Comparison of Diagnostic Accuracy of Panoramic Radiography to CBCT in Maxillary Sinus Diseases.

We aimed to compare the effectiveness of panoramic radiography (PR) and cone beam computed tomography (CBCT) in radiographic diagnosis of maxillary sinus (MS) diseases. MS diseases (mucosal thickening, mucus retention cyst, polyp sinusitis, mucocele and tumoral formations) was carried out on both PR and CBCT images belonging to 625 patients. Analyzes were performed separately for right and left maxillary sinus, and total of 1250 PR and CBCT images. While a diagnosis of disease was made in 42.96% of a total of 1250 MS according to CBCT. According to PR, diagnosis was made in 58.72%. The 537 diagnoses where lesion presence was determined on CBCT in our study were compared over PR, and it was observed that, there was the right diagnosis (true positive) in 106 (19.73%) of these including respectively mucus retention cyst (n = 88), polyp (n = 16), 1 sinusitis and 1 tumor, and there was an incorrect diagnosis (false positive) in 221 (41.15%). In 42.92% of the MS that were identified as healthy based on CBCT, the correct diagnosis was also made on PR (true negative). The use of CBCT instead of PR in the diagnosis of pathological or inflammatory diseases contributes to a more accurate radiographic differential diagnosis.

Inflammation-associated long non-coding RNA signature in radicular cyst tissues.

Radicular cysts are characterized by significant levels of changes in inflammatory biomarkers. Among them, interleukins and growth factors have been reported to be deregulated in radicular cyst tissues. Moreover, long non-coding RNAs are recently discovered non-coding RNA molecules that regulate various intracellular stimuli to keep homeostasis in balance. A growing body of evidence suggests that lncRNAs are significantly involved in the regulation of inflammation by targeting various inflammatory biomarkers. Accordingly, the present study was aimed to investigate the gene expression levels of inflammation-related lncRNAs in radicular cysts and show their possible roles in the development of radicular cysts. For the study, a total of 25 patients with a radiologically and pathologically confirmed radicular cyst were enrolled. For the determination of non-coding RNA expression levels, real-time qPCR was used. As a result of the current study, expression levels of PACER and THRIL were found to be significantly elevated in radicular cyst tissues compared to control tissue samples. However, MALAT1, ANRIL, and NEAT1 expression levels were not significantly altered in radicular cyst tissues compared to control tissue samples. In conclusion, long non-coding RNAs, PACER and THRIL, seem to have significant pathophysiological roles by acquiring molecular changes during inflammation and might be involved in the development and formation of radicular cysts.

Does Temporomandibular Joint Magnetic Resonance Imaging Diagnosis Support Clinical Examination Diagnosis Following Diagnostic Criteria for Temporomandibular Disorders?

PURPOSE: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) has been validated as a clinical diagnostic guideline with high-sensitivity and -specificity in identifying TMDs. The purpose of this study was to evaluate the agreement between DC/TMD diagnoses and magnetic resonance imaging (MRI) diagnoses in patients with TMD. METHODS: A prospective cohort study was conducted on patients with TMD. The predictor variable was the clinical diagnosis of TMD based on DC/TMD criteria. The outcome variable was the MRI diagnosis of TMD. The diagnoses used for both the predictor variable and the outcome variable were the same. They were normal, disc displacement with reduction (DDWR), DDWR with intermittent locking, disc displacement without reduction (DDWOR) with limited opening, DDWOR without limited opening, degenerative joint disease, and subluxation. Age and gender of the patients and number of joints evaluated were covariates. Each subject had clinical examination performed by two independent Oral and Maxillofacial Surgeons. All subjects had a bilateral temporomandibular joint (TMJ) MRI performed which was evaluated by a radiologist. The correlation between the clinical and MRI diagnoses was calculated using Cohen's kappa value with a P value of <.05 considered significant. RESULTS: A total of fifty patients (100 TMJs) were enrolled with 38 females and 12 males. The mean ages were 31.92 and 31.75 years, respectively, with a total of 100 TMJs analyzed. Internal derangement was clinically identified in 76% of the joints and with MRI in 69% of joints. The Cohen's kappa value between DC/TMD and MRI diagnoses was found to be κ = 0.720 (P < .01). The respective sensitivity and specificity in determining disc position clinically for DDWR was 1 and 0.96; for DDWR with intermittent locking 0.78 and 0.91; for DDWOR with limited opening 0.9 and 0.98; for DDWOR without limited opening 1 and 0.9; for degenerative joint disease 0.63 and 0.97 and for subluxation 0.28 and 1.00. CONCLUSION: The DC/TMD clinical examination performed well in all types of disc displacement but is less reliable than MRI in detecting the presence of degenerative disc diseases and subluxation.

