Dental radiographic changes in individuals with COVID-19: a controlled retrospective study.

OBJECTIVE: The aim of this study is to compare the pre-COVID-19 and post-COVID-19 dental radiological findings of individuals with positive rRT-PCR test results and with healthy controls using the apical periodontitis grade scale (APGS), radiographic-based periodontal bone loss (R-PBL), and radiographic DMFT indices, and to investigate the relatively long-term dental effects of COVID-19. METHODS: This study included people who had two panoramic radiographs taken between 2018 and 2022. There are 52 patients with positive rRT-PCR tests in the study group. The control group included 50 individuals. Study and control groups were compared using the apical periodontitis grade scale (APGS), radiographic-based periodontal bone loss (R-PBL), and radiographic DMFT indices. RESULTS: Although results showed a significant difference in percentage R-PBL value and R-PBL types in the study group, there was no significant difference in percentage R-PBL value and R-PBL types in the control group. Also, both groups showed a significant difference in the DMFT index. CONCLUSIONS: According to the results of this study, it can be said that COVID-19 increases the incidence of periodontitis, and it can be interpreted that the pandemic may adversely affect the general oral health of all people.

Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study.

Purpose: The aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs. Materials and Methods: In the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared. Results: In the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible. Conclusion: The ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.

Fractal properties and radiomorphometric indices of the trabecular structure of the mandible in patients using systemic glucocorticoids.

OBJECTIVES: The aim of this study is to evaluate the mandibular trabecular and cortical bone structure of patients using systemic glucocorticoid (GC) and compare to control group with the fractal analysis (FA) and radiomorphometric indices. METHODS: Two researchers retrospectively investigated 192 dental panoramic radiographs to compare individuals using systemic GCs to healthy controls. FA was performed in 4 different regions; geometrical center of the mandibular ramus (ROI1), cancellous bone on supracortical mandibular angle area inferior to the mandibular canal (ROI2), cancellous bone on mesial to the mental foramen (ROI3), basal cortical bone extending mental foramen to the first molars' distal root in the mandibular corpus (ROI4). Panoramic mandibular index (PMI), mandibular cortical width (MCW) and mandibular cortical index (MCI) were performed for evaluate cortical thickness and porosity. The Shapiro-Wilk test was used to determine the normal distribution of the data, the independent t test for comparison of values and the chi-square test for descriptive statistics. RESULTS: There were statistically significant differences in ROI4 and MCW. The fractal dimension (FD) values in ROI4 and MCW were significantly lower in study group. There were no significant differences in FD values in ROI1, ROI2, ROI3 and PMI and MCI measurements between both groups. CONCLUSIONS: FA and radiomorphometric measurements is an efficient method to detect early changes in bone mass. In our study, ROI4 and MCW were significantly lower in study group. Osteoporosis prevention should be considered in patients using systemic GCs.

The evaluation of lateral pterygoid signal intensity changes related to temporomandibular joint anterior disc displacement.

OBJECTIVES: The aim of this study was to evaluate lateral pterygoid muscle (LPM) signal intensity changes related to different degrees of disc status groups using magnetic resonance imaging (MRI). METHODS: Four groups were established according to disc displacement of examined temporomandibular joint (TMJ) and opposing TMJ. MRI scans were obtained with a 1.5 T device. The signal intensity was measured from the sagittal slice where midportion of the muscle belly was observed. The regions of interest were placed over the superior and inferior heads of LPM. To normalize differences in signal intensity, signal intensity of the grey matter and white matter of the brain was also measured. Signal intensity ratio (SIR) was calculated. Measurements were performed in both T1- and T2-weighted images. RESULTS: In the intergroup comparisons, a statistically significant difference was found for SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables (p < 0.01). According to multiple comparison test (Tukey), no significant difference was found between group 0 and group 1 for SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables (p > 0.05). For SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables, significant differences were found between five binary comparison groups (1-2, 1-3, 2-3, 0-2, 0-3) (p < 0.05). CONCLUSION: In conclusion, SIR is correlated with the degree of disc displacement. The internal derangement of the opposite joint did not affect SIR of superior and inferior heads of examined LPM in both T1- and T2-weighted images. The inferior head of LPM was also found affected by disc displacement.

