Variations and thicknesses of anterior belly of the digastric muscle: an ultrasonographic study.

PURPOSE: This study aims to evaluate the anatomy and anatomical variations of the anterior belly of the digastric muscle. METHODS: Hundred and fifty one ultrasonographic images of the digastric muscle pairs were evaluated in Near East University Faculty of Dentistry Department of Dentomaxillofacial Radiology. Morphological variations were recorded using the classification of the digastric muscle into 12 types by Kim et al. For the analysis, the Mann-Whitney U test and Chi-square test were used, and for the correlational analysis, Spearman's rho test was applied. P < 0.05 was considered statistically significant in all tests. RESULTS: Seventy female and 81 male patients aged 19-60 years were evaluated. Type 1 digastric muscle was observed in 145 of 151 patients, Type 2 in 3 patients, and Type 7 in 3 patients. The thicknesses of the right and left digastric muscles were measured, and a statistically significant difference was observed between the groups when the genders were compared. It was observed that both right and left digastric muscle thicknesses were higher in males than females. There was a statistically significant positive high correlation between right and left digastric muscle thicknesses (p = 0.000; r = 0.736). No statistically significant difference was found between genders (p = 0.596) in terms of anatomical variations. CONCLUSION: Considering that the variations of the digastric muscle may have a clinical significance role, the normal anatomy and variations of this muscle should be well known by maxillofacial surgeons and radiologists.

Sphenoid Sinus Volumes of Patients with Unilateral Cleft Lip and Palate.

OBJECTIVE: There is only one study in the literature in which 3D evaluation of sphenoid sinus volume in patients with cleft lip and palate was used. This shows that this issue has not been adequately evaluated. The present study aimed to compare the volume of the sphenoid sinuses in patients with cleft lip and palate on cone-beam computed tomography images, and to compare them with healthy controls. The high variability of sphenoid sinus volumes poses a risk for iatrogenic lesions during surgical procedures. Because the degree of pneumatization due to increased volume increases the likelihood of exposure of vital neurovascular structures such as the internal carotid artery, maxillary nerves, and optic nerves. DESIGN: Retrospective cohort study. SETTING: University Hospital. PATIENTS: A total of 64 patients (32 cleft palate, 32 controls) over 18 years of age who had sphenoid sinuses in the image area were included in our study. OUTCOMES: Sphenoid Sinus Volume. RESULTS: When the groups were compared in terms of total sinus volume, there was a statistically significant difference between them. Total sinus volume was significantly mean 2.806,87 mm lower in patients with cleft lip and palate compared to the healthy group (P = .015). CONCLUSION: To be aware this lower volume of the sphenoid sinus in cleft lip and palate patients will be useful for the surgical approach to sphenoid sinus. However, the literature on the subject is insufficient, more comprehensive clinical and radiological studies are needed on a larger sample.

Association of accessory sphenoidal septum with protrusions of sphenoid sinus.

PURPOSE: Accessory sphenoidal septum (ASS) is a septal variation that exists in addition to the primary septum of the sphenoid sinus and can be found in or near anatomically essential structures. This study aimed to investigate the relationships between protrusions of vital structures around the sphenoid sinus and the ASSs. METHODS: This cross-sectional retrospective study is based on the analysis of CBCT scans of 314 patients in axial, coronal, and sagittal planes with 0.2-0.3 slice thicknesses. Optic nerve (ON), internal carotid artery (ICA), both ON and ICA, maxillary nerve (MN), vidian canal (VN) and ASSs were detected, and the relationship between protrusions of these vital anatomical structures and ASS was evaluated. RESULTS: Statistically significant relationship was observed between the right Type 1 ON protrusion (p < 0.05) and left Type 1 ON protrusion (p = 0.001); left Type 3 ON protrusion (p < 0.05); right Type 4 ON protrusion (p < 0.05) and ASS. Statistically significant relationship was also observed between the right ICA protrusion and ASS (p < 0.05). The right Type 1 VN protrusion (p = 0.001); left Type 2 VN protrusion (p < 0.001); right and left Type 3 VN protrusions (p < 0.001) were found to be significantly associated with the ASS. CONCLUSIONS: ASSs have significant associations with some protrusions, and they tend to cause potentially severe complications in endoscopic sinus surgery. This variability requires a comprehensive understanding of regional sphenoid sinus anatomy with detailed three-dimensional tomographic imaging.

Use of ultrasonography in the diagnosis of temporomandibular disorders: a prospective clinical study.

