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.

Evaluation of the morphological changes in the mandible for dentate and totally edentate elderly population using cone-beam computed tomography.

PURPOSE: The loss of teeth considerably modifies the mandibular shape. The aim of this study was to compare the morphological changes in the mandible for dentate and totally edentate elderly subjects using cone-beam computed tomography. METHODS: In total, 50 cone-beam computed tomography patients (25 dentate, 25 edentate) without any maxilla-mandibular dysmorphosis were analyzed retrospectively. Panoramic representations of the mandible with superimposed axial slices and cross-sectional slices were developed with the cone-beam computed tomography scans. Values of the mandibular cortical index, bone quality index, gonial angle, antegonial angle, antegonial depth and condyle angle in the left and right side were measured. RESULTS: There was a significant difference in the mandibular cortical index between the total edentate group and the dentate group in the left side of the mandible (p < 0.001). There was a significant difference in the bone quality index between the total edentate group and the dentate group in the right side and the left side (p < 0.001). There was a significant difference in the bone quality index between the right side and the left side (p < 0.005). When comparing gender, there was only a difference in the right side (p < 0.05). CONCLUSIONS: Our study concluded that the mandibular basal bone morphology changes as a consequence of tooth loss. Cone-beam computed tomography is shown to be a good tool in investigating and achieving these results.

Aplasia and agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography.

Agenesis of the paranasal sinuses is an uncommon clinical condition that appears mainly in the frontal (12%) and maxillary (5-6%) sinuses; in some populations, it appears at a higher proportion. This study investigated the prevalence of agenesis of the frontal sinuses using dental volumetric tomography (DVT) in Turkish individuals. The frontal sinuses of 410 patients were examined by DVT scans in the coronal planes for evidence of the absence of the frontal sinuses. A bilateral and unilateral absence of the frontal sinuses was seen in 0.73% and 1.22% of cases, respectively. In one case, both agenesis and aplasia of the frontal sinus was seen (0.24%). The low percentage of frontal sinus agenesis must be considered during pre-surgical planning related to the sinuses. DVT may be used as a diagnostic tool for the examination of frontal sinus aplasia.

Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction.

BACKGROUND: Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). PURPOSE: To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. MATERIAL AND METHODS: DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). RESULTS: In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. CONCLUSION: The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study.

The mandibular angle in osteoporotic men.

OBJECTIVES: Osteoporosis induces the reduction of bone mass and screening for low bone mineral density (BMD) by dual-energy x-ray absorptiometry (DXA) has been the current gold standard test to determine osteoporosis. Panoramic radiography is widely used in dentistry for routine examination of jaws. The objective of this study was to determine the relationship between the mandibular angle (MA) values and the vertebral bone mineral density (v-BMD) in 20 osteoporotic men. STUDY DESIGN: In panoramic radiograms of osteoporotic men, the means were calculated for the mandibular angle values measured in the right and left mandible. v-BMD values were also calculated by manual analysis of DXA scans. The correlation between these variables was assessed. RESULTS: A negatively significant correlation was found between the MA and v-BMD. CONCLUSIONS: The size of the mandibular angle decreases when osteoporosis increases. It is suggested that the mandibular angle may be useful in clinical dental practice to identify osteoporotic men with previously undetected low bone mineral density.

No correlation between mandibular and non-mandibular measurements in osteoporotic men.

BACKGROUND: Screening for low bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) has been the traditional method for determining osteoporosis. Panoramic radiography is widely used in dentistry. PURPOSE: To determine the relationships between the values of dental panoramic indices (the mental index (MI), antegonial index (AI), panoramic mandibular index (PMI)) and the values of skeletal BMD (femoral BMD (f-BMD), and vertebral BMD (v-BMD)) in 25 osteoporotic men. MATERIAL AND METHODS: In the panoramic radiographs obtained from a total of 25 male individuals with osteoporosis, the means were calculated for MI, AI, and PMI values measured in the right and left mandible. DXA measurements of the femur and lumbar vertebrae BMD were also calculated. The correlation between these variables was assessed. RESULTS: No correlation was found between the BMD values of the femur and lumbar vertebrae and values of MI, AI, and PMI. CONCLUSION: No significant correlation was found between the mandibular and non-mandibular measurements in men with osteoporosis. MI, AI, and PMI indices should not be used in the evaluation of the skeletal status, because they are not reliable tools in screening for osteoporosis.

Oral pemphigus vulgaris: a case report with review of the literature.

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially manifests in the form of intraoral lesions, which spread to other mucous membranes and the skin. The etiology of pemphigus vulgaris is still unknown, although the disease has attracted considerable interest. The pemphigus group of diseases is characterized by the production of autoantibodies against intercellular substances and is thus classified as autoimmune diseases. Most patients are initially misdiagnosed and improperly treated for many months or even years. Dental professionals must be sufficiently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment, since this in turn determines the prognosis and course of the disease. Here, we report a case of pemphigus vulgaris that was misdiagnosed in its earliest stage.

