Detection of human cytomegalovirus and Epstein-Barr Virus in symptomatic and asymptomatic apical periodontitis lesions by real-time PCR.

OBJECTIVES: Recent studies have investigated the occurrence of human cytomegalovirus and Epstein-Barr Virus in samples from apical periodontitis lesions and a role in the pathogenesis of this disease has been suggested. Because genotype distribution and seroprevalence of EBV and HCMV differ among populations, it is important to determine the presence of these viruses in endodontic periapical lesions of different populations. The aims of this study were to determine the presence of HCMV and EBV DNAs in samples from Turkish patients with symptomatic and asymptomatic apical periodontitis lesions using real-time polymerase chain reaction method and to evaluate their presence in both symptomatic and asymptomatic apical periodontitis lesions. STUDY DESIGN: Periapical samples were collected from 12 asymptomatic and 16 symptomatic periapical lesions in conjunction with apicectomy. HCMV and EBV DNAs were identified in the samples by real-time PCR. The chi-squared test with Yates's correction or the Fisher's exact test was used to analyse the significance of differences. RESULTS: HCMV DNA was detected in 10 of the 16 (62.5%) symptomatic and in five of the 12 (41.7 %) asymptomatic periapical study lesions. The EBV DNA was identified in seven of the 16 (43.7 %) symptomatic and three of the 12 (25 %) asymptomatic periapical lesions. The difference in occurrence of HCMV and EBV DNA between symptomatic and asymptomatic periapical lesions was not statistically significant. (All comparisons have p > 0.05). CONCLUSION: Our findings suggest that HCMV and EBV is a frequent inhabitant of both symptomatic and asymptomatic apical periodontitis lesions of endodontic origin in Turkish population.

Evaluation of surgical-orthodontic treatments on impacted mandibular canines.

OBJECTIVE: The aim of the study was to evaluate patients treated for impacted mandibular canines through a combined surgical and orthodontic approach. STUDY DESIGN: The cases which were made button operations of impacted mandibular canines were selected from 5100 panoramic radiographs taken from patients who made use of our oral and maxillofacial surgery services between January 1998 to April 2006. All of these selected patients were assessed radiographically. Pertinent information such as sex, age at the time of surgery, site of the unerupted tooth, space availability and any other associated pathoses were also recorded. These patients were called again, and the condition of the mandibular canines was evaluated with panoramic radiographs. If the tooth erupted in the right position and it was functional and asymptomatic, we assumed the treatment to be successful clinically. RESULTS: In the present study, from 5100 patients, 69 patients had impacted mandibular canines and only 21 patients ' teeth (a total of 23 teeth) were treated orthodontically. Sixteen impacted mandibular canine teeth of 14 patients erupted successfully. Two impacted canine were extracted, and only one canine tooth was transplanted to the normal position. Four patients ended the treatment because of failure of eruption. CONCLUSION: If a mandibular canine tooth is impacted, not only is surgical exposure sufficient but also traction force must be applied orthodontically after the surgical exposure. In addition, age influences the success of the treatment on impacted mandibular canine teeth more than the position and impaction level of the teeth.

Evaluation of volumetry and density of mandibular symphysis bone grafts by three-dimensional computed tomography.

PURPOSE: Bone grafting before implant placing can improve the treatment in traumatized or regular implant patients. The aim of this study was to evaluate the density and maximum amount of harvestable bone graft in the mandibular symphysis. MATERIALS AND METHODS: Data from 15 CT-scans were obtained from 15 adult patients (10 male/five female) for the purposes of this study. The CT data, in DICOM format, were read into Mimics software from Materialize (Leuven, Belgium), with a slice thickness of 0.5 mm. The volume, density, and dimensions based on Hounsfield units (HU) were measured on the 3D symphyseal bone graft using Mimics software. RESULTS: The average bone volume calculated from the mandibular symphysis was 3491.08 +/- 772.12 mm(3). The average sized corticocancellous block that was measured was 38.75 x 11.05 x 7.80 mm. The mean bone density was 958.95 +/- 98.11 HU. CONCLUSION: The use of three-dimensional computed tomography (3D CT) in combination with a software program is a reliable means of determining the density of graft, evaluating maximal volume and dimensions of the graft that can be harvested from the mandibular symphysis region.

Prevalence of the pneumatized articular eminence in the temporal bone.

OBJECTIVES: The pneumatized articular eminence (PAT) of the temporal bone has been identified as an asymptomatic radiolucent appearance defect in the temporal bone. Although it occurs very rarely, when present, it may represent the potential for complications following surgical manipulation of the temporomandibular joint. MATERIALS AND METHODS: The record of 8107 patients who presented to our Oral and Maxillofacial Surgery services, between January 1998 and February 2008 was reviewed. Observations were made on the side and radiographic appearance of the PAT; and sex and age of patients. RESULTS: Eighty-three of 8107 (1.03%) individuals had PAT with 41 females and 42 males. PATs were located on the right side in 60 individuals and in the left side in 50 individuals. PATs were unilateral in 56 cases and bilateral in 27 (totally 110 PAT). Forty-four of the PATs were unilocular type, and 66 of the PATs were multilocular type. CONCLUSIONS: Treatment of PAT is unnecessary. However if a surgeon who is planning to perform eminoplasty or eminectomy on a patient who has PAT, he/she should be aware of the details of PAT. Moreover, fractures of the temporal bone with PAT can occur easier than temporal bone without PAT.

Comprehensive treatment of the infected maxillary lateral incisor with an accessory root.

Rare anatomic anomalies may occur in the dentition and can affect treatment decisions and prognosis. Accurate diagnosis and therapy performed at the highest level can result in predictable success in these cases. This case report shows the clinical and radiographic findings and successful treatment (nonsurgical and surgical) of a combined apical and marginal periodontal inflammatory lesion of a maxillary lateral incisor with an accessory root.