Perceived sources and levels of stress, general self-efficacy and coping strategies in preclinical dental students.

Dental education programs are known to be highly stressful and stress can affect general health. The aims were to identify sources of stress among preclinical students and to evaluate their perceived levels of stress, self-efficacy and effective coping strategies in a private dental school. One hundred preclinical students in a Turkish private dental school were surveyed using dental environment stress (DES), perceived stress (PSS), general self-efficacy (G-SES) and brief coping scales (Brief-COPE). Age, gender, history of psychiatric treatment, factors that affected the choice of dentistry, choice rank of dental school, scholarship and income was recorded. 'Exams and grades' followed by 'Fear of failing course or year' were found to be the most stressprovoking factors. The most and the least stressprovoking DES domains were 'Workload' and 'Social stressors', respectively. 'Social stressors' affected male more than female (p < .05). The most and the least common coping strategies were found to be 'Planning', and 'Drug', respectively. Female used 'Instrumental support' more than male (p < .05). Demographic factors had impact on the perceived stress factors and levels, as well as coping strategies. Unlike previous studies establishing high stress levels in dental students, preclinical students displayed moderate level of stress. Clinical dental education might be more responsible for creating stress.

Perceived sources and levels of stress, general self-efficacy and coping strategies in clinical dental students.

The aims of this study were to identify sources of stress among clinical students and to evaluate the students' perceived levels of stress, general self-efficacy and effective coping strategies in a private dental school environment. The study group consisted of 130 undergraduate clinical dental students in a Turkish private dental school, during the academic year 2014-2015. The students were surveyed using modified version of the dental environment stress (DES) survey, the perceived stress scale, the general self-efficacy scale (G-SES) and the brief coping scale. Age, sex, year of study, history of psychiatric treatment and factors that affected the choice of dentistry were also recorded. Final year and female clinical dental students, who were found to be the most stressful students, had moderate to high perceived stress scores. Total and 'Faculty and administration' related DES scores increased with the year of study. Stressors related to 'Workload' and 'Clinical training' affected females more than males. G-SES scores were higher in male students and students, who had no history of psychiatric treatment. The most and the least common coping strategies were 'Planning' and 'Substance abuse', respectively. 'Religion' was found to be one of the main coping strategies. Stress factors affecting Turkish clinical dental students studying at private dental school differed from the previously reported stress factors affecting students studying at a governmental dental school. Advanced year and female students experienced more stress than the other students.

Evaluation of morphology of the nasopalatine canal using cone-beam computed tomography in a subgroup of Turkish adult population.

PURPOSE: The aim of the study was to evaluate the anatomy and morphology of the nasopalatine canal (NPC) using cone-beam computed tomography (CBCT) and to determine variations of the NPC in relation to age, gender, and status of edentulism of anterior maxilla. METHODS: Patients scheduled for CBCT imaging for further radiographic evaluation of the maxilla with various reasons were consecutively enrolled in this study. Reformatted sagittal and coronal slices were analyzed with regard to dimensions and anatomic characteristics of the NPC. The correlation of age, gender, and status of edentulism of anterior maxilla with all the variables were evaluated. RESULTS: The study comprised 157 subjects with a mean age of 49.64 years. The analysis of the diameter of the incisive foramen revealed a mean of 4.48 mm whereas the diameter of the palatine foramen revealed a mean of 2.88 mm. The mean length of NPC was 10.87 mm and found significantly longer in males and patients with anterior teeth. In terms of incisive foramen and palatine foramen diameter, there was not any significant difference between males and females and between patients with and without anterior teeth (p > 0.05). CONCLUSION: There was relationship between the gender of the patients and the length of the NPC, with significantly lower mean values in females. This result suggests that careful analysis of anatomical structures by taking into consideration some variables would aid the clinician in performing a safer surgical intervention and prevent possible complications. CNCT scanning prior to implant surgery specifically in edentulous patients with severely atrophic maxillae might be a good diagnostic tool to guide the clinician for a safer and predictable procedure.

Comparison of the radiopacities of different root-end filling and repair materials.

This study evaluated the radiopacity of 3 repair materials, Biodentine, MM-MTA, and MTA Angelus. Standardized cylindrical rings were prepared. Samples of Biodentine MM-MTA and MTA Angelus were prepared (n = 10 in each group), filled into the rings, and preserved at 37°C until setting. A 1 mm thick dentin slice was used as control. All set specimens were removed and radiographed along with the dentine slice and a graduated aluminium step wedge. Digital images were transferred to the computer using a software. The radiographic densities of the specimens were determined, and the values were converted into millimetres of aluminium (mm Al). One-way ANOVA was used for intergroup comparison, whereas Tukey HSD test was used for detecting the group with the difference. The mean radiopacities of Biodentine, MTA Angelus, and MM-MTA were 2.8 ± 0.48, 4.72 ± 0.45, and 5.18 ± 0.51 mm Al, respectively. The radiopacity of Biodentine was significantly lower compared to other materials (P = 0.001), whereas no significant difference was noted between MTA Angelus and MM-MTA (P = 0.109). All materials had significantly higher radiopacities compared to dentine. The relatively lower radiopacity of Biodentine can be improved to achieve more reliable results in procedures such as retrograde fillings.

