Ultrasound analysis of the masseter and anterior temporalis muscles in edentulous patients rehabilitated with full-arch fixed implant-supported prostheses.

OBJECTIVES: Total tooth loss is common in the aging population resulting in insufficient chewing function with subsequent weakening of the masticatory muscles. The study aims to evaluate the changes in thicknesses of the masseter and anterior temporal muscle in edentulous patients following the reconstruction of implant-supported fixed prostheses and compare them with the dentate individuals. MATERIALS AND METHODS: The study was designed as a prospective, single-center, controlled clinical trial. A total of 60 participants were included in the present study. The patients were divided into two groups; Group I (Test Group): 30 edentulous patients who received implant-supported fixed prostheses, Group II (Control Group): 30 dentate individuals of an age and sex-matched group. Ultrasonography was used to measure the cross-sectional thickness of the left and right musculus masseter and anterior temporalis immediately after the cementation of the prosthetic rehabilitation (T1), on the 1st (T2) and 6th (T3) months after rehabilitation and at a single time point in the control group. RESULTS: The results showed that there were significant comparison differences in muscle thickness at the baseline measurements between groups while at the end of the 6th month, these differences were not significant. The muscle thicknesses of both the masseter and anterior temporalis muscles increased significantly at T2 and T3 compared to T1 in the test group. The asymmetry index between the left and right muscles in the test group and the asymmetry differences between groups also decreased significantly at the end of the 6th month. CONCLUSION: The implant-supported fixed prostheses significantly increase the thicknesses of the masseter and anterior temporal muscle together with a decrease in the asymmetry between the left and right muscles. At six months, implant-treated patients showed similar muscle thicknesses compared to dentate individuals. CLINICAL RELEVANCE: The findings suggest that implant-supported fixed prostheses can improve the masticatory function and facial symmetry of edentulous patients.

Evaluation of the thickness of masticatory muscles in patients with chronic periodontitis by ultrasonography.

OBJECTIVES: Periodontitis is one of the most common chronic inflammatory diseases. It causes changes in the biting abilities of individuals. However, periodontal treatment has positive effects on masticatory function. The aim of this study is to determine the effect of periodontitis and periodontal treatment on masticatory abilities by measuring masseter and temporal muscle thicknesses with ultrasonography before and after periodontal treatment in chronic periodontitis patients. METHODS: The patients included in the study were determined by clinical and radiological examination. The thickness of the masseter and temporal muscles of the patients were measured by ultrasonography. Periodontal measurements and treatments of the patients were completed by a single physician. IBM SPSS 20.0 (IBM Corp., Armonk, NY) statistical program was used for statistical analysis. RESULTS: A statistically significant difference was found between the values of periodontal measurements before and after treatment (p<0.05). In the ultrasonography measurements of the thickness of masseter and anterior temporal muscles, a statistically significant increase was observed in both rest and contraction values at all time intervals (p<0.05). Muscle thicknesses of male patients were higher than female patients. CONCLUSIONS: Periodontitis negatively affects the masticatory performance of individuals. Chronic periodontitis patients should be referred for periodontal treatment without wasting time.

The effect of myotonic dystrophy type 1 on temporomandibular joint and dentofacial morphology: A CBCT analysis.

BACKGROUND: Myotonic dystrophy type 1 (DM1) is a neuromuscular multisystem disease. Early involvement of facial muscles may produce an extra load on the temporomandibular joint (TMJ) in DM1. OBJECTIVES: This study aimed to investigate the morphological analyses of the bone components of temporomandibular joint (TMJ), and dentofacial morphology in myotonic dystrophy type 1 (DM1) patients by cone-beam computed tomography (CBCT). METHODS: Sixty-six individuals (33 DM1, and 33 healthy subjects) age ranging from 20 to 69 were included in the study. Clinical examinations of the patients' TMJ regions and evaluation of dentofacial morphology (maxillary deficiency, open-bite, deep palate and cross-bite) were performed. Dental occlusion was determined based on Angle's classification. CBCT images were evaluated regarding mandibular condyle morphology (convex, angled, flat and round) and osseous changes observed in the condyle (normal, osteophyte, erosion, flattening, sclerosis). DM1-specific morphological and bony TMJ alterations were determined. RESULTS: DM1 patients showed a high prevalence of morphological and osseous TMJ changes, and statistically significant skeletal alterations. The analysis of CBCT scans indicated the prevalent condylar shape among patients with DM1 was flat, the main osseous abnormality was flattening, there was a tendency towards skeletal Class II and a posterior cross-bite was frequently detected in DM1 patients. There was no statistically significant difference between the genders on the parameters evaluated in both groups. CONCLUSION: Adult patients with DM1 presented a high frequency of crossbite, tendency to skeletal Class II and morphological osseous alterations of TMJ. The analysis of the morphological condylar alterations in patients with DM1 may be beneficial in the diagnosis of TMJ disorders. This study reveals DM1-specific morphological and osseous TMJ alterations to provide an appropriate orthodontic/orthognathic treatment planning to patients.

