Prevalence and Radiographic Features of Head and Neck Soft Tissue Calcifications on Digital Panoramic Radiographs: A Retrospective Study.

Background In this study, we aimed to determine the prevalence and radiographic features of incidental head and neck soft tissue calcifications (STCs) on panoramic imagesand assess their clinical significance. Methodology Following well-established training and calibration procedures, 9,553 digital panoramic radiographs (DPRs) taken between January 1, 2021, and January 31, 22, were retrospectively evaluated. Only obvious calcifications and clear differential diagnoses were considered. The presence, type, side (i.e., unilateral or bilateral), number (single or multiple), and the presence of different calcifications in the same individual were recorded. STCs were recorded according to age and gender. Data were analyzed using the chi-square test and Fisher's exact test using SPSS version 18.0 (IBM Corp., Armonk, NY, USA). Results Overall, 35.8% of the DPRs studied showed the presence of STCs, including ossified stylohyoid complex (OSHC) (10.3%), thyroid cartilage (9.8%), tonsillolith (9.2%), atherosclerotic plaques (5.8%), calcified triticeous cartilage (CTC) (5.1%), sialolith (1.9%), as well as intra-articular (1.3%) and other calcifications (0.1-0.8%), i.e., calcified lymph node, antrolith, rhinolith, phlebolith, and osteoma cutis. STCs were found to be more prevalent in middle-aged patients and in females. A significant relationship was identified between the presence of carotid artery calcification and calcified superior horn of thyroid cartilage (CSHTC), as well as between the presence of CSHTC and CTC. Calcifications were detected either bilaterally (n = 2,003) or unilaterally (n = 2,388); however, OSHC mostly showed bilateral calcifications (8.5%). Conclusions Panoramic radiographs of dental patients reveal the frequent occurrence of STCs in the head and neck region with differing radiographic features. Certain calcifications show gender and age differences. Accurate detection of STCs may guide the identification of potential underlying diseases and help initiate referral to the relevant multidisciplinary teams.

Effect of the Ongoing Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Dental Service Utilization in Patients With Comorbidities.

BACKGROUND: The keystone of safe and effective patient management is to approach a patient with up-to-date medical information. Assessment of patients for their medical conditions has changed during the coronavirus disease 2019 (COVID-19) pandemic and the need for appropriate research infrastructure has increased. Considering an updated list of high-risk underlying conditions in the post-COVID-19 era, this study aimed to evaluate the utilization of dental services by patients with comorbidities during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS:  Data of patients with comorbidities seeking dental care at a dental school during the COVID-19 pandemic were retrospectively evaluated. Demographic variables (age, gender) and medical history of the participants were recorded. The patients were classified according to their diagnosis. Data were analyzed using descriptive statistics and Chi-square analysis. The significance level was determined at α=0.05. RESULTS:  The study included data from 1067 patient visits between September 1, 2020 and November 1, 2021. Among these patients, 406 (38.1%) were males and 661 (61.9%) were females, with a mean age of 38.28 ± 14.36 years. Comorbidities were identified in 38.3% of the patients with predominance in females (74.1% n=303). Single comorbidity was observed in 28.1% while multi-morbidity was detected in 10.2% of the cohort. The most prevalent comorbidity was hypertension (9.7%), followed by diabetes (6.5%), thyroid disorders (5%), various psychological diseases (4.5%), COVID-19 infection (4.5%), and different allergies (4%). The presence of one or more co-morbidities was observed mostly in the 50-59 years age group. CONCLUSIONS:  The seeking of dental care among the adult population with comorbidities was high during the SARS-CoV-2 pandemic. It would be beneficial to develop a template for obtaining a medical history from patients by taking full account of the consequences of the pandemic. The dental profession needs to respond accordingly.

Benign cementoblastoma of the anterior mandible: an unusual case report.

A benign cementoblastoma, which is another name for a true cementoma, is a rare neoplasm that develops from odontogenic ectomesenchyme. It is characterized by a mineralized mass attached to the apex of the root produced by neoplastic cementoblasts. More than 75% of cases arise in the mandible, with 90% of them manifesting in the molar and premolar regions. This neoplasm occurs most commonly in children and young adults, with males being affected slightly more than females. Radiographically, the tumor is observed as a well-defined radiopaque mass that is fused to a tooth root and is surrounded by a radiolucent rim. The treatment of benign cementoblastoma consists of removal of the lesion and extraction of the affected tooth. This report presents an unusual case of benign cementoblastoma in a 31-year-old female, presenting as a densely mineralized mass seen at the apex of the impacted right mandibular canine tooth on radiographs.

A multi-centre evaluation of multiple supernumerary premolar prevalence.

