Relationship between palatally impacted canines and dimensions and morphology of sella turcica: A cone-beam computed tomography study.

INTRODUCTION: This study aimed to analyze the association of unilateral and bilateral palatal canine impaction with the dimensions and morphology of sella turcica from 3-dimensional cone-beam computed tomography (CBCT) images. METHODS: CBCT images of patients with bilateral (BPI) (n = 12; 9 female 3 male; 20.75 ± 5.88 years) and unilateral (UPI) (n = 35; 22 female 13 male; 19.28 ± 5.57 years) palatally impacted canines were compared with a control group (n = 56; 34 female 22 male; 20.82 ± 4.88 years). Linear measurements regarding sella turcica were made, and its morphologic variations were categorized. Two group comparisons were made with the Student t test or Mann-Whitney U-test, whereas one-way analysis of variance or Kruskal-Wallis tests were used for multiple group comparisons. Categorical variables were compared using the chi-square or Fisher exact test as appropriate. The binary logistic regression analyses and correlations using Spearman or Pearson correlation analyses were used to determine associations between variables (P <0.05). RESULTS: Sella diameter was significantly smaller in the BPI group compared to UPI and control groups. There was a significant association between sella diameter and BPI when compared with the control group (χ2[1] = 9.150; P = 0.008). There were no significant differences between groups in the distribution of sella turcica morphology. CONCLUSIONS: Despite the similar genetic origin of the sella turcica region and teeth, the association of palatal canine impaction with dimensions and morphology of sella turcica was weak. Both local and genetic factors might contribute to the ectopic position of the canine.

Examination of the possible relation of the superior semicircular canal morphology with the roof thickness of the glenoid fossa and bone changes of the temporomandibular joint.

PURPOSE: This study sought to assess the relationships between a morphological characteristic of the superior semicircular canal (SSC) and both the roof thickness of the glenoid fossa (GF) and bone changes of the temporomandibular joint (TMJ) on three-dimensional images. METHODS: Cone-beam computed tomography (CBCT) images of 200 individuals (105 females and 95 males; 400 temporal bone regions) were examined by two different observers. The correlations between the bone thickness overlying the SSC and the thickness of the roof of the GF with TMJ's bone pathologies were analyzed. RESULTS: The superior semicircular canal dehiscence (SSCD) was significantly associated with dehiscence of the roof of the GF. The relationship between the dehiscence of the SSC and the roof thickness of the GF was found to be strongly correlated (p < 0.05). There were no statistically significant differences between the bone changes of TMJ and the presence or absence of the SSCD. CONCLUSIONS: A correlation between the bone thickness overlying the SSC and the roof thickness of the GF was found. However, there was no relationship between the bone thickness overlying the SSC and bone changes of TMJ.

Three-dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes.

PURPOSE: The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS: CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS: No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS: No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.

Correction to: Three­dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes.

In the original publication of the article, the given name and family name of the author were swapped. The correct author name is given in this erratum.

Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths.

OBJECTIVE: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. MATERIALS AND METHODS: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman's rho correlation coefficient, and χ2 tests were used for the statistical analysis. RESULTS: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman's r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. CONCLUSION: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.

Evaluation of the Relationship of Dimensions of Maxillary Sinus Drainage System with Anatomical Variations and Sinusopathy: Cone-Beam Computed Tomography Findings.

OBJECTIVE: The aim of this study was to evaluate the correlation between the length of the infundibulum and ostium height with the anatomic variations of osteomeatal complex (OMC) and sinus pathology using cone-beam computed tomography (CBCT). METHODS: CBCT images of 204 patients (408 maxillary sinuses) were evaluated retrospectively. The height of the ostium and the length of the infundibulum were measured. The presence of maxillary sinus pathology, nasal septal deviation, Haller cells, concha bullosa, and sinus septa were analyzed. The correlation between the size of the maxillary sinus drainage system and anatomic variations was compared using the t test, Fisher's exact test, and χ2 test. The effect of tooth loss on the length of the infundibulum and ostium height was also analyzed using ANOVA. RESULTS: The height of the ostium and the maximal septal deviation angle were found to be significantly greater in males (p < 0.05). As ostium height increased, the presence of maxillary sinus septa increased (p < 0.05). No statistically significant association was detected between other variations and the length of infundibulum or ostium height. The relationship between tooth loss and both the length of the infundibulum and ostium height were found to be insignificant (p > 0.05). CONCLUSIONS: Radiographic examination, especially on CBCT images, is important for an evaluation of maxillary sinuses. here, we demonstrated a significant relationship between ostium height and the presence of maxillary sinus septa. However, it was found that nasal septal deviation, concha bullosa, Haller cells, and other sinusopathies did not have a major effect on the size of the maxillary sinus drainage system.

Deep convolutional neural network-the evaluation of cervical vertebrae maturation.