Investigation of the effectiveness of CBCT and gray scale values in the differential diagnosis of apical cysts and granulomas.

PURPOSE: The aim of this study was to investigate the effectiveness of cone-beam CT (CBCT) findings and gray scale values (GSV) in the differential diagnosis of apical cysts and granulomas. METHODS: Two independent researchers retrospectively analyzed the CBCT images of 21 teeth and histopathologically diagnosed them as having radicular cysts or apical granulomas. In the CBCT images, apical lesions were evaluated and categorized according to 7 criteria. These criteria were determined as relationship of lesions with dental roots, periphery of the lesion, shape, darker focus in the center, root resorption, displacement in related teeth, and cortical bone perforation. In addition, the minimum and maximum gray scale values of the lesions were measured and compared. RESULTS: There was a statistically significant relationship between histopathological (HP) diagnosis and well-defined cortical border and lesion shape (p = 0.003, p = 0.014, respectively). According to the HP diagnosis, no statistically significant difference was found among other variables (p > 0.05) CONCLUSION: The presence of a well-defined cortical border or partial cortical border is a distinctive criterion for cysts. Additionally, the shape of the lesion was found to be a significant criterion for the separation of the two lesions. The shape of cystic lesions was circular and apical granulomas had a more curved shape. There was no relationship between the histopathological diagnosis of lesions and CBCT gray scale values.

The evaluation of agreement between high-frequency ultrasonography and research diagnostic criteria for the diagnosis of temporomandibular joint internal derangements.

AIM: The aim of this study is to compare the diagnosis of patients with temporomandibular joint (TMJ) internal derangements which had been diagnosed using Research Diagnostic Criteria/Temporomandibular Disorders (RDC/TMD) with the dynamic high resolution sonography findings. SETTINGS AND DESIGN: Axis I section of RDC/TMD form had been applied to participants. Participants were divided into three groups as healthy TMJ, disc displacement with reduction, and disc displacement without reduction. The diagnoses had been compared with the dynamic high-resolution sonography findings. MATERIALS AND METHODS: Twelve of the patients had been treated with laser therapy, whereas 13 patients were treated with stabilization splint. Seventeen patients were treated with anterior repositioning splint (n = 42). After the application of different treatment modalities, the position of the articular disc had been determined with Axis I of RDC/ TMD form and dynamic high-resolution sonography. The findings were compared and statistically analyzed. STATISTICAL ANALYSIS USED: Statistical analyses of data were analyzed with Turcosa Cloud (Turcosa Ltd Co, Turkey). RESULTS: For the right TMJ, pretreatment and posttreatment ultrasonography (USG) diagnoses and RDC/ TMD clinical diagnoses were found similar (κ = 0.125-0.008). No statistically significant relationship was found (P > 0.05). For the left TMJ, pretreatment USG diagnosis and RDC/TMD clinical diagnose were found similar (κ = 0.070). No statistically significant relationship was found (P > 0.05). For the left TMJ, posttreatment USG diagnosis and RDC/TMD clinical diagnose were compared. A statistically significant difference was found (κ = 0.256). A statistically significant relationship was found (P < 0.05). CONCLUSIONS: Axis 1 of RDC/TMD form which is used for the diagnosis of internal derangements and dynamic high resolution sonography was not found in the agreement.

Central giant cell granulomas of the jaws: retrospective radiographic analysis of 13 patients.