Keratocystic odontogenic tumor invading the right maxillary sinus: a case report.

Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of a 23-year-old man with extensive KCOT and impacted third molar in the right maxillary sinus. The clinical, radiological, and histological features of this tumor and its surgical management are discussed.

A dentigerous cyst containing an ectopic canine tooth below the floor of the maxillary sinus: a case report.

Ectopic eruption into the dental environment is common, whereas eruption into other sites is rare. Diverse anatomical locations such as the mandibular condyle, coronoid process, palate, maxillary sinuses and nasal cavity can infrequently be the site of ectopic tooth eruption. One of the nondental sites for ectopic eruption is the maxillary sinus. Here, we present a case of dentigerous cyst with an ectopic maxillary canine tooth located below the floor of the right maxillary sinus in a 37-year-old man.

Florid cemento-osseous dysplasia: a case report.

Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissues and involve, essentially, the same pathological process. They are usually classified, depending on their extent and radiographic appearances, into three main groups: periapical (surrounds the periapical region of teeth and are bilateral), florid (sclerotic symmetrical masses) and focal (single lesion) cemental dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For the asymptomatic patient, the best management consists of regular recall examinations with prophylaxis and reinforcement of good home hygiene care to control periodontal disease and prevent tooth lose. Management of the symptomatic patient is more difficult. At this stage, there is an inflammatory component to the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics may be indicated but may not be effective. A case of florid cemento-osseous dysplasia occurring in a 47-year-old Caucasian female is reported which was rare in regard to race and sex.

Nasolabial Cyst: A Case Report with Ultrasonography and Magnetic Resonance Imaging Findings.

Nasolabial cysts are uncommon nonodontogenic lesions that occur in the nasal alar region. These lesions usually present with asymptomatic swelling but can cause pain if infected. In this case report, we describe the inadequacy of conventional radiography in a nasolabial cyst case, as well as the magnetic resonance imaging (MRI) and ultrasonography (US) findings in a 54-year-old female patient.

Mucoepidermoid carcinoma in a minor salivary gland in a child.

Mucoepidermoid carcinoma (MEC), one of the most common salivary gland malignancies, is rare in children. MEC mainly occurs in the parotid gland, along with minor glands being the second common site, particularly in palate. Clinical, histological, and radiological findings of palatal MEC in a 12-year-old girl are presented with three-year follow-up. Pathologic lesions must be considered in differential diagnoses of intraoral asymptomatic lesions, and their detailed inspection should be taken into consideration.

Relationship among Schneiderian membrane, Underwood's septa, and the maxillary sinus inferior border.

BACKGROUND: Osseo-integrated implants are increasingly being used to restore functional dentition; however, in the posterior region, implant placement can be problematic because of inadequate bone height. In this condition, maxillary sinus floor elevation surgery has become the treatment of choice. The presence of anatomic variations within the maxillary sinus such as Underwood's septa and thin Schneiderian membrane decreases the success of the sinus floor elevation. PURPOSE: In this study, we tried to determine the relationship between the anatomic variations of the maxillary sinus: Underwood's septa, Schneiderian membrane thickness, and the cortical thickness of the inferior border of the maxillary sinus. MATERIAL AND METHODS: The left and right maxillary sinus images of 74 patients were obtained by using dental computed tomography (CT). The Schneiderian membrane and the cortical thickness of the inferior border of the maxillary sinus were measured on the coronal images of dental CT scans at the deepest portion of the sinus cavity. The presence of Underwood's septa was identified on the axial images. The correlations between these variables were assessed. RESULTS: We found that there was only a negative correlation between the Schneiderian membrane thickness and the presence of Underwood's septa (r = -0.168 p = .042). CONCLUSION: It is suggested that Underwood's septa may be the reason for the thinness of the Schneiderian membrane. However, future studies among larger groups are necessary for confirming the finding by using well-designed clinical studies.

Do children with Wilson's disease have distinct craniofacial morphology? A cephalometric study.

OBJECTIVES: Patients with Wilson's disease (WD) develop osseous changes such as osteoporosis, spontaneous fractures, areas of sclerosis and demineralization of maxillary and mandibular bones, and neurologic symptoms including swallowing dysfunctions, which may affect dento-facial growth. However, dento-maxillo-facial structures of these patients have never been investigated. The present study aimed to discover if subjects with WD have different dentofacial structures. METHODS: Lateral cephalometric films of 13 children (5 males and 8 females) with WD and of 15 normal subjects (6 males and 9 females) were evaluated. Mean ages of the patients and controls were 12.62 ± 3.09 years and 12.01 ± 1.38 years, respectively. Lateral cephalometric cranial films of all subjects were taken in the same cephalostat in a habitual and unstrained body posture. Thirteen linear and 11 angular parameters were measured to describe the craniofacial characteristics of the subjects. RESULTS: Statistical analysis showed that there is no statistically significant difference between parameters of normal children and children with WD, with the exception of palatal plane inclination. The inclination of palatal plane was higher in children with WD than in normal subjects. CONCLUSIONS: Children with WD and healthy children have approximately the same dento-maxillo-facial structures. However, increased palatal plane inclination may be a finding of WD.