Expression pattern of hypoxia-related genes in odontogenic cysts.

OBJECTIVE: The aim of the present study was to reveal the effects of hypoxia-associated signaling in odontogenic cysts. DESIGN: The expression levels of genes involved in the hypoxia-associated signaling pathway were determined by quantitative Polymerase Chain Reaction (PCR) method. RESULTS: As a result, it was found that phosphatase and tensin homolog (PTEN) expression was low (p = 0.037), and the expression levels of phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) (p = 0.0127), hypoxia inducible factor 1 alpha (HIF1A) (p < 0.001), and HIF1A antisense RNA 1 (HIF1A-AS1) (p = 0.0218) were higher in cyst tissue compared to normal tissue. HIF1A gene expression was found to be significantly altered according to the pathologic subtypes of odontogenic keratocyst, dentigerous cyst, and radicular cyst. CONCLUSIONS: Odontogenic cysts were found to have higher expression of HIF1A and HIF1A-AS1, which may be related to the increased hypoxia in these lesions. In addition, PI3K/Akt signaling may be stimulated by increased PIK3CA and decreased PTEN expression, which promote cell survival and support the mechanism of cyst formation.

Evaluation of biochemical variables in patients with recurrent aphthous stomatitis.

PURPOSE: We investigated the effects of various biochemical agents on the etiopathogenesis of recurrent aphthous stomatitis (RAS). METHODS: We enrolled 70 RAS patients and 70 healthy volunteers. Peripheral venous blood samples were collected. We performed complete blood counts, then measured the levels of ferritin, vitamin B12, iron, magnesium, phosphorus, calcium, thyroid-stimulating hormone, T3, T4, and 25-hydroxy D3. RESULTS: The groups did not differ in terms of age (p = 0.912) or sex (p = 0.612). The levels of ferritin and 25-hydroxy vitamin D were significantly lower in RAS patients (both p Ë‚ 0.05). CONCLUSION: Vitamin D and/or ferritin deficiency may induce RAS. Measurements of vitamin D and ferritin may assist diagnosis and follow-up.

Is the YouTube™ a useful resource of information about orthognathic surgery?: A cross-sectional study.

PURPOSE: YouTube™ has become a widely used resource of information about health-related topics nowadays. This cross-sectional study has aimed to analyze the content and quality of YouTube™ videos on orthognathic surgery. METHODS: In our study, six orthognathic surgery-related keywords (Le Fort I osteotomy, sagittal split osteotomy, jaw surgery, jaw correction surgery, orthodontic surgery, and orthognathic surgery) were used to search on YouTube™. Only the videos in English, which had visually and audibly acceptable quality and were mainly about orthognathic surgery, were chosen from the videos. A total of 360 videos were selected, the top 60 videos for each search term, and sorted according to view count. Of these videos, the first 60 videos were analyzed. Video source (independent or educational), duration, number of views, likes, and dislikes were recorded for each video. Moreover, two impartial observers evaluated the visibility, popularity, quality, usefulness, and reliability of the videos. RESULTS: 41 of 60 videos were of independent sources while 19 of them were of educational origin. Information content of the videos was found to be insufficient. No significant difference was determined between independent and educational videos in terms of popularity, visibility, usefulness and quality analysis of the videos (p > 0.05), but a significant difference was found in terms of reliability values (p < 0.05). CONCLUSION: It can be said that YouTube™ videos were not a reliable and accurate enough source of information when evaluated in terms of orthognathic surgery-related content and quality. Therefore, the information content provided by specialists and health institutions, in particular, should be increased in number, thereby making access to better quality information on orthognathic surgery easy for patients.

Salivary gland tumors exhibit distinct miRNA signatures involved in Wnt/ß-Catenin signaling in formalin fixed paraffin embedded tissue samples.

Advances in high-throughput genomic technologies have enabled the identification of numerous selective tumor markers. However, adapting these newly identified markers to clinical practice is not always possible because most RNA molecules, including mRNAs of protein-coding genes and long non-coding RNAs, are not stable under laboratory conditions, making their testing a major challenge. In contrast to long RNA molecules, miRNAs offer a great advantage in that they are relatively stable due to their small size. Accordingly, herein we aimed to determine the expression levels of miRNAs that are involved in Wnt/ß-catenin signaling pathway in formalin fixed paraffin embedded (FFPE) tissue samples of patients with salivary gland tumors. A total of 42 patients with salivary gland tumors were included in the study. The miRNA expression signatures were evaluated using the RT-qPCR. As a result, ß-catenin positivity was observed in all salivary gland tumors without distinguishing between benign and malignant phenotypes. Remarkably, we found that miR-200a and miR-373 were significantly upregulated whereas miR-30c were downregulated in tissues of patients with salivary gland tumors, compared to adjacent healthy tissue samples. In addition, distinct expression signatures of these miRNAs were significantly associated with the clinicopathological findings of patients such as perineural invasion and lymph node metastasis. Additionally, miR-145 and miR-30a were found to be specifically downregulated in a mucoepidermoid carcinoma. Also, miR-26b was selectively increased in pleomorphic adenomas of the salivary gland. Collectively, our findings suggest that these miRNAs may play chief roles in the differential diagnosis of salivary gland tumors.

Evaluation of the relationship between temporomandibular joint disorders and tinnitus with computed tomography.

PURPOSE: This study aimed to radiographically determine tinnitus and joint disorders by evaluating glenoid fossa depth and the horizontal angle of the ramus mandible in patients with isolated temporomandibular joint disorder and temporomandibular joint disorder with tinnitus by computed tomography (CT). METHODS: In total, eighty two patients with temporomandibular disorders (TMDs) (forty two patients with tinnitus; forty patients without tinnitus) were evaluated using CT. CT images were analysed according to glenoid fossa depth and the horizontal angle of the ramus. RESULTS: A total of 82 cases 43 (52.4%) female and 39 (47.6%) male were included. The distribution of gender was not significantly different between the TMD patients and the TMD-tinnitus patients (p >0.05). The mean age of the patients with isolated TMD was 31.70 ± 9.68 years, and the mean age of the patients with TMD-tinnitus was 34.07 ± 11.72 years. Comparisons were made of the right and left glenoid fossa depths of the patients with TMD and TMD-tinnitus, respectively. There was a statistically significant difference between the right glenoid fossa depths (p = 0.016) also there was also a statistically significant difference between the left glenoid fossa depths (p = 0.049). CONCLUSION: Our study revealed that decreased glenoid fossa depth may be associated with an increased incidence of tinnitus in TMD patients by the way temporomandibular joint and ear can affect each other in diseases such as tinnitus due to their close anatomical relationship.

Deciphering miRNAs associated with cellular stress response and apoptosis mechanisms regulated by p53 activity in patients with lower lip cancer.

Cancers of the lips and oral cavity are a leading cause of death worldwide. Although they account for only 2% of the global cancer burden, they significantly affect the comfort of patients and eventually lead to a person's death. Also, defects in the cellular stress response and apoptosis mechanisms regulated by p53 activity is an important hallmark of cancer cells. Here, we aimed to decipher miRNAs associated with cellular stress response and apoptosis mechanisms regulated by p53 activity in patient with lower lip cancer and reveal the association of these miRNAs with the clinical course of the disease. The present research included a total of 40 eligible individuals with pathologically confirmed lower lip cancer diagnosis. Formalin-fixed, paraffin-embedded (FFPE) tissue samples of patients were obtained, and miRNAs expressions were analyzed by qPCR. Immunohistochemistry was used to determine p53 and Ki67 expression status. While three of these miRNAs (miR-130a, -375, and -128a) were found to be elevated in tumor cells compared to normal tissues of lower lip cancer patients, five were downregulated (let-7a, -7b, -7c, and miR-138, -23a), but only three were significantly altered. Particularly, we identified three miRNA signatures in which miR-128a was significantly upregulated and miR-23a and let-7c were significantly downregulated in patients with lower lip cancer. Remarkably, let-7c identified to be a promising prognostic factor for lip cancer. Our findings demonstrate that these miRNAs play important regulatory roles in lower lip cancer pathobiology, highlighting their potential relevance in diagnosis and prognosis of these patients. Moreover, these miRNAs can be targeted in future therapeutic interventions against lower lip cancer.

