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.

Is ultrasonography sufficient for evaluation of mental foramen?

METHODS:: The measurements were established on 60 MFs of 30 patients (16 males, 14 females) with a mean age of 30.70 ± 9,23 years. The vertical and the horizontal diameters, distance to the alveolar crest of the MF was measured by both CBCT and USG. Results obtained with CBCT and USG were statistically compared. And also the blood flow of the MF determined by Doppler USG. RESULTS:: All of the MFs could be detected by CBCT and USG. The vertical and the horizontal diameter measurements were compatible with each other by CBCT and USG. However, the distance to the alveolar crest was lower in USG than CBCT (p < 0.0001). The blood flow could be detected in all patients by Doppler USG that was weak in 8 MFs and strong in 52 MFs. Also there was no statistically significant association between the blood flow and age or gender. Furthermore, the blood flow was related with the horizontal diameter of the MF; however, it was not related with the vertical diameter and the distance to the alveolar crest. CONCLUSIONS:: USG is quite effective in showing the shape, size, and the location of the MF easily and rapidly. However, it is not as accurate as CBCT in measuring the distance from the MF to alveolar crest. And also it allows to examine the flow rate of mental artery with its Doppler modes.

Comparative study of ProTaper gold, reciproc, and ProTaper universal for root canal preparation in severely curved root canals.

AIM: The aim of this study is to evaluate the root canal transportation, centering ability, and instrumentation times with the ProTaper Gold (Dentsply Tulsa Dental, Tulsa, OK, USA), Reciproc (VDW, Munich, Germany), and ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty mesial root canals of mandibular first molars with curvature angles of 35°-70° and radii of 2-6 mm were included in the study. Root canal instrumentation was performed up to F2 or R25. The instrumentation times were recorded. CBCT scanning was performed both pre- and post-instrumentation. Root canal transportation and the centering ratio were calculated for groups, and the data were analyzed using a one-way ANOVA and least significant difference post hoc tests for the instrumentation time, root canal transportation, and centering ratio at the 95% confidence level (P = 0.05). RESULTS: At 3, 5, and 7 mm levels, there was no significant difference in the root canal transportation and centering ratio among the groups (P > 0.05). There were significant differences between the Reciproc and ProTaper Universal groups in the instrumentation times (P < 0.05). CONCLUSION: Root canal transportation and the centering ratio with the ProTaper Gold were similar to those obtained with the ProTaper Universal and Reciproc.

Effect of instrument speed when used in reciprocating motion on root canal transportation and centering ability.

AIM: This study aims to evaluate the root canal transportation, centering ability, and instrumentation times after root canal preparation using reciprocating motion at 300 rotations per minute (rpm) and 600 rpm. MATERIALS AND METHODS: Twenty mesial root canals of mandibular first molars with curvature angles of 35°-70° and radii of 2-6 mm were included in the study. Root canal instrumentation was performed using R25 according to the manufacturer's instructions at 300 rpm or 600 rpm (n = 10). Cone-beam computed tomography scanning was performed both pre- and post-instrumentation. Root canal transportation and the centering ratio were calculated for both the groups, and the data were analyzed using independent sample t-test for the instrumentation time, root canal transportation, and centering ratio at the 95% confidence level (P = 0.05). RESULTS: At the three levels (3 mm, 5 mm, and 7 mm), there were no significant differences in centering ratio between the groups (P > 0.05). At 3 mm, 600 rpm resulted in more transportation than 300 rpm. However, there were no significant differences in the root canal transportation between the groups at 5 mm and 7 mm levels (P > 0.05). CONCLUSION: At the 3 mm level, 600 rpm resulted in more transportation than 300 rpm. However, centering ratio was similar at both 600 rpm and 300 rpm.

Is Arthrocentesis Plus Platelet-Rich Plasma Superior to Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis? A Randomized Clinical Trial.

PURPOSE: To compare the long-term clinical and radiologic outcomes of temporomandibular joint osteoarthritis (TMJ-OA) treated with arthrocentesis plus platelet-rich plasma (PRP) versus arthrocentesis alone. MATERIALS AND METHODS: A randomized clinical trial in adult patients with TMJ-OA referred to the authors' clinic from May 2012 through July 2013 was implemented. The sample was composed of 30 consecutive patients with TMJ-OA treated randomly with arthrocentesis alone (control group) or initial arthrocentesis plus PRP injection and then 4 consecutive PRP injections (study group). The predictor variable was treatment technique. The outcome variables were visual analog scale evaluations (masticatory efficiency, joint sounds, and pain complaints), maximal interincisal opening, and cone-beam computed tomographic (CBCT) findings. Outcome variables were recorded preoperatively and 12 months postoperatively. Descriptive and bivariate statistics were computed, and significance was set at a P value less than .05. The paired t and Student t tests were used for intragroup and intergroup comparisons, respectively. RESULTS: The sample was composed of 47 joints of 30 patients with OA (control group: 15 joints of 12 patients; mean age, 35.08 ± 14.84 yr; study group: 32 joints of 18 patients; mean age, 32.22 ± 14.32 yr). Joint sounds and general pain complaints decreased statistically in the 2 groups, whereas masticatory efficiency, painless interincisal opening, and lateral motion increased statistically only in the study group. However, only masticatory efficiency showed statistically greater improvement in the study group compared with the control group. CBCT evaluations showed that reparative remodeling of the osseous abnormalities occurred at rates of 87.5 and 46.6% in the study and control groups, respectively. CONCLUSIONS: These findings suggested that arthrocentesis and PRP injections constitute a safe and promising method for the treatment of TMJ-OA that is superior to arthrocentesis alone.

