Face comparison analysis of patients with orthognathic surgery treatment using cloud computing-based face recognition application programming interfaces.

INTRODUCTION: This study aimed to investigate whether the postoperative change in patients after orthognathic surgery, whose facial aesthetics was affected, led to detectable differences using Microsoft Azure, Amazon Web Services Rekognition, and Face++, which were commercially available face recognition systems. METHODS: Photographs of 35 patients after orthognathic surgery were analyzed using 3 well-known cloud computing-based facial recognition application programming interfaces to compute similarity scores between preoperative and postoperative photographs. The preoperative, relaxed, smiling, profile, and semiprofile photographs of the patients were compared separately to validate the relevant application programming interfaces. Patient characteristics and type of surgery were recorded for statistical analysis. Kruskal-Wallis rank sum tests were performed to analyze the relationship between patient characteristics and similarity scores. Multiple-comparison Wilcoxon rank sum tests were performed on the statistically significant characteristics. RESULTS: The similarity scores in the Face++ program were lower than those in the Microsoft Azure and Amazon Web Services Rekognition. In addition, the similarity scores were higher in smiling photographs. A statistically significant difference was found in similarity scores between relaxed and smiling photographs according to different programs (P <0.05). For all 3 facial recognition programs, comparable similarity scores were found in all photographs taken before and after surgery across sex, type of surgery, and type of surgical approach. The type of surgery and surgical approach, sex, and amount of surgical movement did not significantly affect similarity scores in any facial recognition programs (P >0.05). CONCLUSIONS: The similarity scores between the photographs before and after orthognathic surgery were high, suggesting that the software algorithms might value measurements on the basis of upper-face landmarks more than lower-face measurements.

Evaluation of Changes in Nasal Projection After Surgically Assisted Rapid Maxillary Expansion With 3dMD Face System.

The most appropriate treatment option for maxillary expansion in adulthood due to increased cyanosis in sutures is surgically assisted maxillary expansion (SARME). Skeletal and dental changes are observed with SARME. Three-dimensional imaging techniques are gaining importance with the developing technology in evaluating the changes that occur as a result of the treatments applied. The aim of study was to evaluate the soft tissue changes occurring in the nasal projection after SARME in 3-dimensional analyzes during the expansion and post-retention processes. The study sample consisted of 19 patients with a transverse maxillary deficiency of more than 5 mm (11 female and 8 male). 3dMD Vultus software was used for measuring height and width of the philtrum, superior alar, nasal and subnasal width; nasal length, nasal projection, nasal bridge width, nasal tip protrusion and upper face height) before surgery (T0), after the expansion phase (T1), and 6 months postoperatively (T2). A significant difference was found only subnasal width between pre-treatment and post-retention values. Surgically assisted maxillary expansion operations alter the nasal projection and this study certified these results with 3dMD face system. 3dMD face technique is an effective imaging technique for evaluating the soft tissues changes after orthognathic surgeries.

Rehabilitation of the Work Accident-Related Traumatic Mandible With Iliac Free Flap, Distraction Osteogenesis, and Dental Implants.

Mandibular bone defects due to extensive trauma impair occlusion and affect the aesthetics of facial contouring, making it difficult to obtain a satisfactory outcome. Distraction osteogenesis and free flap is an effective and aesthetic treatment option for rehabilating these defects. In this clinical report, the authors present rehabilitation of a wide mandibular traumatic defect due to a work-related accident with iliac free flap, distraction osteogenesis, and dental implants.

Extraoral approach of the surgical treatment of sublingual epidermoid cyst: A case report.

Epidermoid and dermoid cysts account for <0.01% of all oral cavity lesions with dermoid cyst which is twice as common to epidermoid. Epidermoid cysts are benign lesions that occur rarely in children. They usually present early in life as an asymptomatic mass. The treatment option is surgical and intraoral or extraoral approaches can be performed according to the localization and size of the mass. This report presents an 11 year old child with a sublingual epidermoid cyst treated extraorally.