OBJECTIVES: This study aimed to automatically determine the cervical vertebral maturation (CVM) processes on lateral cephalometric radiograph images using a proposed deep learning-based convolutional neural network (CNN) model and to test the success rate of this CNN model in detecting CVM stages using precision, recall, and F1-score. METHODS: A total of 588 digital lateral cephalometric radiographs of patients with a chronological age between 8 and 22 years were included in this study. CVM evaluation was carried out by two dentomaxillofacial radiologists. CVM stages in the images were divided into 6 subgroups according to the growth process. A convolutional neural network (CNN) model was developed in this study. Experimental studies for the developed model were carried out in the Jupyter Notebook environment using the Python programming language, the Keras, and TensorFlow libraries. RESULTS: As a result of the training that lasted 40 epochs, 58% training and 57% test accuracy were obtained. The model obtained results that were very close to the training on the test data. On the other hand, it was determined that the model showed the highest success in terms of precision and F1-score in the CVM Stage 1 and the highest success in the recall value in the CVM Stage 2. CONCLUSION: The experimental results have shown that the developed model achieved moderate success and it reached a classification accuracy of 58.66% in CVM stage classification.

Evaluation of the compatibility of C2, C3, and C4 fractal dimension values with hand-wrist and cervical vertebra maturation methods in determining skeletal maturation.

OBJECTIVES: To examine the correlation between the fractal dimension (FD) values of cervical vertebrae (C2, C3, and C4) and hand-wrist maturation (HWM) and cervical vertebra maturation (CVM) methods. In addition, the correlation between the pubertal growth spurt (PGS) and FD values was examined. METHODS: The lateral cephalometric and hand-wrist radiographs of 120 subjects (61 females and 59 males) aged 8-18 years with a mean age of 13 years, were evaluated retrospectively. The CVM stages were determined in accordance with Hassel-Farman's modification of Lamparski criteria. The HWM stages were determined in accordance with Björk and Grave-Brown criteria. Both HWM and CVM stages were divided into two according to PGS. Fractal analysis of cervical vertebrae was performed according to the White-Rudolph method. The relationships between HWM stages, CVM stages and other variables were evaluated by Spearman's rank-order correlation coefficient. The relationships between FD values, chronological age, and divided stages were evaluated by the Pearson correlation coefficient. The Mann-Whitney U test was used to compare the FD values of two divided stages. RESULTS: There were positive and statistically significant positive correlations between chronological age and both HWM and CVM stages. There was a positive and statistically significant correlation between CVM and HWM stages. In females and total, there were negative and statistically significant correlations between C4 FD values and divided HWM stages, and the differences between C4 FD values of divided HWM stages were also statistically significant. In total, there was a negative and statistically significant correlation between C4 FD values and divided CVM stages, and the difference between C4 FD values of divided CVM stages was also statistically significant. CONCLUSION: The negative correlations found between C4 FD values and divided HWM and CVM stages suggest the fractal analysis of cervical vertebrae, especially of C4, may be used as an objective tool for evaluating the PGS.

Frontal sinus: is it a predictor for vertical malocclusions?

The aim of the present study was to evaluate 3D frontal sinus morphology in consideration with different vertical facial developments. The study was conducted with the pre-treatment CBCT images of 87 patients, who were divided into 3 groups according to the sum of the posterior angle. The frontal sinus measurements were performed on the axial, sagittal, and coronal sections of the CBCT images. Craniofacial measurements were performed on the lateral cephalograms, obtained from the CBCT scans. Normal distribution of the data was confirmed by the Kolmogorov-Smirnov test. ANOVA, followed by post hoc Duncan tests, was used to compare the differences among the three groups. The relationships between sinus dimensions and craniofacial parameters were assessed by the Pearson's correlation coefficient (P < 0.05). The maximum anterior-posterior dimension of the frontal sinuses (0.017), the width of the right (0.020) and left (0.041) frontal sinuses, and the anterior-posterior dimension of the left (0.038) frontal sinus were significantly smaller in the hyperdivergent group compared to hypodivergent group. There was no significant difference between groups in terms of the height of the frontal sinuses. Significant correlation was noted between the maximum anterior-posterior dimension of the frontal sinus and SN-PP, N-Me, N-ANS, SN-GoGn, Post. sum, and Jarabak's ratio. No significant correlation between the height of the frontal sinuses and the craniofacial measurements was found. Individuals with vertical growth pattern presented decreased anterior-posterior dimension of the frontal sinuses, revealing significant correlations with vertical craniofacial parameters.

Nasal septal deviation in the unilateral cleft lip and palate deformities: a three-dimensional analysis.

OBJECTIVES: Lip and palate deformities are an important craniofacial congenital anomaly that negatively affects the anatomy of the nasal cavity and maxilla. This study aimed to evaluate the nasal septum deviation in individuals with a unilateral cleft lip and palate. METHODS: The sample consists of 22 unilateral cleft lip-palate patients and 20 controls with non-cleft skeletal Class III. Maximal septal deviation angle and linear dimension were measured on cone-beam computed tomography images. The localization of maximal septal deviation was determined. The data were analyzed and compared between unilateral cleft lip-palate patients and skeletal Class III individuals. RESULTS: For septal deviation, a significant discrepancy between unilateral cleft patients and skeletal Class III subjects was detected at the anterior nasal spine (ANS) level, the posterior nasal spine (PNS) level and the ANS-PNS midpoint level (p < 0.05). The maximum septal deviation angle of individuals with a unilateral cleft was significantly greater than individuals with skeletal Class III (p < 0.05). No statistically significant differences were found in the localization of maximum septal deviation between the unilateral cleft patients and the Class III individuals. CONCLUSION: Our results demonstrated that the maximum septal deviation angle and dimension had significant differences in individuals with a unilateral cleft, compared to a skeletal Class III control group. However, no statistically significant discrepancy was observed between three levels (ANS, PNS and ANS-PNS middle levels) in the unilateral cleft patients.