Diagnosis of jaw and dentoalveolar fractures in a traumatized patient with cone beam computed tomography.

The purpose of this case report is to discuss and illustrate the clinical usage of Cone Beam Computed Tomography (CBCT) for the diagnosis of maxillofacial fractures in a traumatized patient. In this presentation, a 30-year-old male patient who was referred to Oral Diagnosis and Radiology Department with a limitation of mouth opening was reported. The history of the patient revealed a traumatic injury on his face because of a fall. The patient was initially examined by a medical practitioner in the emergency department of a public hospital. According to 2D cephalometric analysis, no fracture existed. Panoramic radiograph and postero-anterior reverse-town showed bilateral condyle fractures. In addition, a fracture in the left mandibular incisor region could clearly be detected on the panoramic radiograph. For further diagnosis, digital images were taken with CBCT. Cross-sectional views showed two vertical fracture lines on the alveolar bone between teeth numbers 17, 18 and 14, 15. A palatal root fracture was observed associated with tooth number 18. A fracture line in the left mandibular incisor region as well as bilateral condyle fractures could be seen clearly on CBCT views. CBCT is becoming a popular tool in modern dental practise. In the diagnosis of dentoalveolar fractures, CBCT has made it possible for the practitioner to get more detailed information.

Measurements of the foramen magnum and mandible in relation to sex using CBCT.

The purpose of this study was to evaluate pre-existing CBCT images of a large sample of adult females and males to provide data on foramen magnum and mandibular measures of sexual dimorphism for use as a reference sample in cases of establishing identity in unknown fragmentary skulls. The study group consisted of 161 adult patients. 3D images of the patients were assessed retrospectively. FM measurements were obtained from reformatted axial sections. Six mandibular measurements were taken. According to the results, the study identified four mandibular measurements as final predictors of sex which are as follows: the gonial angle (G-angle) and ramus length (Ramus-L), gonion-gnathion length (G-G-L) and bigonial breadth (BG-Br). It was found that the cross-validated grouped overall predictive accuracy was 83.2% for FM and mandible measurements. It could correctly identify males in 77.3% and females in 87.4% of the cases. To assess sexual dimorphism, the gonial angle and ramus, gonion-gnathion lengths, and bigonial breadth of the mandible and sagittal diameter of the FM may be used on CBCT images.

In Vitro Detection of Dental Root Fractures with Cone Beam Computed Tomography (CBCT).

BACKGROUND: Since the diagnosis of non-displaced longitudinal fractures present difficulties for the dentist, three-dimensional evaluation is necessary. OBJECTIVES: The aim of this study is to demonstrate the accuracy of cone beam computed tomography (CBCT) in detecting dental root fractures in vitro. MATERIALS AND METHODS: An in vitro model consisting of 210 recently extracted human mandibular teeth was used. Root fractures were created by mechanical force. The teeth were placed randomly in the empty dental alveoli of a dry human mandible and 15 different dental arcs were created. Images were taken with a unit Iluma ultra cone-beam CT scanner (Imtec Corporation, Germany). Three dental radiologists separately evaluated the images. RESULTS: According to the fracture types and fracture presence, there was an overall statistically significant agreement between the key and readings. Kappa values for intra observer agreement ranged between 0.705 and 0.804 indicating that each observer gave acceptable ratings for the type and presence of fractures. CONCLUSIONS: Detailed information about root fractures may be obtained using CBCT.

Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT.

Assessment of the maxillary sinus anatomy before sinus augmentation is important for avoiding surgical complications, because of the close anatomical relationship between the posterior maxillary teeth and the maxillary sinus. The posterior superior alveolar artery (PSAA) is the branch of the maxillary artery that supplies the lateral sinus wall and overlying membrane. We evaluated the location of the PSAA and its relationship to the alveolar ridge and maxillary sinus using cone beam computed tomography (CBCT). The study group consisted of 135 CBCT scans (270 sinuses) obtained from the archive of the dentomaxillofacial radiology department at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. The distance between the lower border of the artery and the alveolar crest, bone height from the sinus floor to the ridge crest, distance from the artery to the medial sinus wall, and the diameter and location of the artery were determined. The occurrence of septa and pathology were recorded from CBCT scans. The PSAA was observed in 89.3% of sinuses, and 71.1% of arteries were intraosseous with diameters mostly < 1 mm (68.9%). The prevalence of sinus septa was 55.2%, and that of sinus pathology was 57.4%. The mean age was 43.07 ± 17.55 years. There was a statistically significant difference between the location of the artery and gender (p < 0.05). The prevalence of sinus membrane thickening was 57.4%. Detailed knowledge about the location of the PSAA and sinus morphology may be obtained with CBCT before maxillary sinus surgery.

