Evaluation of mandibular trabecular and cortical structure by fractal analysis in hyperlipidemia and hypertension patients.

INTRODUCTION: This study aimed to evaluate the mandibular trabecular and cortical changes in patients with hyperlipidemia (HL) and/or hypertension (HT) using fractal dimension (FD) analysis, mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI). MATERIALS AND METHODS: Panoramic radiographs of 100 patients were evaluated. FD measurement of three region of interest (ROI) including the angulus, corpus and interdental bone area were made. MCW, PMI and MCI were also measured and noted. RESULTS: Angulus, corpus and interdental FD values were significantly lower in three disease groups than the control group. Angulus, corpus, and interdental FD values were significantly lower in the HL+HT group than in the HL group and HT group. MCW value was significantly lower in the HL group, HT group, and HL+HT group than the control group. The cortical index C1 was more common in the control group while C2 was more common in the HT, HL and HL+HT group. CONCLUSION: The fact that FD was significantly lower in the HL+HT group compared to the HL and HT groups indicates the positive effect of their association on bone loss and quality. FD measurements on images obtained using a direct digital panoramic system can be used for treatment planning and follow-up of patients with HL and/or HT.

Evaluation of maxillary palatal process pneumatization by cone-beam computed tomography.

PURPOSE: The aim of this study is to investigate the pneumatization type of the palatal process (PTP) and angular and distance measurements of neighbouring structures on cone beam computed tomography (CBCT) images. MATERIALS AND METHODS: 400 maxillary sinuses (MS) of 200 patients (96 female; 104 male; mean age: 43.2) were retrospectively evaluated. PTP was divided into three as types 1,2 and 3 and evaluated at distances 4, 8, 16, and 24 mm posterior to incisive foramen. The sinus and alveolar ridge height, palatonasal recess angle (PRA) and palatal junction angle (PJA) were also measured and recorded. RESULTS: PTP I (101, 25.3%) was the most frequent type, followed by PTP II (95, 23.8%), and the least was PTP III (4, 1%). In patients with PTP I, the alveolar ridge height in the 4 mm and 8 mm group was significantly higher than in the patients with PTP II and III (p<0.05). In patients with PTP I, PRA in the 4 mm and 16 mm groups was significantly higher than in patients with PTP II and III (p<0.05). Sinus and alveolar ridge height, PRA and PJA did not differ significantly between the right and left sides in the 4 mm, 8 mm, 16 mm, and 24 mm groups (p>0.05). CONCLUSION: Knowing the anatomy of the MS is very important for a successful surgical procedure in this area. Anatomy and pathology of the MS can be understood more clearly in CBCT.

Cone beam computed tomographic evaluation of infraorbital canal protrusion into the maxillary sinus and its importance for endoscopic surgery

Abstract Objective: The aim of this retrospective study is to investigate the prevalence of Infraorbital Canal Protrusion (ICP) degree into the maxillary sinus and its relationship with variations in adjacent structures on Cone Beam Computed Tomography (CBCT) images. Methods: 350 CBCT images (700 Infraorbital Canal [IC]) were evaluated retrospectively. ICP was divided into 3 subtypes according to the protrusion degree. The correlation between IC types and variations in adjacent anatomical structures (Haller cell, middle nasal concha pneumatization, maxillary sinus mucosal thickening and septa) was evaluated. The distance between Infraorbital Canal and Cnine Root (IC-CR) was also measured. For type 3, measurements were performed on IC as the length of the bony septum from the IC to the Mxillary Sinus Wall (IC-MSW), the distance from the inferior orbital rim, where the IC begins to protrude into the maxillary sinus (IOR-ICP), the vertical distance from the IC to the Maxillary Sinus Roof (IC-MSR) and Floor (IC-MSF). Results: The prevalence of type 1, 2 and 3 was 62.9%, 29.1%, and 8% respectively. IC-CR was 10.2, 10.7 and 11.4 mm in type 1, 2 and 3, respectively. IC-MSW, IOR-ICP, IC-MSRand floor IC-MSF was 3.8, 10.9, 7.4 and 27.7mm, respectively. On the right and left side, statistically significant correlation was found between IC types and the presence of the Haller cell and sinus septa. But there was no significant correlation between IC types and middle concha pneumatization. Conclusion: Accurate diagnosis of ICP is very important in preventing infraorbital nerve damage in surgical procedures to be performed in the maxillary region. The results of this study could be a guide for surgical planning in this region. Level of evidence: Retrospective study.