Unilateral Le Fort I Osteotomy for Rehabilitating the Large Alveolar Cleft and Vertical Malocclusion With the Distraction Technique.

Rehabilitation of the large alveolar clefts with autogenous graft or distraction osteogenesis is one of the most common treatment choices. Depending on the clinical situation such as vertical deficiencies, linear transport of the segment does not always ensure a proper closure of the cleft space. In this report, the authors present a patient in whom large unilateral cleft and vertical alveolar deficiency were closed by unilateral Le Fort I osteotomy and distraction technique using the orthodontic elastics.

Evaluation of Changes in Lip Closing Force After Surgically Assisted Rapid Maxillary Expansion.

OBJECTIVE: Morphological changes in patients subjected to surgical treatment to correct occlusal discrepancies may lead to various functional changes. The aim of the present study was to evaluate changes in lip closing force after surgically assisted rapid maxillary expansion in skeletally mature patients. METHODS: The study involved 7 female and 7 male patients treated with surgically assisted rapid maxillary expansion. Maximum and minimum lip pressures of patients were measured with Lip De CumLDC-110R. The intercanine distance and incisors angulations were measured preoperatively (T0), at the end of the expansion (T1), at the end of the third month of retention (T2), and at the end of the sixth month of retention (T3). RESULTS: The greatest values of maximum and the minimum lip closing force were observed at the end of the expansion period significantly. The intercanine distance and inclinations of incisors measured at the third and sixth months showed a significant decrease. CONCLUSIONS: The present study demonstrated that, following surgically assisted rapid palatal expansion, both the maximum and the minimum lip closing force increases had a tendency to revert to their initial values 6 months after surgery.

Does smoking affect the Ki67 and p53 expressions in asymptomatic fully impacted lower third molar follicles?

PURPOSE: Ki67 and p53 protein expressions are the most widely used markers to show the pathologic proliferation and early-stage tumoral alterations in vital tissues. The aim of this study was to compare Ki67 and p53 protein expressions in smokers' and nonsmokers' pericoronal follicles of asymptomatic impacted lower third molars (ILTMs). MATERIALS AND METHODS: A cross-sectional study was planned. The study sample was derived from a population of patients who presented for evaluation and operative treatment of asymptomatic ILTMs. The predictor variable was smoking status, defined as smoker or nonsmoker. Outcome variables were Ki67 and p53 protein expressions in ILTM follicles. Other study variables were age, gender, tooth position, cigarette pack-year, epithelial layer staining, and inflammation. Independent-samples t test analyses were conducted with SPSS 10.0 (SPSS, Inc, Chicago, IL), with statistical significance set at a P value equal to .05. RESULTS: The study sample was composed of 70 patients (35 in the smoker group) who contributed 60 follicles. There were statistical differences between the 2 groups for variables Ki67 and p53. Mean expression levels of Ki67 were 3.93 ± 2.17 and 2.48 ± 2.09, respectively, for smokers and nonsmokers (P = .011). Mean expression levels of p53 were 5.32 ± 1.98 and 3.06 ± 2.34, respectively, for smokers and nonsmokers (P = .000). CONCLUSION: The present study showed that dental follicles of smokers have higher Ki67 and p53 protein expressions than nonsmokers' follicles.

Three-dimensional anatomic analysis of the lingula and mandibular foramen: a cone beam computed tomography study.

PURPOSE: The authors analyzed the anatomic location differences of the mandibular foramen (MF) and lingula in a cone beam computed tomography study, aiming to obtain information that could be used when performing mandibular osteotomies and the inferior alveolar nerve block (IANB). METHODS: Three-dimensional mandibular computed tomography images were reconstructed from data for 139 patients (278 sides) aged between 9 and 18 years (growth group, 27 patients) and aged 19 to 71 years (adult group, 112 patients). RESULTS: In the adult group, positive correlations were seen between right and left measurements. In the growth group, there are significant differences in lingula-anterior and MF-posterior ramus measurements. In the adult group, there are significant differences between man and woman MF-gonion distance measurements. Differences were seen in edentulous and asymmetry patients. CONCLUSIONS: The MF is an important anatomic landmark for ramus surgery and IANB. When applied to ramus operations and IANB, the anatomic data provided by this study may help surgeons gain more understanding of nerve position during surgery.