Assessment of root canal treatment outcomes performed by Turkish dental students: results after two years.

The aim of this study was to evaluate radiographically the periapical status and technical standard of root canal therapies performed by a group of undergraduate dental students in Turkey two years following completion of the treatments. A random sample of 264 patients who received root canal treatment from undergraduate students at the Yeditepe University Faculty of Dentistry in 2009 were recalled after two years. The study sample consisted of 319 root-filled teeth in 158 dental patients (females=97, males=61) who presented to the student clinics during that time frame. For each root-filled tooth, two periapical radiographs were examined to identify the periapical status, one showing pre-treatment and the other showing post-treatment status. The quality of endodontic treatment was examined according to the distance between the end of root filling and radiographic apex and the density of the obturation according to presence of voids within the root filling material. This examination found that 54.2 percent of roots had fillings of acceptable length, while 37.3 percent were short, 7.8 percent were overfilled, and 0.6 percent was unfilled; 2.5 percent of the teeth were observed with broken root canal instruments. After two years, PAI scores of teeth with acceptable length of root canal filling (0-2 mm from the radiographic apex) were found to be lower than those of the overfilling and short filling cases (>2mm) (p<0.01). Moreover, voids were detected in the root canal fillings of 52.7 percent of endodontically treated teeth. The PAI scores of root fillings with inadequate density were significantly higher than adequate ones (p<0.01). Although endodontic treatments performed by undergraduate students do not appear to be unqualified compared to those performed by general practitioners, more emphasis must be placed on the technical quality of endodontic treatment to obtain better results.

The usage of digital radiography and cone beam computed tomography among Turkish dentists.

OBJECTIVES: The aim of this study was to determine the prevalence of the use of digital radiography and report how it was used by Turkish dentists. METHODS: The survey was based on 383 dentists who were present at the sixteenth International Congress organized by the Turkish Dental Association. A questionnaire which consisted of 19 questions was given to the dentists who participated in the study. Data were assessed according to frequency distribution and the χ(2) test was used to determine the significance of differences between two independent groups. RESULTS: 376 questionnaires were analysed. The mean age of the dentists who participated in the study was 37.14 ± 9.6 years (range: 20-63 years). The distribution of the dentists according to the 7 regions of Turkey were: Marmara 58%, Aegean 13% and Mediterranean 10%, Central Anatolia 8%, Black Sea 7%, Southeastern Anatolia 3%, Eastern Anatolia 1%. 124 dentists (33%) said they did not work with digital radiography. 95 dentists indicated that they did not use digital radiography owing to cost (60%). 252 dentists (67%) said they used digital radiography. 40% of the participants noted that the repetition of periapical radiographs was due to digital radiography. 166 dentists (55.9%) and 79.1% academicians had knowledge about cone beam CT (CBCT). CONCLUSION: Digital radiography users are increasing in Turkey and levels of knowledge of CBCT and awareness of radiation safety has also increased.

Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT

Assessment of the maxillary sinus anatomy before sinus augmentation is important for avoiding surgical complications, because of the close anatomical relationship between the posterior maxillary teeth and the maxillary sinus. The posterior superior alveolar artery (PSAA) is the branch of the maxillary artery that supplies the lateral sinus wall and overlying membrane. We evaluated the location of the PSAA and its relationship to the alveolar ridge and maxillary sinus using cone beam computed tomography (CBCT). The study group consisted of 135 CBCT scans (270 sinuses) obtained from the archive of the dentomaxillofacial radiology department at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. The distance between the lower border of the artery and the alveolar crest, bone height from the sinus floor to the ridge crest, distance from the artery to the medial sinus wall, and the diameter and location of the artery were determined. The occurrence of septa and pathology were recorded from CBCT scans. The PSAA was observed in 89.3% of sinuses, and 71.1% of arteries were intraosseous with diameters mostly < 1 mm (68.9%). The prevalence of sinus septa was 55.2%, and that of sinus pathology was 57.4%. The mean age was 43.07 ± 17.55 years. There was a statistically significant difference between the location of the artery and gender (p < 0.05). The prevalence of sinus membrane thickening was 57.4%. Detailed knowledge about the location of the PSAA and sinus morphology may be obtained with CBCT before maxillary sinus surgery.