The Relationship between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps

Abstract Introduction The maxillary sinus and its variations are very important to dentistry and rhinology. Objective To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. Methods The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Results Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. Conclusion This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

The Relationship between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps.

Introduction The maxillary sinus and its variations are very important to dentistry and rhinology. Objective To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. Methods The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Results Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. Conclusion This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

Cone beam computed tomographic evaluation of infraorbital canal protrusion into the maxillary sinus and its importance for endoscopic surgery.

OBJECTIVE: The aim of this retrospective study is to investigate the prevalence of Infraorbital Canal Protrusion (ICP) degree into the maxillary sinus and its relationship with variations in adjacent structures on Cone Beam Computed Tomography (CBCT) images. METHODS: 350 CBCT images (700 Infraorbital Canal [IC]) were evaluated retrospectively. ICP was divided into 3 subtypes according to the protrusion degree. The correlation between IC types and variations in adjacent anatomical structures (Haller cell, middle nasal concha pneumatization, maxillary sinus mucosal thickening and septa) was evaluated. The distance between Infraorbital Canal and Cnine Root (IC-CR) was also measured. For type 3, measurements were performed on IC as the length of the bony septum from the IC to the Mxillary Sinus Wall (IC-MSW), the distance from the inferior orbital rim, where the IC begins to protrude into the maxillary sinus (IOR-ICP), the vertical distance from the IC to the Maxillary Sinus Roof (IC-MSR) and Floor (IC-MSF). RESULTS: The prevalence of type 1, 2 and 3 was 62.9%, 29.1%, and 8% respectively. IC-CR was 10.2, 10.7 and 11.4 mm in type 1, 2 and 3, respectively. IC-MSW, IOR-ICP, IC-MSR and floor IC-MSF was 3.8, 10.9, 7.4 and 27.7 mm, respectively. On the right and left side, statistically significant correlation was found between IC types and the presence of the Haller cell and sinus septa. But there was no significant correlation between IC types and middle concha pneumatization. CONCLUSION: Accurate diagnosis of ICP is very important in preventing infraorbital nerve damage in surgical procedures to be performed in the maxillary region. The results of this study could be a guide for surgical planning in this region. LEVEL OF EVIDENCE: Retrospective study.

Morphological Measurement and Anatomical Variations of the Clivus Using Computed Tomography.

Objectives The aim of this study was to evaluate the clivus morphology, including fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CC), on computed tomography (CT) images. Design This is a retrospective study. Setting Faculty of Dentistry, Department of Dentomaxillofacial Radiology. Participants The CT images of 500 patients (253 males; 247 females) were evaluated. Main Outcome Measures The prevalence of FNM, CBM, and CPC; the length, width, and depth of FNM; and CBM types were recorded. Also, a morphological analysis of the clivus (length of the clivus, angle between the clivus and the posterior margin of the foramen magnum, angle between the clivus and the dens axis, and anteroposterior diameter of the foramen magnum) was performed. Results FNM was identified in 5.4%, CBM in 4%, and CC in 0.8% of the study group. Type 5 CBM was not found. Type 6 was the most common CBM type. There was no significant correlation between the age and gender of patients with FNM. There were significant differences between the clivus length, the angle between the clivus and the dens axis, the anteroposterior diameter of the foramen magnum, and gender. Also, there was a significant difference between the angle between the clivus and the foramen magnum and age. Conclusions The anatomical variations of the clivus are rare and important for the oral and maxillofacial radiologist to make the differential diagnosis. These anatomical variations should not be confused with pathologic formations. The morphological measurements and anatomical variations of the clivus can be evaluated in detail on CT images.

Evaluation of morphological variations of petrotympanic fissure using computed tomography imaging of the temporal bone.

