Evaluation of the Change in Halitosis with the Improvement in Oral Health in Cleft Lip and Palate Patients.

AIM: This study aimed to assess the effects of hygiene education on periodontal health and mouth/nasal halitosis in patients with cleft. MATERIALS AND METHODS: 39 patients with cleft who were accepted for orthodontic treatment divided into two groups as with (Group1; n = 24) and without braces (Group2; n = 15). Plaque Index (PI), Gingival Index (GI), and Tongue coating Index (TCI) values were recorded. The BANA test microbiological kit, was used to determine the amount of anaerobic bacteria. Values of volatile sulfur components (VSC) for the measurement of oral and nasal halitosis were measured with a Halimeter device. After the initial measurements, oral hygiene instructions were given to eliminate the plaque production on teeth, periodontal structure, tongue and palate. All measurements were repeated 4 weeks after the hygiene instructions. Wilcoxon and Mann-Whitney U test were used for statistical analysis. RESULTS: In both groups, the PI, GI, values were significantly decreased (P < .05). Tongue coating area, thickness and TCI were significantly reduced (P < .05). Oral halitosis values decreased significantly (P < .05). The PI values decreased significantly more in the Group 1 (P < .05). Non significant difference was detected in nasal halitosis in both groups. In unilateral cleft lip and palate cases cases (n = 23), no significant difference was found in nasal halitosis values between the cleft and the healthy sides (P > 0.05). CONCLUSION: In patients with clet cases, periodontal health was improved and oral halitosis was reduced by the given hygiene education; brushing the teeth, especially the tongue and palate. However, hygiene education did not have a significant effect on nasal halitosis. Key Words: Cleft lip and palate, Halitosis, BANA test, Periodontal index.

Relationship between palatally impacted canines and dimensions and morphology of sella turcica: A cone-beam computed tomography study.

INTRODUCTION: This study aimed to analyze the association of unilateral and bilateral palatal canine impaction with the dimensions and morphology of sella turcica from 3-dimensional cone-beam computed tomography (CBCT) images. METHODS: CBCT images of patients with bilateral (BPI) (n = 12; 9 female 3 male; 20.75 ± 5.88 years) and unilateral (UPI) (n = 35; 22 female 13 male; 19.28 ± 5.57 years) palatally impacted canines were compared with a control group (n = 56; 34 female 22 male; 20.82 ± 4.88 years). Linear measurements regarding sella turcica were made, and its morphologic variations were categorized. Two group comparisons were made with the Student t test or Mann-Whitney U-test, whereas one-way analysis of variance or Kruskal-Wallis tests were used for multiple group comparisons. Categorical variables were compared using the chi-square or Fisher exact test as appropriate. The binary logistic regression analyses and correlations using Spearman or Pearson correlation analyses were used to determine associations between variables (P <0.05). RESULTS: Sella diameter was significantly smaller in the BPI group compared to UPI and control groups. There was a significant association between sella diameter and BPI when compared with the control group (χ2[1] = 9.150; P = 0.008). There were no significant differences between groups in the distribution of sella turcica morphology. CONCLUSIONS: Despite the similar genetic origin of the sella turcica region and teeth, the association of palatal canine impaction with dimensions and morphology of sella turcica was weak. Both local and genetic factors might contribute to the ectopic position of the canine.

Three-dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes.

PURPOSE: The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS: CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS: No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS: No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.

Evaluation of the Relationship of Dimensions of Maxillary Sinus Drainage System with Anatomical Variations and Sinusopathy: Cone-Beam Computed Tomography Findings.

OBJECTIVE: The aim of this study was to evaluate the correlation between the length of the infundibulum and ostium height with the anatomic variations of osteomeatal complex (OMC) and sinus pathology using cone-beam computed tomography (CBCT). METHODS: CBCT images of 204 patients (408 maxillary sinuses) were evaluated retrospectively. The height of the ostium and the length of the infundibulum were measured. The presence of maxillary sinus pathology, nasal septal deviation, Haller cells, concha bullosa, and sinus septa were analyzed. The correlation between the size of the maxillary sinus drainage system and anatomic variations was compared using the t test, Fisher's exact test, and χ2 test. The effect of tooth loss on the length of the infundibulum and ostium height was also analyzed using ANOVA. RESULTS: The height of the ostium and the maximal septal deviation angle were found to be significantly greater in males (p < 0.05). As ostium height increased, the presence of maxillary sinus septa increased (p < 0.05). No statistically significant association was detected between other variations and the length of infundibulum or ostium height. The relationship between tooth loss and both the length of the infundibulum and ostium height were found to be insignificant (p > 0.05). CONCLUSIONS: Radiographic examination, especially on CBCT images, is important for an evaluation of maxillary sinuses. here, we demonstrated a significant relationship between ostium height and the presence of maxillary sinus septa. However, it was found that nasal septal deviation, concha bullosa, Haller cells, and other sinusopathies did not have a major effect on the size of the maxillary sinus drainage system.