OBJECTIVE: This study was performed to retrospectively analyse the imaging features of 13 patients with central giant cell granulomas (CGCGs) examined at a single institution. METHODS: The orthopantomography and cone beam computed tomography images of 13 patients histopathologically diagnosed with CGCGs were retrospectively analysed. Patients aged > 30 years underwent measurement of their calcium and parathyroid hormone levels. No cases of hyperparathyroidism were identified in the study group. RESULTS: Thirteen lesions of 13 patients (7 female, 6 male) were included in this study. The patients' ages ranged from 8 to 79 years at the time of presentation. Among the 13 lesions, 2 (15.4%) were in the maxilla and 11 (84.6%) were in the mandible. Eight lesions (61.5%) were unilocular and 5 lesions (38.5%) were multilocular with a soap bubble appearance. Three of the lesions were > 5 cm, and the remaining ten lesions were < 5 cm; five of these smaller lesions met at least three of the aggressiveness criteria. Therefore, according to these criteria, eight aggressive and five non-aggressive CGCGs were examined in this series. CONCLUSION: The distinction between aggressive and non-aggressive CGCGs is extremely important because it leads to changes in the individual treatment protocol that is applied. It may be possible to minimise recurrence after treatment by detecting findings such as cortical perforation or thinning, cortical bone expansion, and the presence of root resorption.

Masseter muscle thickness and elasticity in periodontitis.

This study aimed to compare the thickness and elasticity of the masseter muscle between patients with gingivitis and patients with periodontitis. A total of 124 patients (63 gingivitis, 61 chronic periodontitis) were recruited at the start of the study, but only 84 patients were declared as final participants. Patients were divided into two groups: (1) patients suffering from gingivitis and (2) those with generalized chronic periodontitis. Clinical (PI, plaque index; GI, gingival index; PD, probing depth; CAL, clinical attachment loss; and BOP, bleeding on probing scores) and ultrasonographic (thickness and elasticity of the masseter muscle) measurements of periodontitis were performed. There were no significant differences in gender, age, body mass index, education status, income level, or marital status between the two groups (P > 0.05). The mean age ± SD for the gingivitis and periodontitis groups was 39.5 ± 10.8 years and 44.8 ± 8.8 years, respectively. There were significant differences between the two groups in the number of PI, GI, PD, CAL, and BOP scores. There were significant differences between the two groups when thickness of masseter during contraction and at rest was taken into account. The gingivitis group had significantly thicker masseter during both contraction and rest. On the other hand, when the elasticity of the masseter was evaluated, there were no significant differences found between the two groups and two sides for each group. Masseter muscle thickness in the periodontitis group was found to be decreased compared with that in the gingivitis group. Furthermore, loss of periodontal tissues due to periodontitis reduces the masticatory ability.

Odontogenic tumors: a collaborative study of 218 cases diagnosed over 12 years and comprehensive review of the literature

OBJECTIVES: The objective of this study was to analyze the frequency and distribution of odontogenic tumors (OTs)in the Cappadocia region of Turkey, and to compare the findings with those reported in the literature. Study DESIGN: The records of the Oral and Maxillofacial Surgery and Pathology Departments at Erciyes University, with histologic diagnosis of odontogenic tumors (based on the World Health Organization classification,2005), over a 12-year period, were analyzed. The relative frequency of different types of tumors was also analyzed and compared with the literature. RESULTS: OTs in the present study constituted 2.74% of all the 7,942 registered biopsies. A total of 218 cases of OTs were collected and reviewed. Of these, (94.04%) were benign and (5.96%) were malignant. The mandible was the most commonly affected anatomic location, with 170 cases (77.9%). Ameloblastoma with a predilection for the posterior mandible was the most frequent odontogenic tumor (30.28%), followed by keratocystic odontogenictumor (19.5%), odontoma (13.4%), and odontogenic myxoma (8.5%).CONCLUSIONS: OTs are rare neoplasms and appear to show geographic variations in the world. In Cappadocia, Turkey, they are more common in the mandible, with ameloblastoma followed by keratocystic odontogenic tumors with the incidences observed in the present study being similar to those of previous studies from Asia and Africa, and in contrast to those reported from American countries

Odontogenic tumors: a collaborative study of 218 cases diagnosed over 12 years and comprehensive review of the literature.