PURPOSE: Petrotympanic fissure (PF) is important for both dentists and otolaryngologists to know the temporal anatomy well especially for pre-surgical radiological evaluations. Computed tomography (CT) is indispensable method for temporal bone imaging. The purpose of this study was to evaluate PF morphology and position using CT. METHODS: CT scans of 300 patients (600 PFs) were retrospectively evaluated. PF types were recorded by dividing into 3 groups (Type 1,2 and 3). Length of the mandibular fossa (MF) and PF, vertical diameter (VD) of the PF at the MF level, midpoint and tympanic cavity (TC) level were measured. PF position types were subdivided as low, midline and high. RESULTS: Type 1, 2 and 3 was found in 18.7%, 51.5% and 29.8% of the cases, respectively. The mean length of the MF and PF was 18.33 mm and 3.77 mm, respectively. The mean VD of the PF at the MF level, midpoint and TC level was 1.71, 0.98 and 0.97 mm, respectively. The low, midline and high position of PF was observed 14.5%, 54.3% and 31.2% of the cases, respectively. CONCLUSION: Length of the MF and PF in males was significantly higher than females. VD of the PF at the MF level in Type 1 and Type 3 was significantly higher than type 2. In type 1,VD of the PF at the midpoint was significantly higher than type 2 and type 3. VD of the PF at the TC level in Type 1 and Type 3 was significantly higher than type 2.

THE ANATOMICAL AND MEASUREMENT STUDY OF ROSENMÜLLER FOSSA AND OROPHARYNGEAL STRUCTURES USING CONE BEAM COMPUTED TOMOGRAPHY.

The objective of this study was to assess Rosenmüller fossa (RF) anatomy and neighboring structures using cone beam computed tomography (CBCT). A total of 1000 patients were analyzed using CBCT. The reference points were based on the spina nasalis posterior (Snp) and basion. The length between RF and neighboring structures were measured.The mean distance from Snp to the posterior pharyngeal wall was 17.7 mm. The mean distance from right to left torus levatorius was 25.69 mm. The mean depth of right RF was 5.54 mm while the mean depth of left RF was 5.26 mm. RF, also described as the lateral pharyngeal recess, is a source location of nasopharyngeal carcinoma development. Its location is on the lateral pharyngeal wall posterior to the cartilaginous part of the eustachian tube, the torus tubarius. The knowledge of RF is important to diagnose and perform treatment planning of nasopharyngeal carcinoma.

Evaluation of Pediatric Patient's Age, Behaviors, and Reasons for the First Dental Visit in Edirne, Turkey: a Cross-Sectional Study / Evaluación de la edad, los comportamientos y las razones de la primera visita dental del paciente pediátrico en Edirne, Turquía: un estudio transversal

ABSTRACT: Oral and dental health are vital parts of general baby health, and early dental visits provide significant prevention-focused intervention and parental counseling regarding oral health. Evaluating the age and main complaints of children is therefore important during their first dental visit (FDV). The purposes of this study were to determine the age, reason for the visit, behavioral response, and caries status at the FDV and to evaluate the factors affecting these parameters. Parents of 325 pediatric patients (159 males; 166 females; mean age 7.20±2.78 years) at their FDV were asked to fill out a questionnaire requesting sociodemographic information and their child's medical history, brushing habits, and reasons for attending dental consultation. The decayed-missing-filled-teeth (dmft/DMFT) scores were also recorded. The child's behavioral responses during the FDV were evaluated according to Frankl's Behavior Rating Scale (FBRS). Higher maternal education level and dmft/DMFT score were associated with earlier FDV age. The most common reason for the FDV was dental caries in 33.5% of patients, followed by toothache (29.5%). Most of the children showed positive behavior (46.7%), with positive behavior affected by age and negative behavior affected by the dmft/DMFT score and distance from home. The mean dmft/ DMFT score was 8.1±4.4 and was negatively affected by toothbrushing frequency and family income. These study results indicate that Turkish children living in Edirne present at a late age for the FDV. Raising awareness in terms of dental health care among parents is important to ensure that children attend their FDV at an early age.

