Ascher Syndrome: Acquired Double Lower Lip Combined With Epulis Fissuratum.

Ascher syndrome is characterized by double lip, blepharochalasis, and non-toxic goiter triad. This condition of unknown etiology usually occurs in patients younger than 20 years of age. In this case report, the authors present the diagnostic process of Ascher syndrome and surgical procedure of double lower lip in a female patient who applied to our clinic for prosthetic reasons. A 70-year old female patient was referred to our clinic with the chief complaint of incompatible dentures. The patient had been using the same complete dentures for 40 years. Extraoral clinical examination revealed protruded, bulged lower lip at rest and bilateral blepharochalasis, defined as atrophy of the upper eyelid skin. The upper lip and lower eyelids were not affected. Intraoral examination revealed complete edentation of both jaws and a double lower lip, an accessory fold of excess mucosae inside the vermillion border. Furthermore, epulis fissuratum was observed in the lower jaw. There was no family history of double lip. The patient stated that she had noticed another lip inside her lip for several years. As Ascher syndrome was suspected, the patient was referred to the endocrinology department for thyroid examination, and the non-toxic goiter diagnosis was confirmed. Surgical removal of the redundant tissues was necessary because of deficiencies in speech, chewing, and aesthetics. The excess tissues were excised by transverse ellipse incision technique. Dentists should be familiar with Ascher syndrome, as they may be the first physicians to encounter patients with double lip.

Effects of a Glycogen Synthase Kinase 3 Inhibitor Tideglusib on Bone Regeneration With Calvarial Defects.

Tideglusib is a glycogen synthase kinase 3 (GSK-3) inhibitor which has shown the effects of bone regeneration, used for the treatment of Alzheimer disease. The aim of the study was to determine the effects of Tideglusib in the apoptosis and the bone regeneration in rats with calvarial defects. Twenty male Wistar rats (aged 11-13 weeks) were used for the study. Full-thickness flap elevated to exposure calvarial bone. Two 5 mm critical size calvarial defects were created on each rat calvarium. The defects were divided into 4 study groups: 1-Control (n = 10); 2- Gelatin sponge+Tideglusib (Gs+TDG; n = 10); 3- Autogenous bone (AB; n = 10); 4-Autogenous bone+Tideglusib (AB+TDG; n = 10). Then, the rats were sacrificed at fourth week. Three-dimensional imaging, histopathologic and immunohistochemical examinations were performed to evaluate the samples. The most increased bone formation and interaction between graft and new bone were observed in AB+TDG group. Bone morphogenic protein-2 (BMP-2), alkaline phosphatase (ALP), collagen type 1 (Col 1) and osteocalcin (OCN) was determined significantly higher in Tideglusib received groups compared with those of Control and AB groups (P < 0.05). Osteoclast numbers found to be higher in Gs+TDG and AB+TDG groups as well as RANKL expression dis not affected in Gs+TDG group but decreased in AB+TDG group comparing those of Control and AB groups. In addition, Tideglusib increased the Bcl-2 levels (P < 0.05) and decreased Bax levels (P > 0.05) in Tideglusib received groups compared with their controls. The administration of Tideglusib in calvarial bone defects increased bone mineral density, new bone area and total bone area by decreasing apoptosis and increasing osteoblastogenesis.

An unusual case of double stafne bone cavities.

Stafne bone cavity (SBC) is a rare lingual bone depression that is asymptomatic and contains salivary glands. Radiographically, an SBC is usually seen as well-defined homogenous oval radiolucency in the mandibular posterior region, below the mandibular canal. In this paper, a rare case of posterior-variant, double SBCs was presented. A 43-year old male patient was referred to our clinic with the complaint of third molar teeth. Panoramic and cone-beam computed tomographic images showed two well-defined oval radiolucencies on the left mandibular molar region, inferior to mandibular canal borders. No pain or swelling was detected in the region of the radiolucencies. Previous dental radiographs had the same images. Magnetic resonance imaging was performed to evaluate the presence of salivary gland in the radiolucent contents. Images showed that the bone cavities were filled with soft tissue having a signal similar to the submandibular gland. The diagnosis was made as double SBCs and the patient was informed about the lesions.

Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths.

OBJECTIVE: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. MATERIALS AND METHODS: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman's rho correlation coefficient, and χ2 tests were used for the statistical analysis. RESULTS: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman's r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. CONCLUSION: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.

Deviation of Dental Implants Placed by Guided Implant Surgery in Bone Structures with Different Densities.