Effects of fixed and removable space maintainers on halitosis.

BACKGROUND: The current study evaluated the effects of fixed and removable space-maintainers on halitosis and oral health of children. METHODS: Forty-three patients randomly selected between the ages 4-10 whom fixed or removable space maintainers were indicated in Gazi University, Faculty of Dentistry, Department of Pedodontics. The inclusing criteria were: caries-free (with/without restorations), with absence of periodontal diseases, without systematic disease, no mouth breathing and no use of antibiotics the 2-months period before the study. The patients were subdivided into two groups: the group treated with fixed space maintainers (group 1, n = 27), the group treated with removable space maintainers (group 2, n = 16). The the plaque index (PI), gingival index (GI), periodontal screening index (PSI), tongue coating index (TCI) records and the halitosis measurements were obtained at three time periods (T1: immediately after application, T2: 1 week after application, T3: 5 weeks after application). The measurement values of T1 served as control. RESULTS: No statistically significant difference was found in the PI, GI, PSI, TCI and halitosis measurements between T1-T2, T2-T3 and T1-T3 in both appliance groups and between the groups (p > 0.05). CONCLUSIONS: The fixed and removable space maintainers did not affect oral health status and halitosis significantly.

Cephalometric assessment of soft tissue morphology of patients with acromegaly.

AIM: To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. METHODS: Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test. RESULTS: Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). CONCLUSION: Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

Prevalence of Posterior Crossbite for Orthodontic Treatment Timing.

OBJECTIVE: To evaluate the prevalence and distribution of posterior crossbite in different dentition stages in a Turkish sample. STUDY DESIGN: 1554 subjects (843 girls, 711 boys) aged 4-25 years were evaluated to determine the prevalence of posterior crossbite in a Turkish sample. The subjects were classified according to four dentition stages (primary, early mixed, late mixed and permanent) and transversal occlusal status. The statistical evaluation was done by Chi-square, Fischer exact tests. RESULTS: Bilateral and unilateral crossbite on the right and left sides had the highest frequency in the permanent dentition (51.0%, 47.3%, and 53.6%; respectively). No significant differences were found between unilateral (right and left) and bilateral crossbite with regard to dentition stages. No significant differences were found between unilateral right or left side posterior crossbite with regard to dentition stages. CONCLUSION: An increasing trend in the prevalence of posterior crossbite was observed from the primary dentition towards permanent dentition in this study.

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

OBJECTIVE: The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. MATERIALS AND METHODS: Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. RESULTS: With respect to controls, anterior (p<0.05), middle (p<0.01) and posterior (p<0.05) cranial base lengths were increased, sella turcica was enlarged (p<0.001) and upper spine morphology demonstrated differences in the height of atlas (p<0.01) and axis (p<0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p<0.01) and the mandible (p<0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p<0.001), uvular (p<0.01), mandibular (p<0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p<0.001) compared to healthy controls. Soft palate width was significantly higher (p<0.001) and the hyoid bone was more vertically positioned (p<0.01) in patients with acromegaly. CONCLUSIONS: Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

Radiopacity of an endodontic core material.

PURPOSE: To evaluate and compare the relative density values of a new endodontic core material (Resilon) and conventional gutta-percha. METHODS: 15 Resilon and gutta-percha discs for testing radiopacity were prepared by first coiling three size 35 cones. The coiled material was evenly compressed into the well of a brass mold 10 mm in diameter and a depth of 1 mm. All radiographs were taken on No. 4 ultra-speed dental film. The radiopacity of Resilon, gutta-percha, and dentin slices were then measured with a digital transmission densitometer. RESULTS: The mean radiopacities of Resilon and gutta-percha coiled discs were 4.06 and 7.21 mm of aluminum equivalence respectively, which exceeded the minimal requirement of 3 mm. Both tested materials had lower radiopacity values than dentin. There were highly significant differences in radiopacity values among the tested specimens (P < 0.01). Additionally, the mean radiopacity values in root canals were 5.50 and 8.52 mm Al for Resilon and gutta-percha, respectively (P < 0.01).

Localization of mental and mandibular foramens on the conventional and digital panoramic images.

The purpose of this study was to compare the efficiency of conventional and digital panoramic images for localization of mental and mandibular foramens. Six dry edentulous human mandibles were used in the study. Conventional and digital panoramic images were obtained and the vertical and horizontal measurements were performed for localization of mental and mandibular foramens on the images. The correlations between radiographic (conventional and digital) and direct measurements were compared. A measurement error between the radiographic and direct measurements was determined at the level of 1 mm. The measurement errors were generally less in conventional panoramic radiography than digital one. There was statistically strong positive correlation between direct and radiographic measurements. Statistically significant difference was found between radiographic and direct measurements for bone height of mandible in ramus region. According to the results of this study, diagnostic performance of conventional and digital panoramic images seems to be equal for the localization of mental and mandibular foramens. The vertical radiographic measurements are generally reliable and correlated with direct measurements in mandible for conventional and digital panoramic radiography, but the evaluation of bone height in ramus region may not be sufficiently reliable.

Does tooth loss in the mandibular posterior region have an effect on the mental index and panoramic mandibular index?

PURPOSE: Mental index (MI) and panoramic mandibular index (PMI) are important radiomorphometric indices used for assessing the quality of the mandibular bone. The aim of this study was to investigate the possible effect of mandibular posterior tooth/teeth loss in young adults on the MI and PMI (superior panoramic mandibular index: PMI-s, and inferior panoramic mandibular index: PMI-i). MATERIALS AND METHODS: Digital panoramic radiographs belonging to 253 patients aged between 18-35 years old were examined. According to the inclusion criteria of the study, a patient and control group was formed. The patient group (n=46) included individuals having at least one extracted tooth in the posterior region of the mandible, and the control group (n=45) included full dentate patients. The MI and PMI (PMI-i and PMI-s) were calculated bilaterally for all of the individuals. RESULTS: No significant difference was found between the MI, PMI-i and PMI-s indices of the patient group and the control group among both genders. CONCLUSION: The mandibular premolar and/or molar teeth loss in young adults did not lead to any change in the MI, PMI-i and PMI-s indices among both genders.

Evaluation of the gonial angle in the Anatolian populations: from past to present.

Biometrical studies on ancient skeletal series and comparison with modern people by using radiological methods are quite limited in Turkey. Previous studies showed that measurements obtained from orthopantomographs are highly correlated with the actual size of the bones. The aim of the present study is to determine the possible change in gonial angle over time in ancient Anatolian populations with the present. Also an aim was attempted to demonstrate the symmetry of the gonial angle in the jaws and the sexual dimorphism. Gonial angle values (right and left) were taken from 267 Turkish adults with no craniomandibular disorders, orthodontic history or treatment by using panoramic radiographs. Data of the past populations were collected from previous studies. Comparison between right and left sides and the sexual differences were tested by paired student t-test and discriminant analyses were conducted. The results showed that there were no significant differences between the right and left gonial angles of the individuals but there was a significant difference at the left gonial angle between sexes (p < 0.01). Furthermore, no statistically significant difference was found for the gonial angle between the selected past populations with the present sample.

Dental management and orofacial manifestations of a patient with Robinow Syndrome.

Robinow syndrome (RS) is an extremely rare condition. Characteristic craniofacial findings of RS include a fetal facial appearance, ear abnormalities and oral findings. The aim of this case report was to evaluate the oral findings of a 26-year-old man with RS and to describe the dental treatments performed. The patient had short stature, vertebral anomalies, short and broad fingers, a fetal facial appearance, gingival hyperplasia, fissured tongue, caries and multiple impacted teeth. Periodontal and restorative dental treatments were performed under aseptic conditions with due precautions. No surgical treatment was performed to the impacted teeth because of the lack of symptoms.

A radiographic study of location of mental foramen in a selected Turkish population on panoramic radiograph.

Purpose of this study was to investigate the most common position of the mental foramen in a selected Turkish population. The study sample included three hundred and sixty one panoramic radiographs of selected Turkish population taken in Faculty of Dentistry, University of Gazi. The most common position of the mental foramen was between the first premolar and the second premolar (71.5%). The mental foramen was symmetrical in 90.4% of patients. In this study, the difference of the location of the mental foramen in different ethnics groups was discussed. Clinicians and anthropologists should expect to find the position of the mental foramen to be symmetrical and between the first premolar and the second premolar teeth.

The prevalence of antral exostoses in the maxillary sinuses, evaluated by cone-beam computed tomography.