RESUMEN: La salud oral y dental son partes vitales de la salud general del bebé, y las visitas dentales tempranas brindan una importante intervención centrada en la prevención y asesoramiento a los padres sobre la salud bucal. Por lo tanto, evaluar la edad y las principales quejas de los niños es importante durante su primera visita al dentista (FDV por sus siglas en inglés). El propósito de este estudio fue determinar la edad, motivo de visita, respuesta conductual y estado de caries en la FDV y evaluar los factores que afectan estos parámetros. A los padres de 325 pacientes pediátricos (159 hombres; 166 mujeres; edad media 7,20±2,78 años) en su FDV se les pidió que llenaran un cuestionario solicitando información sociodemográfica y el historial médico de su hijo, hábitos de cepillado y motivos de presentación a la consulta dental. También se registraron las puntuaciones de dientes cariados-faltantes-obturados (dmft/DMFT). Las respuestas conductuales del niño durante la FDV se evaluaron de acuerdo con la escala de calificación de conducta de Frankl (FBRS). Un mayor nivel de educación materna y una puntuación de dmft/DMFT se asociaron con una edad más temprana de la FDV. La causa más común de la FDV fue la caries dental en el 33,5% de los pacientes, seguida del dolor de muelas (29,5%). La mayoría de los niños mostró un comportamiento positivo (46,7%), con un comportamiento positivo afectado por la edad y un comportamiento negativo afectado por el puntaje dmft/DMFT y la distancia del hogar. La puntuación media de dmft/DMFT fue de 8,1±4,4 y se vio afectada negativamente por la frecuencia de cepillado de dientes y los ingresos familiares. Los resultados de este estudio indican que los niños turcos que viven en Edirne se presentan a una edad avanzada para la FDV. Es importante concienciar a los padres sobre el cuidado de la salud dental para garantizar que los niños asistan a su FDV a una edad temprana.

MRI investigation of TMJ disc and articular eminence morphology in patients with disc displacement.

PURPOSE: The aim of this study was to evaluate the morphology of the temporomandibular joint (TMJ) articular eminence and disc and the relationship between morphology and inclination in patients with disc displacement. METHODS: TMJ magnetic resonance images (MRI) of 30 patients with disc displacement with reduction (DDWR) on one side and disc displacement without reduction (DDWOR) on the other side were analyzed. Articular eminence morphology was subdivided as box, sigmoid, flattened and deformed. Articular disc configuration was characterized as biconcave, biplanar, biconvex, hemiconvex and folded. The articular eminence inclination was measured as the angle between the Frankfurt plane and a line drawn from the glenoid fossa roof to the lowest point of the articular eminence. RESULTS: Regarding articular eminence shape, in both DDWR and DDWOR groups, the most frequent articular eminence shape was flattened shape. Regarding to the disc morphology, biplanar shape was the most frequently observed in both DDWR side and DDWOR side. The mean articular eminence inclination was 32.62 and 33.85 in the DDWR and DDWOR side, respectively. CONCLUSIONS: Disc and articular eminence morphology was found to have no relationship with TMJ internal derangement except the relationship between flattened type and internal derangement. The articular eminence inclination have no influence on disc reduction.

Volumetric and morphological analysis of condyle and glenoid fossa on computed tomography.

AIM: The aim of this study was to evaluate temporomandibular joint (TMJ) condyle and glenoid fossa morphology with measurements on Computed Tomography (CT) and volumetric analysis using InVesalius software program. MATERIALS AND METHODS: 250 condyles in 125 patients (mean age: 40.64) was evaluated on CT. Length, width, and height of the condyle, condylar volume, the thickness of glenoid fossa (TGF), condyle surface area, anterior space (AS), superior space (SS), and posterior space (PS) were measured in this study. Two left and right sides of the jaw have been measured. Linear measurements were performed with the image analysis program (Image J, 1.4 v version, National Institutes of Health, Bethesda, MD). Volume and surface area measurements were performed with InVesalius software (CTI, Campinas, SãoPaulo, Brazil). RESULTS: To compare the dimensions of the condyle between males and females, there was only a significant difference in left AS and SS and no significant difference was found between males and females in other measured factors. There was a significant difference between the age groups and left SS. A significant difference was also found between the age groups and condylar height, condyle surface area, and condylar volume on both right and left sides. CONCLUSION: Evaluation of condylar morphology is important to assess the TMJ anomalies and bony changes. This study showed no significant differences between gender and all measured factors except in the left AS and SS. However, age factor had a major effect on the morphology.