AIM: The occurrence of multiple supernumerary teeth is rare and often found in association with syndromes such as cleidocranial dysplasia, Gardner's syndrome or cleft lip and palate. Few examples of non-syndromal multiple supernumerary teeth have been reported. The aim of this multi-centre study was to investigate the prevalence of supernumerary premolar teeth in non-syndromic patients and to investigate the association between the presence of supernumerary premolar teeth and malocclusion type in a Turkish population. MATERIALS AND METHODS: The clinical records and panoramic radiographs of 10,700 patients (referred to three different university hospitals) were retrospectively examined for the presence of supernumerary premolars. Age, gender, orthodontic malocclusion type, the number of supernumerary premolars (two or more), the distribution, location, position (vertical, horizontal, inverted, mesio-angular), surgical approach, and related complications (pain, cystic changes, root resorption, or eruption disturbance of adjacent teeth) were recorded. RESULTS: Forty-two cases (13 Class I, 17 Class II, 12 Class III) of multiple mandibular supernumerary premolars in patients without an associated syndrome were detected. A total of 97 (27 Class I, 41 Class II, 29 Class III) supernumerary premolar teeth were found, with a prevalence of 0.39%. No statistical difference was found related to gender, malocclusion type and supernumerary premolars (p > 0.05). The majority of the extra premolars were located in the mandible, which was statistically significant (p < 0.05). CONCLUSION: The present study revealed that the prevalence of multiple supernumerary teeth was 0.39%. The most frequently impacted premolars were found in the mandible and more often associated with Class II malocclusions in the examined Turkish population.

Expansive focal cemento-osseous dysplasia.

AIM: To present a case of expansive focal cemento-osseous dysplasia and emphasize the importance of differential diagnosis. BACKGROUND: Cemento-osseous dysplasia is categorized into three subtypes on the basis of the clinical and radiographic features: Periapical, focal and florid. The focal type exhibits a single site of involvement in any tooth-bearing or edentulous area of the jaws. These lesions are usually asymptomatic; therefore, they are frequently diagnosed incidentally during routine radiographic examinations. Lesions are usually benign, show limited growth, and do not require further surgical intervention, but periodic follow-up is recommended because occasionally, this type of dysplasia progresses into florid osseous dysplasia and simple bone cysts are formed. CASE REPORT: A 24-year-old female patient was referred to our clinic for swelling in the left edentulous mandibular premolarmolar region and felt discomfort when she wore her prosthetics. She had no pain, tenderness or paresthesia. Clinical examination showed that the swelling in the posterior mandible that was firm, nonfluctuant and covered by normal mucosa. On panoramic radiography and computed tomography, a well defined lesion of approximately 1.5 cm in diameter of mixed density was observed. The swelling increased slightly in size over 2 years making it difficult to use prosthetics and, therefore, the lesion was totally excised under local anesthesia, and surgical specimens were submitted for histopathological examination. The histopathological diagnosis was focal cemento-osseous dysplasia. CONCLUSION: In the present case, because of the increasing size of the swelling making it difficult to use prosthetics, young age of the patient and localization of the lesion, in the initial examination, cemento-ossifying fibroma was suspected, and the lesion was excised surgically; the histopathological diagnosis confirmed it as focal cemento-osseous dysplasia. CLINICAL SIGNIFICANCE: We present a case of expansive focal cemento-osseous dysplasia. Differential diagnosis is essential because ossifying fibroma is a real neoplastic entity.

Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish Population

Objective : To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in alarge Turkish population. Study Design A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayýs University Dental School, Samsun, Turkey . Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included . In each case, we analyzed age, gender, type and number of cysts, and cyst location . Imaging pat -terns and pathologies associated with cystic lesions were also determined .Results : The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females . There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst . By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%.Conclusion : The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies . In our study population, cysts were mainly inflammatory in origin (AU)

Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish population.

OBJECTIVE: To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population. STUDY DESIGN: A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayis University Dental School, Samsun, Turkey. Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included. In each case, we analyzed age, gender, type and number of cysts, and cyst location. Imaging patterns and pathologies associated with cystic lesions were also determined. RESULTS: The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females. There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst. By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%. CONCLUSION: The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies. In our study population, cysts were mainly inflammatory in origin.

Timing of permanent teeth eruption in Turkish children.

OBJECTIVE: To identify the mean time of permanent teeth eruption in children aged 5-15 years in Samsun, Turkey. STUDY DESIGN: A total of 1,491 children aged 5-15 years (Female: 773; Male: 718) were included in this study. Teeth were recorded as either "not erupted" or "erupted," which was defined as having at least one cusp visible in the oral cavity. Differences between eruption times for males and females and for maxillary and mandibular teeth were analysed using independent t-tests. RESULTS: Eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars (p < 0.05). For both females and males, the first teeth to erupt were the central incisors and first molars, and the last to erupt were the second premolars, molars and canines. Mandibular incisors and canines erupted significantly earlier than their maxillary counterparts in both females and males (p < 0.05). CONCLUSION: In comparison with other studies, eruption times ofpermanent first molars, central and lateral incisors were delayed by several months, whereas eruption times of other teeth were accelerated by several months. The findings regarding eruption times should be considered when planning dental treatment.