OBJECTIVES: Panoramic radiographs, computed tomography, and magnetic resonance imaging (MRI) are traditionally used for imaging temporomandibular joint (TMJ) and its pathologies. Besides these radiographic techniques, the recent use of ultrasonography (US) in diagnosing joint diseases has been introduced. However, there is no prospective clinical study examining the application of US in imaging of Temporomandibular Disorders (TMD) patients. Therefore, this study aimed to determine the features of the joint and surrounding structures in the US in TMD patients. METHODS: 320 patients fulfilled the inclusion criteria, and 100 of these individuals accepted to participate in the study. This study evaluated 200 TMJ; including the right TMJ and left TMJ of 100 patients. The study was designed as a clinical single-blind observational device trial. RESULTS: It has been seen that women are 3.54 times more likely to have muscle pain than men. It has been determined that the probability of joint pain increased as the joint space with the mouth closed increased. It has been seen that women are 3.61 times more likely to experience headaches than men. CONCLUSIONS: The US, which is becoming increasingly common in dentistry, can be used as an aid in TMD diagnoses. US will not be sufficient when it is desired to evaluate the TMJ joint area more precisely and clearly in patients who will be planned for advanced surgical intervention. Therefore, it may be necessary to refer for MRI. The values of our findings will be a reference in TMD diagnoses. GOV ID: NCT04452110.

Physiologic intracranial calcifications incidentally detected on cone beam computed tomography.

OBJECTIVES: This study aims to determine the incidence of physiologic intracranial calcifications on cone beam computed tomography (CBCT) and to contribute to the differentiation between physiologic and pathologic intracranial calcifications by sharing their characteristic appearances, with the largest number of patients in the literature and many different types of physiologic calcifications. STUDY DESIGN: CBCT images of 996 patients admitted to the clinic between 2018 and 2019 were scanned retrospectively. Petroclinoid (PCL) and interclinoid ligaments (ICL), pineal gland, coronoid plexus, falx cerebri, tentorium cerebelli, and other dural calcifications were evaluated in each radiograph. RESULTS: Physiologic calcification was present in 49.4% of the cases, and pineal gland calcification was the most common (47.6%) type. PCL calcification was detected in 22.1%, and it was mostly bilateral partial. There were complete ICL in 1.2%, coronoid plexus in 11.3%, falx cerebri in 6.3%, tentorium cerebelli in 1.1%, and other dural calcifications in 3.6%. Only PCL calcifications differed between sexes and were more common in males. PCL, pineal gland, and coronoid plexus calcifications were most detected in the third decade of the cases. CONCLUSIONS: Intracranial calcifications are detected incidentally in CBCT examinations. Some calcifications may indicate pathologic conditions, and patients may need to be referred for further evaluation.

Cone-beam computed tomography evaluation of impacted and transmigrated mandibular canines: a retrospective study.

OBJECTIVES: The purpose of this study is to evaluate CBCT images of impacted mandibular canines in detail and to discuss implications for diagnosis and treatment. METHODS: CBCT images of dental patients applied between December 2015 and December 2017 were evaluated retrospectively. 2591 CBCT images, including mandible in their field of view, were determined and evaluated regarding the presence of mandibular canine impaction. 66 impacted mandibular canines of 58 patients were analyzed in detail regarding their location, morphology, associated pathologies, and their relationship with the neighboring anatomic structures, the role of these factors on transmigration, as well as treatments applied. The Pearson Chi square test was used between the groups. RESULTS: Transmigration was observed in 53% of impacted mandibular canines. Teeth with transmigration were localized horizontally, below the apex of adjacent teeth frequently, and had no contact with mandibular cortical bone mostly. 62% of mandibular canines were in contact/proximity with the incisive mandibular canal. The most applied treatment for transmigrated teeth was surgical removal, followed by radiographic monitoring, but orthodontic traction was not preferred in any case. For non-transmigrated teeth, the most applied treatment options were surgical removal, orthodontic traction, and radiographic monitoring, respectively. Autotransplantation was not preferred in any case of impacted teeth. Vertical position of the crown tip (p < 0.05) and the presence of deciduous mandibular canines and their resorption showed significant relation to transmigration (p < 0.05). CONCLUSION: Transmigration is common among impacted mandibular canines. Resorption of adjacent teeth roots was one of the possible complications of impaction and likely contact/proximity of incisive mandibular canal with impacted mandibular canines, which may pose difficulties in surgical treatment, can be better detected by CBCT.