Fractal and radiomorphometric analysis of mandibular bone changes in patients undergoing intravenous corticosteroid therapy.

OBJECTIVE: To evaluate mandibular bone changes by comparing the fractal dimension (FD), mandibular cortical width (MCW), and panoramic mandibular index (PMI) on panoramic radiographs in patients using intravenous corticosteroids versus controls. STUDY DESIGN: In total, 60 patients were divided into 2 groups: 30 patients receiving intravenous corticosteroid treatment and 30 age- and sex-matched healthy people as the control group. Panoramic radiographs of all patients were evaluated. FD was measured in 4 regions: the subcortical area in the condyle, the area superior to the angle of the mandible, the alveolar bone distal to the mandibular left second premolar root, and the alveolar bone mesial to the mental foramen. MCW and PMI were calculated to assess cortical thickness. RESULTS: The FD values in the condyle, angle of the mandible, and mental foramen region were significantly lower in the corticosteroid group (P ≤ .011), but there was no significant difference in the second premolar area (P = .101). MCW values were significantly lower in the corticosteroid group (P < .001). There was no significant difference in PMI between the groups (P = .544). CONCLUSIONS: The FD and MCW values of the patients using corticosteroids can be helpful in quantitatively and objectively evaluating osseous changes in patients receiving intravenous corticosteroids.

Bibliometric Analysis of 50 Most Cited Articles on Odontomas

Abstract Objective: To identify the citation features and review articles on odontomas using bibliometric analysis. Material and Methods: A list of studies about odontoma was obtained by searching using the Scopus database. Abstracts or full texts were read and evaluated. After then, 50 most cited articles were achieved. Studies were categorized as citation numbers, citation density, journal name, article type, the affiliation of the first author and publication year. Descriptive statistics were used to analyze the results. Results: The most frequently cited article received 358 citations, while the least frequently cited article received 42 with a mean of 94.3 citations per article. The mean citation density was 5.13. The study with the highest citation density (12.31) was published in 2006. The highest citation number was found in the 2000s following the 1990s. The 50 most cited articles were published from 1971 to 2011, with 84% (42 of 50) published after 1990. USA (n = 9) and Brazil (n = 6) were the two most contributing countries. According to article type, there were eight (16%) review articles. Conclusion: The USA found to have a strong influence on research about odontoma, followed by Brazil. All researches were reported in English, and most of them were published in good quality journals (AU).

Comparison of Head and Neck Cancer Distribution in Turkish and Syrian Populations.

BACKGROUND: Although oral health improves in several countries, global problems are still present. Predictably, the disadvantaged and poor population groups in both developing and developed countries have high rate of malign disease. The aim of this study was to evaluate the prevalence of head and neck cancers (HNCs) and to compare them between Syrian and Turkish population. METHODS: A total of 4570 patients confirmed to have HNC histopathologically from Hatay Mustafa Kemal University Hospital Pathology report archive were retrospectively evaluated. Among them, 452 were Syrian patients while 4118 were Turkish patients. Data were collected from 2010 to 2017. Gender and age information were taken from medical records. According to the pathological results, HNCs were classified. RESULTS: In 474 patients, HNCs were inscriptived, of which 317 were in males and 157 in females aged 23-80 years with histologically approved cancer of head and neck area. Overall, 100 were Syrian patients while 374 were Turkish patients. In both Syrian and Turkish patients, the most observed HNC was squamous cell carcinoma (SCC). CONCLUSION: Nowadays, the prevalence of cancer is higher because of the excessive consumption of alcohol, tobacco, chewing, and smoking. For the higher cancer incidence in Syrian refugees, we thought that the impact of war such as stress may have been effective as well as the known several etiologic factors of cancer. For the increased risk of cancer, the early diagnosis of this become more important.