Radiologic investigation of prevalence, associated pathologies and dental anomalies of non-third molar impacted teeth in Turkish oral patients.

OBJECTIVE: To investigate the prevalence and associated pathologies of impacted teeth in Turkish oral patients. METHODS: A retrospective survey was carried out in 12,129 patients who visited the Department of Oral Diagnosis and Radiology, Ondokuz Mayis University, Faculty of Dentistry, Turkey, from January 2003 to December 2007. The minimum age for inclusion was 14 years and third molar impactions were excluded from the study. To be enrolled in the study, the patient's chart had to contain a panoramic radiograph with supplemental periapical radiographs. One radiologist examined all radiographs to determine the number, orientation and types of impacted teeth and the presence of associated pathologies and developmental dental anomalies associated with this phenomenon. RESULTS: Of the 12,129 patients, 1117 (9.2%) patients aged 14 to 80 years had one or more dental impactions (in total 1356 impacted teeth). The male to female ratio was 1:1.4 (457:660). The maxillary canine teeth were the most commonly encountered (71.5%), followed by the mandibular premolars (8.6%). The analysis of the orientation of the impacted teeth showed that 480 impacted teeth were in a mesioangular position (35.4%), followed by vertical (28.9%), distoangular (18.9%), horizontal (16.5%) and buccolingual (0.3%) orientations. CONCLUSION: The prevalence of non-third molar impacted teeth was 9.2% among Turkish oral patients. The maxillary canines were the most frequent impacted teeth. The most common orientations of impacted teeth were the mesioangular position and vertical orientation. The most frequent associated pathologic change was cystic change.

Large peripheral osteoma of the mandible: a case report.

Osteomas are benign, slow-growing osteogenic tumors commonly occurring in the craniofacial bones. Osteomas are characterized by the proliferation of compact and/or cancellous bone. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in the mandible. The lingual surface and lower border of the body are the most common locations of these lesions. They are usually asymptomatic and can be discovered in routine clinical and radiographic examination. In this paper, we presented a large solitary peripheral osteoma located in the buccal surface of the left posterior mandible and causing facial deformity in a 37-year-old woman. Radiographic examination by computed tomography revealed radiopacity with a well-circumscribed, pedunculated mass approximately 3 cm in size. The osteoma was removed surgically, and no recurrence has been observed.

Extrafollicular adenomatoid odontogenic tumor of the mandible: report of a case.

The purpose of this study was to report an extrafollicular adenomatoid odontogenic tumor in the mandibular anterior region in a patient. A 15 year-old female with a painless swelling in the mandibular anterior region was referred to our clinic. Fine needle aspiration yielded no fluid. Periapical, panoramic and computer tomography scans showed circumscribed radiolucent area with fine calcifications. The lesion was totally enucleated and the teeth 31, 32 were removed. The rarity of adenomatoid odontogenic tumor may be associated with its slowly growing pattern and symptomless behavior. Therefore, it should be distinguished from more common lesions of odontogenic origin in routine dental examinations.

Correlation of hepatitis C antibody levels in gingival crevicular fluid and saliva of hepatitis C seropositive hemodialysis patients.

Search for hepatitis C virus (HCV) in body fluids other than blood is important when assessing possible nonparenteral routes of viral transmission. However, the role of oral fluids in HCV transmission remains controversial. Our aim was to compare the prevalence of HCV antibody (HCV Ab) levels in saliva, and gingival crevicular fluid (GCF) of HCV seropositive hemodialysis patients. Serum, saliva and GCF samples were collected from thirty-nine patients. Samples were analyzed for HCV Ab using the Ortho HCV 3.0 SAVe enzyme-linked immunosorbent assay (ELISA). HCH Ab levels in saliva and GCF of all HCV-seropositive patients were statistically compared. Reported here are the results of the study designed to determine the correlation between HCV-RNA positivity in serum and the detection of antibodies in GCF and saliva. One hundred percent (100%) of the 39 patients have antibodies to HCV in their serum, 15.4% have antibodies to HCV in GCF, and saliva found out. HCV Ab seropositivity in GCF and saliva was significantly correlated (kappa = 0.462; P < .001). This study supports the concept that GCF may be a significant source of HCV in saliva.

A case of tularemia presenting as a dental abscess: case report.