A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in Turkish individuals.

PURPOSE: In adults, sphenoid sinus agenesis is an extremely rare anomaly. The objective of this study was to investigate the prevalence of sphenoid sinus hypoplasia and agenesis using dental volumetric computed tomography (DVCT) in a population of Turkish individuals. MATERIALS AND METHODS: DVCT scans in the axial, coronal and sagittal planes of the sphenoid sinus of 384 patients were examined for evidence of sphenoid sinus agenesis and hypoplasia. RESULTS: In the DVCT scans, bilateral agenesis of sphenoid sinus was not seen. Unilateral agenesis of sphenoid sinus was seen in 0.26% of the sample, and sphenoid sinus hypoplasia was seen in 0.52%. Unilateral hypoplasia of the sphenoid sinus was observed in 0.26% of the sample, and bilateral hypoplasia of sphenoid sinus was observed in 0.26%. CONCLUSION: In this study, we found a low frequency of sphenoid sinus agenesis. Compared with sphenoid sinus agenesis, the frequency of sphenoid sinus hypoplasia was higher. DVCT may be used as a diagnostic tool to investigate the paranasal sinus.

The effect of right or left handedness on caries experience and oral hygiene.

BACKGROUND: There is an indisputable relationship between tooth decay and oral hygiene. Caries can only be prevented by keeping tooth decay at bay. In several prophylactic methods, brushing is the most important. Brushing efficiency is directly related to an individuals' manual dexterity. OBJECTIVE: To investigate whether there were differences in oral hygiene and caries prevalence between right- and left-handers. MATERIALS AND METHODS: Forty-six elementary school students were included in the study. The subjects were 30 males and 16 females, ranging in age from 11 to 13 years. Handedness was ascertained by using the Edinburgh Handedness Scale. All students were examined intraorally. During this examination, the necessary values to determine oral hygiene status and to determine caries prevalence were recorded. RESULTS: It was observed that subjects who used their right hands were in a better position in terms of oral hygiene than those using the left (P < 0.01). In terms of caries prevalence, however, averages for right-handed individuals were lower than those for left-handed subjects, although the difference was not statistically significant. CONCLUSIONS: It can be stated that the right-handed individuals have better oral hygiene and the lower incidence of caries because of their better manual dexterity and brush efficiency. So, dentists should consider better manual dexterity and brush efficiency in right-handed individuals before treatment planning. However, future well-designed neurologic studies involving larger numbers of subjects will be necessary to confirm the findings of this study and to understand more about the effects of handedness on oral hygiene performance.

Florid cemento-osseous dysplasia: a case report

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Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissues and involve, essentially, the same pathological process. They are usually classified, depending on their extent and radiographic appearances, into three main groups: periapical (surrounds the periapical region of teeth and are bilateral), florid (sclerotic symmetrical masses) and focal (single lesion) cemental dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For the asymptomatic patient, the best management consists of regular recall examinations with prophylaxis and reinforcement of good home hygiene care to control periodontal disease and prevent tooth lose. Management of the symptomatic patient is more difficult. At this stage, there is an inflammatory component to the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics may be indicated but may not be effective. A case of florid cemento-osseous dysplasia occurring in a 47-year-old Caucasian female is reported which was rare in regard to race and sex

The mandibular angle in osteoporotic men

Objectives: Osteoporosis induces the reduction of bone mass and screening for low bone mineral density (BMD)by dual-energy x-ray absorptiometry (DXA) has been the current gold standard test to determine osteoporosis.Panoramic radiography is widely used in dentistry for routine examination of jaws. The objective of this study wasto determine the relationship between the mandibular angle (MA) values and the vertebral bone mineral density(v-BMD) in 20 osteoporotic men.Study design: In panoramic radiograms of osteoporotic men, the means were calculated for the mandibular anglevalues measured in the right and left mandible. v-BMD values were also calculated by manual analysis of DXAscans. The correlation between these variables was assessed.Results: A negatively significant correlation was found between the MA and v-BMD.Conclusions: The size of the mandibular angle decreases when osteoporosis increases. It is suggested that themandibular angle may be useful in clinical dental practice to identify osteoporotic men with previously undetectedlow bone mineral density (AU)