Detection of epidermal growth factor receptor intensity in asymptomatic fully impacted lower third molar follicles of smoking and nonsmoking patients.

OBJECTIVE: The objective of this study was to determine whether smoking causes pathological changes, comparing intensity of epidermal growth factor receptor (EGFR) expression in smokers' and nonsmokers' pericoronal follicles located around asymptomatic impacted lower third molars. STUDY DESIGN: Eighty-two dental follicles were collected from asymptomatic mandibular third molars of 41 smoker and 41 nonsmoker patients. Specimens were examined immunohistochemically using antibody against EGFR. RESULTS: The expression of EGFR in smokers' pericoronal follicles was higher as compared with nonsmokers (P = 0.036). Also, high EGFR expression was detected in female smokers than in female nonsmokers (P = 0.01). There was a statistically significant correlation between pack-years and EGFR expression intensity in male patients. CONCLUSIONS: The risk of pathological differentiation in pericoronal tissues of smoking patients is higher than in the nonsmoking patients. This factor may be taken into account when deciding whether to remove an asymptomatic impacted lower third molar.

Secondary closure of alveolar clefts with mandibular symphyseal bone grafts and with platelet-rich fibrin under local anesthesia: three case reports.

Secondary alveolar bone grafting is a method that enables an excellent oral rehabilitation of the patients having cleft palate. Many types of bone grafts have been used for reconstruction of the cleft, including autogenous bone and bone substitutes. Platelet-rich fibrin (PRF) has been shown to be effective in grafting the defect. The aim of this presentation is to report the closure of an alveolar cleft with the use of symphyseal bone grafts harvested with platelet rich fibrin under local anesthesia. PRF may be a good treatment choice depending on the early radiographical view of the defect and uneventfull healing.

Experimental investigation of the effects of a blood stopper agent (ankaferd blood stopper) on bone surfaces.

OBJECTIVE: This study aims to experimentally investigate the efficiency of Ankaferd Blood Stopper (ABS) on early and long-term bone healing and its effects on bone surfaces. MATERIALS AND METHODS: Thirty adult male Wistar albino rats were used in the study. These rats were randomly divided into three groups, and bilaterally bone defects were created in the femur of each rat. A 3.0-mm-deep monocortical circular defect was created with a 3.0 mm diameter trephine drill on the proximal part of the femur, and 0.05 mL ABS was applied to the experimental group while the control group was left untreated. Group 1, group 2, and group 3 rats were sacrificed on days 7, 28, and 42, respectively. Trabecular bone area (Tb.Ar), medullary bone diameter (Me.Dm), osteoblast area (Ob.Ar), osteoid area (O.Ar) and mineralized bone area (Md.Ar) were examined in the histomorphometric analysis. Also new bone formation was scored according to the histologic evaluation Results: The results showed that while new the to day 7 experimental group showed much more bone formation than the to day 7 control group, there was no significant difference between the to day 28 and day 42 experimental groups and to day 28 and day 42 control groups. Accordingly, ABS applied in bone cavities only had a larger accelerator effect on bone healing for the seventh-day to day 7 experimental group. In clinical observations, no allergic or inflammatory reactions were observed on the skin and other preoperative and postoperative periods. Moreover in, the histomorphometric study, necrotic areas and infection areas were not observed. CONCLUSION: ABS has an acceleratory effect on the short-term bone healing process and is a reliable agent for routine use. However, its effects on the long-term bone healing process are insignificant. We think that a wide series of research projects are required to confirm the effects of ABS speeding up the healing process in addition to its characteristic as a blood stopping agent. CONFLICT OF INTEREST: None declared.