Purpose: This study aimed to evaluate the deviations of implants with two different geometries placed with a bone-supported stereolithographic surgical template into the bone of Misch classification densities of D2, D3, and D4. Materials and Methods: Eight maxilla and eight mandible models were macrodesigned according to the jaw geometries. Bone densities of these models were created in parallel with the most frequently observed densities in the locations: D3 bone density in the anterior maxilla, D4 bone density in the posterior maxilla, D2 bone density in the anterior mandible, and D3 bone density in the posterior mandible. A bone-supported stereolithographic surgical template was prepared in accordance with the jaw models and planning and used to place 64 NobelParallel Conical Connection RP 4.3 × 13 mm and 64 NobelActive 4.3 × 13 mm implants on the models. Global deviation, lateral deviation, angular deviation, and depth deviation between planned and placed implants were calculated with Hypermesh. The Kruskal-Wallis test was used to analyze the differences between deviation data of the study groups, and the Mann-Whitney U test was used for pairwise comparisons of groups with significant differences. Significance was evaluated as P < .05. Results: The study groups showed statistical differences in terms of global, lateral, and depth deviation (P = .017, P = .044, and P = .012, respectively); no statistical difference was detected in terms of angular deviation (P > .05). When the data of all studies were evaluated, the deviation values for all maxillary and mandibular implants were examined regardless of bone and implant type; no statistical difference was found between the arches in terms of deviation type (P > .05). Conclusion: Regardless of the macrogeometry of the dental implants placed with the guide, no significant difference was observed between the deviation values of the different bone densities they were applied to.

Effects of taxifolin on bone formation and apoptosis in experimental periodontitis in diabetic rats.

We investigated the therapeutic potential of taxifolin for treatment of alveolar bone loss (ABL) in experimental periodontitis in diabetic rats. Diabetes mellitus (DM) was induced by streptozotocin. Rats were divided into six groups: untreated control; DM only (D) group; ligature only (P) group; DM + ligature (DP) group; DM + ligature + 5 mg/kg/day taxifolin (Taxi-5) group; DM + ligature + 10 mg/kg/day taxifolin (Taxi-10) group. Experimental periodontitis was induced by ligation of the first molar and allowed to progress for 30 days before performing cone-beam computed tomographic (CBCT), histomorphometric and immunohistochemical analyses of periodontal tissue destruction. ABL was assessed using CBCT. ABL was greatest in the P and DP groups. Decreased ABL was observed in the Taxi-5 and Taxi-10 groups. Bone morphogenic protein (BMP-2), osteocalcin (OCN), receptor activator of nuclear factor kappa-Β ligand (RANKL), alkaline phosphatase (ALP), type I collagen, B cell lymphoma-associated X (Bax), and B-cell lymphoma 2 (Bcl-2) levels were investigated using immunohistochemistry. The Taxi-5 and Taxi-10 groups exhibited decreased RANKL expression, but increased BMP-2, ALP, type I collagen and OCN levels compared to the P and DP groups. Bax activity was increased in the D, P and DP groups. Taxi-5 and Taxi-10 groups exhibited increased Bcl-2 activity. Our findings suggest that taxifolin can reduce apoptosis and improve alveolar bone formation in diabetic rats with periodontitis.

Evaluation of motion artifacts in cone-beam computed tomography with three different patient positioning.

OBJECTIVES: Cone-beam computed tomography (CBCT), despite its advantages, has some drawbacks, such as artifacts and movement of the patient during scanning may lead to motion artifacts (MAs). This retrospective study aimed to evaluate the MAs in three different CBCT devices and to analyze their relationship with age, the gender of the patients, and scanning times. METHODS: This study included 360 CBCT images from three institutions scanned in standing, sitting and supine positions. MAs presence, age, gender, and scanning times were recorded. Of the patients, 129 were scanned in standing position, 131 in sitting position, and 100 in supine position. RESULTS: MAs were found in 6.7% of patients in total; 8%, 7.6%, and 4% in standing, sitting, and supine positions, respectively. No statistically significant relationship was observed between MAs presence and patient position. The mean age of the patients with MAs was higher than patients without, in total and in standing positions. Scanning time showed no correlation with artifact presence. CONCLUSIONS: Patient position is not related to MAs presence. The age of the patient is a factor in movement, and has a high impact in standing position. Although insignificant, MAs were less common in supine position than sitting and standing positions. Sitting and supine positioning might reduce motion artifacts in older patients.

Evaluation of mercury release from dental amalgam after cone beam computed tomography and magnetic resonance imaging with 3.0-T and 1.5-T magnetic field strengths.