Morphometric and morphologic evaluation of the mental foramen in relation to age and sex: an anatomic cone beam computed tomography study.

OBJECTIVE: The aim of this study was to assess the vertical and horizontal position, angle, and diameter of the mental foramen (MF) according to sex and age by cone beam computed tomography in a Turkish patient population. METHODS: Cone beam computed tomography records of 192 consecutive patients consisting of 106 women and 86 men were examined, retrospectively. The vertical and horizontal positions of MF, angle and diameter of MF, and distance from MF to the alveolar crest and the base of the mandible were evaluated with respect to sex and age groups. RESULTS: There were statistically significant differences in the distance of MF to the alveolar crest according to age groups. When we compared the right and left sides, we have only found out statistically significant differences in the angles of MF and that it was higher in the left side. CONCLUSIONS: From our results, the detection of the position of MF can provide detailed information for preoperative treatment planning (for surgery and dental implant surgery procedures), especially in the mandibular premolar region.

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.

Relationship among Schneiderian membrane, Underwood's septa, and the maxillary sinus inferior border.

BACKGROUND: Osseo-integrated implants are increasingly being used to restore functional dentition; however, in the posterior region, implant placement can be problematic because of inadequate bone height. In this condition, maxillary sinus floor elevation surgery has become the treatment of choice. The presence of anatomic variations within the maxillary sinus such as Underwood's septa and thin Schneiderian membrane decreases the success of the sinus floor elevation. PURPOSE: In this study, we tried to determine the relationship between the anatomic variations of the maxillary sinus: Underwood's septa, Schneiderian membrane thickness, and the cortical thickness of the inferior border of the maxillary sinus. MATERIAL AND METHODS: The left and right maxillary sinus images of 74 patients were obtained by using dental computed tomography (CT). The Schneiderian membrane and the cortical thickness of the inferior border of the maxillary sinus were measured on the coronal images of dental CT scans at the deepest portion of the sinus cavity. The presence of Underwood's septa was identified on the axial images. The correlations between these variables were assessed. RESULTS: We found that there was only a negative correlation between the Schneiderian membrane thickness and the presence of Underwood's septa (r = -0.168 p = .042). CONCLUSION: It is suggested that Underwood's septa may be the reason for the thinness of the Schneiderian membrane. However, future studies among larger groups are necessary for confirming the finding by using well-designed clinical studies.

Evaluation of enamel pearls by cone-beam computed tomography (CBCT)

Objective: The aim of this study was to evaluate the frequency of enamel pearls according to population, sex and tooth groups on Cone-Beam Computed Tomography (CBCT) or Dental Volumetric Tomography (DVT) scans of patients, retrospectively. Study Design: In this study, 15185 teeth belonging to 768 patients, 430 female and 338 male, was performed cross sectional examination by CBCT. The volumetric Computed Tomography used in the study is Newton FP based on flat-panel. The data were analyzed with Pearson chi-squared test. Results: Enamel pearls were detected in 36 subjects (4.69%). Of these enamel pearls, 19 were detected in male and17 were in male. There was no statistically a significant association between prevalence of enamel pearls and sex. All of enamel pearls were detected in molar teeth, for prevalence 0.83%.Conclusion: All of enamel pearls are found upper and lower molar teeth, especially the most commonly in maxillary second and third molars (AU)

Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction.

BACKGROUND: Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). PURPOSE: To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. MATERIAL AND METHODS: DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). RESULTS: In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. CONCLUSION: The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study.

A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in Turkish individuals.

PURPOSE: In adults, sphenoid sinus agenesis is an extremely rare anomaly. The objective of this study was to investigate the prevalence of sphenoid sinus hypoplasia and agenesis using dental volumetric computed tomography (DVCT) in a population of Turkish individuals. MATERIALS AND METHODS: DVCT scans in the axial, coronal and sagittal planes of the sphenoid sinus of 384 patients were examined for evidence of sphenoid sinus agenesis and hypoplasia. RESULTS: In the DVCT scans, bilateral agenesis of sphenoid sinus was not seen. Unilateral agenesis of sphenoid sinus was seen in 0.26% of the sample, and sphenoid sinus hypoplasia was seen in 0.52%. Unilateral hypoplasia of the sphenoid sinus was observed in 0.26% of the sample, and bilateral hypoplasia of sphenoid sinus was observed in 0.26%. CONCLUSION: In this study, we found a low frequency of sphenoid sinus agenesis. Compared with sphenoid sinus agenesis, the frequency of sphenoid sinus hypoplasia was higher. DVCT may be used as a diagnostic tool to investigate the paranasal sinus.

No correlation between mandibular and non-mandibular measurements in osteoporotic men.

BACKGROUND: Screening for low bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) has been the traditional method for determining osteoporosis. Panoramic radiography is widely used in dentistry. PURPOSE: To determine the relationships between the values of dental panoramic indices (the mental index (MI), antegonial index (AI), panoramic mandibular index (PMI)) and the values of skeletal BMD (femoral BMD (f-BMD), and vertebral BMD (v-BMD)) in 25 osteoporotic men. MATERIAL AND METHODS: In the panoramic radiographs obtained from a total of 25 male individuals with osteoporosis, the means were calculated for MI, AI, and PMI values measured in the right and left mandible. DXA measurements of the femur and lumbar vertebrae BMD were also calculated. The correlation between these variables was assessed. RESULTS: No correlation was found between the BMD values of the femur and lumbar vertebrae and values of MI, AI, and PMI. CONCLUSION: No significant correlation was found between the mandibular and non-mandibular measurements in men with osteoporosis. MI, AI, and PMI indices should not be used in the evaluation of the skeletal status, because they are not reliable tools in screening for osteoporosis.