Facial recognition by cloud-based APIs following surgically assisted rapid maxillary expansion.

INTRODUCTION: This study aimed to investigate whether the facial soft tissue changes of individuals who had undergone surgically assisted rapid maxillary expansion (SARME) would be detected by three different well-known facial biometric recognition applications. METHODS: To calculate similarity scores, the pre- and postsurgical photographs of 22 patients who had undergone SARME treatment were examined using three prominent cloud computing-based facial recognition application programming interfaces (APIs): AWS Rekognition (Amazon Web Services, Seattle, WA, USA), Microsoft Azure Cognitive (Microsoft, Redmond, WA, USA), and Face++ (Megvii, Beijing, China). The pre- and post-SARME photographs of the patients (relaxed, smiling, profile, and semiprofile) were used to calculate similarity scores using the APIs. Friedman's two-way analysis of variance and the Wilcoxon signed-rank test were used to compare the similarity scores obtained from the photographs of the different aspects of the face before and after surgery using the different programs. The relationship between measurements on lateral and posteroanterior cephalograms and the similarity scores was evaluated using the Spearman rank correlation. RESULTS: The similarity scores were found to be lower with the Face++ program. When looking at the photo types, it was observed that the similarity scores were higher in the smiling photos. A statistically significant difference in the similarity scores (P < 0.05) was found between the relaxed and smiling photographs using the different programs. The correlation between the cephalometric and posteroanterior measurements and the similarity scores was not significant (P > 0.05). CONCLUSION: SARME treatment caused a significant change in the similarity scores calculated with the help of three different facial recognition programs. The highest similarity scores were found in the smiling photographs, whereas the lowest scores were found in the profile photographs.

Misdiagnosed widespread eosinophilic granuloma of the mandible.

Eosinophilic granuloma is the most common expression of Langerhans cell histiocytosis and corresponds with typical bone lesions. Early clinical signs can occur in the mandible and can cause extensive destruction of the periodontal tissues. Pathologic fracture is an unusual finding. A case of misdiagnosed eosinophilic granuloma in a 45-year-old man treated with free fibula flap and implant-supported overdenture prosthesis is reported. Free fibula flap with dental implants is a safe and reliable method for comprehensive functional and aesthetic mandibular defect reconstruction.

Evaluation of RANK, RANKL and OPG Levels in Gingival Crevicular Fluid After Surgically Assisted Rapid Maxillary Expansion.

Objectives: Maxillary transverse deficiency is one of the most common skeletal problems. Patients who have completed skeletal maturity, maxillary transverse deficiency can be treated with surgically assisted rapid maxillary expansion. Orthodontic forces affect the cells in the periodontium to form biologically active substances responsible for remodeling. These substances can be detected in the content of the gingival crevicular fluid (GCF). This study aimed to investigate changes in RANK, RANKL and OPG in the gingival crevicular fluid after surgically assisted rapid maxillary expansion. Materials and Methods: A total of 16 patients with a maxillary transverse deficiency were included in the study. Gingival crevicular fluid samples were collected from the mesiobuccal regions of the upper left central, lateral incisors, first and second premolar teeth before the operation (T0), after activation period (T1) and at the 4th month (T2) after the retention period. Changes in RANK, RANKL and OPG levels of gingival crevicular fluid samples were investigated. Results: RANK and RANKL amounts were found to be significantly increased in the first and second premolar teeth after expansion, and OPG amounts were significantly decreased in central incisor and first premolar teeth. RANKL was also significantly higher in the first premolar teeth than in the second premolar after retention. Conclusion: According to the results of the study, RANK, RANKL and OPG levels are changed in the gingival crevicular fluid after surgically assisted rapid maxillary expansion. Clinical Relevance: Using tooth-borne appliances for SARME operations alters the biological content of the GCF. For avoiding these interactions, bone-borne appliances may be used for SARME procedures.