Does tooth loss in the mandibular posterior region have an effect on the mental index and panoramic mandibular index?

PURPOSE: Mental index (MI) and panoramic mandibular index (PMI) are important radiomorphometric indices used for assessing the quality of the mandibular bone. The aim of this study was to investigate the possible effect of mandibular posterior tooth/teeth loss in young adults on the MI and PMI (superior panoramic mandibular index: PMI-s, and inferior panoramic mandibular index: PMI-i). MATERIALS AND METHODS: Digital panoramic radiographs belonging to 253 patients aged between 18-35 years old were examined. According to the inclusion criteria of the study, a patient and control group was formed. The patient group (n=46) included individuals having at least one extracted tooth in the posterior region of the mandible, and the control group (n=45) included full dentate patients. The MI and PMI (PMI-i and PMI-s) were calculated bilaterally for all of the individuals. RESULTS: No significant difference was found between the MI, PMI-i and PMI-s indices of the patient group and the control group among both genders. CONCLUSION: The mandibular premolar and/or molar teeth loss in young adults did not lead to any change in the MI, PMI-i and PMI-s indices among both genders.

Morphometric analysis of the foramen magnum using cone beam computed tomography

Background/aim: The aim of this study was to perform morphometric analysis of the foramen magnum (FM) using cone-beam computed tomography (CBCT). Materials and methods: This study included CBCT images of 190 individuals (88 males and 102 females). The sagittal and transverse diameters and circumference of the FM were measured. The shape of FM was classified as round, hexagonal, oval, egg-shaped, tetragonal, pentagonal, irregular A, and irregular B. The data were statistically analyzed with chi-square and t-tests to assess the level of significance for sex and age. Results: The means of its sagittal and transverse diameters and also circumference were higher in males than in females. Statistically significant differences were found between males and females for all variables (P < 0.05). No statistically significant difference (P > 0.05) was found between age groups for all variables. The round type was the most common, in 21.6% of the patients. Conclusion: CBCT images can provide valuable information regarding FM and the measurements of its sagittal and transvers diameters and also its circumference may be reliably used for sexual dimorphism in anthropometric analysis and forensic medicine.

Dental management and orofacial manifestations of a patient with Robinow Syndrome.

Robinow syndrome (RS) is an extremely rare condition. Characteristic craniofacial findings of RS include a fetal facial appearance, ear abnormalities and oral findings. The aim of this case report was to evaluate the oral findings of a 26-year-old man with RS and to describe the dental treatments performed. The patient had short stature, vertebral anomalies, short and broad fingers, a fetal facial appearance, gingival hyperplasia, fissured tongue, caries and multiple impacted teeth. Periodontal and restorative dental treatments were performed under aseptic conditions with due precautions. No surgical treatment was performed to the impacted teeth because of the lack of symptoms.

The prevalence of antral exostoses in the maxillary sinuses, evaluated by cone-beam computed tomography.

BACKGROUND/PURPOSE: Exostoses are outgrowths of normal compact and cancellous bone and may occur in different locations of the jaw. Exostoses are a rare anatomic variation in the maxillary sinuses. The purpose of this study was to investigate retrospectively the prevalence of location, size, shape, and symmetry of exostoses in the maxillary sinus, and to assess the relationship between demographic variables (i.e., age and sex) via cone-beam computed tomography images. MATERIALS AND METHODS: Cone-beam computed tomography images of 1000 patients [521 (52.1%) females and 479 (47.9%) males], aged 10-85 years (mean age, 44 years), were examined. Two investigators examined the exostoses for location (i.e., inferior wall, medial wall, lateral wall, or posterior wall of the maxillary sinuses), size, shape (i.e., broad-based or mushroom-like), and symmetry (i.e., unilateral or bilateral). The age of the patients was categorized into three groups: 10-30 years, 31-50 years, and 51+ years. The data were statistically analyzed by using chi-square test, Fisher's exact test, and the t test. RESULTS: In total, 52 exostoses from 48 patients (4.8%) were identified. Exostoses were more common in females (n = 28, 58.3%) than in males (n = 20, 41.7%); however, there was no statistically significant difference between the sexes (P > 0.05). The presence of exostoses was very similar for all age groups with no statistically significant differences (P > 0.05). CONCLUSION: Most exostoses were unilateral and on the inferior wall of the maxillary sinus. No statistically significant difference existed between the frequency and location of exostoses for sex or age groups (P > 0.05).