Evaluation of the effect of antiepileptic drugs on mandibular bone quality by fractal analysis.

OBJECTIVES: Antiepileptic drugs (AEDs) are used to control seizures in epilepsy and their long-term use is common. AED use has been associated with decreased bone mineral density. The aim of this study is to determine the effect of AEDs on mandibular bone quality using fractal analysis and panoramic morphometric indices. METHODS: In this study, dental and medical records of 132 patients (66 AED users and 66 control group) were used. Fractal analysis (FA), the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) measurements were performed on panoramic radiographs. RESULTS: In all metrics, the mean values of the study group were significantly lower than the control group (p < 0.000). There is a statistically significant difference between the study and control groups in terms of KI distribution (p < 0.000). The mean fractal dimension (FD) values in each measured region of the female patients in the study group were found to be significantly lower than the female patients in the control group (p < 0.05). The mean FD values measured in ROI-2 and ROI-3 of male patients in the study group were found to be significantly lower than male patients in the control group (p < 0.05). CONCLUSION: The side effects of AEDs on bone metabolism were shown in this study. Dentists examining patients with epilepsy should be careful about osteoporotic changes in the jaws.

Three-dimensional assessment of pharyngeal airway in individuals with myotonic dystrophy type 1

Background/aim: The objectives of this study were to assess pharyngeal airway volume (PAV) in patients with myotonic dystrophy type 1 (DM1) by cone-beam computerized tomography (CBCT) and to evaluate the impact of diaphragm thickness and pulmonary function tests on PAV. Materials and methods: Thirty DM1 patients (10 female and 20 male; mean age 42.40 ± 12.07) were included in the study. Age and sex-matched thirty patients were participated as control group. In DM1 group pulmonary function tests (PFT) were performed. Independent t-test was used to compare PAV values of patients with DM1 and control group. The Mann­Whitney U test was used to compare the parameters according to sex ( p < 0.05). Pearson and Spearman correlation tests were used to evaluate the relationships between parameters of DM1 patients (p < 0.05). A multiple linear regression analysis was performed to explain the PAV with parameters that showed positive correlation with PAV. Results: Age of onset and disease duration were 22.37 ± 8.45 and 20.03 ± 12.08, respectively, in patients with DM1. PAV values of control group were significantly lower than DM1 group ( p < 0.001). Forced expiratory volume in 1 s and forced volume vital capacity values were higher in males than females in DM1 group according to sex ( p < 0.001). PAV values were greater in male patients than females of the DM1 group ( p = 0.022). Diaphragm thickness in DM1 group after inspiration and expiration were 2.60 ± 0.65 and 1.94 ± 0.40, respectively. According to the regression analysis, DTai and FVC were significantly explained the PAV. Conclusion: PAV was higher in DM1 group. There was a significant positive correlation between diaphragm thickness, pulmonary functions, and PAVs of DM1 patients. The amount of the PAV was mostly influenced by DTai and FVC. It is recommended to evaluate the PAV in patients with DM1 because of impaired respiratory functions and pharyngeal muscle involvement.

The evaluation of superior semicircular canal bone thickness and radiological patterns in relation to age and gender.

PURPOSE: The present study aims to evaluate the superior semicircular canal (SSC) bone thickness and radiological patterns in relation to age and gender in a Turkish population using cone beam computed tomography (CBCT). METHODS: A total of 450 temporal bones were evaluated in the study by two examiners. The radiological patterns of SSC were categorized as follows: dehiscent, papyraceous, normal, thick and pneumatised patterns. The bone thickness of SSCs were measured. RESULTS: The mean bone thickness of the SSC for females was 1.079 ± 0.8 mm. For males, the mean bone thickness was 0.952 ± 0.6 mm. There was no significant difference between males and females for the mean bone thickness of the SSC. (p > 0.05) The normal pattern was found in 258 temporal bones (57.3%). Seventy-two cases (16%) were defined as "papyraceous pattern"; 23 cases (5.1%) were defined as "thick pattern" and 42 cases (9.3%) were defined as "pneumatised pattern". SSC dehiscence was determined in 55 cases (12.2%). There was no significant difference between radiological patterns for age groups and gender (p > 0.05). CONCLUSION: There was no significant relationship between SSC bone thickness with age and gender. The radiological patterns of SSC were not associated with age and gender. Radiologists evaluating the head and neck region for various reasons should be aware of these structures and report not only the SSC dehiscence but also the papyraceous pattern.

Effects of low-level laser therapy on soft and hard tissue healing after endodontic surgery.

