who volunteered to participate. Patients were evaluated for halitosis by 6 clinicians using the organoleptic method and by measuring mouth exhaled air using a halimeter, which is considered the gold standard. Sensitivity, specificity, and positive and negative predictive values were calculated for each clinician. Consistency between clinicians was evaluated through a kappa test. Significance level was set at P < 0.05. RESULTS: Out of the 38 patients, 14 were diagnosed with halitosis by 6 clinicians using a halimeter. The highest sensitivity (89%) was found for clinician No. 6, followed by clinician No. 5 (78%). Specificities were 57% for clinician No. 4 and 36% for clinician No. 1 and No. 5. The most correct positive predictive value (halitosis according to halimeter readings) was made by clinician No. 6 (65%), who also had the highest rates (83%) of negative predictive value (no halitosis according to halimeter readings). There were no statistically significant differences (P > 0.05) between the diagnoses of clinicians No. 1, 2, 3, 5, or 6; however, the diagnoses made by clinician No. 4 were statistically different (P < 0.05) than those of all other clinicians. The highest rate of agreement (44%) in diagnoses was between the two calibrated clinicians. However, there was no correlation between the halitosis diagnoses and the age, gender and years of experience of the clinicians. CONCLUSIONS: This study indicates that calibration of clinicians is a significant factor in the organoleptic evaluation of halitosis.

Effects of tongue coating and oral health on halitosis among dental students.

PURPOSE: To assess halitosis and determine the relationship between halitosis and tongue scores, periodontal status and DMFT among dental students. MATERIALS AND METHODS: The study comprised 268 (178 female, 90 male) dental students. Halitosis was measured using a Halimeter and the organoleptic method. Halitosis was diagnosed with a mean volatile sulphur compounds (VSC) level of >=125 ppb and an organoleptic measurement of >= 2 on a 0- to 5-point scale. Tongue scores were obtained using a tongue coating index (TCI), periodontal status was measured and assessed using the Community Periodontal Index of Treatment Needs (CPITN) and DMFT indices were calculated. RESULTS: Halitosis occurred at higher rates among male students than female students (83% vs 71%, P = 0.02). No differences were found in halitosis rates among students in different academic years (P = 0.6) or age groups (P = 0.6). A relationship was found between halitosis and tongue scores (P < 0.001) and between halitosis and mean CPITN scores (P = 0.004). The mean DMFT was 4.02 (SD = 3). No relationship was found between halitosis and DMFT index (P = 0.5). CONCLUSION: Halitosis was prevalent among dental students. Given their responsibilities for diagnosing and improving oral health, they may benefit from increased awareness of the problem and encouragement to improve their own oral hygiene, especially male students.

Delayed diagnosis of oral squamous cell carcinoma: a case series.

INTRODUCTION: In malign neoplasms, oral cancer is one of the important causes of mortality and morbidity. Squamous cell carcinoma is the most common form of oral cancers in adults and is related to risk factors such as smoking and alcohol consumption. CASE PRESENTATION: In this article, we present three case reports of oral squamous cell carcinomas with delayed diagnosis. The first patient was a 52-year-old Turkish man, the second patient was a 61-year-old Turkish man and the third patient was a 60-year-old Turkish woman. All were referred to the Ankara University Faculty of Dentistry with pain, swelling and various complaints in their jaws. CONCLUSION: Early diagnosis is of vital importance for the prognosis of the patients with oral squamous cell carcinomas. For this reason, dentists play a crucial role in the early detection and prevention of oral cancers.

Dental anomalies in individuals with cleft lip and/or palate.

Significant heterogeneity has previously been reported but with no consensus on the prevalence of dental anomalies in subjects with a cleft lip and palate (CLP), thus, the purpose of this study was to investigate the frequency of various dental anomalies in the upper dental arch in different cleft groups. Diagnostic records, i.e., panoramic, occlusal and periapical films, dental casts, and intra-oral photographs, of 122 subjects (mean age: 14 +/- 5 years; 67 males and 55 females) were grouped as either unilateral left cleft lip and palate (ULCLP), unilateral right cleft lip and palate (URCLP), bilateral cleft lip and palate (BCLP), or cleft palate (CP). Prevalence rates of 15 different dental anomalies were calculated for each group. Wilcoxon's test was used to determine if there was a statistically significant difference in the number of missing teeth between the right and left sides, in each cleft group. Overall, 96.7 percent of patients were found to have at least one dental anomaly. The most prevalent was agenesis in the anterior region on the cleft side (70.8-97.1 percent). There was a statistically significant difference in the prevalence of agenesis by cleft and non-cleft sides but only in the ULCLP group (P < 0.001). Significantly higher rates of impaction were observed in the anterior and premolar regions in the CLP groups (2.9-29.2 percent), with the highest rates in the anterior region on the cleft sides. A very high proportion of subjects were found to have at least one dental anomaly. Thus, the management of dental anomalies should be central to the treatment planning process of individuals with a cleft.

Prevalence of dental anomalies in various malocclusions.

INTRODUCTION: The purpose of this study was to evaluate the prevalence of dental anomalies in different orthodontic malocclusions. METHODS: Based on pretreatment diagnostic records, 900 orthodontic patients were classified as Class I (n = 358), Class II (n = 325), Class II Division 2 (n = 51), or Class III (n = 166). The occurrence rates of each dental anomaly were calculated as percentages of the total sample. Differences in incidence rates of each dental anomaly by sex and malocclusion were analyzed by using chi-square, Fisher exact, and z tests. The Mann-Whitney U test was used to determine whether there were significant differences in the occurrence of dental anomalies by age. RESULTS: It was found that 40.3% of patients (n = 363) had at least 1 dental anomaly. Agenesis was the most common (21.6%), followed by dens evaginatus (6.2%), invaginatus (5.0%), pulp stones (4.2%), and impaction (2.9%). No statistically significant correlations were found between dental anomaly and type of malocclusion, with the exception of impaction and short or blunt roots (P <0.01 and P <0.05, respectively). The Mann-Whitney U test indicated no significant difference in dental anomalies by age. CONCLUSIONS: A remarkably high rate of dental anomalies was recorded in orthodontic patients; therefore, orthodontists should carefully examine pretreatment records for dental anomalies to include their management in the treatment planning.