OBJECTIVES: The objective of this study was to analyze the frequency and distribution of odontogenic tumors (OTs) in the Cappadocia region of Turkey, and to compare the findings with those reported in the literature. STUDY DESIGN: The records of the Oral and Maxillofacial Surgery and Pathology Departments at Erciyes University, with histologic diagnosis of odontogenic tumors (based on the World Health Organization classification, 2005), over a 12-year period, were analyzed. The relative frequency of different types of tumors was also analyzed and compared with the literature. RESULTS: OTs in the present study constituted 2.74% of all the 7,942 registered biopsies. A total of 218 cases of OTs were collected and reviewed. Of these, (94.04%) were benign and (5.96%) were malignant. The mandible was the most commonly affected anatomic location, with 170 cases (77.9%). Ameloblastoma with a predilection for the posterior mandible was the most frequent odontogenic tumor (30.28%), followed by keratocystic odontogenic tumor (19.5%), odontoma (13.4%), and odontogenic myxoma (8.5%). CONCLUSIONS: OTs are rare neoplasms and appear to show geographic variations in the world. In Cappadocia, Turkey, they are more common in the mandible, with ameloblastoma followed by keratocystic odontogenic tumors with the incidences observed in the present study being similar to those of previous studies from Asia and Africa, and in contrast to those reported from American countries.

Evaluation of the nasopalatine canal and variations with cone-beam computed tomography.

PURPOSE: Although nasopalatine canal (NPC) is one of the most important anatomical structures in premaxillary region, few documents are available with regard to anatomic variations, size, and morphology of NPC in the literature. In recent years, the need for radiological identification of anatomical structures has grown with increased dental implant applications in anterior maxillary region with higher esthetic expectations. This study aimed at investigating the NPC's shape and anatomical variations by cone-beam computed tomography (CBCT) in the Turkish society, in a particular region. METHODS: A total of 500 individual CBCT images were investigated in terms of morphological, dimensional, and anatomical features of NPC. In addition, the width of incisive foramen (IF) and foramina of Stenson were evaluated. RESULTS: There was no statistically significant difference (p = 0.234) between women and men in terms of NPC shape. Morphological assessment of NPC revealed that 38.78 % of NPCs were hourglass-like in shape, 27.35 % of canals were funnel-shaped, 9.18 % of canals were conical shaped, and 8.25 % of canals were cylindrical shaped. The mean IF width and NPC length was found as 5.06 and 12.59 mm, respectively. And the mean canal length was found significantly longer in men than women (p < 0.001). CONCLUSION: It has been shown that NPC has a lot of anatomical variations with regard to its dimensions as well as its morphological appearance. Therefore, identification of the anatomical structure of this region with two- and three-dimensional imaging techniques maybe thought to be important in facilitating surgical management and preventing possible complications.

Aberrant Anatomical Variation of Maxillary Sinus Mimicking Periapical Cyst: A Report of Two Cases and Role of CBCT in Diagnosis.

Most periapical lesions are associated with microorganisms from infected root canal systems. Maxillary sinus can pose a diagnostic dilemma radiographically because of its anatomical variation which can mimic a periapical pathosis. The aim of this study was to describe two cases of aberrant anatomical variation of the maxillary sinus that presented radiographic similarities to a periapical cyst in order to call the attention of clinicians to the fact that several different diseases are able to mimic endodontic periapical lesions. An accurate assessment of this morphology was made with the help of cone-beam computed tomography (CBCT).

Prevalence of bifid mandibular condyle in a Turkish population.

The aim of this study was to determine the frequency of bifid mandibular condyle (BMC) using panoramic radiographs supported by different radiographic techniques. A retrospective study was carried out by evaluating panoramic radiographs of 18,798 patients referred to the Department of Dentomaxillofacial Radiology. T-tests were used to compare the frequency of BMC between left and right sides and between female and male patients. In this study, 98 patients (0.52%) were found to have BMC. Of these patients, 51 (52%) were females and 47 (48%) were males. Of the 98 patients, 71 (72.4%) had unilateral and 27 (27.6%) had bilateral BMC. A total of 125 BMCs were found in 98 patients. No statistically significant differences were found between the right and left BMCs or between female and male patients (P > 0.05). Because symptoms associated with BMC are either absent or minimal, it is usually discovered as an incidental finding during routine radiographic examination. Different appearances of BMC can be seen on panoramic radiographs. The exact orientation of the condyles can only be determined using 3D imaging techniques. BMC may be a more frequent condition in the Turkish population.