The aim of this prospective study was to examine possible benefits of low-level laser therapy (LLLT) on soft and hard tissue healing after endodontic surgery. Seventy-six endo-surgery cases on maxillary incisors were included. The patients were assigned randomly into control and laser groups. In the laser group, gallium-aluminum-arsenide (GaAlAs) diode laser irradiation (810 nm, 129 mW, 3.87 J/cm2) was performed immediately after surgery and daily for postoperative 7 days from buccal and palatal surfaces (5 min for each side). In the control group, patients were not subjected laser therapy. The patients were compared in terms of pain, clinical and radiological findings, and life quality indexes [Oral Health Impact Profile-14 (OHIP-14) and General Oral Health Assessment Index (GOHAI)]. Seventy-one patients completed the study (n = 37 for control group, n = 34 for laser group). The laser group showed better results in edema, wound healing, and the number of analgesic tablets used on the 1st, 3rd, and 7th postoperative days. Significant reduction in ecchymoses was observed in the laser group on the postop 3rd and 7th days. The patients had significantly lower pain on the 1st and 3rd postop days in laser group. The laser group showed significantly better results in OHIP-14 and GOHA indexes on postop days 1 and 3. The laser group showed significantly favorable results in terms of bone density, defect volume and area, and periapical index in the postop 3rd month. This study concluded that LLLT improved soft and hard tissue healing after endodontic surgery and also showed favorable effects on pain and life quality of patients especially in the early phase of healing period.

Short Implants Versus Standard Implants: Midterm Outcomes of a Clinical Study.

INTRODUCTION: The aim of this study was to evaluate the midterm survival rate, marginal bone resorption (MBR), and stability of short implants and to compare the results with standard length implants. MATERIALS AND METHODS: A total of 38 patients were included. In total, 147 implants (Nucleoss Implants, Izmir, Turkey) were placed (86 short implants and 61 standard implants). Cement-retained metal-ceramic prostheses were fabricated. MBR was evaluated on periapical radiographs taken at implant placement, at the time of crown insertion and annually thereafter. The stability of the implants was evaluated by resonance frequency analysis. RESULTS: The 3- and 5-year cumulative survival rates for standard implants was 98.4% and for short implants was 96.5% (P = 0.644). The MBR of the short implants was significantly lower than that of the standard implants after 1, 2, and 3 years of loading (P < 0.05). No significant differences were found between 2 groups after 6 and 12 months of loading in terms of implant stability (implant stability quotient values) (P > 0.05). CONCLUSION: Within the limits of this study, it is concluded that short implants achieved similar results as standard implants after 3 to 5 years of loading.

A new measurement protocol to differentiate sources of halitosis.

OBJECTIVE: Three sources of halitosis exist, potentially in any combination: mouth, nasal cavity or alveolar breath. There has been no universally accepted protocol which differentiates and quantifies each odour source separately. In this study a new gas measurement protocol is described and tested to determine whether each odour source can be separately detected without contamination. MATERIALS AND METHODS: Ninety healthy volunteers were divided into three groups. Hydrogen sulphide (H2S), volatile organic compounds (VOCs) and hydrogen (H2) were artificially generated in the mouth, nose and pulmonary alveoli, respectively. VOC, ammonia (NH3), sulphur dioxide (SO2), H2S and H2 gas readings from mouth, nose and alveolar air were measured and compared. Measurements were taken before and during gas generation. RESULTS: Contamination of nasal air (2.8%) and alveolar air (5.0%) by oral H2S; alveolar air (2.06%) and oral air (4%) by nasal organic gas; nasal air (18.43%) and oral air (9.42%) by alveolar H2 was calculated. CONCLUSION: The results demonstrated that artificially generated oral H2S nasal VOC and alveolar H2 can be individually quantified. This gas measurement protocol can be used diagnostically or to gauge response to therapy in any medical or dental setting.

Assessment of the soft tissue volumetric changes following acellular dermal matrix grafts with cone beam computerized tomography.

OBJECTIVE: The aim of this study was to use cone beam computerized tomography (CBCT), which consistently allowed the determination of the dimensions of the soft tissue, to evaluate acellular dermal matrix grafts (ADMG) used to increase gingival soft tissue thickness (GSTT). METHOD AND MATERIALS: In total, 90 gingival defects were included in the study. Surgical procedures were performed to augment the gingival tissue with ADMG. While GSTT measurements were assessed at baseline and 6, 12, and 18 months post-surgery, ADMG measurements were performed with CBCT at 6, 12, and 18 months post-surgery. RESULTS: All parameters showed statistically significant differences between time intervals. In the ADMG-treated sites, the baseline GSTT was 1.00 ± 0.37 mm and the final thickness was 1.66 ± 0.34 mm. The 6-month measurement of ADMG was 0.79 ± 0.08 mm, and the final measurement was 0.11 ± 0.09 mm. CONCLUSION: High-quality images of the GSTT and ADMG can be consistently obtained with CBCT. The present findings indicate that soft tissue augmentation can be achieved in gingival defects with the use of ADMG.