Evaluation of the associations between maxillary sinus dimensions and adenoid hypertrophy using multislice computed tomography.

INTRODUCTION: Adenoid hypertrophy is especially common in childhood, raising the concern that such growth might affect maxillary sinus volumes during the developmental period. This study evaluated the developmental relationships between maxillary sinus volumes and adenoid hypertrophy via computed tomography. MATERIALS AND METHODS: It was examined computed tomographic images of 118 individuals: 61 boys and 57 girls. The participants were divided into a healthy control group (n = 59) and an experimental group (with adenoid hypertrophy) (n = 59). Raw data were recorded in DICOM format and analysed using the ITK-SNA algorithm; it was measured the right, left, and total maxillary sinus volumes and adenoid tissue sizes. RESULTS: It was found significant between-group differences in the three maxillary sinus volumes and adenoid tissue dimensions (linear maximum anterior and posterior depth; maximum upper and lower height, and maximum width to the right and left) (all p<0.001). On the contrary, there was no significant difference according to sex in terms of either maxillary sinus volumes or linear adenoid tissue measurements. Maxillary sinus volumes increased significantly according to age in both groups. CONCLUSION: Adenoid hypertrophy decreases the maxillary sinus volumes, regardless of sex. The impacts of adenoid growth on maxillary sinus aeration and sinus disease should be further investigated.

Non-coding RNAs transcribed from ultra-conserved regions (T-UCRs) are differentially expressed in dental follicle tissues of impacted mandibular third molars.

INTRODUCTION: Transcribed ultra-conserved regions (T-UCRs) are a new class of long non-coding RNA molecules transcribed from ultra-conserved regions (UCRs) of the human genome. T-UCRs are extremely conserved in the human, rat, and mouse genomes. Deletions of genomic areas containing UCRs resulted in live mice that developed without distinguishable phenotypes, implying that T-UCRs are involved in developmental processes. In addition, there is increasing evidence that dental follicle tissues exhibit various cellular alterations involving deregulation of protein-coding genes and non-coding RNAs. Accordingly, the main objective of the present study was to determine the clinical significance and distinct expression signatures of non-coding RNA molecules transcribed from ultra-conserved regions in dental follicle tissues of impacted mandibular third molars. MATERIALS AND METHODS: From March 2021 to December 2021, a total of 42 patients who referred to clinic of oral and maxillofacial surgery department with the indications of impacted mandibular third molar extraction from 38th and 48th positions were enrolled for the study. For the analysis of T-UCR expression levels, real-time quantitative reverse transcription PCR method was used. RESULTS: Findings of the present study indicated that T-UCRs are distinctly expressed in dental follicle tissues of impacted mandibular third molars. The expression of uc.38, uc.112, and uc.338 was found to be significantly increased in the dental follicles of impacted mandibular third molars, indicating a clinical significance of these molecules. In addition, no differences in T-UCR expression were found as a function of demographic characteristics. CONCLUSIONS: Collectively, transcribed ultra-conserved elements, such as uc.38, uc.112, and uc.338, are considerably deregulated in the dental follicle tissues of impacted mandibular third molars and might be responsible for the molecular changes acquired by dental follicle tissues of impacted mandibular third molars.

Clinical significance of Vimentin Antisense RNA 1 and its correlation with other epithelial to mesenchymal transition markers in oral cancers.

Oral squamous cell carcinoma (OSCC) is the most common form of malignant tumor in the head and neck region worldwide. Hence, the identification of biological signatures with high diagnostic and therapeutic potential for OSCC will be of great clinical importance. Epithelial to mesenchymal transition (EMT) is a key driver of malignant transformation of human tumors including OSCC. Loss of epithelial properties and gain of mesenchymal cell properties is one of the most important hallmarks of malignant tumors. Although much has been reported on the protein components of the EMT process, studies on the non-protein coding components are quite limited. Consequently, here we sought to explore biological significance of VIM antisense RNA 1 (VIM-AS1) in OSCC. A total of 36 patients diagnosed with oral cancer were recruited for the study. Formalin-fixed paraffin embedded (FFPE) tissue samples of patients were obtained from pathology archive. For the gene expression analysis, quantitative RT-PCR was used. We also analyzed the expression levels of E-cadherin and Vimentin. Notably, it was found that the expression levels of VIM-AS1 and Vimentin were significantly elevated, while the expression of E-cadherin was downregulated in OSCC. Deregulation of VIM-AS1 was associated with the clinicopathological features of OSCC patients. ROC analysis also showed that VIM-AS1 is an independent diagnostic biomarker for OSCC. Consequently, our findings suggest a chief role for VIM-AS1 in oral cancers.

Investigation of the expression level of long non-coding RNAs in dental follicles of impacted mandibular third molars.

OBJECTIVES: Dental follicle (DF) is made up of mesenchymal cells and fibers surrounding the enamel organ of a developing tooth. It has been shown that cystic and neoplastic lesions can develop from the pericoronal follicles of impacted third molars (ITMs). But the molecular transformation of DF tissues has not yet been uncovered and remains elusive. Accordingly, in the present study, we aimed to investigate the differential expression of lncRNA genes in DF tissues associated with asymptomatic impacted mandibular third molars (IMTMs) that do not show pathological pericoronal radiolucency in radiographic examination. MATERIAL AND METHODS: A total of 30 patients with unilateral mesioangular IMTMs were enrolled for the study. The expressions of lncRNA genes were determined in the DF and healthy gingival tissues obtained from study patients. For the determination of lncRNA expression levels, RNA was isolated from the obtained tissues, converted to cDNA samples, and analyzed by quantitative real-time PCR method. RESULTS: As a result, we found that the gene expression of MEG3 was increased about 10-fold in DF tissues compared to healthy gingival tissues (p < 0.0001). In addition, NORAD expression was found to be upregulated 4.2-fold (p = 0.0002) in DF tissues. Also, expression level of MALAT1 was found to be decreased 1.24-fold (p = 0.584) and TP73-AS1 increased 2.6-fold (p = 0.093) in DF tissues compared to healthy gingival tissues. CONCLUSIONS: Consequently, present findings suggest that differentially expressed lncRNAs in DFs might be associated with the various levels of cellular events including osteogenic differentiation, DNA damage, and the transformation into odontogenic pathology. CLINICAL RELEVANCE: Expression levels of MEG3 and NORAD lncRNA molecules may guide clinicians in the evaluation of asymptomatic ITM dental follicles that cannot be determined radiologically and during extraction of these teeth for prophylactic purposes.

The effect of pre-operative submucosal administration of dexamethasone, tramadol, articaine on the success rate of inferior alveolar nerve block on mandibular molars with symptomatic irreversible pulpitis: A randomized, double-blind placebo-controlled clinical trial.

AIM: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). METHODOLOGY: In this randomized double-blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre-operative pain levels of the patients were measured with the Heft-Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one-way ANOVA or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi-square test was used to compare the categorical variables. RESULTS: The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p < .05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p < .001). CONCLUSIONS: In patients with SIP, pre-operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone increased the duration of anaesthesia. These agents can be used in cases where effective anaesthesia cannot be obtained during root canal treatments.

Asporin levels in patients with temporomandibular joint disorders.

BACKGROUND: Understanding the pathogenesis of temporomandibular joint disorder (TMD) is important for diagnosis and treatment planning. Thus, biochemical analysis is usually used for the detection of tissue damage. OBJECTIVE: In this study, we aimed to investigate the serum asporin levels in patients with TMD. METHODS: Our study was planned to be performed on 43 healthy individuals (control group) without any joint problems and 43 patients with temporomandibular joint internal derangement (TMJ-ID; patients group) according to the Wilkes classification (stages 3, 4 and 5). Serum asporin levels were determined by the enzyme-linked immunosorbent assay (ELISA) method and compared between groups. Asporin levels were analysed according to the demographic and clinical characteristics of the patients, and the differences between them were demonstrated. RESULTS: Asporin levels were found to be significantly increased in the patients group compared to control group (p = .0303). The age and gender distributions of the samples in the control and patients groups were homogeneous, and there was no statistically significant difference between the groups. In addition, while there was no significant change in asporin levels in females in the patients group compared with the control group, the asporin levels were significantly increased in males in the patients group (p = .0403). CONCLUSIONS: Consequently, asporin seems to be an important biomarker in the pathobiology of TMJ-ID as it is significantly upregulated in these patients.

Evaluation of serum prolidase activity and oxidative stress in patients with temporomandibular joint internal derangement.

Objective: To investigate serum prolidase activity and oxidative stress in patients with temporomandibular joint internal derangement (TMJ-ID).Methods: Seventy patients with Wilkes stage III, IV, and V joints and 70 healthy controls were included. Serum prolidase activity and oxidative stress parameters, including total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), advanced oxidation protein products (AOPP), glutathione (GSH), ferric reducing antioxidant power (FRAP), and lipid hydroperoxide (LOOH) were measured.Results: The levels of prolidase, TOS, OSI, AOPP, and LOOH were significantly higher in the TMJ-ID group than in the control (p = .0001). TAS and FRAP level was significantly lower in the TMJ-ID group than in the control (p = .0001). There was no significant difference in GSH between groups.Conclusion: Significantly increased prolidase activity and oxidative stress in patients with TMJ-ID may be related to long-term collagen tissue damage, and inflammation and can be effective in the etiology of TMJ-ID.

Is the only buccal infiltration anesthesia enough for extraction of mandibular anterior incisors and premolar teeth? A split-mouth randomized clinical trial.

OBJECTIVES: The issue of needing additional lingual injection in extractions of mandibular premolar and incisors is still not clarified. The aim of this study is to investigate whether it is necessary to perform lingual injection in addition to buccal infiltration anesthesia in mandibular incisors and premolar teeth extractions. MATERIALS AND METHODS: Sixty-six patients who admitted to our clinic for the removal of bilateral mandibular anterior teeth were included in the present study. Patients were divided into two groups. The experimental group received only 1.5 ml of 2% lidocaine with 1:80,000 epinephrine by injection into the buccal vestibule of the tooth. The control group received 1.5 ml of 2% lidocaine with 1:80,000 epinephrine by buccal injection into the buccal side and 0.3 ml same lidocaine solution injected into the lingual side of the tooth. After 5 min, tooth was extracted and each patient was asked to record the intensity of injection and extraction pain by 0-100 mm and a 10-point Visual Analogue Scale (VAS) and six-pointed Face Pain Scale (FPS). RESULTS: The injection pain scores were significantly higher in terms of the VAS 0-10 point and 0-100 mm and FPS in the control group to which additional lingual injections were applied than the experimental group (p < 0.05). No statistically significant differences were found in all three scales between the groups in terms of extraction pain (p > 0.05). The mean extraction pain scores were lower in the experimental group according to the three scales. No additional anesthetic injection and post-operative complications were observed in all patients. CONCLUSIONS: The extraction of mandibular incisors and premolar teeth can only be done with only the buccal infiltration. CLINICAL RELEVANCE: In the extraction of mandibular anterior teeth, it can be performed with less anesthetic amount without the need for an additional lingual injection.

Evaluation of the Oxidative Stress Level and Serum Prolidase Activity in Patients with Sleep Bruxism.