Comparison of psychosocial and aesthetic features of class III malocclusion after orthognathic surgery: Conventional approach versus surgery-first approach.

The aim of this study is to investigate and compare the changes in psychosocial status, self-esteem, and quality of life in patients treated with conventional and SF approaches. 14 patients (mean age 23.04±3.36; 9 male and 5 female) who met the inclusion criteria were included in the SF group; 18 patients with class III malocclusion (mean age 29.27±3.78; 9 male and 9 female) were included in the COS group. In the research protocol, the first questionnaires were carried out 2 weeks before surgery (T0); second survey approximately 4 weeks after surgery (T1); and the third one was done to patients after the treatment was completed (debonding) (T2). In our study, Orthognathic Quality of Life Questionnaire (OQLQ), Pyschosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14), Beck Depression Inventory second edition (BDI-II) and Rosenberg Self-Esteem Scale (RSES), surveys were conducted. No statistically significant difference was observed in all of the PIDAQ parameters and most of the OQLQ parameters within the COS and SF groups (P>0.05). When the BDI-II results were examined, different trends in scores were observed between the two groups, and this difference was found to be statistically significant (P<0.05). In the SF approach, progressive improvement was detected in the patients in terms of psychosocial and quality of life in the early period of treatment. The greater improvement in psychological and social characteristics in the SF approach compared to conventional orthognathic surgery may also be associated with a shorter treatment time.

Evaluation of the effectiveness of different puncture points for second cannula in double puncture arthrocentesis of temporomandibular joint.

The study at checking if treatment outcomes in double puncture temporomandibular joint (TMJ) arthrocentesis (DPTMJA) changed when the puncture points of the second cannula punctate were changed. Using a retrospective cohort study design, the investigators enrolled a sample of temporomandibular joint disorder (TMD, internal derangement) patients receiving DPTMJA. The decision of whether to perform a modified or traditional arthrocentesis was made by the patients: Patients who accepted the close cannula relationship were evaluated as group 1 (modification group), and those who did not agree as group 2 (traditional group). The predictor variable was puncture points of the second cannula (close to vs. far from the first cannula; group 1 and 2, respectively). The main outcome variables included maximum mouth opening (MMO), and pain assessed using a Likert-type (0-10) visual analogue scale (VAS) before treatment and at 1st day and 3rd months intervals. Appropriate statistics were computed using P < .05 was considered significant. The study sample comprised 32 patients (93.8% females; 50% in each study arm) with an average age of 36.9 ± 15.3 years (range, 18-78). Although, patient age and gender, and baseline VAS in both groups were not significant different (P > .05), the baseline MMO in group 2 was significant higher than that in group 1 (P = .03). The within-group analyses demonstrated the significant improvement of both MMO and VAS at postoperative month 3 (P < .05). However, the between-group analyses rejected the significant differences between the 2 groups at day 1 and month 3 (P > .05). Within the limitations of the study the choice of one or the other technique should be left to the discretion of the surgeon.

Surgical rehabilitation of nasoalveolar complex in patients with alveolar clefts.

OBJECTIVE: The objective of this study was to review the outcome of surgical rehabilitation of nasoalveolar complex in patients with alveolar clefts. STUDY DESIGN: Twenty-seven patients (13 female, 14 male) with 4 bilateral and 23 unilateral alveolar clefts who were treated in our clinic during the period between 2002 and 2009 were included in the study. RESULTS: All the patients had oronasal fistulas, and all of them were closed successfully except one. Recurrence of the oronasal fistula was seen in 1 patient. Alar base was supported by onlay cortical bone in most of the patients. Eleven of the canines at the cleft site erupted after the operation in to the grafted area. Seventy-six percent (n = 16) of the 21 patients could be assigned to the successful groups 1 and 2, whereas 24% (n = 5) were assigned to the unfavorable group. There was not any insufficient result. CONCLUSIONS: Bone graft placed along the piriform margin and alar wings during alveolar bone grafting improves the results of nasal correction. Late grafting should be performed at least to support the alar base for nasal symmetry.

Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS.

OBJECTIVES: With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year students (if any) and to determine students' perception of the importance of this disease for our country and our world. MATERIAL AND METHODS: This descriptive study comprised first-year and last-year students of Akdeniz University Faculty of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel University Faculty of Dentistry. A questionnaire was administered to a total of 357 students. RESULTS: Lack of the relevant education is obvious among all three occupational groups in our study. CONCLUSIONS: The importance of HIV/AIDS as a public health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.

Use of Ankaferd Blood Stopper as a hemostatic agent: a clinical experience.

AIM: To determine the efficacy of the topical application of Ankaferd Blood Stopper (ABS) on hemorrhagic diathesis following dental procedures under different conditions. BACKGROUND: Some patients have a tendency to bleed excessively after dental surgery for a variety of reasons, making oral surgical procedures more risky for these patients. Since hemorrhage can cause major morbidity and mortality, the identification of a novel, effective hemostatic agent could improve the management of excessive bleeding that occurs during dental procedures. CASE DESCRIPTIONS: Four patients (3 females, 1 male) aged 28-45 with bleeding tendencies due to different presurgical conditions such as von Willebrand Disease, chronic liver failure, and mitral valve replacement presented for tooth extraction. Hematological consultations were obtained prior to surgical intervention and their international normalized (INR) ratio values were adjusted to less than 1.5; none received clotting factor replacement. All the extractions were performed under local anesthesia with and without epinephrine. In the presence of postsurgical bleeding, the efficacy of the ampule form of topical ABS was observed. Sex, age, anamnesis, von Willebrand Factor, activated partial thromboplastin time, factor VIII, and platelet counts of patients were recorded prior to the extractions. CONCLUSIONS: ABS was found to be effective within 10 to 20 minutes in controlling bleeding in most of the patients after dental surgery. These observations suggest the use of ABS may be a beneficial hemostatic agent for use in patients with hemorrhagic diathesis following tooth extraction. Additional research is needed to clarify the role of this unique medicinal product in the surgical treatment of dental patients with bleeding tendency. CLINICAL SIGNIFICANCE: ABS has demonstrated potential for being an effective hemostatic agent for the treatment of excessive bleeding following dental surgery in four patients with hemorrhagic diathesis.

Clinical impact of ectopic teeth in the maxillary sinus.

OBJECTIVE: To evaluate the clinical features, aetiologic factors, challenging properties (such as radio opacity in Water's view in a patient with no sinusitis), signs and symptoms of the ectopic teeth in the maxillary sinus. STUDY DESIGN: Clinical symptoms and radiographic findings of 14 patients with ectopic teeth in the maxillary sinus were evaluated. Computed tomography (CT) and conventional radiographic images of maxillary sinus and clinical findings were compared with each other with regard to the final diagnosis. RESULTS: Water's view is inadequate to diagnose ectopic tooth in the maxillary sinus in some cases. Panoramic radiographs may be preferred before CT to evaluate the ectopic tooth in the maxillary sinus as structure of a tooth can be clearly detected on panoramic radiographs. Crowding was the most common aetiologic factor among the 14 cases. CONCLUSION AND SIGNIFICANCE: The patients with ectopic tooth in the maxillary sinus should be evaluated thoroughly by complete otorhinolaryngologic, intraoral examinations and proper diagnostic imaging procedures in order to avoid misdiagnosis of maxillary sinusitis. As the opacity of the maxillary sinus in Water's view due to ectopic tooth can be misinterpreted as maxillary sinusitis, patients who have sinusitis-like complaints and opacity of maxillary sinus in Water's view who are resistant to medical treatment should be evaluated with respect to the presence of ectopic tooth.