OBJECTIVES: This in vitro study aimed to investigate leakage of mercury from amalgam restorations after cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) examinations. STUDY DESIGN: In total, 238 amalgam disks were prepared and placed in saline solution. The samples were allocated randomly to 7 groups, with 34 samples in each group. CBCT imaging was performed for 4 groups with different imaging parameters (narrow/wide field of view [FOV]; standard/high-resolution). MRI procedures were performed with 3.0-T and 1.5-T magnetic field strengths. No imaging was performed for the samples in the control group. The amalgam samples were removed from the tubes 24 hours after imaging and submitted for plasma mass spectrometry analysis. Kruskal-Wallis and Dunn's tests were performed to compare data. A P value less than .05 was accepted as statistically significant. RESULTS: The highest mean mercury value was found in the 3.0-T MRI group, whereas the lowest mean value was found in the narrow FOV, standard-resolution CBCT group. There were no significant differences between the control group and the experimental groups (P ≥ .338) or between the experimental groups (P > .05). CONCLUSIONS: CBCT and MRI procedures similar to those used in patient care caused no significantly different mercury release compared with nonexposed samples.

Analysis of Dentistry YouTube Videos Related To COVID-19.

This study aimed to analyze the videos available on YouTube related to dentistry and the novel coronavirus (COVID-19), as there is no such analysis in the existing literature. The terms "dental" and "COVID-19" were searched on YouTube on May 9, 2020. The top 116 English-language videos with at least 300 views were analyzed by two observers. Data was saved for each video, including target audience, source, country of origin, content, number of views, time watched, average views, duration, like/dislike ratio, and usefulness. Total video information and quality index (VIQI) scores were calculated, consisting of flow, information, accuracy, quality, and precision indices. Non-parametric tests were used for analysis. The analyzed videos were viewed 375,000 times and totaled 20 h of content. Most videos were uploaded by dentists (45.7%), originated from the United States (79.3%), and contained information targeted towards patients (48.3%). Nearly half of the videos (47.4%) were moderately useful. For the usefulness of the videos, statistically significant differences were found for all indices as well as total VIQI scores. A comparison of the indices according to the relevance of the videos showed statistically significant differences in the videos' information and precision indices and total VIQI scores. The results of this study showed that dentistry YouTube videos related to COVID-19 had high view numbers; however, the videos were generally moderate in quality and usefulness.

Turkish adaptation and implementation of the modified infection control questionnaire in intraoral digital imaging.

PURPOSE: There are very few studies evaluating the knowledge of dentists about infection precautions in oral radiology. The aim of this study was to assess the psychometric properties of the Turkish version of the modified form of a developed questionnaire and to apply this questionnaire to Turkish dentists. MATERIALS AND METHODS: The questionnaire was applied to a sample of 250 dentists for the scale development [200 for confirmatory factor analysis (CFA) and 50 for control] and 173 dentists for the implementation of the scale. The scale was applied to 200 dentists and construct validity was examined with CFA. For model fit; chi square to df ratio, RMSEA (Root Mean Square Error of Approximation), TLI (Tucker-Lewis Index), CFI (Comparative Fit Index), GFI (goodness of fit index), AGFI (adjusted goodness of fit index) and NFI (normed fit index) were obtained. Also, reliability analysis was applied and itemtotal correlations and Cronbach's alpha values were given. Adapted scale scores using a different sample of 173 dentists were compared according to demographic characteristics. RESULTS: CFA showed good fit statistics (X2/df=1.511, RMSEA=0.057, TLI=0.942, CFI=0.953, GFI=0.926, AGFI=0.900, NFI=0.928) for the scale. Item-total correlations were over 0.30 and Cronbach's alpha was calculated as 0.877. In addition, experienced dentists had higher scores in the dimension of personal hygiene (p<0.05). CONCLUSION: The Turkish version of the modified infection control questionnaire in oral radiology showed adequate psychometric properties. This indicated that it could be a valid and reliable tool for the assessment of infection control in oral radiology among Turkish dentists.

The effects of taxifolin on alveolar bone in experimental periodontitis in rats.

OBJECTIVE: This study aimed to evaluate the effect of taxifolin, a powerful antioxidant, on the progression of periodontitis by immunohistochemical and cone-beam computed tomography (CBCT) examination. DESIGN: This study was performed with 32 rats in four experimental groups: a non-ligated group (Control, n = 8), periodontitis group (Perio, n = 8), periodontitis with 1 mg/kg/day taxifolin group (Taxi-1, n = 8), and periodontitis with 10 mg/kg/day taxifolin group (Taxi-10, n = 8). A ligature-induced experimental periodontitis design was used. All rats were sacrificed at 30 days. Alveolar bone loss was determined by CBCT. Hematoxylin-eosin stained slides were examined. The expression levels of bone morphogenetic protein 2 (BMP-2), osteocalcin (OCN), alkaline phosphatase (ALP), collagen type I (Col 1), Bcl-2, Bax, and receptor activator of NF-κB ligand (RANKL) were determined immunohistochemically. RESULTS: Both doses of taxifolin showed a decrease in alveolar bone loss. The inflammatory reaction was higher in the Perio group and lower in the taxifolin groups. BMP-2, OCN, ALP, and Col 1 expression were dose-dependently elevated in the taxifolin groups. RANKL immunoexpression decreased with both doses of taxifolin. Bcl-2 expression increased and Bax expression decreased in the taxifolin groups. CONCLUSION: Taxifolin successfully reduced apoptosis and improved bone formation in alveolar bone in this experimental periodontitis model.

Diagnostic accuracy of cone-beam computed tomography in detecting secondary caries under composite fillings: an in vitro study.

PURPOSE: The aim of this in vitro study was to assess the diagnostic performance of cone-beam computed tomography (CBCT) in the detection of secondary carious lesions under composite resin fillings applied to different types of cavities. MATERIALS AND METHODS: Occlusal cavities (O) (n=18), occlusal cavities with mesial or distal component (MO/DO) (n=30), and mesial-occlusal-distal cavities (MOD) (n=30) were prepared in seventy eight extracted human posterior teeth. In half of the cavities in each group, artificial secondary caries lesions were simulated. All cavities were restored by using composite resin. All specimens were embedded in silicone and they were positioned to have approximal contacts. CBCT imaging was done and data were evaluated two times with two week interval by two observers, using a five-point confidence scale. Intra- and inter-observer agreements were calculated with Kappa statistics (κ). The area under (Az) the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy. RESULTS: Intra- (κ =0.89) and inter-observer (κ = 0.79) agreements were found to be excellent. Az values were highest for the O restorations which is followed by the MOD and DO/MO restorations. Az values for MOD and DO/MO restorations were very low and no statistically significant difference was found. Sensitivity for DO/MO restorations and specificity for MOD restorations were found to be the lowest values. CONCLUSION: Diagnostic performance of CBCT was higher in O composite restorations than MOD and DO/MO restorations for secondary caries detection. The use of alternative imaging methods rather than CBCT may be useful for evaluating secondary caries under composite MOD and DO/MO restorations.

Analysis of dentistry youtube videos related to COVID-19

Abstract This study aimed to analyze the videos available on YouTube related to dentistry and the novel coronavirus (COVID-19), as there is no such analysis in the existing literature. The terms "dental" and "COVID-19" were searched on YouTube on May 9, 2020. The top 116 English-language videos with at least 300 views were analyzed by two observers. Data was saved for each video, including target audience, source, country of origin, content, number of views, time watched, average views, duration, like/dislike ratio, and usefulness. Total video information and quality index (VIQI) scores were calculated, consisting of flow, information, accuracy, quality, and precision indices. Non-parametric tests were used for analysis. The analyzed videos were viewed 375,000 times and totaled 20 h of content. Most videos were uploaded by dentists (45.7%), originated from the United States (79.3%), and contained information targeted towards patients (48.3%). Nearly half of the videos (47.4%) were moderately useful. For the usefulness of the videos, statistically significant differences were found for all indices as well as total VIQI scores. A comparison of the indices according to the relevance of the videos showed statistically significant differences in the videos' information and precision indices and total VIQI scores. The results of this study showed that dentistry YouTube videos related to COVID-19 had high view numbers; however, the videos were generally moderate in quality and usefulness.

Resumo Este estudo teve como objetivo analisar os vídeos disponíveis no YouTube relacionados à odontologia e ao novo coronavírus (COVID-19), visto que não há tal análise na literatura existente. Os termos "dental" e "COVID-19" foram pesquisados no YouTube em 9 de maio de 2020. Os 116 principais vídeos em inglês, com pelo menos 300 visualizações, foram analisados por dois observadores. Os dados foram salvos para cada vídeo, incluindo público-alvo, fonte, país de origem, conteúdo, número de visualizações, tempo assistido, média de visualizações, duração, proporção de gostar/não gostar e utilidade. As pontuações do índice total de informação e qualidade de vídeo (VIQI) foram calculadas, consistindo em índices de fluxo, informação, exatidão, qualidade e precisão. Testes não paramétricos foram usados para análise. Os vídeos analisados ​​foram assistidos 375 mil vezes e totalizaram 20 h de conteúdo. A maioria dos vídeos foi enviada por dentistas (45,7%), com origem nos Estados Unidos (79,3%) e com informações direcionadas aos pacientes (48,3%). Quase metade dos vídeos (47,4%) foram moderadamente úteis. Para a utilidade dos vídeos, foram encontradas diferenças estatisticamente significantes para todos os índices, bem como para os escores totais do VIQI. Uma comparação dos índices de acordo com a relevância dos vídeos mostrou diferenças estatisticamente significativas nas informações dos vídeos e nos índices de precisão e nas pontuações totais do VIQI. Os resultados deste estudo mostraram que os vídeos de odontologia no YouTube relacionados à COVID-19 tiveram um alto número de visualizações; no entanto, os vídeos eram geralmente moderados em qualidade e utilidade.