AIM AND OBJECTIVE: Sleep bruxism is a complicated disease, and its cause remains controversial. If the etiology of bruxism is resolved, the treatment can be adjusted to the prevailing aetiological factor. Thus, the aim of this study was to evaluate the oxidative stress level and serum prolidase activity in patients with sleep bruxism. MATERIALS AND METHODS: Seventy healthy subjects and 51 patients with sleep bruxism were included in this study, and blood samples from all patients were collected. Serum samples were analyzed for total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and prolidase activity. RESULTS: The prolidase, TOS, and OSI levels were significantly higher in patients with bruxism than in the healthy controls (p = 0.001, p = 0.001, p = 0.001, respectively). The TAS level was significantly lower in bruxism patients than in healthy controls (p = 0.003). CONCLUSION: The increased TOS, OSI, and prolidase levels and decreased TAS levels could be assumed to result in oxidative injury in patients with sleep bruxism. However, the study could not determine whether oxidative imbalance and increased serum prolidase levels could be a cause or a result of bruxism.

Efficacy of submucosal tramadol and lidocaine on success rate of inferior alveolar nerve block in mandibular molars with symptomatic irreversible pulpitis.

The aim of the present study is to compare the efficacy of additional 100 mg/2 ml tramadol and 40 mg/2 ml lidocaine applications on the anesthetic success of inferior alveolar nerve block (IANB) in mandibular molars with symptomatic irreversible pulpitis (MM-SIP). One hundred and five patients diagnosed with symptomatic pulpitis in the lower first or second molars were included in the study. Patients were randomly divided into three groups (n = 35) composed of control and two experimental groups administered submucosal tramadol and lidocaine. Preoperative pain levels of the patients were measured with Heft-Parker visual analog scale (HP VAS). Following, standard IANB with 2% lidocaine 1: 80,000 was administrated to all groups. After observation of lip numbness, 2 ml of saline in the control group, 100 mg/2 ml tramadol in tramadol group and 40 mg/2 ml (2%, 1: 80,000) lidocaine in lidocaine group were administered submucosally. After 15 min, standard endodontic treatment was initiated and the pain levels measured from access cavity preparation to pulp extirpation were measured with HP VAS. The success rate of pulpal anesthesia was 28.5% in the control group, 45.7% in the submucosal lidocaine group and 48.6% in the tramadol group. There was no statistically significant difference in the success rate between the groups. Additional submucosal administration of 100 mg tramadol did not significantly increase the success of IANB applied with a combination of 2% lidocaine 1:80,000 and epinephrine in MM-SIP compared to control group.

Comparison of the Anesthetic Efficiency of Lidocaine and Tramadol Hydrochloride in Orthodontic Extractions: A Split-Mouth, Prospective, Randomized, Double-Blind Study.

PURPOSE: The aim of the present randomized controlled split-mouth clinical study was to evaluate and compare the clinical anesthetic efficacy of lidocaine and tramadol hydrochloride in orthodontic extractions. MATERIALS AND METHODS: A total of 32 systemically healthy patients requiring bilaterally maxillary first premolar extractions for orthodontic reasons were included. Each patient received 1.8 mL of lidocaine (36 mg lidocaine HCI and 0.0225 mg epinephrine) on 1 side and 1.8 mL tramadol (50 mg tramadol HCl and 0.0225 mg epinephrine diluted to 1.8 mL by distilled water) on the other side. The anesthetic solutions were infiltrated into the buccal vestibule (local infiltration) based on a computer-generated list. In each patient, the time of anesthetic onset and finish, anesthetic activity, duration of postoperative analgesia, additional analgesic medication, wound healing, possible side effects, and satisfaction levels were recorded intraoperatively and postoperatively for both sides. RESULTS: Although no relevant differences were found between the solutions for anesthetic onset, lidocaine was significantly more effective statistically for the total anesthesia duration. Comparing the anesthetic activity at 5 minutes before extraction, we found that tramadol was significantly more effective statistically compared with lidocaine. Similarly, tramadol was significantly more effective statistically than lidocaine for satisfaction level and wound healing. Moreover, compared with tramadol, in terms of postoperative pain, the visual analog scale scores with lidocaine were significantly higher at statistically 7, 8, 9, and 10 hours during the first 12 hours. In general, the lidocaine values were dramatically higher than were the tramadol values. CONCLUSIONS: The results of the present study suggest that using tramadol combined with epinephrine can be an alternative local anesthetic for maxillary first premolar tooth extractions in oral-maxillofacial surgery.