OBJECTIVE: The purpose of this report is to present a tularemia case accompanied by a neck mass that easily may be confounded with dental abscess. SUMMARY: Francisella tularensis is a potential agent of biologic terrorism. Thirty percent of the symptoms seen in tularemia localize in the head and neck region and are sometimes mistaken for complications of a dental abscess. To our knowledge, reports of the differential diagnostic characteristics of tularemia are lacking in the dental literature and, to date, no dental journal articles have focused on the disease. In this present case, a 51-year-old woman arrived at the public health department with high fever and facial swelling. The findings suggested a dental origin and the patient was directed to dentistry. Radiology and a detailed intraoral and extraoral examination failed to reveal a dental problem. Fortunately, the patient was known to come from a tularemia region; with the suspicion of tularemia the patient was referred to the faculty of medicine. Serologic tests showed that the patient had a Francisella tularensis infection.

Hypohidrotic ectodermal dysplasia with true anodontia of the primary dentition.

Ectodermal dysplasia is a rare congenital hereditary entity. The most commonly observed forms of ectodermal dysplasia are the hidrotic and hypohidrotic types; discrimination is based on the absence or presence of sweat glands. In this report, a child with hypohidrotic ectodermal dysplasia having true anodontia of the primary dentition is presented. Physical, mental, and intraoral examinations were performed. Photographs and occlusal and panoramic radiographs were taken. A medical consultation and biopsies were requested. Mentally, the patient was normal. His hair and eyebrows were light colored and sparse. He had frontal bossing, a saddle nose, reduced vertical facial dimension, and prominent supraorbital ridges and chin. Radiographs revealed absence of all primary and permanent teeth except the bilaterally unerupted maxillary permanent canines. An armpit biopsy specimen revealed the absence of eccrine and apocrine glands. A removable prosthesis was made to satisfy the patient's esthetic and functional needs. The absence of primary teeth (true anodontia) is a rare phenomenon. It is claimed that primary teeth must be present for the development of their permanent successors. In the present case, however, the permanent canines existed despite the absence of their predecessors. Dental clinicians can be the first to diagnose ectodermal dysplasia. The dental team should be aware of its signs and symptoms in order to provide the correct therapies for the functional and psychologic needs of these patients.

An unusual case of talon cusp on a geminated tooth.

Talon cusp is a developmental anomaly seen on the lingual surface of anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. This paper presents an unusual case of gemination accompanied by talon cusp in permanent dentition. The clinical and radiographic findings are described.

An unusual case of talon cusp on a geminated tooth

Talon cusp is a developmental anomaly seen on the lingual surface of anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. This paper presents an unusual case of gemination accompanied by talon cusp in permanent dentition. The clinical and radiographic findings are described.

Cúspide em garra (talon cusp) é uma anomalia de desenvolvimento que occore na face lingual de dentes anteriores. Geminação é uma anomalia causada quando um germe dental tenta se dividir durante a fase de desnvolvimento. Estas anomalias de desenvolvimento podem causar problemas clínicos tais como comprometimento estético, dor, cárie e apinhamento dental. Este artigo relata um caso incomum de geminação acompanhado de cúspide em garra (talon cusp) na dentição permemente. Os achados clínicos e radiográficos são descritos.

Oral and dental findings in Fanconi's anemia.

Fanconi's anemia is an autosomal recessive disorder characterized by progressive pancytopenia and congenital malformation of the skeleton. This study investigated the oral health status of 15 children with Fanconi's anemia, including oral lesions, gingival and periodontal status, and dental abnormalities. All children in the group were found to have a tendency to develop tooth decay and were in need of dental treatment. Two had aggressive periodontitis. In one patient supernumerary teeth were found, while in another teeth were congenitally missing. The increased tendency toward periodontal disease in patients with Fanconi's anemia may be due not only to the anemia, leukopenia, and defective detoxification of oxygen radicals that are characteristic of the disease itself, but also to medications applied during intense immunosuppressive treatment, such as prednisolone.

Aggressive periodontitis with supernumerary teeth: a retrospective study.

BACKGROUND: There are four key studies in the periodontology literature reporting the correlation between supernumerary teeth and aggressive periodontitis. The aim of this study is to detect such a relationship. METHODS: Patients with supernumerary teeth were identified retrospectively from their orthopantomographs and were invited to the periodontology department for intraoral examination. They were then evaluated for aggressive periodontitis. The number of existing teeth, age, family histories, attachment loss, probing depths, and bleeding on probing scores were recorded. RESULTS: Of the 5,850 subjects randomly observed among 48,000 patients, only 174 exhibited supernumerary teeth. Of these 174 subjects, only three patients were diagnosed with aggressive periodontitis. One of the patients was also suffering from Fanconi's anemia. CONCLUSIONS: Despite the similarities (aggressive periodontitis accompanied by supernumerary teeth) in the previous reports, we do not agree with the earlier results. We rather suggest that this association might be a random occurrence, rather than a biological one, although this observation should be further investigated using genetic testing.