A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes.

OBJECTIVES: The objective of this prospective, controlled clinical study was to determine the outcomes of dental implant therapy with staged guided bone regeneration procedures in patients with type 2 diabetes. PATIENTS AND METHODS: Twenty-four patients were included in the study. Half of the patients were diagnosed with type 2 diabetes mellitus (group 1) while the other half (group 2) of the patients consisted of patients without diabetes. The edentulous maxillary anterior/premolar regions with sufficient vertical height but inadequate horizontal width were treated with staged guided bone regeneration technique and with one or two implant-supported fixed restorations. The patients were followed up at least for 12 months. The parameters that were evaluated were radiographic evaluations on CBCT images and periapical radiographs, histomorphometric analysis, resonance frequency analysis (RFA) and wound-healing parameters. The data were analyzed statistically. RESULTS: A total of 43 implants were placed in 24 patients (22 implants in group 1 and 21 implants in group 2). The survival rates of implants were 100% for both groups. The success rate of implants was 95% for group 1 and 100% for group 2. None of the parameters including CBCT findings, RFA values, success rates and wound-healing scores showed a significant difference between the two groups. CONCLUSION: Staged guided bone regeneration is a feasible augmentation procedure for the treatment of horizontal bone deficiencies of the maxillary anterior/premolar regions in well-controlled type 2 diabetic patients.

Outcomes of periradicular surgery of maxillary first molars using a vestibular approach: a prospective, clinical study with one year of follow-up.

PURPOSE: The aim of the present prospective, randomized, controlled, clinical study was to compare the outcomes of periradicular surgery of the maxillary first molar tooth using the vestibular approach between 2 preoperative radiologic evaluation methods: cone beam computed tomography (CBCT) and conventional radiography. PATIENTS AND METHODS: Periradicular surgery was applied to the maxillary first molar tooth in 40 patients. The patients were divided into 2 groups. The patients in group 1 underwent examination and preoperative planning with CBCT, and the patients in group 2 underwent examination and preoperative planning with conventional radiography. The outcomes of the treatment were evaluated radiographically and clinically, and the data were analyzed statistically. RESULTS: The mean operative time was significantly shorter in group 1 than in group 2. According to the radiographic and clinical healing criteria used in the present study, the healing of patients in group 1 was rated as a success in 35%, an improvement in 40%, and a failure in 25%. In the group 2 patients, healing was rated as a success in 42.1%, an improvement in 31.6%, and a failure in 26.3%. Sinus membrane elevation was performed in 92.3% of all patients. Sinus membrane perforation occurred in 20% of the patients in group 1 and 36.8% of the patients in group 2. CONCLUSIONS: Periradicular surgery of maxillary first molars using a vestibular approach is a viable treatment method with a low complication rate. Preoperative CBCT examination demonstrated positive contributions to the treatment outcomes.

Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain.

INTRODUCTION: The purpose of this study was to assess the structural characteristics of styloid process (SP) by cone-beam computed tomography (CBCT) examination in a patient population suffering from orofacial pain. The second aim was to assess the prevalence of elongated SP and its relation to gender, site and subjective symptoms in the study population. METHODS: Clinical and radiographic records of 208 patients were evaluated retrospectively. Radiological examinations including measurements of the structure, length, and medial angulations of SP were performed on CBCT images. RESULTS: Out of 208 patients, 96 (46%) had not-elongated SP, 28 (13%) had left side, 16 (8%) had right side, and 68 (33%) had bilateral elongation of SP. The patients with elongated SP had significantly decreased angle values. There were no statistically significant differences in length values of SP between males and females in both groups. Significantly increased prevalence of symptoms except headache was observed in patients with elongated SP. CONCLUSIONS: This study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Patients suffering from orofacial pain, who also had elongated SP, had increased rate of corresponding neurological complaints compared with non-elongated ones.

Compound odontoma involving the four quadrants of the jaws: a case report and review of the literature.

Odontomas are the most common odontogenic tumors, representing 70% of all odontogenic tumors. They may present in two specific forms; compound odontoma forms multiple small tooth-like structures, while complex odontoma forms an amorphous calcified mass. In this report, we present a 27-year-old male patient with multiple compound odontoma occupied regions at his jaws. The odontomas involve both alveolar and basal processes of the maxilla and mandible as well as both maxillary sinuses. Converse to conventional recommended treatment, which is surgical excision of the lesion, the management was removal of the lesion and clinical-radiologic followup. The first year's follow-up findings are presented in this case report.

A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features.

Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail.