Fractal characteristics of the trabecular pattern of the mandible in patients with renal transplantation.

OBJECTIVE: In this study, we examined the mandibular trabecular bone structures by performing fractal dimension (FD) analysis in patients who underwent renal transplantation (RTx). METHODS: Our study is an observational study with 69 RTx patients and 35 control group patients. The mean FD values of the patient and control groups were calculated and compared. In addition, biochemical parathyroid hormone (PTH), serum calcium, phosphorus, alkaline phosphatase (ALP), and vitamin-D parameters and FD values of both groups were analyzed. RESULTS: FD values were significantly lower in the patient group than in the healthy group (p < .05). In the RTx group compared to the control group, ALP (90.71 ± 34.25-66.54 ± 16.8, respectively) (p < .001) and PTH (75.76 ± 38.01-38.17 ± 12.39, respectively) (p < .001) values were higher. There was a positive correlation between the FD values and ALP (rspearman  = .305, p = .011) and a negative correlation between FD values and vitamin-D (rspearman  = .287, p = .017) of patients with RTx. CONCLUSION: FD values were found to be lower in patients who underwent RTx compared to the control group. It should be considered that FD analysis can be a method that can be used to evaluate trabecular bone structure in patients undergoing RTx.

Dental implant brand and angle identification using deep neural networks.

STATEMENT OF PROBLEM: Determining the brand and angle of an implant clinically or radiographically can be challenging. Whether artificial intelligence can assist is unclear. PURPOSE: The purpose of the present study was to determine the brand and angle of implants from panoramic radiographs with artificial intelligence. MATERIAL AND METHODS: Panoramic radiographs were used to classify the accuracy of different dental implant brands through deep convolutional neural networks (CNNs) with transfer-learning strategies. The implant classification performance of 5 deep CNN models was evaluated using a total of 11 904 images of 5 different implant types extracted from 2634 radiographs. In addition, the angle of implant images was estimated by calculating the angle of 2634 implant images by applying a regression model based on deep CNN. RESULTS: Among the 5 deep CNN models, the highest performance was obtained in the Visual Geometry Group (VGG)-19 model with a 98.3% accuracy rate. By applying a fusion approach based on majority voting, the accuracy rate was slightly improved to 98.9%. In addition, the root mean square error value of 2.91 degrees was obtained as a result of the regression model used in the implant angle estimation problem. CONCLUSIONS: Implant images from panoramic radiographs could be classified with a high accuracy, and their angles estimated with a low mean error.

Unilateral bone cavities situated near the angle of the mandibula.

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

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

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

Dental age assessment for different climatic regions.

OBJECTIVE: The aim of this study was to evaluate the impact of several aspects of climate, such as temperature and altitude, on dental maturation. MATERIALS AND METHODS: The total sample consisted of 944 panoramic radiographs (473 Turkish children from Central Anatolia [228 girls and 245 boys] and 471 Turkish children from Eastern Anatolia [222 girls and 249 boys]). The children aged between 7.0 and 14.9 years. The radiographs were randomly selected from 2 cities in Turkey, Kayseri and Erzurum. Independent t tests and paired t tests were performed to compare sex, location, and age to determine the relationships between tooth developments. RESULTS: The Central Anatolian children were approximately 0.2 to 3.0 years more advanced in dental maturity than the Eastern Anatolian subjects. CONCLUSIONS: The development standards proposed by Demirjian are affected by climatic factors. However, further research and detailed information to gather data are needed.

A comparison of three different diabetes screening methods among dental patients in Turkey.

OBJECTIVE: This study was conducted to describe the frequency of diabetes in dental patients, and to compare three different screening methods: the random finger plasma glucose (RFPG) test, the Finnish diabetes risk score (FINDRISC) survey and a special clinical guideline developed for dental patients. METHODS: The study design was cross-sectional, descriptive and comparative. The data were collected between August 2011 and February 2012. A total of 702 dental patients participated in this study. The screening tools were RFPG, FINDRISC and a clinical guideline. Data were analyzed using the Chi-squared test, the t test, analysis of variance, and the Pearson correlation test. RESULTS: The frequency of diabetes was 8.3% for the participants. The prevalence of participants at risk for undiagnosed diabetes was 20.1% according to the RFPG test, 29.9% according to the FINDRISC, and 29.8% according to the clinical guideline. Correlation analysis showed a significant positive correlation between the screening methods (p<0.001 for each). CONCLUSION: The overall frequency of diabetes was 8.3%. It was found that the three screening methods used in this study were statistically similar. However, FINDRISC and clinical guideline as the questionnaire screening tools indicated a little larger group than RFPG with respect to diabetes risk.

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

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

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

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

The Use of Artificial Intelligence in Dentistry Practices.

Artificial intelligence can be defined as "understanding human thinking and trying to develop computer processes that will produce a similar structure." Thus, it is an attempt by a programmed computer to think. According to a broader definition, artificial intelligence is a computer equipped with human intelligencespecific capacities such as acquiring information, perceiving, seeing, thinking, and making decisions. Quality demands in dental treatments have constantly been increasing in recent years. In parallel with this, using image-based methods and multimedia-supported explanation systems on the computer is becoming widespread to evaluate the available information. The use of artificial intelligence in dentistry will greatly contribute to the reduction of treatment times and the effort spent by the dentist, reduce the need for a specialist dentist, and give a new perspective to how dentistry is practiced. In this review, we aim to review the studies conducted with artificial intelligence in dentistry and to inform our dentists about the existence of this new technology.

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

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

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

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

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

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

Frequency and characteristics of tooth agenesis among an orthodontic patient population.

PURPOSE: The objectives of this study were to investigate the prevalence and characteristics of tooth agenesis and the associated skeletal morphology and arch widths in a group of Turkish patients seeking orthodontic treatment. MATERIAL AND METHODS: We designed a retrospective study composed of pre- and post-treatment panoramic radiographs and lateral cephalometric films of 3,341 patients (2,040 females and 1,301 males). Tooth agenesis was evaluated for hypodontia and oligodontia -excluding the third molars- from the orthopantomograms. The significance test for the differences in the skeletal morphology between hypodontia and non-hypodontia patients was performed using the Pearson chi-square and Student t-test. RESULTS: The prevalence of tooth agenesis was 4.6 percent for the Turkish orthodontic patient population. Tooth agenesis was found more frequently in females than in males, although this difference was not statistically significant (p>0.05). The most commonly missing teeth were the maxillary lateral incisors, followed by the mandibular second premolars and mandibular central incisors. Intercanine and intermolar widths in the maxillary and mandibular arches were significantly reduced in the hypodontia group compared with the control group (p<0.01). Tooth agenesis was statistically and significantly less in patients with skeletal Class II (p<0.01). There was no statistically significant difference in hypodontia patients in the vertical relationship of the jaws (p>0.05). CONCLUSIONS: The prevalence of tooth agenesis was found to be 4.6 percent for the Turkish orthodontic patient population (hypodontia 4.3% and oligodontia 0.3%), and was found more frequently in females. Intercanine and intermolar widths were significantly reduced in the hypodontia group for both jaws compared with the control group.

The prevalence of root dilacerations in a Turkish population.

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

Third-molar agenesis among patients from the East Anatolian Region of Turkey.

AIM: The aim of this study was to determine the frequency and distribution of third-molar agenesis in orthodontic patients from the East Anatolian Region of Turkey. METHODS AND MATERIALS: Our data were obtained from the panoramic radiographs of the 2,579 patients 12 to 16 years of age in the Department of Orthodontics at the Atatürk University in Erzurum, Turkey. Subjects with congenital deformities, such as a cleft palate, were excluded from the study. Statistical analysis was performed using SPSS software and a chi-squared test. RESULTS: Of the 2,579 subjects, 1,964 (76.2 percent) had all four third-molar teeth, 238 (9.2 percent) had three, 214 (8.3 percent) had two, 66 (2.6 percent) had one third molar, and 97 (3.8 percent) had agenesis of all third-molar teeth. There was no significant difference in agenesis of third-molar teeth between the right and left sides and no gender predilection was noted. However, significantly more third-molar teeth were found to be missing from the maxilla compared to the mandible, with a ratio of approximately 1.5:1. CONCLUSION: According to our results, the absence of one third molar is the most frequently detected pattern in the East Anatolian population. Additionally, the absence of third molars is more frequent in the maxilla than the mandible. CLINICAL SIGNIFICANCE: To date no information about third-molar agenesis in the East Anatolian population from Turkey is documented. This is believed to be the first known study on this subject in this population.

Bilateral bifid mandibular canal: a case report.

The objective of this case report is to help clinicians identify bifid mandibular canals on panoramic radiographs and subsequently use the information in the modification of dental treatment planning. A 45-year old man was referred to the service of Oral Diagnosis and Radiology. Routine panoramic radiography, suggested the presence of bilateral bifid mandibular canals (BMC). Mandibular computed tomography revealed a clear view of bilateral mandibular canals. BMC can be detected on a panoramic radiograph.

The frequency and characteristics of idiopathic osteosclerosis and condensing osteitis lesions in a Turkish patient population.

OBJECTIVES: The objective of this study was to investigate the frequency of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in a Turkish patient population, considering factors such as age and sex of the population, in addition to shape and localization, as well as the dental relationship between IO and CO lesions. PATIENTS AND METHODS: A retrospective study was performed using panoramic radiographs of 6,154 patients ranging in age from 5 to 69 years old, who had been subjected to dental treatment. Descriptive characteristics of radiopacities, including shape, localization and dental relationship were recorded. The Chi-squared test was used. RESULTS: A total of 238 radiopacities were detected, which included 185 IO lesions in 150 (2.44 %) subjects (96 female, 54 male and mean age: 26.2), and 53 CO lesions in 50 (0.81 %) subjects (27 female, 23 male and mean age: 32.8). Both IO and CO lesions were found to be higher in number among females, as compared to males. However, this difference was statistically significant for IO lesions only (p<0.001). The frequency of IO lesions was found to be significantly higher in the 3rd and 4th decades of life (20-39 years) than in other decades (p<0.001). On the other hand, the frequency with which the CO lesions were detected was similar in ages ranging between 20-39 and 40-69 years old, and its frequency in these periods was noted to be statistically higher than in the 1st and 2nd decades of life (p<0.01). CONCLUSION: Our results point to the low IO and CO frequency among the Turkish population. In addition, our findings support the theory that IO lesions are developmental variations of normal bone architecture unrelated to a local stimulant, whereas CO lesions could be considered reactive formations related to teeth with severe caries, restoration or pulpitis.

Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population.

OBJECTIVES: The purpose of the present study is to determine the nature of the complaints that bring patients to our clinic and to what degree these complaints affect their quality of life (QoL). We also aimed to determine any associations between gender, education or harmful habits and each patient's oral health-related quality of life (OHQoL). METHODS: A total of 1090 patients, consisting of 651 females (59.7 %) and 439 males (40.3 %), were included in this study. Of these patients, 220 constituted healthy controls. Two patient-centered outcome measures, the 14 item OHIP-14 and the 16 item OHQoL-UK measures were used. RESULTS: Most of the patients presented with toothache and caries (50.1 %), 11.2 % had suffered tooth loss and had denture needs, 9.2 % had periodontal problems, 1.8 % had temporomandibular joint (TMJ) disorders, 3.8 % had buried third molars, 2.4 % had orthodontic and aesthetic disorders, 1.3 % had suffered injury due to trauma, and 20.2 % came only for control checkups. OHQoL was best in the control group and the worst in patients who had suffered trauma. In addition, we noted correlations between gender, education and harmful habits, and that of the patient's oral health-related quality of life. CONCLUSION: According to our results, OHQoL is associated with the oral complaints of patients. Furthermore, OHQoL may not only be associated with the oral health status of patients, but factors such as gender, education and harmful habits may also play a role.

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

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

Oral pemphigus vulgaris: a case report with review of the literature.

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially manifests in the form of intraoral lesions, which spread to other mucous membranes and the skin. The etiology of pemphigus vulgaris is still unknown, although the disease has attracted considerable interest. The pemphigus group of diseases is characterized by the production of autoantibodies against intercellular substances and is thus classified as autoimmune diseases. Most patients are initially misdiagnosed and improperly treated for many months or even years. Dental professionals must be sufficiently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment, since this in turn determines the prognosis and course of the disease. Here, we report a case of pemphigus vulgaris that was misdiagnosed in its earliest stage.