Diagnosis of common intraosseous lesions of the dentomaxillofacial region by chemometry-assisted FT-IR spectroscopy in dental tissue samples.

PURPOSES: This study aimed to determine the differential diagnosis of three intraosseous lesions (odontogenic keratocyst (OKC), central giant cell granuloma (CGCG), and dentigerous cyst (DC)) of the dentomaxillofacial region with very similar radiological and clinical features by using chemometrics assisted FT-IR (Fourier transform infrared) spectroscopy in tissue samples. METHODS: Tissue samples (exposed to formaldehyde for a similar time) of 20-micron thickness belonging to 19 intraosseous lesions diagnosed histopathologically were obtained from the pathology laboratory. The samples were analyzed by FT-IR spectroscopic method using the 400-4000 cm-1 wavenumber range, and the obtained spectra of the samples were evaluated using the orthogonal partial least squares discriminant analysis (OPLS-DA) algorithm. RESULTS: The intraosseous lesions with different histopathological diagnoses were accurately and precisely clustered with different FT-IR bands corresponding to the main molecular vibrations, especially the phosphodiester region, of the tissue components using the proposed model with 3 latent variables. CONCLUSIONS: The model showed high sensitivity and specificity. The present study is the first to report the elucidation of clear spectral differences between similar lesions in the maxillofacial region. In the future, the FT-IR method may be used in the non-destructive classification of similar lesions in the maxillofacial region as an alternative to histopathological evaluation.

The findings of impacted and transmigrated maxillary and mandibular canines: a retrospective cone beam computed tomography study.

BACKGROUND: The aim of this study was to examine and evaluate the maxillary and mandibular impacted and transmigrant canines, their relationship with neighboring tissues and pathology with cone beam computed tomography (CBCT). METHODS: CBCT data of 217 patients, between January 2018 and December 2019, with a total of 293 impacted canines were retrospectively reviewed. Clinical records were also evaluated. Maxillary or mandibular localization, angulations, transmigration, lateral and premolar tooth resorption, apical dilacerations, pathological formations, presence of persistent deciduous canines and treatment methods were investigated. RESULTS: For 293 impacted canines, 237 were in the maxilla and 56 in the mandible, with this difference being statistically significant (P<0.05). Among the 293 impacted canines, 14 (4.8%) transmigrated canines were detected. From the 14 transmigrant canines, 13 were in the mandible and 1 was in the maxilla. This difference was found statistically significant (P<0.05). Eighteen dentigerous cysts (10 maxilla, 8 mandible) and 4 odontomas (3 maxilla, 1 mandible) were found in impacted canines. For a total of 293 impacted canines, 57 were extracted, 13 were referred to orthodontics and a follow-up decision was made for 223 teeth. CONCLUSIONS: Transmigration incidence is statistically significant, on a higher area of the lower jaw, compared to the upper jaw (P<0.05). In patients with impacted canines, taking CBCT together with a detailed clinical examination is effective in correct treatment planning and in minimizing complications that may occur during surgical extraction.

The Investigation of Radiographic Findings of Mandibles on Panoramic Radiographs of Patients with Primary Hyperparathyroidism Using Fractal Analysis.

OBJECTIVE: The basis of the research is the application of fractal analysis (FA) to panoramic radiographs of patients with primary hyperparathyroidism (PHPT). In addition, the relationship between the relevant biochemistry parameters and fractal values of healthy controls and patients with PHPT will be evaluated. MATERIALS AND METHODS: In the current study, FA was performed with ImageJ program on panoramic radiographs of 48 patients diagnosed with PHPT. Fractal dimension (FD) values of the patients and 48 healthy subjects were compared. In addition, biochemical [parathyroid hormone (PTH), serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and vitamin D] parameters and FD values of both groups were analyzed with Mann-Whitney U-tests and Pearson correlation coefficient (P < .05). RESULTS: FD values of four different angular areas were significantly lower in the patient group than in the healthy group (P < .05). There was no statistically significant difference between the patient and control groups in the measurements between the apexes of the right and left premolar and molar teeth. The mean PTH, Ca, P, and vitamin D values of the patients with PHPT and control group were highly significant, and all the parameters of the patient group showed higher values than the control group except for the P values (P < .001). In the patient group and control group, there was no significant difference between mean ALP values (P = .48). No correlation was found between the two groups. CONCLUSION: Bone biopsy is the gold standard method for the diagnosis of bone structure changes in patients with PHPT. However, it is not used routinely because it is an invasive method. The FA method applied to panoramic radiographs may be used as a noninvasive, easy-to-apply method to reveal the changes in the trabecular structure of the jaw bones of the patients.

