Evaluation of Sphenoid Sinus Variations in Cleft Lip and Palate Patients: A Comprehensive Cone Beam Computed Tomography Analysis.

OBJECTIVE: This study aims to compare sphenoid sinus variations between unilateral and bilateral cleft lip and palate (CLP) patients and healthy controls using CBCT images. It is notable for its large sample size and comparison of unilateral and bilateral cleft patients, cleft and noncleft sides, and different age groups. DESIGN: Retrospective cohort study. SETTING: University Hospital. PATIENTS: CBCT images of 97 CLP patients (76 unilateral, 21 bilateral) and 97 healthy controls were evaluated.Main Outcome Measures: Sphenoid sinus main types, sellar subtypes, clival, and lateral extensions were assessed for all groups. RESULTS: A significant increase in the anterior type was observed in both unilateral and bilateral CLP groups. The bilateral CLP group had a higher prevalence of the lesser wing type. In CLP and control groups, lesser wing, combined type, and lateral type were statistically significantly lower under 13 years of age. CONCLUSIONS: The study highlights an elevated prevalence of anterior pneumatization in unilateral and bilateral CLP individuals, emphasizing its significance in surgery planning due to proximity to critical structures like the optic nerve and sphenopalatine artery. The increased prevalence of the lesser wing type in bilateral CLP patients requires extra caution during anterior clinoidectomy. Lower pneumatization rates in CLP patients under 13 suggest their sphenoid sinus development is similar to that of healthy individuals. Understanding these variations is crucial for appropriate surgical planning and avoiding complications during transsphenoidal surgery.

Reliability and validity of the Turkish version of the Rapid Estimate of Adult Literacy in Dentistry (TREALD-30).

OBJECTIVE: To culturally adapt the Turkish version of Rapid Estimate of Adult Literacy in Dentistry (TREALD-30) for Turkish-speaking adult dental patients and to evaluate its psychometric properties. MATERIAL AND METHODS: After translation and cross-cultural adaptation, TREALD-30 was tested in a sample of 127 adult patients who attended a dental school clinic in Istanbul. Data were collected through clinical examinations and self-completed questionnaires, including TREALD-30, the Oral Health Impact Profile (OHIP), the Rapid Estimate of Adult Literacy in Medicine (REALM), two health literacy screening questions, and socio-behavioral characteristics. Psychometric properties were examined using Classical Test Theory (CTT) and Rasch analysis. RESULTS: Internal consistency (Cronbach's Alpha = 0.91) and test-retest reliability (Intraclass correlation coefficient = 0.99) were satisfactory for TREALD-30. It exhibited good convergent and predictive validity. Monthly family income, years of education, dental flossing, health literacy, and health literacy skills were found as stronger predictors of patients'oral health literacy (OHL). Confirmatory factor analysis (CFA) confirmed a two-factor model. The Rasch model explained 37.9% of the total variance in this dataset. In addition, TREALD-30 had eleven misfitting items, which indicated evidence of multidimensionality. The reliability indeces provided in Rasch analysis (person separation reliability = 0.91 and expected-a-posteriori/plausible reliability = 0.94) indicated that TREALD-30 had acceptable reliability. CONCLUSION: TREALD-30 showed satisfactory psychometric properties. It may be used to identify patients with low OHL. Socio-demographic factors, oral health behaviors and health literacy skills should be taken into account when planning future studies to assess the OHL in both clinical and community settings.

Cone-beam computed tomography evaluation of impacted and transmigrated mandibular canines: a retrospective study.

OBJECTIVES: The purpose of this study is to evaluate CBCT images of impacted mandibular canines in detail and to discuss implications for diagnosis and treatment. METHODS: CBCT images of dental patients applied between December 2015 and December 2017 were evaluated retrospectively. 2591 CBCT images, including mandible in their field of view, were determined and evaluated regarding the presence of mandibular canine impaction. 66 impacted mandibular canines of 58 patients were analyzed in detail regarding their location, morphology, associated pathologies, and their relationship with the neighboring anatomic structures, the role of these factors on transmigration, as well as treatments applied. The Pearson Chi square test was used between the groups. RESULTS: Transmigration was observed in 53% of impacted mandibular canines. Teeth with transmigration were localized horizontally, below the apex of adjacent teeth frequently, and had no contact with mandibular cortical bone mostly. 62% of mandibular canines were in contact/proximity with the incisive mandibular canal. The most applied treatment for transmigrated teeth was surgical removal, followed by radiographic monitoring, but orthodontic traction was not preferred in any case. For non-transmigrated teeth, the most applied treatment options were surgical removal, orthodontic traction, and radiographic monitoring, respectively. Autotransplantation was not preferred in any case of impacted teeth. Vertical position of the crown tip (p < 0.05) and the presence of deciduous mandibular canines and their resorption showed significant relation to transmigration (p < 0.05). CONCLUSION: Transmigration is common among impacted mandibular canines. Resorption of adjacent teeth roots was one of the possible complications of impaction and likely contact/proximity of incisive mandibular canal with impacted mandibular canines, which may pose difficulties in surgical treatment, can be better detected by CBCT.

Evaluation of Radiolucent Lesions Associated with Impacted Teeth: A Retrospective Study.

BACKGROUND: Impacted teeth are commonly asymptomatic and not associated with any pathologic lesions for years. Any change in the size of the follicle associated with impacted teeth may result in odontogenic cysts or tumors. CBCT plays an important role in determining the radiographic features of a lesion and therefore, is very helpful for accurate diagnosis and treatment planning. OBJECTIVE: This study aims to evaluate radiolucent lesions associated with impacted teeth in terms of age and sex distribution, localization, and comparison with the pathological diagnosis. METHODS: In this retrospective study, out of 6758 CBCT images, 400 images revealing radiolucent lesions were detected. The study included only 190 cases (regarding 180 patients) which had a matching histopathological evaluation. Data related to the age and sex of the patients, localization of the lesions, and their comparison with the pathological diagnosis were recorded and analyzed. RESULTS: The most encountered lesions were dentigerous cysts (60%) and odontogenic keratocysts (26.3%). Males were the most affected (63.3%). Most of the lesions were found in the left and right posterior mandible and mostly (66.8 %) associated with third molars. Out of 123 radiological diagnoses of dentigerous cyst cases, histopathological diagnoses confirmed 108 cases. Regarding odontogenic keratocyst, histopathological diagnosis confirmed 40 cases out of 48. CONCLUSION: Radiological diagnoses of the lesions mostly match with their pathological diagnosis unless their characteristics are changed due to infection. CBCT, as a technique enabling detailed imaging of the involved dental structures, is a helpful instrument for differential diagnosis.