BACKGROUND/PURPOSE: Exostoses are outgrowths of normal compact and cancellous bone and may occur in different locations of the jaw. Exostoses are a rare anatomic variation in the maxillary sinuses. The purpose of this study was to investigate retrospectively the prevalence of location, size, shape, and symmetry of exostoses in the maxillary sinus, and to assess the relationship between demographic variables (i.e., age and sex) via cone-beam computed tomography images. MATERIALS AND METHODS: Cone-beam computed tomography images of 1000 patients [521 (52.1%) females and 479 (47.9%) males], aged 10-85 years (mean age, 44 years), were examined. Two investigators examined the exostoses for location (i.e., inferior wall, medial wall, lateral wall, or posterior wall of the maxillary sinuses), size, shape (i.e., broad-based or mushroom-like), and symmetry (i.e., unilateral or bilateral). The age of the patients was categorized into three groups: 10-30 years, 31-50 years, and 51+ years. The data were statistically analyzed by using chi-square test, Fisher's exact test, and the t test. RESULTS: In total, 52 exostoses from 48 patients (4.8%) were identified. Exostoses were more common in females (n = 28, 58.3%) than in males (n = 20, 41.7%); however, there was no statistically significant difference between the sexes (P > 0.05). The presence of exostoses was very similar for all age groups with no statistically significant differences (P > 0.05). CONCLUSION: Most exostoses were unilateral and on the inferior wall of the maxillary sinus. No statistically significant difference existed between the frequency and location of exostoses for sex or age groups (P > 0.05).

Approximal carious lesion depth assessment with insight and ultraspeed films.

This study evaluated the efficiency of a new E/F-speed film, Insight, at the determination of approximal carious lesion depths compared with Ultraspeed. Radiographs of 80 extracted human molars and premolars were taken with both films under standardized conditions. The presence or absence of caries and depth of lesions was determined by three observers using a predetermined scale. The actual status of each surface was determined histologically. Observer responses were assessed with the Gamma measure of association test. Differences between the observers' agreement levels were not significant. The efficiency of Insight and Ultraspeed at true depth diagnosis was found to be 54.9%; 55.8% and Gamma values were found to be 0.883 and 0.922, respectively, at p<0.001. The difference between the two films was not statistically significant (p=0.852). This study suggested that there was no statistically significant difference between the two films at detecting the depths of approximal carious lesions.

Prevalence and characteristics of non-syndromic distomolars: a retrospective study.

AIM: Distomolars are defined as the supernumerary teeth that erupt distal to the third molar. The aim of the present study was to evaluate the prevalence of distomolars in permanent dentition in a non-syndromic Turkish subpopulation. METHODS: A total of 10 111 panoramic radiographs of patients aged 18 years and over, who had no systemic diseases and syndromes, and who had not undergone any extractions in the third molar area, were examined to determine the presence, location, shape, and laterality of distomolars. The patients' age and sex were noted. RESULTS: The results showed that distomolars were observed in 0.26% of the investigated population. Distomolars were seen in 0.29% of male patients and in 0.23% of female patients. In total, 30 distomolars were observed in 26 patients. Maxillary distomolars were more frequently encountered than mandibular teeth. Bilateral distomolars were found in three male patients. Of the 30 distomolars, 25 were impacted and five were erupted. CONCLUSIONS: Although the frequency of distomolars is low, early diagnosis and treatment are important to minimize or prevent complications, such as delayed eruption, tooth displacement, crowding, root resorption of the adjacent tooth, and cystic formations.

Evaluation of oxidative events and copper accumulation in oral tissues of patients with Wilson's disease: three case report.

Wilson's disease (WD), also known as hepatolenticular degeneration, was first described in 1912 by Kinnear Wilson. It is an autosomal recessive disorder caused by mutations in the ATP7B gene, a membrane-bound copper transporting ATPase. The disorder is caused by impairment of the copper transporting ATPase, ATP7B, in the liver, which disturbs copper transport, excretion into the bile, and incorporation into apoceruloplasmin. WD is an inherited copper metabolism disorder with pathological copper accumulation in many tissues, but especially in brain and liver. We conducted this study because copper accumulation in oral tissues in patients with WD have not been studied before. We think that copper accumulation and differences of oxidative events in oral tissues can cause tendency to periodontal diseases.

Common errors on panoramic radiographs taken in a dental school.

The aim of this study is to evaluate the frequency of common errors seen on panoramic radiographs taken in the Radiology Department of a dental school by trained assistants. Four hundred and sixty radiographs were evaluated for 20 categories of common errors. Out of the evaluated radiographs, 37.61% were found to be error-free. The most common errors were found to be the palatoglossal airspace shadow of air above the tongue due to the patient not raising the tongue against the palate (46.30%) and the superimposition of hyoid bone with the mandible (26.30%) respectively. The least common error was found to be dirty or bent films (0.21%). The quality of panoramic radiographs could be enhanced by improving radiographic technique.