Buccal bifurcation cyst (paradental cyst) defined by ultrasonography and cone-beam computed tomography.

Buccal bifurcation cyst (BBC) is an uncommon inflammatory odontogenic cyst that generally occurs at the buccal region of the permanent mandibular first molars in children aged 6-8 years. The diagnosis of BBC cannot be made from the histopathologic features; therefore, diagnosis is primarily based on specific clinical and radiographic findings. In this case report, we present the clinical and radiological findings, including ultrasonography (USG) and cone-beam computed tomography (CBCT) images, of a 10-year-old boy who was referred with a complaint of swelling on the lower right jaw. According to the radiographic and clinical findings, the differential diagnosis of this lesion included lateral radicular cyst, lateral periodontal cyst, dentigerous cyst, eruption cyst, and others. Recently, in addition to classical radiographies and CBCT, USG has been considered important for diagnosis. In particular, if a cyst produces a perforation in the cortical bone, it is helpful to make a pre-diagnosis with USG.

Changes in jawbones of male patients with chronic renal failure on digital panoramic radiographs.

OBJECTIVE: To compare the existence of gonial cortical bone thickness, antegonial index, mandibular canal bone resorption and gonial angle values and pathologies like ground-glass appearance in jawbones and brown tumor in male patients undergoing dialysis due to chronic renal failure and men from the healthy control group on panoramic radiographs. MATERIALS AND METHODS: Panoramic radiographs were taken from 80 male individuals in total (40 normal and 40 dialysis patients). Values obtained from the right and left sides of the mandible were summed and their means were calculated. Gonial cortical thickness, antegonial index and gonial angle values were assessed with the Student's t-test, mandibular canal wall resorption with the Chi-square test, and pathologies such as ground-glass appearance and Brown tumor as "available" or "not available." RESULTS: Statistically significant differences were observed among the antegonial index (P < 0.001), gonial cortical bone thickness (P < 0.001), and gonial angle (P < 0.001) values of study and control groups. Besides, mandibular canal wall resorption (P < 0.001) was also statistically significant. In the study group, pathologies with ground-glass appearance were encountered in mandible, but no radiographic findings were observed similar to brown tumor. CONCLUSIONS: Compared to the control group, decreases were found in gonial cortical bone thicknesses, antegonial index values, mandibular canal wall resorption, and gonial angle values of the patients receiving dialysis treatment due to chronic renal failure. Although it is not statistically significant, pathology with ground-glass appearance was detected in a patient, but no pathologies like brown tumor were observed. These findings from patients with chronic renal failure must be evaluated in panoramic radiography.

Unilateral bone cavities situated near the angle of the mandibula.

Stafne bone defects (SBDs) are asymptomatic radiolucent lingual/buccal bone lesions of the lower jaw and are frequently caused by soft tissue inclusion. These defects have a cystlike appearance on plain radiographs. The diagnosis of this defect is incidental because patients do not usually present clinical symptoms. The common variant of SBD exists at the third molar region of the mandible below the inferior alveolar canal. To date, only 1 case of multilocular SBD has been reported in the literature, including both clinical cases and archaeological specimens. The purpose of the current study was to describe a new case of multilocular appearance of SBD near the angle of the mandibula that was diagnosed with the aid of a three-dimensional cone beam computed tomographic scan.

Cone beam computed tomography imaging of ponticulus posticus: prevalence, characteristics, and a review of the literature.

OBJECTIVE: The aim of this study was to investigate the frequency of ponticulus posticus (PP) using cone beam computed tomography (CBCT) and to describe the radiologic characteristics of the detected cases. STUDY DESIGN: The presence and types of PP were investigated on 730 CBCT images. RESULTS: PP was found in 17.4% (127) of the 730 CBCT scans. Of these 127 patients, 79 (10.8%) had bilateral PP and 48 (6.6%) had unilateral PP. Male predominance was found with a prevalence of 19.5% (54 of 277) and female prevalence was 16.1% (73 of 453). The prevalence of PP increased with age; the highest prevalence of PP was seen in those who were 49 to 81 years of age. CONCLUSIONS: This study shows that PP is not an uncommon anatomic variation and is a natural incidental finding on CBCT.

Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths?

Heterotrophic soft tissue calcification occurs with the deposit of calcium salts in soft tissue rather than bone. The aim of this report is to describe cone-beam computed tomographic (CBCT) and ultrasonographic (US) findings of 2 cases of soft tissue calcifications that were initially diagnosed as submandibular or parotid sialolithiasis. Multiple soft tissue calcifications were evaluated by panoramic radiography, CBCT imaging, and US imaging in a 50-year-old male patient and a 30-year-old male patient. Calcifications were detected in the soft tissue of the submandibular area at axial, coronal, and multiplanar reformatted examinations and were prediagnosed as sialolithiasis. US examination was conducted to determine the complete relation between the soft tissues and the calcifications. In conclusion, high-resolution dental volumetric tomography with a low radiation dose is the optimal diagnostic tool to analyze the skeletal structure of the maxillofacial region in 3 dimensions. However, it is not sufficient to examine the soft tissues. US imaging is a useful diagnostic tool to evaluate the relation between the soft tissues and the calcifications in the submandibular area.

Median rhomboid glossitis: a clinical and microbiological study.

OBJECTIVES: The purpose of this study was to investigate the relationship between median rhomboid glossitis (MRG) and Candida and bacteria species, prevalence and possible association with age, gender, smoking, denture wearing, and diabetes mellitus. METHODS: Tongue examinations were performed on 4244 consecutive patients. Of all the examined patients, 30 diagnosed with MRG were selected as the study group and another 30 patients were selected as the control group, and these 2 groups were compared in terms of age and gender. Tongue cultures from these 60 patients were subjected to bacterial and mycological examinations. RESULTS: MRG frequency was detected to be 0.7%. In mycological examination, Candida species were determined in 90.0% of the MRG patients and in 46.6% of the control group. This difference was statistically significant. Multivariate logistic regression indicated that diabetes mellitus and 20-39 years of age were significantly related to MRG. However, the association between MRG, gender, smoking, and 40-69 years of age was not statistically significant. CONCLUSIONS: It was determined that although there was a significant association between MRG, Candida and diabetes mellitus, the possible risk factors such as gender, smoking, and denture wearing for oral candidiasis were invalid for MRG.

Rhabdomyosarcoma of the oral cavity: a case report.

Rhabdomyosarcoma (RMS), a tumor of skeletal muscle origin, is the most common soft tissue sarcoma encountered in childhood and adolescence. The common sites of occurrence are the head and neck region, genitourinary tract, retroperitonium, and, to a lesser extent, the extremities. In the head and neck region, the most commonly affected sites are the orbit, paranasal sinuses, soft tissues of the cheek, and the neck. RMS is relatively uncommon in the oral cavity, and the involvement of the jaws is extremely rare. Here, we report a case of oral RMS in a 13-year-old child and describe the clinical, radiological, histopathological, and immunohistochemical findings.

Predisposition of allergy in patients with benign migratory glossitis.

OBJECTIVE: The purpose of this study was to investigate the presence of allergy in patients with benign migratory glossitis (BMG) using patch and prick tests. PATIENTS AND METHODS: Eighty patients (40 BMG and 40 healthy controls) received patch and prick tests. If at least one test result was positive, patients were considered to be allergic. RESULTS: The prick test was positive in 10 patients (25.0%) of the study group and in 4 patients (10.0%) of the control group. The patch test was positive in 12 patients (30.0%) of the study group and in 6 patients (15.0%) of the control group. When results of both tests were evaluated together, the study group showed a positive rate of 47.5% (n = 19), whereas the control group showed a positive rate of 22.5% (n = 9) (P = .02). CONCLUSION: Our results revealed that a combination of prick and patch tests can significantly enhance the diagnostic accuracy of predisposition of allergy in patients with BMG.

Investigation of tooth transposition in a non-syndromic Turkish anatolian population: characteristic features and associated dental anomalies.

OBJECTIVE: The aims of this study were to investigate the frequency and characteristics of dental transpositions and to evaluate associated dental anomalies in a large sample of Turkish Anatolian population. STUDY DESIGN: A retrospective study was performed using panoramic radiographs of 6983 patients (4092 females and 2891 males) ranging in age from 12 to 27 subjected to Faculty of Dentistry at the University of Ataturk (Erzurum, Turkey) between 2005 and 2008. For each patient with tooth transposition we recorded the demographic variables (including age, sex), history of trauma, type, classification, and location of tooth transpositions, and associated dental anomalies. The Pearson chi-squared test was used to determine potential differences in the distribution of tooth transposition when stratified by gender. RESULTS: Tooth transposition was detected in 19 subjects (0.27%), with a 2.2:1 female male ratio (P=0.38). The most commonly observed transposition was maxillary canine-lateral incisor (60%). The frequencies of complete and incomplete transpositions were equal (10/10) and it was more common in the left side than in the right side (11/9). Of the 19 subjects, 10.5% had a peg shaped lateral incisor, 21.1% one congenitally missing tooth excluding third molar. Supernumerary tooth, impacted teeth excluding third molars, transmigrated tooth, and dilacerations were also observed. CONCLUSION: The frequency of tooth transposition was 0.27% in a Turkish Anatolian population and maxillary canine-lateral incisor was the most frequently observed transposition. Retained primary teeth were the most frequently observed dental anomaly in all types of tooth transposition.

Frequency of agenesis, impaction, angulation, and related pathologic changes of third molar teeth in orthodontic patients.

PURPOSE: The objectives of the present study were to investigate the frequency of impaction, agenesis, angular position, and related pathologic changes of third molar teeth in a group of orthodontic patients. MATERIALS AND METHODS: Our sample included the panoramic radiographs of 351 orthodontic patients aged 20 to 26 years (mean 22.8). The descriptive characteristics of agenesis, impaction, angular position, and pathologic changes of third molars were recorded. The chi(2) test was used for analysis. RESULTS: The proportion of third molar agenesis was 17.3% with no statistically significant gender differences (18.4% for women and 15.8% for men). The frequency of impacted third molars (ITMs) was 35.9% (24.2% in men and 45.0% in women; P < .05). The frequency of maxillary ITMs was 43.2% (192 of 444 teeth), and the frequency of mandibular ITMs was 56.8% (252 of 444 teeth). The position observed most often was mesioangular inclination, with a frequency of 50.0%. Only 10.4% of the ITM teeth were affected by any pathologic changes, and most of these changes were associated with the horizontal position. CONCLUSIONS: The present results showed that agenesis accounted for 17.3% and impaction for 35.9% of the pathologic features in this group of Turkish orthodontic patients aged 20 to 26 years of age. Mesioangular inclination was seen in 50.0%, and a small proportion (10.4%) had pathologic changes of the ITMs.

The prevalence of root dilacerations in a Turkish population.

OBJECTIVES: The aim of this study was to determine the prevalence of root dilaceration in a Turkish dental patient population, considering factors such as dental localization and the relationship between the sexes in this anomaly. STUDY DESIGN: A retrospective study was performed using periapical radiography of 2,124 patients, who ranged in age from 15 to 65 years old. All data (age, sex and systemic disease or syndrome) were obtained from the patient files and analyzed for root dilaceration. Descriptive characteristics of sexes, jaws, and dental localization were recorded. The Pearson chi-squared test was used. RESULTS: Of the 2,251 patients, 214 (9.5%) were found to have root dilaceration. Root dilacerations were determined in 276 (4.3%) of 6386 teeth, belonging to a total of 2251 patients. Anomalies were found in 9.8% of males, compared with 9.3% of females, a difference that was not statistically significant (p>0.05). Root dilacerations were distributed fairly evenly between the maxilla and mandible. The most frequently root dilacerated teeth were found to be mandibular third molars (12.8%), followed by maxillary third molars (7.4%), and maxillary first molars (6.7%). Root dilaceration was not detected in maxillary central incisors, mandibular central incisors or mandibular lateral incisors. CONCLUSION: root dilaceration is an uncommon developmental anomaly which occurs mostly in the posterior teeth, which are not prone to suffer trauma. The radiographic diagnosis of this anomaly is important before surgery, and especially before endodontic treatment or orthodontic treatment.

The prevalence and risk factors associated with benign migratory glossitis lesions in 7619 Turkish dental outpatients.

OBJECTIVE: The aim of this study was to investigate the frequency of benign migratory glossitis (BMG) in a Turkish population with respect to gender, age, smoking, atopic and allergic diseases, dermatological diseases (psoriasis and seborrheic dermatitis), systemic diseases, and fissured tongue (FT). PATIENTS AND METHODS: The study was conducted on 7619 patients (3819 female, 3800 male) with various dental complaints, ranging in age from 4 to 60 years, recruited from the Department of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey. RESULTS: BMG was found in 1.5% (95% CI: 0.9-1.9) of all patients examined. Multivariate logistic regression indicated that age less than 30 (OR: 6.7 [95% CI: 2.9-15.5]), not smoking (6.3 [2.8-14.1]), and history of allergy or atopy (6.5 [3.3-12.5]) were significantly related to BMG. Of the patients with BMG, 34.5% (n = 40) had FT. No significant associations existed with gender, dermatological conditions (psoriasis and seborrheic dermatitis), or systemic diseases (diabetes mellitus, hematological disorders, cardiovascular disorders, hepatitis, gastrointestinal disorders, respiratory disorders, connective tissue disorders, and genitourinary disturbances). CONCLUSION: The present study demonstrated that BMG is more prevalent in young, nonsmokers, and atopic or allergic individuals.

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.